6. Formative incidents in my early acupuncture life: Lessons from the master, JR Worsley (1)

When I am teaching, a question I am asked often serves to remind me of some important incident which took place during my training or my early years as a practitioner, which I now know set me thinking quite differently about my practice.  Each of these incidents proved a catalyst, opening up new directions to my thoughts.  I am surprised to find how many such important events have occurred in my acupuncture life, and appreciate now that without them I would not have made the often unconventional detours I did.  Much of my development as a five element acupuncturist, and reflected now in my writings, has been based on what could be considered the rather unconventional approach I have adopted when measured against that of many of my peers.

I have often thought that the tone was firmly set early on when I was asked to teach an evening class about acupuncture at a London evening institute at a time well before complementary practices were in such common use as they are today.  This was also when I had only just qualified.  It meant that I was free to develop my own thoughts about my practice unhampered by others, since there weren’t any others around doing what I was doing.  I found myself talking about five element acupuncture to a very wide range of lay people, and therefore had to couch my thoughts in very general terms, rather than assume that my audience and I spoke the common language familiar to all acupuncturists.  I taught at several of these institutes during the first few years of my practice, allowing the differing groups of people who came to my classes to influence how I expressed myself and how far what I was learning from my practice could be translated into a language they could all understand, from the builder, the retired postman, the young student, the bank clerk and the unemployed people who crowded into my classes evening after evening.

This allowed me a freedom to be cherished, something I did not realise until later, for I was able to develop my own ideas quite independently of other professional acupuncturists, and quite unhampered or inhibited by opinions about the practice of acupuncture which might well have differed from mine.  When I rejoined my fellow acupuncturists two years later as part of my first advanced training course under JR Worsley, I brought the often rather odd ideas I had developed into my time with him, a time which proved to be the most exhilarating of all my years of acupuncture training.  It also proved to be a time of heightened tension in the five element world as it coincided with JR Worsley’s own fight to keep the college he had nurtured so carefully for the past 20 years untainted by the introduction of other less traditional forms of acupuncture as he felt strongly it would be.  Eventually he lost this fight and had to resign, and this led almost directly to my starting the School of Five Element Acupuncture (SOFEA) with the express intention of continuing his work of spreading the practice of this branch of acupuncture, and often, to my delight, with his active support.

I took every opportunity I could to observe JR in his interactions with patients, and was fortunate that the time of my postgraduate training with him coincided with his last years at Leamington. There was therefore a rather febrile atmosphere at the Leamington college during my last years there, with acupuncturists lining up on one side or the other of unfortunately an increasingly hostile divide.  Sensing this, I made every effort to stay as close to JR as I could, attending all his seminars and taking many patients to private consultations with him.  I view these few final years at Leamington as forming my own personal apprenticeship to the master of five element acupuncture.

It was during this period of intense activity that I experienced many of the seminal moments which have set my acupuncture practice on such a fulfilling course.  In particular I am now enjoying reliving some of the profound lessons I learnt when studying with JR. The first of these occurred when I was sitting in the classroom at the Leamington college during a lunch break watching a video of JR with a patient, in which he was asking the young patient a question.  I remember her looking puzzled, thinking for a minute, and then saying, “I’m not sure how to answer that”.  Unnoticed by me, JR had come into the classroom, and was standing behind me.  I heard him murmur, “Only a II CF would say that”.  Translated into the acupuncture language in common use now this meant that only a Fire person who was Inner Fire (the Small Intestine is given the Roman numeral II in five element acupuncture) would express herself in those terms.  Not only did this teach me a lot about the distinctions to be made between Outer Fire’s much more articulate responses to a question and Inner Fire’s verbal hesitancy as it tries to sort its thoughts out, it also taught me a lot about myself, and has continued to do so over the years, for it has made me, an Inner Fire person, so much clearer to myself.  So, I asked myself, was this the way I respond to questions, with the initial brief air of puzzlement this patient showed, before finally deciding on an answer to give which satisfies the Small Intestine’s need to pass only what is pure on to the Heart?  Now, whenever I try to work out whether a person’s Fire element is that of Inner or Outer Fire, I always draw on the image of this girl’s puzzled face to help me decide.

