Procedure for diagnosing 130 budding five element acupuncturists in one day

I am often asked how on earth we have attempted to offer a five element diagnosis to the many hundreds of acupuncturists in China who have come to our seminars over the past eight years.  I am just returning from another week’s seminar in Beijing where we have tried yet again to do just that, so I would like to describe the procedure we have worked on over the years to do this.

Of the 300 or so practitioners who attended, some 130 were new to us.  All these had previously attended one of the many preliminary five element courses in many towns all over China organized by the more experienced of our five element group of practitioners, now promoted to the role of five element teachers.  By the time Mei, Guy and I arrive at a seminar all those attending will have been given a provisional diagnosis of their element as a starting point from which we work.

In China, nobody seems to worry at all when I explain that all diagnoses we make are only a first attempt at finding their element.  They are very unconcerned when we change these preliminary diagnoses, and may change them again during the week of our seminar.  This is probably because I always emphasize that none of us can ever truly “know” the guardian element until treatment has confirmed that we are on the right track.   

As encouragement for myself, and for others, I always like to remember JR Worsley telling us when we were students that we would all be able to diagnose as quickly as he did when we had as much experience as he had after his 45 years of practice.  I have now had 30 or more years of five element practice to help me, and if I add these years to those of Guy and Mei, I like to think that together we reach JR’s total of years.  Certainly to my surprise, every time to we return to China  the three of us are getting better and better at our diagnoses, and quicker and quicker at making them, too.  And we work together very well as a team.

So here I will describe the procedure for carrying out these multiple diagnoses which we have developed to cope with the ever-increasing number of those attending our seminars who wish to have some idea of their own element.  As we know, all five element acupuncturists should as far as possible be sure of their own element as an essential pre-requisite for their practice, for without this we do not know what shadow our own element unconsciously casts over our patients.  And all those attending quite rightly crave a diagnosis from the most experienced five element practitioners they can find.  I therefore think we have a duty to offer them our expertise in diagnosing the elements, with the proviso that we make these diagnoses in a rather idiosyncratic way to take account of the sheer numbers involved.  The Chinese, bless their hearts, willingly accept this without complaint.

This is what we do:  To help us, we are given photographs of the new practitioners grouped together according to the element to which they have been assigned in the introductory seminars.  We then count the total number for each element.  This seminar (April 2019) the numbers were:

Wood: 17,  Fire: 10,  Earth: 32,  Metal: 21, Water: 42, plus 11 still left undiagnosed.   

From experience we know that if we work quickly, we can get through this large number in a day, divided into a morning section from 8.30 – 12, a long lunch-break of 2 ½ hours from 12 to 2.30 (the Chinese always take a nap after lunch), and an afternoon session from 1.30 – 5.30.  Five chairs are placed on the raised platform at the front of the large seminar room, and Mei, Guy and I sit in the front row of the audience group, with many people sitting on the floor all around us, and everybody else seated behind us.  There is always a scramble for people to get as close to us as possible, because they want to hear the discussions we carry on between us. 

This time we started with one of the larger groups (when our minds were fresh!), choosing Earth first, because starting with the largest group, Water, was likely to give the room a more uneasy feel (Water’s fear showing itself as it is asked to talk in front of such a large group of people).  An Earth group is much more at ease, and this helps to settle the room down nicely at the start.

Five of the each group sit down in turn on the platform in front of us, and we look at this small group as a whole to see how far they seem at ease with each other (or not), and whether any particular person stands out from the group in some way.  Then each of the five is asked to talk a little about anything they want, as we listen to their voices (the audience group is told to do this with closed eyes for part of the time), and observe them closely.  Over the years everybody coming to our seminars has got much better at spotting the odd person who doesn’t seem to fit in with the rest of the group.  This may be the one who sits forward whilst the others sit back, the one who turns to look at the person talking, whilst the others look straight ahead, or is constantly moving whilst the others remain still.  We have found that the audience as a whole has become surprisingly good at pointing out any significant differences.

