Thursday, October 28, 2021

83. One of the challenges of writing about the elements

One of the challenges of writing about the elements is that, because of their different qualities, elements demand different kinds of approach from their practitioner.  That means that practitioners have to learn to adapt how they deal with their patients to take account not only of the differences between patients of the same element, but also the fact that their own element will respond in its own specific way to what the patients they treat will demand of them.  This requires a high degree of sensitivity and flexibility on a practitioner's behalf, and, above all, a degree of self-awareness that few of us possess before we start on the long road to becoming an experienced therapist.

 

Each of us, patient and practitioner alike, is formed of a unique blend of the elements, creating what we can call our own unique elemental DNA.  When this unique imprint meets the equally unique, but obviously different, elemental DNA of our patients, there is obviously the risk of some misunderstanding between the differing needs of these two people in the therapeutic relationship.  For we must not forget that, whilst it is obvious that the patient arrives in the practice room with specific needs of his/her own, the practitioner, too, enters it with what may at first sight not be, or what the practitioner may think should not be, their own needs. So what are the patients' needs and how may they conflict with those of the practitioner?

 

We often don't think enough about this, as though taking for granted that we know why our patients are coming to us.  Surely, we may think, it is that they wish to feel better, to heal themselves of some symptom, usually something physical.  But if we look more carefully, beneath the obvious reasons lie often deeper ones, hidden sometimes from both the patient and the practitioner, and only gradually exposed as a result of the changes prompted by treatment.

 

The more experienced and adept a practitioner is, the more quickly these hidden areas of a patient's life come to light.  I know that I learned quite quickly to open the door to this more hidden world to patients by asking questions in such a way as to give them permission to talk more freely.  A good example of this was when a patient came to me complaining of bad neck pains.  After listening to him describing this, I turned the questioning in another direction, by asking, "And is there anything or anybody in your life who you also feel is a pain in the neck?"  I was almost amused to see how quickly my patient responded to this, by admitting that, yes, his youngest son was causing him a great deal of problems.  By connecting the two levels of his distress, the physical and the emotional, this allowed him to open up to the deeper problems in his life, to his obvious relief.  This was also likely to contribute to his physical pain, if not indeed simply being its cause.   

 

I therefore recommend that all aspiring five element acupuncturists should learn the techniques necessary to bridge the gap between patients talking about their physical symptoms to emphasizing that five element acupuncture is also there to help heal emotional trauma.  Patients and practitioners often find it easier to remain at the more superficial, physical level of their patients' lives.  Practitioners may therefore be happy to follow their patients' agenda in their approach to why they are coming for treatment, rather than venturing into the more challenging areas by touching upon what are usually the more deeply-rooted and therefore often more painful areas of patients' emotional lives.

 

And then there is the question of how far practitioners' own element dictates their approach to treating patients.  All of us are untouched by the characteristics of our particular guardian element.  An Earth practitioner, for example, will, therefore, approach his/her patients quite differently from a Wood practitioner.  Each practitioner has to be aware of this, and counteract any particular bias which may start to creep into their practice because they may have their own personal response to the different elements of the patients they treat.  

 

I realised early on in my practice that I had problems dealing with my Wood patients which I seemed not to have with patients of other elements.  But I only became aware of this when I noticed that I seemed to have very few Wood patients.  It was only when I looked carefully into the reasons why this should be that I realised that my own slight fear of the forcefulness presented by the Wood element, which my Fire element often found difficult to counter, had unconsciously given me a bias to avoid diagnosing Wood in favour of elements I found easier to deal with.  This was a great learning curve for me, because it made me examine how far my diagnoses might be skewed by personal factors, rather than being based on the realities of the patients before me.  A salutary lesson indeed!

 

On the other hand, we must not ignore the fact that our own element also shapes the kind of relationships we develop with our patients in both a negative and a positive sense.  All Fire practitioners will want to engage more actively, perhaps too actively, in their patients' lives than will a Metal practitioner, who may well tend to give his/her patients more space to work out solutions for their problems themselves.  Perhaps some of Metal's patients, though, might prefer a more involved approach. And what, then about the other three elements?  


From observations of my fellow practitioners, I have learned that of all the elements it is Earth which may find itself burdened the most by its patients' needs, because it can so easily feel overwhelmed if too much is demanded of it.  It may also find the one-to-one relationship of patient to practitioner more difficult to cope with than other elements do, as it is usually happier when working in a group rather than on its own. On the positive side, Earth will be more than ready to empathise with its patients' distress.  Wood practitioners, on the other hand, have to hold back from expressing their tendency to think that they know what is best for their patients, and refrain from getting irritated by some of their patients' decisions.  They will, however, be very clear about the kind of help they can offer.  Water practitioners have the advantage of being very sensitive to their patients' needs, but may tend to be too susceptible to self-doubt in relation to their work, leading them to query constantly whether what they are doing is the right thing for their patients.

 

Of course everything I write about the elements is personal to me, and therefore to some extent only partially relevant to other practitioners' approach to their practice.  it is good always to remember that each of us has to develop our own relationship to the elements and establish our own understanding of them, which will inevitably differ in certain respects from mine, although I hope not completely.  Those reading this will therefore need to adapt what I say in the light of their own experiences. 

 

  

Friday, October 1, 2021

82. The fear of getting things wrong

Nowhere is the fear of getting things wrong more evident than when five element acupuncturists are faced with diagnosing a patient's element.  All of us seem to be worried that not "getting it right" straightaway may somehow be regarded as a failure.  I have written more about this in my two latest blogs (80 and 81).  Here I want to continue this discussion with more insights as to why treatment on any element can never be harmful to a patient, provided we remember the basic rules of good five element practice. 