One of the tips I also learnt from JR Worsley, which I have followed successfully ever since in all cases where my relationship to my patient is under some strain, is always to be honest with the patient, and tell them as soon as I sense that there is a problem.  You need to be brave enough to ask them whether they, too, feel that this is so.  I always preface what I say with the words, “I feel that ….”  Saying this removes any risk of the patient feeling that we are blaming them for what is not right, and gives them the courage to be open with us.  I am then often surprised by my patients’ answers, which may be quite different from what I have imagined.  This frankness between us goes a long way to solving some of the tricky patient/practitioner issues which complicate our work.

For treatment to be successful it is always essential that both patient and practitioner are equally involved, 50% the patient and 50% the practitioner.  We cannot do good work if we are not sure what is going on in the practice room.  It is therefore good to remember that we can never help a patient who is reluctant to receive treatment.  As soon as we sense this, we need to stop what we are doing and address the issue.   

 

 

 

5. Two further incidents confirming my belief in the forces we can draw upon in treatment

Both of these two cases concerned two very ill patients of mine, each, because of the severity of their condition, unable to talk easily to me to help me make my initial diagnosis.  The first was a friend’s mother, who was in a very advanced stage of bone cancer, in great pain and with a body with many tumours.  I really didn’t know how I could help her, but was determined to do something.  She was lying in bed, and severe back pain prevented much movement.  This was obviously not the time to carry out even the most cursory diagnosis, and I had prepared myself for this by asking my friend beforehand to describe her mother to me in as much detail as she could.  From this I gained the impression that she might be Earth, something reinforced by the yellow colour I thought I could see on her skin, although I did wonder how far this rather unhealthy yellow was not so much an accurate pointer to Earth but the result of her illness. 

She could hardly move, but her daughter and I managed to prop her up sufficiently for me to put needles in the three upper series of points for the AE drain (Lung, Heart Protector and Heart), where a great deal of Aggressive Energy appeared as angry red circles around all six needles.  I could only hope that there was no further AE on points lower down the back which I could not reach.  As the AE drained, I was amazed to see that the patient’s initially very burnt-looking back caused by so much radiotherapy treatment gradually lots its angry red and returned to a good, clear skin colour.  After this, I cleared a Husband/Wife block, and ended with Earth source points.

When I had finished the treatment, the patient looked much more peaceful and less distressed.  I tucked her up with a kiss, and went downstairs, leaving her daughter to sit with her.  About half-an-hour later, to my surprise, my friend walked into the kitchen where I was sitting with the rest of the family, saying, “Mum is coming downstairs behind me.”  She told me that her mother had not been able to stand on her own for the past few weeks, but now felt strong enough to join us.  My friend said that this was also the first time that she had seen her mother smile for a long time.  And there was her mother slowly walking towards us.

I continued to treat the patient, and from that point onwards until her death six months later her spirit never faltered, even though it was obvious to all that she had not many more months to live.  This was a very moving experience for me, because it showed me so clearly that my acupuncture treatment could help a patient cope so much better even with a life-threatening disease and even in the last few months of life.  

The second instance of what I learnt from treating a very ill patient occurred at much the same time, when I was asked to go to hospital to treat a man who had just suffered a very severe stroke.  Again the patient was too ill to talk, but I did the best I could to make a diagnosis with all my senses on full alert.  He had been propped up in a wheelchair, so I was able to take his pulses, but he could not be moved sufficiently for me to do an AE drain.  Those were the days when the thorough early training I had received had inculcated into me a rigid adherence to taking all the preliminary steps we had to take before the first treatment.  Even in such a serious case, I thought that I should do the Akabane test, particularly as I thought this might show some significant readings because there had been such a severe left-sided stroke.

