Just a bowl of medicine soup?

I am grateful to one of my Nanning students, Huang Jing, for the following, acute observation about the challenges facing those who work in busy acupuncture clinics where they are asked to treat many patients, and who want in some way to move on to treat with five element acupuncture.  Her email has prompted me to think carefully how I can help my students over in China to make the transition to five element acupuncture without endangering their livelihoods.

“With Five Element Acupuncture I could only see 4 - 5 patients in any half-day, and with today’s demand on outpatient service, this is far too little, and I will never be able to treat all the patients… I need to see about 28 patients in half a day.” 

And then she goes on to say, “However I see that in this way we are seeing a lot more patients, but we can only treat the very surface of their problems.  We have not got the time to trace or to understand where their problems have actually come from.  In the times we are living in now especially, people are carrying around huge emotional burdens, and their physical problems are often caused by these internal problems.  We really ought to be giving our patients not just a bowl of medicine soup, but we should also find a way to give them some spiritual nourishment.”

It is quite understandable that practitioners who may work in a system based on the need to treat a lot of people as quickly as possible find it difficult to move to five element acupuncture, where we accentuate the need to develop a long-standing one-to-one relationship with our patients.  These two approaches to practice, the one, the “bowl of medicine soup” approach, and the other the “spiritual nourishment” approach, appear to be irreconcilable, but I do not think they are.  There are certainly ways of adapting what I do in my everyday London practice to what is needed in a busy outpatients’ clinic, as some of my fellow practitioners have proved when they worked in the stressful conditions in Sri Lanka after the floods treating as many patients as my Nanning student is asked to treat.  It is now my task to work out the best way to help my students adapt their practice.

In this context, I find it interesting that my translation work on Elisabeth Rochat de la Vallée’s 101 Key Concepts of Chinese Medicine has strengthened my understanding that the “bowls of medicine soup” of the original pioneers of acupuncture, some 2000 years ago, contained as their most important ingredient that of “spiritual nourishment”.  The two, the physical and the spiritual, were always regarded as an indissoluble whole. The sad thing is that this has got so thoroughly lost in modern TCM, and particularly in those places where living conditions demand a high turnover of patients.  It is as though patients’ spirits have become irrelevant to the restoration of health.  It is little wonder, then, that my Chinese students are amazed at the speed of improvement when using five element acupuncture as compared with their current acupuncture practices.

Here it is useful to look at what we do at our first treatment, during which we always drain Aggressive Energy.  This is a quick and effective way of drawing out any negative energy which may be polluting the elements, and is probably worth 10 treatments from other forms of acupuncture, where this sapping away at the elements’ strength remains undetected and untreated.  And the same, if not more so, can be said of those important blocks to treatment, husband-wife and possession.  From that point of view, I see five element acupuncture as providing a surprising short-cut to a return to health which it is not always recognised as offering.   

At the start of practice, as with every other kind of acupuncture, a fledgling practitioner will obviously require time to develop the skill to give effective treatment, and in five element acupuncture you can’t look up a formula of points which TCM likes to do.  But you can certainly get quicker and quicker at doing an AE drain, and the nature of this treatment (needles in the back for some period of time) gives the practitioner more time to talk to the patient.  So in that way, when I was in Nanning, and was asked to treat many patients in a way very unlike that of the leisurely time I grant myself for my initial diagnosis with my London patients, I learnt very quickly to move on to the AE drain after perhaps only 10 minutes or so.  Here my knowledge of the elements came to my aid, because I would try to focus my questioning on those areas which I thought would probably be the most important for that particular patient.  And I was surprised at how easy it was to home in on certain areas of emotional distress very quickly, all the more so because the patients were only too keen to accompany me into areas of their life which nobody had shown any interest in exploring with them before.

Of course I have many years of experience at diagnosing the elements to draw upon, but I was delighted to see how quickly my students homed in on the different elements and with what surprising accuracy.  Here their deep-seated knowledge of the elements, so engrained in them since childhood, comes to their aid, and, coupled with their keenness to learn, makes my task all the easier.  The question now is how to guide them to make the transition from a formulaic approach to treatment to the more individually-focused five element treatments, whilst dispelling some of their natural fear at having to learn such a different approach.

I am formed from an exploding star

Amidst all the gloom in today’s world, I came across this heartening bit of news in the Guardian today that made me smile. It was in an article entitled: “In the beginning ...Supernova produces life’s elements”, about the explosion of a star far out in space.

“Understanding how these giant explosions create and mix materials is important because supernovae are where we get most of the elements that make up the Earth and even our own bodies. For instance, these supernovae are a major source of iron in the universe. So we are all made of bits of exploding stars,“ said Mark Sullivan of Oxford University.

I like the thought that I am made of a bit of an exploding star.

Nanning photo

Since getting back from China, I have been trying to work out a way of downloading the photo of the group of 50 or so who came to listen to my talks for 10 days in Nanning. I hope I have now managed to do this.

I am sitting next to Liu Lihong, with his wife on my left side, and next to her Wendy Kiely, who acted as my helper throughout. To the right of Liu Lihong is Mei Long who introduced him to five element acupuncture, translated my Handbook of Five Element Practice and acted as my translator.

Developing a format for five element distance-learning for my Chinese students

It is fascinating working out a distance-learning schedule for my Chinese students, because they start from a totally different position from European students. First of all, they already have a much deeper understanding of the elements as though these are etched into their bones and in their heart. They are companions with which they have grown up, not the rather strange aspects of life which European students have gradually to be introduced to. And then the students are very well-trained, drilled almost, in their point location and practical techniques, such as needling. So I found that I started at a higher level in terms of their practical skills.

On the other hand, they are at a much lower level in terms of much that we take for granted here in five element practice in the West, and that is in relation to a practitioner’s approach to their patients. The one thing I was constantly surprised at was to hear Liu Lihong emphasizing throughout my days of teaching in Nanning what he called my compassion to the many patients I was asked to treat. When I looked at what I was doing, I realised that what, to me, is the most fundamental aspect of my practice, my warm relationship to my patients and the importance I place on establishing this from my first contact with them, was a completely new area of practice to those observing me in China. This is, after all, the essence of what we, as five element acupuncturists, are trying to do, which is to develop such a close relationship with our patients that they feel secure enough in our presence gradually to lay aside their masks and allow their elements to reveal themselves in their true colours.

So one of the first lessons I will be thinking about is to encourage the students to use even such basic skills as pulse-taking as a first step to developing the proper physical contact with their patients without which no subsequent treatment will be successful. This is why I don’t agree with taking pulses with only one hand. We need both our hands to enfold the patient’s hand in a warm, loving clasp. And as we feel each pulse, we should remember JR’s lovely phrase as he told us how we should take pulses: “As you feel each pulse, you are asking, “Small Intestine, how are you today? Heart, how are you today?” If you say this to yourself, there is no way your pulse-taking can become the automatic snatching at the mere beat of a pulse which a Western pulse diagnosis has sadly turned into.

My first lesson is already winging its way to China by email. It is on the Wood element, and how the students can find ways of observing its manifestations through looking at examples of some of the patients treated in front of the class when I was there, and adding to these some famous examples of Chinese people from the web. I have also asked them to learn the points not only according to their Chinese names, which gives each name an individual importance, but more in terms of their relationship one to another along a meridian. The point numbers we use, such as Stomach 1 – 45, draw the points together and attach them more closely to the line of the meridians they lie upon, something TCM is not so concerned with.

I have also decided, to my profound delight, to use the Roman numerals for the officials, I for Heart to XII for Spleen, which were embedded in Leamington’s teaching when I was a student there, and have so unhappily and so unnecessarily been discarded for the TCM approach which likes to start instead at the Lung. (If you look at the texts upon which the original teachings coming to this country in the 1950s were based, you will see that the Heart always appears first.) Maybe the reason the Heart has been demoted to a subsidiary position in this way reflects the lack of heart in TCM practice, something which is reflected in Liu Lihong’s desire to instil more heart in his students’ practice by inviting me, a Fire person (and Inner Fire as well!) to warm up the teaching for his students. He told his class several times that “we need more Fire here”.

So Heart once again takes what I consider to be its proper place as the head, the emperor, of all the elements. Luckily the Chinese students told me that they are already familiar with Roman numerals, unlike many of my former students, which makes their task easier.

So on to Lesson 2, the Fire element, and a discussion of the importance of touch.

A simple guide to five element treatments

It is with the encouragement of my good friend, Peter Eckman, the author of In the Footsteps of the Yellow Emperor (still in my view the best, if not the only, history of acupuncture’s migration from East to West), that I have started to think about writing a book about the first few treatments any five element acupuncturist should be considering for a new patient. I was at first a bit reluctant to do so, because it seemed to me to be a little superfluous. Surely, I thought to myself, everybody who practises five element acupuncture knows that we always start as simply as possible, directing all our attention at the element we have chosen, the one I call the Guardian Element, to see whether it responds to this focused attention. But to my surprise and dismay, though this may have been true of all who learnt in the good old days when JR held sway at his college in Leamington, it now most certainly is not, as I experience each time I teach a class of newly qualified acupuncturists.

