Compassion

I was preparing for a seminar I am about to give and decided I wanted to talk about the qualities needed to be a good practitioner. At the head of the list I wrote the word compassion. Surely that was self-evidently the most important quality? And then I paused, for what did I really mean by the word? I had used it, I felt, almost glibly, as though it was something we all took for granted.

The word itself comes from the Latin, meaning “feeling with”, and I think at some level we would all, especially therapists of any kind, like to think that we can do this, and that our compassion comes from our ability to feel what another is feeling, and thus share in that person’s experience. But in my view this is not strictly true. I believe that none of us can truly understand what another person is feeling about anything, because we are who we are and they are who they are. Depending on the amount of insight we have, though, we can make a stab at understanding some part of another’s experience, particularly those which resonate with ours. It is, however, arrogant and, in a therapeutic context, unwise, to assume that we understand the whole.

If, as I believe, we can only think ourselves into how another is feeling to the extent that their experience is in some way akin to something we, too, have experienced, then true compassion is understanding how our own experience can only partly mirror that of our patients. It must extend to accepting that there will be areas of another’s life which we cannot really enter into, but which we can acknowledge by allowing that other person the time and space to express what they are feeling without distorting the reality of their feelings. This is a more difficult task than it appears, as I know from many years of trying to help students work their way towards an appropriate approach to others’ distresses.

All our own hang-ups come to the fore here. We may find what a patient is saying disturbing for some personal reason and therefore want to coat it quickly in a layer of platitudes, by far the worst being those terribly trite and meaningless phrases such as “I feel for you”, or “I feel your pain”. At some unconscious level within ourselves, perhaps, we may be hoping that this will effectively silence our patients. Or we may interrupt them with intrusive questions which don’t allow them time to tell us what they want to talk about in the way they want to say it, but instead direct them where we want them to go.

I believe true compassion, therefore, is the ability to allow another person to express their deepest feelings to us whilst we acknowledge that these feelings will always be unique to them. It is indeed a rare gift to be able to do this, and one we need to nurture carefully. For a five element acupuncturist what is important here is that, if we give our patients the emotional space in which they feel free to express what they are feeling in the way they want to, the elements, instead of retreating into the shadows in the face of a lack of understanding, will emerge in ever clearer outlines, as though they dare to show their true faces only to compassionate eyes.

The election leadership debates and the elements

I am using the TV debates between the three leaders to further my diagnostic skills. We have here three people who interestingly appear to be of three different elements. Since I don’t know them personally, this diagnosis is obviously made on the basis of what I see and hear on TV and the radio, but here goes. Gordon Brown - Water, David Cameron – Earth and Nick Clegg – Fire (possibly Inner Fire, but I am not quite sure about that).

Gordon Brown (Water): we have here a person who we really can describe as “still waters run deep”, showing hesitation and fear except when confronted with the life and death situation of the bank collapses, where his will to survive surfaced strongly enough to pull the whole world in his wake, like an unstoppable torrent of water. But in a situation where interaction with others (the studio audience and the millions out there looking in) is required, his need to push through obstacles translates into a bullying, lecturing manner uncomfortable to watch and listen to. Of the three leaders, he is the most hampered by what can, in different circumstances, become his element’s qualities, single-mindedness, hard ambition and unyielding determination to get his way.

I think his skin colour looks bluish-black and he undoubtedly has a groaning voice, with that quality of never being able to stop himself of water in full flow.

Compare this with David Cameron (Earth), who has much softer edges, a more all-encompassing approach to those around him, obviously never happier than when he is surrounded by a group of people. I can’t remember ever seeing him doing his campaigning without this circle of people in the midst of which he stands at ease, enjoying his central role and thriving as soon as he is in the limelight. This is so unlike Brown who seems to shrink as he approaches people, and tends to move towards each person in a straight line, shaking their hands and then moving quickly on to the next, as though pushing each aside as he moves on. His attempts to draw the Conservative party into a more compassionate role, evidence of Earth's emotion, sympathy, sits uneasily with the much more hard-hearted conventional role of the Conservatives, and draws it closer to Labour, thus confusing the electorate.

I think Cameron’s skin has that overall yellowish colour of Earth, and his voice the undulations and soothing articulations of a singing tone.

