Monday, August 14, 2017

Further delight of the unexpected

A reader of my past blogs may recall one entitled Hidden delights of London:  Phantom railings (3 September 2012).  Imagine my delight today, therefore, when once again passing the wall outside the British Museum about which I wrote, I could hear my footsteps creating a strident echo, as though their speed and strength was being mimicked by sounds coming from the wall.  I paused, turned back and retraced my footsteps, only for my surprise to turn into a happy recognition of the re-appearance of the musical artwork called the Phantom Railings, about which I wrote.  This time, though, the creators of this installation seem to have added a little more to it.  I gather that the sounds made by my footsteps as I pass this installation are now being streamed live and can be heard on www.publicinterventions.org.  

I am writing this in the British Museum, and will now hurry back past the wall to delight once more in this installation, before returning home to what I hope will be a session listening to the live streaming as others make their way past the wall. The sounds my footsteps made are those which resemble the familiar sound of somebody running a stick along an iron fence.  This was in the days before the second world war demanded the removal of railings round houses and parks, so that they could be turned into armaments for the war effort.  Or at least that was what I was told when reading about the installation five years ago.  Now, though, a completely different interpretation has been put on the removal of the railings.  Far from being an attempt to help the war effort, they were, the notice on the wall states, “a democratic gesture to remove restrictions to public access to parks and gardens”, much advocated apparently by George Orwell himself.

I enjoyed my time walking up and down, creating my own symphony of sound.

Tuesday, August 8, 2017

How do we judge whether treatment is a success or a failure

I think most of us assume that a successful course of treatment should result in the patient feeling better in some way.  But in what way?  And who decides what feeling better actually represents?  In Western medical terms the successful outcome of any treatment can probably be judged as being whether the physical symptoms have improved or disappeared.  But when we view things from a less physically oriented point of view, as a five element acupuncturist or a psychotherapist would do, the role physical symptoms play in assessing the success of treatment is much less clear-cut.   

We take it for granted that we are offering treatment for soul as well as for body, and are therefore viewing things holistically, so how do we gauge how successful our treatment has been in helping our patient at the deeper level?  This is a much more difficult question to answer than merely noting that a patient is suffering from less headaches or is sleeping better, and the outcome of treatment may therefore be much more difficult to assess.  We then have to consider more complex questions, such as a patient’s own assessment of how far treatment may have helped them in changing some more intangible aspect of their life.  This could involve something like coming to terms with a past emotional trauma or having the courage to confront an unresolved issue with a partner.  Improvements in these areas of life are difficult to quantify, because they are based on much more subjective criteria, and may often at first hardly be perceived by the patient and only by a practitioner trained to notice what are often very subtle changes..

I learnt a very important lesson not long ago, which has given me a different perspective on the whole issue of what can be considered a failure of treatment.  A patient told me that he had been given my name “by a friend of mine who said you had transformed her life.”  I was puzzled, because I could hardly remember who this former patient was.  Looking up my notes afterwards, I found that she had come for just two treatments and then disappeared.  At the time I had assumed that she had not been happy with treatment, and I therefore listed her amongst those I thought I had not managed to help.  Obviously, though, this was not how the patient herself had viewed things. This taught me that we can never really know how far what we have done for our patients has helped them or not, or indeed what they themselves want from treatment.  It is therefore likely that patients and practitioners will have different criteria by which to judge the success or failure of treatment.  It also helped me understand the importance of not becoming too self-critical, a tendency I think we all have, particularly when we start in practice, because we may not be aware that our expectations are not matching those of our patient.

We must always ask ourselves whether what we assume our patient wants from treatment is actually what they are coming to us for.  Perhaps the few treatments I gave my former patient was all she felt she needed to set her life on the right path again, whilst I might have been considering a different outcome for her.  The very simple but profound treatments of the Aggressive Energy drain and an element’s source points which we start our treatments with can by themselves give a strong boost to the elements and help them regain balance.  An AE drain, for example, is a way of asking the elements whether they have been invaded by harmful negative energy, and, if so, clearing it from the body.  Addressing an element’s source points is one of the deepest and safest ways of stimulating that element’s energy.  These first treatments therefore set the tone for all subsequent treatments, and act as their firm foundation.

Perhaps for some patients, as with my former patient, this simple treatment is all they need.  Others, though, come for more than this, and may be uneasy about being left to sort out their life by themselves without ongoing support from their practitioner.  If this is so, it is a clear reminder that each of us is likely to want something uniquely different from treatment, often related to the specific needs of our element, and that it is the acupuncturist’s task to gauge these needs sensitively and try to satisfy them in the best way possible.

We can also waste a lot of time analysing each treatment in too much detail to see whether we could have done better.  Some good advice I was given early on, which I have found increasingly easy to follow the older I get, is to stop thinking about our patients the moment they leave the practice room at the end of treatment, and not continue to clutter our minds up by taking thoughts about the first patient with us into the next patient’s treatment, or home with us at the end of the day to preoccupy us later on.  Originally I thought that switching off from a patient too quickly at the end of treatment might be doing them a disservice, but I now realise that the opposite is true.  Before the start of each treatment, it is useful to give ourselves time to empty our minds of what has gone before so that our next patient receives the full attention from us that he/she needs, not the half-distracted attention somebody still preoccupied with thinking about the last patient will bring them.  And then when the patient comes back next time we are fully able to concentrate on them once again. 

