My mantra of the moment

The secret to understanding another person’s guardian element lies hidden deep within ourselves.  If we can interpret correctly how another person makes us feel, then we are on the way to understanding the dominant element which guides their life.

Filming a Traditional Diagnosis (TD)

I decided that it was important for my Chinese students to observe me carrying out a TD at the start of a new patient’s treatment.  I have always said – and I repeat here again for emphasis – that a diagnosis only forms the first loop in a never-ending chain which unwinds a little bit more each time we see a patient.  One example of this is something which happened with a very longstanding patient of mine last week.  He told me something about himself that gave me a totally different insight into who he was, jolting me out of the kind of complacency an association of more than 20 years can lull us into.

This new patient of mine is a young man who was very happy to consent to being filmed, and enjoyed the thought that the video was to be played to an audience of Chinese acupuncturists in China.  On looking at it after the TD was completed, I thought that I had, overall, achieved what I had set out to do, which was to demonstrate the important components of a TD.   I felt I had already started to establish a close relationship with this patient, had heard about the most significant aspects of his life in some depth, learnt the reasons why he felt he needed help from me, and started to piece together the different areas of his life to create some kind of a pattern explaining why he was as he is now.

I realised how much the years of my practice and the hundreds of patients I had seen in that time had contributed to honing my diagnostic skills by helping me focus on what was significant rather than, as students tend to do, getting bogged down in a lot of detail which proves later to be of little significance.  This is where what I call a feel for the odd comes in, the sudden awareness of something the patient is saying or doing which jars.  I am better at recognizing the hidden signals patients send out, pointing to often submerged areas of their lives which we need to explore because of their importance. This means that I am able to home in more quickly on something which needs following up, as I noticed I did with this patient, persisting in returning to it again and again until I found an explanation.  I noted, too, those places where I had left some loose ends as something I needed to discuss with the patient next time.

The thing that I was constantly being told in China was people’s surprise at how much what they called “compassion” I showed the patients I treated there.  This was merely a reflection of the importance we attach to developing a close relationship with our patients.  This certainly always involves both compassion, and, just as importantly, and an essential ingredient of compassion, a sincere interest in every area of our patients’ lives.

I will be interested to see what my Chinese students make of this video. 

"Look up at the stars, not down at your feet"

I love this quote from a speech by Stephen Hawking.  I think we all spend too long looking down at our feet, whilst the stars and universe beyond are beckoning to us to look up.

A few simple tips to make a five element acupuncturist's life easier

Don’t hurry!  Don’t worry!

• The first rule is to have compassion for your patient.  Compassion means to “feel with”.  The more you can feel what your patient is feeling, and therefore can understand them, the more quickly you will be able to discover which element is directing their life.  Unless we allow our own hearts to resonate with our patient’s feelings, we will never understand which of the five elements guides their lives.
• Do not be in a hurry to diagnose the right element!  The elements will wait for you to find them, and show their faces more and more clearly with time.   And all elements will enjoy the kind of focused attention they receive from simple command-point level treatments. 
• If you are not in a hurry, you can relax and learn to get to know your patient better.  All of this will give you time to observe whether there has been any change from treatment, and show you whether or not you should continue treating that particular element.
• Don’t think that your patient is necessarily expecting a quick fix.  Patients appreciate the care and deep concern their practitioner shows them, and return again and again for that.  This is usually unexpected and rare, compared with the impersonality of doctors’ surgeries and hospital waiting rooms.  Patients are usually only too happy to give the practitioner all the time they need.
• The most important aspect of any treatment is not the amount of time spent on the actual physical procedures, but the time it gives you to understand your patient, observe them and help them get used to you.  Patients won’t be counting up how many points you needle, but they will be assessing how interested you are in them and how concerned you are about them.
• Think of each treatment as asking a question of the elements.  The practitioner’s task is to try to interpret the answers the elements give.
• Do at least three treatments on any element you choose.  If you are treating once a week, then this gives you at least 3 weeks in which to observe an element’s responses.
• Don’t confuse the elements by changing from one element to another after only a short time or in the same treatment, if you are not sure which element you should be treating.
• Don’t judge any change in your patient simply by using the criteria of changes to physical complaints.  Get used to assessing change in the patient as a whole, particularly  in the patient’s spirit and emotional balance.  It is by getting better at noticing what can be even very small changes in a patient’s behaviour or physical appearance that we begin to see whether our treatment is directed at the right element.
• If in doubt, simplify, and do the least number of points possible.  Don’t judge the success of treatment by the number of points you needle.  If you aren’t sure where you are going with your treatment, don’t add to your confusion by haphazardly piling point upon point.  Try to clear your mind by just doing one pair of command points, preferably the source points.  This helps you focus your attention directly and deeply upon an element.  Then let the elements answer you.
• Don’t spend too long trying to diagnose the major blocks (possession, husband/wife).  They are much more difficult to diagnose than you may think.  It doesn’t matter if you miss them to start with.  They become more and more obvious the longer they remain untreated.  An expert practitioner may see them straightaway;  a less experienced practitioner will inevitably take longer to recognise them.  There is a risk that a newly qualified practitioner will over-diagnose blocks because of the excitement of doing them!

