13. The challenges of point selection

During our training we were introduced to the main principles of point selection, which I have always felt stood me in excellent stead, and have underpinned all my work both as practitioner and teacher since then.  Recently, though, I realised that I had taken for granted how much I had adapted these principles over the years of my practice, often without realising I was doing this.  This led me to expand what I had written in my Handbook of Five Element Acupuncture about point selection.  Originally I listed the points for only the first five treatments.  This I now extended to cover the first 15 treatments, because novice five element practitioners have told me that they would welcome further guidance.

As I looked through these treatments I began to realise how much I had adapted the point selection principles I am teaching now to take account of what I recognise to be the individual needs of my patients, so that in effect my point selection is often not truly in line with the very principles I was telling my students they should follow.  Looking in detail at each example of treatment selection, I realised that my choice of points obviously reflect my growing confidence as a practitioner.  So then I have moved on to look at how I actually decide upon a specific treatment, and what has led me to adopt an often more idiosyncratic approach to point selection.  I have taken to observing myself more closely in the practice room to try and work out the thought processes behind my selection of points for a specific patient at a specific time, and I realise that my selections have much to do with my assessment of how my patients present themselves.  As practitioners we become acutely aware of how a patient feels to us, of how the energies flowing from the patient towards us are impacting upon us, and how far this impact is resonating with what we have learnt about our responses to one or other element.

We are trained to observe our patients with all our emotional and sensory antennae on full alert, aware that we have to interpret what they are conveying to us in a remarkably short period of time between the few minutes of our initial interaction with them and the time when we lift a needle to treat.  JR Worsley would joke that you only need a few minutes to treat a patient:  one minute to decide which element is crying out for treatment, one to do the treatment and the last minute to say goodbye.  The less experienced practitioner amongst us will take far longer than this, but my own experience of more than 35 years’ practice tells me that it takes me an increasingly shorter time to decide what treatment to give.  Often I seem to register quickly that the patient may be showing signs of a Husband/Wife imbalance or there is a need for an AE drain.  I will also be quick to see when they look well and require only the slightest nudge to their element before I can send them on their way.  What I am aware of, therefore, is that I have lost much, if not all, of the worry any novice practitioner will have about trusting my senses to tell me a great deal surprisingly quickly about my patient’s needs, and this usually happens well before I have listened to what the patients have to say or have taken their pulses.  In other words, I allow my understanding of how the elements are manifesting themselves in my patients to lead me to assess quickly what impact they are having upon me, and then for me to decide what treatment is likely to be needed.

In the early years of their practice, five element practitioners need to learn the general principles which underpin point selection, but with practice each practitioner will gradually learn to allow themselves some latitude in how to apply them, as their understanding of their patients’ needs develops.  My mantra of “think elements, not points” has stayed true for me at every stage of my practice, but my experience has led me to see that “thinking elements” means that we become increasingly adept at assessing an element’s needs and thus adapting our point selection to satisfy those needs. This means that, as with all principles, we must allow ourselves a surprising degree of flexibility in adapting these principles to specific practice situations. Both as teachers and as students we have to accept that point selection, far from being a prescriptive science with rigid rules of application, is instead an art dependent on the practitioner’s ability to adapt these principles flexibly to fit a patient’s unique needs at any particular time.  Just as there is nothing rigidly fixed about how energy courses through all nature bringing life to each of us, so there must be nothing rigid in a five element practitioner’s approach to encouraging these elemental energies to greater balance through our choice of points to do this work.

As with the teaching of any skill, time and much patience is always needed for a practitioner to learn their craft and to gain enough experience to dare trust that their own level of understanding permits them to start “doing their own thing” in terms of their practice.  It has however always comforted me to know that none of my patients has ever reacted badly to any treatment I have given.  They may of course suffer the temporary discomfort caused by to the appearance of some block or other, which forms a necessary and natural part of each treatment, quickly dealt with.  The worst that can happen is for patients to experience no change at all, even after a succession of treatments, and I always see this as a failure on my part to assess their needs accurately.  Whatever points we select to treat our patients, we can be sure that a little bit of variety and possibly a bit of daring in our point selection can do no harm, and can incidentally also help to keep us on our toes.