Some thoughts on seasonal treatments

A fellow five-element acupuncturist who lives in Malawi, Sophie Barrowcliff, has asked me about seasonal treatments, and this has made me think about the often tricky question of when exactly we should be giving them.  I quote here from her email:

 

“The seasons here are not just the opposite way round to the northern hemisphere, and I wanted to have your opinion on a question that has long bothered me.

We typically have a hot season, wet season, and dry  season.   The start of the rains, when everything bursts into life, is clearly spring. The hot rainy months are summer   And the end of the rains, the golden harvest time of autumn.  This is followed by our cold season (May-July), with cold winds streaming from the south and the lowest temperatures of the yearly cycle; it feels wintery. And yet it is only the start of autumn, the retreat back into the earth, with the leaves only coming off the trees in a month or two.

Sometime in August/September the winds change, it rapidly warms up, it gets progressively drier and everything feels dead and the land is parched: this is the dead inertia of winter. This is the conundrum for me - how winter here is actually hot!   So as I treat patients, I constantly vacillate as to which the best seasonal treatment is.”

I was taught about the elements and their relationships to the individual seasons in this country, Great Britain, which is in a temperate zone where each element can be allocated to a distinct season.  I have therefore never had to deal with the complications presented by the tropical weather which Sophie describes.  Her questions have set me thinking.

 

The purpose of giving horary and seasonal treatments is to help a patient’s energy attune itself better to the environmental energies around in terms of the time of day, for horary treatments, and of the relevant season, in terms of seasonal treatments.

It is easy to see that it is likely that a Metal person will benefit from having his/her Metal energy boosted during the hours of the day when Metal is at its strongest according to the 24-hour Chinese clock, which will be at that time according to whatever time-zone we are in anywhere on the planet.  The problem is how to adapt seasonal treatments to places where the seasonal differentiations are not clear-cut.  The question for Sophie is when exactly is she to decide when autumn is for her Metal patients.

 

I think it would be sensible for her to assess each seasonal treatment on its own merits, adapting to what may well be fluctuating temperatures and weather conditions.  For example, if she is treating a Water patient, it might be good to give Water its winter seasonal treatment during the “dead inertia of winter”, but not if it is hot outside.  If she feels that there is still autumn in the air, but the leaves haven’t yet dropped from the trees, she might be best to wait a little until giving her Metal patients their autumn treatment.

 

I also like to ask patients which season they feel they are in, and adjust my seasonal treatments to fit in with what they tell me. I do this because I realised very early on that each of us can have a very different idea as to which the current season is after discovering that more than half of the students in one of my classes thought we had definitely moved into summer, whilst the remainder were equally sure that we were still in spring.  Patients, too, may well have a different take on the season from us as practitioners, and we should therefore learn to adjust our treatment to correspond to a particular patient’s assessment of the season.  For example, it doesn’t seem right to give a patient a Wood seasonal treatment if he/she feels that we are still in the depths of winter.  In other words, a practitioner needs flexibility in deciding which seasonal treatment to give which patients when.   

 

And then there is still, to me, the unresolved question as to whether we should give everybody a seasonal treatment in each season irrespective of their element.  I know that some practitioners do this, but I do not.  This is because I remember giving a Fire patient a winter seasonal treatment (the Water points of the Bladder and Kidney), and for her to be one of the very few patients who told me that she had not felt well after treatment.  This made me decide not to experiment any further with seasonal treatments off a patient’s element.  I am a practitioner who rarely moves away from a patient’s element, so that giving seasonal treatments on other elements does not sit easily with me.  On the other hand, many of my fellow five element practitioners may be quite happy doing this.

I hope what I have written here helps you, Sophie.

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Passing people by on the street in lockdown London

I don’t know why I am still so surprised at the different reactions I am getting to my approaches to those I encounter on my daily walk around the streets.  Surely, I ask myself, I should know by now that my smiles, accompanied often by a few words, will not always be welcomed.  Indeed they can often be rebuffed, which happens surprisingly often, even in these difficult days when I suppose I assume that we would all welcome friendly approaches from our fellow quarantined human beings.  I am also taken aback at how hurt I feel when I encounter blank stares as I try to engage people I pass in some kind of interaction.  They must all be aware of me, as they correctly swerve 2 metres away from me, and yet they often make not a flicker of eye contact, let alone respond to my words of thanks as I see them moving aside to let me pass.