Carrying out the Akabane test was not easy, although easier on the hands than on the feet which were on the footrest of his wheelchair.  By dint of kneeling on the floor I managed to do the reading on all the meridians, but when correcting the block had to be careful to make sure that the lighted moxa stick did not burn my patient, because he only nodded slightly or blinked an eye to show me when he felt the heat.  To my surprise every single Akabane reading was out, with excess readings all on one side and almost no reaction at all on the other side.  I assumed that this was the effect of the stroke.  So I set about correcting them as best as I could, remembering that we were told that often correcting just one meridian’s imbalance would be likely to correct any others that were out of balance.  And this is what happened.  By this time I  thought that he might well be Metal (from the strong Metal smell and his colour), so decided to correct the Lung and Large Intestine Akabanes first, to offer immediate help to his Metal element in this way.  After having done this, I re-checked the other Akabane readings, and found that they had indeed returned almost to normal, with much less discrepancy between the two sides.  I also corrected a Husband/Wife imbalance I found, something I imagine may often be the result of a severe stroke (the Heart under attack), and I completed the treatment with the Metal source points.  When I had finished I was delighted when my patient suddenly said, “I feel better now”.  When I had first seen him, I had thought he was very close to death.  Now I no longer felt this.

The treatments of these two patients confirmed for me the simplicity of the five element protocols I had been taught.  It was good see how the elements responded so powerfully to the simplest of treatments, and confirmed for me what JR Worsley had often emphasized, that to treat an element it would be enough to needle its source points again and again, and we would achieve the same results “only perhaps it would take just a little longer” than if we moved on to more complex element points.

What I learned from these two treatments also convinced me that the urgency of helping a very sick patient feeds some power with us, which can raise what we do to another level.  I did not think it was a coincidence that I had somehow been led to home in on the right elements and choose the right treatments.  The words, a practitioner’s intention, are bandied about rather too blithely, but I do think that if we are focussing all our attention upon trying to help somebody, our heightened senses may well be guiding us to select the right treatment.  At least this is what I have learned.

This also reminds me of the time when a young practitioner friend of mine told me sadly, “I use the same points as you do, but I don’t seem to get the same results.”  I puzzled about this for a time, but eventually realised that he and I had a very different approach to our practice.  I was totally convinced of the power of what five element acupuncture could achieve.  He doubted it, and eventually moved on to practising another kind of more physically based acupuncture.  His doubts must have conveyed themselves to the treatment he was giving, whereas I came to realise my absolute conviction added power to the treatments I gave.  This was another of those profound lessons my practice taught me which have have stayed with me to support me over the years.

 

 

4. Important milestones in my five element life

An experience in my early acupuncture life had a long-lasting effect upon me, because it brought me face to face with an area of life which until then I would probably have denied existed or would even have ridiculed.  These were very early days in my practice and I was still a very uncertain practitioner, often unsure of what I was doing.  I doubt if I had treated the condition we call a Husband/Wife imbalance on my own before then, and found myself faced with diagnosing a case obvious enough from the pulse picture and my patient’s distress for me to be certain that this block was there.  At the time I had the mistaken idea, culled from I know not where, that it would be dangerous on a Metal patient, as this patient was, to do the part of the treatment which required me to transfer energy from Metal to Water (the Water tonification points) to help re-establish the smooth flow of energy from the pulses of the right hand to those of the left hand.  I felt that this would be going against the principle that we always need to strengthen the pulses of the guardian element, in this case, the Metal element.  In fact the rule is always to treat the Husband/Wife imbalance, whatever the patient’s element is, and then continue treatment with the source points of the chosen element, whichever that is.

