How quickly Metal makes decisions

Although Wood is the element which controls decision making, it is Metal which is by the best element at making quick decisions.  It wants to make them all by itself, with no interference from anybody else. 

It is therefore a good element to give advice, because its advice is done in short, sharp sentences, and like any metal object cuts straight through to the heart of the problem

An amusing confirmation of my diagnostic skills

As many of you know, I enjoy watching sport on TV, as much for the sport itself as for being another way of observing the elements revealing themselves under stress.  And ever since I was a young child, in quarantine for 6 weeks with scarlet fever, and forced to amuse myself with the only thing available all those years ago, which was the radio (of course then called the “wireless”), I have enjoyed listening to cricket commentaries and now watching cricket on TV.  So imagine my delight when yesterday I heard a commentator describe one of the cricketers, Joe Root, who I had already diagnosed as definitely being Fire, with the words “Root is the heartbeat of the side”.

How nice to know that the elements evoke universal echoes in all of us, not just in those who learn about them as part of their acupuncture training.

If you want to see Joe Root in action, those of you who are from the cricket-loving and cricket-playing countries of the old British Commonwealth, look him up on YouTube, and you will see Fire blazing away.

 

Beware of becoming too comfortable in our work

All therapist can fall into bad habits over the years, risking becoming careless in what we do.  One such pitfall is that we may become a little bit too comfortable in our work, not challenging ourselves as much as should do.  We may start to forget that each time we see our patient we see a slightly different person who is altered by the passage of time.  The patient before us is not the same person we saw at the last treatment.  We have to understand the need to see them with fresh eyes, requiring possibly a different approach from us.

It is indeed very difficult to retain a freshness of approach to our patients if they have been coming to us for a long time.   Often we are only too pleased to welcome patients we think are doing well, because we feel they are unlikely to challenge us by presenting us with new problems.  These are patients whose treatment we assume to know in advance.  Here we can be at risk of falling into rather too well-worn a rut if we are not careful, thinking that our patients will be as they were before.  Perhaps unconsciously we ignore the possibility that they may have changed in some way, since changes require us to make more effort.  It is much easier, we may think, to continue doing what we have done so apparently satisfactorily before.

And then we may not see, or choose not to see, something in our patient which should be pointing us in a new direction.  A long- term patient of mine, whose treatment I regarded as being simple to plan ahead for, turned up for one appointment not as I expected her to be.  If I had not been alert, I could easily have overlooked the slight change I perceived in her.  She herself volunteered nothing until I probed a little more and discovered that quite a disturbing event had happened to her, which totally changed the direction of the treatment I was intending to give.  Looking back on this afterwards I realized that I had been in danger of assuming in advance that I would find her as I had done before, and might perhaps have ignored the pointer alerting me to a need to re-evaluate the treatment I was intending to give her, which was now no longer appropriate.  We must never assume that we know our patient’s needs of today, since yesterday may have changed them

 

 

Getting to know our patients

If you are going to be of any help at all to another human being, as we as acupuncturists surely hope to be, then we have to make every effort to get to know who the person is who is coming to us for help.  And getting to know somebody is certainly not as easy as it may sound.  For each of us can present different faces to the world, having learnt during our life to adapt ourselves to the different people we encounter.  The practice room represents an unknown world, and at first patients will be unsure both about the treatment being offered and the person offering this treatment.  Practitioners, too, meeting an unfamiliar person, will have their own concerns to face in adapting to what is to them also a new situation. 

All this represents different kinds of challenges.  Patients are being asked to reveal something of themselves to a stranger about whose capacity for empathy and ability to put them at their ease they are initially unsure of. They will be asking themselves whether the practitioner is a safe person to whom to show any vulnerabilities, those which all of us may wish to hide from others, but which reveal the true nature of why we are seeking help.  The practitioner, too, will be trying to adapt to the many different ways patients present themselves in the unfamiliar situation they find themselves in.

There is a great skill in helping a patient overcome their natural reticence at opening themselves up to another person.  We have to learn ways of convincing our patients that we are a safe repository for self-exposure of this kind.  We need to know what kind of a relationship with their practitioner our patients feels comfortable with, since for each person this differs.  Some, with a trust in human nature, will assume that anybody in the guise of practitioner will be worthy of this trust.  Others, at the other end of the spectrum, will take much longer and request much greater evidence from their practitioner that the practice room is a safe place before lowering their defences.

The initial encounters between patient and practitioner are therefore delicate affairs, requiring great sensitivity on the practitioner’s part to all the little signs we give out indicating where others must tread warily when they approach us.  If practitioners do not pick up such signals, we are very likely to act too clumsily and effectively silence our patient.  Here, as with all things, a knowledge of the elements comes to the practitioner’s aid.  For each element demands a different approach from us.  And as we get better and better at analyzing the complex nature of each approach, this will give us increased insight into what may well be our patient’s element.

