(Article submitted to the Acupuncturist, the
newsletter of the British Acupuncture Council)
We are used to thinking of
the transmission of traditional Chinese medicine as being a form of one-way
traffic passing from East to West, but somewhat to my initial surprise, I have
become a key factor in its journey in the opposite direction, from West to
East. Specifically, it has become my
task to take the first steps in helping five element acupuncture build a bridge
back to its land of birth, China.
Over the years China has made many
different, often contradictory attempts to try to integrate its traditional
form of medicine within the framework of Western medicine or to find ways of
making Western medicine fit within it. It has never been quite clear whether it
should view it as a powerful indigenous medical system on a par with, or even
superior to, Western medicine, or as a more primitive branch of medicine which
Western medicine had in many ways superseded.
This uncertainty has hovered over China’s
at times almost schizophrenic approach to its traditional medicine, and is one
of the reasons for the confusion which this still causes, not only in China but to
practitioners of Chinese medicine round the world. In other words, can Chinese traditional
medicine be viewed as a stand-alone, intellectually coherent form of medicine
based on more than 2000 years of continuous practice, or has the appearance of
Western medicine in the past 100 years or so demoted it to an inferior,
ancillary role?
It will be obvious from my
writings and my teachings that I am utterly convinced of the former, but sadly
I am not sure how far my view is shared by many of its practitioners either in China or the
rest of the world.
Through a series of what
could seem to have been coincidences, but I regard now as clearly defined steps
along a path which has guided me throughout my long association with
acupuncture, I was led to meet Professor Liu Lihong at
the Rothenburg conference in Germany a few years ago, together with his very
good friend and translator, Heiner Fruehauf. Liu Lihong is
described as being “arguably the most
important Chinese medicine scholar of the younger generation in present-day China. His controversial book Sikao zhongyi
(Contemplating Chinese Medicine) became an instant bestseller when it was first
published in 2003. Since then, it has
attracted a larger and wider circle of readers than any other Chinese medicine
book in modern times. His book
represents the first treatise written in the People’s Republic of China that dares to openly discuss the
shortcomings of the government-sponsored system of TCM education in China, which
informed the evolution of TCM around the globe.”
I was then invited by him to
give a seminar on five element acupuncture to acupuncturists at his research
institute in Nanning in South
China in November 2011, the first of five seminars I have given
there to a growing number of acupuncturists.
At my last visit in April, Professor Liu, who is himself a scholar of
the classics, when introducing me to the class of 70 acupuncturists, said, “The seed of five element acupuncture is a very
pure seed. I think it originates directly
from our original classic Lingshu, “Rooted in Spirit” (Chapter 8 of Lingshu),
or “Discourse on the law of needling” (Chapter 72 of Suwen). That is to say it
fits easily within the Neijing. It is therefore not created from nothing. It has its origin in the far-distant past and
has a long history. The seed which
underlies its practice is very pure. For
many good reasons, this seed has now returned to its homeland and started to
germinate. In Nora’s words, its roots
have started to penetrate downwards.”
I have been invited to give a
keynote lecture on “Returning the spirit to
acupuncture in China” at the BAcC conference on 26 September 2014, when I
will be describing in greater detail the process by which the roots of five
element acupuncture are being encouraged to grow steadily stronger in China.
I have just spent a happy few days in Berlin with two very dedicated German five
element acupuncturists, Christian and Thomas.
This was very stimulating, both culturally, because I saw more of Berlin on this, my
second visit, and from an acupuncture point of view, as it always is.
It was during a day spent looking at patients together that
I was made aware once more of the importance of the question of the spacing of
treatments as representing an essential, but often overlooked, aspect of how we
help our patients.
I don’t think that we pay enough attention to this in the
normal course of events. At the start of
a patient’s treatment I expect we all tend to give them a number of weekly
treatments, normally something like six or so, and then we tend to space
treatments more widely from once every 2-3 weeks to monthly and eventually to
once a season and less. It is what happens as we
move further on in treatment that problems can arise. I was made aware of this again by one of the
questions I was asked. How was the
practitioner to deal with a patient who, he said, “insisted” on weekly
treatments whilst also maintaining that treatment was not helping him in any
way.
