Sunday, March 31, 2019

12. Some early mistakes in my practice

Looking back at the early years of my practice, I sometimes cringe with shame at some of the mistakes I made.  These were not, as some people might assume, to do with my very basic understanding of the elements, or my choice of treatments, although they, too, were with hindsight often rather naïve or even somewhat inappropriate.  Instead they were nearly all to do with my relationship to my patients.  Based on something which JR Worsley had impressed upon us, I somehow thought that I had to make myself available to my patients at all times, even interpreting what he said as meaning that a patient should be able to contact me at any time they wanted to.  Those were the days well before emails and mobile phones when patient-practitioner contact was nearly 100% by good old-fashioned telephone.  Since I worked from home, I soon realised that I needed to install a dedicated practice line so as not to confuse my private with my professional phone calls.  This meant also having two answering machines, making quite an impressive array of phone equipment lining my kitchen shelf.

I still remember the excitement of coming back home and seeing the “message received” light blinking on my practice phone.  I would always hope that this meant that a new patient was making contact, for each new patient was then a highly exciting event.  There was, however, one definite advantage of patients having to get in touch with me by phone, and not, as usually happens nowadays, by email or text message.  This meant that when I answered them our first contact was always person-to-person, and not the much more impersonal contact of the written word through emails.  It is now often overlooked how important this initial contact can be, not only because it offers both patient and practitioner a bridge to that key aspect of five element treatment, which is the setting up of a good relationship with our patients, but it also gives us the luxury of a first attempt at trying to diagnose two key components of an element’s presence, the tone of voice and the emotion the patient is showing.  On the patient’s side, it helps get them past the often challenging situation of a first meeting in the practice room.  I felt that this first phone call shaped the nature of my future relationship to my patients.

But the flipside of these personal phone calls was that it gave my patients the impression that they could phone me whenever they wanted to, and this was where I started to make things difficult for myself.  I didn’t then have enough confidence to lay down careful guidelines as to when they could phone and what they could phone me about.  And I soon found this led to a further mistake.  Patients got used to phoning me at odd hours of the day, either early in the morning or, most often, rather late in the evening.  And I would find myself engaged in long conversations with them, all of which, I should have told them, were best suited to being continued at their next treatment.  It took me quite some time, and many interrupted evenings of phone calls, before I realised that what the patients and I were talking about belonged much more appropriately to the practice room, where it would help me determine the kind of treatment the patient needed.  As five element acupuncturists it is the treatment we offer our patient which helps solve their problems, and although five element acupuncture is partly a talking therapy, because of course our patients need to talk to us and we to them, it is good to remember that it is the needle, not our words, which eventually helps them.

This open-door, or rather open-telephone, policy of mine also opened the door to the thorny question of discussing the element I was treating them on.  I learnt to my cost that it is never a good idea to talk this through with a patient, because often one of the reasons for doing this can be our unconscious desire for reassurance from the patient that we are on the right track, and it is surely not their task to help us.  We are often hoping that they will confirm that we have made the right choice.  I have come to realise that nobody, even the most experienced five element practitioner, is good at diagnosing their own element, though practitioners often like to feel that they are the best judge of this.  Unfortunately this is rarely the case, since we all tend to be rather blind to our own faults and like to think we have a special relationship to an element whose qualities we admire.  If you mistakenly start to discuss a patient’s element with them, what do you do when you change your mind and change element, or change it several times?    Do you tell your patient this, or leave them with the mistaken idea that they are of the Earth element when you have perhaps moved through Fire before finally landing on Wood?   We all know how often we find ourselves trawling through the elements before finally finding the correct one.  Thankfully, though, this happens less and less for me now.  So take heart all you novice five element acupuncturists out there.

I always advise practitioners to lay down firm guidelines for their patients on when and how to get in touch with them between treatments, particularly now in the age of social media.   If we don’t do this, we are laying ourselves open to the possibility of patients controlling treatment.   

Finally, it is not a good idea to tell patients what points you are using apart from very occasionally.  It is difficult enough for us to put into words why we are choosing a particular point or set of points, let alone explain this to a lay person.  If they ask, I have learnt to say, “I am not here to teach you to be an acupuncturist.  If you are interested in learning more, I suggest you read my Simple Guide which explains my approach to treating you”.  The following are some of the few exceptions to this rule:  telling patients about horary and seasonal treatments (because we have to book our patients in at specific times for these), and correcting an Akabane imbalance, because patients are often fascinated to find that the readings change after treatment.  I have found that this is a very good way of convincing rather sceptical patients, particularly hard-headed businessmen, at the very start of treatment that there is something in what I do.

It is also useful to explain to patients that some of their symptoms may be the result of an entry/exit block, and obviously we need to explain in a little detail why we think a CV/GV (Ren Mai/Du Mai) block needs to be cleared.  In the case of this block I always first ask if the patient feels very exhausted all the time, a very good sign of a CV/GV block, and tell them that this is because the main pathways of energy running up and down the body are blocked, draining them of energy.  Sometimes I add the fact that JR Worsley told us that if only these points were on the wrist we would do them on every patient!

On the other hand for obvious reasons I never tell a patient that I am about to clear a Husband/Wife block or do Possession treatment, because the last thing you want to do is worry the patient by giving them the idea that there is something seriously wrong with them.  With Possession, however, I tell the patient that I am doing some lovely connecting treatment, and that I need their help to make sure that they feel each of the seven points properly.  I have noticed that patients needing this treatment really understand what I mean when I say this, as though I am reassuring them that I know that they feel disconnected.  This is also a good way of describing Possession, which is in effect a level of disconnection of the spirit.

I am passing on some of my tips for what to tell patients because I wish I had been told much of what I learnt by hit and miss through my own practice.  It would have avoided some of the problems I created for myself.

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