I see instead people who are often confused, as we certainly were not, as to where to direct their attention. So many of them, to my despair, have been seduced into thinking that they somehow need to add to this pure approach all sorts of other things which have infiltrated into the teaching of five element acupuncture, the most harmful of all, in my opinion, being the, to me, odd idea that into the five element mix must be thrown a goodly dab of TCM to leaven it, with its quite different approach to the elements. So both the elements in the patient and the practitioners themselves doing this have become muddled as to where exactly the focus of their treatment should lie, with the resultant confusion which I witness when these practitioners ask me for help.

So whereas years ago there was no need for such a book, so firmly entrenched in all us five element acupuncturists was a simple, focused approach to the first stages of treatment, now there appears to be a great need for somebody to disentangle what has become a confused area of practice, and lay down again the beautifully simple principle which guides each day of my practice: “Just treat the element, and let the element tell you by its response whether you are focusing your treatment upon the right segment of the five element circle”.

So I am starting today, amongst all the other projects I am working on (a reprint of my Keepers of the Soul before the copies run out, my translation of Elisabeth Rochat de la Vallée’s 101 Concepts of Chinese Medicine, and my latest project, drawing up a distance-learning schedule for my Chinese students), to write down in a clear, not to be misunderstood way, for each element, the simple first steps every five element acupuncturist should take when treating a new patient. It pleases me, of course, that this will also be perfect for my teaching in China.

Where do we go from here?

There were so many people asking where they could learn more about five element acupuncture in China that I must now think carefully what will be the best way to go forward from here, and build upon this exciting new ground.

There is already a small band of about 15 students in Nanning who will form the nucleus of a five element school in the future, and we must concentrate on helping them learn more. The challenging part will be to work out a programme of teaching which takes account of the different levels of expertise of this group. How much they will learn and how quickly they will feel confident enough to incorporate five element acupuncture into their practice will depend to a great extent upon how well I structure the different levels of teaching required.

A lot of hard work lies ahead but it represents an exciting new challenge for me.

A refreshingly new acupuncture landscape

There was something very stimulating about moving from what I have come to regard as the somewhat weary world of acupuncture in the UK to a refreshingly new acupuncture landscape in China. The wonder of this whole experience was that I was speaking to people to whom the world of the elements is a familiar place, unlike those first embarking on acupuncture in the West, and who therefore had such a quick understanding of the principles of five element acupuncture, and only needed to be given a few signposts to guide them.

The most concentrated teaching was in Nanning, in Guanxi province in the south, where I taught at a newly opened centre for traditional medicine, the Tong You Sanhe, founded by Liu Lihong at whose invitation I was in China. On most days the group consisted of up to 50 people, of whom about 15 are serious students of five element acupuncture.

Then after 9 long days of teaching, which included the treatment of many people, both privately and in front of the class, we had 2 days’ relaxing time travelling to the Guilin mountains and up the Li River to Yangshou. I was very moved to see at last the very mountains whose photo I had chosen as the front cover of my Handbook many years before. Again something coming full circle.

Then on up north to Beijing and to a large traditional medicine conference at which I spoke to the 500 or so participants, each of whom, flatteringly, was holding a copy of the Mandarin version of my Handbook which they had been given in their conference bags. After the seminar, much signing of books and much taking of photos.

The response wherever I taught was overwhelming, with people asking again and again, “Where can we learn five element acupuncture?” Where indeed! It has proved difficult enough in this country over the years to find good five element teaching, and over there it will be even more difficult. But being such an enterprising nation, I have no doubt that they will find a way. And I like to think that I will continue to be there to accompany those amongst them who wish to set their feet ever more firmly on the five element path.

My first blog about my visit to China (written on the Great Wall on Sunday 13th November before leaving for home)

What can I say? I’m sitting on the Great Wall in China trying to catch my breath, both physically, because of the steep steps leading to it, and emotionally, because of all that has gone on since our arrival two weeks ago. I am also trying to fit what we did into bite-sized packets of information, and then into words suitable for my blog.

All I can now say is that it has been in every way a totally moving, instructive, warm and overwhelmingly fruitful experience, with ramifications for five element acupuncture which spread out to the furthest corners of China, to which the 500 or so seminar participants who came to Beijing to listen to me are now returning, with new thoughts about what is, to them, an utterly new approach to acupuncture to mull over.

More, much more, when I have had time to collect my thoughts, after my return to London the day after tomorrow.

Finally off to China!

This is my last blog before I am off to China, and then there will be a silence from me for three weeks into which will pour all the impressions awaiting me there – impressions not only of the vast country and its people, but of what I foresee as being an awesome moment, as I touch the spirit of the place from whose roots what I do sprung more than two thousand years ago.

I like to see myself and all those practising five element acupuncture each as a tiny bud upon one of the branches of the might tree of acupuncture. I know that my own bud will be nourished by visiting its ancient homeland, and I hope in turn that my visit will add a little bit more nourishment to its roots.

I am busily rehearsing the few lines of greeting in Mandarin with which I hope to start my seminars both in Nanning and in Beijing, but I am not holding myself to saying them if my courage fails me at the last moment and I find myself reverting to the safety of English!

I look forward to reporting back in future blogs on my return.

The dangers facing traditional Chinese medicine

I am preparing what I want to say about five element acupuncture on my visit to China, and am finding the process surprisingly challenging. After years of talking about my love for what I do, how exactly do I want to convey this love to a new audience, and an audience, above all, whose understanding of the elements is so very deep-rooted that I hesitate to think that I have anything new to add to what they already know?

And then today, to help me in my search for the right words, I came across a fascinating video of a Chinese master of traditional medicine discussing the problems he sees confronting it today, and this gave me the lead I needed. He talked about the “standardization process” to which it is being subjected in China, and which, he says, is leading to a “thinning out of the depth of Chinese medicine.” The evocative phrase “thinning out” resonated with me, and goes right to the heart of what I think is happening not only in China but throughout the world; it has undergone a process of etiolation. This is a lovely word I have often longed to use, and which leapt to my mind as such words do as I write. The dictionary defines it as “making plants pale by excluding light” and “giving a sickly hue”. I think this is a vivid and true description of how I view the dangers facing traditional Chinese medicine everywhere, including in its birth-place, China, and which threaten to drain it of much of its vitality.

So off I fly next week to add what I hope is my own little bit of bright colour and light to what is taught over there!

Some beautiful quotations to share

I love coming across quotations which illuminate my world for me, and make me see things quite differently. I give you some that I have come across recently, and have been carrying around with me in my diary (yes, I still use a hand-written diary!). I glance at them now and again, and receive each time a renewal of that initial feeling of shock at words so simple and pure, and yet which say so much. Each of us will read some significance in them which is personal to us alone and to nobody else, such is the universal meaning hidden within them.

The first is by W B Yeats, and was sent to me by a friend of mine, both of us well beyond the 50 years of the poem, but the poem spoke to both of us nonetheless:

My fiftieth year had come and gone,
I sat, a solitary man,
In a crowded London shop,
An open book and empty cup
On the marble table top.
While on the shop and street I gazed
My body of a sudden blazed;
And twenty minutes more or less
It seemed, so great my happiness,
That I was blessed and could bless.
                                                        W. B.Yeats

The next two quotations are by that strange and idiosyncratic writer, Mervyn Peake, taken from the wall of an exhibition on his writings and drawings at the British Library:

“Neither be afraid of the unorthodox subject nor in finding delight in the contemplation of commonplace things. Anything, seen without prejudice, is enormous.”

"…. When every heartbeat hammers out the proof
That life itself is miracle enough.”
                                                        Mervyn Peake

And finally, in my eyes the purest of all these quotations, this time by an American poet, Samuel Mensashe, whose obituary I read on 22 August 2011, and about whom I knew absolutely nothing until then, but whose works I am now trying, with some difficulty, to track down:

Rue
For what I did
And did not do
And do without
In my old age
Rue, not rage
Against that night
We go into,
Sets me straight
On what to do
Before I die –
Sit in the shade,
Look at the sky

Cargo
Old wounds leave good hollows
Where one who goes can hold
Himself in ghostly embraces
Of former powers and graces
Whose domain no strife mars -
I am made whole by my scars
For whatever now displaces
Follows all that once was
And without loss stows
Me into my own spaces
                                                       Samuel Mensashe

I think his phrase, I am made whole by my scars, is one we can take into the practice room with us, both as applied to ourselves, for surely we hope that we are whole when we practise, and eventually, too, we hope as applied to our patients. The healing, the “making whole” of their scars, will, we hope, apply to their physical scars, of course, but more profoundly still to their emotional scars, which should ultimately form the focus of our work at its deepest level.

Regaining control in the practice room: how the elements cast their magic upon patient and practitioner

This is a follow-up to my blog of September 13th on losing control in the practice room.

I am delighted to be able to say that this patient’s next treatment not only restored my faith in my own ability to maintain control, but also, and, far more importantly, showed me once again how the elements cast their magic not only upon our patients as they start to heal them, but also upon us as practitioners, as they remind us of their ability to transform.