We have various ways of assessing the effect of
treatment. There are our own
observations as to whether we notice any changes or not, and then there are the
patient’s own assessments of how treatment is going. Usually these two sets of observations will
coincide. Problems only start when the
two differ, as for example if the practitioner notices how much better the
patient looks, or the changes he/she is making to their life, and yet the
patient him/herself says that there has been no change at all. We cannot try to persuade the patient by
saying things like, “but you seem to be walking better” or, “you have not been
talking about your family problems as much”, because that is denying the
patient the right to make their own assessment of what they consider constitutes
improvement. On the other hand, we may
be concerned that the patient is choosing not to acknowledge that there have
been changes for other reasons. These
may include such things as a fear that we are “giving up” on them, or, more
subtly, as part of some kind of a hidden power struggle between the patient and
us. Some people can be unconsciously
reluctant to accept the help of others.
How do we as acupuncturists get over this difficulty? If the relationship between our patient and
us has been well-grounded from the start, there should be no problem, as the
patient’s strengthened energies give them sufficient support gradually to do
without our help. But if something in
this relationship has tilted it towards over-dependence on us or otherwise distorted
it, it may become more difficult to hand control back to the patient. We may, for example, allow our patients to contact
us too often between treatments by phone or now increasingly by email,
something I was guilty of in the early days of my practice, because I felt I
always had to be there to help my patients whenever they needed me. This can
make it all too easy to blur the necessary lines of separation between patient
and practitioner which make a healthy relationship possible.
We must never forget that our aim must always be to reach a
point where we step back and treatment is no longer needed, the point where
patients are now able to maintain balance by themselves. If we are having difficulties with working
out how gradually to space out treatments for patients we can see require less
treatment, we should examine our relationship with them to see if we have
encouraged on over-reliance on us, and, if so, start gently to take steps to
encourage the patient to greater independence.
Of course, as with everything
relating to our patients, our approach to each one will be different, and must
be adapted to their individual needs.
With one patient treatments may remain weekly for much longer than with
another. At each stage we have to assess
whether our relationship to our patient is adapting flexibly to that patient’s
needs, and not depend upon a fixed formula for the spacing of appointments.
Today’s newspaper yielded yet another interesting
snippet. An article from the New York
Times International Weekly had the intriguing title “Chinese unwind with a hug
and a song”. Apparently the Chinese are “finally
learning to hug each other” - although, from my own experience in China, they
already know how to hug with great enjoyment.
Or perhaps it is just that I have met those who have spent
time looking at the elements, and have had their interest in emotional responses
stimulated by being told to observe what each element offers. Most Chinese, this article appears to
indicate, “have been slow to embrace the embrace”. Liu Lihong told
the class I was teaching that “we need more Fire here”. In the case of hugs, it is probably more
Earth that is needed, since I think hugging is much more a response to one of
the Earth element’s needs, which is to draw people close to them.
The article said that “recently it seems like everyone is
hugging. Friends are hugging. Family
members are hugging…. The tables are turning….. Schools are now conducting
classes in emotional intelligence. For
homework, children have been assigned to hug their parents.”
This trend towards learning to be unafraid to show emotions
may be part of the reason why my Chinese five-element students are so keen to
learn all about the emotional manifestations of the elements, and enjoy doing
exercises which help train them in learning to detect emotions both in
themselves and in their patients.
We all know the dangers caused by the over-use of
antibiotics, and the resistance to them which encourages the spread of
disease. There is an article in today’s Observer newspaper which epitomizes for
me how far our modern treatment of illness has divorced us from the natural
world. It starts with the strong
statement: “Wards in British hospitals need to be redesigned to provide defences
against the spread of deadly, antibiotic-resistant superbugs. That is the stark
warning of scientists, who said last week that the danger now posed by
drug-resistant infections had reached crisis level.”
So what are the proposals these same scientists put forward
to help our hospitals do this? Among
these, believe it or not, is one that hospital wards should have “large,
openable windows”. …”We are talking
about returning hospital wards to the type we had 100 years ago.”….
