27. The way people walk

Since our observations will be filtered through our own personal spectacles, we will all observe the life around us from different angles.  I notice, for example, that I appear to be very aware of the way people walk, and can recognise them from a long way away just by the way they are moving and well before I can even see their faces as they come towards me.  This is therefore one of the things I look for in patients to help me with my diagnosis.  There may not be as much time to observe their walk as they move towards me in the practice room as there is out in the street, but if we extend the concept of walking to include the way a person moves in general, we can obtain a surprising amount of information even within the small confines of a practice room and the comparatively brief time we have with a patient.

My observation of movement was originally sparked by something my own practitioner at the time once said to me.  At the end of treatment I was told to get up from the couch and get dressed.  Apparently, although I myself didn’t realise this, I leapt off the couch in a hurry, reaching for my clothes almost before my feet had touched the ground.  “Goodness”, she said, “you are a speedy person.”  At the time, not having observed people as closely as I do now, I had not noticed that my movements are always quick, often much quicker than others around me, and speed up even more when I think somebody is waiting for me to leave and I assume, usually wrongly, that they are waiting impatiently, as I may well have thought my practitioner was.

Thinking back on this from my present standpoint, I realise that the speed of my springing up from the couch was closely associated with my fear, one that I have always had, that I am somehow outstaying my welcome and need to get myself out of the way quickly.  Fire, my element, is naturally an energetic element, but added to my natural Fire quickness was also Fire’s fear that it is somehow not getting something right.  I suppose this comes from its very heightened awareness of others and of others’ needs, and its desire to ensure that what it does is not upsetting to other people.  My rapid jumping up from the couch could then be interpreted as a clear pointer to the Fire element.  It took me some time to put this quick interaction in the practice room into context, and see it as pointing towards an example of the Fire element in action within me.

Another example was offered me when I was casually watching some golf on TV, and I suddenly noticed the golfer Rory McIlroy’s walk.  I can best describe it as a kind of jaunty stride.  It is certainly not a stroll nor does it appear to be a form  of hurrying, and yet I can find no better way of describing it than to say that he walks as though pushing the air aside in front of him, not in any way aggressively, but firmly.  It is definitely a stride, but done with a kind of joyousness to it.  He is so obviously an excellent example of the Fire element.  He can’t stop smiling as he walks, nor can he can’t stop wanting to make other people laugh.  You feel that if you were in front of him you would have to give way to allow this force of nature to pass by.

That set me thinking about the different ways the other elements walk.  I then compared McIlroy’s walk with that of another golfer who I diagnosed as the Wood element.  Wood, after all, is another very yang, outgoing element, with perhaps an even more forceful signature than Fire as its hallmark.  But this Wood golfer’s walk, though firm, differed from McIlroy’s because it did not have the same kind of joyous spring to it.  It was more of a firm placing of one foot in front of the other, a kind of a stomp, like someone claiming that bit of ground for himself, so that he made me more aware of the force with which each foot landed on the ground.  McIlroy’s stride makes me aware of the top of his body, as his chest pushes aside the air in front of him, the Wood golfer’s more of his feet conquering the ground.  This may seem a little fanciful, but I don’t think it is.  Wood, after all, emphasizes the feet, Fire the top half of the body.  If I think of a Wood person coming towards me, the word “striding” comes to mind, adding another distinctive layer to the concept of a walk.  Striding is first of all a vigorous activity, as though the air is being moved aside to allow the person through.  It is a robust form of walking, and is a good description of the kind of strong actions which Wood’s body enjoys.  If we are wondering if a person is Wood, therefore, it would be good to ask ourselves whether we can imagine them as striding rather than strolling towards that future which is where all Wood people want to head. 

All this made me think about my own Fire stride.  Did I have something akin to McIlroy’s walk, and did other Fire people, too, or had my observation not revealed a characteristic peculiar to all Fire people but only to the one?  I have not yet come to any satisfactory conclusion about this, but if anybody were to watch me walking along the street they might be surprised to note how often I glance in shop windows as I try and catch myself in mid-stride to analyse how I am walking.   

Whilst I am in the world of golf, I can also think of golfers who are Earth, and compare their walk to that of people of other elements.  Like many Earth people, I notice that they place their feet very solidly on the ground, and one could picture all their ten toes spreading out to find as much support for their body as they could.  I have often noticed this about Earth people, and realised that it is not surprising that an element with such a need for stability, literally for “ground beneath their feet”, should make their contact with this ground as firm as possible.

I can’t at the moment find any good example of Water golfers, though I am sure they are there, as all the elements are in every walk of life, but a supremely characteristic Water sportsman from another sport is Roger Federer, the tennis player.  There is a rhythm and sinuous flow to his movements which mimics that of what I am sure is his element, Water.  I would imagine that the Water element must be well-represented in dancers, for that reason.