I remember freaking out a little, wondering if I would be doing the patient harm by needling these points, so calmed myself by very slowly marking the points whilst trying to gather my thoughts.  I had forgotten that I had given my patient a copy of JR Worsley’s Talking about Acupuncture in New York in which he mentions the importance of treating this block.  As my fingers felt for the points to locate them before needling, she suddenly said, unprompted and after a few moments of silence, “That sounds like quite a dangerous thing that Husband/Wife imbalance your Professor writes about in his book.”  I remember sending up silent thanks to the good lord of acupuncture hovering over me, and with a sigh of relief, carried out the treatment and cleared the block, emboldened now by my patient’s unconscious confirmation that it needed to be done.  She never mentioned JR’s book again to me afterwards in all the many further treatments I gave her. 

I have always asked myself what had moved her to help me in this way.  And this proved to be the first of many examples of the power of the often hidden forces which can stir the elements to life through connections set up by something as apparently simple as stimulating the points as I mark them, or, as here, some unconscious request I must have been sending out for help in dealing with a difficult treatment situation.  I have found that, at other difficult times in my practice, help has surprisingly been forthcoming in odd ways, as though I somehow offer up a prayer for help to whatever powers rule the universe and summon an answer when I feel an answer is desperately needed, as in the case of this patient.

This is when the rational part of me, nurtured since childhood in the atmosphere of an agnostic family with no particular interest in spiritual matters, and with an unshakable trust in the power of orthodox medicine to heal, for the first time encountered something I could find no rational explanation for.  And yet my family had been prepared to welcome a rather odd cuckoo into their nest, an eminent astrologer whose writings I later learnt were evidence of a belief in much esoteric thought.  So perhaps there was something in the atmosphere at home that prepared the ground for my growing realisation that somehow my practice of acupuncture had the potential to tap into forces in the universe which lay beyond my experience so far.  The incident with my patient with a Husband/Wife imbalance first alerted me to this.  What had made her mention JR’s words about Husband/Wife at the very moment when I was unsure what to do?  I don’t really know the answer to this, but the feeling that my acupuncture practice stirs into life forces so far unknown to me or ignored by me has grown increasingly strong with my years of practice.

 

 

3. Individual approaches to diagnosing the elements

We can never be neutral observers of life.  As all scientists now acknowledge, the observer is always part of what is observed, so there is no such thing as being objective.  Our judgements are always subjective.  The important thing is to be aware of this, and to try and understand ourselves as deeply as possible so that we can understand the nature of our involvement in any human interaction.  In five element acupuncture terms, this means understanding how our own guardian element colours how we perceive all the people we meet, and in particular how this fact colours our interactions with our patients, and our diagnosis of their particular element.  The important thing is that we should try to trace and analyse the impact each element has on us, and use what we learn from this to hone our diagnostic skills.  So if the Water element does not feel as ephemeral to you as it does to me, or Earth does not feel as needy to you as it does to me, then these differences will help you work out your own personal criteria for how the elements impact on you, and this in turn must help you in your practice.

We therefore need time to home our diagnosis to a point where treatment of the chosen element has had sufficiently positive results to make us feel sure that we are on the right path.  We have to call on our observations of the many ways that the elements imprint themselves upon us to help us pinpoint the most dominant.  And these marks are in everything we do, such as the way a person walks or talks or the kind of choices they make in life.  But above all, and in my view, definitely providing the greatest level of additional information, is the nature of how an element makes us feel.  In other words, the answer to the problem of tracking an element down lies within each five element practitioner, if we are sufficiently self-aware to appreciate this.  If we can learn accurately to measure another person’s impact upon us, we can apply this information to any other new person we encounter who makes a similar kind of impression upon us, thus providing us with a way of pinpointing the guardian element.

We learn to develop our own way of recognizing the different elements, although there are some general characteristics which distinguish one element from another and which we can use as diagnostic aids.  This means that there may only be a few characteristics which we would all accept as common pointers to a particular element.  Our own element and our own life experiences will inevitably colour what we perceive in ways which may well differ.  The experiences gained from our own meetings with people of the different elements will add a particular slant to how we interpret what we see in those we meet, making it likely that we will respond to another person in our own unique way.  There will therefore always be something very personal to us about how we diagnose the characteristics our patients present us with.