"Living on the knife-edge of insecurity"

I just sat down for a quiet moment, and casually picked up today’s Guardian.  The actress Siân Phillips was being interviewed, and in answer to the question, “What’s the best advice anyone ever gave you”, she said:

“Saunders Lewis, the great Welsh poet, befriended me.  When I went to London and gave up my life in Wales, he wrote me a letter that said, “You have to live on the knife-edge of insecurity.”  And I thought:  “OK, that’s what I’ll do.”

I love the phrase, “living on the knife-edge of insecurity”.  It encapsulates what I see as the need willingly to accept the often frightening challenges life presents us with.  

Why it is never wise to treat our friends

I have recently been asked to treat two friends, one very close and the other more a friend of a friend.   Both of them were reluctant to go to another acupuncturist, and both were in quite a lot of distress.

This has made me think carefully about what has always guided me in my decision to treat or not to treat a friend.  Ideally, as we all know, we should not be treating family and friends because their very closeness means that we are not detached enough to see them clearly and to cope with finding out exactly what is wrong with them.  We assume, usually very wrongly, that we really know all about them, and can therefore skip doing a proper diagnosis and move straight on to treatment.  But my experiences in the past have put a lie to this, for I have often assumed somebody I know is of one element and decided quite some time later that they reveal another side to themselves and I have had to change my mind.  This has happened with me with a very close relative and a very close friend, both of whom I had somehow put into an element box which, looking back, I suppose I felt was part of my comfort zone.   When I later discovered how wrong I had been, I realised that I had almost deliberately been overlooking aspects of these two people which made me feel uneasy.  Since learning these two difficult lessons, I have been very reluctant indeed to treat those close to me, unless there is absolutely no alternative (for example, if geographically there is no other practitioner near enough to treat them, or they are hospitalized and would simply go without treatment).

With family members, however unwise being their practitioner is, it is unlikely that my treating them is going to cause a change in our relationship.  With friends, I have found, things are quite different, and my relationship to the friends I have had to treat in the past has always changed, and never for the better.  Usually what has happened is that the friend now views me only as their therapist, and wishes me to continue in this role even when I am not treating (by talking over symptoms or the effects of treatment in a social context, for example).  In a more extreme case, the friendship itself became endangered by the fact that a somewhat competitive friend did not like to feel that I was somehow gaining the upper hand, and persisted in claiming that treatment was making her feel worse.  In the end, I lost her both as friend and patient, because we never rediscovered our easy relationship of before.

In the two examples that have come my way now, I have, with a sense of relief, passed both the friend and the friend of a friend on to a fellow practitioner, knowing that I was doing the right thing.  This was not done without a slight tussle, because my first impulse is to offer help to anybody asking me for help, and it requires some strength of character for me to move aside.

       

Just a bowl of medicine soup?

I am grateful to one of my Nanning students, Huang Jing, for the following, acute observation about the challenges facing those who work in busy acupuncture clinics where they are asked to treat many patients, and who want in some way to move on to treat with five element acupuncture.  Her email has prompted me to think carefully how I can help my students over in China to make the transition to five element acupuncture without endangering their livelihoods.