Finally, an obvious Metal sportsman whose movements were not as flowing as Water’s, but were completely focused on the goal ahead was a former 100 metre Olympic champion, Linford Christie, whose almost trance-like stare as he looked up from his blocks ready to run always seemed to me to be the epitome of Metal’s determination to reach its goal.  Metal, like Water, is light on its feet, but does not float so much as glide.  It reflects a person that somehow wants to move upwards, and dislikes being tied to the earth, unlike its fellow element, Earth, which so clearly needs always to be tethered to the ground in some way.

It is perhaps not surprising, therefore, that it is usually Earth people who develop a fear of flying, often experiencing the moment when the aircraft takes off as something frightening.  It is no coincidence that the Earth command points are on the feet and legs, whilst those of Metal are on the hands and arms.  Feet can only leave the ground for very short stretches of time.  Hands are free to move away from the body, and, most significantly, can stretch up above our heads.  Both positions of the two elements’ command points symbolically represent their respective elements’ needs, Earth’s to anchor itself firmly to the ground, Metal’s to allow itself the freedom to explore.

 

 

 

Unravelling the puzzle of point locations a little

For many years I was completely unaware of the fact that different branches of acupuncture used anatomical locations for some of their points which differed from the ones I had been taught.  The first five or more years of my practice were spent in a complete five element bubble, since at that time JR Worsley’s college at Leamington was the largest college, and many of us who trained there were completely unaware of the existence of other schools of acupuncture.  I know I certainly was, until rumours started to spread around the acupuncture community that acupuncturists who had visited China were bringing back with them another form of acupuncture which appeared not so much to complement what we had learned, but to cast doubt in the minds of some five element acupuncturists about the validity of what they were practising.  This was first brought home to me when standing in a lunch queue at an acupuncture event and being told by a fellow acupuncturist, with some disdain in her voice, “JR has a very odd way with moxibustion”, followed by, “You don’t still only do five element acupuncture, do you?”.

I always find it interesting when I observe how often people are only too happy to grab hold of anything which might seem to undermine some practice or concept which holds a dominant position, almost as though they cannot wait to mock what before they expressed admiration for, or indeed, as in the case of many five element acupuncturists, actually used for years in their practice.  This happens all too often, particularly where somebody has been pre-eminent in one discipline.  Perhaps it is then only natural that those sheltering in the shadow of such a person may start to feel increasingly disempowered, and look for ways of asserting their own independence of thought.  This happened most famously with Carl Jung’s abandonment of his admiration for his mentor, Sigmund Freud, and the same thing happened in this country when JR Worsley’s legacy to acupuncture started being mocked in the way I encountered.

In a very short space of time this was followed by a growing onslaught by the acupuncture world in general, led unfortunately by the British Acupuncture Council, on the right of five element acupuncture to be considered as a stand-alone discipline.  I have written a lot about the difficulties I, as a devoted five element acupuncturist, have encountered in defence of my practice over the years, but in this blog I want to look at how influences from China have apparently changed this country’s approach to the location of certain points, and how far this is still something five element acupuncture needs to take into account.

The subtle undermining of an accepted five element tradition extended also to the area of point location, where people started discussing whether the five element locations used, based on a long-established tradition going back through to JR Worsley’s teachers, Jacques Lavier and Wu Wei Ping, came up against the locations modern Chinese acupuncture was now deciding for us, and which have come to be replaced by many British acupuncture colleges.  I am certainly no historian of acupuncture, nor have I any way of knowing whether the point locations which have gradually superseded some of those used in five element acupuncture have clinical validity or not.  And this is the only factor in the debate about different point locations which I feel needs to be taken into account.  If I needle a point in my well-practised five element location will a point at a slightly different location used in modern Chinese acupuncture, and following hard on its heels, modern British acupuncture, have the same clinical effect?

We sometimes think that acupuncture does not lend itself to “evidence-based research” in quite the same way as scientifically-based therapies, because it does not seem possible in a holistic discipline such as ours, and similarly in any of the different forms of psychotherapy, to obtain sufficient objective evidence of the efficacy of any clinical procedure which cannot be measured by some physical instrument.  But I think my many years of practice have provided me with just as much evidence that the points I use in treatment have actually effected material changes in my patients, and ones which are perceptible to others, provided that their senses are sufficiently honed to perceive sensory and emotional changes.

When a patient says, as one of my patients did yesterday, that “the treatment you gave me a few days ago really made me feel I could face life again,” is that not evidence of the efficacy of the particular treatment, made possible by needling specific acupuncture points?  The problem is that a reader of this blog only has my word for this, and if I were to invite observers into my practice room during the treatment, might the presence of unfamiliar faces affect the patient’s response to the treatment, and perhaps nullify it?  I do, though, have what I like to call one objective proof of the location of one of the disputed locations of an acupuncture point as a result of a moving encounter I had when consulting JR Worsley about one of my patients.