My patient appeared at the door of my practice room as, in my eyes, quite another person. He greeted me less nervously, and with a warm smile that had not been there last time. He was much less nervous of the needles, chatted about his week’s work very easily, and interestingly did not, as he had done last time, demand a time for his next appointment. Instead, he apologized that his work-schedule was making it difficult for me to fit him into the times I normally see patients. The relationship between us had relaxed markedly. I can only attribute this to the transformative effect, on my patient, of strengthening his Water element and thus reducing his fear, and, on me, of helping me understand that the somewhat threatening interplay between us at his first treatment was caused by his fear and by my not responding appropriately to this fear.

And so I continue to learn.

One of a practitioner’s greatest qualities must be curiosity

I was reminded yesterday of one of the most important qualities a good five element practitioner needs to possess, and if they do not already possess it, needs to cultivate as thoroughly as possible, and that is curiosity, pure and simple – curiosity, put baldly, about what makes us ourselves and those around us tick.

The particular incident from yesterday’s practice which made me think about this came about when I was called in by another practitioner to look at a patient of hers, “whom,” as she put it, “I can’t quite get a handle on”. She felt that the patient was holding her at arms’ length all the time, and wondered if she was not treating the right element, which she had, in my opinion, rightly, diagnosed as Fire. I could feel that though the patient was friendly, pleasant and smiling all the time, she was indeed keeping the deep part of herself firmly locked away from us.

Why was this? And what had happened that had made her so defensive? There was something here to explore, and our diagnosis of her element helped me find a way in. Fire wants above all to relate. It needs relationships, particularly sexual relationships, in the way that Earth needs to be nourished and Metal craves self-respect. She had not been in a long-term relationship for many years, because “I always choose the wrong person”. I decided to address this issue head-on and asked, “Did any relationship you have had in the past end by breaking your heart?”, and was not surprised to hear that, yes , one had. Her first really deep relationship had lasted 3 years and should have ended in marriage if she had not discovered very close to the wedding day that he was a serial philanderer. Living as she did in a very small, tightly-knit community, she was then forced to be a witness to his marrying a friend of hers with whom he now has several children.

It was interesting to watch the change in this patient as she talked about all this. There was obviously relief at being able to tell us her story, and a great deal of sadness as she did so, but also, after a lovely further treatment on Fire, starting with Ki 24, Spirit Burial Ground to resuscitate her damaged spirit, a kind of transformation within her as her Fire element started to heal itself at a deep level and no longer needed to throw up such a defensive screen around to protect her.

This was a lovely treatment with a lovely result, and a lesson to us all to persist in our questioning until we get to the core of a patient’s troubles. And I only really managed to reach this core when my persistent but gentle questioning at last got through her defences and made her feel safe enough to say what in effect she had held back from saying for years. Interestingly, patients themselves are often unaware, as this patient was, of the long-term effects of something that happened years ago upon the present state of their health. This patient’s ostensible reason for coming for treatment was not the hurt this failed relationship had inflicted upon her, but a physical complaint, persistent head-aches. It was only my questioning that gradually revealed to her the true depth of the pain this first love of her life had inflicted upon her.

Here the element we choose will guide us in the type of questioning we need to pursue. If she had been Metal, for example, I would perhaps not have focused so much on relationships but upon the areas of her life which had brought her the greatest sense of self-fulfilment. It is not enough, then, simply to say that the patient is Fire or Metal. We have to know exactly what kind of things have happened to force that Fire or Metal so far out of shape that it can no longer function properly. And we are only able to find this out by by being really curious to know what has gone on in our patient’s life and by not being afraid to tackle deep areas of hurt. I sometimes feel I go “where angels fear to tread”, but that angels are there to beckon me in.

Losing control in the practice room

I am still surprised at how easily I can allow myself to be controlled by a patient even after all these years of practice. This may come from my desire to please others (my Fire wanting everybody around them to be happy), which which can lead me too quickly to do something which I don’t really want to do and which I eventually realise is not right for me to do. My Small Intestine is also always only too ready to think that the other person may be right in what they are demanding of me, and it is only after some thought that I may decide that this is not so, by which time I may well have agreed to something I eventually come to regret.

In the practice situation this may reveal itself as not being quick enough to realise that in some way I am being manipulated by a patient, something as practitioners we all know can happen when patients, who may feel uneasy about coming for treatment, try to wrench control back into their own hands. This may appear as something apparently insignificant as a patient making an extreme fuss about the heat of a tiny moxa cone or being determined not to accept a practitioner's time constraints.

This is what happened today. A new patient, very uneasy indeed from the moment he walked in the door, managed to get me to make the next appointment on a day which I had crossed out in my diary with the words, “Keep day free” written in big letters across it. It was only after he had gone that I realised what had happened, as I tried to analyse the great feeling of disempowerment which his treatment had left me with. Though I was cross at myself for allowing myself to be outmanoeuvred in this way, I had to laugh because, feeling as I did that his element was Water, it had, as usual, managed to get its own way, and I, as Fire, had, as usual, allowed myself temporarily to be extinguished by its force.

Obviously each element will offer different challenges to different practitioners, and practitioners who are not Fire may not recognise this particular challenge, but everybody should look carefully at which situations cause them the greatest stress and then try to trace this back to the element or elements in their patients which are causing this. It is also an excellent way of helping ourselves track down an element, as I found in this instance. My careful unravelling of why this patient had made me uneasy helped to strengthen my belief that I was dealing here with Water.

Now my task is to try to regain control at the next treatment, and to make sure that my Fire blazes sufficiently strongly to turn the powerful force of his Water into less threatening steam. A good lesson for me, and I hope for anybody else reading this who has found themselves struggling to remain in control in the practice room. And the moment we lose control, we also lose our ability to help.

Preface to the Chinese edition of my Handbook of Five Element Practice

I give below Mei Long's translation of Liu Lihong's Preface to the Chinese edition of my Handbook which has now appeared in bookshops throughout China.  I am very honoured that he volunteered to write the preface, and am touched with what he has written.  I think this preface is an important document charting the first steps in the return of five element acupuncture to its birthplace.

"The Handbook of Five Element Acupuncture, written by Nora Franglen, will soon be available to Chinese readers. Whilst for the 4th time reading this book admiringly, I must admit that I regret somehow that I have offered myself too eagerly to write the introduction. Since being still learning five element acupuncture myself, I realize that I could hardly give any comment on her book. However, to keep my promise, I’ll manage to write something here.

I came across 5EA because of Dr. Long Mei, who graduated from Chengdu University of TCM in 1991 and has lived in the Netherlands since 1997. In the beginning of 2010, she wrote me a 10-page-long letter, telling me how she came across 5EA, her understanding and experience of practising this school of acupuncture. Deeply touched by Mei’s letter, I realized how wonderful this style of acupuncture is. How amazing that the lineage, rooted in China, is still passing on abroad! Hardly can I stop feeling guilty unless making any effort to welcome it coming home. So last summer I invited Long Mei to run a one-week seminar on 5EA in Nanning.

Originated in China, 5EA has already undergone a history of more than thousands of years. In the second half of last century, prof. J.R. Worsley, an English master of five element acupuncture, made great efforts to promote this school of acupuncture. And thanks to his contribution, the transmission of 5EA has been carried on in Europe and the United States, benefiting so many people. Whereas in her homeland, 5EA has become unknown to Chinese people, both laymen and professionals. As prof. Worsley mentioned, it was an oral tradition, which is very much like the Zen tradition in China – no written history.

In his preface of ShangHan Zha Bing Lun, Zhang Zhongjing wrote: “Heaven distributes 5 phases to create and move 10,000 kinds of species. Endowed with 5 elements, human beings thus have their 5 zangs (organs), Fus and meridians. The deep secrets and the meanings of the manifestations and the changes of Yin and yang, which are closely interrelated and connected to each other, are revealed in such a subtle and profound way that they are hardly understood except for those who are gifted with profound insight.” As to me, this can be a perfect description of 5 element acupuncture.

… It is in finding our guardian element that has made 5EA so difficult and fascinating. Also, this is where we, as practitioners, need to improve ourselves. And by so doing, we are getting more and more into our senses.

To find the right element, is to understand the profoundness of human nature. So we have to, just as prof. Worsley said, “Get out of our mind and into our senses.” Getting out of our mind, as I understand, is to get into our heart. Therefore, to be able to understand and deepen ourselves in this style of acupuncture, we need to let go many ideas and concepts of stereotypes. Whilst the engagement of our brains is so emphasised as to gain the knowledge in the modern time, the heart, however, was much more involved in the old time. In the book of Neijing, the heart was regarded as the emperor, the brains, however, only as one of the Fu organs. It is here that we see the difference between the old value and the new ones. And it must be worthwhile for us pondering over such difference. Understanding the difference between the brains and the heart is probably the key to deepen our understanding in Chinese Medicine. 5EA certainly offers the shortest access to gain the essence of Chinese medicine.