Of course there are many exceptions, people who are happy to smile in response, even sometimes to stop and talk, and these brief encounters lighten my day and warm my heart.  As a Fire person, I suppose by now I should be aware of how much this heart of mine needs the warmth of its interactions with other people to keep it going.  But I often seem to forget this simple fact, which should act as a reminder to me that, however, much we think we know each element’s needs, particularly our own, we can never fully satisfy them.  At some level we never easily leave that one small circle which our element forms in the larger five-element circle of life.  We remain as though conditioned by who we are despite all our attempts, particularly as five element acupuncturists, to think ourselves into the circles of the other elements.  It becomes a weakness in us if we ignore this, and forget how much our element colours all we do. 

Perhaps, then, it would be a good lesson for me on my walk outside today to try simply to “walk on by”, rather than feel that I should interact in some way with each person I pass.  And I could also learn to use my experiences out in the streets as a useful way of trying to diagnose the different elements of those I meet through their reactions to my approaches.

 

Fighting Fire with Fire

During my acupuncture training I remember hearing the words “fighting Fire with Fire”, and the phrase has always stuck with me.  I am now not sure what the context was, except that it had something to do with not being frightened of using moxa on patients who complain of sweating, where we might hesitate to place further stress on the Fire element by adding moxa cones to our needling.  Later on in my practice, I used what I remembered from this to see if I could  help patients who were suffering hot flushes as part of their menopausal symptoms, and found that this contributed significantly to reducing them if I added one of the most wondrous points of all, III (Bl) 38 (43).

I was reminded of this when a fellow acupuncturist got in touch with me recently, asking for my advice about how he could help his wife who was suffering from very debilitating hot flushes, which persisted almost continuously throughout the day and left her feeling exhausted.   Using the experience from my own practice, I suggested he should add III 38 to the treatment he was giving her (her element is Metal), and asked him to let me know afterwards whether this had helped. 

He phoned me the next day to say that the effect had been miraculous.  His wife's hot flushes had stopped completely immediately after needling III 38 (with 7 moxa cones) ,and he noticed that her skin looked and felt quite different.  Where previously it had been hot and clammy, and had a rather sickly colour, it felt much cooler to the touch and had regained a healthier colour, and she no longer felt cold and shivery as she had done.  I interpreted this as evidence that this point, well warmed by moxibustion, had enabled her body to take control of the fire raging inside her as the hot flushes took hold.  He completed the treatment by needling the source points of Metal.  Two days later his wife had had no further hot flushes.

Thinking through why this point should have such an effect on reducing hot flushes, I have come to the conclusion that this must be because it has a close relationship to the Fire element.  We know that each point is related to the other points lying on the same meridian, as well as to points on other meridians which have a close anatomical relationship to it.  For example, III (Bl) 37 (42), on the Outer Bladder line, lies at the same horizontal plane as the AEP (back shu point) of the Lung, Bl 13, on the Inner Bladder line, and can therefore be seen as having a particular relationship to the Metal element.   Similarly, III 38 on the Outer Bladder line, lies at the same level as the AEP of the Heart Protector (Pericardium), III (Bl) 14, on the Inner Bladder line, and therefore can be seen to relate closely to the Fire element.  At a physical level, the two Outer Fire officials, the Heart Protector and the Three Heater, are in control of the blood and the body’s temperature mechanism, both of which the appearance of hot flushes show to be under extreme stress.  Needling III 38, beautifully warmed up by adding 7 moxa cones beforehand, is therefore a way of helping bring balance back to Outer Fire.  If further treatment is needed, more moxa cones can be added.

Bl 38 is one of the few points, apart from command points, which we can use several times in succession, and to my mind is probably one of the points which form the bedrock of five element practice.  One of its qualities is that it can increase its effect simply by increasing the number of moxa cones by a factor of 7 at subsequent treatments, up to a total of 50 cones (or more symbolically, I like to think, 49 (7 x 7) cones). It has an amazing effect on patients undergoing chemo- or radiotherapy, or for those with anaemia, where it can be used at successive treatments, often only a few days apart, to help the Fire element regain control of the blood. 