And then finally we have Nick Clegg (Fire), beautifully positioned between the two others, with his Fire energy exuding warmth and humour, and with an ability to relate easily to anybody he is talking to, which includes both the studio audience, the TV audience out there and the crucial one-to-one encounters with television interviewers in which Fire’s love of such close interactions comes to the fore. He had no problem looking straight at the questioners in the TV debates, because this is the only way Fire can relate, addressing each of them directly and so successfully that the other two leaders were forced to try to copy him in the second debate, predictably somewhat uneasily. Cameron had to keep on reminding himself to stare straight at the camera, and Brown was even less successful in maintaining such direct eye contact. Clegg was (literally) in his element in these situations, revelling in just those kind of personal interactions, with the added advantage of the ability to see the humourous even in such an emotionally charged situation, including laughing at himself. This makes him appear more human, and forms a bridge to the listener, a quality Tony Blair (also Fire) had in abundance. It is no coincidence, then, that Clegg is being compared with Blair, as they have many of the Fire-like qualities which make for easy leadership.

It will be fascinating to see whether Water (Brown) can douse Fire (Clegg) sufficiently to come out on top. This was, after all, the essence of the relationship between Blair and Brown for many years, with Blair’s Fire either constantly vapourizing Brown’s Water or being extinguished by it, as neither overcame the other. Or will Cameron’s Earth prove strong enough beneath his feet to swallow up Brown’s Water and prove insufficient foundation on which Clegg’s Fire can thrive.

And, much more importantly, will the country as a whole want the optimism of Fire to lift them out of this economic depression and take them into the unknown rather than stick with the known?

The serendipities of life

I love the word serendipity. I looked it up in the dictionary, and apparently it comes from a Sri Lankan fairy tale, was used by Horace Walpole for the first time in 1754, and means “the faculty of making happy and unexpected discoveries by accident.” Apart from the joy I experience in listening to the almost ridiculous rhythm of the syllables, the word makes me think of a lucky dip, with its image of a ragbag of things put together by chance. A brace of serendipities has come my way over the past few days, and made me revel in the curious interconnections of life. The first relates to a painting I was looking at, the second to a book I had read.

I happened to be walking down Bond Street and saw a lovely Pissarro painting in the window of an art dealer. I plucked up courage to go inside (they are daunting places, these showcases for art worth millions), and after bathing in the glories of the Pissarro and other similar paintings, found myself unexpectedly in a room of more modern art, amongst them two lovely paintings by a painter from St Ives I had never heard of, called Paul Feiler. I noted his name down, thought no more about him, until the next day I read an account of an interview with Hilary Spurling, the biographer, who mentioned that with the first money she earned from her writing she went out and bought herself a Paul Feiler.

The second serendipitous event was perhaps more remarkable. A little while ago I read with great interest a marvellous autobiography by the Austrian writer, Stefan Zweig, whose background was very much that of the Austrian side of my own family. He lived the kind of Viennese intellectual’s life familiar to me, and I suspect, though have no way of confirming this now since there is nobody left to ask, that he was a friend of the family, or at least moved in the same circles as my grandmother. His greatest joy was his collection of signed manuscripts, mostly of music and letters by musicians, including those of the greatest composers, such as Bach and Mozart. He describes how he gradually built up this collection over the years, and then, as he was forced into exile as a Jew, how he eventually lost or sold it before fleeing first to England and then to South America, where he committed suicide in the 1940s.

I gave my son a copy of this book for his birthday a few weeks ago. He rang me yesterday to tell me that he had been introduced to the girlfriend of a fellow musician at a jazz concert who told him that she worked on manuscripts in the British Library. She was now looking at a collection which had been bequeathed to the library, part of (you can guess what I am going to write) Stefan Zweig’s collection.

I have written a book called The Pattern of Things, because I believe there is a pattern underlying all things, much of it unperceived by us but occasionally surfacing, as it has done with these two episodes for me, to remind us that all is not haphazard or chaotic, but instead, at some level, ordered. My work as acupuncturist encourages me in believing this, as it confirms for me this often hidden sense of order.

