47. We are all discoverers of hidden truths

I have just come across the phrase “the discovery of hidden truths” in a video of Liu Lihong, my host in China, on the website www.classicalchinesemedicine.org .  Once he was introduced to five element acupuncture, Liu Lihong very quickly recognized that here was a hidden truth which he wanted me, as somebody who had inherited this very spiritual lineage of acupuncture, to return to China, where up to this moment he felt it lay buried.

I love the expression “the discovery of hidden truths”, because I think it reflects something very fundamental about human nature.  We can all be said to be discoverers of hidden truths, those which lie hidden within each one of us.  The older I get, the more aware I become of these layers of hidden truths within me, and constantly surprise myself by the fresh discoveries about myself which life forces me to make even after all the many years of living which I trail behind me.

Today, for instance, this phrase stimulated another thought.  Could all our lives be said to be lifelong attempts to discover more and more who we really are, where the “hidden truth” of ourselves really is?  Can we, indeed, ever say that we know ourselves completely?   

Perhaps indeed we only ever have occasional glimpses of all that lies within us, all these hidden truths which age reveals only slowly to us.

 

 

 

46. The curse of the mobile phone

I have written before about the way in which I think the use of mobile phones and other electronic equipment is having a negative effect upon human interactions.  I am reluctant to condemn all these new inventions because in many ways they are miracles of human invention, but it is hard for me to see their good in a world now increasingly peopled by automaton-like figures peering into their screens with never an eye raised to acknowledge the presence of those they are passing by.

If you become used to allowing the demands of the mobile phone to control your life in this way, I wonder how this will affect human interactions in the long term.  More and more people now appear to be compelled by their insistent ringing tones to give mobile phones priority over everything else to the extent that they allow them to interrupt whatever social interactions are taking place at the time.

I was reminded of this at a restaurant I went to last week, where the owner said that she was quite happy for us to sit on as long as we wanted after we had finished our meal, because she was so pleased to find people who had not spent the whole of their meal shouting into mobile phones, as her other guests often do. She is appalled at the way these telephone conversations are conducted at high volume without consideration for other diners, but said, “I can’t tell people they mustn’t use their phones because I would lose too many customers if I did”.  Recently I heard the story of an irate diner, who, plagued by the incessant loud mobile conversation at the table next to his, had simply got up, grabbed the phone and thrown it into a large bowl of flowers where it bobbed about helplessly. “You’ve spoilt my meal, “he said, “so now I’m spoiling yours”.  I certainly often have a strong inclination to follow suit, but I’m not sure I have this man’s courage.

There appear to be very few people left who would still consider it rude to interrupt a conversation with a friend to answer their phones. And if we increasingly ignore those that are physically close to us as we respond to the demands of those disembodied voices on our machines, what effect will that have on human relationships in the future?

Why the need, too, for so much hurry?  We have become slaves to these tiny machines.

  

 

 

 

45. The seven ages of man (and woman)

I have always liked to see the five elements as each embodying one of what are known as the Seven Ages of Man (though two of those ages are shared between the five elements).  If we think of human life as circling in stages from birth to death, each life forms a similar progression to that of the elements, as it passes from its beginnings in Water on to Wood, to Fire, to Earth, to Metal and finally back to Water again.  As Shakespeare puts it in Jacques‘ famous soliloquy in As you like it:

“All the world's a stage,
And all the men and women merely players:
They have their exits and their entrances;
And one man in his time plays many parts,
His acts being seven ages. At first the infant…..

And ending with:

………………Last scene of all,
That ends this strange eventful history,
Is second childishness and mere oblivion,
Sans teeth, sans eyes, sans taste, sans everything.”

I see each phase of this circle of life as imparting its own quality to that life, each adding the quality of the element which it represents to those whose guardian element it is.  There will therefore always be something of the child in a person with Wood as their guardian element, as there will be something of the exuberant joyfulness of the young adult emerging into the wider world of the adult in all Fire people, whatever their age.  Each Earth person will show something of the mature adult throughout their life, as will a young Metal person show something of the wisdom of those approaching old age even in childhood.  Water, always the most mysterious of all elements, the beginning and end of all things, will show both the naivety of the child which Wood always shows and the age-old wisdom of those living at the end of their days, which Metal hints at.

If a five element practitioner is unsure which element dominates in one of their patients, and they are unable to get enough information from their five senses to point towards one element, an attempt to see their patients in terms of how they appear in relation to the kind of stage of life they represent is a further way of helping our diagnosis.  In my book Keepers of the Soul  I gave the example of my mother, definitely of the Wood element, who showed a childlike enjoyment of life at nearly 90 years of age, and I have a Metal son who I turn to to put me right about decisions in my life which my Fire element does not appear mature enough to make.

In this context, it is interesting to note the emotional ages of the friends we choose.  I seem mostly to have chosen those who are further along the cycle of the elements than me, predominantly the Metal element.  I notice, too, that other people’s choices of friends reflect something about the need for their own element to receive support often from an element not their own which stimulates them.

I have never made a statistical survey of people’s elements compared with the elements of their friends.  This would indeed prove an almost impossible task, given that we need to treat a person for some time before really being sure of their element.  But I suspect that many of us choose friends from amongst elements other than our own.  I have always certainly done so, because, I have decided, I do not wish to have to observe in my friends the weaknesses I see in myself.   