 

Firstly, always keep things as simple as possible.  The simpler is always the better because five element treatment is based on giving simple instructions to the element we have chosen as a patient's dominant element.  We then give that element time to show us clearly whether its response is one of relief at being so firmly addressed, or leaves the patient almost unchanged.

 

Another important rule is that we should never take energy away from a depleted element in order to pass it on to an element which already has more energy.   Nor should we confuse the elements by needling points on different elements during the same treatment.  The only exception to this rule is when we are correcting certain energy blocks, such as a Husband/Wife imbalance.

 

Practitioners are often reluctant to offer their patients these simplest of treatments, in the false belief that they will be impressed by the number of needles used.  For example, it has always been difficult for me to convince students that one of the most profound five element treatments you can ever give a patient is simply needling the source points of one element and leave it at that - four points, two for each official on either side of the body.  JR Worsley used to tease us by saying that a good acupuncturist would take only 3 minutes to do a treatment: one minute to greet the patient and take the pulses, one minute to needle the very few points needed and one minute to say goodbye.   

 

And then there is the question of how much time during each appointment we should take up by talking with our patients, and this is because there is some confusion as to whether five element acupuncture should be considered to be a talking therapy or not.  We certainly need to get to know our patients by questioning them and giving them the opportunity to talk about their problems.  We must, however, always remember that it is the patient's elements which will ultimately help solve these problems, rather than spending too much time talking them through with the patient.

 

As an additional note here, I learnt early on from my own treatment the importance of keeping to simple treatments.  I was being treated by a practitioner at JR Worsley's Leamington college, and JR would often come in to give my practitioner the benefit of his experience.  So I had a great deal of evidence of how simple the treatments he suggested each time were.  Often the same treatments were given at intervals, such as the AEPS or Windows, but always the basis for each treatment were the command points.  I don't remember an occasion when he recommended any points beyond this classical repertoire.  The sheer simplicity and, I like to think, purity of the proposed treatments have stayed with me and have formed the foundation for all the many years of my own practice and teaching.

 

  

Tuesday, September 21, 2021

81. Necessary short-cuts to a five-element diagnosis

I have been thinking a little more about the lack of five element teachers, which I mentioned in my last blog (no.80). There is always a problem venturing in the footsteps of a proven master.  Jung had difficulty in emerging from under the great shadow which  his master, Freud, had cast over him.  All JR Worsley's successors have to deal with the same problem.  Those who learnt directly from JR Worsley himself, and the following generations who were taught by this first cohort, have a natural reluctance to claim to "do a JR" when diagnosing patients, particularly in front of a class of students.  This term was a shorthand for being able to do what he told us was his ability to diagnose colour and smell as he came into the practice room, and follow this up in a very few minutes with sound and emotion as soon as the patient had responded to his questions.

 

Because we have been asked to diagnose hundreds of Chinese practitioners and patients on our seminars over in China, I realise that I am getting much better at making quick decisions about the elements I am seeing.  I have had to be, in view of the time constraints we are working under - perhaps only a morning to make over 150 diagnoses.  But then I have always emphasized that this is completely the wrong way to make a good diagnosis.  I should be sitting down alone with each of these 150 people in a practice room, and giving them all the attention and time that carrying out a good TD (Traditional Diagnosis) demands.  But as the saying goes, "needs must when the devil (here simply the time available) drives"!  If we (and that includes my five element companions, Guy Caplan and Mei Long) were not to do this, none of these enthusiastic five element practitioners and students would ever have the slightest inkling of their own element, something I consider essential for any five element acupuncturist.  And we know that we are always very bad at diagnosing our own element, for all sorts of reasons, often choosing an element which we long to be!

 

I have therefore had to learn to do the best that I can, calling these initial diagnoses simply our first hypothesis about the element, to be amended as we get to see things more clearly in the light of how treatment on that element has or has not brought about any changes.  Luckily during these seminars in China we see everybody for a full week, and so have many opportunities of observing closely those whose diagnoses we are unsure about, and then changing these where necessary accordingly.  As I said before, Chinese acupuncturists, probably because of our emphasis on the provisional nature of our initial diagnosis, are quite happy to have their elements changed, happier, I think, than their European counterparts, certainly their British.

 

Also, if we see examples of possession in the group (surprisingly often, perhaps for cultural reasons), we make sure all these patients are treated before we leave, as this is not a simple treatment for apprentice five element practitioners either to diagnose or to recognize when it has been cleared.

 

I know that my own 40 or so years of five element studies have helped me pinpoint the elements more quickly, and, I hope, more accurately, but I do wish that more of all those competent five element acupuncturists out there would take a leaf from my book and venture out into teaching.  I always remember one of my wise teachers, Dr Oskar Adler, master musician, teacher of the violin to the composer Schoenberg, and astrologer, author of some fascinating books on astrology, writing how important it was for everybody to pass on whatever they have learnt.  In a lovely quote, he said, "What would have happened if Mozart had not written down his music?".  And Mozart, after all, was almost hounded to his death through poverty and many of his manuscripts only survived by accident.  Think!  We might not now have his Magic Flute or Marriage of Figaro, or hear his sublime piano concertos!

 

So any of you experienced five element acupuncturists out there, please take courage in your hands and offer up to the next generation whatever you have learnt from your own practice.  Only in this way will any discipline survive, and particularly such a rare discipline as five element acupuncture.