A Samuel Pepys quote for today

Plus ça change, plus c’est la même chose
(The more things change, the more they stay the same)

Every day a page of Samuel Pepys’ diary appears in my email inbox, to be read with delight at how acutely he observes human behaviour, and how his writings of 400 years ago continue to resonate so strongly now.  I have just followed him day by day through the months of the Great Plague and the Great Fire of London, so what he writes about how people are profiting from these disasters will be echoed by what I fear will soon be happening over here now, or maybe is already happening, as we deal with the repercussions of this terrible Covid19 virus.

From Samuel Pepys’ diary:  Sunday 5 May 1667

“Among other things (I) tell him what I hear of people being forced to sell their bills before September for 35 and 40 per cent. loss, and what is worst, that there are some courtiers that have made a knot to buy them, in hopes of some ways to get money of the King to pay them, which Sir W. Coventry is amazed at, and says we are a people made up for destruction, and will do what he can to prevent all this by getting the King to provide wherewith to pay them.”

Substitute “the Government” for the King, and you have all the people now licking their lips at the thought of buying up the thousands of failed businesses and the thousands of rented homes of those left penniless by this disaster .  After all, didn’t many of often the richest people, particularly the banks, get even richer on the ruins of the 2008 financial collapse?

Let us hope that the Government (“the King”!) will “provide wherewith to pay” all those who will be left destitute in the months and years to come.

 

 

 

None of us can escape our past

During these terrible days as COVID19 locks down the world, I have been thinking a lot about what may cause some of those in power to react in the often disturbing ways they do when faced with dealing with the pandemic decimating their countries.  These thoughts have been triggered by a comment I read today by Philippe Sands in the Guardian newspaper who was discussing his latest book, The Ratline: Love, Lies and Justice on the Trail of a Nazi Fugitive.  He writes that he was at the International Court of Justice listening to Aung San Suu Kyi trying to justify the Myanmar military’s actions against the Rohingya community, and asks, “How could she not see the facts as others did?” Answering himself, he wonders whether the reason may lie in her relationship to her father, the previous ruler.  He then transfers this thought to the son of the man who was in charge of the extermination of the Jews in Poland during the war, including members of his own family, and wonders whether this son has learnt to accept his father’s appalling actions as “a way of being able to live, a means of survival”.

This made me think of Donald Trump, as I tried to apply this understanding to his inability to empathize in any way with another human being.  I then tried to relate my thoughts to my knowledge of the five elements.  I have always believed that Aung San Suu Kyi is of the Metal element, and can see that her need to maintain her father’s legacy, possibly added to the effects of years of enforced isolation, may indeed be her “way of being able to live, a means of survival” that somebody not subject to Metal’s yearning for an absent father may be unable to understand.

Donald Trump, on the other hand, is, I think, of the Wood element, at the opposite point of the five element circle.  Do his words and actions show a Wood element which is pathologically out of balance?  We know that Wood is the child among the five elements, and it is significant that a speech expert described Trump’s way of talking as “oddly adolescent”.  There is definitely something frighteningly childish about him.  Perhaps this can be traced back to a childhood in which his mother apparently played little part, his brother saying that the children rarely saw their mother.  Since we know the emotion associated with the Wood element is anger, it is not surprising, therefore, that this is the emotional atmosphere in which Trump feels most at home, quite happily stoking up anger in all who surround him, like a child indulging in tantrums.  It is terrifying that somebody with more power than anybody else in the world should be the least able to exercise any self-control. 

But perhaps, like the other two examples I mentioned, Aung San Suu Kyi and the son of the prominent Nazi, this is his “only way of being able to live, a means of survival”.  And perhaps this applies to us, too, for how each of us lives our life can indeed be said to be our only way of being alive, and a means of survival, though we hope with less extreme consequences for the people around us.

