67. The Water element: 2

Water people tend to make us feel uneasy, even if they themselves look quite calm.  They can have a kind of frozen stillness, which can change into a leap into action if they feel threatened, as when something unexpected happens.  Then their eyes are the give-away.  Water eyes are always wary, watching everything carefully, and ready to swivel away to look at anything unexpected which might be happening to the side or behind them.  They can then suddenly look startled, even though the rest of their face can remain surprisingly still.

I see Water’s colour as being of two kinds.  There can be a very dark shadow over the whole face, in men often accompanied by the typical blue shadow around the beard area which Richard Nixon showed, particularly when he was under threat politically.  You can then think of the whole face as being dark, even though when you look closely you wonder why you think that it looks so dark.  Then there is the other kind of Water colour, when it has a kind of translucence, so that other colours show through it.  I like to think that the dark-bluish colour is the Kidney, the more hidden, deep yin aspect of Water, whilst the translucent, lighter colour is the Bladder, its more outward-facing, flowing yang aspect.  Those who have the Kidney as their guardian official give the impression of being much like still waters, which run slowly and deep, whilst Bladder people are much more like quicksilver in their movements and thoughts.

The Water element’s yang official, the Bladder, has the widest reach of any meridian, even dividing into two parallel pathways as it spreads over the back, and having the greatest number of acupuncture points, 67 in total.  Its function is that of being in charge of the storage of water, whilst the Kidney, its yin companion, is more simply called the controller of water, with a mere 27 points.  But even this number is the most of any other yin official.  Merely by adding together the total of Water points we are made aware of Water’s importance to the whole energy network, understandable, when we remember that our bodies are composed of more than 80% water.

I have grown increasingly better at detecting a Water smell.  It can be very obvious if there is great imbalance, when the smell of stagnant urine can be quite clear.  At a more balanced level, I have found that when I am standing by the couch, what comes up to me is a feeling that there is some dampness around, as though I am near a pond or a bath full of water.  This is when the smell just wafts upwards to my nose.  This is certainly not an unpleasant smell at all, which the word “putrid” seems to indicate, but instead just a rather pleasant dampish smell.

I find the sound of a Water voice is rather tiring to listen to for a long time.  It has a droning sound, which seems to drill into me, but in a more hidden, less direct way than the force in Wood’s voice.  Listen to Bob Geldof or David Beckham talking (extracts on YouTube are an excellent way of doing this), and this drone, like a bee buzzing away at us, becomes very clear.

But, above all, we need to examine how we feel in the presence of a person, and ask ourselves whether it is we who are experiencing a kind of uneasy fear, and, if so, whether this is the fear in the other person, well-hidden.  It is important to remember that Water will always try to hide its fear, transferring it instead on to us.  Water is therefore often misdiagnosed, as it is very adept at hiding itself behind other elements.  When I think I can see many different elements in one of my patients, then I have found it is often Water that is the element underlying them all.

   

66. Showing patients that we really care

Meghan Markle, the Duchess of Sussex, is said to have replied to a reporter who, seeing her looking exhausted, asked her simply, “Are you OK?”, by saying, “Thank you for asking.  Not many people have asked if I’m OK.”  She then went on to say that the new normal, with masks concealing faces, was forcing people to look into each other’s eyes, adding, “For the first time in a long time, as human beings we are really seeing one another.  Are we OK?  We will be.”

In this short exchange of words, she pinpointed two very significant areas of interest for five element acupuncturists.  She emphasized the importance of giving another person the chance to say honestly how they are feeling, and she is aware of how important eye contact is for every human interaction.  By chance this second point also illustrates what I wrote in my recent blog about the Metal element “Are we living in an age of Metal? https://afiveelementcompanion.blogspot.com/2020/11/the-metal-element-5-are-we-living-in.html.    Both these examples illustrate something which should remain constantly at the forefront of our minds in our dealings with our patients, which is the importance of showing them that we are genuinely concerned to find out how they really feel.

Obviously Meghan Markle’s comments hit a nerve, because I have just read a reader’s letter in a newspaper in which the writer says, “Can I suggest that when you meet people who are grieving, you ask, “How are you today?”  My husband, who died from motor neurone disease in 2017, said this acknowledged that some days were better than others.”

In this context, I often recall the many times a health worker, be it a doctor, a nurse or a dentist, has offered me the standard greeting of “How are you?”, which I never know how to reply to.  Does he or she really want to know how I am, as I walk into the consulting room, and well before I have seated myself?   Are they, or are they not, expecting me to answer this question truthfully?  Surely not.  And yet the conventional greeting has already opened up a slight gulf between us, making it more difficult for me to say what I had come to say.  Every time I am greeted in this way I feel a tiny stab of disappointment, because I would like to answer genuinely, but realise that an honest answer is not being expected of me.  I only remember one occasion, which stood out so sharply because of its rarity, when a nurse unexpectedly said, “You hate being here, don’t you?”  This was a really welcome moment of appreciation of how acutely she had been observing me, and I can still recall the relief I felt at realising that at last somebody was interested enough in me to see beyond the conventional mask we all put on.  I always emphasize to my acupuncture students how important it is not to engage in this kind of idle chat as they greet their patients, but wait until they have settled themselves down and are composed enough to answer such a question honestly.  

We always say that the purpose of a good five element diagnosis is to help patients feel safe enough to remove their mask, and it is our eyes, those windows of the soul, which show our true selves the most clearly.  At this time of COVID 19,when the physical masks we all now have to wear hide all but our eyes, we are given a wealth of opportunity as we walk past people in the street to catch glimpses of the real people through their eyes.  We should take every opportunity to use these brief interactions to try and help us diagnose the messages the different elements are sending us, for each element will look out at the world in a different way.  Each encounter can then become a useful diagnostic lesson if we choose to use it for this.

What distinguishes a merely competent practitioner from a really good practitioner is the degree to which they are genuinely curious about every aspect of their patients’ lives.  I think that having a good memory is a blessing for any therapist, because our interest in building up a complex picture of our patients’ lives helps us establish close and lasting relationships to them, to the extent that not long ago I happened to meet a patient in the street after many years had passed, and could immediately recall that she had problems with one of her children.  It was fortunate for my future calling as five element acupuncturist that since childhood I have always been fascinated by human interactions, enjoying watching groups of people wherever they gather, so that although my memory for facts is not very good I can build up very clear pictures of my patients’ lives which stay with me for years.  That is a skill we could all usefully develop if we wish to help our patients.

65. The Water element: 1 The most mysterious element of all

I find it interesting, and significant, that I seem to have written the least about this most mysterious of elements, Water, than I have about the other elements.  Looking at my writings, I realise that the number of words I have dedicated to the different elements has varied.  Perhaps it is understandable that Fire has occupied my thoughts the most, and that may not just be because it is my own element, but additionally, and perhaps more importantly, because it shelters what are in effect twin elements, Inner and Outer Fire, each with its own circle of influence and its own paired officials.  Though they both quite obviously have the same sensory signatures, they are distinct enough to have characters quite their own, to the extent that I was delighted one day to see JR Worsley nod his head slightly when I dared to say, “Really I think there are six elements, not five.”

If I count up the numbers of words I have written about each element, there appear to be more about the two yang officials, Wood and Fire, a little fewer about Earth and increasingly less about Metal, before finally dwindling down to the least number for Water.  I have concluded that this is probably because it is much easier to write about Wood and Fire, because their yang nature makes them very visible, whereas the more yin characters of first Earth, then Metal, and finally the almost ephemeral of all, Water, are less easy to grasp in words because of their more hidden, yin nature.  Or at least I find them so. 

When I have given talks about the elements, inevitably I always start with Wood, since its upfront character appears to be the simplest for me to describe and  it is therefore the easiest element for my audience to identify with.  I once tried to change my routine and started with Water, but I felt very uncomfortable doing so, particularly as I could feel that I was losing my audience as I stumbled through my description of Water’s qualities.  In a similar vein it is much easier to talk about the glories of spring with all nature’s abundance on show than the unremittingly passive picture of the dark days of winter, Water’s season, with a landscape lying apparently fallow for months, often buried beneath snow.

Water is the element that I always feel quite wary of.  And this is such an appropriate word to use when describing anything to do with this element, particularly if you are, like me, of the Fire element.  Because Fire is always slightly apprehensive whenever it comes into contact with Water, just as Water is equally just a little nervous when it comes into contact with Fire.  I believe, however, that Water has this effect upon people of all elements, but perhaps to different degrees.

It is always good to think of the way these elements manifest themselves in the natural world, for their appearance and their actions in nature are why the elements have originally been given the names that they have.  There is something which makes us think of the earth beneath our feet when we think of an Earth person, just as there is something very specific to our thinking about metal objects or things made of precious materials, such as gold or silver, when we think of a Metal person.  It is therefore not by coincidence that the ancient Chinese named the five elements as they did.