Mei, Guy and I then put our heads together and decide whether or not we agree with the provisional diagnoses.  We discuss quite openly where we have doubts and why this is so and which element group we think a person should be re-allocated to. 

When we have gone through an element group as a whole, we ask all those we still think are that element to stand together on the platform for us to take a look at the group as a whole.  And here we may change our diagnosis again, because in the large element group, one or two will now stand out as feeling different.  These we then re-allocate to join another element grouping during the day.

At previous seminars Guy had the bright idea of providing coloured stickers in the five element colours, which we would put on those we had diagnosed so that everybody could see from a distance which element we had provisionally allocated to those attending.  This time, instead of a coloured sticker, each person was given a much more visible ribbon to wear around their neck, the colour of which could be spotted a long way away to help us if we decided to change a diagnosis.

After this seminar I totted up how many changes we made for each element. For Wood it was 5 out of 17, for Fire it was only 1 out of 10, for Earth it was 17 out of 32, for Metal 8 out of 21 and for Water 8 out of 42.  From this random survey we could conclude that the Chinese five element acupuncturists running the preliminary seminars are better at diagnosing Fire (nearly 100% right), than Earth (only about 50% right)!  For some reason there are always a large number of Water people at our seminars, and practitioners over there therefore have a lot of practice in diagnosing this element.

This may seem a rather complicated procedure, but it works surprisingly well, and is an excellent way of helping a large group of practitioners learn more about diagnosing the elements in one day than they will learn from seeing only a few patients at a time.  We do the diagnoses at the start of a five-day seminar, which leaves us nearly four days in which to change our minds.  When you are sitting in front of a roomful of people, all wearing very visible coloured ribbons around their necks, it becomes surprisingly easy to see those who respond to what is going on in an expected way and those who don’t.  I was delighted that the last thing I did as I left the platform on our last afternoon was ceremonially to remove the red ribbon around a young man’s neck and replace it with a yellow ribbon to great applause in the room.  I had been talking about the Fire element, and in my usual Fire way had stoked up a lot of laughter in the room, except in this young man who only looked puzzled.  “He looks worried as though trying to process something, and isn’t his colour yellow?” I asked myself.  “He must surely be Earth, not Fire”.  He himself was delighted at the change, as he had felt that he didn’t really fit in amongst his fellow Fire practitioners.

We have also added another simple diagnostic technique to our teaching, which is to ask the group whether they feel a patient coming before the class makes the room feel “up” or “down” (i.e., yang or yin).  If “up”, then it is likely to be either Wood or Fire, if “down” then Metal or Water, with Earth “neither up nor down”, or “both up and down”.  This is again a surprisingly simple way of helping those new to five element acupuncture start examining the feelings different elements evoke in them.

Two prime examples of the Wood element out of balance (2)

Instead of the constant mantra-like repetitions of key phrases, which are one of the hallmarks of Theresa May’s speeches, we have instead in Donald Trump a different kind of example of the Wood element out of balance.  His Wood element appears as though trapped eternally in a kind of infantile world, with bursts of often incoherent words babbling forth in uninhibited tweets, much like a child enjoying itself with a new toy.  He combines this with a need to make a stream of off-the-cuff decisions without apparently giving any thought to their consequences.  I see this as the Wood element, the element of spring, growing innumerable little buds and shoots without worrying about which of these will develop into full-grown plants, instead just taking pleasure in all this activity for activity’s sake.  

I like to think of each element as having its particular place along the cycle which represents our lifetime.  According to this, Wood represents our childhood, Fire our youth and early maturity, Earth our full maturity, Metal the time of late adulthood and early old age, and Water, that mysterious time  which represents both the end of one cycle and the beginning of the next, offering us the seeds of the future.  Being the child element, Wood people therefore express much of the joyousness of the young.  But as with all children, this sense of uninhibited enjoyment can reveal its imbalance in different ways;  it can become suppressed, or it can become exaggerated.  Theresa May and Donald Trump are two very clear, and contrasting, examples of this.