Some more little pointers to the Wood element

I was with a Wood friend one day and after a few hours in her company I realised that I wanted to ask her an odd question, which was, “Do you ever have doubts?”  I wondered why this question had popped into my mind and realised it was because the hours with her had in a subtle way undermined me.  She seemed so sure of everything she said, stating everything as an established fact.  It was as if I was listening to many statements all having the effect of a pronouncement, a kind of “this is so”, and “that is so” and “that is all there is to say about it.”

I asked myself why this had thrown me as much as it obviously did, because there I was half a day later still slightly disturbed.  Mulling this over, as I always do when something happens which throws me off-balance, I realised that the strong certainty with which she talked about things had caught me on the hop by highlighting what I felt were my own uncertainties and making them look like weaknesses.

 If I look carefully at the times when I think of myself as uncertain, it is not in fact the result of weakness, rather the reverse.  It represents merely the necessary time my Inner Fire (Small Intestine) needs to weigh up possible alternatives, because I always have to allow myself to see two sides of every situation.  In contrast to Wood  I am asking myself: “It may be like this, but I must also consider whether it may on the other hand be like this.”  And then my Inner Fire carries on with its ceaseless work of sorting what it is right for the Heart to do.

The Wood element, on the other hand, has other priorities.  Wood does not have the luxury of weighing up pros and cons.  It is there to get on with things, and its decisions have to be rapid and taken in a “no turning back” kind of spirit.  Once made, these decisions have to be put into effect as soon as possible, and once it has decided what its opinion about anything is, that fixes it, if not for all time, then certainly for the immediate future.  During the time I spent with my Wood friend, I heard many statements of fact which sounded as though they were my friend’s firm opinions.  With each of her emphatic statements I could feel any confidence in my own certainties fading a little, as my Small Intestine tried to take on board what was being so firmly offered as fact.  It often felt itself swayed by these dogmatic statements because it couldn’t give itself enough time to assess whether at heart it agreed with them or not. 

This was another important lesson for me on the differences between Wood’s ability to make decision and my own, and also gave me further insights into Inner Fire’s potential weaknesses, as well as its potential strengths.  These are related to its need always to see the other side of the question and therefore to evaluate the relative merits of the arguments being presented to it.   I feel that Wood has no such hesitations.  Once having made up its mind, that is it.  And as I put it myself, it can’t afford to have doubts, because doubts will hold it back from acting, and action is above all what Wood wants.

I learned a further lesson about the Wood element from one of my Wood patients who told me, rather aggressively, that he found my presence challenging, and, being also an acupuncturist, he attributed this to my being, he thought by mistake, 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 his own dislike of being challenged and had in effect made me angry, often the effect Wood can have when the Wood person or I are 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.

Sometimes I come across very appropriate quotations about the elements in books that I read which I like to collect.  Here is one about the Wood element in a book by Helen Dunmore called The Spell in Winter

“I was bad at anger;  I’d always been bad at anger.  There was something pitiful in Miss Gallagher which muddled me.”

I, too, have always been "bad at anger".  That doesn't mean that I don't get angry.  I certainly do.  But my anger leaves a strong aftertaste in me which it takes me a long time to get rid of.  It is as though I am ashamed of feeling this emotion.  The "something pitiful" which the protagonist in this book feels is something which resonates with me, because I also tend to find quite legitimate excuses for the behaviour in people that has provoked my anger.

Thus do I learn a little more each day about myself, about my Inner Fire and about my relationship to the Wood element.

Finally, here is a lovely illustration of Wood’s sensitivity to the effects of acupuncture treatment.  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 the pathway of part of the Gall Bladder meridian.  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 as a result of treatment.   I have not had such detailed descriptions of the passage of energy from patients of other elements.                                                                                                                    

The challenge of being a five element acupuncturist

We must never be too quick to say “I know this patient’s element is obviously Fire (or Wood or Earth or Metal or Water)”.  There is nothing “obvious” at all about the way in which an element presents itself to us.  We may learn to recognize its presence more and more clearly with time, but we should always keep a healthy question-mark hanging over it reminding us that elements can hide themselves so subtly behind manifestations of other elements that they still have the power to surprise us, as they do me even after all these years.  Pride, as they say, comes before a fall, and never is this truer when trying to diagnose an element.  We risk much if we think our understanding of the elements is greater than it truly is.

