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.