It was significant that when asked to describe an incident when she had been a naughty child, the only one Theresa May could recall (or the only one she wanted to share) was a rather harmless time when she ran into a field of growing corn.  By any standards this could hardly be considered a very wicked thing for a young child to do, but it was significant that she regarded it as such.  Her feelings of guilt about this seemed to me to show evidence of some suppression of Wood’s natural exuberance rather than enjoyment of it.  From then on I began to regard her as a very good example of inhibited Wood, the suppressed emotion associated with this being what we call a lack of anger. 

Trump, on the other hand, shows signs of quite the reverse.  His Wood element is not only not suppressed as May’s appears to be, but is allowed much too much freedom to express itself in a totally uninhibited and inappropriate way.  The emotion he shows is therefore what we could call an excess of anger.  The pointed finger, one of the characteristic Wood gestures, as he furiously jabs the air as though attacking those he is arguing against, is also evidence of this.  Suppressed anger and excess anger are the two sides of the Wood element out of balance.  Neither can be said to be an appropriate emotion to be displayed by the leader of a country.  This can be contrasted to their detriment, and often is, with Barack Obama’s more mature and more balanced emotional expression, which I interpret as being that of a thoughtful Metal element, a much more appropriate emotion for one who is asked to lead his country.

The only signs of the Wood element that I could observe from looking at clips on TV or social media were those associated with sound and emotion, since I could obviously not observe colour clearly or sense smell.  Their voices both bear the hallmark of Wood’s distinctive forcefulness. Trump’s is a more overtly shouting voice, whilst May’s has a much more controlled tone.  Their way of walking, too, expresses the two very different sides of Wood very clearly.  Trump stomps along with heavy feet, and sits forward almost aggressively in a clear attempt to control whoever he is sitting next to, whilst May’s body and facial movements are more tightly controlled.  In fact, a New York Times article on May has just described her, appropriately, as “famously wooden”.  Her jaw is clenched, with tight neck muscles, always a sign of the Wood element under stress, and she now walks in an increasingly hunched position, with bent shoulders.  All these are signs of Wood’s control over our tendons and ligaments showing its stress.

Interestingly, both Theresa May and Donald Trump like to surround themselves with a very close band of advisers, chosen not for their expertise but because they apparently don’t feel threatened by them.  They are both reluctant to appoint experienced people with a proven record of expertise in a given field, relying instead on hand-picked advisers, often friends, whom they catapult into jobs for which they are completely unqualified.  Or, in the case of Theresa May, not only friends.  Think of her surprising appointment of Boris Johnson as Foreign Secretary, a man totally unsuited to the delicate negotiations required, but nonetheless appointed in the hope that such a dangerous opponent of hers would have to show apparent loyalty to her in his new position.  This was another example of an extremely unwise, ill thought-out decision.

Neither May nor Trump appears to have the emotional depth necessary to show empathy of any kind with their fellow human beings in distress.  We should think here of Theresa May’s unwillingness to visit the Grenfell tower block until a few days after the fire, and Trump’s equally unfeeling approach to locking young children up in cages on the Mexican border. 

To end this blog on a happier note, it is useful to contrast what I have written with a shining example of an appropriate human reaction to tragic events which was that of Jacinda Ardern, the New Zealand Prime Minister, whose response to the shootings in the Christchurch Mosques could not be faulted.  It helps, of course, that she is Fire, I believe, which is the element most capable of showing its emotions, “wearing its heart on its sleeve”, as we say.  It may always be more difficult for Wood to show a similar level of empathy however balanced it is, but certainly not the complete lack shown by these two leaders.

 

 

 

Two prime examples of the Wood element out of balance (1): Theresa May and Donald Trump

I think we tend to see the elements in terms of their general characteristics rather than training ourselves to recognize the degree of their balance or imbalance.   I am particularly aware of this now because we have before our eyes the very public, and highly disturbing, spectacle of two totally unbalanced world leaders, our own Prime Minister, Theresa May, and the American President, Donald Trump.  It may be no coincidence from the point of view of the state of world affairs at the moment that I believe that they are both of the Wood element, and both, in their differing ways, examples of Wood frighteningly out of balance.