This sent me back to look at a chapter in my book Keepers of the Soul in which I discuss
what I call “the medicalized society” we now live in. And I wrote, with rare prescience,.”…we show
as little regard for the environment in which all these terrifying interventions
take place, the frightening machines, the lack of natural air, even the ban on
plants and flowers in the hospital wards of the most sick, as if such harmless,
natural and beautiful things bring with them a greater chance of disease than
dealing with the high incidence of hospital-induced infections.”
Let us hope that the design of new hospitals will now
include windows which open to allow nature inside to help patients’ lungs
breathe and bugs to escape.
Over the years I have become used to patients telling me
things after treatment such as “now I feel more myself again”, or “I know now who
I am”. Yesterday I had another
heart-warming example of five element acupuncture’s ability to reach to the
very heart of our needs as human beings when a five element acupuncturist
colleague of min, Audley Burnett, told me how moved he had been when a patient described the effect of
treatment in these words: “I feel as if I’ve come into
myself.
I think that is such a lovely way of saying what we would
all want to feel: that we have “come
into ourselves”. And how moving that
what five element acupuncture can do is help our patients achieve that. In so doing it also helps its practitioners
achieve much the same thing, but by a different route, that of the
therapist. When I feel a treatment I
have given has helped my patient, I feel more fully myself.
I always find it reassuring to receive confirmation of the
universal nature of human qualities.
This is something we usually take for granted in everyday life.
Politicians, for example, assume that those they negotiate with experience the
same feelings they do, and are as horrified by the same injustices acting
themselves out in far-flung places in the world out there as other politicians
are. We think, too, that ordinary human folk,
reading of tragedies such as the recent loss of the airliner or the ferry
disaster, will be able to understand the sufferings of the bereaved at one
remove. Unthinkingly for the most part,
we assume that what others round the globe experience as suffering or joy
mirrors our own experiences of suffering or joy.
Since as a five element acupuncturist my working life
revolves around attempts to understand just what makes my patients suffer or be
joyful, I am made particularly aware of my assumption of the universality of
human emotions when I go to China,
from where I have just returned. I wrote
in a previous blog on 30 March, “We all
want to be heard”, which was about what I was expecting to be the focus of
our seminar over there. I can now truly
say that not only did the Chinese acupuncturists show that they did indeed hear
what their patients wanted them to hear, but that their responses to their
patients reflected an increasing understanding and ability to respond to their
patients’ emotional needs.
There were about 70 acupuncturists at the seminar, of whom
half were new to five element acupuncture.
It was heart-warming to see how well those who were now practising five
element acupuncture had integrated into their practice what they had learnt
before. The comforting impression I returned
with was a mixture not only of deep satisfaction at
how many acupuncturists are now treating only with five element acupuncture,
but – and this is perhaps the most surprising aspect of it all – how much
easier I always find it handing on my knowledge to Chinese acupuncturists than
I used to do to my English students. As
I told them in China, “you are all already halfway there compared with European
(and presumably also American) students, because an understanding of the elements
is deeply embedded in all of you from the day you are born, whilst non-Chinese
students have to learn what is initially an alien language from scratch.” I well remember an English student asking me
at the end of her first year at SOFEA, “but how do you know that there are
things called elements?”
It is therefore a continuing delight to me to see how much
of what I want to convey to others about the wonder of the elements’ presence
within all of us is understood by my Chinese listeners almost before I open my
mouth to speak. I notice how relaxed
this makes me feel, as though I am wandering in a landscape with familiar
landmarks, rather than the often difficult terrain I have had to negotiate over
the years as my five element beliefs encountered the surprisingly sceptical
opinions of my TCM colleagues.
I am very fortunate indeed to be accompanied on my visits to
China by two very dedicated fellow five element acupuncturists, Mei Long and
Guy Caplan, Mei from the Netherlands and Guy from here in London. We have now been together over there twice as
a group, and Mei and Guy have also taught there once more without me in
November 2013 when I was recovering from my recent illness. We act as a very unified group, each of us
having slightly different roles which complement each other. It helps that Mei is Chinese and can speak
without requiring the help of a translator.