 

Thursday, September 16, 2021

80. The certainty of uncertainty

 Oh, how we would all like to be 100% certain about things.  In five element terms this would mean that with sufficient experience we would be absolutely sure of a patient's guardian element, leaving no room for doubt.  But that is not how things are, nor should we hope that this is how they should be.  Instead we must learn to accept what I like to call the certainty of uncertainty underlying all human activities, including our diagnosis of a patient's element.

 I am strongly reminded of this truth now because of something which has happened whilst Guy and I are helping put together the latest of a series of courses for Chinese five element practitioners.  In previous courses we have looked at videos of patients and made preliminary diagnoses of their elements.  For this course we are being sent further videos of patients we have previously diagnosed after they have received further treatment either on the new element we diagnosed or on the original element we confirmed as being the correct one.  We are focusing on helping develop practitioners' relationships with their patients and improving their ability to observe the often subtle changes in patients which indicate that they are treating the right element.  

 

All five element practitioners have to be honest enough to admit when our diagnosis is not yet the right one.  This thought is at the forefront of my mind at the moment because I have just been sent some more videos of a patient we diagnosed a few months ago which have made me alter my original diagnosis.  The patient does not seem to be showing any of the changes I expected to see after some treatments on the new element.  After seeing more videos of her, I am now much more confident of her being of another element.   

 

Here indeed is a real lesson in humility.  We are using these videos as teaching material for perhaps some hundreds of five element practitioners in China.  There is now no doubt in my mind that we need to change our diagnosis, and it would be wrong to continue with my original diagnosis.  How do I make this change  in diagnosis without undermining my students' trust in what I am teaching them?  This is a dilemma all five element teachers have to face.

 

This is where my thoughts turned to something I read in Professor Liu Lihong's book, Classical Chinese Medicine, which so impressed me with his understanding of the need for humility in all that we do.  He said that we will all start any discipline by getting things about 10% right, and gradually increase this with practice to 40%, then 50 or 60%, but we never reach 100%.  Traditional Chinese medicine is a discipline based on practitioners' subjective experience, unlike Western medicine, which prides itself somewhat naively on believing that it bases itself on objective criteria. As five element acupuncturists, on the other hand, we welcome the fact that the relationship between patient and practitioner forms a crucial part of all treatment.   There is therefore every reason for us to accept the very human uncertainties which are an essential ingredient of what each practitioner brings to his/her practice.   

 

So I will be using our approach to diagnosing and treating this patient as a prime example of good five element practice.  I hope that showing fledgling five element acupuncturists that my ready acknowledgement that I needed to change my original diagnosis will encourage them to retain sufficient humility in their own practices. They therefore need not be afraid to admit when they don't get things right straightaway, and allow themselves not to be undermined by this fact.

 

I often think that this fear of what may be seen as showing fallibility in front of their students by not wishing to reveal that they are uncertain of their elemental diagnoses may be one of the reasons why so few good and experienced five element acupuncturists wish to venture into the world of teaching.  This is one of my sadnesses, for it is reducing the flow of five element teachers to a tiny trickle.  As one of my students said to me many years ago: "If JR is the only person to be 100% sure of his diagnosis, how will I ever get to that point?"  To which I would give the answer JR Worsley gave to a class of us when I was a student at Leamington:  "If you had all practised for 40 years, as I have, you would all see the elements as clearly as I do.  So just wait!"  

 

Five element teachers have to have enough self-confidence not to mind telling their students that they, too, are human enough to change their minds, as I am about to do on my latest video recording for my students in China.

 

In my own teaching I have always emphasized that my first diagnosis of a person's element is a provisional one, a hypothesis which subsequent treatment is there to prove or to amend.  Chinese students seem to be quite happy with this and don't appear to be thrown when I change my mind later.  But being human, which means that I do after all want to show that as an experienced practitioner of many years' standing I know what I am doing, I still find it difficult when, as now, I have to announce publicly that I got it wrong!

  

Sunday, September 5, 2021

79. A potential horror story, with a happier ending (I hope)

One of my lovely sons, after much encouragement on his side and much resistance on mine, persuaded me that it was high time to exchange my old pc computer for an iMac.  And bless him, he actually got it delivered to my home to prevent me from changing my mind.  It lay under my desk in its box for a month or so, until my idleness during lockdown made me unpack it and install it with the help of my son's long-distance instructions.  To my relief, he arranged things so that at all times he could see what was going on on my computer, and help me start learning how to use it.  I tried very hard not to give way to my usual panic at learning about any new piece of equipment, so am now fairly at ease with it, although occasionally casting a sad eye back to what I could do on my much simpler pc.

 

Gradually over the next few months I have learnt a complicated new computer language, with many false steps and many odd deletions.  But no false stop and no deletion was as bad as what I did last week.  By some mischance, instead of merely deleting one name from a folder on which I invited people to have access to one of the video series I have recorded for China, I apparently deleted all the 20 video recordings (about 30 hours in total).  Despite frantic calls to my son to see whether I could retrieve them they have apparently disappeared for good from my computer.  They include the videos in which I record my life as a five element acupuncturist, from my first days at acupuncture college to my last visit to China, a time which coincides with the growth of five element acupuncture.