This point is the one on the Kidney meridian which in the five element point numbering is IV (Ki) 7.  As any five element acupuncturist knows, this is one of the first points in the combination of six points, needled bilaterally, used to clear one of the most serious energy blocks recognized in five element acupuncture, that of a Husband/Wife imbalance.  IV 7 is a tonification point, drawing energy from Water’s mother element, Metal, and in the five element location is at 3 ACI (cun) from the prominence of the medial malleolus.  We were taught to needle all six points before taking the pulses to see whether we had cleared the block, in effect checking whether the patient’s Heart energy - (I (Ht) 7 is the last point in the procedure - was recovering sufficiently to combat the spiritual despair which is one of the main indicators of this block.

I had taken a patient to see JR Worsley, and he had diagnosed this block, leaving me to carry out the treatment.  As this was early on in my acupuncture career, it took me some time to mark up the points, particularly those on the Kidney meridian which require much careful measuring of the leg, so when JR returned I had only had time to needle the first two points, III (Bl) 67 and IV (Ki) 7.  Before I had told him that I had not completed the whole procedure, he took the pulses, nodded at me, and said, “That’s cleared.  Good.”  It was then that I realised that the re-establishment of a strong connection between the Metal and Water elements through the tonification points must have been sufficient to clear the block.  From then on I have always checked the pulses at this early stage in the procedure just to see if this often happens, which I find it does.  Each time, though, I go on to carry out the full procedure because I recognize that needling the remaining points strengthens the connection between the elements which a H/W imbalance shows has been weakened.

From this, and from my own later experiences, corroborated by my years of clearing many H/W blocks, I know that the tonification point on the Kidney meridian is definitely where we locate it in five element acupuncture, at 3 ACI from the level of the medial malleolus.  The Kidney source point, IV (Ki) 3, too, which also forms part of the H/W procedure, is at a different location from the more recently accepted location.  I therefore recommend any practitioner trying to clear a H/W block to adopt the five element anatomical location of these two points.  I like to think that I am stepping in the footsteps of an acupuncture master in using the points exactly where he told us they were, and feel that something of the energy I felt passing from him through to the patients I brought to him for consultation is transferring itself a little to me as I needle the points where he told us to find them.

Thoughts on the 12 guardian officials in preparation for our coming seminar in Beijing

Guy Caplan, Mei Long (from the Netherlands) and I are off in a few days for our next seminar in Beijing (from 17 – 26 October).  I have lost count, but I think this will be the 14^th seminar we have given there.  As usual, each time I go, I like to think of something new I would like to concentrate our teaching upon.  This time, it has been prompted by an email sent to me by Caroline, a dedicated five element acupuncturist and the lovely translator of my books.  She wondered whether I could talk more about the functions of the 12 officials, because the people she teaches at the five element introductory seminars held before we come seem only to think of them in terms of physical organs, and not as having the deeper meanings associated with their individual elements. 

That made me realise that I, too, concentrate much more upon the elements as a whole, rather than trying to distinguish which of the yin or yang officials holds a dominant position.  I have always thought that it was difficult enough homing in on the correct element, and that I would only confuse myself by trying too hard to see which of its two officials is the most important.  JR Worsley would diagnose somebody as being a “Metal CF”, and then write next to this “IX” or “X” in brackets, meaning that either the Lung or the Colon was the dominant aspect of the Metal element for this particular patient.  I have now rather cheekily coined the phrase “guardian official” to describe this official.  In all the time that I observed patients with him, I never heard him explain what it was in the patient which made him select one or other official, except in the case of the Small Intestine (II).  Here he would always specify, not that this patient’s CF was a I/II as we say in five element acupuncture, but simply a II CF.  I remember very clearly him saying one day as he watched a video of himself asking a patient a question, “Only a II CF would answer like that”.  This taught me a lot about the Small Intestine and the way it looks as it tries to find the correct answer to a question.

Thinking about this carefully in preparation for my Beijing seminar has also brought to my mind the question which has remained a slight puzzle for me throughout my acupuncture life.  In all the hundreds of patients JR diagnosed in front of me, I never once heard him say that a person was a “I CF” (in other words had the Heart as his/her guardian official).  Somebody told me that he had indeed diagnosed an acquaintance of mine as a “I CF”, but that was only hearsay, and never corroborated by JR himself.  And my doubts about the Heart official being the primary cause of an imbalance (that’s what “CF” means) always seemed to me something that a tutor of mine at Leamington put well into words for me.  He said that he himself felt that the Heart, the Supreme Controller of body, mind and spirit, would never allow itself to be so much weakened as to be the ultimate “causative factor of disease”.  Unfortunately I never thought to ask JR himself why I had never seen him diagnose a person as being a Heart CF, so this has always remained an unanswered question for me.  Somehow, though, I have always felt that what my tutor told us rings true. 