As for the practitioners, 5EA, based on the principles of the Classics, has a special focus on the Spirit. This has made 5EA so profound a form of healing which guides her practitioners following a path that of a supreme physician’s (Shang gong), who always goes beyond the physical level. Whereas for laymen, understanding the elements would bring more joys to their daily lives and help them to live their lives in a healthier way.

In June this year, whilst attending the international TCM congress in Rothenburg, I had chance to meet Nora and from whom I received my treatment. Metal is my guardian element according to Nora. After following a complete process, Nora selected Yuji (Lu, 10, fish region), the most spiritual point of the whole body, she told me, to end the treatment. The point, Lu 10, made me think. As I always enjoy doing: getting the meaning hidden deep within the Chinese characters. I then realized that there must be a connection between character “鱼” (yu), meaning ‘ fish’, and another character “宇” (yu), meaning ‘the universe’. The secret behind Yuji, “fish region” must be” the universe region”! In the book of Yellow Emperor’s Yin Fu Classic, it writes: “the universe lies in our hand, everything in the universe lies in our body.”

Reading Nora’s Handbook, I’m inspired by her profound insights and wisdom; whilst getting her treatment, I’ve experienced the subtleness and sincerity. Being with her, feeling her faith and love for Chinese medicine, flowing out of the heart, I can imagine how delighted Nora feels that 5EA is coming back to the homeland, a journey which has been waiting so long. And I can’t stop admiring and respecting how she is, advanced in her age, yet childlike in spirit. But meanwhile, I feel awesomely sorry, and wonder: as being Chinese, what have we done and what can we do for passing on Chinese medicine?

Liu Lihong, in the midsummer of 2011, at the foot of Green Mountain, Nanning"

Heart-warming encouragement

I have just received the following from an acupuncturist in Germany who is trying to deepen his understanding of five element acupuncture by working his way through my books. We have decided that when I feel he is ready for me to do so, I will come and visit his practice to help him with his patients. I give it to you in his own words:

“So far I read your guidelines* and do it now a second time. After finishing these, I will start with your handbook from the beginning, in which I sometimes dip in and read a chapter.

Your words are very, very helpful for me, because I had a lot of different information about 5-Element-Acupuncture in the past, and have now a good and safe point to start again. I like your observations of people and situations in general very much, as well as your relationship to feelings (like asking the pulses how they, the organs, feel). I looked for this kind of treating / observing for many years.

For me one of the most important point of your work (so far I may be able to assess this) is that you try to see the whole world around you in the context of the 5 elements. It is not a kind of work for you, it is your life. That seems to be your claim (I hope this is the right word), and it is also mine.

As well I’m fascinated about your clarity with all the different steps of 5-element-procedures. Most of the people who teach stuff like this are not this clear, sometimes they are not close enough to the bottom (which includes me as well).

I like it when you write about your weakness as well, because only if we are clear at this point, we have the best possibility to develop. But I like also, that you don’t hide your knowledge, develop your books and blogs. Sometime we are not brave enough to do this (who am I, to tell other people that is right and that is maybe wrong…). But without this, I would not have the gifts of your work. It is very kind of you to spread this out in the world, as well as back to China. All people need a way like this.”

It is receiving encouragement for my writings like this which makes all my work worthwhile.  Thank you, Christian.

*Tips on How to Start Learning about the Elements, SOFEA website http://www.sofea.co.uk/

Five element acupuncture to the rescue during the Christchurch earthquake

I was deeply moved and heartened to hear of the work of one of SOFEA’s graduates, Jane Grofski, in the aftermath of the Christchurch earthquake in New Zealand. This is her account of treating people from the Search and Rescue Teams with five element acupuncture.  I hope this dispels one of the myths still hovering out there that five element acupuncture cannot be used for emergency treatment:

“We’ve had 7460 earthquakes now in the last 11 months and so you can imagine the state some of my clients are in. It’s certainly challenging to live through.

I worked for the Search and Rescue Teams here after our largest earthquake and gave them all a 30 minute treatment. They were queuing all day and I got through about 170 firemen each week. I remembered your words about being tough enough to stay on our feet for a long time! It was incredible to see how much faster they processed all their stress and fatigue with acupuncture treatment. Some of them said they felt better after the 2 weeks in Christchurch than when they had arrived!

I worked from the principle of using all the most basic points. Check for blocks and use source and command points. Somehow it seemed there were more Fire elements among the firemen! The chest points helped frequently with processing the grief and the CV points were also common. I have developed my skill of being able to ‘see’ the meridians and points, so I could treat the points that just looked like they were the most blocked. In fact at one point the lights went out and the patient’s body looked like it was covered in glow-worms – really beautiful and not something I’d seen before (I don’t treat in the dark!).

I believe there is a great use for acupuncture in trauma care. I’d like to develop treatment criteria for other acupuncturists in acute trauma care and that would be a great topic for us to discuss. Often the firemen were actually dealing with previous issues and some had seen thousands if not hundreds of thousands of dead bodies in their lifetime. My basic principle was that if I could speed up their ‘processing rate’ then they would be able to deal with their daily stresses and fatigue. They are all highly trained and incredibly well self-managed emotionally; they just required their system to be ‘sped up’ to deal with the increased load. They responded particularly well to treatment as they were already in a highly focussed state of mind and motivated to get the best results from treatment.

I've now been asked to be a specialist consultant for the International Search and Rescue Advisory Group based on the initiative I set up here. I would like to see acupuncture used more extensively with the trauma teams and am applying for a grant to enable me to research this more extensively."

I give Jane’s contact details below. She is interested to hear from anybody else who would like to share their experiences in working in this area. And perhaps there is some person or organization out there who would be interested in helping her fund her research:

Jane Grofski
Equilibrium Health and Wellness Spa
4 Teal Close, Ferrymead
Christchurch, New Zealand
021 795 855
jane@equilibrium.net.nz
http://www.equilibrium.net.nz/

A postscript to the above:  I have just received the following from Jane to add to my blog: 

"At the time of going in to work with the Search and Rescue Teams, my two children and I were out of my house and living in a tent, without sewage, water or electricity. It really was such a strong calling to go and do this work."

A moment of triumph!

I went today to the Garden of Peace at the National War Museum here in London, which was inaugurated in 1999 by the Dalai Lama. A pillar commemorates his visit, and shows on three sides an English, Tibetan and Mandarin version of his words of peace to the world. I was overjoyed to find that, with a little bit of a helping hand from the English version, I could just about decipher the Mandarin characters for 15 May 1999. I also thought I recognised part of a character which had something very like the rather magical flourish beneath the character for the Dao, which I thought might represent one of the characters for the Dalai Lama.

I felt a stupidly warm glow of self-satisfaction at such a tiny achievement!

Interesting insights into the Water element

I have just received from a former patient – all the way from India –the following fascinating insights into how the Water element feels.

She has always been very interested in five element acupuncture, and sees a similarity in approach to Ayurvedic medicine, which she studied for a while. She has been following my blog with interest, and was stimulated enough by my last comments on Fire to send me her own impressions of the kind of pressure Water exerts.

“Water has its surges (like tides I think) but will often feel unsure of its approach even when it is at a high (or communicable) state, even reaching out is filled with uncertainty and hesitation and the fear that the other person may not understand one's intention. There is no intended push (as in Wood) or pull (as in Earth) but just a kind of narrowing of a gap, an attempt to fill up some empty space or distance as water might do in nature itself. But it is done with wariness and the first sign of it not being recognized for what it is is enough to make it draw back and move elsewhere. This is a rather strange tendency and now that I can see it, I try and be less judgemental about people and about my own reactions.”

The energy of Fire

In the past few weeks I have become very aware of the Fire element, particularly as here in England we hardly seem to have had a summer before late summer is in the air, and even, oh horror, so early, a hint of the autumn to come. Perhaps my own Fire element has craved more of the warmth and sunlight it needs to fill it before its season passes, but, whatever the reason, it is at Fire that I find that I am looking with somewhat new eyes.

For what I have noticed increasingly, in a way that I did not do before, is the sheer energy this element shows in all it does, like a spring within it always coiled and ready to be released at each new encounter with the world. It is even there in its smile, an outpouring of warmth towards others, very unlike the timid, passive or more withdrawn smiles of other elements. I don’t think I had realised until now quite how much yang energy is contained in this most yang of all elements, whose season, after all is high summer, the yang high-point of the year.

I think we often regard Fire as being a gentle element, perhaps because we believe that the love that it brings to bear on all things is a gentle emotion, which it so rarely is, just as Fire is far from being as gentle as the impression it likes to give of itself. I have recently been looking at videos on YouTube of famous Chinese people to take as examples close to home for when I teach in China, and this is when I was struck, so unexpectedly, by the weight of energy pouring out in all Fire’s movements. Watching yet again the Chinese pianist, Lang Lang, it is so vividly clear in the way he plays. Through his playing he reaches out forcefully to the conductor in front of him, the orchestra around him and the audience beyond him, almost as though trying to capture them with his joy. I compared this with other pianists I know, some of whom will sit quite still and withdrawn at the piano, so yin-like, as though communing silently with the music and apparently, during these moments of their playing, unaware of the world beyond them.

