83. One of the challenges of writing about the elements

One of the challenges of writing about the elements is that, because of their different qualities, elements demand different kinds of approach from their practitioner.  That means that practitioners have to learn to adapt how they deal with their patients to take account not only of the differences between patients of the same element, but also the fact that their own element will respond in its own specific way to what the patients they treat will demand of them.  This requires a high degree of sensitivity and flexibility on a practitioner's behalf, and, above all, a degree of self-awareness that few of us possess before we start on the long road to becoming an experienced therapist.

 

Each of us, patient and practitioner alike, is formed of a unique blend of the elements, creating what we can call our own unique elemental DNA.  When this unique imprint meets the equally unique, but obviously different, elemental DNA of our patients, there is obviously the risk of some misunderstanding between the differing needs of these two people in the therapeutic relationship.  For we must not forget that, whilst it is obvious that the patient arrives in the practice room with specific needs of his/her own, the practitioner, too, enters it with what may at first sight not be, or what the practitioner may think should not be, their own needs. So what are the patients' needs and how may they conflict with those of the practitioner?

 

We often don't think enough about this, as though taking for granted that we know why our patients are coming to us.  Surely, we may think, it is that they wish to feel better, to heal themselves of some symptom, usually something physical.  But if we look more carefully, beneath the obvious reasons lie often deeper ones, hidden sometimes from both the patient and the practitioner, and only gradually exposed as a result of the changes prompted by treatment.

 

The more experienced and adept a practitioner is, the more quickly these hidden areas of a patient's life come to light.  I know that I learned quite quickly to open the door to this more hidden world to patients by asking questions in such a way as to give them permission to talk more freely.  A good example of this was when a patient came to me complaining of bad neck pains.  After listening to him describing this, I turned the questioning in another direction, by asking, "And is there anything or anybody in your life who you also feel is a pain in the neck?"  I was almost amused to see how quickly my patient responded to this, by admitting that, yes, his youngest son was causing him a great deal of problems.  By connecting the two levels of his distress, the physical and the emotional, this allowed him to open up to the deeper problems in his life, to his obvious relief.  This was also likely to contribute to his physical pain, if not indeed simply being its cause.   

 

I therefore recommend that all aspiring five element acupuncturists should learn the techniques necessary to bridge the gap between patients talking about their physical symptoms to emphasizing that five element acupuncture is also there to help heal emotional trauma.  Patients and practitioners often find it easier to remain at the more superficial, physical level of their patients' lives.  Practitioners may therefore be happy to follow their patients' agenda in their approach to why they are coming for treatment, rather than venturing into the more challenging areas by touching upon what are usually the more deeply-rooted and therefore often more painful areas of patients' emotional lives.

 

And then there is the question of how far practitioners' own element dictates their approach to treating patients.  All of us are untouched by the characteristics of our particular guardian element.  An Earth practitioner, for example, will, therefore, approach his/her patients quite differently from a Wood practitioner.  Each practitioner has to be aware of this, and counteract any particular bias which may start to creep into their practice because they may have their own personal response to the different elements of the patients they treat.  

 

I realised early on in my practice that I had problems dealing with my Wood patients which I seemed not to have with patients of other elements.  But I only became aware of this when I noticed that I seemed to have very few Wood patients.  It was only when I looked carefully into the reasons why this should be that I realised that my own slight fear of the forcefulness presented by the Wood element, which my Fire element often found difficult to counter, had unconsciously given me a bias to avoid diagnosing Wood in favour of elements I found easier to deal with.  This was a great learning curve for me, because it made me examine how far my diagnoses might be skewed by personal factors, rather than being based on the realities of the patients before me.  A salutary lesson indeed!

 

On the other hand, we must not ignore the fact that our own element also shapes the kind of relationships we develop with our patients in both a negative and a positive sense.  All Fire practitioners will want to engage more actively, perhaps too actively, in their patients' lives than will a Metal practitioner, who may well tend to give his/her patients more space to work out solutions for their problems themselves.  Perhaps some of Metal's patients, though, might prefer a more involved approach. And what, then about the other three elements?  