One of the advantages of studying the elements as five element acupuncturists do is that this can help transform any personal responses to the elements which we may find personally difficult to deal with into lessons teaching us a more objective approach to the elements.   When they are not stoking up my own Wood element to a high pitch of anger as I contemplate what suffering these two leaders are inflicting on their respective nations, I therefore try to lighten my mood by seeing them both as excellent examples which teach me a lot about Wood’s imbalances.  I also fantasize about how some good five element acupuncture treatment for them might help make the world a happier place for us all.

By chance, I happen to know two people who have worked with Theresa May, one before she was a Member of Parliament and the other in one of the civil service departments she was in charge of.  Both say that it was always well-known that she was incapable of making decisions.  This is almost laughably typical of the Wood element under stress.  We all know that its function is to be in charge of our planning and decision-making.  If Theresa May is Wood, then, this helps highlight something which has laid the cold hand of Brexit over the past three years of this country’s political life.  It explains the dogmatic statement Theresa May made at the start of her first speech as Prime Minister, when she told us so emphatically that “Brexit means Brexit”, and explains why she has never deviated from this in all the negotiations she has engaged in since then.

If decision-making is something you are uneasy with, but know that it is an essential part of your job constantly to be asked to make important decisions for the good of the country, then to be plunged so suddenly into the Prime Minister’s role which demands a high level of balanced and quick decision-making would have put an enormous strain on both Theresa May’s Liver, which would have been asked quickly to plan her first speech to the people, and then her Gall Bladder which would have had to decide when and how to say it.  Her quick-fire statement “Brexit means Brexit” failed miserably on both counts.  A more balanced Wood might have recognized that the referendum vote only marginally tilted the country in favour of Brexit, and would therefore have understood that it would be important to reach out to the nearly half the nation who voted to remain in the EU.  I see the dogmatic statements which have been her trademarks in the years since then (“strong and stable” being an obvious one) as being her way of persuading herself that the decisions she makes are always the right ones.  When we are unsure about doing something, but don’t want to reveal our uncertainty to others, we can often over-compensate by hiding these uncertainties under an over-emphatic shield of apparent confidence.  This is often what Wood does, and I think this is Theresa May’s default mode.  The less certain she is about what she should do, the more dogmatic her statements become, and the more stridently she repeats them. 

Those with a more balanced Wood element would plan ahead more carefully, using the vision which this element offers to ensure that any decisions made are flexible enough to be altered if events change, as they inevitably do. The quality of flexibility is one that is singularly lacking in Theresa May.  Her dogmatic approach makes her quite incapable of changing her mind, leading to total inflexibility when confronted with difficult situations which call for adaptability.  Hence the disastrous political mess this country is now in.

My next blog will continue these thoughts on the Wood element out of balance, as I look more closely at Donald Trump’s actions since becoming President.  I see his as being a very different kind of Wood imbalance. 

Energy transfers: a lesson in how to avoid complicating things unnecessarily

My introduction to energy transfers came during my first year at JR Worsley’s Leamington college, and set the tone to an approach which carried through the three years of my undergraduate training. This first introduction was made very confusing because unfortunately the tutor who was teaching us got the procedure wrong, selecting the wrong points, and only corrected  himself when one of the class pointed this out to him.  This was hardly an ideal way for us to learn how to include energy transfers into our practice.

The very complex energy transfers we were asked to do as part of our exams also did nothing to make things clearer to us.  By the end of my undergraduate training I had, through hard work, learnt by heart the procedure for carrying out such energy transfers, but, to my surprise, had never been prompted by any tutor to include transfers in treating the patients our tutors were supervising. 
 
Then came the welcome day during my postgraduate training, when JR Worsley explained the importance of energy transfers in such a simple way as to strip away all the confusion which up till then had surrounded what we considered to be this tricky area of five element practice.  From then on I started to incorporate energy transfers into my practice.

