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.
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.
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.
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.