From observations of my fellow practitioners, I have learned that of all the elements it is Earth which may find itself burdened the most by its patients' needs, because it can so easily feel overwhelmed if too much is demanded of it.  It may also find the one-to-one relationship of patient to practitioner more difficult to cope with than other elements do, as it is usually happier when working in a group rather than on its own. On the positive side, Earth will be more than ready to empathise with its patients' distress.  Wood practitioners, on the other hand, have to hold back from expressing their tendency to think that they know what is best for their patients, and refrain from getting irritated by some of their patients' decisions.  They will, however, be very clear about the kind of help they can offer.  Water practitioners have the advantage of being very sensitive to their patients' needs, but may tend to be too susceptible to self-doubt in relation to their work, leading them to query constantly whether what they are doing is the right thing for their patients.

 

Of course everything I write about the elements is personal to me, and therefore to some extent only partially relevant to other practitioners' approach to their practice.  it is good always to remember that each of us has to develop our own relationship to the elements and establish our own understanding of them, which will inevitably differ in certain respects from mine, although I hope not completely.  Those reading this will therefore need to adapt what I say in the light of their own experiences. 

 

  

82. The fear of getting things wrong

Nowhere is the fear of getting things wrong more evident than when five element acupuncturists are faced with diagnosing a patient's element.  All of us seem to be worried that not "getting it right" straightaway may somehow be regarded as a failure.  I have written more about this in my two latest blogs (80 and 81).  Here I want to continue this discussion with more insights as to why treatment on any element can never be harmful to a patient, provided we remember the basic rules of good five element practice. 

 

Firstly, always keep things as simple as possible.  The simpler is always the better because five element treatment is based on giving simple instructions to the element we have chosen as a patient's dominant element.  We then give that element time to show us clearly whether its response is one of relief at being so firmly addressed, or leaves the patient almost unchanged.

 

Another important rule is that we should never take energy away from a depleted element in order to pass it on to an element which already has more energy.   Nor should we confuse the elements by needling points on different elements during the same treatment.  The only exception to this rule is when we are correcting certain energy blocks, such as a Husband/Wife imbalance.

 

Practitioners are often reluctant to offer their patients these simplest of treatments, in the false belief that they will be impressed by the number of needles used.  For example, it has always been difficult for me to convince students that one of the most profound five element treatments you can ever give a patient is simply needling the source points of one element and leave it at that - four points, two for each official on either side of the body.  JR Worsley used to tease us by saying that a good acupuncturist would take only 3 minutes to do a treatment: one minute to greet the patient and take the pulses, one minute to needle the very few points needed and one minute to say goodbye.   

 

And then there is the question of how much time during each appointment we should take up by talking with our patients, and this is because there is some confusion as to whether five element acupuncture should be considered to be a talking therapy or not.  We certainly need to get to know our patients by questioning them and giving them the opportunity to talk about their problems.  We must, however, always remember that it is the patient's elements which will ultimately help solve these problems, rather than spending too much time talking them through with the patient.

 

As an additional note here, I learnt early on from my own treatment the importance of keeping to simple treatments.  I was being treated by a practitioner at JR Worsley's Leamington college, and JR would often come in to give my practitioner the benefit of his experience.  So I had a great deal of evidence of how simple the treatments he suggested each time were.  Often the same treatments were given at intervals, such as the AEPS or Windows, but always the basis for each treatment were the command points.  I don't remember an occasion when he recommended any points beyond this classical repertoire.  The sheer simplicity and, I like to think, purity of the proposed treatments have stayed with me and have formed the foundation for all the many years of my own practice and teaching.

 

  

81. Necessary short-cuts to a five-element diagnosis

I have been thinking a little more about the lack of five element teachers, which I mentioned in my last blog (no.80). There is always a problem venturing in the footsteps of a proven master.  Jung had difficulty in emerging from under the great shadow which  his master, Freud, had cast over him.  All JR Worsley's successors have to deal with the same problem.  Those who learnt directly from JR Worsley himself, and the following generations who were taught by this first cohort, have a natural reluctance to claim to "do a JR" when diagnosing patients, particularly in front of a class of students.  This term was a shorthand for being able to do what he told us was his ability to diagnose colour and smell as he came into the practice room, and follow this up in a very few minutes with sound and emotion as soon as the patient had responded to his questions.