 

At first somewhat disturbed at having destroyed so many recordings about my life, I now realise that it has given me a chance to look at that life from a different viewpoint a few months further on, when I am a little older and the world has turned on, too, in many ways which have been so difficult.  All this, Brexit, Covid, Afghanistan, global warming, all these traumas we are going through have impacted upon me, and like all things, have affected the way I, and the elements that form me, particularly my Fire Element, with its dominant Small Intestine official, have had to learn to adapt.  So I am trying to see this as an opportunity to look at my life again from a different perspective. 


Happy update a week later!

 

Good news!  I have managed to retrieve all the video recordings I thought I had deleted in error.  I had the happy idea to ask my Chinese friends whether they could post the videos I had originally sent them back to me, thinking this might be a bit unlikely but worth a try.  And now here they all are back at home on my computer.

 

But I'm still going to record some more thoughts about My Life as a Five Element Acupuncturist to add to the original series.

 

 



Thursday, August 5, 2021

78. Welcome to my 8th book!

Unexpectedly I was approached by my Chinese publisher who asked me whether I would be happy if he published another book of mine, this one intended just for the Chinese market.  As readers of this blog know, I have been sending teaching videos recorded on my sofa at home to create various series of online seminars for Chinese five element acupuncturists.  The latest, to be made available on subscription in a few months' time, describes my life as a five element acupuncturist from my earliest days as a student under JR Worsley to now, as the lead tutor for the five element programmes being run all over China.  What I did not know until I received this request was that these recordings, which I thought simply had Mandarin subtitles added, have been translated in their entirety.  It is this translation that the publisher wants to make available in book form with the title of "Learning five element acupuncture with Nora". 

Of course I agreed to this unexpected offer, who would not?  Perhaps at some point in the future somebody will want to publish an English version!

 

This will become my 8th book, and has prompted me to look at the other seven books I have written, and see what I think about them now.  I have talked before about the need for each of us to leave behind a legacy of our life.  It does not matter whether this is a private legacy, one known only to oneself and perhaps a few people close to us, or one on the public stage, known to a wider audience.  I wonder where I would place myself on this scale.  In the world of five element acupuncture I am quite a well-known figure, particularly now in China, but in the acupuncture world as a whole I think I only occupy a very peripheral role.  And this does not worry me, for my greatest concern has always been to ensure that five element acupuncture survives, not to have my own contribution to its survival recognized 

 

I don't often write about my books, thinking each one should promote itself on its own, but perhaps now is the time to grade them according to how I value them.  Far ahead of the field, perhaps almost out of touch with the others, is what I call my magnum opus, my most favourite of all, my Keepers of the Soul.  Funnily enough this was my first book, written in the full flush of the excitement of my discovery of five element acupuncture.   I have been told that it is a difficult read, perhaps because, coming as I do from a rather literary background, I am very conscious of the need for my writing to reflect the beauty of words.  In the pursuit of exactly the right cadence to what I wish to express, I make few concessions to my readers, for which I make no apologies. After all, if they don't like what I write, they only have to put the book aside. 

 

My other books all express my thoughts about the practice of five element acupuncture in different ways, two, Blogging a Five Element Life and On Being a Five Element Acupuncturist, offering a selection of my blogs over the years.  The Simple Guide to Five Element Acupuncture was originally intended for acupuncture patients, but has proved to be a useful introduction for anybody interested in learning more about the five element approach to life.  The Handbook of Five Element Practice is a practice manual for acupuncture students and was the first of my books to be translated into Mandarin.  It has proved so popular over there, with more than 45,000 (yes, thousand!) copies sold in the past 10 years that the publisher tells me that it is the highest selling book on acupuncture in China.  Its popularity reflects the great interest in learning about a branch of acupuncture up till then almost completely unknown in China.

 

So on now to my 8th book.  Will it be my last, or will more of what I talk about in the series of videos I continue to record prompt me or my Chinese publisher to propose a 9th book?

Friday, July 30, 2021

77. The Metal phase of my life

I think I must now be very much in the Metal phase of my life, and I am increasingly aware of time passing.  With my love of the elements, I have reduced the seven stages of life Shakespeare tells us about in As You Like It to five, each represented by one of the elements, with Water, ever-ambiguous and mysterious, straddling both the end and the beginning of life to create an unbroken circle.  In my picture of the elements forming life's cycle, Metal lurks there almost at its end, its autumn, and at my age, now in my mid-80's, I accept that this is the stage I am at.

I feel we are living through strange times, evoking yet another Shakespearian thought, for many of us feel, with Hamlet, that "the time is out of joint".  Covid, global warming and Brexit are combining to make me assess my life anew - and this includes my approach to my five element practice and teaching.  I am treating very few people now, first forced into this by Covid restrictions and then at last accepting that the time has come for me to concentrate whatever energy is left to me on what I consider the most valuable thing for me to do.  It's important for me to know that whatever legacy I leave behind represents the best that I can offer those coming after me.  To my surprise, lockdown has given me new teaching tools to use to do this which I never suspected were there.  Things literally fell into my lap one day when I was trying to familiarize myself with my new i-Pad when it struck me that one way of occupying myself whilst I was prevented from carrying on my teaching in China would be to spend some time learning how to record myself teaching online.  My blog of 6 June: Continuing teaching during lockdown describes how I learnt how to do this.

 

Not only has recording the 100 or more videos occupied my time usefully, but it has also given me the opportunity to think my thoughts through more thoroughly, and particularly work out new ways of helping students from a distance.  With Guy and Mei I have now completed several series of video seminars, and we are about to embark on some new seminars, both online in China, and potentially in person in a chateau in the French Loire valley, once Covid travel restrictions permit this.