It is of course natural to continue to think through the events of our day when we have finished practising, but we should try to do this at quiet times and not during the hurly-burly of the day’s activities.  Only then can we clear our minds sufficiently to help us sort out any problems we need to deal with.  All this is easier said than done, but if we are aware of some of the issues which make practising problematic for us, we are half-way to solving them.

 

Sunday, August 6, 2017

Usain Bolt - again

I have written about Usain Bolt and the Fire element before (see my blog of 24 August 2016), and I am delighted to be writing about him again today, the morning after he ran his last race here in London.  He didn’t win last night, but interestingly he didn’t seem to mind.  I could see him obviously enjoying to the full the love pouring towards him from the huge crowd.  This reflected what I had read in the newspaper on the morning of the race, words which so accurately describe the effect that the Fire element can have when it tries to share its joy with those around it.  Here are some of the article’s descriptions of how he affects other people:

“He is not only the face of athletics but its light-house, luring even the most casual fan to its shores.”

“..Usain really is a people person, too.  When he first went on the circuit, a decade ago, he would be in the hotel lobbies talking to people at 1am or 2am. He loves people and interacting with them.  I had to tell him to go to bed.”

And one description which makes me think Usain Bolt is Inner Fire:

“What struck me was just how willing he was in the middle of a conversation to break off and oblige a fan for a photo or an autograph, never complaining, always smiling…”

“He’s a selfless human being, one who genuinely loves to make others happy.”

All these descriptions could only be applied to Fire, I think, and in my view particularly to Inner Fire, which has a greater ability than Outer Fire to multi-task, even at the most emotionally extreme moments (such as running in the Olympics).
 
I know this from myself, who am Inner Fire.  Many years ago, long before I had even caught sight of an acupuncture needle or understood anything about the elements, I realised that I had this ability to do more than one thing at a time when somebody expressed amazement that I was able to switch from a very serious moment to pointing out something rather trivial happening nearby, almost as if the two events, the very serious one and the trivial one, were happening at one and the same time.  Watching Usain Bolt again, I could see that, whilst preparing for his race, he was nonetheless all the time aware of those around him and interacting with them, exchanging smiles and the odd word with whoever was next to him.  We can contrast this with the absolute and necessary self-absorption that Metal would display in a similar situation, as I have observed before.
 
So all hail to this most charismatic and joyous representative of the Fire element.  Feast your eyes on him wherever you can catch him on TV or social media, and you will get a lesson about one of the elements that you will never forget.  I wish it was as easy to find such outstanding examples of the other elements.

Tuesday, August 1, 2017

Horary treatments

Many things have happened during my years of practice which still make me laugh at myself, none more so than my attempts to give my patients what we call horary treatments at the right hour of the day (or night).  The word horary, used as far as I know only in the context of acupuncture now, comes from the Latin word meaning “hour”.  Horary treatments are treatments given at specific times of the day which are seen as having a particular relationship to different elements.  The 24-hour day is divided into six four-hour periods, one specific to each of the elements (two for Fire), and, within these four-hour periods two two-hour periods relating to that element’s yin and yang officials.  Thus the hours from 3 – 7am relate to the Metal element, with 3 – 5am that of the Lung, (often the time of day when people take their last breath), and 5 – 7am that of the Colon (which is why this is an excellent time to empty the bowels ready to take on food between 7 - 9am, which is the Stomach’s horary time).

Giving a patient a horary treatment, particularly in the season of that patient’s element (for example some time in the early morning between 3 – 7am in autumn for the Metal element) is considered to be the very best treatment of all.  Bearing this in mind and remembering JR Worsley’s exhortation to us not to forget horary treatments, even if they are at anti-social times, such as in the middle of the night, in the full flush of being a keen new practitioner eager to put everything that I learnt into practise, I gathered together two of my Wood patients for a horary treatment in the night, the best time being just before 1am still in the Liver’s horary time and just after 1 am just into the Gall Bladder’s horary time, carefully setting my alarm for 12.30am to be sure to wake up.  To my surprise both turned up on time, and I completed the treatment, congratulating myself on doing what a good practitioner should do, however tired I would feel the next day.

Imagine my horror then when a few months later I realised that with the greater experience I had gained since then I now recognized that neither patient was Wood.  Imagine also my confusion when another patient, who this time I was sure was Wood, and I had also scheduled to come during the night, overslept and never turned up.  Was I to phone her home, though I was reluctant to do so for fear of waking the whole household (this was the time before everybody had mobile phones by their beds), and how long should I stay up in case she arrived late?  Even when I felt I was treating the horary points at the right time during the night, did this justify the possible inconvenience which my previous sad experiences had shown me?  Finally, too, had horary treatments proved to be the uniquely excellent treatments that warranted all this trouble?

I cannot say that the results of giving horary treatments at more sociably acceptable times of the day have prompted me to consider that facing the possible hurdles of night-time treatments is worthwhile.  But I still like to remember with affection my novice practitioner’s enthusiasm.  Certainly my patients were terribly impressed that I was prepared to sacrifice a few hours’ sleep for them, which I am sure made our relationships all the closer, perhaps the best result of all.

I now think back rather sadly and with some nostalgia to a time when I so enthusiastically tried to put everything I had been taught into practice, and realise that I, older, much more hard-bitten and less idealistic, but perhaps not wiser, would be unlikely to do the same now.