 

Because we have been asked to diagnose hundreds of Chinese practitioners and patients on our seminars over in China, I realise that I am getting much better at making quick decisions about the elements I am seeing.  I have had to be, in view of the time constraints we are working under - perhaps only a morning to make over 150 diagnoses.  But then I have always emphasized that this is completely the wrong way to make a good diagnosis.  I should be sitting down alone with each of these 150 people in a practice room, and giving them all the attention and time that carrying out a good TD (Traditional Diagnosis) demands.  But as the saying goes, "needs must when the devil (here simply the time available) drives"!  If we (and that includes my five element companions, Guy Caplan and Mei Long) were not to do this, none of these enthusiastic five element practitioners and students would ever have the slightest inkling of their own element, something I consider essential for any five element acupuncturist.  And we know that we are always very bad at diagnosing our own element, for all sorts of reasons, often choosing an element which we long to be!

 

I have therefore had to learn to do the best that I can, calling these initial diagnoses simply our first hypothesis about the element, to be amended as we get to see things more clearly in the light of how treatment on that element has or has not brought about any changes.  Luckily during these seminars in China we see everybody for a full week, and so have many opportunities of observing closely those whose diagnoses we are unsure about, and then changing these where necessary accordingly.  As I said before, Chinese acupuncturists, probably because of our emphasis on the provisional nature of our initial diagnosis, are quite happy to have their elements changed, happier, I think, than their European counterparts, certainly their British.

 

Also, if we see examples of possession in the group (surprisingly often, perhaps for cultural reasons), we make sure all these patients are treated before we leave, as this is not a simple treatment for apprentice five element practitioners either to diagnose or to recognize when it has been cleared.

 

I know that my own 40 or so years of five element studies have helped me pinpoint the elements more quickly, and, I hope, more accurately, but I do wish that more of all those competent five element acupuncturists out there would take a leaf from my book and venture out into teaching.  I always remember one of my wise teachers, Dr Oskar Adler, master musician, teacher of the violin to the composer Schoenberg, and astrologer, author of some fascinating books on astrology, writing how important it was for everybody to pass on whatever they have learnt.  In a lovely quote, he said, "What would have happened if Mozart had not written down his music?".  And Mozart, after all, was almost hounded to his death through poverty and many of his manuscripts only survived by accident.  Think!  We might not now have his Magic Flute or Marriage of Figaro, or hear his sublime piano concertos!

 

So any of you experienced five element acupuncturists out there, please take courage in your hands and offer up to the next generation whatever you have learnt from your own practice.  Only in this way will any discipline survive, and particularly such a rare discipline as five element acupuncture.

 

80. The certainty of uncertainty

 Oh, how we would all like to be 100% certain about things.  In five element terms this would mean that with sufficient experience we would be absolutely sure of a patient's guardian element, leaving no room for doubt.  But that is not how things are, nor should we hope that this is how they should be.  Instead we must learn to accept what I like to call the certainty of uncertainty underlying all human activities, including our diagnosis of a patient's element.

 I am strongly reminded of this truth now because of something which has happened whilst Guy and I are helping put together the latest of a series of courses for Chinese five element practitioners.  In previous courses we have looked at videos of patients and made preliminary diagnoses of their elements.  For this course we are being sent further videos of patients we have previously diagnosed after they have received further treatment either on the new element we diagnosed or on the original element we confirmed as being the correct one.  We are focusing on helping develop practitioners' relationships with their patients and improving their ability to observe the often subtle changes in patients which indicate that they are treating the right element.  

 

All five element practitioners have to be honest enough to admit when our diagnosis is not yet the right one.  This thought is at the forefront of my mind at the moment because I have just been sent some more videos of a patient we diagnosed a few months ago which have made me alter my original diagnosis.  The patient does not seem to be showing any of the changes I expected to see after some treatments on the new element.  After seeing more videos of her, I am now much more confident of her being of another element.   

 

Here indeed is a real lesson in humility.  We are using these videos as teaching material for perhaps some hundreds of five element practitioners in China.  There is now no doubt in my mind that we need to change our diagnosis, and it would be wrong to continue with my original diagnosis.  How do I make this change  in diagnosis without undermining my students' trust in what I am teaching them?  This is a dilemma all five element teachers have to face.

 

This is where my thoughts turned to something I read in Professor Liu Lihong's book, Classical Chinese Medicine, which so impressed me with his understanding of the need for humility in all that we do.  He said that we will all start any discipline by getting things about 10% right, and gradually increase this with practice to 40%, then 50 or 60%, but we never reach 100%.  Traditional Chinese medicine is a discipline based on practitioners' subjective experience, unlike Western medicine, which prides itself somewhat naively on believing that it bases itself on objective criteria. As five element acupuncturists, on the other hand, we welcome the fact that the relationship between patient and practitioner forms a crucial part of all treatment.   There is therefore every reason for us to accept the very human uncertainties which are an essential ingredient of what each practitioner brings to his/her practice.   