There has always been a slight niggle in my mind about this diagnosis, because I felt very strongly when I was with this person, that she was very like me, and that our two Small Intestines were engaged in a slight tussle for supremacy, as each tried to sort the other person out.  Surely the Heart, such a yin official, would just be residing quietly rather than battling with me, as my own yang Small Intestine quite likes to do when it is under some sort of stress.  The niggle was also strengthened by the fact that this person liked to feel that she was a rather rare person by reason of her guardian official being the most important official of the twelve.  I did wonder whether she had herself spread this rumour, rather than that JR had actually diagnosed her as such, but I will never know, whatever my slight suspicions.

 

So I am now thinking carefully about the different qualities of the officials so as to help the 300 or so practitioners gathering next week to hear us in Beijing.  They, of course, are brought up on rote learning of the Neijing Suwen, and I have told them to prepare for what we will be talking about by re-reading Suwen Chapter 8, which is all about the officials, and gives each of them their distinctive name.  Now I have to ask myself, “Do I really understand how the Liver differs from the Gall Bladder in a person with Wood as their guardian element, or the Stomach from the Spleen for Earth?”  These are all very important questions to which I am ashamed not to have paid sufficient attention over the years.  So, as usual, my visits to China and all the other seminars I have held over the years offer fresh stimulation to my thoughts.

 

 

A draft introduction to another book

I am just drafting the introduction to some more of my writings about the elements, and am posting this below as a blog.

"I am drawing together in this book some of the writings about my practice as five element acupuncturist which I feel will be helpful for any of my colleagues, particularly now those in China, who want to benefit from what I have gradually learnt over the years.  I am especially keen to pass on the lessons from my own acupuncture master, JR Worsley, with whom I studied closely for several years as part of my postgraduate training.  One of the many things I remember him telling us was that we would always learn more from what we didn’t get right to start with, especially our diagnosis of guardian element, than when we got things right.  I know that the mistakes I made in my early practice were always valuable lessons for me, and I therefore hope that what I write here will give five element practitioners a little more confidence and enjoyment in their five element practice.

 

We can never be neutral observers of life.  As all scientists now acknowledge, the observer is always part of what is observed, so there is no such thing as being objective.  Our judgements are always subjective.  The important thing is to be aware of this and to try and understand ourselves as deeply as possible so that we can understand the nature of our involvement in any human interaction.  In five element acupuncture terms, this means understanding how our own guardian element colours how we perceive all the people we meet, and in particular how this fact colours our interactions with our patients, and our diagnosis of their particular element.

 

All I write about the elements is always therefore to some extent coloured by what I perceive through the filter of my own element, Fire, and in particular its inner core, the Small Intestine and the Heart deep within.  Anybody reading what I write must therefore take this into account, and accept my particular slant on the elements which a lifetime of being Fire gives to it.  Of course I have many, many years of observing how people of other elements interact with other people, and learning from these observations so that I hope I have  also much to say about the world as seen through the filters of elements which are not my own.  

 

The subjective nature of all our interactions with the world around us is undoubtedly why I notice that my writings about the elements which I present here are not evenly spread over the five, but tend to be focussed more on Wood and Fire, with Earth a slightly more distant third.  Throughout my writing life, I appear to have written far less about Metal and Water.  I rationalize this a little by thinking of the order in which the elements are placed around the great five element circle.  Fire’s relationship to its fellow elements is closest to its mother element, Wood, and its child element, Earth, whilst it has a more distant relationship to the following two yin elements, Metal and Water.  I wonder also whether this helps explain my yang Fire’s deeper understanding of totally yang Wood and half-yang Earth, than of the two more mysterious and more hidden yin elements.  Despite myself, then, this book is tilted slightly more towards the yang, the sunny side of the mountain and daylight, than towards the yin, the shady side of the mountain and the darkening light.

 

As I draw together the observations of all the elements and their interactions with each other which I present here, it is useful for those reading this to understand that, unique as each human being is, everybody will have their own individual take on the elements which will lead to their own often quite different perceptions, but ones which are as valid as mine are for me.  The important thing is that we should constantly test our understanding against what we learn from our interactions with one patient after another, so that we remain honest enough to modify our thoughts to take account of any new insights we gain."

 

 

More on what makes the Earth element angry

Here are two observations about what I wrote in my last blog by two of my Earth practitioner friends, one living in Beijing and the other in London.  Both comments have helped me to understand Earth a little better.