44. Always query your diagnosis

I always like to focus our seminar days on diagnosing the elements in patients our participants want help with, or diagnosing the participants themselves who want a clearer picture of their own element.  You will note that I say “a clearer picture” rather than a definite diagnosis.  This is something I insist upon, because I am so aware that a diagnosis can initially only be a tentative hypothesis and awaits confirmation from the way in which a patient responds to treatment.  In other words, we are never sure that we have the right guardian element until that element has shown us, through its positive reaction to treatment, that this treatment is directed in the right place along the circle of the elements.

I know that hovering over all five element acupuncturists is the picture of JR Worsley interacting with a patient for a few minutes, and then turning to us with an immediate diagnosis of one element.  This picture can delude us into thinking that every diagnosis we make should be equally as fast.  But, as JR told us as students, it had taken him more than 40 years’ hard work to get to the stage he had reached.  We would all be able to do the same, he said, once we had the same number of years’ practice behind us.  So those of us with far fewer years’ experience will have to accept that tracking an element down to its source in a patient takes more than just a few minutes, and very often many more than just a few treatments.

What I tell students is that no patient minds how long this takes provided they feel our compassion for them.  A practitioner who has attended many of our seminars, has just sent me the following lovely quote:  “People don't care what you know, they want to know that you care.”  As long as we show we care, a patient will trust us to know what we are doing and allow us the time to work out gradually which element we should address with our treatment.  We must never allow ourselves to be hurried by our patients into feeling that things should be moving more quickly than they are.  One of the things we were told as students was that it takes about a month of treatment for every year of illness.  That does not mean continuous weekly treatments, but it is a helpful rule of thumb, and allows us to tailor our expectations to a more realistic level.

Once my patients have started treatment, I have noticed that very few of them, if any, seem to spend much time talking about their symptoms, but instead want to talk about their life in general.  In fact they often forget altogether why they originally came to see me, evidence that patients do indeed want “care”, and not necessarily a “cure”, although with care often comes cure, since usually the two are closely related.

43. The joy of being with other five element acupuncturists

I always return from my seminars in China invigorated by having taken part in another heart-warming seminar there.  I love the word “heart-warming”, a word close indeed to every Fire person’s heart, such as mine, because it does feel as if my heart is indeed warmer after time spent in the presence of a group of dedicated five element practitioners and students.

We look at patients together, observe their treatments, include some practical work helping participants feel more confident about their clinical skills, and, most importantly of all, mull over together the problems we confront as practitioners.  Mostly, though, we concentrate simply on making participants feel more confident in what they are doing, and helping them by making them aware that they are part of a family of five element acupuncturists.  The main thing which I like to emphasize and which I hope they all take away with them are my two mantras, “The simpler the better”, and “Points are messengers of the elements, not the message itself”.

I am constantly bewildered by the emphasis so many people now seem to put on points and point selection.  When I trained all those years ago, we never seemed to worry about which points to select because the whole emphasis of training was on trying to find a patient’s element. Once found, or at least once we had made our first decision about which element to address, we carried out the simplest of treatments:  first, of course, Agressive Energy drain, then source (yuan) points, tonification points, horary points, AEPs (back shu points), interspersed, obviously, by clearing any blocks, such as Possession, Husband/Wife or Entry/Exit blocks.  I don’t remember us ever worrying about point selection, unlike present generations of practitioners who seem to spend an inordinate amount of time mulling over the actions of different points and when to use them, and disproportionately less time learning to look carefully at the elements of which these points are just the servants.

Another mantra of mine could be “Find the element and the points look after themselves”.  And if they don’t yet look after themselves, because you are new to the world of five element acupuncture, then look at a copy of my Handbook of Five Element Practice, published by Singing Dragon Press, which lists in careful detail the points on each element to be used at different stages of treatment.

So time spent with my group of five element practitioners and students, all speaking the same language of the elements, is confirmation that the spirit of five element acupuncture in its purest form continues to flourish.  This confirmation has been given an additional boost by an email from one of the participants which I received at the end of the day, telling me how grateful he and other members of the group were to see “how you simplify five element  acupuncture in a way that helps us all get a real grasp of the elements”.   

 

 

42. Tips for novice five element practitioners

It takes time for new five element practitioners to become sufficiently comfortable and relaxed in the practice room to make their patients feel safe enough to remove their masks and tell us what their problems really are.  So those starting on their practice must not demand too much of themselves.  Many of the problems the novice practitioners have are learning about how to maintain control in the practice room.  I think their greatest worry is always at first directed at trying to diagnose the right element, rather than doing that most essential of all things, which is getting to know their patient and putting their patient at ease with them.  No patient stops coming for treatment if we don’t diagnose the right element, but they do stop if they feel uneasy in the relationship to us.  Rather than concentrating all our attention upon trying to track down the element, we should instead take as much time as is necessary to establish a sense of trust between our patients and us, and make sure that they feel we are really interested in learning about their lives.  This provides the necessary foundation for a good patient-practitioner relationship, without which no diagnosis, even of the right element, will ensure successful treatment.  If a patient is uneasy in our presence, I like to think that their elements cower away, and fail to respond to treatment, however focussed it is.