So if you are a five element acupuncturist and are trying to work out ways of recognising Fire, watch out for the energy you feel coming towards you. And then learn to compare this with the very different energies of those other two powerful elements, Wood and Water. Wood does not try to share anything with you in the way Fire so ardently would like to do, but wants more to force itself on to you. Water’s energetic thrust is much more elusive, being apparently so gentle at one moment, and then, like flood water, sweeping you aside in its rush to survive.

I am always delighted to discover yet again the elements’ ability to surprise me with the variety of ways in which they reveal their differences.

The delight of unexpected words

Yesterday I spent an hour wandering through an exhibition at the British Library of that much under-rated and under-read writer, Mervyn Peake, of Ghormenghast fame. And I give below three lovely quotations of his for those who read this to ponder a little.

I particularly love the first, which echoes why we five element acupuncturists always, always, start, not, as is the unhappy custom now, from the Lung, but from that much more important organ, the Heart, which is numbered One in our Roman numerology of the 12 officials for that very reason.

“To live at all is miracle enough…
…. When every heartbeat hammers out the proof
That life itself is miracle enough.”

....“Neither be afraid of the unorthodox subject nor in finding delight in the contemplation of commonplace things. Anything, seen without prejudice, is enormous.”

....“For it is one’s ambition to create one’s own world in a style germane to its substance, and to people it with native forms and denizens that never were before, yet have their root in one’s experience. As the earth was thrown from the sun, so from the earth the artist must fling out into space, complete from pole to pole, his own world which, whatsoever form it takes, is the colour of the globe it flew from, as the world itself is coloured by the sun.”

An illuminating article by Heiner Fruehauf all should read

I have just read Heiner’s article on Chinese Medicine In Crisis: Science, Politics, And The Making Of “TCM”, which appears in the August 2011 newsletter of his website http://www.classicalchinesemedicine.org./ .  This is an update of his 1999 article with the same title.

I give below his opening sentence and the quotation with which he heads his article:

The latter half of the 19th century and through the end of the 20th century has been a time of great political, economic, cultural, and scientific transformation in China. Chinese medicine, the shining gem of traditional science, has had to endure many assaults in this process, sinking the field into a quagmire where it had to fight bitterly for its own survival. This course of events can be called “The Century When Traditional Chinese Medicine Was Tied up in the Straightjacket of Utter Delusion.”
          –Li Zhichong, Director of Chinese TCM Association, 2002

Heiner writes that his article “is based on the conviction that the traditional art of Oriental medicine is dying – both in mainland China, home of the mother trunk of the field, and consequently overseas where branches of the tree are trying to grow.”

I think everybody who wants to gain a deeper understanding of the current state of traditional Chinese medicine throughout the world will find something to ponder about in this article.

Now China, here I come!

Everybody interested in the future of five element acupuncture will share my delight that it is now making its way back to China, carried first on the wings of the Chinese-language edition of my Handbook of Five Element Acupuncture, which will be in Chinese bookshops in a week or so, and then by my own presence in China. I have been invited over there at the end of October by Professor Liu Lihong of the Clinical Research Institute of Classical Chinese Medicine attached to the Guangxi College of Traditional Chinese Medicine. He is a colleague of Heiner Fruehauf, who many of you will know as the author of the very important article Chinese Medicine in Crisis (Journal of Chinese Medicine No 61, October 1999). You can also see Professor Liu talking to Heiner on the website http://www.classicalchinesemedicine.org/. Professor Liu encouraged Mei Long, a Chinese postgraduate student of mine, now living in the Netherlands, to translate the Handbook.

I will be flying first to Chengdu, then to the Guanxi College of Traditional Chinese Medicine in Nanning to teach a group of acupuncturists there for about a week. I will then fly on to Beijing to give a seminar at the large international conference which Professor Liu is organizing. He regards this as a very significant step in the important programme of re-introducing five element acupuncture to China and re-attaching Chinese acupuncture more firmly to its traditional roots. (Heiner’s article is a very good introduction to the background to this.)

It is a great honour to have been invited by him and to have been recognised by him as an important contributor to his work.

(You can also read a fuller background to this visit in my blogs of 1 June, 2 August & 8 November 2010 and 16 June & 7 July of this year.)

At the same time I am continuing my translation for Elisabeth Rochat de la Vallée of her 101 Notions-Clés de la Médecine Chinoise (101 Key Concepts of Chinese Medicine), which brings together many of her teachings of the classics of Chinese medicine over the years. It forms a fascinating companion to my own recently-started studies of Mandarin. I feel it is important that I can at least greet and thank my hosts in China in their mother tongue! As a former linguist, I have always felt it was a pity that I did not have enough time to study Mandarin in depth, and am happy now to be able to remedy this, with the incentive of my China visit spurring me on.

On the domestic front, it is also good to have news of the phoenix rising from the ashes of CTA in the form of the Acupuncture Academy starting soon in Leamington, appropriately the birth-place of five element acupuncture training in the UK. I have visited their new premises, and wish the Academy every success as it launches its innovative new course. Dublin, too, is going to have its own five element college. It is good to be able to report good news of this kind for five element acupuncture, both here and in the wider world, at the end of a difficult year on the acupuncture front.

More blogs about my visit on my return from China.

Zaijian! (Goodbye!)

We can only cope with what we can cope with

As I get older, I hope I get a little wiser and also a little more tolerant of my own inadequacies. And one of the snippets of wisdom this year has taught me is contained in a mantra I now say to myself, “We can only cope with what we can cope with”. It’s no good our being cross at ourselves or at others for doing things which, at the time or with the benefit of hindsight, we know are not wise things to do or to have done. It is difficult enough working our way through the stresses life presents us with without adding to them the weight of too much guilt when we feel that our actions have been misguided. I think it is therefore good to get used to telling ourselves that that is all we could have done at the time.

It is a particularly useful lesson for me as a five element acupuncturist, because understanding what any particular patient can cope with is another one of the subtle ways of tracing the imprint of an element. When we realise, for example, that Metal cannot cope with the sort of things Fire can, or Wood with what Earth can, we are on our way to understanding a little better what makes the different elements tick.

The art of asking the right questions in the right way

Since seeing a new patient for the first time last week I have been thinking a lot about what is the right and what the wrong way of saying things. Twice I found myself asking a question awkwardly or saying something clumsily, but realised this in time, and quietly re-phrased what I was saying in a way that satisfied me.

The first time was when I asked my patient, “Are you happy with your life?”, and realised immediately that this was not the right way to frame the question. I then changed it quickly to, “How happy are you with your life?” Thinking back on this, I realise that my initial question gave my patient only the option of saying “yes” or “no”, either reply being unlikely to reflect the truth, since nobody is either truly only happy or only unhappy about all aspects of their life. Such a black and white question makes it easy only to respond with a black and white reply, leaving no room for all those grey areas in which we live our lives most of the time, sometimes happy, sometimes unhappy, but never either of these all the time.

The second time was when my patient told me that she was going back to Ireland to see her family for the first time in 4 years, and I found the words, “How lovely”! How exciting for you!”, coming to my lips, before I bit them off in time, and asked instead, “Are you looking forward to this or are you dreading it?”. My first question was like one of those meaningless interchanges we litter our social life with and which mean absolutely nothing, such as, “How are you?”, “I’m fine”. It would effectively have closed the door on any hope of hearing how my patient actually felt about seeing her family after such a long time. Why had she left it so long, after all, if it was an easy relationship? Ireland, unlike Australia, is easy to travel to.

On such little shifts in the way we frame our questions and responses to our patients often hangs the development of a good or tricky relationship with our patients. I still myself remember the time when a friend told me that she was surprised that I had reacted as I did to something that had happened, and said, “I can’t understand why you didn’t…….” That effectively stopped me from telling her anything more about myself, because I felt I was regarded as a bit odd for being as I was. Instead of being offered an implied criticism, what I would have responded well to would have been to have been asked why I did what I did.

And we must make sure that our engagement with our patients, too, gives them the freedom to tell us truly why they did what they did and felt what they felt. We must never assume we know the answers to this. Only our patient does.

Find the element, and the points will look after themselves

I am not somebody who enjoys experimenting in my acupuncture. I regard myself as a steady plodder, and like to think I work my way along paths well-trodden before me. One of the ways in which this somewhat cautious approach reveals itself is in my choice of points. I have often said that I have a very small repertoire of points, concentrating mainly on those few points which have a close and safe relationship with the element I am treating. I focus mainly on the command points,then on other points on the elements which I have gathered together over the years, on points which release energy blocks of all kind, and finally, and only then, on that difficult but important category of points which we select, as we say, “for their spirit”. It is this group which causes every acupuncturist the most trouble, since it is like opening a can of worms, as we ask ourselves which point exactly we need to use today for its spirit for this particular patient, and often can’t come up with the answer.