My Chinese friend wrote:  “Thank you for sending me your new blogs, I learned a lot about what makes Fire angry. And about what makes Earth angry, I agree with you when you say that “Earth can show its anger when it feels that somebody is not paying enough attention to what it wants to say, or interrupts it in mid-sentence.” But I think “angry” might be a little bit too strong here from my point of view, because I would only feel a bit unhappy about that, and if that’s something I really want to express, I will try to find another chance to tell the practitioner about it. But I will get angry if I tell the practitioner something that really makes me upset or sad or worried, and the practitioner shows no understanding but says something like ”that’s nothing, I don't know why you…”, I may even stop getting treatment from him or her. And in everyday life, I think Earth may get angry when it feels that somebody it really cares about is not paying enough attention to its devotion, or even worse, totally denying it.”

And when asked what would make her angry, my English friend told me: “It would take a lot to make me angry.”


After publishing this blog, this friend added the following to her comments: 

 

"Just to add to mine.... when I get angry about something I feel that I have to express myself over a period of time to different people until I have reached the point that I can let go of it. I guess this is my Earth processing.  And having space and time to mull it over. Also by talking about it over and over it is my way of being understood and heard."

 

 

What do the different elements get angry about?

I always like looking at the ways the different elements express their emotions, and  my last blog (14 August) has made me think about how each element expresses its anger. 

When we express emotions other than the one our particular element imprints us with, these other emotions will always be coloured a little by the specific emotion which has our guardian element’s stamp upon it.  If I take the example of Metal, then Metal’s expression of anger will always be tinged with Metal’s own emotional needs, one of which is its demand for others to respect it.  What makes Metal most angry, therefore, are likely to be those things which impact negatively upon its sense of self-respect, or, by extension, upon the self-respect of others around it.  I have seen Metal people becoming extremely angry, and to me quite frighteningly so, when somebody has ridiculed them openly in front of other people.

Earth can show its anger when it feels that somebody is not paying enough attention to what it wants to say, or interrupts it in mid-sentence.  Its need is not so much a craving for sympathy, but a craving for understanding in its widest sense.  It wants to be given the space and time to express exactly how it feels, and becomes irritated if it is not allowed to do this.  This is something that I, as a rather over-hasty Fire person, have sometimes been guilty of doing, at my Earth patients’ cost. 

I have found Water’s expression of anger to be more hidden, but like Metal’s it can be quite frightening to witness.  It can appear out of the blue (what a Water-like phrase!), like a tornado erupting suddenly out of a clear sky.  Water needs to be constantly on the move, and its sudden expression of anger can be its response to feeling that something is blocking its path.  Behind this outburst of anger lies all the power which Water exerts on all it does.

There is then the Wood element’s own expression of anger.  This is an element most at ease within a given structure and with order in its life.  It is when structure and order are under threat that its dominant emotion of anger will show its stress.   It is easy for us to see an exaggerated example of this in the shouting and fighting to be observed in drunken people on the streets at night.  There is, however, the flipside to this, which is often forgotten, and which often leads us to misdiagnose the Wood element.  This is the suppressed expression of this emotion which we call lack of anger.  Here the voice can speak in an exaggerated whisper instead of a shout, and there may be a marked inability to express anger where anger would be a balanced reaction to some external event. 

Lastly, how do I think Fire tends to express its anger?  I should know, because I am, after all, Fire, but there is always the complication with Fire that, unlike any other element, it has two sides to it, which I have called Inner and Outer Fire.  I have always felt that in some ways this double-sided element could really be described as harbouring two elements, making a total of six in all.  I remember saying this to JR Worsley one day, and was rather delighted when he nodded.  Of course the two sides share Fire’s sensory signatures of colour, sound and smell, but their emotional approach to life is very different.  I can really only speak at first-hand for Inner Fire, although having observed Outer Fire for many years I have learnt to understand some of its qualities as I have those of the other elements.

I know what makes me angry, and that is any injustice meted out to other people, not so much injustice of which I am the object.  I like to fight my battles more on behalf of others than on behalf of myself, and feel deeply, and thus become very angry, when others are wronged.  In my experience Outer Fire’s anger is more directed at feeling that they have been the victim of some injustice.  Both sides of Fire, though, will not harbour grudges for long for they tend to feel that difficulties in any of their relationships with others may somehow be their fault.  Their anger is therefore likely to simmer down quite quickly, once they acknowledge their own role in whatever initially angered them. 

These are my thoughts on the different expressions of anger which each of the five elements may show.    

Don't shut the elements up into too small boxes

In our attempt to pin down some of the characteristics of the five elements to help us with our diagnostic skills, there is always a danger that we apply the very broad definitions we have learnt for each element in too rigid a way.  General descriptions, such as that Fire’s emotion is joy, or Earth’s colour is yellow, are all well and good as starting points to help us understand the differences between the elements, but we have to be careful not to regard them as fixed categories.  Instead we should see them as providing us with broad outlines into which we will gradually learn to fit our growing understanding of the elements.  In each of us as unique human beings they meld together to form something far less clear-cut.