“With Five Element Acupuncture I could only see 4 - 5 patients in any half-day, and with today’s demand on outpatient service, this is far too little, and I will never be able to treat all the patients… I need to see about 28 patients in half a day.” 

And then she goes on to say, “However I see that in this way we are seeing a lot more patients, but we can only treat the very surface of their problems.  We have not got the time to trace or to understand where their problems have actually come from.  In the times we are living in now especially, people are carrying around huge emotional burdens, and their physical problems are often caused by these internal problems.  We really ought to be giving our patients not just a bowl of medicine soup, but we should also find a way to give them some spiritual nourishment.”

It is quite understandable that practitioners who may work in a system based on the need to treat a lot of people as quickly as possible find it difficult to move to five element acupuncture, where we accentuate the need to develop a long-standing one-to-one relationship with our patients.  These two approaches to practice, the one, the “bowl of medicine soup” approach, and the other the “spiritual nourishment” approach, appear to be irreconcilable, but I do not think they are.  There are certainly ways of adapting what I do in my everyday London practice to what is needed in a busy outpatients’ clinic, as some of my fellow practitioners have proved when they worked in the stressful conditions in Sri Lanka after the floods treating as many patients as my Nanning student is asked to treat.  It is now my task to work out the best way to help my students adapt their practice.

In this context, I find it interesting that my translation work on Elisabeth Rochat de la Vallée’s 101 Key Concepts of Chinese Medicine has strengthened my understanding that the “bowls of medicine soup” of the original pioneers of acupuncture, some 2000 years ago, contained as their most important ingredient that of “spiritual nourishment”.  The two, the physical and the spiritual, were always regarded as an indissoluble whole. The sad thing is that this has got so thoroughly lost in modern TCM, and particularly in those places where living conditions demand a high turnover of patients.  It is as though patients’ spirits have become irrelevant to the restoration of health.  It is little wonder, then, that my Chinese students are amazed at the speed of improvement when using five element acupuncture as compared with their current acupuncture practices.

Here it is useful to look at what we do at our first treatment, during which we always drain Aggressive Energy.  This is a quick and effective way of drawing out any negative energy which may be polluting the elements, and is probably worth 10 treatments from other forms of acupuncture, where this sapping away at the elements’ strength remains undetected and untreated.  And the same, if not more so, can be said of those important blocks to treatment, husband-wife and possession.  From that point of view, I see five element acupuncture as providing a surprising short-cut to a return to health which it is not always recognised as offering.   

At the start of practice, as with every other kind of acupuncture, a fledgling practitioner will obviously require time to develop the skill to give effective treatment, and in five element acupuncture you can’t look up a formula of points which TCM likes to do.  But you can certainly get quicker and quicker at doing an AE drain, and the nature of this treatment (needles in the back for some period of time) gives the practitioner more time to talk to the patient.  So in that way, when I was in Nanning, and was asked to treat many patients in a way very unlike that of the leisurely time I grant myself for my initial diagnosis with my London patients, I learnt very quickly to move on to the AE drain after perhaps only 10 minutes or so.  Here my knowledge of the elements came to my aid, because I would try to focus my questioning on those areas which I thought would probably be the most important for that particular patient.  And I was surprised at how easy it was to home in on certain areas of emotional distress very quickly, all the more so because the patients were only too keen to accompany me into areas of their life which nobody had shown any interest in exploring with them before.

Of course I have many years of experience at diagnosing the elements to draw upon, but I was delighted to see how quickly my students homed in on the different elements and with what surprising accuracy.  Here their deep-seated knowledge of the elements, so engrained in them since childhood, comes to their aid, and, coupled with their keenness to learn, makes my task all the easier.  The question now is how to guide them to make the transition from a formulaic approach to treatment to the more individually-focused five element treatments, whilst dispelling some of their natural fear at having to learn such a different approach.

I am formed from an exploding star

Amidst all the gloom in today’s world, I came across this heartening bit of news in the Guardian today that made me smile. It was in an article entitled: “In the beginning ...Supernova produces life’s elements”, about the explosion of a star far out in space.