Everyone should at some level be wary of Water, because in its often silent and rather hidden way it is quite remorseless in ensuring that it finds its way to whatever goal it has set itself.  If you think of the force of water in the natural world, you can see that it has the ability to transform itself in seconds from being something as apparently harmless and peaceful as the smooth surface of a small pond into becoming the awesome, overpowering force of a torrent drowning whole villages and towns in its path.  It represents our determination to achieve whatever we have set out to achieve, come what may, and at the deepest, most primitive level, is our survival instinct.  This is why so many people who have reached the top of their profession often owe allegiance to this element.

I call it the hidden element, being the most deeply yin of all the elements, because it is not as obviously aggressive as Wood, a yang element, but the power it can exert can be all the greater because it can be so unexpected and catch us unawares.  I always feel that Water people can creep upon on us without our being conscious of their presence, whilst the more yang movements of the Wood element announce themselves much more openly

People often underestimate Water’s power and single-mindedness because these are often disguised by its apparently gentle, pliable nature.  So what is there about water as we observe it in nature which will help us understand the nature of this element better?  At its deepest level, I think it has much to do with one of its characteristics, which no other element shares, and that is its ability to change its shape at will whenever it feels the need to do so.  At a stroke, often associated simply with changes in environmental temperature, it can transform itself, becoming in turn steam or ice, and in so doing turning the soft flow of water into ice-bound glaciers, a boiling kettle or the steam of hot geysers.  I have always seen Water’s ability to change its shape and consistency as offering it different escape routes enabling it to avoid capture, the thing that Water most fears, for to become captive would be to hold it back from performing its main task, which is to be on the move, with the aim of drawing things together into a whole, and thus to create the image of wholeness, which is that of the unbroken circle of the Dao,  

As a footnote to these thoughts about Water, I was sent some very illuminating insights into this element all the way from India by a friend of mine whose guardian element is Water.

“I read your recent blog, which was interesting. These short, simple observations of each element in a particular situation are very easy to remember and think about. It's also certainly a fact that on the street, I would look at people but immediately look away! I think it is because I don't want them to know that I am looking at them unless they want to initiate contact. If they smile, for example, I would spontaneously smile back and maintain contact for a short while before looking around. It's as if I feel I am transparent and everyone is always able to see through me (literally I mean) and that everyone is trying to read my mind and judge me. And I need to distract most people (except those I am very comfortable with) from something I may have been focusing on by looking here and there, away from what originally caught my attention. I think this is what partly causes the jerkiness that is experienced by others in Water. It's also as if I need to constantly check the environment to condition my own response or state of being to it, perhaps a bit like water which changes its state so often. This takes up a lot of physical and mental energy unconsciously in its own way (as Fire does in its attempt to reach out and every other element does in their individual ways).”

 

 

  

64. The Metal element 5: Are we living in an age of Metal?

I would recommend all of you to read a book by Andrew Keen, called The Internet is not the Answer (Atlantic Books 2015).  It contains important warnings about the world we live in, and the risks we are running of remaining, not the free agents in a free world we like to see ourselves as, but ever more like slaves entrapped in a world controlled by the large corporations, such as Apple, Amazon and Google, whose power over us grows by the day.

The author points to a worrying aspect of today’s world, our current obsession with ourselves.  The rise of the mobile phone and Instagram have disturbing consequences, one of the most frightening being what he calls our “self-centric culture”, in which “if we have no thought to Tweet or photo to post, we basically cease to exist.”  And “the truth about networks like Instagram, Twitter, or Facebook is that their easy-to-use, free tools delude us into thinking we are celebrities.”

I have often thought that the electronic equipment most of us feel to be absolutely indispensable to our modern lives, and which is intended to link us ever more closely to one another, ironically leads instead to our distancing ourselves more and more from each other.  The cameras in our mobile phones are encouraging us to look at each other through a lens, rather than in the eye.  The messages we send are beginning to stop us speaking to one another, voice to voice.  We now text rather than talk.

The young woman sitting opposite me in the café a few days ago made no contact with anybody during the time that I watched her, all her human interactions being through her electronic equipment.  It felt as though she lived in a bubble all on her own.  As Andrew Keen says, “The truth…is that we are mostly just talking to ourselves on these supposedly “social” networks…. (It is) an Internet in which the more social we become, the more we connect and communicate and collaborate, the lonelier we become.”  Are we perhaps starting to live in an age of Metal, that element which mourns the loss of what is valuable, and in its imbalance may cut us off increasingly from each other and from the world around us?

Finally, to add to these rather depressing thoughts, a little comment by the writer, Robert Macfarlane, whose lovely books about walking in nature and in the wild all of us should also read.  In an article of his in the Guardian newspaper, I read that the new edition of the Oxford Junior Dictionary now includes words like “chatroom” and “broadband”, but not “bluebell” or “kingfisher”.  I also read that they are now discussing whether children should continue to be taught handwriting in school, presumably because it is assumed that they will no longer be using pen and paper but tapping away on their keypads to communicate.  All these different developments underline the seismic changes going on around us.  No doubt many of these may herald exciting new departures which we should welcome.  Others, though, represent losses.  I am sad that children’s vocabularies may no longer include bluebells or kingfishers.

 

63. The Metal element 4: A Metal patient's story

Every day I receive confirmation that the elements do indeed imprint a personal stamp upon each one of us in the shape of one of the five elements.  It is both exhilarating and humbling to receive these continuing proofs of the truth of what I practise.  I received one such confirmation at a fellow acupuncturist’s practice some time ago, when I was asked to help a patient of hers.

A few years ago this patient had suddenly begun to experience severe pains down his body, accompanied by strange involuntary jerking movements of his left leg.   I asked him whether he had been suffering from any particular stresses at the time the pains started, perhaps something which he might experience as a shock to the system.  “No“, he said, but then I noticed his eyes suddenly filling with great sadness.  “Is his element Metal then?”, I began to ask myself, as I saw this look of grief.  We are always being given pointers to the elements if we are sensitive enough to notice them, however slight they may be, little gifts of help.  And then came another gift.  He was silent for quite a while as I took his pulses, and then, out of the silence, unexpectedly he said quietly, “I always wished I had had some relationship with my father.”  Aha, I thought, who but Metal is likely to say this?  For of course we know that Metal has a particularly strong association to the father.

Metal is the “if only” element, the element that looks back into the past, and often thinks more about this past than about the present.  So here was a double pointer to Metal, the grief in the eyes and the immediate connection with a father who, though still living, is as though lost to him.

So I continued with my questioning, guiding it now along a path that my experience tells me that Metal will accept.  It wants to be left alone to make its own connections and assess for itself what is relevant or irrelevant.  So I suggested lightly that maybe something had indeed happened around the time all this pain appeared. “Maybe some stress at home or at work, perhaps?  But only you will know what that might be.”  And I added, “Perhaps the involuntary jerking of your leg is because you want to kick somebody!”  We both laughed, and then he was given his first treatment on Metal, just the source points, and I left him with this rather light, almost joking remark hanging in the air.

 A few hours later he phoned, and wanted to tell us something he had never told anybody else before.  Two years ago his wife had had an affair with his best friend which had devastated him.  They had worked through this now, but he could not forgive his friend, and never wanted to see him again – another great loss in his life.  I suspect that now that he has admitted to his anger, he will no longer unconsciously need to kick out, either at his wife, or more likely at his friend, as good treatment focused on his Metal element helps him gradually heal.

This was further evidence for me that we need only lightly suggest something to Metal, and then stand back to allow them space to work out their own solutions, since Metal is so acute and quick at making connections for itself.

How much we achieved in such a short time!

I’m sure five element acupuncturists reading this will expect me to write about any other signs of Metal I noticed in terms of the other sensory signs.  His emotion I have talked about;  his colour was not very clearly what I associate with Metal.  I couldn’t detect any smell at all, but the sound of his voice was very flat, very yin, dragging me down with it.  This is the sound which I associate with Metal’s weeping tone.  

 

 

 

62. The Metal element 3: Metal's two officials

Of all the elements, Metal is the one whose two associated officials, the Lung and the Large Intestine, have the widest reach, spanning the whole body from top to bottom, from the nose and the lungs down and through the colon as far as the body’s lowest point.  The Lung, our organ of intake, is the element’s direct connection to the world outside, and establishes this connection through the act of inhaling air as well as through the pores of the skin, which are called the third lung in Chinese medicine.  The Lung passes oxygen on to every cell of the body, before the Large Intestine takes over to carry out the final processing and elimination of all needless waste material from the body.