My final example of serendipity illustrates this. A patient of mine was unable to shake off an obsession with a previous boyfriend which was stifling her life. I told her that it was a pity that she could not meet him again to see how far her feelings were the remnants of something long vanished. She rang me that evening to say that, when she left me, she got on to the underground train to go home, only to find herself sitting opposite this man! They went off for a meal together, and she realised that she was well and truly over the affair. “I can’t think what I saw in him.” He lived in Scotland and she lived elsewhere in London, and the chance of their meeting on a North London train except for some fore-ordained reason was effectively nil.

What a strange, strange, mysterious world we live in, volcanic dust clouds and all, no doubt sent to mock our dangerous feeling that we control the universe.

The act of reading

I went to a fascinating evening at Daunts bookshop in Marylebone Hight Street last week where I heard Margaret Willes and Alberto Manguel discussing their books on reading*. Before this I had certainly never thought that there was any need to think about the act of reading in any special way. I thought I just read, and that was that. I know that recently I had asked myself why I read, for I read very fast, as though sucking up the words and then spitting them out again, and often all they seem to leave behind is an after-taste of something which can either add to my life or not, depending on whether the words are stimulating or not. I find that I often can’t remember the plot of a book, its title or even its author minutes after I have finished reading it, and yet whilst I read I am transported to another space, to the extent that it takes repeated intrusions for the world outside to intersperse itself between me and the words on the page sufficiently to prize my attention away from them. So to ask myself why I read was a good question, and already, having now started the Margaret Willes book, I have some answers to whet my curiosity and make me want to read more.

If nothing else, I have this lovely quote from Margaret Willes’ book to nourish me in my blog-writing, where what I write “in all privacy, in my bureau” can now be seen by “every butcher and baker” in the land, but, I imagine, for substantially more than “3 pence”, if we add the costs of linking up to the internet. It does indeed give me an “exceeding odd sensation”!

“After a secret visit to (Bell’s Circulating Library), Fanny (Burney) wrote, “I have an exceeding odd sensation, when I consider it is now in the power of any and every body to read what I so carefully hoarded even from my best friends, till this last month or two – and that a work which was so lately lodged, in all privacy, in my bureau may now be seen by every butcher & baker, cobler (sic) & tinker, throughout the 3 kingdoms, for the small tribute of 3 pence.”

* Margaret Willes, Reading Matters; Five centuries of discovering books, Yale University Press, 2008
Alberto Manguel, A Reader on Reading, Yale University Press, 2010

The dreaded words "placebo effect"

Definition in the Concise Oxford dictionary: “Medicine given to humour, rather than cure, the patient” (coming from the Latin word “to please”)

How I hate the word placebo and all the baggage of negativity it brings with it! Not only does it patronize the treatment to which it is applied, but, unforgivably, in my view, it also appears to patronize patients by “humouring” them, as if it does not matter if wool is pulled over their eyes in this way.

Calling something a placebo is an acknowledgment that it helps the patient feel better, whilst at the same time mocking this help. But if a patient feels better we should surely be applauding rather than mocking. And hidden somewhere behind the use of the word is the implication that making people feel better is somehow not the aim of treatment. I also see this approach as evidence of the Western mind-set determined to deride what it doesn’t understand. This is nowhere more evident than in comments like these directed at complementary medicine.

Why, then, I ask, are not some orthodox treatments, such as sleeping pills or antidepressants, also labelled as placebo treatments? These, too, could surely be said to fall under the definition of humouring, rather than curing, the patient!

Review of The Pattern of Things

I give below a review of my book, The Pattern of Things, viewing Life through the Prism of the Five Elements, by Rob Ransome, who graduated from my first group of students at the School of Five Element Acupuncture. His review has made me re-evaluate my book, and given me further food for thought. I hesitated about including it in this blog, but then realised that it would help people decide whether this was a book for them. So here it is. Many thanks, Rob, for the thought you put into this.


“Nora qualified and gained her masters at the College of Traditional Acupuncture over twenty years ago. Her passion for the elements and Five Element acupuncture extends beyond the clinic or classroom and is embraced in her every breath. In her writing she endeavours to pass on her knowledge and love for the elements. Her fourth book is no exception.

The Pattern of Things is a series of reflections of how Nora experiences being an acupuncturist, the challenges this has thrown at her and the fears she has had to face as a result. In this book Nora shares her insights on how it is to be with a patient in the practice room, something that is quite rare. In doing so she has made me reflect on my own practice and the challenges I face working with my patients.