What I don’t usually do, though, is experiment. I have not had the habit, as other acupuncturists apparently have, of looking up the list of acupuncture points and branching out in a new direction by choosing a point I have never used, usually basing this choice on a point’s name. I have thought about this quite a lot recently, because I am at the stage in my practice where I am enjoying injecting something new into it, and what can be newer than using a point I have never used before? So, venturing on to new terrain, I have done this for one or two patients and then stood back to assess whether I have learnt anything from this experiment, and whether, more crucially, my patients, thus experimented upon, have responded in ways that differ from their responses to the more familiar kinds of treatment I have offered them before.

What I find, not unexpectedly, is that I really could not say what effect any of these new points have had, except that, as usual, my patients have continued to improve as they did before with my familiar array of points. I asked myself whether there was any sign that something new had occurred, and came up with the answer, “no”. So on a very small sample of just a few treatments, certainly, a mathematician would say, not a statistically significant number of any kind, I learnt nothing which shook my long-held belief that the fundamental nature of any five element treatment consists in addressing the element, rather than worrying about the points we use to address this element. I will always stick to my mantra, “Think element, not points”, to help me in my practice. The selection of points then always becomes secondary to the importance of selecting the right element.

So take heart all those many acupuncturists who seem to worry too much about point selection, and particularly about what exactly “selecting points for their spirit” means. All points, particularly those all-important command points, have a “spirit”.

Once you find the element, the points will look after themselves.

Preparing to meet a new patient

I have written before about the courage it takes to be a practitioner as we prepare to confront the unknown in each new patient we meet (see my blog of 25 April 2011 on The unknowability of another human being). I am preparing myself to do just that this week when I meet a new patient for the first time.

It will be up to me to ensure that I conduct this meeting in such a way that it ends with my patient feeling that I have already helped her in some way. It should also leave me feeling, not that I must “know the patient’s element”, as though that is the be-all and end-all of this initial interaction, but that I know enough about her to make her feel happy to come back a second time.

Of course this knowledge, and all the other little bits of knowledge I will gain each time I meet her, will eventually together point me towards one element, I hope, but even if I feel confident about which element early on, that alone will never be sufficient. Just deciding on an element, however correctly we may make our diagnosis, only does so much, unless we add to it that deeper level of understanding, that “soul to soul” bit, which will give to our treatment its special flavour. And we must never forget that we can start off on what we eventually find is not the right element and yet help our patients at a deep level through our empathy with them.

Above all, I must be curious. Perhaps I am fortunate that I have always been fascinated by glimpses of other people’s lives. If I am amongst a group of people, what I most enjoy is sitting back, unobserved, and watching how they interact with one another. These interactions are endlessly fascinating, and, for a five element acupuncturist, endlessly instructive. I must bring this curiosity with me as the most important gift I will be bringing to my new patient. I need to gather all those snippets she will tell me about her loves, her longings and her disappointments, and use them to start building up a picture of her life and how she lives it now and will hope to be living it better in the future if the treatment for which she has approached me is to help her. And then I will need to look deeply into myself and examine how what she has told me, and the way in which she told me this, points me in the direction of one element.

I have learnt over the years not to be too hard on myself, and not to allow any dissatisfaction I may feel about the way I conduct this first encounter to affect me too deeply. I can only do the best I can at the time, and if I feel that I have somehow failed my patient in some way by not quite adjusting my approach sensitively enough, then there is always the next time in which to correct this. We must never ask too much of ourselves in this very delicate business of our engagement with our patients. As long as they feel we care about them, they will always come back a next time and give us another chance to get things a little more right.

There are 25 ways of expressing the 5 emotions

It is worth remembering that, since each of us is composed of a unique combination of all the five elements, and each element expresses every one of the five emotions, there are in effect 25 possible expressions of the different emotions. The five principal categories which tradition associates with a particular element, such as joy for Fire and fear for Water, are therefore modified when it is not a Fire person expressing joy or a Water person expressing fear. When a Metal person expresses joy or fear, those expressions of joy or fear will be shaded by grief, Metal’s dominant emotion, and therefore will express themselves in a different way from a Wood person expressing joy or fear, or a Fire or Water person expressing joy or fear.

It is therefore not simply a matter of observing joy or fear expressed to their fullest in Fire or Water people, but of having experience of observing these emotions in people who are not Fire or Water. We have to begin to differentiate the type of joy or fear being shown, however much this may be buried beneath the dominant emotion of another element. Fire or Water will show these two emotions in their purest form, since they pour out straight from the organs controlled by these two elements, whereas joy shown by an Earth person or fear shown by a Metal person will be modified by the patina of sympathy or thoughtfulness Earth throws over all it does and the patina of grief which Metal shows in all it does. In other words they will show an Earth or Metal-type joy or fear, which will be quite different from joy or fear expressed in pure form by Fire or Water.

In trying to gain a foothold in the tricky world of interpreting the emotional signatures of an element, we therefore have to look carefully at all the different possible nuances of emotional expression. We have to bring to this all the knowledge of the elements we have accumulated so far to help point us in one of the five directions. We can do this in retrospect, as it were, by looking carefully at a person whose element we are sure of, and observing how they express the emotions of the other four elements, not just their own. How, for example, does a Metal person express their anger or their sympathy, or a Wood person their grief or their fear? Such an exercise is a very useful way of expanding our library of pointers to the different elements.

Unfortunately words are inadequate tools to describe such subtle distinctions, so regretfully this blog is the only answer I can give to the request of another acupuncturist who asked if I “could perhaps say something about the different responses you have to the control of Wood and the control of Fire. I have a patient who is like a blazing log stack, a wonderful human in there but very controlling, and I can't come down on a CF”. Sorry I can’t help you more than this, Kate, except to encourage you to focus your emotional antennae a little more each time you see this patient. Something about the nature of what you see as his/her controlling character will eventually point you to one or other element (which may after all prove to be neither Wood nor Fire, just to confuse you further!). But give it time! We’re usually, if not always, in more of a hurry than our patients.

The significance of a “Husband-Wife” imbalance and its diagnosis

I have written this blog in answer to a query from somebody commenting on my blog of 23 June in my sister blog http://www.five-element-treatments.blogspot.com/, but I think it is important enough to include here in this blog. I was asked how I had diagnosed a Husband-Wife imbalance just by looking at the patient. What did I observe that made me diagnose H/W? I give my answer below. It is a very detailed answer because the question fired me to think carefully what a H/W imbalance means, and touches upon what is a very complex and profound area, that of pulse diagnosis.

We are told to diagnose a H/W through the pulses, with the pulses of the left side, the “husband’s” side being qualitatively stronger than those of the right, “the wife’s”. Diagnosis from pulses alone presupposes that our pulse-taking is sensitive enough to feel what may be an extremely subtle difference. I have often said, and will go on repeating, that it is foolish to rely entirely on our pulse-taking in making a diagnosis, since it is a very great skill accurately to interpret what the pulses are telling us, acquired only after years of practice. To understand this, but certainly not to be too daunted by this, it is essential that we remember at all times what we are attempting to assess at those 6 positions at each wrist that we gently palpate to give us a pulse-reading of the 12 officials forming the five elements.

We should think of the 12 pulses as access points to the elements. They can be palpated most clearly where the blood flow is at its strongest and nearest the surface. Since time immemorial in traditional Chinese medicine, and in modern times in Western medicine, too, the most easily accessible point has been accepted as being over the radial artery at the wrist. It is important to visualize the pattern the 12 pulses form on any pulse chart, and here we should divide them into 6, since at each position there are two, one at the superficial level and one at the deep level. (I know that different diagrams of the pulses have been drawn up over the centuries showing an intermediate position, which would in effect make 18 possible pulses, and also different pulse positions, particularly in relation to one of the pulses on the right side (the five element Outer Fire pulses), but I am writing here only about the order of the pulses which five element acupuncturists use.)

In effect, the understanding that the five elements will reveal the state of their health in body and soul at a tiny site like this, less than a couple of inches (oh how I still love my old form of measurement!) (a few cms) in length, is awe-inspiring and still blows my mind. It means, in effect, that the work of all the elements acting together is creating the blood flow at every point in the body, not just at the wrist, but that it can be detected most easily where the arterial blood is closest to the surface. (Pulses can also be palpated at the ankle or over the carotid artery in the neck where there are equally strong pulsations, but the wrist is used for reasons of easy access.) It is important always to remember the order of the pulses, and here not just the order on each hand but the order of both hands taken together. If we hold the hands together facing upwards (do this now if you are reading this), imagine that you are drawing a line which starts at the pulses nearest the wrist on the left hand, moves down to the two other pulse positions on the left wrist and then passes over to the pulses on the right hand, continuing down to the third position on the right before looping back over again to the first pulses of the left hand again, forming a continuous figure of eight. In effect, we are tracing the order of the elements backwards, from Inner Fire (Heart/Small Intestine), back to Wood and Water, back across to the right wrist to Metal, Earth and Outer Fire (Heart Protector/Three Heater), before looping back to the inner side of Fire again and so on.