 

So in this most contemplative phase of my life, in the autumn of my days, I think I am fulfilling the needs of the Metal element within me to clear away the garbage and pass on as much of the true essence of my understanding of five element acupuncture as I can.  

 

 

 

Friday, June 25, 2021

76. Some of the reasons why it takes courage to be a five element acupuncturist

 It is only recently that I have realised how much courage it requires of any therapist to enter the emotional and, as acupuncturists, also the physical space of another human being.  This is all the more so if the conditions under which we practise make the kind of close relationship of patient and practitioner almost impossible.  Here in the West at least we live in a world very familiar with the one-to-one relationships which form part of all psychotherapeutic encounters, amongst which I count five element acupuncture.  I found that this was not the pattern yet in China, where it is rarely practicable to find the space or have the time to treat individual patients to foster the close relationships necessary for a good five element practice 

  I only became aware of some of the difficulties those training to become five element acupuncturists encountered in China after a few visits there, and I therefore did not realise how much Chinese practice conditions differed from what I was used to in this country.  This meant that what I was recommending for my budding five element practitioners was simply something they could not do.  Patients and practitioners alike were then accustomed to view acupuncture as a kind of adjunct to orthodox Western medicine, regarding it as just another form of physically-based therapy, concerned only with helping to treat physical symptoms.  The concept of dealing with patients' deeper emotional levels was a totally alien one, so much so that I remember one Chinese practitioner saying sadly, "I really don't know how to start talking to my patients about their problems as you do."

 

There was the additional problem, still experienced even now by most Chinese five element acupuncturists, and one touched upon by my French acupuncturist friend, Pierre, (see my recent blog of 18 June 2021).  This relates to the thorny question of who is paying for treatment, and what such payments cover.  Where the state or medical insurance includes some cover for acupuncture treatment, how many treatments does that include, and perhaps also for what conditions?  This is an area of practice with which I am unfamiliar, since most of my years of practice have been at a time when patients could not yet take out any medical insurance to cover acupuncture treatment, and therefore took it for granted that they would be paying for treatment themselves.  This had the effect of keeping fees as low as possible to be affordable to as many people as possible, with most acupuncturists having a sliding scale of fees, which could be adapted to help the less well-off.  

 

In his email to me, Pierre writes:   

"In France, we have " la sécurité sociale", that allows people to consult a physician for free. We pay but afterwards we are reimbursed by the social security. So French people are really not accustomed to pay for their health without reimbursement.  And when they come to acupuncture (they know that this practice is out of the reimbursements of the social security) then they want the treatment to be as short as possible because they don't want to pay too much for that. 

I realize that is may be a very different thing between France and England. 

This is a very bad thing, that the government here in France has accustomed people to a false free health care. Acupuncture for them is a short treatment. Totally different from psychotherapy for which they agree in relation to long-term treatment." 

 

Pierre is therefore treating patients with a clock ticking away over his head, not an easy situation to deal with.  To some extent, though, the same can be said of every practice situation which I have had to deal with during my years of practice.  Even though my patients were not relying on outside help to pay for their treatments, they and I were always very conscious of the cost of the kind of long-term treatment a good five element practice demands.  Because I was very aware of this, I gradually worked out how to counter patients' natural concern about the cost of treatment by addressing the issue right at the start of treatment. I found that by doing this I avoided the kind of problem Pierre has to deal with.

 

What I did was make sure during my first interaction with a new patient that they understood what I hoped five element acupuncture could do for them, emphasizing that it dealt with the whole person (hence the use of holistic (from the Greek work meaning "whole") to describe it, as compared with orthodox Western medicine which tended to deal only with physical problems.  I would make sure that a new patient was aware of the reach of five element acupuncture from the start of their treatment, by saying things like, "I'm interested in hearing about any physical problems you have, but these may be related to other issues.  For instance, a stiff neck may be caused by somebody you know being literally a pain in the neck, or a sore knee because you may feel like kicking somebody."  These comments may sound a bit flippant, and often made the patient laugh, but I could immediately detect the change in tone as patients were quick to acknowledge the relevance of what I was saying.

 

I would also tell them that the initial stage of treatment would require 5 - 6 weekly treatments before they might feel any benefit.  Any longstanding problems might take longer than that to be helped, but treatment would be spaced out gradually from weekly to monthly and longer as soon as they felt any improvement.  I emphasized that, unlike psychotherapy, where patients often have to commit in advance to as long as a year's weekly treatments, they would be free to stop treatment at any point if they felt it was not helping them.  Interestingly no patients I addressed like this ever did stop treatment, and many were content to continue as my patients over many years at ever longer intervals.

 

 

Friday, June 18, 2021

75. We should never assume that we know what our patients want from treatment

A French five element acupuncturist, Pierre, comes regularly to our seminars and uses the time between them to send me interesting questions about his practice.  He is tucked away in Brittany, far from any regular five element support network, and has been brave enough to study on his own.  His latest email to me deals with one of the uncertainties therapists of all kinds have to learn to face.  What do we do if we are not sure that we are helping our patients?  What if the patient's symptoms persist?  It is interesting that his email also contains part of the answer to his question without his realising it.  