I’m sure this is a welcome relief from the inevitably interrupted
communications which Guy and I make as we wait for our words to be translated. Again we were lucky to have two very good
translators to help us, Caroline and Nuha, both themselves acupuncturists, and I noticed this time
how many of the group understood more English than they admitted to, laughing
at my jokes before they were translated.
I think there is quite a lot of English study going on during our
absences.
And there were many jokes.
We had a very happy time indeed, working hard and playing hard, too –
many lovely meals out, some Karaoke evenings, and a festive atmosphere as
though all of us were enjoying a holiday together. And this is how I think the Chinese group
view their time with us, as one long drawn-out holiday experience. In a way, I do, too, returning refreshed and
stimulated by the enthusiasm and warmth with which we are surrounded throughout
our time there.
I am only just getting used to carrying my own bags, too. In China, I was not allowed to carry
anything at all, a small group waiting patiently for us in the hotel foyer
every day at whatever time we emerged from our rooms, ready to grab my bags and
lovingly accompany us the 100 yards or so to the centre where we taught. I can’t remember the last time anybody helped
me carry my bags in England!
I have just come across something which Pablo Picasso
apparently said: “One starts to get
young at the age of 60.”
I love that. I am
many years older than Picasso was when he said that, but I quite understand the
feeling. And it sends me off to China
today very young in heart, if slightly creaky in body.
I am off to China
again with Mei and Guy in a week. And as
usual before I go, I like to think of what stage I have reached in my own
approach to my practice, and what will be the main theme around which we will
build the two weeks of our seminar over there.
The title which came to my mind this morning was: “We all want to be
heard”.
It sounds so simple, put in that way, but actually it is one
of the most difficult things of all for us to feel secure enough in our
relationship to our hearer to have the courage to open up sufficiently so that
what we say reflects truly what we feel, and therefore what is heard by our
hearers is truly what we would like them to hear. What is so important for a good five element
practice is that a patient must feel they can reveal what they are really
feeling whilst knowing that what they reveal
is being heard and understood properly.
All too often, even in the caring professions, patients’ words become
distorted by hearers’ preconceptions.
So my two weeks with my Chinese students will centre around
the importance of allowing a patient sufficient space and time to feel
emotionally safe with us, and ensuring that for our part we do not cast our own
shadows over our patients so that what we hear is a distortion of the reality. When a patient feels that what they are
telling us is being heard as they want us to hear it, this allows the elements
within them to express themselves freely. When we cloud a patient’s elements
through incomprehension, we will not perceive them as they truly are, and will therefore
be unable to respond to their needs. Elements
can so easily disguise themselves, and, like snails under attack, draw back
into their shells when they feel misunderstood.
And this inevitably distorts our diagnosis.
I will use these thoughts as the foundation for our two
weeks in Nanning. This is all the more important because
Chinese culture places no emphasis on the importance of allowing patients to
open up emotionally, and Chinese practitioners have to be encouraged to dare
take their first tentative steps in this direction. I well remember an incident from a previous
visit to China,
when an acupuncturist asked me, “But how do I learn to talk to my patients
about their emotions?”
I hope that after a further seminar with us she will be
given some more help on how to do this.
I am reading a very interesting book at the moment, The Spirit Level: why equality is better for
everyone by Richard Wilkinson and Kate Pickett. It has made me think a lot about the
particular stresses of modern life, and whether different countries are subject
to different stresses. Since I am off to
China again in a couple of weeks, it has become particularly relevant for me to
look at what stresses we in this country are exposed to compared with those of
the Chinese.
I am fascinated by the main message of the book which is how
much extreme financial inequalities, such as those now experienced in this
country, affect everybody, not just the poorest. I was interested to see, for example that it
was noticeable how local communities reacted in different ways in New Orleans in response
to Hurricane Katrina in 2005, in contrast to the Chinese response to its devastating
earthquake in 2008. In the much more
settled local communities in China there was much greater cooperation and help
for the survivors than in New Orleans, with its very deprived communities, where
looting and violence were the norm.