Many years back when I was an acupuncture student we were told to concentrate our diagnosis upon the four sensory signals emitted by the elements, under the well-known headings of colour, sound, smell and emotion.  It does, however, require many years of hard study to develop these sensory skills to the appropriate level to give us accurate information about the elements.  Since I initially found this difficult, I soon came to see that each of us is a walking, talking manifestation of the presence of the elements, so that I gradually began to draw together all sorts of little pointers to one or other element to supplement the four sensory categories. This means that, to the acute observer, everything in a person can be seen as diagnostically pointing towards one or other element. 

My own deepest learning about the elements started soon after I qualified, when I was asked to teach some evening classes, and found myself talking to a whole range of people, from plumbers to retired people and young, unemployed mothers.  Looking back, I realise that in explaining what the elements represented for me, and trying to find examples of them in famous people the whole class were familiar with, I learnt to see the elements, not simply as a component of acupuncture treatment, but as one way of approaching the complexities of human behaviour.  I have always felt that anybody interested in understanding more about human nature in all its amazing variety can benefit from learning about the elements, whether they then wish to extend this knowledge into the field of acupuncture or not.

The subjective nature of all our interactions with the world around us is undoubtedly why I notice that my writings about the elements which I present here are not evenly spread over the five, but tend to be focussed more on Wood and Fire, with Earth a slightly more distant third.  Throughout my writing life, I appear to have written far less about Metal and Water.  I rationalize this a little by thinking of the order in which the elements are placed around the great five element circle.  Fire’s relationship to its fellow elements is closest to its mother element, Wood, and its child element, Earth, whilst it has a more distant relationship to the following two yin elements, Metal and Water.  I wonder also whether this helps explain my yang Fire’s deeper understanding of totally yang Wood and half-yang Earth, than of the two more mysterious and more hidden yin elements.  Despite myself, then, what I write is tilted slightly more towards the yang, the sunny side of the mountain and daylight, than towards the yin, the shady side of the mountain and the darkening light.

 

2. The qualities of the elements

Fire wants to share
Earth wants to involve

Wood wants to tell 
Metal wants to observe

Water wants to make sure

The above is my present take on the elements as I perceive them at the moment.  Over the years I have defined the elements for myself in many different ways, and will no doubt continue to add to my definitions in the years ahead.  Whilst discussing the point III (Bl) 47, Ambition Room, I remember JR Worsley saying : “Everybody must have an ambition for each day.  It doesn’t matter if what you believe you want for today changes when tomorrow comes."  I like to apply this to the definitions of the elements which I come up with from time to time.  The list above therefore represents my thoughts today.  It won’t matter if I change my mind tomorrow, for there are as many ways of describing the elements as there are people in this world.  Is not each human being a unique manifestation of their qualities?

 

As acupuncturists we use as our principal instrument of diagnosis, not Western medicine’s array of physical equipment, but the much less tangible, much more mysterious quality which we call qi energy.  And in direct contrast to Western diagnostic methods, which try to remove the subjective from their procedures, we are actively encouraged to take note of how we are reacting in the presence of our patients. We train ourselves to observe how the energy network within us created by our unique combination of elements responds to that of those coming to us for treatment.  We therefore have to be aware of the actions of the different elements not only within our patients, but also, and perhaps more importantly, within ourselves.

 

I say more importantly, because as I have written on many occasions, until we understand the balance of our own elements, and in particular the role which our Guardian Element plays in our interactions with others, we will be unable truly to understand how we may be affecting these interactions, and how this may unconsciously be distorting our relationships with our patients.  My take on the elements shown in this list is therefore inevitably shaped by my own Guardian Element, Inner Fire, and anybody reading this should accept this as a given.  They may then find it useful to use this list to draw up their own definitions of the elements based on their own element.