When we think of Metal’s season, autumn, we can see that nature’s work at this time is to filter as much goodness from what Earth’s harvests have left behind, before sending all this goodness down to the roots below ground, to the Water element, to feed the next cycle.  Metal not only has to help the Lung inhale life-giving air, but help the Large Intestine sift through and discard all the waste material from the other elements, retaining only those few which are sufficiently pure to support the renewal of life.  If we look at the components listed on bottled water, for example, we can see that they include a great number of essential trace elements, the products of Metal’s work in filtering all the purity from what has gone before.  These trace elements leave no actual trace for the human eye to perceive, but without them no seed will grow.  The Water element will then stores these trace elements as nutrients for the seeds it nurtures throughout the winter.

The process of breathing becomes what we can think of as an act of purification, as the nasal hairs catch as many impurities as they can, acting as filters to remove them, and expelling them in our sniffles and sneezes as we breathe out.  The Lung is therefore one of the body’s purifying agents for all the physical activities involved in breathing, as well as for the deeper mental and spiritual activities for which it is responsible.  It then passes on the residue of these activities which it no longer needs to Metal’s companion official, the Large Intestine.

The Metal element can therefore be seen as bearing a heavy burden, that of being responsible for ensuring both the purity of what we take in and the removal of all the impurities and waste material no longer of use to us.  The wide range of its responsibilities has always made me regard Metal people as having to live their lives under a surprisingly great level of strain, for if they fail in their task, they will allow through that which the Lung should be filtering out.  I remember well one of the most important lessons I learned about this element was from a Metal patient who told me one day, “I feel dirty inside all the time”, a description which could be seen as clearly reflecting her Lung official’s inability to maintain the purity which she craved.  It was very significant that this patient always turned up for treatment to start with in what I could only imagine was a set of fresh white underwear, as if by wearing these she could somehow hide the pollution she felt deep inside her.  I regarded it as visible evidence that her treatment had been successful when, after a few months, she turned up in coloured underwear, as if she now no longer needed to hide her body in what most of us would consider the purest colour of all, white.

  

61. The Metal element 2: Some of the difficulties in diagnosing and treating Metal patients

I have always found Metal people to be the easiest patients to treat, provided (and this is an important proviso) that I am quick to diagnose that Metal is really their element. I have therefore had to work out my own ways of pinpointing specific Metal characteristics which help me with my diagnosis.  A person’s first impression upon us is always very revealing, particularly if we can catch a glimpse of some similarity with how we have previously reacted to somebody else, and perhaps revealingly so if the person we are reminded of is a patient whose element we are sure of.  This makes life much easier for us, of course.  A very clear comparison of the similarities between our reactions to the two people is very helpful.  Less helpful is what happens more often, which is that some little quirk in appearance or behaviour, something like the way they move their mouth as they smile or talk, or the way they look at us, sets off a vague memory of somebody else we know who smiles, talks or moves in a similar way.  We may not immediately track back to work out who this is, and it may take us a few hours or even longer to pinpoint the person we are thinking of, but once traced this is a nearly infallible way of finding an elemental signature to help us.

There is an added factor to making a diagnosis when we treat a Metal patient, which is that the relationship between patient and practitioner is always a very delicate one, but with Metal it is especially so.  I have sometimes described it as one where I have to tread lightly, as though on glass.  Metal is the most sensitive of all elements in detecting a slight of any kind directed towards it, and will harbour the memory of it for a long time.  It regards anything as a slight as something which implies some criticism of its behaviour.  Buried deep within Metal is a search for perfection, and this is what lies behind all that it does, as it tries to weigh up what is right and good and to discard what is wrong.  This, of course, includes judging its own actions.  It is prepared to do this itself, but allows no-one else the right to do this.  Any criticism will therefore imply a negative judgement and will be resisted.  No element wants to be taken as seriously as Metal.  To mock it or make it feel unworthy in any way is to lose any respect it has for us as a person and even more so for us as its practitioner.  This is why the first interactions with a Metal patient are so crucial, and can be very tricky if we do not pick up on a patient’s need to be allowed to do things their own way with as little interference as possible from others, and thus from us as their practitioner.

One of the pointers to the Metal element is the strong feeling that I have to tread warily in what I do and say.  This is my particular reaction to sensing the space that Metal people like to keep between themselves and others, even between those to whom they are emotionally most closely related.  I feel under inspection, being observed almost dispassionately, as though I am being assessed from a distance.  This is something Metal is likely to do to everybody who approaches it, and also does to itself, since it is the harshest self-critic of any element, constantly judging its own actions.  If it feels that I am not offering it what it thinks I should, I will be dismissed as having no further use.  This will translate itself into a Metal patient abruptly deciding to discontinue treatment.  On the other hand, once it has accepted that what I am offering as a practitioner is something it can value, it will be remarkably easy to treat.  It is no coincidence, I feel, that when I was palpating the wrist of one of my Metal patients to locate the position of the Metal source points, he told me quietly, “That feels very pertinent to me,” as though such a sensitive response to my touch had activated some reaction which he recognized as profound even before the point was needled.

I have noted over the years that many practitioners including myself fail to recognize the signatures of the Metal element for some reason which I have found difficult to decipher.  It may well be associated with its yin qualities, which it shares with the other yin element, Water, for what is yin is inward-looking, unwilling to reveal itself, quite unlike the outward-looking qualities of the two very yang elements, Wood and Fire.  Neither of these hesitates to express openly what it feels, whereas the two purely yin elements tend to be more comfortable keeping their feelings in the shadows, as though unwilling to reveal their true nature.  In other words we are always slightly uncertain where Metal and Water people are positioning themselves, unlike Wood and Fire who are so unmistakably there in front of us.  Earth, of course, being a combination of both yin and yang, can be both very visible, as though partly living life above-ground and partly more hidden, as though below-ground, as befits the rather ambiguous intermediate position it takes up.

It is therefore all too easy to mistake the face Metal turns towards the world as revealing what is truly going on below the surface, which I feel helps explain why practitioners may find Metal difficult to diagnose.  We are not quite sure whether what we are seeing is revealing how Metal really feels and acts.  One of the ways I have learnt to deal with this is by understanding that Metal, whose function is to assess the true nature of things, must rely on itself to do this, not ask for help from others.  Metal people may listen to what others advise, but will then take this advice quietly away inside themselves to mull over it, and decide whether it is sufficiently or insufficiently valid to take or reject. 

I learnt this lesson quite early on in my practice, when I happened to be treating a Metal patient immediately after an Earth patient.  The Earth patient was very happy to discuss openly what she was concerned about.  This was something which had been occupying her during many of our previous sessions, and was continuing to do so now.  On the other hand, when I afterwards went in to see the Metal patient, who had told me at the last session that he had some difficult decisions to take in his life, he said without prompting, “I’ve decided what I will do,”, and that was that.  I felt that he had come to this decision by himself, presumably, I hoped, after feeling the benefit of the treatment which he had just received, and there was now no further need to discuss it.  Nor did I feel he would welcome my questioning him further.  He had moved on in that quiet but determined way that Metal has.

 

 

  

60. Our individual take on the elements

One of the problems we have when teaching five element acupuncture is how to introduce students to the concept of the elements and the individual characteristics by which we learn to recognize them in human beings.  To do this we have to draw on some of the descriptions which have been attributed to them over the years, best illustrated at a very early age by those set out in the Suwen.  We have all learnt, for example, that the colour associated with Fire is red, and Metal’s emotion is grief, and this has been repeated numerous times since then in lectures and books, such as mine.  The problem here is that these descriptions can soon, perhaps all too soon, develop into stereotypes, and stereotypes which risk taking no account of the more fluid, often quite blurred outlines with which the elements reveal themselves to us, and which we have to learn to work with.  Human beings do not fit into fixed frameworks like this, much as we would sometimes like them to.

This certainly doesn’t make for an easy life as a five element acupuncturist, because the elements appear in so many different guises.  We are formed of a unique combination of all five elements, requiring us to sift through all sorts of gradations of colour, sound, smell and emotion which these imprint upon us.  This means that what we eventually may decide is the weeping voice of a Metal patient may be overlaid by quite a lot of singing or laughing, tempting us initially to think the patient’s element may be Earth or Fire.  The subtle interactions of all the sensory signs the elements place on us may appear to overshadow those of the dominant guardian element, and have eventually to be discarded before we reach below them to those which represent our element’s true imprint upon us.  This makes a five element diagnosis into a form of sifting process which requires time and patience, rather than the moment of intuitive recognition that some people like to feel it should be.

This is why the different characteristics the elements show will also be experienced differently by us in ways which reflect the influences our particular guardian element has upon us.  We will each have our own individual approach to other people, coloured not only by the needs and responses of our guardian element, but also by our life experiences.  From the point of view of being a five element acupuncturist, this means that we develop our own individual take on the elements.    

The crucial thing here is that each of us will react in quite different ways to observing the elements’ presence in our patients, because our responses to the elements in their different manifestations will be unique.  My appreciation of a patient’s cheerfulness, which I may ascribe to the Fire element, may well differ from a fellow acupuncturist’s, who may see this patient as being of another element, because he or she experiences a person’s expressions of joy differently.  Here a practitioner’s own element will often be a determining factor, which is why it is so important that each practitioner is constantly aware of how much their own element may be colouring their perceptions of the elements in their patients.   