 

 

The legacy we leave behind

Every time I go to China I am reminded of how important the Chinese regard the transmission of knowledge from generation to generation.  For there on the wall in the centre where we teach I find a photo of JR Worsley, and hanging next it one of me, then of Mei and of Guy.  Our hosts regard us as the guardians of an inheritance of traditional acupuncture which is now no longer part of the traditional medicine practised in China, and all the more lamented for its absence.  And we, as inheritors of this tradition, are therefore warmly welcomed and deeply revered.

Here in the UK, and I suspect in the West in general, it is rare for such reverence to be accorded to those, like me, who have many years’ practical experience.  I am made aware of this each time I return from China, when I compare the number of practitioners wishing to learn personally from me, a very small group now, with the many who crowd into our twice-yearly seminars in China.  What is there about us in the West that we appear to be somewhat arrogant about how much we know and somewhat indifferent to how much we really still need to learn, whilst to the Chinese the acquisition of knowledge is a much sought after privilege?

I am also increasingly worried when I notice how few five element acupuncturists there are here in the West (and by implication also therefore in the future in China) who are prepared to go out and teach what they have learnt, something I find myself repeatedly pointing out.  And here I am talking only about those acupuncturists whose five element practice is not altered by the introduction of TCM concepts, as occurs unhappily nowadays all too often.   I am also concerned about how much of what I have learnt I will in turn pass on as my own personal transmission of this legacy.  Am I doing enough myself?

I always remember what a very wise old Austrian astrologer and musician, Dr Oskar Adler, wrote.  He said that we each have a duty to leave behind for others whatever we have ourselves learnt, however small and insignificant in our own eyes this might appear.  So I am always alert to the need to encourage any who are now practising five element acupuncture to have the courage to hand on whatever they have learnt to those coming after them.  There are, unfortunately, so few who want to do this, probably because they think they have to emulate JR Worsley who would diagnose people’s elements within a few minutes of meeting them.  Most of us know that it will take much, much longer to diagnose the elements.  This has never worried me.  As JR always reminded us, “I have been doing this for more than 40 years.  You will be able to do the same when you have practised as long as I have.”

In the meantime, I try to encourage experienced five element acupuncturists to take their courage in their hands and think about teaching others.  In my case, I only dared to start doing this because I was asked to run an evening class on acupuncture.  At first I was reluctant to accept this challenge, since I had only just qualified, but as JR told me later when I discussed my doubts with him,  “Remember, you know more than they do!”.  And another tutor of mine reinforced this by telling me, “When you teach, never pretend you know more than you do.  If you are honest and say that you don’t know the answer to a student’s question, tell them so and they will respect you for that.”  I myself never believe those who always seem to find an answer to everything, whilst I do believe those who tell me they don’t know what the answer is.  These I trust for their honesty.

So to any five element acupuncturist out there keen to pass on their knowledge to those with less experience than they have, I say, “Please do so, whatever your doubts.  After all, we badly need you.”  

 

Cutting diagnostic corners in China

When we were students, we were always being told that we must allow our patients plenty of time to get to know us as practitioners so that they feel safe to start talking honestly about the problems they face in life and the help that they are really asking for.  This is particularly so during our first interaction with them, which we call a Traditional Diagnosis (TD), to distinguish it from a purely Western medical diagnosis, something we were told never to hurry through. It is therefore ironic that, in China, time is the one thing we cannot ask for, since we are only there for a few days, and in those few days we are expected to achieve so much.  Indeed, it makes me sad sometimes to think how privileged our students at SOFEA were in the amount of individual time we dedicated to each of them – individual tutorials, individual supervision of their treatments – as much individual time as we felt each student needed.

If I compare this now to what we have to do in China, I am amazed that we have achieved so much based upon the little time we have to offer anything in the nature of individual tuition to the many, many students who crowd into our courses.  Nowhere am I more aware of this than in our efforts to offer each student a diagnosis of their own element as a foundation on which to build their future practice.  In England students carrying out a diagnosis are expected to spend up to two hours completing this, during which they cover a long list of questions about a patient’s physical and emotional issues, with the emphasis above all on establishing a good relationship with the patient.  But how do we condense this into what we want to offer our Chinese students, the 40-50 new ones coming to each seminar we give?

At first I thought that there was no way we could do this, but quickly realised how disappointed students were if we gave them no indication whatsoever of what their own element might be.  This started to have a negative effect on our teaching.  We would be helping them learn to diagnose the elements of the patients brought before the class, but then were doing nothing to give them any indication of their own.  And anybody who has been reading my blogs will know that I emphasize the importance of a practitioner understanding how their own element may be affecting the way they treat (see my blog of 17 October 2013 How important is it that a five element practitioner is sure of their own element?).  So we had to think of a different form of diagnosis to fit the very specific situation we were faced with. 