We are taught to palpate the pulses in this way, first left-hand pulses starting with the first position over the Heart/Small Intestine aspect of Fire and then right-hand pulses starting with the Metal pulses. This is a simple way of reading the pulses, and emphasizes the importance of the Heart pulse as being the first pulse we palpate, but in doing this we tend to forget the actual order of the elements, even if we were ever aware that the pulses represent this, which many of us are not. It is only in helping us make a Husband-Wife diagnosis (and that of an Entry-Exit block) that it is so imperative to think of this order to understand what our pulses are telling us.

We know that the flow of energy moves along the Sheng cycle from Fire to Earth to Metal etc. We know also that we correct a H/W by needling the following points: Bl 67, Ki 7, Liv 4, Ki 3, SI 4, Ht 7. This order of points does the following: First it reconnects the mother element, Metal (a right-hand pulse) with its child, Water (a lef-hand pulse), then, by needling Liv 4, it draws energy from the Metal element (right-hand pulse) across the Ke cycle to the Wood element (mother element to grandchild element) (left-hand pulse), then by needling Ki 3 it does the same from Earth across the Ke cycle to Water, and finally it reinforces the Heart by needling the source points of Inner Fire, finishing with Ht 7. 

In effect, by diagnosing an excess of energy in the right-hand pulses and a frightening depletion of energy in the left-hand pulses, the classic diagnosis of H/W, the pulses are telling us that there is a potential breakdown between the elements, and in particular between the point at which energy from Metal passes over to its child, Water. It isn’t a complete breakdown, because that means death, but it is sufficiently serious for us to regard a H/W imbalance as a dangerous condition because it is depleting the energy flowing to the Heart. It is therefore interesting to see how often the pulses leap back into balance immediately Metal is reconnected more stronly to Water, i.e, after needling Bl 67, Ki 7. It is therefore a good idea to read the pulses after you have needled these two points to see if you can detect the immediate sign of relief as the energy flow starts to re-establish itself, and the Heart can begin to relax.

With all this in mind (and I am sure anybody not a five element acupuncturist reading this will have given up well before now!), I will go back to the question which has prompted this exposition of what a H/W imbalance actually represents. If it reveals a serious weakening of the flow of energy from mother to child element around the complete cycle of the five elements, which it does, then this serious weakening must somehow show itself not only on the pulses but in the way a patient presents themselves, which it does. Patients will look despairing, as if they have given up hope (the Heart almost giving in). As well as showing this despair, they will surprisingly often say things which help our diagnosis, such as, “I don’t think I can go on” or “I feel like giving up”. They may look as if they are too weak to talk, just wanting to lie there passive with their eyes closed.

H/W can appear suddenly, as though the Heart all at once can take no more, unlike imbalances such as Aggressive Energy which appear slowly over time, so the change in a patient from one treatment to the next can be very obvious. In the case of the patient I was writing about, he came into the room looking so very different from how he had left me the week before, that the change was dramatic enough for me to suspect H/W even before I took his pulses.

Finally, I repeat my mantra, “never rely on pulses alone to tell you what is going on”. Use all your senses and all your feelings and any other diagnostic information to help you diagnostically, such as a patient rubbing their eyes in the case of a SI-Bl block or the onset of hay-fever in the case of a Co-St block, since our pulse-taking (mine included) may not be sensitive enough to do the diagnosis on its own.

Does plagiarism matter?

I have noticed that writers get extremely hot under the collar when they suspect somebody of plagiarizing their work in some way. And I always wonder why. It seems to me that all the words of all the writers we have read echo within us for a long time without our realising it, and of course this is particularly true of the oft-repeated sayings of famous writers. I don’t think any of us would now write “to be” without hearing the echo of “or not to be” in our heads. And I was pleased to read the following yesterday in a book I bought at Stratford-upon-Avon after I had watched that marvellous actor, Patrick Stewart, re-create Shylock for me in The Merchant of Venice in a totally absorbing new way.

“Scholars have long and fruitfully studied the transforming work of that (Shakeseare’s) imagination on the books that, from evidence with the plays themselves, Shakespeare must certainly have read. As a writer he rarely started from a blank slate; he characteristically took materials that had already been in circulation and infused them with his supreme creative energies. On occasion, the reworking is so precise and detailed that he must have had the book from which he was deftly borrowing directly on his writing table as his quill pen raced across the paper.” (Stephen Greenblatt, Will in the World, Pimlico 2005, p 13)

I think Shakespeare would be flattered if he had realised how deeply his words have scored us. Inevitably, then, the chances of our inadvertently including some figure of speech into our writing, some juxtaposition of colouring or shape into a painting or some musical expression into a composition, all garnered from other writers, painters or composers, are extremely high, so high indeed that I was told that Andrew Lloyd Webber is so frightened of copying somebody else’s work that he refuses to listen to other people’s music for a time as he composes. I don’t know how true this anecdote is, but it certainly illustrates the fear that we may be accused of somehow not being original.

This has never worried me, since I am always happy to acknowledge my own debt to all the many writers I have ever read. Only a few days ago I heard the cadences of William Faulkner’s idiosyncratic and beautiful prose in a sentence I wrote. I know that behind every sentence of mine lie banked up many thousands of others’ writings which have each in their differing ways created the foundation upon which I build up my own thoughts in words. I am also flattered, rather than dismayed, if I find, as I do, echoes of my own words in other people’s writings, particularly in my field of acupuncture. One such incident comes to mind. When I started my acupuncture school in the mid-90s, I coined the, to me, happy and thought-provoking phrase, “An ancient form of healing for a modern world” to describe what we did, then took it as a compliment, rather than as something worrying, when another acupuncture college a few years later used nearly the same words in their promotional material.

I think thought should be free wherever this is reasonable, not circumscribed by lawsuits and trademarks. I suppose this depends on the level and amount of copying and the purposes to which it is being put. A student cutting and pasting large chunks of other people’s writings without adding anything of their own and without acknowledgement is obviously one thing. A writer echoing a few words or cadences of speech in an entirely new creation is quite another.

Somebody recently asked me whether I had protected the translation of my Handbook in its Chinese edition with enough copyright safeguards. I have done what I have been told is sensible to do, but if by some chance some publisher somewhere, perhaps in one of the far-flung countries, such as Indonesia or Venezuela, which read my blog, decides to bring out an uncopyrighted edition of any of my books, I think that I might say, “Good luck to them”, rather than pursuing them, usually fruitlessly, with the law. At least in this way more people will read the books, and what I may lose in money (and there is little enough, if any, money to be made in publishing these days), I will gain in readers, surely the aim of all writing.

Mandarin – here I come!

The translation of my Handbook of Five Element Acupuncture into Chinese (see my blog, Meetings with remarkable people, of 16 June) is a moment of completion for me, as if my journey into five element acupuncture, started more than 25 years back, has now come full circle, very satisfyingly. All the fears I had for five element acupuncture as I closed my school some 4 years ago have, in a surprisingly different way from any that I could have imagined, proved groundless. Here now the door back to China, and with it to all those countless people who still look to China to guide them in their approach to traditional Chinese medicine, has re-opened itself to this beloved discipline of mine, and invited it back in. I feel that my work has indeed been accomplished.

But not quite yet fully! For I am invited to China once my book appears on Chinese bookshelves, and to prepare for this I feel, as a former linguist, proud of trying never to travel to a country without at least some slight knowledge of its language, that it would be discourteous of me not to learn at least the rudiments of Mandarin in order to be able to respond to what my Chinese hosts will be saying. I have always been surprised that I have delayed so long before immersing myself in the Chinese language which underpins all acupuncture in a very profound way, particularly as I am now translating Elisabeth Rochat de la Valléé’s Les 101 Notions-Clés de la Médecine Chinoise (101 Key Concepts). Perhaps it was simply a matter of never finding the time, for I tried to start several times, or because I was afraid (and still am) that my increasingly deficient hearing will not pick up the nuances of Chinese speech. But now I intend to make up for this strange omission if I can, and am about to enrol in an intensive Mandarin course. More of this anon!

Why are actresses called actors now?

In my last blog I wrote about a film actor and actress, and found myself irritated yet again by the, to me, utterly ridiculous convention which appeared some years back out of nowhere, and I hope may at some time in the future disappear as quickly again, that of calling actresses actors. Is this political correctness gone mad? We still distinguish a husband from a wife, a girl from a boy, a widow from a widower, a prince from a princess, so why not an actor from an actress? Of course some professions only have one word to describe both male and female practitioners, such as a barrister or a doctor, perhaps because women were only admitted later to these professions, whilst actresses belong to a long tradition. And nobody appears to have thought of calling a female barrister a barristress or a female doctor a doctress, although this is what other languages do. But why replace a perfectly good word which has been used for centuries? And in an obscure way, I find its removal to be demeaning rather than respectful to women, as though we all need to make an effort to remember gender equality.

Interestingly, the convention has not yet crept into everyday speech, where people still talk about the actress Judi Dench, but in the written press and on radio or television it has been banished to the archives, the latter obviously by BBC edict. And yet I was amused the other day to hear a journalist stumbling over himself, the word “actress” coming out unbidden, before being quickly corrected to “actor”.

Can anybody tell me when and why the change from actress to actor took place?