I have just looked up what I have written about them in my Handbook of Five Element Practice.  The second edition of the Handbook (published by Singing Dragon Press) has a much simpler, and, I hope, more accessible version of my original text.  I therefore refer any reader interested in delving more deeply into this subject to pages 115 – 120 of the Singing Dragon edition, where I describe in detail the procedure to be used.  In particular I repeat what JR told us:

“The aim of any transfer of energy is to balance the relative energy shared between the elements and officials so that none retains more energy than another.  This way of redistributing energy helps to resolve tension between all the officials, and is an amazingly simple and effective way of restoring harmony.  Transferring energy in this way is therefore one of the most powerful and effective forms of treatment since it benefits all the elements by reducing disparities between them.”

Emboldened by JR’s encouragement I started to make more frequent use of energy transfers, and quickly found how effective they were.  After a transfer of energy of this kind, all the elements would breathe a sigh of relief, as imbalances between them cleared, and the smooth flow of energy round the cycle was restored.

I then started to look at which were likely to be the most common transfers. Again quoting from my Handbook: 

.. “some transfers are more frequently done than others, since certain elements tend to have more energy than others.  For example, the Wood and Earth officials are usually relatively stronger than the Water and Fire officials, which are called upon to provide our reserves of energy.”

This procedure is indicated when the pulses of the grandmother element are stronger than those of the mother element, and the simple transfer of energy using the tonification points between mother and child cannot be carried out, or would be less successful.

In practice, therefore, I found that I only used the following transfers:

From Earth to Outer Fire:          V (Pc) 3, IV (Ki) 3),

From Metal to Wood:                VIII (Li) 4,
From Earth to Wood:                 VIII (Li) 4, IX (Lu) 9
From Wood to Earth:                 XII (Sp)1

I then just learnt the points and the procedure to be used for these few transfers, and have never looked back.
 
As you can see, the transfers I list are carried out only between yin officials across the Ke cycle.  The procedure we were taught as undergraduates included finishing the transfer with the junction point between its yin and yang officials, but I no longer do that.  This is because I can clearly hear JR’s voice telling us that there is rarely a split pulse representing an imbalance between the paired officials within an element.  So when you bring energy to a yin official it will immediately share it with its partner yang official.  This also makes the procedure less complicated.

I hope what I have written here simplifies the approach to carrying out energy transfers a little, and encourages five element acupuncturists to use them as frequently as their reading of the pulses requires.

A reminder to myself about treating Metal and Earth patients

This week a practitioner asked my help with a patient of his, whom I diagnosed as Metal.  I thought she was more likely to be the Lung official (not able to take in) rather than the Large Intestine (not able to let go).   As usual, seeing this patient added something to my thoughts about the elements.

After I left the practice room I realised that I was in danger of forgetting something JR Worsley told us about treating Metal patients, and which I had not pointed out at the time to the practitioner.  This is something which also applies to treating Earth patients.  He told us that we need to be aware that, for different reasons, both elements might find the start of treatment difficult.  Both might find that the first few treatments could have the somewhat disturbing effect of making them feel rather empty.  I see this as confirming that these first treatments have such a profound effect by addressing the element so directly that they often strip away some of the defences we put up to cope with life.  Metal may therefore experience, perhaps for the first time, a profound emptiness of the spirit, that spiritual disconnection which is the burden Metal has to bear when it is out of balance.  Earth, by contrast, may experience a more physically-based emptiness, that of not being nourished, literally the gnawing feeling we have when we are hungry.

We should therefore always warn our Metal and Earth patients that this might happen, reassuring them it this is a good sign that treatment is clearing things away, so that their energy can be replenished with the good things of life.  After all, that is why we often add that prime clearer-away-of-rubbish, the point IX (Lu) 8, Meridian Gutter, to the normal command point treatment at the very early stages of Metal treatment.  And similarly with Earth, we may add XII (Sp) 8, Earth Motivator, or XI (St) 24, Lubrication Food Gate, early on.  In their different ways, these points all have the effect of helping the element we are directing our attention at to reveal its true needs.