 

So I will be using our approach to diagnosing and treating this patient as a prime example of good five element practice.  I hope that showing fledgling five element acupuncturists that my ready acknowledgement that I needed to change my original diagnosis will encourage them to retain sufficient humility in their own practices. They therefore need not be afraid to admit when they don't get things right straightaway, and allow themselves not to be undermined by this fact.

 

I often think that this fear of what may be seen as showing fallibility in front of their students by not wishing to reveal that they are uncertain of their elemental diagnoses may be one of the reasons why so few good and experienced five element acupuncturists wish to venture into the world of teaching.  This is one of my sadnesses, for it is reducing the flow of five element teachers to a tiny trickle.  As one of my students said to me many years ago: "If JR is the only person to be 100% sure of his diagnosis, how will I ever get to that point?"  To which I would give the answer JR Worsley gave to a class of us when I was a student at Leamington:  "If you had all practised for 40 years, as I have, you would all see the elements as clearly as I do.  So just wait!"  

 

Five element teachers have to have enough self-confidence not to mind telling their students that they, too, are human enough to change their minds, as I am about to do on my latest video recording for my students in China.

 

In my own teaching I have always emphasized that my first diagnosis of a person's element is a provisional one, a hypothesis which subsequent treatment is there to prove or to amend.  Chinese students seem to be quite happy with this and don't appear to be thrown when I change my mind later.  But being human, which means that I do after all want to show that as an experienced practitioner of many years' standing I know what I am doing, I still find it difficult when, as now, I have to announce publicly that I got it wrong!

  

79. A potential horror story, with a happier ending (I hope)

One of my lovely sons, after much encouragement on his side and much resistance on mine, persuaded me that it was high time to exchange my old pc computer for an iMac.  And bless him, he actually got it delivered to my home to prevent me from changing my mind.  It lay under my desk in its box for a month or so, until my idleness during lockdown made me unpack it and install it with the help of my son's long-distance instructions.  To my relief, he arranged things so that at all times he could see what was going on on my computer, and help me start learning how to use it.  I tried very hard not to give way to my usual panic at learning about any new piece of equipment, so am now fairly at ease with it, although occasionally casting a sad eye back to what I could do on my much simpler pc.

 

Gradually over the next few months I have learnt a complicated new computer language, with many false steps and many odd deletions.  But no false stop and no deletion was as bad as what I did last week.  By some mischance, instead of merely deleting one name from a folder on which I invited people to have access to one of the video series I have recorded for China, I apparently deleted all the 20 video recordings (about 30 hours in total).  Despite frantic calls to my son to see whether I could retrieve them they have apparently disappeared for good from my computer.  They include the videos in which I record my life as a five element acupuncturist, from my first days at acupuncture college to my last visit to China, a time which coincides with the growth of five element acupuncture.

 

At first somewhat disturbed at having destroyed so many recordings about my life, I now realise that it has given me a chance to look at that life from a different viewpoint a few months further on, when I am a little older and the world has turned on, too, in many ways which have been so difficult.  All this, Brexit, Covid, Afghanistan, global warming, all these traumas we are going through have impacted upon me, and like all things, have affected the way I, and the elements that form me, particularly my Fire Element, with its dominant Small Intestine official, have had to learn to adapt.  So I am trying to see this as an opportunity to look at my life again from a different perspective. 

Happy update a week later!

 

Good news!  I have managed to retrieve all the video recordings I thought I had deleted in error.  I had the happy idea to ask my Chinese friends whether they could post the videos I had originally sent them back to me, thinking this might be a bit unlikely but worth a try.  And now here they all are back at home on my computer.

 

But I'm still going to record some more thoughts about My Life as a Five Element Acupuncturist to add to the original series.

 

 

78. Welcome to my 8th book!

Unexpectedly I was approached by my Chinese publisher who asked me whether I would be happy if he published another book of mine, this one intended just for the Chinese market.  As readers of this blog know, I have been sending teaching videos recorded on my sofa at home to create various series of online seminars for Chinese five element acupuncturists.  The latest, to be made available on subscription in a few months' time, describes my life as a five element acupuncturist from my earliest days as a student under JR Worsley to now, as the lead tutor for the five element programmes being run all over China.  What I did not know until I received this request was that these recordings, which I thought simply had Mandarin subtitles added, have been translated in their entirety.  It is this translation that the publisher wants to make available in book form with the title of "Learning five element acupuncture with Nora". 