After a few hit-and-miss attempts at devising a way of carrying out diagnoses on as many students as possible in the extremely short time available, we now dedicate a very specific amount of time at each seminar to diagnosing, or at least attempting to diagnose, any new students coming to these seminars, as well as checking on those previously diagnosed to see whether we still agree with our original diagnosis. If we don’t, which of course happens, we are quite open about telling the group that we have changed our minds (or, more specifically, our senses have changed our minds!).  At the latest seminar a few weeks ago we diagnosed 45 practitioners in one morning, a feat which required much concentrated attention from Mei, Guy and me.

Although this is a cautionary tale of just how NOT to carry out a TD, I realise that increasingly we have become surprisingly efficient at seeing the elements in this highly pressurized situation.  We ask students to sit in groups of five in front of the class, each of them talking a little about anything they want to, and the three of us, Mei, Guy and I, observing them carefully.  After all five have spoken, we put our heads together and come up with what we call a provisional diagnosis, one that we tell them we may well change as the seminar progresses and we have more time to look at them.  It is interesting how the placing of one person next to the other often reveals very clearly their differences, showing up their elements by comparison with each other.  And we have become better and better at seeing these differences, and attributing them to one or other element.

To reinforce our diagnosis, each student is then given their first five element treatment by another participant (all of whom are qualified acupuncturists).  This consists of the Aggressive Energy drain (or, if we think this is necessary, the Dragons treatment followed by an AE drain), and finishes with the source points of the element we have diagnosed.  And then we continue to observe them carefully in class over the next few days to see whether we feel that our original diagnosis is confirmed, or not, and in particular whether it is corroborated by the effects of treatment.

This is NOT, I repeat NOT, how a five element diagnosis should be carried out, far from it.  But  “needs must….”, as they say.  I would, however, beg all five element practitioners not to skimp on the time they spend on carrying out a TD just because they are reading here what we have to do in China.  If only we had the amount of time to give our 45 new students which our patients in the UK are so lucky to be given!

"The truth is always kept in a far place"

Somebody, I don’t remember who now, gave me this lovely quotation which haunts me, though I’m not sure exactly what it means: “The truth is always kept in a far place”.  The words have a lovely ring to them, and awake in me an image of a far-distant land with at its centre a lovely picture of Truth, who I see as a graceful woman presiding over this far country.  Perhaps the reason the words affect me so much now has something to do with my latest visit to a far-distant land, that of China, for my seventh visit there a week or so ago, though why should I be thinking of truth residing there?

Probably this is because in some ways it is truth which I discover each time I return there, the truth of what I have dedicated the second half of my life to, this discipline of mine called five element acupuncture.  For each visit strengthens my conviction of the deep truths about the human condition underlying what I do.  Somehow in China these truths become ever more evident to me, because of the speed at which my Chinese students so quickly understand what I teach them and unquestioningly accept the fundamentals of five element practice as though they are absolutely self-evident to them.  It is rare for those I have taught in the UK and Europe to reach such an instinctive and profound understanding as rapidly as do the Chinese. To us Europeans they are at first in what seems to be a foreign language, which it takes us much time to understand, whilst to the Chinese they are familiar concepts underlying all their lives.

I have been privileged to be invited by Professor Liu Lihong into this (geographically) “far place” in a way which still surprises me for its rightness at this stage of my life.  Each visit to China strengthens my bonds to my students over there and reinforces my gratitude for being given such a gift.

To Professor Liu and the 80 students who sat enthralled in our classes as they gained insights into something which for them is often a new discipline of acupuncture, I send my thanks for the happy time we spent together.  And these thanks I also pass on to Long Mei and Guy Caplan who shared this seventh step on my journey to China so creatively with me.

I am sure I heard this quotation from somebody whilst I was in China last November.  Perhaps one of those reading this blog over there will tell me who it was.

The three levels of the human being: body, mind and spirit

I remember one very important day during my training under JR Worsley at Leamington 30 years ago.  We were learning about Aggressive Energy, and JR was explaining to us why it was so essential to insert the needles very shallowly into the Associated Effect Points on the back (back shu points) so that each needle barely penetrated the skin.  What I remember most clearly was the diagram he drew to illustrate this, simply a small block of three parallel lines one above the other, with a needle just nicking the top line but not penetrating below to the other two lines.  He said that this illustrated the three levels of body, mind and spirit.  The superficial level was represented by the line at the top into which the needle was inserted.  The bottom line was the level of the spirit, and the line between these two represented the mind, the intermediary between the body on the surface and the spirit in the depths.  For the purposes of the AE drain, the needle inserted at the physical level would draw any Aggressive Energy from the spirit up through the intermediary, the mental level, and then out from the body, the physical level, at the top.  This would appear as red markings around the needle as the Aggressive Energy drained away slowly to the outside air.  If the needle was inserted too deeply, any Aggressive Energy was pushed further inside, causing greater harm as it invaded the spirit.