We must not be frightened of acknowledging that we will inevitably have our own individual take on the elements which may well differ from that of our fellow acupuncturists.  What is important is that we gradually hone our understanding of these elemental manifestations down to some common descriptions of the individual elements which practical experience has taught us to be true, and which we then learn to use as part of our individual diagnostic templates.  The important thing here is to base our understanding on solid evidence from our own practice.  If the result of the treatments I have given a particular patient has confirmed that this patient is of the Water element, this is one step further along the path to recognizing this element’s particular sensory signatures in future patients.  I can then add the characteristics of this particular patient to the template I am drawing up for the Water element, now based on further evidence from my practice. This is how we gradually build up our understanding of the manifestations of each element patient by patient slowly over the years.

I always say that it requires courage to be a five element acupuncturist, since we have nothing but our own personal reactions to the different elements to help us towards a diagnosis.  We may initially base our diagnostic decisions on some of the stereotypes pointed out to us by more experienced practitioners, but in the final analysis we have to be brave enough eventually to develop our own take on the different elements.

59. The Metal element 1: General characteristics of the Metal element

Metal people have a much greater sense of stillness about them than other elements.  There can be a complete absence of movement when they lie on the couch, for example, almost as though they are like those stone effigies of knights lying in their tombs in cathedrals.  This is not a suppression of movement, as there might be with Water, as it tries to hold itself back, but a feeling of withdrawal and detachment from what is going on.

They make very steady and acute eye contact, and it is to the eyes that we are drawn, rather than to the mouth, as we are with Earth.  Whilst looking directly at us, and obviously seeing us very keenly, they appear at the same time to be looking past and through us, as though searching for something beyond us.  It is in their eyes that the sense of grief underlying this element is revealed.

Grief is an emotion which separates us from other people.  We are each alone as we grieve, the very opposite of how we feel when we express Fire’s joy or Earth’s sympathy, where we welcome others to us.  We might think that Metal only grieves for a death, but there are many other kinds of losses we can feel.  Its grief can stem from the actual loss of a person, but it can also grieve for what can be as acute, or even more acute, than a loss, which is an absence, a person who is not there for them, either physically or emotionally, such as an emotionally distant parent.  It can also mourn all that it will never have and all that was never there.  It can grieve for the things it has never done and will now never do, for what it has never known and for what it will now never know, for the losses it will never make up and the joys it will now never experience.  These are some of the losses which Metal, of all the elements, can experience the most profoundly.

I think the following is a beautiful description of the loneliness of grief, the feeling of isolation we all feel when we experience loss. It comes from a book by the American writer, Francine Prose, called Goldengrove, which is all about how a young girl copes with the death of her sister.

“So many of (those trying to offer comfort) said the same things that I might have thought that there was common ground, if I hadn’t known that I was alone on an iceberg split off from a glacier….. When they wept, I cried, too, and for a moment I almost believed that my iceberg might have room for another person.” 

I have also been helped in my understanding of the Metal element from the time when I unexpectedly experienced the emotion grief in an intense form for one day.  I woke one day feeling unutterably sad. Though I racked my brains I could find no reason for this. Nothing was then happening which could be causing me the kind of sense of deep loss I was experiencing, nor could I pin it down to any recent event which might have occurred around this time of the year. I looked at the season I was in, and it was not autumn, Metal’s season, when we might all feel a little melancholic at the imminent death of the year. Nor did the date have any particular resonance for me, as I fretted away at my memory. So where had this overwhelming, all-permeating feeling of sadness come from? 

The feeling lasted just that one day. By the evening it was fading, and by the morning it had gone completely, never to this day to re-appear. At one level it puzzles me that I should have been so shot through with such an unfamiliar emotion, one that even in times of deepest distress at some real loss in my life I had so far never experienced. Its very unfamiliarity was disturbing, for it propelled me into unfamiliar emotional territory. I felt cut off, alienated from my surroundings, and unwilling or unable to share my thoughts with anybody else. I felt as if I was wandering alone like a shadow amongst strangers, unapproachable, as though nobody could reach me beneath this mantle of grief that I was enveloped in, like a garment I could not take off.

The memory of this strange day has faded, but its significance has not, because at some time during it I found myself saying to myself, “so this is what it is like to be Metal. This is what Metal people must be feeling at every moment of their lives.” Was this realization the reason I was asked to experience such an unsettling day? Now I like to think it was, for that journey on to what I like to think is Metal’s territory and my identification, however briefly, with the emotional terrain upon which Metal lives its life, have given me deep, personal insights into this element which I think I could have gained in no other way. These have stayed with me ever since, and guide me with a surer hand to my diagnosis of Metal in other people.

When trying to work out whether a voice has the weeping tones of Metal, it is worth closing your eyes and just listening.  Somehow when we listen in the ordinary way, watching the person talking, I find that we can overlook the quiet, yin, falling quality in a Metal voice.  Listened to by itself without any input from our eyes, it becomes surprisingly flat and low, and draws us downwards.  This is exactly the opposite of the yang, rising tones of Wood and Fire.

When trying to work out whether somebody is Metal, it is worth watching how the person is making you feel.  Are you finding that you are somehow careful in what you say, as though choosing your words carefully in case you may be criticized?  Metal judges;  that is its role, to weigh the good and the bad, and discard the bad.  It therefore cannot help itself from judging us, and we can feel this as implied criticism, although it may not be intended as such.  It is, of course, above all critical of itself, but will not take lightly anybody criticizing it.  You can laugh with Metal, it can laugh at itself (it can have a very acute, sharp sense of humour), but you can never laugh at it without finding that it withdraws completely from you.  In the case of a patient, this may be the reason why they decide to stop treatment, because they will experience your laughing at them as you as their practitioner judging them to be in some way inadequate, and this they cannot allow.

 

58. The Earth element 5: Lying in the bath

I had an insight into the Earth element as a result of some observations I made whilst having my bath.   I was lying in the bath, slowly letting the bathwater drain out.  As it drained away, I started to feel my body grow heavier, moving from a point where I had been totally unaware of its weight to a feeling of increasing heaviness as parts of me emerged above water, until, with the bath now empty of water, I felt as though my body had become a dead weight whose heaviness seemed to be pinning me down. I was made aware of the considerable effort it required to unpeel myself from the floor of the bath, and was astonished by the force of the gravity which had seized hold of my body as the water sucked away from it. Why had I never noticed this before?

Once upright, normality returned, as all the mechanisms which we learn as a child to enable us to stand clicked into place. By the time my feet were on the bathmat my body no longer felt heavy, and it took me some effort to remember how difficult the transition from weightlessness to weight had been.

Those few minutes in the bath have helped me understand how Earth people can feel, for they live their lives in an endless balancing-act between the desire to remain safely tethered to the ground and the need for their Spleen to help move them forward.  And thus for the few moments as one foot after another leaves the ground they can in principle be vulnerable to falling over. When out of balance, this desire for security can outweigh the need for movement, and suck them down into the earth as though they are stuck in damp clay. Or the opposite may happen, and this damp clay turn instead into dry sand which allows no foothold.

This is how I see the two extremes of the Earth element out of balance: the one as though they are stuck fast in oozing mud, the other as though they are trying to keep their footing on ever-shifting sand. Between these two extremes lies stable Earth, with its feet firmly planted on the ground, and yet with sufficient balance to move securely forward when movement is required.

You may find that your next bath can be a lesson which teaches you as much as a whole lecture on the Earth element!

57. The Earth element 4: The Earth element and breastfeeding

The emotions that fly around the question of breastfeeding have always interested me since the days when I was of an age to bear children, and observed the problems people had with feeding their babies which I found I did not, and wondered why I did not and they did.  Now that I understand better the qualities of the element, Earth, which controls how we feed ourselves , and how we respond to being fed or not being fed, I have been able to find a wider context within which to place this very complex issue.  For it goes to the very root of our being, our ability to obtain for ourselves that which we need, at the simplest level merely to survive and not starve to death, and at the much profounder level to nurture ourselves by feeling ourselves cherished, enfolded by love and concern.

The food which is in mother’s milk can do both or neither of these.  In those who are starving, it may be insufficient to sustain life, though still providing love, and in the rich, it may sustain physical life but be insufficient to cherish.  In the society in which I live and for which I write, I do not, fortunately, deal with the physically starving, but I do meet, surprisingly often, the emotionally starving, and my dealings with these have helped me understand at a much deeper level the needs within all of us which the Earth element is there to satisfy, and which are touched upon at a physical level each time we feel ourselves to be hungry.