It is good if we take some time for what I call setting the scene for treatment for our patients, so that they understand better what treatment involves.  It is useful to have in our minds a checklist of the topics we should discuss with them before they start treatment. They need to be given some facts, such as how many treatments they should be prepared for, how spaced-out these treatments will be and how treatment might affect them.  We also need to give them time to ask their own questions, for most of them will arrive for their first treatment with very little idea about what treatment will involve and what they should expect from it.

This blog is also in answer to more of the questions the practitioners at our latest seminar in Beijing asked.  Thinking how best to answer them, I realised that it would be useful for me to work out a kind of protocol to act as a checklist for each of us to go through with any new patient.  In our eagerness to get started, we often forget that patients come to us usually unfamiliar with acupuncture, and very uncertain about what to expect; they are therefore often uneasy.  It helps both them and us if we prepare the ground before they come for their first treatment so that they are already to some extent prepared for what is going to happen. 

In working through this preparatory checklist now, I had to think about how much to include in it, and how to condense the essential components of five element treatment into a simple format.  The list below is my first attempt at doing this.   

1. First of all, you must show that you are really interested in your patient, and are curious to learn as much about their lives as they wish to share with you.  Often the time with us is the first time anybody has shown them any real interest in their life, apart from perhaps their physical symptoms.  You have to develop a good memory for all the things they tell you, noting particularly those things which send up little warning signals in your mind.  We were told to call them “red flags”, meaning that here is something significant which we need to explore in greater detail with our patient later on.
2. .We must help our patients understand that five element acupuncture treats the whole person, body, mind and spirit, and that, unlike Western medicine, we are not interested only in their physical symptoms, but in their emotional well-being as well.  This is often a surprise to them, and usually a very welcome surprise.
3. We must not be judgemental or bring our own agenda into the treatment room.  We do, however, bring our own life experiences with us so that we can offer our patients help based upon what we ourselves have learnt.  Even if we have a patient who we find difficult to deal with because they have such a different approach to life or different values from us, we must be careful not to show that we find their opinions difficult or find them in any way unpleasant as human beings.  We have no right to impress our own values and prejudices on our patients.
4. We must remain in control of treatment at all times, which means that we don’t allow a patient to direct whatever he/she wants from treatment.  It is up to us to decide what treatment the patient needs and which element to treat, and we should not involve them in discussing our clinical decisions.  The frequency and spacing of treatments is also a clinical matter, and we are the only ones competent to decide on this.  If they are not happy with this, we are quite in our right to suggest that they go to another practitioner.
5. One of the lessons we all have to learn is to not to allow ourselves to be overwhelmed by events in our patients’ lives, but to develop sufficient emotional strength in ourselves to cope appropriately with whatever problems our patients present us with.
6. If you feel that there is something not right with your relationship to your patient, then do what we are often too nervous to do, which is learn to talk things through with your patient.  Always start by saying, “I feel that….(for example) you are not happy with your treatment..”  Often this will resolve problems because you may be surprised that your patient is quite happy with what is going on and it is your uncertainty which is making you doubt that your treatment is helping.
7. Don’t discuss a patient’s treatment with them outside the treatment room. If the patient has a problem they want to discuss with you, tell them that you will discuss this at the next treatment, and make an appointment for them to come.  Don’t discuss their treatment on email or social media.  All discussion needs to be kept private in the practice room.  If the patient wants to go on talking at the end of treatment and your next patient is waiting, you have to tell them that you will discuss this further at their next treatment.  Always keep to your treatment schedule, because some patients love to go on talking!
8. I don’t think it is helpful for patients to be having different kinds of therapy at the same time, for example herbs and acupuncture, because you never know which of the therapies is helping or whether the patient is not responding to your treatment because of the effect of the other therapy.  If a patient wants to try out all sorts of different therapies, I always tell them that it would be better if I don’t treat them.
9. There is always a problem with how to deal with a patient taking medicines prescribed by Western-based medical practitioners and five element acupuncture.  Some drugs are life-saving and must never be discontinued.  Others can gradually be reduced if the acupuncture treatment is helping the patient’s condition, but this must always be done with the consent of the patient’s prescribing practitioner.  We must not interfere with Western medical treatment, even if we feel that it is not helping our acupuncture treatment.  We always hope, though, that our patients will persuade their doctors to reduce the drug doses when the drugs are no longer necessary.
10. I believe that we are given our guardian element at the moment of our conception, and that it stays the same throughout our life, shaping that life in a special way according to the qualities of the element that has been handed to us as our elemental destiny.  I do not believe that it changes, although different elements may colour the dominant element at different stages of our life, depending on the life experiences we are subjected to.  For example the Metal element may appear to overshadow our guardian element for a while if we suffer some great bereavement, or Fire if we are very happy in our relationship.  But below this superficial colouring of another element there always remains the presence of our dominant element.