If the presence of an element were so simple to detect, we would all be brilliant five element acupuncturists from early on in our career, but human beings are much more complex than we think.  So we should never underestimate the time it will take us to find the one element buried deep within the circle of the elements which gives each of us our individual stamp of uniqueness.

In any case, the secret of good five element acupuncture is not simply managing to diagnose the right element, despite this being what many practitioners think.  Instead it is learning to respond appropriately to that particular element’s needs in that particular patient.  Even if we diagnose the right element, do we know how to respond to its needs in a way which makes the patient feel that they have been heard as they want to be heard?  If that understanding is not there, treatment will rest on fallow ground, however much it may be focused upon the right element.

Supposing, for example, that we diagnose a patient’s element, correctly, as Metal, but respond to it in a way which would be more appropriate to an Earth patient, offering a kind of “Oh dear, Oh dear, you poor thing” kind of response, we will find that our Metal patient soon backs away and decides not to continue treatment.  Our own element may be Earth and it may be natural for us, mistakenly, to offer to all our patients what we ourselves feel most comfortable with.  Unfortunately, however, we have to learn to feel comfortable in the company of elements not our own.  To surround Metal, for example, with a kind of enveloping sympathy is not what it wants.  It will feel suffocated by it, its Lung unable to breathe.  Instead we must learn to offer the space it always wants to place between itself and others.

And the same holds true for how we need to approach our interactions with the other elements.  As far as possible, then, we must learn to suppress the needs of our own element and think ourselves into those of the element we have chosen to treat.  This is not an easy task, and one that it takes some skill and much practice to acquire.

 

 

 

A call for more five element teachers

It is one of my sadnesses that so few good five element practitioners want to pass on their experiences to a new generation of student acupuncturists.  What I have learnt from teaching in China (see my blog of 31 January 2020) has helped me understand some of the reasons for this, and helped me try to devise ways of persuading my fellow five element acupuncturists to have the courage to follow in my footsteps and in those of other five element teachers.  There appear to be very few people now who are prepared to face what they may think is the daunting prospect of diagnosing patients’ elements in front of a group of people.  People are often afraid of committing themselves to diagnosing an element publicly in case they have to change their opinion later on.   

In all the years during which I have been helping practitioners develop their five element skills, I have tried to emphasize the fact that they should not be obsessed with finding the right element immediately, because this is an impossibility, particularly for novice practitioners with little experience to draw upon.  The speed at which we eventually home in on this element is directly related to how long we have been practising, how many patients we have treated, and with what humility we approach our practice.  JR Worsley always said that we learnt more from not getting the element right than from finding the right element often almost by chance, because we might otherwise assume that our diagnostic skills are more highly developed than they are, and this might lead us to become a bit too complacent.

I can confirm from my own experience that he was right.  I am reminded here of a very humbling incident which took place a few years after I qualified when  I returned to the Leamington college to start my postgraduate studies under JR.  Our class of about 25 was asked to diagnose a patient, and to my horror everybody but me raised their hands for Earth, whilst I was the only one who thought the patient was Fire.  What the others had observed, but I had not, was that the patient was circling round the same point again and again in what she was talking about.  To everybody this apparently pointed to Earth’s need to process its thoughts in a repetitive way, which they all saw as being typical for Earth, something I did not. So why had this bit of learning passed me by during my undergraduate training?  Had I perhaps been daydreaming when this was being discussed, a habit I still have, where I find my thoughts veering off sideways from the main topic under discussion?

I naturally felt foolish to find myself unaware of something so typical of the Earth element after two years in practice.  And yet I have never forgotten this incident.  It taught me to overcome the natural feelings of incompetence which a wrong diagnosis will arouse in us all, particularly as I felt I was so publicly exposed.  I realise, though, that this had the long-term effect of making me less worried than some other practitioners are at accepting as quite normal that sense of utter blankness after first meeting a patient, rather than expecting to experience a blinding flash of recognition of an element’s signature.  And the sooner all us five element practitioners learn not to beat ourselves up if we do not recognize a patient’s element as quickly as we think our years of experience warrant, the better a practitioner we will each become.