Sadly, of course, as China, too, becomes an increasingly unequal
society, with the rich now becoming the super-rich, the support of a local
community is becoming as rare as in this country, where the rich are now holed
up in their large houses behind barriers, and the poor hammer at the gates with
rage.
All this increases the stresses of modern life in terms of
mental health, alcoholism, obesity, infant mortality, the crime rate and much
more, but equally affects those living behind those barred gates to a
surprising degree. This is a terrible
downward spiral, encapsulated for me in the headline yesterday in the Guardian
newspaper which states baldly “Divided Britain: Five families own more than poorest 20%: Handful of super-rich are wealthier than 12.6m
Britons put together”. Such enormous
discrepancies in wealth, the authors of this book say, are the direct cause of
some of the most complex types of modern illness, called, somewhat wittily,
“anxiety disorders”, “affluenza virus” or “luxury fevers”, as the status
anxieties that a consumer society fosters in everybody cause increasing levels
of stress, unknown by me as a child during and after the second world war, when
we didn’t go shopping for ever more tantalizing goods because the shops were
empty.
Nor did we feel the lack of this at all. I remember quite happily listening again and
again to the few gramophone records we had, and reading again and again the few
children’s books we had, and not feeling deprived at all – rather the reverse.
The message obviously is that where there is satisfaction
with our lives, whether we are poor or rich, the healthier and happier we will
be. And the more status stress we cause
ourselves by trying to emulate all the acquisitive habits of the rich (their
clothes, their homes, their furnishings), the more illnesses we will suffer
from. There is a lesson here for
acupuncturists, since our aim must surely be to help our patients live as
peaceful and as fulfilled a life as possible.
Do read this book. It
opened my eyes to many reasons for the increasingly stressful environments we
live in now, and made me understand why the enormous inequalities we see in the
world today inevitably lead to increased ill-health. We need to strive for greater equality for
the sake of the health of all, not just of the poor.
This reminds me again of what my Indian friend, Lotika,
asked me: “Why do you in the West want
to be happy? We just accept.” And this is what even the poorest Indians
sleeping on the streets do, as I observed them as they smilingly made way for
me on the pavements, and pointed out helpfully where I had to go as I stood
waiting for a taxi at Delhi
station. I learnt a lot from that. I could not imagine the same thing happening
in this country now. It is more likely
that, in the same situation, far from being offered help, my handbag would be
snatched from me.
Why do all babies seem to need dummies now? This question often
occurs to me as I watch babies passing me on the street, all lustily sucking on
dummies, or as I watch parents shove a dummy back into their offspring’s mouth
even when the baby is not crying out for it.
Years ago, dummies were frowned upon;
it was thought instead that if babies cried they should be given the
warm nipple with its natural supply of comforting food rather than the
unpleasant cold plastic variety which gives a baby nothing, however much the
baby tries to suck from it.
I find it interesting to speculate why the dummy has become
such a universal accessory to a baby’s life.
It worries me that babies now grow up being sold an illusion, tempted to
believe, as the dummy goes in the mouth and stimulates the sucking reflex, that
it will provide food, whilst it does nothing of the kind. It is a bit as though you offer somebody what
appears to be a sweet in a lovely wrapping, only for them to find when the
wrapping is undone that there is nothing inside after all. It can surely not be healthy to keep on
disappointing a baby in this way.
It is little wonder then that so many people have problems
relating to food in their later life, since all eating habits start in
childhood, as we know. In five element
terms, this shapes a person’s relationship to their Earth element, the mother
element. The provision of nourishment for
her child, which is a mother’s first task, should always be associated
with the love and warmth of being held
close to a mother, not the stuffing of a surrogate plastic nipple into a baby’s
mouth.
As I watch babies sucking feverishly on their dummies, my
heart bleeds for what this is doing to the development of their Earth element,
and their capacity to nourish themselves later in life. And perhaps, too, this goes some way to
explain the sight of so many adults streaming along the road to work, all
carrying their dummy-replacements, a plastic cup of coffee, as though they,
too, have been brainwashed since childhood by the need to have something,
anything, in their mouth to suck on.
Just as babies can’t nowadays seem to do without a dummy, so
adults can’t seem to do without a cup of coffee in the hand.
410 words