41. Is a state of balance ever achievable or even desirable?

It was whilst I was thinking about how the different elements manifest their states of balance or imbalance that I realised that it would be useful to look at this from a much wider perspective, rather than from the point of view of each element.  I think we need to ask ourselves whether any of us can ever be said to live our lives in a state of anything more than temporary balance.  The pressures upon us exerted by those close to us, our families and friends, as well as the many thousands of others amongst whom we live in our communities, let alone the many millions more around this small globe of ours, all these pressures make it unlikely that any of us can avoid our elements being subject to all kinds of stresses which must lead them at intervals to struggle to maintain whatever balance they may have achieved.  Or at least to weaken their ability to withstand pressures upon their balance.

Before I look more closely at this, I need to define for myself what I regard as a balanced human being, and how far that is something achievable at more than rare times.  I must also ask myself how far we should regard this as something desirable.  Is there, as I think there may be, a positive side to the constant struggle of the elements to maintain their balance?  Is this, perhaps, something which offers human beings the potential for leading stimulating, creative lives?  In my Keepers of the Soul I wrote that we are, as I put it, “necessarily incomplete”.  I say this because each element is only able to hold its dominating role for one-fifth of the complete cycle.  We can see this in nature where each season only holds sway for a short time before having to hand over to the next season, Wood in spring having to hand over to Fire in summer, and so on.  This finds its echo within us, as each element passes on its function to the next, as they work together to bring us life. This means that since each element represents only one stage in the complete cycle, each has to accept that it is as I put necessarily incomplete.  And therefore each in a different way always remains at heart dissatisfied because the tasks it sets itself are never done.  If I think of my own element, Fire, everything I do is in some way connected with Fire’s need to enter into relationships with everybody it meets, and its deep need is to ensure that these relationships are good ones, bringing the happiness and joy its Heart strives for in all whom it encounters.  But then it must hand over its duties to its child element, Earth, as the cycle rolls on from summer to late summer.  And Earth, not pre-occupied as Fire is with the need to enter into relationships with everybody, has instead been given its own quite different task, that of producing the fruit of the two preceding elements, Wood and Fire.

The actions for which each element is responsible can therefore be seen as finding their completion not within the element itself but in the succeeding element, Wood in the Fire element, Fire in the Earth element and so on.  Each element concentrates with almost fanatical dedication upon achieving that one aspect of the complete cycle which it is its task to perform.  Fire can only do what Fire is there to do, just as summer can only be summer, and Water can only do what Water is there to do, as winter is always winter.  There is something almost tragic in each element’s recognition that it will not by itself be able to complete the tasks it sets itself, but has to hand them over incomplete to the elements which succeed it.  Wood will forever seek to carry out all the activities it is there to initiate, but will never complete all the activities it wants to before the cycle moves on and it has to hand over to Fire.  And so on, from element to element.

I like to think of the play of the element within us as what I call representing our elemental DNA, and like our body’s physical DNA this gives us a unique imprint which distinguishes us from anybody else.  The elements’ interactions within us are unique to us so that no Earth element manifests itself the same in any two people.  This is all the truer of those more complex inter-elemental relationships which we call those of the elements within our guardian element.  If a person’s Wood element is diagnosed as also having much of the quality of the Earth element within it, colouring its dominant green with a little yellow, and even deeper within it has a pink tinge which the Fire element adds to the Earth within it, this combination of elemental colours stamps us with a unique mark, as unique as any DNA sequence discovered by modern science.

And I also like to think that there may be a purpose to this, some reason why human beings have been endowed with this unique potential, offering each of us the possibility of being ourselves and like no other. None of us can truly know why human beings have been chosen amongst all the sentient beings on this planet to have been given individual destinies associated with one of the five elements.  No other species has to cope with the difficult task of shaping its own destiny as we have.  All others seem to be satisfied with living a herd-like existence, one among many, being almost clones of each other.  Each of us, on the other hand, has been given what seems to be an individual fate, related to the challenges the interactions of the elements within us offer us.  This seems to be for some deep purpose, related to our ability each to think our own thoughts and do our own thing, and therefore closely linked to the demands of our guardian element.   

 It would appear that we sit at the pinnacle of advanced life, our brains by far the most complex of any other living creature’s, with unparalleled ability to shape our environment both physically and spiritually through our artistic and intellectual achievements.  No other creature has managed not only to stand on its two feet and reach up to the heavens above, but to devise the means to escape the pull of gravity to penetrate far out into the secrets of deepest space.  And no other living creature, as far as we know, even wants to do this.  This curiosity of ours pushes us inexorably to try to decipher the secrets of the universe.  And somehow I feel that the great diversity which the characteristics of the different elements endows each of us with must play its part in all this.

I have written in The Keepers of the Soul of my own understanding of why this should be so.  Others may obviously have quite different views on this. I wrote: “I like to think that the impetus within us to evolve towards ever higher levels of diversification became so overriding at some point in our evolution that we were no longer able to contain within each of us the totality of characteristics which make up humankind.  Our very complexity appears to have placed so great a burden upon our individual capacity to absorb the awesome range of powers the human being has developed that we might be said to have burst the bounds of what each of us can encompass within ourselves of the human condition, becoming dispersed into so many fragments of the whole.”