I believe that the reason why so many five element practitioners hesitate to put themselves forward as teachers comes from the speed at which JR diagnosed patients, which they either observed themselves as I did over many years, or heard about from those he taught.  He would always insist that we would all have reached the same level of diagnostic skill that he had once we had gained the 40 years’ experience he had.  I’m not sure that this is strictly true, but certainly there was an element of truth in what he told us.  The problem is that his example appears to have cast a shadow over the teaching of five element acupuncture which he himself would have been very sad to note.  When I told him one day that I felt that I did not have enough experience to teach others, he said very simply, “You know more than they do, Nora.”  And I remind myself of these words whenever I lose trust in my own ability to teach others.

I started my own teaching life by giving evening classes before I had fully qualified, and I learnt so much from teaching the little I knew then.  One of my acupuncture tutors who encouraged my teaching told me that as a teacher one should never claim we know something that we don’t.  Again this is something which has stood me in good stead, and I always judge those I want to learn from if they are happy to admit that they don’t know the answer to somebody’s question.  It is the teachers who give the impression that they are all-knowing who I am suspicious of, and I have known quite a few of these.

It is interesting that the Chinese five element acupuncturists I teach are quite happy to change their diagnoses, because I have emphasized from the start that it always takes time to home in on a patient’s element. This has meant that many of them are already quite happy to take on the role of teaching others the fundamentals of five element practice, without the fear I often encounter in acupuncturists in this country.

So this blog is a plea for anybody wishing to spread an understanding of five element acupuncture to as many people as possible to overcome their natural fear and just pass on their own delight in their practice.  They should remember that anybody who has been in practice for even as short a time as only a year knows more than those who have never practised five element acupuncture at all.

 

 

An ancient form of healing for a modern world in crisis: how an understanding of the five elements helps us cope better with the stresses of modern life

We are living through difficult times, perhaps more difficult than any that I can recall as an adult, though a childhood spent under the shadow of the second world war must certainly have weighed more heavily upon my parents.  Now with the sudden invasion of the coronavirus almost bringing the world to a halt, we are all confronting what is perhaps the most frightening of all, which is facing the unknown.  None of us can now predict how things will develop, not even the most experienced scientists used to exploring the secret worlds of viruses, with their eery ability to change shape and ferocity at will, in a never-ending attempt to outwit our human capacity to master them.

We are left, then, with our individual responses to this challenging situation.  In five element terms this will depend very much upon the element which guides our life, and the level of its balance or imbalance.  We need each to ask ourselves how, finding ourselves in such an uncertain and therefore threatening world, we will counter these uncertainties and threats.  Some elements will thrive and others will shrink.  So what particular challenge does the appearance of this virus, and its effects upon our everyday life, present for the different elements?  And here we have to look closely at situations which an element finds comfortable to be in, and those which by their very nature threaten and disturb it.  As with all things, we can use our insights here to teach us a little more about the elements.

First we have to look at how a five element acupuncturist deals with named diseases, like cancer, or the coronavirus now.  We have to remind ourselves that our approach to any patient suffering from any condition whatsoever must always be the same.  We must find out as much as possible about our patient, and gradually pinpoint their element.  Then by treating that element we hope that we will strengthen it sufficiently for it to cope with whatever stresses it is being subjected to.  The only difference when dealing with a very serious medical condition is the fact that this will be having a major effect upon the patient, and his/her elements will be under greater stress than if they are only suffering from a minor imbalance, such as a headache or slight emotional trauma.

Because all major illnesses are considered by orthodox medicine to be purely physical in origin, and therefore to be treated by purely physical remedies, such as drugs or surgery, the emotional and spiritual effects of these illnesses are usually overlooked.  This is precisely where five element acupuncture, with its treatment of all three levels of body, mind and spirit, can help.  Our treatment should therefore be able to support patients suffering very severe physical illnesses at a level which purely physical treatments cannot.

