The challenge of teaching five element acupuncture in China

I have now given 14 twice-yearly seminars on five element acupuncture in China since 2011.  On my return from the last visit in October 2019 I realised that my  approach to our teaching over there had subtly developed over the years.  It will therefore be useful to chart these changes and the reasons for this, to help both my own development and that of anybody wishing to tread in my footsteps.  This will be one way of learning to understand the intrinsic differences which exist between how I teach in this country (and by extension in Europe generally) and how I have had to learn to teach in China.

And there are very great differences indeed which I was totally unaware of when I was first invited to give a seminar on five element acupuncture in Nanning by Profession Liu Lihong.  If I remember rightly, I arrived with only very vague ideas as to who the people I was going to teach were, how many there would be and how I would structure the seminar.  I had no idea at all about the level of knowledge of five element acupuncture, or even whether those taking part in the seminar were already trained acupuncturists, or would simply form the kind of audience composed mostly of lay people I was often used to talking to in this country.  With hindsight I am surprised that I had not discussed all this in greater detail before setting off for China, but I think I was basing my thoughts on a brief discussion I had had with Mei Long about her introductory seminar in Nanning which gave Liu Lihong the incentive to invite me.  And in the photos Mei showed me it was obvious that what was waiting for me was a small but very eager group of mainly students or herbalists (Liu Lihong is a qualified herbalist)

In the event I walked into a classroom of about 40 people in the newly set-up centre of the Tong You San He Foundation in Nanning.  Half the group was composed of complementary medicine practitioners (herbalists and some acupuncturists), and the remainder were a mixture of interested lay people, including members of Li Lihong’s family.  I was amused to see among these the guard from the Nanning compound which housed the centre, who would join us at intervals, obviously listening with great interest to what I was teaching.   Also among the audience were some of those who were actively supporting Liu Lihong in his attempts to set up what has now become a highly successful Research Foundation focused on research into traditional forms of Chinese medicine.  This has now moved to Beijing, and has also expanded into establishing centres in other Chinese cities.

Something which shaped my teaching very strongly became obvious from the start. Unlike in this country everybody was steeped in an understanding of the elements.  All of Chinese life is based on respect for the elements which are regarded as forming an integral part of every aspect of how people conduct their lives.  There was therefore no need to spend time on starting my introduction to five element acupuncture with a description of the qualities and characteristics of the elements, which takes up so much of every five element course in this country.  What I quickly discovered, though, was that although the understanding of the elements was based on extensive knowledge of the classics of Chinese thought, such as the Nei Jing, it did not translate into the, to me, obvious application of this to the actual practice of acupuncture.  I came to see that what all Chinese acupuncture students learn by rote, often reciting word for word whole passages of the Nei Jing, remained completely separate from their acupuncture practice.  This was in contrast to five element acupuncturists over here who can easily call upon many passages from the Nei Jing to support their practice   After all, this forms the basis of much of Father Larre’s and Elisabeth Rochat de la Vallée’s excellent work in helping interpret these ancient texts in a form which makes them easily accessible for our five element practice of today.

It became clear to me that what I was bringing with me into the practice room for Chinese acupuncturists was providing a welcome link in the chain of transmission from the ancient Chinese world to the present day, a chain which had become weakened over the centuries.  This has also been one of the unhappy effects of the introduction of Western medicine into China, starting with the appearance of Christian missionaries in the 19^th century.  Since then Western medicine has become ever more dominant, to the extent that it has come to be considered superior to traditional forms of Chinese medicine, which have been consigned to an inferior role. It is against this background, therefore, that I started what I regard as my important work in returning to its ancient homeland this most spiritual of all acupuncture disciplines.    

One of the most significant aspects of my teaching was something which struck me very early on, and this was the astonishment many students showed at seeing the emphasis we placed on the importance of the personal relationship between our patients and ourselves.  I realised that this emphasis on the emotional aspects of a therapeutic relationship was something totally alien to them, and something which disturbed them for its unfamiliarity.  I remember one of the students, an acupuncture practitioner of many years, who, after watching me talk to a patient in front of the class, asked, “How can I learn to relate to my patients as you did to this patient?  I don’t know how to do that.”  And I remember answering, “All you need to do is just be human,” which was perhaps a rather inadequate reply but the best I could think of to help her at the time.