If this is in some respects true, then the unique destiny conferred upon each of us through the imprint of our elemental DNA places not only a burden upon us, but is potentially a gift which we can make use of if we choose to do so.  But it leads us often to live precarious lives, subject to the unique demands placed upon us by the interactions of the elements within us and their interaction, in turn, with the elements of all those we encounter.  It is little wonder that human life is experienced as being so complex that it often threatens our ability to maintain our balance.

 

40. The positive and negative aspects of each element

I have been told that some of my Chinese students think that the Wood element has what we call a “bad press”.  They feel that we often make the kind of negative remarks about it which we apparently do not make about the other elements.  I am always surprised to hear this, because I like to think that I always emphasize that each element has both a positive and a negative side, one side which it shows when it is in balance, as opposed to the other when it is out of balance.  To me, lack of joy or excess joy, both evidence of the Fire element out of balance, for example, is just as disturbing to witness as an unbalanced expression of Wood’s emotion can be.  I have always felt that the reason why people think Wood’s imbalances are emphasized may very well lie in the word anger which is used to describe its emotion.  This has negative overtones which attach themselves to the Wood element, which the names of the emotions of the other four elements, joy, sympathy, grief and fear, do not immediately have.  This is why I always like to add a further definition of Wood’s emotion to that of anger, which is the word forcefulness.  Being forceful sounds much nicer in English than being angry, and yet anger, when expressed appropriately, is as positive an emotion as any of the other four.

It is good to look at the whole question of how each element reveals itself both in its balanced and in its unbalanced state.  First we need to define what we regard as a balanced element, and look at the way this may start to lose its balance when it is subject to too much pressure upon it.  Each element has balanced expressions of those four sensory attributes, its colour, its sound of voice, its smell and its emotion, by which it signals its control over those handed over to its protection.  (This is why I like to call this dominant element a person’s guardian element, because, like the more common expression, guardian angel, it hovers protectively over each of our lives.)  If we concentrate here on one of these qualities, an element’s emotion, then we should start by thinking about what we would describe as a balanced expression of these five emotions.  For each of us this will reflect something quite personal to us, perhaps based on our life experiences when engaging with people of different elements, but I imagine that there may well be a common quality about each emotion which we all recognise as being an expression of it when it is in balance.    

It is easiest here to use Wood as an example, because its emotion, anger, is the most visible and in-your-face of all the emotions, and therefore one that we can relate easily to, unlike the more hidden emotions of grief or fear.  I think we can all agree that it would be entirely appropriate for anybody to show their anger if, as happened to me, somebody tried to snatch the cash as I was withdrawing it from a cash machine in the street. I remember shouting at the man as he did  so, my shout alerting those around me in the queue so that he let the money drop and sprinted away.  I like to think that my anger, which had the accompanying effect of changing my voice to a shout, can be seen as being an appropriate and balanced response to the situation.

But what if, instead of this, I had cowered back and refused to engage with the incident?  Could this not have been considered an inappropriate reaction from my Wood element, as it failed to do what balanced Wood would have done?  In that case, I would have been showing a lack of anger, an inability to show anger where anger would have been appropriate.  Equally, if Wood people explode with anger inappropriately, perhaps because they are the kind of people who blow their car horns repeatedly when in a traffic jam for no obvious purpose except to let off steam, this could be described as being an expression of excess anger.  Here both lack of anger and excess anger are the two sides of the same coin, both showing the Wood element out of balance.

It is good to look now at how each of the other four emotions changes from positive to negative as it becomes unbalanced, and how we need to learn to recognize this as a way of diagnosing imbalance in our patients.  If we look at the element at the centre, Earth, it will show, in balance, the comforting qualities associated with this loving mother element, nurturing us, supporting us, ensuring that we feel grounded in all that we do.  All these attributes, however, can become liabilities if it itself starts to feel deprived of good nourishment and is unable to feed itself sufficiently, both physically and emotionally, to replenish the reserves it needs with which to feed others.  It can then react in one of two ways, either by exaggerating its particular qualities, so that we see them as expressing an unnecessary level of sympathy, of the “poor you” kind, where this would be inappropriate.  The reverse of this is when it feels it has to suppress its natural tendencies, and instead turns itself into a surprisingly hard and unforgiving element, its emotion becoming an unyielding lack of sympathy for the problems of others.   

Very different, indeed, from this example of an unbalanced element is that of Earth’s own mother element, Fire.  Unlike Wood, Fire is always likely to be viewed positively, for does not the word joy, which describes its emotion, immediately make us feel happier?  But, as we know, there can always be too much of a good thing, and exaggerated expressions of joy can overwhelm those who approach a Fire element which is out of balance, much as we might scorch ourselves if we move too near an open flame.  Other elements, particularly I expect that coolest of all elements, Metal, can feel threatened by what can seem to them to be the somewhat overpowering warmth which the Fire element in excess can spread around itself.  The opposite manifestation of unbalanced Fire, that of depleted Fire, will express itself as a lack of joy.  I have found that this form of low Fire energy can have an extremely draining effect upon those in its presence, making us feel as though all the warmth of our own heart is being drawn from us.