The extent of the spread of the coronavirus has raised the level of fear in everybody.   In this atmosphere of fear, it is difficult even for five element acupuncturists to remember that simply supporting the elements at all levels is likely to increase a patient’s resistance to infection. The more balanced all the elements are, the less likely they are to be overwhelmed by any disease. We also know that old people and others already weakened by illness are those most at risk, and we would hope that our treatment will help strengthen their ability to withstand the debilitating effects of any other infections they are exposed to.

When we look at how the different elements will cope with the serious task of dealing with the coronavirus and the understandable fear it engenders in all of us, it will be good to start by looking first at the Water element, since its emotion, fear, is the dominant emotion swirling around now.   Even the most laid-back person will be experiencing some deep-seated fear of what the future may possibly have in store for them, should it spread to whatever country they live in.  Being Water’s emotion, fear will already have given Water people a lifetime’s experience of learning to cope with this emotion.  In some ways, therefore,  they may be better able than people of other elements to deal with the current situation, perhaps by being the first to take practical steps to remove themselves quickly from the risk of possible infection.  If they can’t do this, they may then be able to draw on their natural skill in hiding the fear they are experiencing, thus making themselves look well able to cope, where people of other elements may not be able to do this.  If Water cannot flee from a frightening situation, which is always its first reaction, it has learnt to turn its fear into the kind of response a cornered animal will make, which is to fight rather than to give up.  Water people may then be the ones who appear to be the least disturbed by the real risks involved in any situation, and thus look best able to cope.

When we move on to Wood, we will find a different copying mechanism.  For Wood is likely to want to counter the risk of catching the virus by taking some definite action, and, unlike Water, whose actions may often be more hidden and surreptitious, and therefore appear to be seen as avoiding action, Wood likes to act not only openly, but to feel that it is controlling the situation for other people around it.  It is always happiest to be the one taking obvious control of any situation, whereas Water is likely to be more concerned simply with its own safety, with less interest in seeing how others are coping.  Wood will therefore be happiest if the whole environment in which it lives is operating smoothly and things are under control for everybody around it.  It will counter fear with action.

To get some idea of how the Fire element will deal with the current situation, I can use myself as the best example, because I have personally been faced with the reality of having to take some decisions about whether I should still consider going to China in mid-April as planned.  I expect my trip would have in any case had to be postponed because many airlines have already halted all flights until the end of April, but since my Chinese hosts persisted in telling me that all would soon be well, I felt it was up to me to make the final decision, and not wait for the airlines to make it for me.  In the end, it was I who postponed my trip.  Looking at my reasons for doing this, I realise that fear for my own health and safety was not the predominant one.  My main concern was for the Chinese acupuncturists I felt I might be letting down if I cancelled my visit.  It was only when it was pointed out to me that perhaps my Chinese hosts did not want to be the first to cancel my visit that I felt able to take the decision.

I also amused myself by envisaging myself landing at Beijing airport suffering from a slight sniffle, being whisked off to quarantine to some god-forsaken place I’d never heard of, succumbing there to the virus and being hospitalized, turning my visit into a disaster for my hosts.  I suspect that Fire’s reaction to dealing with a situation like this may always include a strong component of not wanting to be a bother to other people, mixed with any natural fear it feels.  Fear, though, is not an emotion I am very familiar with, and wonder whether that is a general Fire reaction.

Earth, on the other hand, will always tend to look after its own needs first, before checking that those around it are safe.  I think it will experience an appropriate degree of fear, which will encourage it towards acts of self-preservation.  Metal will weigh up the risks more carefully than any other element, work out a way of dealing with them, and then, once having made its decision about what avoidance measures it would be sensible to take, will just get on with its life.  Its assessment of the situation and the dangers involved for it and for others will be the clearest of any element.  It was my Metal son who was the first person to warn me not to go to China, well before the risks became so overwhelming.  All he said to me was “Watch it, Mum”, and then left it to me to decide what to do.  Since he is not somebody who would make more of a situation than it merits, I took his advice to heart, and have “watched it” by deciding to postpone my visit.

My observations here are necessarily very generalized, but I believe there is a strong core of truth in my thoughts on how the different elements deal with fear.