 

With his permission, I will quote what he was written (and he asked me to forgive any faults in his English!):

 

"The more I treat patients with Five Element Acupuncture only, the more I feel I miss something like a deep knowledge of the spirit of the points.  The treatments I give to somebody, focused on the CF (guardian element), is often good to improve their well-being.  But too often they continue to suffer at a level that I seem not to be able to achieve. After a number of treatments, I feel like I'm going around in circles with the points I use to help them and the treatment seems to be on a plateau.  Examples : The pain (a patient) feels on the wrist doesn't really change, the weight (a patient) wants to lose doesn't really move,  the fear (a patient) has concerning his future retirement doesn't really reduce,  but they all feel better inside them with some improvements in their well-being and even in their other symptoms. 

 

How to improve a treatment with somebody beyond the treatment of the CF (guardian element) when we feel that we are on a plateau?" 

 

I can see that there may be some mismatch here between what his patients expect of their treatment and what he does.   This brings me to an important aspect of our practice.  By what criterion do we judge the success of treatment?  In a purely physically-based medical system, such as that of most orthodox Western medicine, a successful outcome is usually measured by how far one or more physical symptoms have disappeared, or at least been alleviated.  That assumes that as five element acupuncturists we are there simply to treat the physical, whilst ignoring the other, deeper levels of our being, our minds and spirits, or in general terms our emotional well-being.  We all know that a holistic therapy like five element acupuncture does not or should not confine itself to treating just the physical level, indeed often viewing this as in some senses the most superficial level.  And my French acupuncturist's patients appear to recognize what five element acupuncture has done for them at this deeper level by telling him that "they all feel better inside them with some improvements in their well-being and even in their other symptoms".

 

It seems, though, that it is the practitioner who is more concerned with assessing the effect of his treatment on his patients' physical symptoms than they are.  Perhaps to some extent we all live in a medical environment concentrating so much on treating purely physical complaints that we may overlook what to our patients may well be the most important effect of their treatment, which is the fact that they "feel better".  My advice to my French friend will be to be glad that his treatment has increased his patients' general well-being, to continue with the kinds of treatment that have already produced such good results, and, most importantly, to give himself more time for treatment to work.  He may be in too much of a hurry to judge the success of treatment simply because he is overlooking how much his treatment is already helping his patients.

 

When I was a student we had a rule of thumb which stated that it takes one month of treatment for each year that a condition has persisted.  For most patients their imbalance has lasted for many years, and a practitioner must therefore assume that things will not improve quickly (although they may!).  Often it is the practitioner who is in more of a hurry to get things moving than patients are.   

 

 

  

Sunday, June 13, 2021

74. What recording my videos has taught me about myself

My preferred way of teaching is not to draft what I want to say in advance, as many people feel they need to do, but to gain inspiration from those listening to me.  I may have a topic in mind, perhaps a title for my talk, just as the title for this blog is prompting what I want to write about here, but I rarely have any idea what words are going to come from my pen (if I am writing something) or from my mouth (if I am lecturing or recording myself on video). In fact, past experience has taught me not to attempt to fit my teaching into what is, for me, the straitjacket of a prepared text.  I've tried to do this in the past, feeling that I should rein in my very impromptu lecturing style, but with no success.  Quite the opposite.  I was asked by my translator tin China to give her an outline of what I intended to say to help her prepare.  And at times I have tried to do this, only to realise how far I was diverging from what I had intended to say in order to elucidate some additional point I felt needed saying.  This acted as an inhibiting factor on me from the start, confusing my thoughts and almost bringing me to a halt.   

I always like to relate people's behaviour, here my way of teaching, back to a person's element, and I have therefore thought a great deal over the years about where this, to some people, rather odd way of delivering my lectures comes from.  I now recognize this as being an understandable product of my Fire element, and specifically, of my Inner Fire official, my Small Intestine.  It will be useful here to summarize the Small Intestine's task as part of the family of the 12 officials, for this does much to explain the way I like to teach.

The Small Intestine is known as the sorter, the official in charge of sorting the pure from the impure, and disposing of the impure through the Large Intestine, as its physical counterpart does in our body.  It is the closest official to the Heart, being the yang official tied for all eternity to the yin of the Heart, and this close relationship gives it its most important function, that of ensuring that it gets things right for the Heart.  It is there to help this Emperor of the kingdom of body, mind and soul rule with justice and fairness.  If the Small Intestine is weak and gets things wrong, it will allow impurities through which will pollute the Heart.  The need to sort things out therefore influences all that I do, including what I say and write, and how I do both.  I have to be sure that what I say at every point represents the truth of what I wish to convey.  

 

Whilst I am talking, therefore, I am at the same time checking to see that the words I am using accurately reflect what I wish to say.  If I am lecturing to a group of people, I also watch my audience carefully all the time to check whether they follow what I am saying or are puzzled by it. If they are, I then adjust what I intended to say to take account of my audience's reaction.  From the listener's viewpoint I may then appear to qualify one statement I make with other statements which I think will add to what I am saying until I am happy that I have covered all I want to talk about.  Hence my poor Chinese translators' bewilderment, as they try to follow some unexpected detours before arriving back at where they expected to be.

 

I have observed how other people approach their teaching, none more so than my fellow acupuncturist, Guy Caplan, who accompanies me to China.  He, I clearly see, prepares his talks very carefully, sticks to what he has planned in advance to say, and certainly doesn't confuse his Chinese translators, as I tend to do.  But then this is his Metal element working within him to determine his actions, so different from my Fire element, with its Small Intestine working so busily to get things right.

