In praise of libraries

Libraries are some of my favourite places, and now all the more precious to me for being under such dire threat from government cuts. I have always been a stalwart member of my local library, careful to order as many books as I could through it as my contribution towards helping persuade the local council to keep it open. This year, though, I indulged myself and gave myself the luxury of a Christmas present by joining the London Library, a private library in the heart of London with a 150-year old tradition on its shelves.

The two libraries, my local library and the London Library, are two very different places, and offer two very different but complementary experiences. In my local library I can be sure to find all the recent bestsellers, the detective stories which I love, and all the standard repertoire of books to be found in any Waterstones. They will also order a surprisingly wide variety of books which they do not have in stock, either summoning them from other libraries, or, quite often, buying them for me, something that I still find amazing in these cash-strapped days, all for some tiny contribution in pence from me.

The selection of books in the London Library, on the other hand. reflects its long history. Its dimly lit shelves are laden with weighty volume after weighty volume, conveying an aura of great scholarship for research-minded people, amongst which, unfortunately, I cannot count myself, but I love the smell of old books, whether I open them or not, cherishing the feeling that within them lies hidden so much that creates what we call our culture. Yesterday I found my way to a book of Mozart’s letters, then moved on to browse amongst French novels, before settling down to look at their French dictionaries to help me with my translation of Elisabeth Rochat de la Vallée’s work.

Long may all libraries flourish, from the smallest in some village hall to their most exalted representative in the British Library. And we should all fight to keep our local libraries open, for when they close a little bit of civilization dies with each book that disappears with them.

Why it helps to know about the elements

Knowing something about the elements can help explain our own behaviour, the behaviour of other people and in particular our behaviour in relation to other people. We do not exist in isolation. Everything we do impinges on those around us, as they impinge upon us. The well-worn cliché about raising a finger here on earth and thereby altering the movement of the most distant star is just as valid in the purely human sphere of our relationships to one another. Nothing I do can leave another close to me untouched, just as they in turn cannot fail to influence me. Often these influences may be too subtle for us to notice, but they are nonetheless there. Sometimes, of course, they are so obviously powerful that some encounters knock us off-balance. We may like to think that we live our lives cocooned in a bubble of self-sufficiency, but we all have growing out from us soft antennae, like tendrils, which touch those passing by us, and these touches shift something in us and change our shape in small or large ways. 

If we are to smooth the path to better understanding and greater tolerance, we must not forget how different we are from one another, despite all our many similarities, and, I would say, that we are necessarily different, for this creates the amazing variety of human thought and behaviour. It is surprisingly difficult to understand how others view the world. And to those who differ from us we often react with irritation or perhaps even downright dislike, since our inability to understand their way of thinking makes us judge them harshly. We tend to criticize what is unfamiliar to us, and herein lies the root of so many of our prejudices. If, then, our understanding of the elements helps us to see where these differences are coming from, then we are well on the way to engaging in more harmonious interactions with those around us. And, however basic may initially be our understanding of the elements, even the tiniest bit of knowledge will contribute to greater tolerance, a quality sadly much lacking in the world around us, and therefore all the more to be cherished.

Showing different sides of ourselves to different people

On the whole, in our relationships with the people we choose as friends we tend to show only one side of ourselves, the one which fits comfortably with the other person. It is likely that we will have discarded early on any too uncomfortable fits, unless we enjoy punishing ourselves or unless, as I as a young girl found I did, I felt it was somehow my fault that I didn’t get on with somebody and persisted in maintaining the friendship long after it stopped adding something to my life. Things are much more difficult with family relationships, because on the whole they are there for a lifetime;  we therefore have to learn ways of avoiding those areas we find uncomfortable, and we do this more or less successfully.

With patients we enter quite a different level of relationship. We do not choose them as we do our friends. They ask to see us, and we agree to treat them unless there is any professional reason why we should not accept them as patients. We are expected to enter into a patient/practitioner relationship with them whatever our personal likes or dislikes, for our personal preferences should not play a part here. Whether a patient votes the same way as we do or has religious beliefs that we do not should not be a reason for our not treating them. There is also something reassuring in the fact that, unlike in the case of our family and friends, we do not need to extend our concern for our patients into that part of our life which lies beyond the practice room. It is one of the signs of a maturing approach to our practice that we learn not to let it overshadow the rest of our lives as often happens in the early days of our practice, when we may become too preoccupied with analysing every tiniest part of our interaction with our patients.

I have often quoted the words of Sogyal Rinpoche, “Do not get attached to your giving”, but I am happy to repeat them here for they have in many ways helped me maintain the necessary professional detachment without which we may allow our own feelings to cloud our perceptions, and in this way fail our patients.