Postscript to this, added today, 7 July:  I have read the following in the Independent of 5 July:  "...two of Hollywood's best acresses, Helena Bonham Carter and Gillian Anderson,...."!

The quality of tenderness

I have just seen a lovely French film, Potiche (Trophy Wife), with Catherine Deneuve and Gerard Depardieu. Watching Depardieu set me thinking again about that elusive quality called tenderness. This is a quality which this strange giant of a man (and he has now become almost gross in size) shares with another large actor, Robbie Coltrane. A friend of mine commented upon this after seeing the film. “What an attractive man Depardieu is”, she said with surprise in her voice. And I knew exactly what she meant. The tenderness shines out of his eyes, a quality of gentle loving-kindness which draws us to him. It is the eyes, those windows of our soul, which reveal the capacity of their owner’s soul to express love, and, in the case of these two actors, their eyes show it so unreservedly and warmly. It is worth going to see Potiche just for those few moments when Depardieu looks at Deneuve with love, and also for the beautiful scene in which the two of them, both middle-aged and slightly ungainly, dance gently together. This is more erotic than many much more explicit love scenes often lacking in any tenderness whatsoever.

It is a quality we need much of as acupuncturists.

“Protecting oneself from the eternities”

I have spent the last days re-reading one of my favourite books, The Enchanted April by Elizabeth von Arnim. If you haven’t read it, and want to emerge from the last page smiling and at peace, then do. It is a beautiful, heart-warming book. (And the film they made of it, surprisingly, recreates this warmth and beauty wonderfully.)

And, as usually happens when one reads, up popped some words which echo so much that I feel expresses my wonder at the depths and awesomeness of human life.

“She pulled her wrap closer round her with a gesture of defence, of keeping out and off. She didn’t want to grow sentimental. Difficult not to, here; the marvellous night stole in through all one’s chinks, and brought in with it, whether one wanted them or not, enormous feelings, - feelings one couldn’t manage, great things about death and time and waste; glorious and devastating things, magnificent and bleak, at once rapture and terror and immense, heart-cleaving longing. She felt small and dreadfully alone. She felt uncovered and defenceless. Instinctively she pulled her wrap closer. With this thing of chiffon she tried to protect herself from the eternities.”

Perhaps we can never truly protect ourselves from the eternities, nor should we. We should be awed by them, often frightened by them, but always, always acknowledge their presence.

Meetings with remarkable people

I am fortunate to have had that part of my life, the part into which five element acupuncture burst like some spray of stardust, its second half, illuminated (not too strong a word) by two remarkable masters, both of whom, in their differing ways, moved my life onwards in a different direction, but to me, looking back now, somehow in a pre-ordained way.

The first was JR Worsley, the second now is Liu Lihong. The first led me deep into a world of the spirit which has informed my acupuncture practice ever since. The second has only just appeared over my horizon, but is just beckoning to me from that vast region of the physical world which is China, and from that vast region of the spiritual world which is Chinese thought embedded deep in its past, the thoughts of the Nei Jing, of Lao Tse and of all the long and ancient lineage of practitioners of traditional Chinese medicine.

I started my acupuncture studies because I was curious to understand the profound reactions awoken in me by my own treatment. I only encountered JR Worsley late on in my studies, but my further studies with him, his visits to my practice and my many visits with my patients to consultation days with him deepened my understanding of his profound contribution to moving acupuncture forward into the modern world and widening it to encompass the psychological insights this modern world has provided. He represents the first stage of my encounter with acupuncture.

The second stage starts after I closed my acupuncture college a few years ago, and this was followed by a gap in time before the next part of my acupuncture life began about a year ago. It was then that I met Mei Long, a young Chinese acupuncturist practising in Holland, and my acupuncture path moved forwards in a different direction, this time towards China (see my blogs of 1st June, 2nd August and 8th Nov 2010). Mei has now completed her translation of my Handbook of Five Element Practice into Chinese, and it is now in proof form (it looks beautiful), awaiting an introduction to be written by Liu Lihong.

And here we come to my second important encounter, that with Liu Lihong, which took place at the Rothenburg Conference a few weeks ago. Having written a seminal book, Reflections on Traditional Chinese Medicine, which Mei tells me is a bestseller in China, he is determined to bring back to traditional Chinese medicine the spirit which has drained from it, and sees five element acupuncture as representing that spirit in the field of acupuncture (he is a traditional herbalist). He is encouraging me to come to China once my book is published over there, which should be in the next few months. So as one door closed upon my life as a teacher in this country, the next, beckoning me to continue my teaching in China, now opens for me. My acupuncture life has indeed been fortunate to have been blessed by two such important encounters with remarkable men.

Finally, lest anybody should think that it is only men who have taught me the great lessons of life, these encounters were preceded by one which brought to an end the first half of my life, for this part of my life was illuminated by the insights of a very great woman, Anna Freud, Freud’s daughter. She died just before I encountered acupuncture, and she would have been delighted to know the direction my life took not long after her death, for she was always encouraging me “to do something big”. I think I now dare say, a little hesitantly and I hope with due humility, that I have now done what she would have liked me to do. I am sure that without her encouragement I would never have dared do what I have done or write what I have written, including this present blog! Nor would I have been ready to accept the challenges my life has offered, and might instead have been tempted to turn my back upon them as I would have done in earlier days.

I give thanks for having been granted the rare grace of encountering three such remarkable people, each of whom in some way changed or is changing the direction of my life.

A lesson in humility

Without our being aware of it, we tend to overlook the shadows our own element cast over the patients we are treating, and which therefore inevitably to some extent distort the signals our patients’ elements are sending us. We all have one (or more) weak spots in recognizing specific elements, and if we are to be good practitioners we must learn to accept this and take this into account in any diagnosis we make. Mine is definitely distinguishing between Fire and Earth, something I find I have in common with many other practitioners. I see that this comes from the fact that both elements, in their differing ways, need people, and therefore respond to people with some eagerness.

In my case, I have come to see that one of the reasons for this may lie in the interaction between my own Fire element and Earth people and other Fire people, and the way in which my own Fire responds when confronting the needs of these two elements. My Fire need is to relate closely to each of my patients, and I will be tempted to interpret the warmth with which both Fire and Earth will respond to my warmth as though filtered through what I call my pink Fire spectacles. But Earth’s and Fire’s responses differ, as we know. Earth responds more because it is glad to be offered understanding, Fire more because it is happy to bestow warmth upon the practitioner. Both interactions will make my own Fire element happy, but for different reasons. With Earth I am pleased to see that my offerings are being so warmly accepted (we could say, taken in and swallowed), and I will bask in the warmth my Fire patients offer me.

The direction of movement is quite different in the two cases. Earth’s is to move back and take in, while Fire’s is to move forward and give.

I have been thinking a lot about this ever since a fellow practitioner said to me recently, “You know that famous film actress with the large smile? I see her as so typically Earth, with that mouth which you, Nora, have often called an Earth mouth, open like a baby bird crying out for food.” She was talking about Julia Roberts. I was taken aback because Julia Roberts is somebody I rather blithely included in my list of what I considered to be Fire people. Was it possible that my fellow practitioner was right, and was that, perhaps, the reason why Julia Roberts doesn’t actually make me feel warm inside, despite the great smile? So off I went to look at her on You-Tube, and indeed, when I looked more closely and more carefully, what I saw was somebody who demanded something of me, rather than somebody who gave me something.

This reinforces one of my mantras. Never allow yourself to be lulled into thinking you are absolutely certain about a person’s guardian element, but always keep open the possibility that you may be misinterpreting the signals coming from their elements. And always, always, remain humble and ready to learn. The uniqueness of each person is not easily encapsulated within the all-encompassing meanings contained in. one of five words, Wood, Fire…..

All the little relationships the Small Intestine is asked to enter into

A conference like the one I went to at Rothenburg in Germany last week, with its 1000 participants, makes special demands upon my Small Intestine. The little mediaeval town is overrun with acupuncturists, making it extremely likely that the person you pass in the street will be a fellow acupuncturist. This presents a particular challenge for anybody who is Inner Fire, like me, for every contact with another person, however fleeting, offers the potential for a tiny relationship to be formed. Each person I passed in the Rothenburg streets therefore placed a slight strain on my Small Intestine as it asked itself how wide it wanted to open the doors to my Heart, or whether it was wiser simply to look away and not engage.

These constant challenges to my Small Intestine meant that it could never really relax, for if it does so it would feel that it is abdicating its responsibility to protect the Heart. Luckily, the meetings with good friends of mine who were also there helped to lighten the load. When I was with them, all was well, my Heart beamed with joy and my Small Intestine could at last relax. But never entirely, however, for it is such a necessarily restless aspect of Fire, and always has to be on the go, sifting and sorting, sifting and sorting.

In an idle moment I sometimes wish I were another element! And if I had a choice as to which one, I think it would have to be Metal, so quiet and self-contained, so able to cut itself off from people without a second thought. It would have no such problems as I have in deciding who to smile at and who to ignore. But then I know that it, too, will of course have its own different, but less people-centred stresses.