Of the four sensory signatures of colour, sound, smell and emotion I always think the most accessible initially are the emotional signs.  The others are likely to be more difficult for us to detect, since our senses tend to become blunted as we grow.  Our emotional sensitivity, however, has to continue to be sufficiently acute throughout life to guide us through the intricacies of human relationships, and this is why we may often concentrate our diagnostic antennae more upon how a patient makes us feel emotionally than upon whether we can detect a specific smell or colour.  With time, of course, our other senses grow sharp enough to help us with our diagnosis, but even now, after 40 years of practice, I find that my first impression of a patient is based upon their emotional impact upon me.  Subsequently, I will draw upon information my other senses give me to add to this. 

At least that is true for me, but may not of course be the same for other five element practitioners.  One of my fellow students at our Leamington College, for example, had a very acute sense of smell, and used his ability to pinpoint a five element smell as the basis for his diagnosis.  Presumably painters must have an acute ability to see colour, and musicians an equally highly-developed sensitivity to sound.  I am neither a painter nor a musician, so I tend to fall back on what I feel is my most developed sensory skill, which is that of recognizing the emotional signals directed at me by my patients. 

Here, too, though, we must beware of relying too heavily upon boxing the elements into too rigid categories.  Something like this is always likely to happen as a result of being told that a particular emotion is assigned to each element.  If we take Wood, for example, whose emotion is described as anger, it becomes all too easy to think that any expression of anger must point to this element, whereas experience will gradually help us understand that each element can express anger in its own way, since every person, whatever their element, has a liver and a gall-bladder, which are Wood’s organs within us.  For example, I am of the Fire element, but can all too often explode with anger, but for very different reasons from those which my Wood or Water friends will express.  Earth’s sense of fear differs from that of Water, Wood, Metal or Fire, just as Metal’s expression of joy differs from that of each of the other elements.

These thoughts have been stimulated by another email from my very “curious” French acupuncture friend, Pierre.  Here are his latest questions to me:

“Which element is the most connected with curiosity? And particularly in the sense of discovery and novelty?

 

Which one wants to look for efficiency first? Wood?

 

Do Earth people have trouble moving, i.e. travelling, exploring?”

 

Based on what I have written above, I think that Pierre’s problem is that he still tends to think that any human characteristic, such as curiosity or efficiency, must be a quality of a particular element, rather than being a common human quality which each different element will express in its own particular way.  My answer to Pierre is therefore that all elements can be “connected with curiosity”, or “a sense of discovery and novelty”, just as all can “want to look for efficiency” in addition to the Wood element, (I, as Fire, certainly do!), and not only Earth people have “trouble moving”.  The crucial thing for us five element acupuncturists is to determine the specific way in which they are expressing these general human tendencies.

The significance of a CV/GV (Ren Mai/Du Mai) block

A CV/GV block is the deepest block of all Entry-Exit blocks, indicating that there has been some disturbance to the central line of energy passing up and down the back and front of the body.  The two pathways of Conception and Governor Vessels link together to create a great circle of energy within which we are enclosed, body and soul.  These central meridians provide the source of all the energies of the other 12 meridians which branch off from them.  They together form two great streams in the ocean of life which feed 12 subsidiary tributaries, each of which then has its own function in maintaining the cohesion and health of the whole.  Any impediment to the smooth flow around this central circle of energy must then necessarily have a great effect upon the ability of all the 12 officials to function as they should.  

I remember JR Worsley telling us that when there is a CV/GV block, a patient “lingers miserably”, whilst with a Husband/Wife imbalance they feel as though they can’t go on and just want to give up.  I think the idea of “lingering miserably” expresses well the debilitating loss of energy this block causes in a person.  From the point of view of our pulse readings, we know that all the pulses should be indicating great weakness, revealing an overall lack of energy in all the elements.  When I think the block is there, I therefore always ask my patients whether they feel exhausted most of the time, reflecting this general depletion in their energy, and inevitably they always do.  This is another guide to help me  with my diagnosis.

Since all the elements are under stress, the symptoms shown can vary greatly, depending upon which element or elements are most affected.  The elements will show that they are suffering in different ways, and a patient will often talk about all kinds of niggling symptoms which indicate an attack upon one or more elements.  In particular, the block can often appear after a Caesarian birth, where a large incision will have been made right across the CV line.  I have found it is worth needling the points to clear this block in any patient who has had this surgery, as well as in women trying to conceive, where one of the impediments to conception is often a weakness in the flow of energy along the CV meridian.  The same can also be true for men as well as woman.  The health and nature of the sperm can be affected by blocked energy along the CV meridian or between CV and GV.