I felt that this Metal patient had so profound an emptiness of spirit that after the initial Metal treatments with which we should always start treatment (see my Handbook of Five Element Practice here for advice on what these points are), I felt she might need more to replenish her.  The obvious point which comes to mind here is IV (Ki) 24, Spirit Burial Ground, but I also felt that she might benefit from another point one or two treatments later, a point which JR Worsley told us is “like IV 24, only deeper”, and that is III (Bl) 42, Spiritual Soul Gate.  And somewhere I feel the lovely point, I (Ht) 1, Utmost Source, beckoning at some time in the future.  JR told us that this was the supreme connecting point, re-establishing a direct connection between Heaven and Man (and Woman of course).  It can be used for patients of any element, and what better point for a Metal patient who, in my eyes, so obviously has lost a sense of this connection.

 

The effect of needling Large Intestine 7 Warm Current on two Metal patients

I like to share interesting feedback from the practice of other five element practitioners, so below I pass on what I have just received in an email from Pierre Bulteau, who lives in Rennes in Brittany.  It is with his permission that I include this in a blog. 

Pierre is one of those brave people who have dared to take the courageous step to engage wholeheartedly in treating his patients using five element acupuncture, although trained in a different discipline.  He has had to do all his learning quite on his own, except for coming regularly to SOFEA’s seminars, because there are no other five element acupuncturists in his area.  I very much admire his tenacity and dedication in making this decision.  It’s never easy changing your approach to practice, particularly when there is nobody around to help you when you start doubting what you are doing.

I say that it requires courage to be a five element practitioner because we have no textbook to refer to and no fixed criteria we can call upon to define an element.  Who can describe, in words, the green colour on a person’s face or the sound of laughter which distinguishes Fire’s outburst of joy from the nervous expression of Water? Because we have to rely on our purely subjective skills, we have to learn to cope very much on our own with the inevitable highs and lows our practice demands of us.

So here is what Pierre emailed me in his own words:

“Today I would like to give you a feedback about the use of a point.  I had read in your handbook that you like using the point X7 to bring some heat to a Metal patient. In the last month I had the occasion to use it on two Metal patients.

The first one, despite the good treatment I give him since 4 months, still had cold feet all the time. After using Warm Current X7, his feet are normally hot now without collapse.

The second one is a Metal patient I have treated during 2 years. Until now, his health was good and the last year I just saw him at the season change. But on Monday when he visit me for the preparation of the spring he explained me a constant feeling of cold in the lumbar with chills since Christmas. I used again X7 with success because today he sent me a SMS to say that the symptom has disappeared.

It's wonderful to discover another way to use the points through an element and his channels.

Before, because of their weak kidney pulse I would have reinforced the kidney Yang. Now with five element acupuncture I stay on an element and I look for a point which can help this person belonging to a specific element.

What a wonderful system of healing!”

Aware that other branches of acupuncture locate X 7 at 5 ACI (cun) rather than the 7 ACI that we do, I asked him where he had needled the point.  This turned out to be at 5 ACI, which again raised the question in his mind, and in mine, about a practitioner’s intention when needling.  He then sent me a very interesting reply with his thoughts on this, which concludes with the following beautiful thought:

“So, as a quantum physicist that I am before being an acupuncturist, I really think that our faith coming from our heart is the key to allow a treatment to succeed. Indeed, consciousness has a direct action on the Qi.
No matter where you choose to locate a point, what really matters is to believe it with all your heart."
 
This has set me thinking again about what I always describe as the tricky topic of a practitioner’s intention, to be discussed further in another blog when I have thought this through in more detail.

I would like to thank Pierre for constantly stimulating my ideas with his often challenging questions in the many emails he sends me asking for help with his five element practice.  You certainly keep me on my toes, Pierre!