I learnt something new about my relationship to the Metal
element this week as a result of treating one of my Metal patients. At one point during the treatment I found
that I was talking too much, and noticed that my patient only seemed to talk
after prompting from me. The two-way
communication I was engaged in appeared to be heavily weighted towards one side,
where I was doing the talking, whilst the other side, my patient, was mostly
doing the listening.
This set me wondering afterwards how far this was in general
true of my interaction with Metal, and I decided that it was. I then looked at my interactions with all Metal
people, and found that as a general rule it is as though Metal
needs to wait to hear what I have to say before entering the conversation. I interpret this as a sign that Metal wants to assess the
quality of what I am saying before deciding whether and how to take part in a dialogue with me.
I have now gone on to look at where my interaction with Metal might differ from those with patients of the other elements. The most obvious difference here is in the case of
Fire, because, unlike Metal, it is generally unhappy with the kind of silence Metal feels at home in. A Fire
patient is likely to be the one to start talking even as they come into the practice
room, although, being a Fire practitioner myself, the chances are that they
will have to be very quick of tongue to outpace my own need to speak to
them!
Earth, too, is one of the elements most consistently engaged
in speech, a sign of its need to make the listener understand what is going on
for them. Conversations with Earth
patients may sometime be more in the nature of a monologue than a dialogue,
unless the practitioner steers the talk carefully. Wood may also need no prompting to talk if it
has something it needs to say, and wants to make sure the practitioner is listening to what they are being told. Again, here, speech can descend into a
monologue if the practitioner loses control.
Finally, my verbal interactions with Water patients always
seem to have a very distinctive character of their own, which makes of them not
so much a dialogue where one person talks, then listens whilst the other person
talks, but a conversation where both talk at the same time in a kind of
concerted murmur. It is as though the
sound of the words, rather than the meaning of the words, is more important,
offering the kind of reassurance that Water is not alone which it craves in
order to still its fear.
Of course, all these observations are based on the fact that
my reaction to everybody I come into contact with will be strongly coloured
by my Fire element. In trying to look at their experiences with
patients, each practitioner must therefore take into account how far their own
guardian element shapes the way they interact with their patients and their
patients interact with them.
I am now determined to watch myself more closely to see whether my
own talking in the practice room is an appropriate response to the needs of my
patient rather than an inappropriate response to my own needs.
Please note here that I do not say “how to deal with a difficult
patient”. It is not that patients are
simply difficult in themselves, but that we as people find them difficult to
deal with. For practitioners, that is a
crucial difference. As Shakespeare might
have said, “the fault lies not in our stars (or in this case our patients) but
in ourselves…”
So here goes about this particular difficult situation. The patient was one who came for treatment as
part of a clinical day I spent helping another practitioner with his patients. She is a woman of 35 and moves around in a
wheelchair. Her medical notes show that
she was diagnosed as autistic and with attention deficit problems as a
child. She has a long list of other
medical conditions, the main being a spinal accident which left her confined to
bed for a year when she was 8 and meningitis when she was 10.
What interested me was noting that she appeared to be quite
capable of moving without help from the wheelchair to the treatment couch, nor
did she have any difficulty in turning over on the couch. Her legs, too, did not have the look of ones
where the muscles have atrophied from little use. She was wearing very heavy short boots, much
like men’s army boots, which looked incongruous on a wheelchair-bound person by
reason of their sheer weight alone. She
brought with her a little doll, the kind a five-year old child might have,
which she insisted on tucking next to her on the couch. I also noticed other disconcertingly
odd things which made me question how far she was actually incapacitated.
Having expected from the notes that contact with her might
be difficult because of her autism, I was surprised to see how easily she
seemed to relate to us, and in particular noticed that she was darting hidden
glances at me when she thought I wasn’t watching.
The practitioner is also her medical practitioner, and had started
his five element treatment by relying only on her medical diagnosis rather than on a
much more extensive five element diagnosis which would not have concentrated so
exclusively on her physical conditions.
The distinction between his role as her physician and as her acupuncturist
had become understandably blurred. Initally, I, too,
made the mistake of going along with this.
The practitioner and I therefore assumed all sorts of things
about her condition, basing ourselves on very little information about her
current medical condition. Did she in
fact need a wheelchair at all, and could she be described as still being
“autistic”?