This picture of the three levels of the human being has stayed with me since then, providing an excellent illustration of the emphasis in five element acupuncture on the importance of treating the deep (the spirit) and through this also treating the physical.  Many therapies, including different branches of acupuncture, concentrate treatment at the superficial level, the physical, and ignore its connections with what lies deep within us.  But the two levels, with the mental acting as intermediary between them, cannot be detached from one another in this way.  If we ignore the deep, it will call out more and more insistently for our attention, often doing this through the increased severity of physical symptoms.  We ignore at our peril what is deep within us, our souls, and do our patients a grave disservice if we concentrate too much of our treatment on the superficial.

This is what I want to talk about to the 80 or more acupuncturists who will be gathered together at our seminar in Nanning in 10 days’ time.  And as I have found during my six other visits there, this is one of the most important lessons that five element acupuncture can teach them.

To understand what lies deep within a patient’s spirit also demands compassion from us as practitioners.  Only with compassion can patients allow themselves to open up this deepest, and thus most vulnerable, part of themselves, their soul.

“The lost art of exchanging glances”

I am delighted to have found myself only yesterday in very exalted company, with none other than the historian Simon Schama as my companion.  In an article in the Guardian as part of the launch of a new exhibition at the National Portrait Gallery here in London, called The Face of Britain, he says:  “…society would be a better place if people, perhaps on their daily commute, actually looked at the faces of strangers”.  Anybody who has read my blogs of 24 February and 1 March will know how warmly I support what he says.

He is also very scathing about the craze for those instant self-portraits we know of as selfies (horrible word, I always think).  He says, “What we love about selfies and phones is that it’s of the moment, but the true object of art is endurance….”  “The meteorite shower of images that we contribute to and come to us every single day in every medium, especially social media, is the equivalent of white noise, and great portraits deliver the music.”

It is very comforting that I am not alone in thinking thoughts such as these.

"Step into the blank of your mind"

I love this quote which comes from a poem by somebody called Richard Wilbur:

     “As a queen sits down, knowing that a chair will be there

      As a general raises his hand and is given the field-glasses,
      Step off assuredly into the blank of your mind.
      Something will come to you.”

It represents very accurately what I often feel as I sit, pen in hand, waiting for some thought to come to me which I think is worth pursuing.  At the moment I am indeed faced with the “blank of my mind” in relationship to writing about acupuncture.  I have concluded that this may be because I am just about to set off for my seventh visit to China, and as usual my mind is preoccupied with planning what I will take with me, and, much more importantly than any clothes, what the overall aim of my time there will be.  I always like to think of a theme around which I weave what we will be teaching there.  Last time it was the importance of developing a good patient/ practitioner relationship.  This time I note that I have written something about "it requires patience to be a five element practitioner”.  This echoes one of my constantly repeated mantras:  “Don’t hurry.  Don’t worry”.

We live in a world which is obsessed with results, so that we feel pressurized “to get things right”.  In five element terms, this means “getting the element right”.  But we need to lose some of our fear of not getting things immediately right.  Today on the radio I heard a headmaster, Anthony Seldon, saying that everybody is now concentrating far too much of their attention on children’s exam results.  We should be looking at things differently.  “Don’t ask how intelligent a child is”, he said, “Ask instead how is this child intelligent?”  This is an important distinction, which also applies to acupuncture.  We should not be thinking of the disease or condition that a patient comes to us for help with, but of the patient who is suffering from this condition.  This distinguishes us as five element acupuncturists from Western medical practitioners.  It is not simply enough to say that a patient is of the Earth element, much as a patient, in Western terms, could be said to be suffering from arthritis.  Instead we should be thinking not about the arthritis but about the patient - not what is the patient suffering from, but who is the patient who is doing the suffering.

This crucial distinction emphasizes the uniqueness of each patient, rather than the common nature of the disease they are suffering from.  We are not trying to lump a group of patients together under the heading of arthritis, or in five element terms, under the heading of the Earth element, but instead are trying to see the patient as a unique example of the Earth element, requiring a unique approach to the treatment we will be offering, whilst still under the umbrella of the Earth element.

These thoughts have just come to me as I sit here pondering on my theme for the week in China.  For a few moments, then I “stepped off into the blank of my mind”, as the poet says, and something has indeed “come to me.”