Of course I agreed to this unexpected offer, who would not?  Perhaps at some point in the future somebody will want to publish an English version!

 

This will become my 8th book, and has prompted me to look at the other seven books I have written, and see what I think about them now.  I have talked before about the need for each of us to leave behind a legacy of our life.  It does not matter whether this is a private legacy, one known only to oneself and perhaps a few people close to us, or one on the public stage, known to a wider audience.  I wonder where I would place myself on this scale.  In the world of five element acupuncture I am quite a well-known figure, particularly now in China, but in the acupuncture world as a whole I think I only occupy a very peripheral role.  And this does not worry me, for my greatest concern has always been to ensure that five element acupuncture survives, not to have my own contribution to its survival recognized 

 

I don't often write about my books, thinking each one should promote itself on its own, but perhaps now is the time to grade them according to how I value them.  Far ahead of the field, perhaps almost out of touch with the others, is what I call my magnum opus, my most favourite of all, my Keepers of the Soul.  Funnily enough this was my first book, written in the full flush of the excitement of my discovery of five element acupuncture.   I have been told that it is a difficult read, perhaps because, coming as I do from a rather literary background, I am very conscious of the need for my writing to reflect the beauty of words.  In the pursuit of exactly the right cadence to what I wish to express, I make few concessions to my readers, for which I make no apologies. After all, if they don't like what I write, they only have to put the book aside. 

 

My other books all express my thoughts about the practice of five element acupuncture in different ways, two, Blogging a Five Element Life and On Being a Five Element Acupuncturist, offering a selection of my blogs over the years.  The Simple Guide to Five Element Acupuncture was originally intended for acupuncture patients, but has proved to be a useful introduction for anybody interested in learning more about the five element approach to life.  The Handbook of Five Element Practice is a practice manual for acupuncture students and was the first of my books to be translated into Mandarin.  It has proved so popular over there, with more than 45,000 (yes, thousand!) copies sold in the past 10 years that the publisher tells me that it is the highest selling book on acupuncture in China.  Its popularity reflects the great interest in learning about a branch of acupuncture up till then almost completely unknown in China.

 

So on now to my 8th book.  Will it be my last, or will more of what I talk about in the series of videos I continue to record prompt me or my Chinese publisher to propose a 9th book?

77. The Metal phase of my life

I think I must now be very much in the Metal phase of my life, and I am increasingly aware of time passing.  With my love of the elements, I have reduced the seven stages of life Shakespeare tells us about in As You Like It to five, each represented by one of the elements, with Water, ever-ambiguous and mysterious, straddling both the end and the beginning of life to create an unbroken circle.  In my picture of the elements forming life's cycle, Metal lurks there almost at its end, its autumn, and at my age, now in my mid-80's, I accept that this is the stage I am at.

I feel we are living through strange times, evoking yet another Shakespearian thought, for many of us feel, with Hamlet, that "the time is out of joint".  Covid, global warming and Brexit are combining to make me assess my life anew - and this includes my approach to my five element practice and teaching.  I am treating very few people now, first forced into this by Covid restrictions and then at last accepting that the time has come for me to concentrate whatever energy is left to me on what I consider the most valuable thing for me to do.  It's important for me to know that whatever legacy I leave behind represents the best that I can offer those coming after me.  To my surprise, lockdown has given me new teaching tools to use to do this which I never suspected were there.  Things literally fell into my lap one day when I was trying to familiarize myself with my new i-Pad when it struck me that one way of occupying myself whilst I was prevented from carrying on my teaching in China would be to spend some time learning how to record myself teaching online.  My blog of 6 June: Continuing teaching during lockdown describes how I learnt how to do this.

 

Not only has recording the 100 or more videos occupied my time usefully, but it has also given me the opportunity to think my thoughts through more thoroughly, and particularly work out new ways of helping students from a distance.  With Guy and Mei I have now completed several series of video seminars, and we are about to embark on some new seminars, both online in China, and potentially in person in a chateau in the French Loire valley, once Covid travel restrictions permit this.

 

So in this most contemplative phase of my life, in the autumn of my days, I think I am fulfilling the needs of the Metal element within me to clear away the garbage and pass on as much of the true essence of my understanding of five element acupuncture as I can.