We all have our personal, often idiosyncratic, relationship to food.  From an acupuncturist’s point of view this relationship is understood to be determined by that most primary relationship of all, that to our mother.  The element we are dealing with here, the Earth element, is the one which can truly be called the mother of all elements.  As we know, this most primary relationship, that to our mother, also makes it the most complex of all, for it sets the tone for our ability to nurture ourselves and others for the remainder of our life.  This prime relationship scores deeply into all that we do, and affects all our interactions which concern the nurturing of others, above all that of infants.  This issue is made even more complex because that part of the mother created for feeding, the breast, has acquired, in the human, additional sexual functions which equivalent nourishing organs do not appear to have for other species.  We do not, for example, see bulls nuzzling at cows’ udders.

Much has been written about how or why human sexuality has developed as it has, but its effect upon attitudes towards the feeding of babies has been overwhelming, and differs from country to country.  The breast does not now simply offer the possibility of food, but much more complex pleasures as well, which are usually, although increasingly less in more open societies, supposed to be carried out in private, to the point where the breast as fountain of baby food has become entangled emotionally with more furtive, often hidden pleasures, confusing the simplicity of the breast’s original function, and often subtly downgrading it.

The picture is complicated further by the complexities of each of the individual relationships with our mothers that we bring with us into everything we do, not least, and above all, to the feeding of our infants or of those infants for whom we take professional care.  The often confused picture adds further layers to all the professional advice surrounding mothers in relation to how they should feed their babies, this advice, too, being inevitably coloured by an individual adviser’s own relationship to their mother, but rarely acknowledged as playing any part in the advice given.  Such age-old comments, such as, “You mustn’t spoil a child by feeding it when it cries”, often stem from the fact that those giving or accepting such advice are keen to deny the baby something they themselves have not experienced, the unconditional offer of food (and thus love) whenever they wanted it.  We are often disturbed by seeing others getting what we cannot have or have never had, and this is never truer than in the case of those watching a baby demand with all its being the unrestricted outpouring of breast milk, and being granted its wish.  Watch how people often look away from the sight of a baby’s uninhibited joy in receiving this boundless sustenance, and the mother’s joy, too when this sustenance is accepted unconditionally.  Do we have within us, unacknowledged, some jealousy of such a demonstration of perfect satisfaction, made no longer possible as we grow up, when our pleasures have to be tempered by more realistic expectations, and our mothers are no longer there to satisfy our needs?  And, if so, is that why there are so many books which appear to want, however subtly this is done, to deny babies such pleasures, apparently in the interests of babies’ health?

And then, too, there are all the issues surrounding our need to have our offers of sustenance accepted every time we offer something.  Mothers often feel rejected when a baby struggles to get away from breast or bottle, and continue to try to force milk upon the baby even when it indicates it is satisfied.  This is the flipside of the approach which advocates withholding food from the baby, but stems from an equal level of imbalance.  It also lies at the heart of many of the problems of obesity in babies and children, for mother (and it is still predominantly the female in a family rather than the male) can easily overfeed, particularly with artificial milk which flows much too quickly and much too uniformly richly from the bottle compared with the breast which has its own in-built filtering mechanisms, allowing it to become ever thinner as the baby’s suckling slackens.  I have watched mothers force the bottle on to a baby who is lying quite contentedly there and continue to try and coax it to drink more even when the baby turns its face away.  And on the face of the mother appears satisfaction as soon as the baby starts sucking again and dismay when the baby indicates it has enough but there is still milk left in the bottle, as though what she regards as her offerings of mother love have been rejected, rather than understanding that the baby’s stomach is full.

Different cultures have different attitudes to the feeding of babies, to do with very complex social and economic attitudes.  These include a culture’s approach to the natural functions of the body, to a mother’s place in society and obviously, too, the availability and promotion of powdered milk as a satisfactory, and apparently recommended, alternative.  Some countries, such as Sweden or Norway, for example, where breastfeeding is taken as absolutely the norm, cannot understand what they see as British mothers’ reluctance to breastfeed, having an almost 100% record of breastfeeding.  It is a pity that we in this country and in other countries, such as the United States, do not follow this praiseworthy example.

56. The Earth element 3: We comfort eat when we don't get enough comfort from eating

Some time ago I was sitting in my favourite café enjoying my favourite meal of the day, which is breakfast – a small espresso with a drop of very hot milk and a fresh croissant to dunk into it.  I was contemplating the world around me, thinking how good it was peacefully to savour the taste of what I was eating, when a thought popped into my mind, which was how important it is to give ourselves the time to enjoy food.

That led me to think how little attention we often now pay to the simple pleasure of eating when we can dash into a coffee-house and grab a quick drink and a bite to eat on our way to hurrying to wherever we are going.   This made me consider what this is doing to our Earth element, our mother element which is there to nourish and support the other elements, and which needs to be nourished and supported itself if it is to do its work properly.  It has to learn how to do this, as all elements do, as they gradually take over the role their mother has taken on in the womb.   I now watch with dismay as mothers stuff bottles into small babies’ mouths in their prams in the street or even in buses amidst all the tumult and traffic noise.  Here there is none of the peaceful enjoyment of feeding time which we should be allowing our babies, and which help its tender little Earth element to assume its role.   

I wonder how far our lack of attention to the actual process of enjoying the food we put in our mouths, particularly in the early days of a child’s life, is one of the reasons for the sharp rise in obesity we see all around us.  The Earth element can only develop as it should in a loving, caring environment, where it is able to welcome food as something which warms and nourishes it.  It needs this to sustain a healthy relationship to food throughout later life.  If it is denied this comfort because its Stomach official is asked to snatch at the food that reaches it, it will try to hold on to as much of this food as it can, being unwilling to discard what is unwanted because it is not given enough time to process it.   Rather than satisfying it, then, the food that reaches it is tantalizingly snatched away as it is gobbled down in the hurly-burly of modern life.

This may perhaps be one of the reasons behind the success of so many TV cookery programmes.  Do we, through them at one remove as it were, learn to enjoy again, or even for the first time, the delights of food cooked as it should be, as though we are kidding ourselves that this is how we are feeding ourselves?  Is this, too, the reason for the runaway success of The Great British Bake Off, with a mother or a grandmother substitute for the whole country so clearly there in Mary Berry, as the TV immerses us in succulent images of home-baked cakes, so Earth-like a delight?

Somewhere hidden in this, too, may well lie the reason why I hardly pass a person in the street who is not holding a cup of coffee or tea in their hands, often making no attempt to drink it, a substitute for a mother’s nipple if there ever was one, as though their Earth element is sending out a constant reminder to them of its need for attention.

And is this, too, why I so enjoy sitting in a coffee house with my coffee and croissant, a reminder, perhaps, of home and hearth (and mother) all those years ago?

55. The Earth element 2: Our relationship to food - and what it tells us about the Earth element

I have been thinking a lot about our relationship to food in a five element context.  First, because I was asked by a fellow practitioner to help her treat an anorexic patient, and secondly, because I was made aware of my own often unbalanced relationship to the eating of chocolate.

Second things first:  I have always attributed my odd cravings around chocolate to my upbringing during the Second World War when there was no chocolate in the shops.  My family spent a major part of the war in what was then called rural Westmoreland in flight from the Blitz in London.  We rented a rat-infested little cottage by the lakeside in Bowness-on-Windermere, which had an old pre-war food kiosk in the road outside.  In its window there was a display box of what were obviously paper chocolates, getting dustier by the day over the four years we were there.  I would press my nose against the glass to look longingly at them, imagining to myself what they would taste like.  Chocolates remained rationed long after the war ended, and being from a large family, we were each only allowed one small piece once a week.  I always think that this may explain part of why chocolate is still something I yearn for, even though I can now buy as much as I like.  Interestingly I hardly ever do, but if I am given a box, I will be hard put not to eat it all one go, as though making up for all those years of deprivation.

Buried in this personal story, though, there hides a great lesson about our understanding of the element which controls our attitude to food, the Earth element, our Mother element, and the element of hearth and home, which shelters the Stomach official and all that involves our relationship to food. And this brings me now to the anorexic patient.  Food is inevitably associated with our mothers, and therefore with the kind of mothering, nurturing and feeding of body and soul which we each received as a child and which stamped itself upon how our Earth element deals with the food we are given.  With eating problems of all kinds, whether those associated with over-eating or under-eating, we need to look at the kind of nurturing our patients received in childhood.  If we look deeply enough, it will be there that we may find some explanation for what may later on have disturbed our patient’s approach to food.  In my own case, I feel it was no coincidence that, war child that I was, there were long periods when we were left in our grandmother’s care to free our mother to return to London for weeks at a time to help our father with his London work.  And in effect I must have felt for these times quite motherless.