Sunday, June 6, 2021

73. Continuing teaching during lockdown

Being unable to give any person-to-person seminars during this year of COVID has meant that I have had to come up with other ideas for continuing to help my many hundreds of Chinese five element practitioners and students from a distance.  Like many of us, I have been driven to think of ways of using social media to do this, and it was while watching one of the many online programmes which helped me while away some of the lockdown time that I realised that here was another excellent way of passing on my knowledge.  So for many months now, but only after many hours of tuition from a media-savvy son, I would sit down each day in front of my iPad and record myself for up to 10 minutes talking about whatever five element topic came into my mind as being of interest to my students.  

 

These recordings started off without much of a plan, but I soon realised that they had developed into an excellent accompaniment to my Handbook of Five Element Practice, the text which all Chinese five element students base their studies upon.  I was very pleased to hear recently that over 50,000 copies have been sold worldwide over the past 10 years, making it the most successful book on acupuncture my Chinese publisher has sold.  I thought it that was very likely, therefore, that there would be many aspiring five element practitioners who would welcome the kind of personal teaching my video recordings offer in my absence.  I arranged these video recordings around the different topics covered in the Handbook so that the complete set of more than 30 videos adds something to the text.  I sent each video over to China as I recorded it; they were then edited, Mandarin subtitles added and put online to be downloaded on subscription.  These subscriptions have proved very popular, with more than 1500 people so far enrolled.  And Guy Caplan has now added a further series of videos on ways of helping students with their CSOE (colour, sound, odour and emotion) sensory skills.

 

After completing the Handbook videos, I moved on to recording a more advanced set for practising five element acupuncturists, and followed that with a kind of online autobiography, describing my journey from my first encounter with five element acupuncture as a patient more than 30 years ago to my arrival in China.  Finally I am also now working with Guy Caplan on a series of videos about treating long-term patients, which will list the kinds of treatment we give patients who have been coming to us for many years.  

 

Novice practitioners often find the move from the well-defined early stages of treatment to the more spaced-out treatments at later stages difficult to deal with.  For these long-standing patients there is no longer any need to worry ourselves about finding the right element, since the fact that they are still coming to us after so many years of treatment is proof that they are doing well and just need some top-up treatment.  Practitioners, though, often feel that they have to ring the changes and each time should be searching around for different points to use.  This is not what is needed, and we list for each element the kind of simple treatments we continue to give our long-term patients, showing that, apart from interspersing basic element treatment with the occasional clearing of a block, the points we choose are often much the same year in year out, with the simple aim of reinforcing the patient's element.  

 

In fact, long-term treatment is in a way the easiest treatment of all.  By this time, we know all about our patients' lives, and have developed very easy, warm relationships with them.  Patients' eagerness to continue coming for treatment year after year is satisfying proof of how effective five element treatment can be.  This can provide a welcome relief from the much more complex work involved in attempting to manoeuvre a path through the undergrowth of the different elements until we find our way to the right element at the start of a patient's treatment.  So we have asked long-standing patients of each element if they are happy for us to record them talking about themselves, and tell us how their treatment has helped them in the past and is continuing to help them now.  We also list the one or two years' treatments they have recently received as further encouragement for our fellow practitioners. 

 

 

Friday, May 7, 2021

72. Another lesson about the Earth element

It still surprises me how much I learn each time I'm with another person, particularly if I am paying the kind of concentrated attention I reserve for looking at patients. Yesterday I observed something new about the way the Earth element impacts upon me.  As I watched a video of a Chinese acupuncturist's interaction with one of his patients, I learnt something about this element that I had not seen before.  The description that came to mind was that the patient made me feel surprisingly comfortable.  He was sitting back at ease in his chair with his hands loosely clasped together on his lap, and I could sense myself relaxing in response to him.  There was little of the usual feeling I have come to associate with the presence of Earth, that of something being demanded of me, a need for understanding which may have become the stereotype of my response to this element.  This patient did not make me feel that he was pulling at me in any way, and I decided that he was an example of balanced Earth, with little of the neediness I had come to associate with this element.

 

I then asked myself how I would be feeling if the patient was one of the other four elements, and I therefore looked at each in turn, starting with Wood.  I asked myself how I would feel if I was facing one of my Wood patients, and was immediately aware that I would have reacted differently, by sitting up a little straighter and leaning forward towards the patient as if to counter a slight obstacle.  This tends to be my reaction to Wood since it always has a slightly challenging effect upon me, as its strong yang energy meets my own Small Intestine's yang energy.  If the patient were Fire, this would also have had a different effect upon me, as our two Fire energies, both in some ways trying to enter into some kind of a relationship with each other, being such a familiar feeling for me, would have left me even more relaxed.

 

This is quite unlike the effect a Metal patient would have upon me, for Metal, far from wanting to enter a relationship with those it encounters, wants space between it and other people, more than either Wood, Earth or Fire do.  Like all elements, though, it makes its own demands, and when I am with Metal patients I feel that I must work out carefully how to respond in an appropriate manner to what they want of me, otherwise they will withdraw into their shell.  Finally, then, I am left with wondering how I would react if this patient were Water.  I think I would feel slightly apprehensive, this being a reflection of Water's own fear conveying itself almost unconsciously to me, and making me uneasy.  There was no such uneasiness within me as I watched this Earth patient.  

 

It is by studying carefully the subtle differences in my responses to the different elements in this way that I have learnt to improve my diagnostic skills over the years.  So I have now added this slice of fresh learning to the drawer in my filing cabinet of element examples labelled Earth.