 

 

 

 

The challenge of teaching five element acupuncture in China

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

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

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

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

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

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

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

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

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

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

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

 

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

 

 

 

 

 

 

Future writing plans

To divert myself from the many unhappy events happening out there in the world today – the day of our leaving Europe, the horrors Trump is unleashing, and now the disasters of the spread of the coronavirus around China – I find myself escaping into the written word, not only by reading as much as I can (more of this later), but also looking through things I have written, much of it still unpublished.  At the moment I am concentrating on two topics:  one which is taking a fresh look at the elements, and the other which is examining how far I have had to modify the way we teach five element acupuncture to Chinese practitioners to take account of the cultural differences between our two countries.  We also have to be aware of the restrictions placed on our teaching because we are there for only two brief seminars twice a year, and there is therefore a lack of experienced five element practitioners to support practitioners when we are not there.

I have sent some of my writing to Caroline in China, who is the translator of my work.  She has now added her own thoughts to what I have written.  My next blog sets out some of my own thinking, finishing with Caroline’s comments after reading what I had written.  I think that Caroline expresses beautifully the cultural challenges we face when attempting to adapt the five element approach to practice to a Chinese context.

 

My New Year's blog for the Chinese Year of the Rat

My vision for the future of five element acupuncture

We have invited a group of five element acupuncturists from the Chinese Five Element Society to come to London in July. They include many of the people who have been following us with such dedication in seminar after seminar since our first days in Nanning in 2011 to the much grander venues in Beijing which now host more than 300 keen five element acupuncturists every time we come.  This group will include those who can now be regarded as the core of a five element teaching team spread around China.  This visit will be a lovely way for Guy and me to repay some of the overwhelming hospitality we receive each time we go to China.

Planning the group’s time here has made me think more about how I see the future of five element acupuncture, both in China and in this country.  My founding of the School of Five Element acupuncture in 1995 was a direct answer to the appallingly cynical downgrading of five element acupuncture in the eyes of many people in this country and around the world.  I still remember well being asked rather scornfully by somebody seduced by the temporary glitter of the introduction of TCM into this country, “Do you still only practise five element acupuncture?”, as though I was practising some primitive form of out-dated acupuncture. 

Nobody now dares say this, either to me or to anybody else, in the light of China’s wholehearted welcome for the return of five element acupuncture to the land of its birth some few thousand years ago.  This turnaround delights me, and justifies my fight for the survival of five element acupuncture in its purest form – and what a fight that was.   I feel the battle is now won, thanks in great part to the support Professor Liu Lihong in China has given me with such great heart from the first day we met and the years since then.  I am so proud that, in his dedication to the translation of Liu Lihong’s great book Classical Chinese Medicine, Heiner Fruehauf mentions five element acupuncture as being one of the disciplines now well-established under the umbrella of traditional Chinese medicine in China.

The original vision Professor Liu Lihong and I had of bringing five element acupuncture back to its homeland has, I feel, been achieved.  But that is only the first step, although a momentous one, in five element’s journey back from West to East.  The most important thing now is the journey it will continue to take as it consolidates its position in the Chinese traditional medicine world.  And here the visit of the first group of Chinese five element acupuncturists to spread their international wings abroad will become an important turning-point, providing an opportunity for future international co-operation between practitioners from our two countries. The group will spend time at The Acupuncture Academy in Leamington Spa, where they will meet tutors and students there. 

My hope is that this visit will eventually lead to cooperation between members of the Chinese Five Element Society and five element acupuncturists in this country on two fronts, one relating to research and the other to clinical practice.  The Director of the Acupuncture and Moxibustion Institute of the China Academy of Chinese Medical Sciences in Being, Wang Jingjing, is a very keen practitioner of five element acupuncture, and has already published a paper on five element acupuncture in the Science and Technology Review in China.  It will be exciting to see how this work can be expanded, and I hope, too, that there will be greater opportunities for future student exchanges between our two countries.

All in all, a very exciting start to the Chinese Year of the Rat.  From being just a personal quest on Professor Liu Lihong’s and my part to spread an understanding of five element acupuncture in China, our work there will now move to a wider, more international arena.  How exciting the future of five element acupuncture now appears to me to be!

A Happy New Year of the Rat to you all!