My response to the emptiness of Fire, which we call a lack of joy, is here very different from what I experience in the presence of Metal, where the unbalanced expression of grief, lack of grief, is where this element is unable to show grief in situations in which grief would be appropriate.  Here Metal seems to distance itself from us even more than it normally does, an extreme expression of suppressed grief making it seem totally unapproachable.  Lack of grief is the kind of emotion Metal people show who we would describe as emotionally numb or stony-faced when others around them are weeping.  It is not that such people are not experiencing grief.  It is that they are so overwhelmed by their feelings, that they are unable to express them and have learnt to suppress them.  Unbalanced Metal can also express itself as excess grief, which is when a person is unable to recover from the death of a beloved person, and may continue to mourn for many years.

The unbalanced expression of Water, our final element, is very different from that of its parent element, Metal.  Its fear, appropriate when it faces any frightening situation, becomes exaggerated when it loses its sense of proportion, and sees danger where a greater sense of balance would reassure it that all is well.  Excess fear is easier to diagnose than lack of fear, as we may not be sufficiently sensitive to detect the anxieties hidden behind a Water person’s show of apparent indifference to danger.  I remember a Water patient of mine who enjoyed putting herself into extremely risky situations (a solo parachute jump with very little prior training, for example), and seemed to enjoy the challenges she voluntarily faced, despite fearing them.  I would call this a lack of appropriate fear.

All elements can therefore exhibit a range of responses which veer from the most appropriate, and therefore the most balanced, to the unbalanced, on a scale of from a mild to an extreme expression of their emotion.  By listening carefully to how our patients describe their responses to stressful situations we can learn a great deal about the balance of the elements within them.

 

39. The transmission of a five element lineage

We are not good at lineages in the West, and we also appear to have surprisingly little respect for the expertise of others.  In fact, most of our educational system appears to be built, not so much on the idea of learning from those of greater experience than us, but more of teaching students to discover things for themselves, almost as if the hard-won knowledge of those preceding them should be discarded as somehow not so relevant.

I have spent many weeks in China since 2011, introducing five element acupuncture to what must now be many hundreds of Chinese acupuncturists, and have learnt from these visits how much respect they show the lineage of five element acupuncture which they view me as representing.  This is why, there on the wall of the Tong You San He Centre in Beijing where I teach, I am greeted - each time with a slight sense of surprise - by a large panel of photographs, the first showing my teacher, J R Worsley, followed by my own photograph and those of the two teachers who accompany me, Guy Caplan and Mei Long, who initiated my first contacts with China through Liu Lihong, the Centre’s director.  Through his writings and teachings he is the person who has done most to stimulate Chinese traditional medicine’s search for its past roots.

For the Chinese, the line of transmission extending back to the Nei Jing, and on through the centuries to reach J R Worsley, then me and beyond, represents what they feel they have lost, a direct connection to the past.  In the West, on the other hand, we seem to be, if not exactly indifferent to this, then somewhat disinterested in the routes of transmission, as though we are not ourselves quite clear what lineage we are heir to.  This probably stems from the fact that generally both in this country and in China there is little clarity about how to integrate the precepts of traditional medicine with modern attempts to draw acupuncture closer to Western medicine.

The display of photographs which confronts me each time I return to China has made me re-evaluate my own thoughts about the transmission of a lineage, and led me to a new appreciation of what has been transmitted to me.  The way the Chinese view what I bring to them makes me more aware of the precious inheritance which has been passed down to me, and which the Chinese now clamour for me to pass on to them.  Here I am, coming from a far-off land, the bearer of an unknown treasure, my knowledge of an acupuncture discipline which fascinates them.  And, most importantly, somebody with about forty years’ clinical experience, which is something they value particularly highly.  I bring them a precious gift, the transmission of what they regard as the esoteric knowledge contained within the lineage of a particular branch of five element acupuncture handed down over the centuries from master to pupil.  This has found its way through devious routes to the West and is now finding its way back to its country of origin through me, an inheritor of this lineage.  It is useful to read Peter Eckman’s In the Footsteps of the Yellow Emperor, Long River Press 2007, as the best, and in my view, so far the only, in-depth study to trace these routes of transmission.

In England we often forget how precious the legacy of the past can be, tending to take this past for granted.  To the Chinese, anything which helps them trace this past is a gift to be nurtured.  Even though all practitioners are brought up on rote-learning the Nei Jing, they are aware that they have lost many of the connections between what is in these old texts and their practice of today.  In their eyes, the branch of five element acupuncture I represent makes these connections clear to them.

To the Chinese acupuncturists that I teach, therefore, five element acupuncture embodies a spiritual tradition which they regard as lacking in much of the acupuncture now taught in China, and connects them to a past which they feel they have lost.  Its emphasis on ensuring that so much attention is paid to the spirit is something they respond warmly to.  It echoes what they have learnt from the Nei Jing, but is something which is ignored by the TCM they are taught in their acupuncture colleges.   

To witness the joy with which they greet all the five element teaching I offer them is to raise an echo within me of a similar joy that I experienced sitting on my first day in the classroom at the Leamington college all those years ago, and learning about the Fire element with the Heart at its centre.  It seemed to me then, as it still does, and does, too, to all my Chinese students, that to base an acupuncture practice upon treatment of the elements was to state a natural truth about life.  Learning from the Chinese approach to their past, I can now see more clearly than ever that I, and every other five element acupuncturist, form one link in the unending chain stretching from the earliest days of the Nei Jing down the years to today.  This path of transmission passed to the West in the 20^th century and is now coming full circle on its return to its birthplace, China, in the 21^st century.  This is indeed an inheritance to treasure.