It is all too easy to think of an element as something static and not as qi in motion, or regard the next patient as a symptom or a CF, rather than as a unique person, or forget that the quality of patient-practitioner relationship also depends on us being fully in that relationship. Nora addresses this, looking inwardly at how she experiences each element within herself in order to gain greater understanding of both herself and the dynamics of her relationship with whomever she is interacting with. And by doing so, she invites us to do likewise.

One does not need to be a five-element practitioner, nor agree with Nora’s perspective, to gain from reading this book. Her challenge to the readers is to put under the microscope what they themselves do in their own practice and to learn from this.

The Pattern of Things could easily be a bedtime read. The danger for the reader is to gloss over the contents, missing the wisdom that lies within the simplicity and fluidity of thought, and failing to take the time to reflect on their own personal meaning. I found this to be a much easier and shorter read than her previous book, Keepers of the Soul. The new book evolved as a series of essays written over time, some having a beginning well before Keepers was completed. Thus the thoughts also evolve, perhaps revolving onto another page, or overlapping with ideas described in the Keepers, and this indeed is an example of continuous, reflective practice.

The author expressed to me an uncertainty as to whom the thoughts in her book are addressed, though in my view they are intended primarily for practitioners and students. As to the title, this was nearly given to Keepers of the Soul, though in the end it was relegated to a chapter heading there. The title, The Pattern of Things, has great significance for Nora. I have debated with her its appropriateness in relation to the material in her book. This led me to re-examine those fundamental patterns of life described in the Tao Te Ching and the early chapters of the Su Wen. On reflection, I am still unsure that her title encapsulates the contents. Perhaps this is something else for the reader to consider. But first I recommend that you read the book.”

A sphere of thought stretched across the world

There are many ways of passing on what we have learnt to those who come after us, and perhaps this is what we should be concentrating upon as we grow older. It is certainly what I feel I need to do, and one of the ways I am doing this is through this blog. Writing a blog is a form of exposure, an opening up of my innermost being to the world at large, and, for me and for everybody else who embarks upon these forms of communication, represents an act requiring some courage. It is the instantaneous nature of it which is both stimulating and frightening.

These thoughts reminded me of the astonishment with which I read Teilhard de Chardin’s Phenomenon of Man, written more than 50 years ago, and in which, with uncanny prescience in view of what was to come, he predicted the advent of the internet. He foresaw what he called a noosphere, a sphere of thought, growing up around the world like a membrane stretched across it, over which thoughts would transfer themselves instantaneously, much as though the world had grown the synapses of a gigantic brain. He predicted that a word spoken in Japan would register in a few seconds in Alaska. And this is what happens now. I need only press a button, and all the words on my screen will fly across to the most distant computer tucked away on some person’s mobile in the jungle or on the steppes of Russia.

How many thoughts, like seeds blown astray on the wind, just dissipate themselves away to land who knows where?

For those who are not familiar with Teilhard de Chardin, he was a Jesuit priest and a palaeontologist, a rare combination, which led to his excommunication by the Catholic church for his views on the origin of Man. He saw the development of this great world brain as an extension of our evolutionary development, and made me understand how crucial to this was the fact that we learned to stand upright on two legs all those millennia ago. As well as releasing our two hands to develop the miraculous dexterity our 10 fingers give us, it led directly to the shrinking of the heavy jaw needed to hold a four-legged creature’s head upright, and thus provided our brains with the space to expand. I like the thought that the trouble we often have with our wisdom teeth is connected directly to evolutionary changes as our jaws continue to shrink and our brains to grow, a fact my dentist confirmed. Teilhard de Chardin was truly a visionary.

In the Footsteps of the Elements: Colour

I was asked for a title for my next seminar at the College of Traditional Acupuncture in Warwick on July 14th, and what I came up with quickly was “In the Footsteps of the Elements”. This is a direct reference to Peter Eckman’s book on the history of acupuncture in the West, “In the Footsteps of the Yellow Emperor”, but also represents very neatly what I think we do as five element acupuncturists. We try to trace the footprints the elements leave on all of us, and we do this because we hope that they will eventually lead us to the guardian element.