Persistent problems which treatment of the elements seems unable to shift may also be caused by a CV/GV block.  For example, this may be one of the reasons why a person cannot lose weight despite being very careful with their diet, since the sluggishness of the overall level of energy throughout the meridian system slows down their elements’ ability to process food and eliminate waste material, leading to its being hoarded as fat in the body.  It is always worth considering this block, even if your fingers cannot detect an overall picture of empty pulses, whenever a symptom persists unchanged despite all the elemental treatment you give your patient. 

The importance of ensuring an interrupted flow of energy through CV and GV was brought home to me when JR Worsley told us that if the points used to clear this block were on the hand, we would do them on all our patients.  Because of their position and practitioners’ reluctance to use them routinely, the block is sadly much under-diagnosed, to the detriment of patients’ health.

 

We should never rely too much on our pulse-taking

An Israeli practitioner, Anton, who is making every effort to deepen his understanding of five element acupuncture, has recently sent me the following interesting question:

I have a question about the husband/wife block. Today I treated a patient and found this block on her. And this is the third time in four months that I make this treatment for her. Well, maybe I am missing something, am I? Does it seem ok to you to have this block back almost every month?

 

This patient delivered a baby four months ago, and the baby has a heart problem from birth. He needs to undergo a surgery on the next week. I explain to myself that all the worry about new born baby makes the block to come back every time, but is it really so? Do you think it is possible, or maybe I need to pay attention to something else?

 

This was my reply to him:

It is very rare for blocks to come back more than once in a short time.  It is most likely that this patient’s pulses are always a little stronger on the right hand than the left hand, so that it isn’t a H/W block.  Just assume that that is what is the case, and don’t treat the block again.

I mulled over his question and my reply for a time afterwards, and realised that I should have added something important.  I myself never rely only on my pulse-taking to help me diagnose a block of any kind. As I have said on many occasions, pulse-taking is a very complex art, much more complex than I think we like to admit to ourselves.  In effect we are attempting to read the state of the five different elements and their 12 officials with what I always like to think of as the rather blunt instruments of our finger-tips.  Of course we get more adept at doing this as the years pass, but I have never forgotten the lessons I learned comparing JR Worsley’s pulse-readings with my own, even after I had been more than 3 years in practice (plus 3 years training myself to read pulses). 

He would tell me one of my patients had an Entry/Exit block or a Husband/Wife block when I simply could not feel this.  Conversely, what I rather simplistically thought to be some kind of a block would turn out not to be that.  In other words the delicate art of accurate pulse-reading was something I realised would take me many years to learn.  And in the meantime I realised, too, that I had to look for other indications in patients which should be helping me suspect the presence of a block.  In the case of a Husband/Wife block, we must never forget that this is the indication of a deep attack on the Heart, and a patient must be showing signs of some desperation, of almost wanting to give up.  They may not articulate this in words, and some may like to hide their despair, but as good five element acupuncturists we should always be looking below the surface to see what is really going on deep inside a patient.

Anton’s patient is dealing with the serious condition of her baby, but not everybody facing something like this would necessarily feel like giving up.  It may not be causing a Husband/Wife block, though it is always worth considering this, and carrying out the treatment procedure for a block even if we are not sure of the pulse picture.  Remember that it never matters if we try to clear a block of any kind, from Possession to a simple Entry/Exit block, if the block is not there.  It is then only like trying to open a door which is already open.  So it is better to err on the side of treating for a block even if we are unsure of its presence, rather than ignoring what might be a block.  On the other hand, once you have treated a block, you don’t need to repeat this treatment if you are sure you got the points the first time.

 

 

 

 

 

 

 

 

 

Some early mistakes in my practice

Looking back at the early years of my practice, I sometimes cringe with shame at some of the mistakes I made.  These were not, as some people might assume, to do with my very basic understanding of the elements, or my choice of treatments, although they, too, were with hindsight often rather naïve or even somewhat inappropriate.  Instead they were nearly all to do with my relationship to my patients.  Based on something which JR Worsley had impressed upon us, I somehow thought that I had to make myself available to my patients at all times, even interpreting what he said as meaning that a patient should be able to contact me at any time they wanted to.  Those were the days well before emails and mobile phones when patient-practitioner contact was nearly 100% by good old-fashioned landline.  Since I worked from home, I soon realised that I needed to install a dedicated practice line so as not to confuse my private with my professional phone calls.  This meant also having two answering machines, making quite an impressive array of phone equipment lining my kitchen shelf.