 

 

 

 

 

 

 

38. 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.

 

 

 

 

 

 

 

 

37. We must beware of becoming too comfortable in our work

All of us five element acupuncturists 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.

 

 

 

36. The three levels of the human being

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.

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.

 

 

 

 

 

 

 

35. One of the many challenges of being a five element acupuncturist

We must never be too quick to say “I know this patient’s element is obviously Fire (or Wood or Earth or Metal or Water)”.  There is nothing “obvious” at all about the way in which an element presents itself to us.  We may learn to recognize its presence more and more clearly with time, but we should always keep a healthy small (or large) question-mark hanging over it, reminding us that elements can hide themselves so subtly behind manifestations of other elements that they still have the power to surprise us, as they do me even after all these years.

If the presence of an element were so simple to detect, we would all be brilliant five element acupuncturists early on in our career, but human beings are much more complex than we think.  So we should never underestimate the time it will take us to find the one element buried deep within the circle of all the elements which gives each of us our individual stamp of uniqueness.

Pride, as they say, comes before a fall, and never is this truer when trying to diagnose an element.  We risk much if we think our understanding of the elements is greater than it truly is.

In any case, the secret of good five element acupuncture is not simply managing to diagnose the right element, despite this being what many practitioners think.  Instead it is learning to respond appropriately to that particular element’s needs.  Even if we diagnose the right element, do we know how to respond to its needs in a way which makes the patient feel that they have been heard as they want to be heard?  If that understanding is not there, treatment will rest on fallow ground, however much it may be focused upon the right element.

Supposing, for example, that we diagnose a patient’s element, correctly, as Metal, but respond to it in a way which would be more appropriate to an Earth patient, offering a kind of “Oh dear, Oh dear, you poor thing” kind of response, we will find that our Metal patient soon backs away and decides not to continue treatment.  Our element may be Earth and it may be natural for us, mistakenly, to offer to all our patients what we ourselves feel most comfortable with.  Unfortunately, however, we have to learn to feel comfortable in the company of elements not our own.  To surround Metal, for example, with a kind of enveloping sympathy is not what it wants.  It will feel suffocated by it, its Lung unable to breathe.  Instead we must learn to offer the space it always wants to place between itself and others.

And the same holds true for how we need to approach our interactions with the other elements.  As far as possible, then, we must learn to suppress the needs of our own element and think ourselves into those of the element we have chosen to treat.  This is not an easy task, and one that it takes some skill and much practice to acquire.

 

 

 

34. Giving advice to patients

I recently received an email from a Chinese acupuncturist asking how she can improve the skills needed to help her patients cope with their problems. She writes, “How to interact with our patients is very subtle and skilful, and a very challenging task for us practitioners.  I really wish I could do better on this, but I don’t know how I could improve… (Their) problems are so tricky that I always have no suggestion to give.  I even sometimes don’t know how to comfort them when they are sad.  I wish I could say something to make them feel better!”

I am sure that every practitioner can relate to what she says, for these are issues we have all struggled with in our practices, and no doubt continue to struggle with.  There is no one approach that will suit all practitioners, because we will each have worked out our own way of dealing with our patients.  As with everything we do, our own guardian element will shape our interactions with our patients and determine the nature of these interactions.  Some practitioners will be much more hands-on in their approach than others (perhaps those with Fire as their element), whilst others will be much less so, giving their patients more room to breathe as it were (perhaps those with Metal as their element).  No particular approach is better than any other, provided that the practitioner is aware at all times of how far what they are doing and saying matches their patient’s needs.

Of course this is where experience comes to our aid.  If I think back on the years of my practice, I realise that there were many occasions when my own very hands-on approach disturbed some of my patients, where allowing a little more space between us would have given them the time they needed to work out their own solutions to their problems.  As with any profession, we can only learn by hit-and-miss, and only experience will teach us how much advice it is helpful to give our patients, and what kind of advice this should be.   We always have to be careful not to assume anything about our patients.

Finally, it is helpful to remember that we are not there to solve our patients’ problems;  only they can do that.  Our help must focus on offering treatments which bring greater balance to their elements, and then allow these to do the work.

 

 

 

33. Unravelling the puzzle of point locations a little

For many years I was completely unaware of the fact that different branches of acupuncture used anatomical locations for some of their points which differed from the ones I had been taught.  The first five or more years of my practice were spent in a complete five element bubble, since at that time JR Worsley’s college at Leamington was the largest college, and many of us who trained there were completely unaware of the existence of other schools of acupuncture.  I know I certainly was, until rumours started to spread around the acupuncture community that acupuncturists who had visited China were bringing back with them another form of acupuncture which appeared not so much to complement what we had learned, but to cast doubt in the minds of some five element acupuncturists about the validity of what they were practising.  This was first brought home to me when standing in a lunch queue at an acupuncture event and being told by a fellow acupuncturist, with some disdain in her voice, “JR has a very odd way with moxibustion”, followed by, “You don’t still only do five element acupuncture, do you?”