It is revealing, too, to see the changes in body-shape which under- and over-eating cause.  An anorexic person can appear to be shrinking gradually back down to their shape as a young child, as weight drops off, muscle loses its tone and menstruation ceases.  An obese person moves in the opposite direction, as bulk is added;  it is as though they are forming themselves into a shape which accommodates not only themselves but somebody else inside their skin.  They appear to be enclosing themselves within something which could be said to offer the warm comfort of a home into whose arms they can sink.  And this great envelope of flesh seems to be able to offer them an endless supply of food for a hunger that cannot be satisfied unless the deep underlying needs can be acknowledged and understood.

We may think that such imbalances in the Earth element point to this element being the guardian element in each of these cases, but that is not so.  Any of the five elements, including Earth, may suffer from eating problems.  The anorexic patient I saw this week was of the Wood element, and my element is Fire.  In each case, though, it is our Earth element which takes on the burden (emotionally and physically) of whatever imbalance lies at the root of the problems.   

Finally, since the actual level of food intake is the effect, not the cause, of a patient’s imbalance, it is unhelpful to focus all our and our patients’ attention upon the amount of food consumed, as many therapies dealing with eating problems do.  Instead we need to help patients work out ways of dealing with the underlying problems, and this is done by strengthening the guardian element’s ability to restore balance. My craving for chocolate, I always think, is more to do with my mother’s absences from home and my fear that something might happen to her under the London bombings than to the rather sad paper chocolates in the kiosk window.

The Earth element 1 (revised): Learning to build up a good relationship with Earth patients

My experience has taught me that what Earth needs is not a blanket response of sympathy of the “Oh, you poor dear” kind, but instead it needs to be understood.  It wants to be heard, and wants to be heard to the end, if possible without interruption.  Its thinking is a circular process, ending where it began and then beginning again.  If it is out of balance, it begins again with the same words and goes over the same ground, like an oxen tied to a circular grindstone, going round and round.  When it is in balance, this need to churn over the same thoughts is lessened, but never disappears completely.  Since its function is to process all things, thoughts as well as food, it has to perform this task endlessly as the other elements pass their energies to it for processing. 

If I remain clear that my Earth patients need to be allowed time to circle round a subject, even though I may have heard the same thing in the same words before, I am able to stand back and allow this circular movement to continue without getting irritated.  But being a quick thinker and talker myself, the slow chewing-of-the-cud which is Earth’s way of thinking can tend to irritate me and make me want to interrupt it if I am not careful.  So a warning sign goes off in my head with every Earth patient I treat:  Let the patient speak, Nora, and only interrupt or add your own comments when you have given your patient time to process his/her thoughts and express them fully in the way they want.

The Earth element’s position in relation to the other elements has always been somewhat equivocal.  It was originally shown on acupuncture charts as taking a position centre-stage with the other elements circling round it, before it later became part of the circle, and was slipped in between the Fire and Metal elements.  Its association with a season has also been a little idiosyncratic.  Its original position at the centre of the element was seen as connecting it to each of the seasons and their associated element in turn, so that a small wedge of time at the end of each season was regarded as being under its influence, rather than having a complete season dedicated to it.  Once it took up its current place in the circle between Fire and Metal, it is now associated with the intermediate season between the end of full summer and the beginning of autumn, a season we call late summer, as the year tilts from the yang of summer to the yin of approaching autumn.

There is something of this slightly ambiguous role in all that relates to the Earth element, for it constantly acts as a pivot between yin and yang and back again.  It is no surprise, therefore, that it is the only element which has both of its two meridians running only over the front of the body, which is considered a yin area, unlike the twin meridians of all the other elements which run both over the back and the front of the body.  It is also significant that its yang official, the Stomach, should pass over the nipple, surely one of the most yin places in the body, as if in so doing it unites both yin and yang within itself.

  

It is as though there are always two sides to Earth, reflected both in the positioning of its two meridians and in its close relationship to both yin and yang seasons.  In terms of its emotion, too, it can be said to alternate between expressing two different aspects.  We call its emotion sympathy, which has such a warm, giving tone to it, implying a person’s ability to feel themselves into the situation of another person and understand what they are experiencing.  Sympathy could be considered to be a very unselfish emotion, and Earth is after all the element which represents the mother who is expected unselfishly to feed her children.  But as with everything to do with this element, there is a paradox at its heart.  All elements are given specific burdens which represent the demands they make upon those who come under their patronage.  Earth’s special burden is that it cannot give to others until it has enough within itself to give.  If its larder is empty, it cannot therefore offer food to those around it.  It has both a need to give (a more yang-orientated activity) and a need to take (a more yin-orientated activity).   We need to understand this if we are to help our Earth patients.

An Earth friend of mine is a good example of this dilemma.   When talking about another person she often asks me, “Do I need to worry about them?”, said with a  kind of weariness in her voice.  I see this as a reflection of an appreciation of her role as supporter of others, the mother role, the person worrying about somebody else, but implicit within the weariness behind the words is the feeling that this is a burden.  It contains a question as to whether she has perhaps the right to shrug off this burden, as well as the question as to whether instead she ought to find the strength to bear it.  And here I am given a role to play, for in her question to me is implied the wish, indeed the demand, that I be the one to take some of the burden, in effect to absolve her of the ultimate responsibility of taking on the burden of worry.  By asking the question she has placed me, rather than herself, in the role of taking responsibility for providing the answer.  Hidden within the question, too, is clearly the hope that I will reply, “No, you need not.”

Earth people, then, can often experience others as potential burdens, as here in this example of my friend, with the fear that they may not feel themselves up to the task of carrying the weight of what they are expected to offer others.  This explains in part the plaintive note in an Earth’s voice, its singing, sighing quality carrying a demanding tone, a “gimme, gimme” tone, a kind of sucking inwards, as a baby bird sucks in food.  This is how I regard Earth’s need, and if we are to give that dominant emotion within it the word “sympathy”, then perhaps in many instances we could add (in brackets) “for me too, please”.

I have also found that the need to be nurtured which all Earth people have awakes an echo of the same need in me, because at some deep level within me I would like some of the same kind of nurturing I am being asked to offer Earth.  A few days ago, interestingly, an Earth practitioner told me that he finds his first interaction with his patients disturbing because he feels their differing needs tugging at his Earth element which is reluctant to offer what is being demanded of it. Once I am aware of this reaction in myself, I remind myself firmly that I am here for the patient and not for my own needs.  

54. The Fire element 4: Inner Fire characteristics

There are an almost unlimited number of outside pressures upon us exhorting us to be what we call politically correct (pc).  Those, like me, whose guardian official, the Small Intestine, forms the yang aspect of Inner Fire, are particularly burdened here, since it is my Small Intestine which has constantly to find a way of dealing with these pressures.  There are many things I have to face during the course of a day, but none so tiring, because so apparently insignificant, as what happened this morning.  This may seem to be a frivolous example of the Small Intestine at work, but, like everything our guardian element insists that we do, is also a very significant illustration of that official’s work.  So any practitioner reading this should take note, because it is only through understanding the load each official bears as it attempts to do its work for the good of the whole that we learn to help our patients.

So to this morning’s tiny incident:  I feel very strongly that I must support my two small local newsagents, one at each end of a long street, at the centre of which, and closest to where I live, is a Tesco’s.  (This comes under the politically correct heading no 1, which is “Support your local shops”.)  I have a weekly subscription to the Guardian/Observer newspapers. (This comes under politically correct heading no 2, which is “Keep buying newspapers to save them from the threat of the internet”).

The problem arises if 1) it is the weekend, as today, or 2) I am in a hurry, also as today, when it would, of course, be far easier just to pop into the Tesco’s just over the road.  At the weekend, one newsagent opens late on a Saturday and is closed altogether on a Sunday, and the other only opens for a few hours on a Sunday morning, so I have to remember to get there before it closes.  So today I set off virtuously on my long walk to one newsagent, forgetting that it was Saturday and not yet open, turned to walk back towards the other end of the long street, passing the doors to Tesco’s on the way.  I spent (or at least my Small Intestine spent) the 100 yards or so of this walk towards Tesco’s debating whether I would or would not succumb to laziness and pick up my Guardian there, or whether I should continue for another 5 – 10 minutes up to the other newsagent.  Giving myself the excuse that I was in a hurry, I gave in and popped into Tesco’s.  Each time I look at today’s Guardian now I feel a slight twinge of guilt.

To some people, this dilemma, which acts itself out surprisingly often, is a ridiculous waste of energy, but try to tell that to the Small Intestine.  If it feels something is wrong - here supermarket chains crushing small shopkeepers - it has to do something about it, even at the cost of all the apparently unnecessary heart-searching that it has to do (and remember the Small Intestine’s function is to advise the Heart to do what is right).

 

During the course of a day, there are many other similar examples of the dilemmas I am faced with.  These include things such as: should I buy a pint of milk from the little café I like to support but at a higher price than from Waitrose, which, as part of John Lewis, is an acceptable supermarket to buy from;  or does my little dishwasher use more water than if I wash my plates by hand;  or should I avoid walking past my usual Big Issue seller because I have just bought a copy from another one further up the road, and will he therefore think I have abandoned him? 