Accurate feedback from a Wood patient

It would help us in corroborating some of the principles according to which we work if patients were able to report precise effects when feeding back on the outcome of any particular treatment, but it is rare for patients’ assessment of improvement (or otherwise) to be so precise as to enable us to relate this to any particular treatment rather than to a combination of treatments. To encourage us, however, it does, occasionally happen that a patient may say something like, “whatever you did last time made me feel marvellous (made my backache better, helped me cope better)”.

On rare occasions, feedback can be even more specific. I treasure still, like some beacon in this particular wilderness, the memory of a Wood patient who, when I needled Gall Bladder 40, described immediately in perfect detail what has been handed down to me as the Gall Bladder’s meridian pathway. He traced the movement of energy down to the toe and back up along the outer leg, where with great accuracy he showed me the odd lateral dip the Gall Bladder is said to take at mid-calf, and then continued to draw a path up over his knee to his abdomen, finally arriving at his head, where he said, “I seem to feel something up here at the side of my eye.” I have had other Wood patients describe the line of some movement of energy along a Gall Bladder pathway in this way, but none so precisely as this. It may well be that Wood, the element which structures us, can feel the structure of its own shape reasserting itself as more energy, like sap in a plant, courses through its pathways. I have not had such detailed descriptions of the passage of energy from patients of other elements.

Comment made by a patient about my Blog of Jan 7th about the challenges facing the Fire element

I was heartened by a comment made by one of my patients, a Fire patient, who came for treatment the day after I published this blog. She follows my blog with interest, something I find surprisingly comforting because it confirms for me that what I write must be based on a valid understanding of human nature, certainly valid enough for her to recognise herself in what I write. She told me that what I had written about the Fire element’s impulse to offer gifts wherever it can had sparked an echo in her, and made her understand her own motivations better. In receiving such direct confirmation of an aspect of the Fire element which I had noticed, I accepted this as a kind of reward for some of the hard work I have to do in trying to unearth again and again small kernels of truth about the elements and then find a way of writing about them. Thank you, Susan, for offering me this encouragement.

Further insights into point selection

Prompted by a comment about point selection on my treatment blog (Treatment 15), I have been thinking more about the principles upon which I base my point selection. Writing about Bl 38 (43) made me remember JR Worsley’s explanation for why he chose it for a patient. This led me on to thinking about how very rare it was, in all my years of observing him with patients, to hear him explain in any depth why he chose a particular point for a patient, or more frequently a particular series of points. We were certainly discouraged from interrupting treatment with such questions, and we just got on with marking up the points he told us to use. Occasionally I would hear a gem fall from his lips, but often in little asides, as if I was only meant to hear it if I was really attentive. One such occasion was with a patient who was incontinent, when he lightly touched his lower abdomen and muttered, “We’d better do something down here for you”, suggesting CV (RM) 2 to me.

I came to see that what we sometimes thought of as his obstinancy in not divulging more about his reasons for choosing certain points was instead a very profound form of teaching between master and pupil. I remember him once saying, “If she has to ask that question, she won’t understand the answer”. Now I understand much more clearly that I was being told that it was up to me to work out the answers, and that only when I had worked things out for myself would my real learning begin.

I have always been very suspicious of books which give lists of the actions of one point after another. I have often said (see my Nov 16 blog “Think element, not points”) that the secret of good treatment lies in understanding the elements, rather than pickn’mixing points, as though we are making a selection at the sweet counter. We always have to maintain the connection of a point with the element which feeds it. When we concentrate on trying to understand the elements at an ever deeper level, this thankfully brings with it quite naturally a deeper understanding of which points to use when.

I repeat, “Think element, not points”, and I would add to this now “and then the points will look after themselves.”

Fears patients may have

If we are honest, we must acknowledge that we all feel some slight apprehension at meeting a person for the first time, particularly when we are about to embark on some form of therapy, where the therapist takes on the role of the person who knows, and we may feel we take on a somewhat subservient role, of the person to whom something will be done, about which we at first know very little. In the case of acupuncture, there is the additional fear of the needle itself, instilled within all of us from our earliest days of sitting on our mother’s knee and submitting to the pain of vaccinations through a similar instrument. However much we may try to hide or override this fear as adults, it is always to some extent there, however faintly. In some, the fear of the needle may be so strong that it stops them from entering our practice room in the first place. All these fears, faint or strong, may set up a barrier to our first contacts with our patient which we need to take into account.