As is obvious to any five element acupuncturist from what I
have written, we decided to treat her with Internal Dragons. We followed this with an Aggressive Energy
drain and the source points of her element which I thought was Fire. I had a question mark around Inner Fire
(Small Intestine), something to do with the quickness of her understanding (even
though she didn’t like to show that she did understand) and the sharpness of
her glance!
I felt surprisingly angry at the end of the treatment, as
though she had got under my skin and had outmanoeuvred us. And I went so far as to tell the practitioner
that I wasn’t sure there was any point in continuing treating her with
acupuncture because she appeared to be manipulating the situation in a way that
made treatment impossible.
It was my anger which brought me to my senses, and I told
the practitioner later that I did not think I had dealt properly with the
situation. I had failed to take the
right steps to get her treatment back in the correct five element groove. We should have done a proper Traditional
Diagnosis after the treatment in whatever time we had available, to be
continued at the next treatment. She
should be asked to demonstrate how far she can stand and walk by herself, and
the practitioner should get some answers to more detailed questions about her
life. We were not even clear about her
living situation. Does she live alone or
with her family? Does she have friends? What does she do with her time?
But all is not lost.
I have suggested to the practitioner that he should now start as though from
scratch, trying to forget the wheelchair and the label of autism. Nor must he
allow himself to be manipulated back into the old relationship where she
appeared to be dictating how she wanted him to treat her. My mistake was to allow her to do the same to
me.
This is the only way in which we can help this patient. And we should try to do that, rather than walk
away. She is really crying out for help,
and has probably been crying out for this help all her life in the only way she
knows how.
It may be helpful to read this blog in conjunction with my
blogs of 13 September 2011 “Losing control in the practice room” and of 9
October 2011 “Regaining control in the practice room”, which complement this blog and deal with other
problems in the practice room.
And so my learning continues!
It’s funny how often I come across some quotation which seems
particularly relevant. A few days ago, I
read the following in, of all things, a detective story: “Things always have to even themselves out between plus
and minus. Between going forward and
going back. That’s the only way to
live.”
I like the to think that life has to balance itself between
pluses and minuses (acupuncturists would say, between yin and yang). We tend to hope, unrealistically, that
somehow the life we live should always be lived on the plus side. Far better to accept that every plus needs
its minus, for this brings the necessary
tension which moves us towards change. Time always hustles us along
despite ourselves, jolting us out of complacency, as a minus does its
companion plus and plus its minus, and as yin does its yang and yang its yin.
Interesting to find such a potentially deep thought tucked
away between the covers of a simple detective story.
My flight to China
on November 9th has now been booked.
Mei and I will be over there for 3 weeks and return on December 2nd. We will spend the first two weeks at the Tong
You San He Centre of Chinese Medicine in Nanning,
where I will be concentrating on helping my dedicated group of five element
practitioners. We will also be
expanding this group to include some of the many other practitioners clamouring
to learn.
We then fly to Chengdu for
the final days, where I will be giving another seminar at a conference similar
to the one I attended last November in Beijing. The title of my talk this year will be “The
Significance of Five Element Acupuncture for life in the 21st century”.
I now have to think carefully about what I see as the stresses
of modern life which are common to all of us, and whether these are the same
for people living in the East as they are for us in the West. Some interesting thoughts here for me to
explore.
If you walk from Gower Street to the back of the British
Museum, at the corner where Keppel Street meets Malet Street you will find the
most delightful sound installation called ‘Phantom Railings : an interactive
sound sculpture’. The old iron railings
along a high wall surrounding the gardens at the back of Gower Street were
removed during the Second World War to be used for the war effort, as all
railings were, and for some reason have not been replaced. You can still see the metal stumps left
behind. As I walked
past, my walk was interrupted by loud plinking and plonking noises. I stopped and looked around to see where they
were coming from, only for the noises to stop, too. When I started walking again, the noises started
up again, and I realised they were being controlled by the pace of my steps. By this time I had reached the large gates to
the garden, which displayed a notice explaining that this was an installation “to
evoke the phantom of a lost iron fence”.
The footsteps of passers-by recreate the sound of somebody running a
stick along metal railings.
Delighted with this unexpected source of art displayed so
discreetly in quite a hidden corner of Malet Street, I walked up and down
several times, changing the speed of my steps and creating my own tiny symphony
of sound.
And to round off my morning, I settled down to an Espresso
at a little café round the corner, only to be charged £1.00 for it, the
cheapest in London yet right in the centre of town. And it was served with a smile and piping
hot, just as I like it!
What pleasures
we come across in such unexpected places!