 

So on to Fire.  For me, sharing everything that is mine is more important than keeping things for myself.  I learnt this long ago when a friend told me that she thought “silence is golden”, whereas, for me “speech is golden”.  The need to communicate with those I come into contact with, either through the written or the spoken word, is as essential to me as breathing.   I need to share my thoughts in words, as I am doing in my writing here, or in my teaching.  I need to smile at people I meet in the street, smiles and laughter being just another form of the sharing that nourishes my soul.   

 

For Earth, on the other hand, I feel a different need dominates, that of drawing others into its orbit, reflecting the centrifugal force which Earth people exert upon all who surround them.  I remember seeing this most clearly many years ago when asked by the predominantly Earth group of my fellow acupuncture students to take part in what they called a “group hug” to celebrate our graduation.  Hugging is something which seems to me to be such a very Earth-like activity, for when you hug you enclose the other person within the circle of your arms.  And this image of Earth trying always to be at the centre of a circle is also there in its speech.   I see it as wanting to draw others into whatever it says, often circling several times around a subject in an attempt to make sure that the listener has really understood what they are trying to say.

 

When we move on to Wood, I feel that it is much more concerned with getting its point across, irrespective of who the listener is.  I have an image in my mind of Wood talking with a raised finger pointing at me to emphasize what it is saying, with a kind of commanding gesture.  This is why I describe it as liking to tell the world what is going on, not asking it, or sharing it.  It tells what it wants others to hear, so that it can order things as it thinks they should be ordered, and thereby stay in control.

 

I experience Metal as expressing itself in an almost dramatically opposite way to Wood.  Instead of Wood's emphatic speech, it gives itself time to ponder, to think things through, and then will speak quite quietly, but at the same time firmly. It stands back and observes, casting a watchful eye on what is around it.  Its speech is very measured, and it speaks only when it judges it right to do so.  Unlike other elements, it will be quite at ease with silence as it gives itself time to assess what is going on, often critically and dispassionately.

 

Finally, I come to Water, which somewhere deep within itself always harbours the fear that things may come to an end.  It worries that the link which it is there to establish between the end of one cycle and the start of the next might eventually break, despite all its efforts, forcing life to come to a halt.  It constantly needs the reassurance necessary to still its fears.

 

These are just some of my current thoughts on the different qualities of the elements.  Others reading this will have quite different opinions which will be just as valid for them as these are for me, provided that they are tested out in all our encounters with others.  By the time I draw up some future list of my take on the elements, no doubt my understanding will have deepened, and this future list may differ quite markedly from the present one.   As JR said, the important thing is that we should be flexible enough to allow space and time for tomorrow’s thoughts to build on those of today.

1. A Five Element Companion

I find that I have written down many more of my thoughts on my five element practice that have not yet seen the light of day than I thought I had.  My old Viennese astrologer friend, Dr Oskar Adler, whom I have mentioned before in my writings, always said that each of us has a duty to pass on whatever we have learnt to the outside world.  "We never know who will read what we have written and who will learn from it," he would say.  So in the belief that the more that is written about five element acupuncture the better, I will be using this new blog to pass on my thoughts to whoever wishes to read them.  I intend to add a new post about once a week, and these individual entries taken together will form my eighth book. 

I am drawing together some of the writings about my practice as five element acupuncturist which I feel will be helpful for any of my colleagues, particularly now those in China, who want to benefit from what I have gradually learnt over the years.  I am especially keen to pass on the lessons from my own acupuncture master, JR Worsley, with whom I studied closely for several years as part of my postgraduate training.  One of the many things I remember him telling us was that we would always learn more from what we didn’t get right to start with, especially our diagnosis of guardian element, than when we got things right.  I know that the mistakes I made in my early practice have always proved to be valuable lessons for me, and I therefore hope that what I write here will give five element practitioners a little more confidence and enjoyment in their five element practice.