I always find it interesting when I observe how often people are only too happy to grab hold of anything which might seem to undermine some practice or concept which holds a dominant position, almost as though they cannot wait to mock what before they expressed admiration for, or indeed, as in the case of many five element acupuncturists, actually used for years in their practice.  This happens all too often, particularly where somebody has been pre-eminent in one discipline.  Perhaps it is then only natural that those sheltering in the shadow of such a person may start to feel increasingly disempowered, and look for ways of asserting their own independence of thought.  This happened most famously with Carl Jung’s abandonment of his admiration for his mentor, Sigmund Freud, and the same thing happened in this country when JR Worsley’s legacy to acupuncture started being mocked in the way I encountered.

In a very short space of time this was followed by a growing onslaught by the acupuncture world in general on the right of five element acupuncture to be considered as a stand-alone discipline.  I have written a lot about the difficulties I, as a devoted five element acupuncturist, have encountered in defence of my practice over the years, but in this blog I want to look at how influences from China have apparently changed this country’s approach to the location of certain points, and how far this is still something five element acupuncture needs to take into account.

The subtle undermining of an accepted five element tradition extended also to the area of point location, where people started discussing whether the five element locations used, based on a long-established tradition going back through to JR Worsley’s teachers, Jacques Lavier and We Wei Ping, came up against the locations modern Chinese acupuncture was now deciding for us, and which have come to replace those in many British acupuncture colleges.  I am certain no historian of acupuncture, nor have I, any way of knowing whether the point locations which have gradually superseded some of those used in five element acupuncture have clinical validity or not.  And this is the only factor in the debate about different point locations which I feel needs to be taken into account.  If I needle a point in my well-practised five element location will a point at a slightly different location used in modern Chinese acupuncture, and following hard on its heels, modern British acupuncture, have the same clinical effect?

We sometimes think that acupuncture does not lend itself to “evidence-based research” in quite the same way as scientifically-based therapies, because it does not seem possible in a holistic discipline such as ours, and similarly in any of the different forms of psychotherapy, to obtain sufficient objective evidence of the efficacy of any clinical procedure which cannot be measured by some physical instrument.  But I think my many years of practice have provided me with just as much evidence that the points I use in treatment have actually brought about material changes in my patients, and ones which are perceptible to others, provided that their senses are sufficiently honed to perceive sensory and emotional changes.

When a patient says, as one of my patients did, that “the treatment you gave me a few days ago really made me feel I could face life again,” is that not evidence of the efficacy of the particular treatment, made possible by needling specific acupuncture points?  The problem is that a reader of this blog only has my word for this, and if I were to invite observers into my practice room during the treatment, might the presence of unfamiliar faces affect the patient’s response to the treatment, and perhaps nullify it?  I do, though, have what I like to call one objective proof of the location of one of the disputed locations of an acupuncture point as a result of a moving encounter I had when consulting JR Worsley about one of my patients.

This point is the one on the Kidney meridian which in the five element point numbering is IV (Ki) 7.  As any five element acupuncturist knows, this is one of the first points in the combination of six points, needled bilaterally, used to clear one of the most serious energy blocks recognized in five element acupuncture, that of a Husband/Wife imbalance.  IV 7 is a tonification point, drawing energy from Water’s mother element, Metal, and in the five element location is at 3 ACI (cun) from the prominence of the medial malleolus.  We were taught to needle all six points before taking the pulses to see whether we had cleared the block, in effect checking whether the patient’s Heart energy - (I (Ht)7 is the last point in the procedure - was recovering sufficiently to combat the spiritual despair which is one of the main indicators of this block. 

 had taken a patient to see JR Worsley, and he had diagnosed a H/W block, leaving me to carry out the treatment.  As this was early on in my acupuncture career, it took me some time to mark up the points, particularly those on the Kidney meridian which require much careful measuring of the leg, so when JR returned I had only had time to needle the first two points, III (Bl) 67 and IV (Ki) 7.  Before I had told him that I had not completed the whole procedure, he took the pulses, nodded at me, and said, “That’s cleared.  Good.”  It was then that I realised that the re-establishment of a strong connection between the Metal and Water elements through the tonification points must have been sufficient to clear the block.  From then on I have always checked the pulses at this early stage in the procedure just to see if this often happens, which I find it does.  Each time, though, I go on to carry out the full procedure because I recognize that needling the remaining points strengthens the connection between the elements which a H/W imbalance shows has been weakened.

From this, and from my own experiences, corroborated by my years of clearing many H/W blocks, I know that the tonification point on the Kidney meridian is where we locate it in five element acupuncture, at 3 ACI (cun) from the level of the medial malleolus.  The Kidney source point, IV (Ki) 3, too, which also forms part of the H/W procedure, is at a different location from the more recently accepted location.  I therefore recommend any practitioner trying to clear a H/W block to adopt the five element anatomical location of these two points. I like to think that I am stepping in the footsteps of an acupuncture master in using the points exactly where he told us they were, and feel that something of the energy I felt passing from him through to the patients I brought to him for consultation is transferring itself a little to me as I needle the points where he told us to find them.