I also learnt a lot about how they viewed my approach as a result of a comment made at the end of one of the first seminars.  One participant started to cry, as she told me that when I met her in the hotel lobby at the start of the seminar, “You looked at me and smiled.”  That helped me understand that interpersonal relationships between teachers and pupils were very different from what I had been used to with my own students in England.  The emotional detachment which those in authority exercise in every walk of life in China extends to the interactions between patient and practitioner.  To break down this barrier has required some courage on the part of the Chinese practitioners, for this brings up all kinds of personal issues which anybody undergoing any form of therapy in the West is well used to acknowledge.

It therefore took quite some persuasion from me to encourage students to step into the unfamiliar territory of their patients’ emotional lives.  Initially their presentation of the patients they brought to the seminars covered only physical symptoms, but gradually the more daring of them widened their approach to touch upon their patients’ emotional problems.  I was therefore delighted to observe, after this my 14^th visit, that every practitioner now obviously discusses emotional issues as well as physical complaints with their patients.  In some cases, practitioners concentrated almost exclusively upon these, which represented a huge breakthrough in their approach to five element practice.

The cultural differences also extended to certain areas of emotional life which I did not suspect, and so I found myself at my last visit, all of eight years since my first, making what was obviously a deeply offensive faux pas in joking about something which my European students would certainly have joined me in laughing at.  I was talking about how patients often cannot acknowledge the cause of their distress, and assume it is because of some physical disorder.  I told them of a patient of mine who came to me for help with severe back pain, and after some weeks of successful treatment suddenly laughed and said, “I thought the reason I was coming here was for my back.  I now realise that it may well be because I have not until now realised how much I dislike my father.”  When I have told this story at our seminars in England, citing this as evidence that physical complaints are often a safe way of masking emotional distress, my listeners have laughed with me.  In China, however, my words caused an absolute silence to fall in the crowded seminar, and I knew that I had had made some grave mistake.  Asking my Chinese friends about this afterwards, they explained that it would be considered extremely rude to express such negative feelings towards a parent in this way, family being such a powerful influence in every Chinese person’s life.  In the West, where we are all conditioned by many years of psychological exploration of our relationships with our families, and where nearly everybody now has had some form of counselling help to explore their “inner you”, negative feelings towards members of the family are almost regarded as the norm and to be expected, and their expression often actually encouraged.  This taught me a great lesson, and I won’t make this mistake again.

There were, however, surprisingly few tricky moments like this, considering the very different backgrounds my Chinese students have compared with their English counterparts.  Instead, the common humanity we all share with one another, whatever our cultural differences, has shone through any slight misunderstandings or bewilderment at trying to take account of each other’s differing lifestyles and expectations.

After reading the above, Caroline, my Mandarin translator, sent me the following interesting comment:

 

“Being a Chinese who has never been abroad, I used to take what I had learned from my culture and education for granted, thinking this is what life should be. However, after being treated by five element acupuncture and following your teaching for 7 years, it is like opening in five element terms a "Window of Sky" for me. It not only gave me a chance to stand in a much higher and all-round position to look at my own culture, but also taught me to have my own judgement not based on what the so-called authority told me but on Nature and Dao. I can still remember clearly that you said in one of the seminars in Beijing that five element acupuncture is to help us to be unique individuals and it is dangerous to follow the herd. Being brought up in a cultural background of emphasizing collectivism and filial piety, I guess it is difficult for most Chinese students  to understand the importance of "to be unique individuals". Interestingly, some of my patients, when they reach to a point that they have to say NO to their parents to be themselves, they feel so disturbed and guilty because their parents and relatives might accuse them to be "unfilial", some of them may even stop the treatment to escape the conflict. Sadly, some practitioners also think that we should always listen to our parents' (and also our teachers' and other authorities') instructions instead of following our own choices. So except for other challenges of developing five element acupuncture in China, I think this is a huge barrier we have to face and break down if we have enough courage and strength.”