Not to mention, should I buy my books from my small local bookshop, rather than Amazon, or, a further dilemma, through the Guardian bookshop?  Which needs my support more, the local bookshop or the Guardian?  Or should I not buy the book at all, but order it from my local library, which also badly needs my support? (These come under pc headings 3 and 4, Support your local bookshop and Support your local library.)

I give below another example of the unnecessary pressures my Small Intestine official can put me under.  I travelled by train from London to Salisbury one day, not something requiring much mental exertions, one would think.  But with every train journey I take comes the moment as I walk along the platform when I have to decide whether I want to head for the carriage with the quiet zone, and opt for a journey theoretically free of people talking loudly on their mobiles, or just sit in an ordinary carriage and suffer.  As everybody now probably knows, I absolutely hate mobile phones, however necessary they have become, not only because of the complete disregard for other people their owners show, but also because they are increasingly cutting people physically off from contact with one another - ironically, because they are intended to do just the opposite.   So do I suffer a journey interrupted by the endless pinging of mobile phones, and forced to listen to conversations I have absolutely no interest in, or do I sit in a carriage in peaceful silence? 

Except it is rarely silent, I have found.  What usually happens is that somebody, finding that there are more seats available than elsewhere, plonks themselves down without seeing where they are sitting, and immediately switches on their phone.  Then there comes the moment when I look round to see if any other occupant is as annoyed as I am, which they, surprisingly, rarely are.  So I am forced yet again to gesture to the signs on the window, to be greeted usually, not by an apology, but by irritation, with the speaker either hurriedly grabbing his/her bags to walk to another carriage or walking through the carriage to the area beyond the door still talking loudly.

And this may happen not once but twice during a journey.  And if it doesn’t happen, then at every station along the route, as new passengers come, in I tense myself for another such encounter.  What an utter waste of my energy!  Wouldn’t it be far better for me, plagued as I am with bad hearing, just to turn off both hearing aids and sit in utter silence wherever I choose?  But I know that when I take my next train journey, I will go through the same rigmarole.

It is on occasions like this that I would love to be any other element than Inner Fire to allow my poor Small Intestine simply to relax and enjoy the journey, rather wasting so much time sorting things out in such an unsatisfactory way. But, sadly I often think, it can never truly relax, as it sifts and sorts, sifts and sorts to protect the Heart.  Oh, the burdens upon my Small Intestine of trying to do what is right!

Finally, one of my Inner Fire patients delighted me this week when she said, rather sadly:  “I run on my thoughts.  Other people seem to run on their emotions.”

Cars run on petrol, lorries on diesel, and she recognizes that she “runs on thoughts”. 

Yes, I thought to myself, that is an excellent description of what powers the Small Intestine.  It always has to think everything through, sorting and sorting its thoughts out to make sure that its companion official, the Heart, receives good advice.  I have described the Small Intestine official as acting as the Heart’s secretary, often doing its deep thinking for it, and then passing on what it hopes are only pure thoughts to the master of all, the Heart.

This is how I have learnt to distinguish Inner from Outer Fire, which is never an easy distinction to make.  If you think a patient is Fire, ask them some rather complicated question, and watch how they try to answer it.  Inner Fire often looks slightly puzzled, frowning a little as it tries first to take in what you are asking, and then start sorting out its reply to your question.  There will always be signs of a kind of slight hesitation, as if the answer is not easy to find, and the reply may sound slightly confusing, as though the patient is still sorting out what to say as they talk. 

Outer Fire, on the other hand, will perhaps take a little more time to answer, but tend to give a more straightforward reply, and one which is much less involved in its own thought processes.

Being an Inner Fire person myself, I have often said that I sort my thoughts out as I talk.  And now, hearing what my patient said, I agree that I, too, run on my thoughts.

 

53. The Fire element 3: The Fire Element's Four Officials

Being a Fire person, for whom the relationship of one person to another forms the central focus of their life, I have always been fascinated to see how humans interact with each other.  I remember as a child enjoying sitting in the corner of the room just watching how the different members of my large family dealt with each other.  I was always very sensitive to any changes in atmosphere, particularly if things became a little strained and uneasy, and, even as a young girl, I would try to work out for myself what was happening to make it so.  This was useful preparation for my similar work as a five element acupuncturist, and has stood me in good stead to this day.  Perhaps it was therefore inevitable that I would eventually find my way towards a calling which drew so deeply on my interest in people, and which fed my Fire element’s desire to find out exactly what is going on in the human interactions I am witnessing.

I have always had an image in my mind’s eye when I think about the Fire element, and that is of a mediaeval castle, surrounded by a moat and battlements. These represent the Heart’s outer protectors, the Three Heater and the Heart Protector, which work together, and which I have named Outer Fire.  The battlements have what is called a portcullis guarding its entrance from the outside world.  For those not familiar with the word, a portcullis is a heavy iron or wooden barrier in a mediaeval castle which is lowered down from above to cut off anyone trying to gain access over the castle’s moat, and thus to protect the castle from intruders.  At the very centre of the castle there is a further structure, again surrounded by its own fortification, which represents the Heart with the Small Intestine circling around it and protecting it.  To these two officials I have given the name of Inner Fire.

The beat of a heart is the first sign that a tiny life is slowly shaping itself in the womb.  It therefore seems totally appropriate that in five element acupuncture the Heart official should head the list of all the organs, and is designated by the first Roman numeral (I).  I have always found it slightly odd that in many branches of acupuncture it is the Lung which takes the dominant position, with the Heart relegated to a lower place.  In my eyes this robs the Heart of much of the significance acknowledged by its traditional name of Supreme Controller, the Emperor of body and soul.  Surely the Emperor, the ruler of all, must occupy the most important position.

There is something very comforting in this symbolism attributed to the body’s organs by the ancient Chinese, and still adhered to in a modern age, where such symbolism could easily be mocked as being somewhat primitive.  It is far from that.  Indeed, symbols represent an astute way of describing very profound thoughts in simple, easily accessible terms.  To think of the Heart as representing the Emperor in what we can think of as the kingdom of body and soul adds a level of significance to the physical organ itself which far outweighs its purely physical manifestation.  It recognizes its dominant role in the hierarchy of the organs, assigning to it a special position unlike that of any of the other organs, for it is associated with the two most important landmarks in each of our lives:  the emergence of life with its first beat, and the onset of death when this beat fails. 

This being so, it is appropriate that this most precious organ is always approached with a reverence given to no other organ in five element acupuncture.  To the Japanese, who inherited most of their interest in acupuncture from the Chinese, it became a sacred organ, its points not to be needled, or, if so, only with great care.

I don’t know where I got the image of a castle from.  Did one of my teachers at my Leamington College describe the Fire element in these terms, or was it an image I developed for myself to understand the different functions of the four Fire officials?  I know that it was already clearly imprinted on my mind by the time I started my evening classes in London soon after I qualified, so it has become a very long-standing representation of this element for me.  And I find it very useful as it helps explain for me some of the differences between the two Inner and two Outer Fire officials.  For each pair has a different function within the Fire element, has different characteristics, therefore expresses itself differently within us, and needs to be treated differently with its own groups of points.

Let us start by looking at the Heart, and thus with Inner Fire, as we should always do, since it is our most important official.  There it sits safely behind all kinds of barricades in rather lonely splendour, with only its companion official, the Small Intestine, granted close access.  It is cut off from the rest of the castle to protect it, and there is no direct connection between it and Outer Fire.  This is the inner sanctum of the Fire element, with the Supreme Controller, like a Lord of a Manor or an Emperor in the Forbidden City in Beijing, hidden well away from sight, and closely guarded by its yang companion, the Small Intestine. 

The Heart’s importance, and thus to some extent also its vulnerability, is signalled by the fact that, unlike any other organ, it is not only protected by its companion yang official, the Small Intestine, but by the two overarching functions of Outer Fire, whose areas of responsibility extend far beyond the Fire element itself to the body as a whole, those of the Heart Protector (Pericardium), guardian of the network of blood vessels, and the Three Heater official, which harmonizes all things and keeps the body’s temperature at the correct level to maintain life.  These two officials form an outer defensive ring, patrolling the castle’s ramparts and forming the outer perimeter of the heart’s defence system. Together these three Fire officials form a tightly-knit unit, sheltering the Heart in their midst.

The Heart Protector can be thought of as a guard always with weapons in its hands, defending the castle from attack.  Its yang companion, the Three Heater, ensures that every part of this defensive structure functions harmoniously and as a single unit.  These two officials are alert to any danger, and do all they can to prevent an attack upon the Heart deep within.   We can interpret this emotionally as an awareness of the risks inappropriate relationships can bring.  It is interesting to note how often an Outer Fire person may cross their arms across their chest when they talk to other people, a physical sign that they are trying to protect the Heart inside.  This image reveals some of the characteristics which the two Outer Fire officials show as they maintain their defensive attitude at all times.  This can manifest itself as vulnerability when they are weak, as though retreating behind protective barricades.  It is as if they are physically lowering the portcullis when danger threatens.