I still remember the excitement of coming back home and seeing the “message received” light blinking on my practice phone.  I would always hope that this meant that a new patient was making contact, for each new patient was then a highly exciting event.  There was, however, one definite advantage of patients having to get in touch with me by phone, and not, as usually happens nowadays, by email or text message.  This meant that when I answered them our first contact was always person-to-person, and not the much more impersonal contact of the written word through emails.  It is now often overlooked how important this initial contact can be, not only because it offers both patient and practitioner a bridge to that key aspect of five element treatment, which is the setting up of a good relationship with our patients, but it also gives us the luxury of trying to diagnose two key components of an element’s presence, the tone of voice and the emotion the patient is showing.  On the patient’s side, it helps get them past the often challenging situation of a first meeting in the practice room.  I felt that this first phone call shaped the nature of my future relationship to my patients.

But the flipside of these personal phone calls was that it gave my patients the impression that they could phone me whenever they wanted to, and this was where I started to make things difficult for myself.  I didn’t then have enough confidence to lay down careful guidelines as to when they could phone and what they could phone me about.  And I soon found this led to a further mistake.  Patients got used to phoning me at odd hours of the day, either early in the morning or, most often, rather late in the evening.  And I would find myself engaged in long conversations with them, all of which, I should have told them, were best suited to being continued at their next treatment.  It took me quite some time, and many interrupted evenings of phone calls, before I realised that what the patients and I were talking about belonged much more appropriately to the practice room, where it would help me determine the kind of treatment the patient needed.  As five element acupuncturists it is the treatment we offer our patient which helps solve their problems, and although five element acupuncture is partly a talking therapy, because of course our patients need to talk to us and we to them, it is good to remember that it is the needle, not our words, which eventually helps them.

This open-door, or rather open-telephone, policy of mine also opened the door to the thorny question of discussing the element I was treating them on.  I learnt to my cost that it is never a good idea to talk this through with a patient, because often one of the reasons for doing this can be our unconscious desire for reassurance from the patient that we are on the right track, and it is surely not their task to help us.  We are often hoping that they will confirm that we have made the right choice.  And I have come to realise that nobody, even the most experienced five element practitioner, is good at diagnosing their own element, though practitioners often like to feel that they are the best judge of this.  Unfortunately this is rarely the case, since we all tend to be rather blind to our own faults and like to think we have a special relationship to an element whose qualities we admire.  And if you mistakenly start to discuss a patient’s element with them, what do you do when you change your mind and change element, or change it several times?    Do you tell your patient this or leave them with the mistaken idea that they are of the Earth element when you have perhaps moved through Fire before finally landing on Wood?   We all know how often we find ourselves trawling through the elements before finally finding the correct one.  Thankfully, though, this happens less and less for me now.  So take heart all you novice five element acupuncturists out there.

So now I always advise practitioners to lay down firm guidelines for their patients on when and how to get in touch with them between treatments.   If we don’t do this, we are laying ourselves open to the possibility of patients controlling treatment.  For further discussion about this see my two blogs of 14 June 2018: Never let a patient take control in the practice room, and A lesson from JR Worsley: the importance of keeping control in the practice room.

Finally, it is not a good idea to tell patients what points you are using except very occasionally.  It is difficult enough for us to put into words why we are choosing a particular point or set of points, let alone explain this to a lay person.  If they ask, I have learnt to say, “I am not here to teach you to be an acupuncturist.  If you are interested in learning more, I suggest you read my Simple Guide to Five Element Acupuncture which explains my approach to treating you”.  The following are some of the few exceptions to this rule:  telling patients about horary and seasonal treatments (because we have to book our patients in at specific times for these), and correcting an Akabane imbalance, because patients are often fascinated to find that the readings change after treatment.  I have found that this is a very good way of convincing rather sceptical patients, particularly hard-headed businessmen, at the very start of treatment that there is something in what I do.

It is also useful to explain to patients that some of their symptoms may be the result of an entry/exit block, and obviously we need to explain in a little detail why we think a CV/GV (Ren Mai/Du Mai) block needs to be cleared.  In the case of this block I always first ask if the patient feels very exhausted all the time, a very good sign of a CV/GV block, and I tell them that this is because the main pathways of energy running up and down the body are blocked, draining them of energy.  Sometimes I add the fact that JR Worsley told us that if only these points were on the wrist we would do them on every patient!

On the other hand for obvious reasons I never tell a patient that I am about to clear a Husband/Wife block or do Possession treatment, because the last thing you want to do is worry the patient by giving them the idea that there is something seriously wrong with them.  With Possession, however, I tell the patient that I am doing some lovely connecting treatment, and that I need their help to make sure that they feel each of the seven points properly.  I have noticed that patients needing this treatment really understand what I mean when I say this, as though I am reassuring them that I know that they feel disconnected.  This is also a good way of describing Possession, which is in effect a level of disconnection of the spirit.

I am passing on some of my tips for what to tell patients because I wish I had been told much of what I learnt by hit and miss through my own practice.  It would have avoided some of the problems I created for myself.