We categorize these footprints under the four heading of colour, sound, smell and emotion (I prefer the down-to-earth, Anglo-Saxon word smell to odour, but that is a personal preference). Yesterday, talking to some new graduates, I mentioned to their surprise that I see an element as imprinting its colour not only on to areas of the face, but over the body as a whole, as it penetrates deep within each cell. If you can’t see colour on the face, then, learn to look carefully at whatever area of the body is exposed as you needle (abdomen, legs or back, for example). Use the skin colour of your own hands as a reference point to help you here. You may be surprised to see how strongly your own element’s colour stands out on your skin when placed against that of another element. My hands, for example, take on a much deeper red colour when seen against the skin of the other four elements, whilst they seem to tone in easily with the colouring of other Fire people.

This is my diagnostic tip for today.

Experiencing the Earth element

I wrote in my 19 March blog about my day inside the Metal element. Some time ago I had a similarly sudden immersion in the Earth element, and, as you will see, immersion is exactly the word to use. I was lying in the bath, slowly letting the bathwater drain out. As the water drained away, I started to feel my body grow heavier, moving from a point where I had been totally unaware of its weight to a feeling of increasing heaviness as parts of me emerged above water, until, with the bath now empty of water, I felt as though my body had become a dead weight whose heaviness seemed to be pinning me down. I was made aware of the considerable effort it required to unpeel myself from the floor of the bath, and was astonished by the force of the gravity which had seized hold of my body as the water sucked away from it. Why had I never noticed this before?

Once upright, normality returned, as all the mechanisms which we learn as a child to enable us to stand clicked into place. By the time my feet were on the bathmat my body no longer felt heavy, and it took me some effort to remember how difficult the transition from weightlessness to weight had been.

Those few minutes in the bath have helped me understand how Earth people can feel, for they live their lives in an endless balancing-act between the desire to remain safely tethered to the ground and the need for their Spleen to help move them forward, and thus for the few moments as one foot after another leaves the ground be vulnerable to falling over. When out of balance, this desire for security can outweigh the need for movement, and suck them down into the earth as though they are stuck in damp clay. Or the opposite may happen, and this damp clay turn instead into dry sand which allows no foothold.

This is how I see the two extremes of the Earth element out of balance: the one as though they are stuck fast in oozing mud, the other as though they are trying to keep their footing on ever-shifting sand. Between these two extremes lies stable Earth, with its feet firmly planted on the ground, and yet with sufficient balance to move securely forward when movement is required.

You may find that your next bath can be a lesson which teaches you as much as a whole lecture on the Earth element!

Experiencing grief for a day

Not long ago I experienced something which had never happened before and which gave me quite a different insight into one element in particular, the Metal element. I woke one day feeling unutterably sad. Though I racked my brains I could find no reason for this. Nothing was then happening which could be causing me the kind of sense of deep loss I was experiencing, nor could I pin it down to any recent event which might have occurred around this time of the year. I looked at the season I was in, and it was not autumn, Metal’s season, when we might all feel a little melancholic at the imminent death of the year. Nor did the date have any particular resonance for me, as I fretted away at my memory. So where had this overwhelming, all-permeating feeling of sadness come from?

The feeling lasted just that one day. By the evening it was fading, and by the morning it had gone completely, never to this day to re-appear. At one level it puzzles me that I should have been so shot through with such an unfamiliar emotion, one that even in times of deepest distress at some real loss in my life I had so far never experienced. Its very unfamiliarity was disturbing, for it propelled me into unfamiliar emotional territory.. I felt cut off, alienated from my surroundings, and unwilling or unable to share my thoughts with anybody else. I felt as if I was wandering alone like a shadow amongst strangers, unapproachable, as though nobody could reach me beneath this mantle of grief that I was enveloped in, like a garment I could not take off.

The memory of this strange day has faded, but its significance has not, because at some time during it I found myself saying to myself, “so this is what it is like to be Metal. This is what Metal people must be feeling at every moment of their lives.” Was this realization the reason I was asked to experience such an unsettling day? Now I like to think it was, for that journey on to what I like to think is Metal’s territory and my identification, however briefly, with the emotional terrain upon which Metal lives its life, have given me deep, personal insights into this element which I think I could have gained in no other way. These have stayed with me ever since, and guide me with a surer hand to my diagnosis of Metal in other people.