This kind of defence is quite unlike the response of the Small Intestine to pressure upon it.  Since it is the closest official to the Heart, it cannot afford to retreat in this way, but has to stay in control at all times.  Instead, its yang quality shows itself increasingly the more defensive it may feel inside.  It counters stress upon it more by verbal sparring and mental agility.  We know that the Small Intestine’s function is to sort the pure from the impure, rejecting impurities to protect the Heart.   It is therefore constantly responding to whatever situation it is presented with by trying to sift from it only that which it is good to allow through. When we are trying to distinguish the characteristics of an Inner Fire person from that of Outer Fire, this somewhat restless activity can be seen as one of its distinguishing features.  The slightly puzzled look in an Inner Fire’s eyes as it tries to sort out its responses to a given situation is a good clue.   Outer Fire is not puzzled by life, just alert to its dangers.

Despite all my good efforts, I still remain slightly puzzled when I try to pin down the differences between Inner and Outer Fire.  Perhaps, because I am personally so closely involved here, since the Small Intestine is my own guardian official, this may well be a distinction that I will never find easy fully to understand.  I have, however, fought my way through the Fire thicket until now I feel that I have a little more of a handle on the crucial differences between the two aspects than I had earlier on in my practice.  Working out what the distinction is has probably been so important for me, as it helps me understand my own Inner Fire better.   I have noticed people of other elements, and even those of Outer Fire, seem less pre-occupied than I am by trying to work out where the differences lie, or they may simply be able to recognize them more easily than I do, since they are able to stand back a little and observe from a distance whilst I cannot do that.

I have always found it oddly appropriate that my particular place within the kingdom of body and soul represented by the five elements should be within the one Fire official which is the closest companion to the Heart, the Small Intestine.   With the hindsight I have gained through my work on the elements, it has become clear to me how profound has been the influence my Small Intestine official has cast over how I live my life, and in particular over the path I have found myself as though compelled to take, first to study five element acupuncture, then to practise it and finally to teach it.  

I remember sitting in the classroom of JR Worsley’s Leamington College many years ago watching a video of him with a patient in which JR asked the patient a question.  I can recall seeing the young girl’s puzzled look as she cast around in her mind for an answer, before saying, “I’ll have to think about that.  I’m not sure…”  And I heard JR, muttering quietly to himself, “Only a II (Small Intestine) person would say that”, one of those significant comments that have stayed with me in the 40 years since then.  At the time, I, too, puzzled myself over what exactly had made him see the patient’s reply as being typical of the Small Intestine.  And, as with all things to do with my acupuncture life, there was a great personal significance to my having heard JR say that, for it has illuminated my understanding of myself and my own relationship to the Small Intestine official, and helped me understand in a very subtle way why my work has taken the direction it has.  Like JR’s patient, I, too, have to “think about things”, always initially being “not sure” what to think or say until my Small Intestine has had time to sort its thoughts out.

Seen from this point of view, the whole of my acupuncture life with its digressions into teaching and writing could then be said to represent a continuous attempt by me to sort out what my understanding of the elements teaches me about life, and then to express the results of this sorting process both in spoken and written words.  It is, after all, communication which is the Fire element’s chosen method of engaging with others.  I have therefore come to see myself as a walking, talking symbol of Inner Fire, for there could be no more appropriate official to help me than my own Small Intestine, with its insatiable need to sift through what comes towards it.  Hence the many different ways I have devised to say perhaps the same things, but each time from a slightly different angle, so that the whole picture I gradually build up is illustrated by as many new insights as possible.  It is no coincidence that I use many different types of communication to do this:  blogs, books and different forms of teaching, now principally large-scale seminars.

Echoing what the young girl in the video said, perhaps all my teaching and my writings can therefore be said to be continuous attempts to “think about” whatever puzzles life confronts me with.  This whole book which presents new thoughts about the elements is then the result of much intense mental and emotional activity, evidence of the workings of a lively, restless official ever conscious of the need to evaluate and re-evaluate every thing that it encounters.

As five element acupuncturists we have to be alert to the constant need to look closely at all those who surround us, trying to assess the influence within them of the different elements and their relative importance one to another.  We are on the look-out for subtle manifestations of different aspects of the elements (“Is it the colour white I am seeing?”, or “Is this person’s voice pushing at me”, or “Does this person make me feel nervous?”).  All our Small Intestine officials will here be involved in trying to sort out the minute differences which point to one element rather than another, and this is true of none more than someone, like me, whose guardian element is Fire, and whose place within the hierarchy of the Fire officials is Inner Fire.  You can say that it can be considered both a blessing and a curse to have been granted as close an association with the Small Intestine as I have. On the one hand it gives me some very specific tools with which to home in on an element, whilst on the other it often overburdens me with the constant need my Small Intestine has to question every conclusion I come to. 

When learning about the astrological significance of the star sign of Gemini, I remember laughing to myself because my chart is heavily laden with this sign, and I found it interesting to draw a parallel between the characteristics of Gemini and my own close association with the Small Intestine.  Both spend their time weighing up the relative importance of two contrasting things, in effect asking the question, “Is it this or is it that?”, an assessment of alternatives leading to much querying of any decision I make, as though asking myself, “Am I sure I am right?”.  As a five element acupuncturist this can be a powerful tool in helping me track down a person’s guardian element, for I will only be satisfied when I have obtained positive proof from the effect of successful treatment.  On the other hand (a favourite Small Intestine phrase!), it can lead to much soul-searching as the resultant lack of certainty feeds into uncertainty in treatment.  But then any element and any official within an element has both its positive and its negative side.                    

I have always felt how appropriate it is that the Small Intestine official’s meridian should end deep within the ear at SI 19, at a point where all the impressions pouring towards us from the world around are sifted before being transformed into the shape of thoughts and words with which we can communicate to others.  No wonder little children, inundated on all sides by the relentless volume of verbal information their little ears are asked to filter and make sense of, often fall prey to ear infections of all kinds as a kind of defence mechanism as they try to close their ears to too much verbal noise.  Adults, too, often suffer the same sense of being overwhelmed by a continuous flow of new information and impressions, perhaps one of the reasons why people are now so keen to keep their earphones clamped to their ears as they walk along the street, as though trying, probably in vain, to keep to a minimum the auditory stimulus these ears are subject to, or at the very least to filter what they hear through the channel of self-selected music which they hope will drown out all the other noise.  It was therefore no coincidence that, as a child, I suffered numerous serious ear infections, probably one of the reasons why my gradual hearing loss occurred so early on in my life.

I remember a tutor at the Leamington college laughing at me because I kept on asking, “How do you know that it is the Heart Protector/Three Heater side of Fire, rather than the Heart/Small Intestine side?”  I soon realised, however, that I had a particular problem in understanding this distinction because it affected me so personally, and things which touch us more deeply than other people can always be problematic.  The mere fact that I still puzzle over whether a patient of mine is Inner or Outer Fire is proof of my own close involvement with the question.  And probably nobody but an Inner Fire person could have spent as much time as I have over the years enquiring with such stubborn persistence into what exactly distinguishes the two. 

I have also noticed that though I have always been fascinated by trying to work this out, other people certainly are not.  When they ask about how they can recognize Inner Fire, I always reply, “Just look at me, listen to me, and you will see its workings at close hand”.  But I notice that very few of them listen to this advice, almost as if they find it confusing to be given such a clear example of Inner Fire right in front of their eyes.  What this apparent lack of interest has made me understand is that we all have different areas of interest, and that includes five element acupuncturists in their search to understand the elements.  

Tips for distinguishing the two sides of Fire from one another:

Outer Fire:

Easier than Inner Fire for people to relate to. (This reflects its time of maximum activity which is the evening, at the end of the day, as people start to relax.)

Relaxed company, spreading warmth and joy around it.
More articulate than Inner Fire, since it does not need constantly to sort out its thoughts.

Inner Fire:

More active than Outer Fire, since its time of maximum activity is around noon, when the sun’s yang energy is at its height.

More prickly than Outer Fire. 
Likes to spread warmth and joy, but is often prevented from doing this because it is concentrating more on trying to work out what needs to be done to help the Heart.
Can look puzzled by life and remains puzzled until it has worked out a solution.  Can therefore send out confusing signals which other people may find disturbing.

Despite these tips, it is not easy to distinguish the differences between these two sides of Fire.  This is why we always start by treating Outer Fire for a few treatments to strengthen the Heart’s defences before moving to Inner Fire if we feel we have not reached the core of a patient.

I like to think that Outer Fire asks "Is this person safe to love?", whilst Inner Fire asks "Is this person wise to love?”

Copyright:  Nora Franglen 2020