As patients, we also have to deal with our natural fear of exposing ourselves to another person, as our practitioner tries to get to know us. The words “tries to” are here significant, because, either deliberately or involuntarily, we may resist revealing too much of ourselves in the early stages of treatment if we are uneasy about the kind of relationship with our practitioner this will expose us to. We may not actually tell lies, although that, too must not be ruled out, but we may, as the expression goes, be economical with the truth, saying just enough not actually to tell an untruth, but not enough to tell the truth about ourselves. This means that we will inevitably paint only a partial picture of what is going on within us, which can easily be misinterpreted by our practitioner. It takes a surprisingly long time for a patient to feel safe and confident enough in their practitioner’s compassion and discretion to open themselves up with honesty. In fact, I believe that each of us will always retain a part of ourselves which we reveal to nobody but ourselves, not even, or perhaps particularly not, to our nearest and dearest, for many different reasons, amongst them the need to retain our own sense of self-respect. As practitioners, we must always allow our patients the right to keep this private area within themselves hidden to the outside world rather than expecting them to open themselves up to us in total honesty, but we must not lose sight of the fact that it may be there.

This is where our perception of the elements guides us towards what is really going on within a patient, for the elements, unlike words, do not lie; they just learn to hide themselves a little to too intrusive an eye. This is also why we should never rely on words spoken to tell us the truth, but use sensory and emotional signatures clearly to spell out this truth in their own particular way. It is easy for our lips to lie in the words they utter, but not in the way they shape themselves as they are uttering this lie, or the way our eyes can reveal something at odds with the tone of our speech.

Daily challenges to our Fire element

We may not ourselves be aware of how far each minute of our life lived amongst other people will be occupied with relationships of one kind of another.  I will use an example taken from the brief duration of a typical day’s journey into work to illustrate this. We may be surprised to find how many tiny threads of relationship we knit together on this journey, from the moment we open our front door and turn to wave goodbye to our family, to an encounter with a neighbour, the interaction with a newsvendor and a ticket collector, the avoidance or acknowledgement of eye-contact with all those packed tight with us in the underground or bus, and finally the arrival at work with the greeting of our colleagues. All these involve numerous small or large skeins of new and old relationships being sorted into their different threads. This covers just a few short hours in a 24-hour period at most, and an infinitesmally small part of all the hours of one year in our life, let alone all the hours of all the years in our life.

In each of these encounters with another person, the Fire element’s need to establish a relationship wherever it finds itself with other people will be taxed to the full. Just detailing all this activity is quite tiring, but not nearly as tiring as Fire may feel if, during these few hours between home and office, something occurs which puts excessive strain on this element, such as an argument before leaving home, an unpleasant encounter on the bus or the dread of a meeting with a feared colleague. The constant level of hard work needed to help the Fire element in its task of adjusting to all the demands others make upon us places a particular strain upon Fire people, for of all the elements they are the ones which most ardently (oh, such a Fire word!) desire to make these relationships work. That is, after all, what they regard as the main purpose of their existence.

What, then, are the main ways in which we can help Fire in its relationships? To a Fire person the answer appears so simple; it is by allowing them to make us happy, in other words, allowing them in some way to give us something. Fire wants the recipient of its gifts to be happy to receive them, even when we may not ourselves have asked for them. Fire may not consider how appropriate its gifts are, in fact will only do so in states of great balance, for it may be so intent on the gesture of giving that it does not have time to gauge how its recipient is reacting. Nor is it gratitude that Fire is asking for. Instead it seeks the smile and warmth of eye in another person, and, if denied this, will experience this as a slap in the face, a rejection, something which can scar its heart.

A lesson in dealing with a Wood patient

One of my Wood patients told me, rather aggressively, that they found my presence challenging, and, being also an acupuncturist, they attributed this to my being, they thought erroneously, of the Wood element. Although I have learnt over the years never to show that I am taken aback by personal comments from patients, I found that I reacted inside myself with quite a vehement desire to answer back sharply, and had to hold myself back from doing so. Afterwards I found that the episode had disturbed my inner equilibrium, and I tried to work out why this was.

By dint of some careful self-examination, I realised that this patient had projected on to me her own dislike of being challenged and had in effect made me angry, often the effect Wood can have when out of balance. I then analysed my feelings to see what they told me about anger in myself and how far my reaction had been unbalanced, before finally using what I learned from this as a way of understanding not only the Wood element better, but other elements within me, such as Water (my fear of the anger) and Fire (my own element’s reaction to stress). An interaction of just a few minutes therefore became, through this, a valuable lesson about the part of me which reacted to the Wood element, as well as about Wood and other elements in general.