“Understanding how these giant explosions create and mix materials is important because supernovae are where we get most of the elements that make up the Earth and even our own bodies. For instance, these supernovae are a major source of iron in the universe. So we are all made of bits of exploding stars,“ said Mark Sullivan of Oxford University.

I like the thought that I am made of a bit of an exploding star.

Nanning photo

Since getting back from China, I have been trying to work out a way of downloading the photo of the group of 50 or so who came to listen to my talks for 10 days in Nanning. I hope I have now managed to do this.

I am sitting next to Liu Lihong, with his wife on my left side, and next to her Wendy Kiely, who acted as my helper throughout. To the right of Liu Lihong is Mei Long who introduced him to five element acupuncture, translated my Handbook of Five Element Practice and acted as my translator.

Developing a format for five element distance-learning for my Chinese students

It is fascinating working out a distance-learning schedule for my Chinese students, because they start from a totally different position from European students. First of all, they already have a much deeper understanding of the elements as though these are etched into their bones and in their heart. They are companions with which they have grown up, not the rather strange aspects of life which European students have gradually to be introduced to. And then the students are very well-trained, drilled almost, in their point location and practical techniques, such as needling. So I found that I started at a higher level in terms of their practical skills.

On the other hand, they are at a much lower level in terms of much that we take for granted here in five element practice in the West, and that is in relation to a practitioner’s approach to their patients. The one thing I was constantly surprised at was to hear Liu Lihong emphasizing throughout my days of teaching in Nanning what he called my compassion to the many patients I was asked to treat. When I looked at what I was doing, I realised that what, to me, is the most fundamental aspect of my practice, my warm relationship to my patients and the importance I place on establishing this from my first contact with them, was a completely new area of practice to those observing me in China. This is, after all, the essence of what we, as five element acupuncturists, are trying to do, which is to develop such a close relationship with our patients that they feel secure enough in our presence gradually to lay aside their masks and allow their elements to reveal themselves in their true colours.

So one of the first lessons I will be thinking about is to encourage the students to use even such basic skills as pulse-taking as a first step to developing the proper physical contact with their patients without which no subsequent treatment will be successful. This is why I don’t agree with taking pulses with only one hand. We need both our hands to enfold the patient’s hand in a warm, loving clasp. And as we feel each pulse, we should remember JR’s lovely phrase as he told us how we should take pulses: “As you feel each pulse, you are asking, “Small Intestine, how are you today? Heart, how are you today?” If you say this to yourself, there is no way your pulse-taking can become the automatic snatching at the mere beat of a pulse which a Western pulse diagnosis has sadly turned into.

My first lesson is already winging its way to China by email. It is on the Wood element, and how the students can find ways of observing its manifestations through looking at examples of some of the patients treated in front of the class when I was there, and adding to these some famous examples of Chinese people from the web. I have also asked them to learn the points not only according to their Chinese names, which gives each name an individual importance, but more in terms of their relationship one to another along a meridian. The point numbers we use, such as Stomach 1 – 45, draw the points together and attach them more closely to the line of the meridians they lie upon, something TCM is not so concerned with.

I have also decided, to my profound delight, to use the Roman numerals for the officials, I for Heart to XII for Spleen, which were embedded in Leamington’s teaching when I was a student there, and have so unhappily and so unnecessarily been discarded for the TCM approach which likes to start instead at the Lung. (If you look at the texts upon which the original teachings coming to this country in the 1950s were based, you will see that the Heart always appears first.) Maybe the reason the Heart has been demoted to a subsidiary position in this way reflects the lack of heart in TCM practice, something which is reflected in Liu Lihong’s desire to instil more heart in his students’ practice by inviting me, a Fire person (and Inner Fire as well!) to warm up the teaching for his students. He told his class several times that “we need more Fire here”.

So Heart once again takes what I consider to be its proper place as the head, the emperor, of all the elements. Luckily the Chinese students told me that they are already familiar with Roman numerals, unlike many of my former students, which makes their task easier.

So on to Lesson 2, the Fire element, and a discussion of the importance of touch.