  

Wednesday, April 21, 2021

71. Greater tolerance: one of the gifts of five element acupuncture

Very early on in my study of the elements I realised that I was becoming a much more tolerant person, simply because what I was learning about the elements made me understand, probably for the first time, that there were good reasons why people differed, from one another, and that I should no longer be surprised at these differences.   It was through learning about the different qualities of the elements that this was spelt out so clearly to me. If, as I learned on the first day of my acupuncture course, and believed so utterly from then on, each of us was imprinted with the mark of one of the five elements, then the particular qualities of that element gave all of us something which I like to call our elemental DNA.

 

We are often reluctant to acknowledge such innate differences, perhaps because it is easier simply to be critical of aspects in other people with which we are not familiar than it is to welcome them as signs of the richness of what we contribute to the human experience.  Even now, after all these years of acquainting myself more closely with the different expressions of the elements, I can still find myself dismissing some opinion contrary to mine as proof of a person's narrow-mindedness or even stupidity, rather than bting a legitimately held view based on another element's approach to life which inevitably differs from mine. 

 

We are conditioned to see life in all its complexities through the lens of our particular element.  However carefully we may try as five element acupuncturists to discount the distortions to our thinking this inevitably results in, we cannot totally eradicate this tendency.  I cannot stop my own Fire element colouring my interactions with the different elements in the people I meet, and even, though to a slightly lesser extent, in those of my own element.  For in the presence of another Fire person I feel myself relax a little, even if that person is a patient of mine, and this very relaxation may mean that I am not as observant as I should be in all my interactions with my Fire patients.

 

Understanding how each element shapes all that we do, from the way that we talk, the way that we make judgements, the way that we relate to other people, and even perhaps even to the kind of political party we may tend to belong to, certainly leads all of those with some knowledge of the elements to explore why other people act as they do, and try to find the reasons for this within the circle of the elements.

 

This is why JR Worsley always said that everybody who wanted to study five element acupuncture should be allowed to do so, irrespective of their academic qualifications. Nor did those wanting to study need to have as their aim the desire to practise.  It was simply enough to wish to learn more about a fascinating philosophy of life.  Initially this was my own reason for enrolling in JR Worsley's acupuncture college.  It was only after my first year of study that I realised that I was totally hooked, and began to overcome the doubts I had about my suitability to become a practitioner.  Gradually these gave way to a deep conviction that here at last I had found my true calling, a conviction which only became stronger as the years passed.

 

Five element acupuncture's ability to help each of us cope better with other people is probably the greatest gift this form of healing offers an increasingly intolerant world which often appears to be tearing itself apart.  So I urge everybody to learn as much as they can about this ancient form of healing, which is so well-suited to the needs of a modern world, for in doing so we help smooth our relationships to all around us.  And that is such a worthy aim. 

Saturday, April 17, 2021

70. Updating the procedures for clearing Possession and Aggressive Energy

When teaching students I have always had to draw an imagery line between what I have learnt to do in my practice as an experienced five element practitioner and what it is advisable to tell students to do.  I am sure that many of my fellow five element acupuncturists have over the years also developed their own approaches to their practice.   


I had to consider this when writing my Handbook of Five Element Practice, which is intended for budding five element acupuncturists, and now, in its latest edition, has the addition of a Teach Yourself Manual for all those who are not able to join a college course or train with a five element acupuncturist.  In the original edition, published first more than 15 years ago, I rather blindly copied what I had been taught in my original training at JR Worsley’s Leamington College.  It was only when my own students started pointing out to me some years later that what I was teaching them in class differed in some respects from what I had written that I realised how far in my own practice I must have adapted what I had been taught without realising it.

 

This has been brought home to me very strongly recently by questions from practitioners on two different and important aspects of five element practice, both relating to clinical procedures.  The first is about the procedure for clearing possession and the second about that for an AE drain.  Both questions have made me think carefully about why I have adapted what I was taught in the way I have, and whether it is appropriate to incorporate these changes into any future teaching that I do.  Alternatively I ask myself whether there will always be some discrepancy of this kind between what an experienced practitioner does compared with what it is advisable for novice practitioners to do.

 

First, to the procedure for clearing possession.  I have been troubled for some time by the fact that in all the years during which I saw JR Worsley with patients, and he diagnosed many cases of possession, not once did he suggest that we should start treatment with EDs (External Dragons), nor, on the only occasion when he thought IDs (Internal Dragons) had not been successful, did he immediately suggest that I should move on to EDs.  And yet in his Points Book not only are the points for EDs listed, but also two sets of points for IDs, making a total of three sets of possible points.  This has always puzzled me, but I sadly never took the opportunity of my many hours following JR to ask him when we should be thinking of using EDs, nor how we should choose between the two sets of ID points.  We were told to use one set of the ID points listed, those for patients “with depression”.   Like so many things I now wish I had asked him, I wasted that opportunity, and will now never know why all three sets of points were listed.

 

Of course, other practitioners may have had different experiences when consulting JR, but I have had to base my thoughts on what I personally observed.  So why did we learn in class that if IDs did not clear possession, we should straightaway move on to EDs, when I never saw this happening in practice?

 

In fact, what I did learn from treating my patients with IDs diagnosed by JR was how quickly possession cleared with ID treatment.  Certainly it never took the 20 minutes’ wait that we had all been told might be necessary, and which I dutifully copied into my Handbook as part of the procedure.

 

Having over the years therefore observed how quickly possession clears if the needles are inserted correctly, I now tell students to leave them in for a much shorter time, about 5 minutes, if there is no effect, before tonifying the points strongly and removing them.  I find the strong tonification usually does the trick which the initial sedation may not have done, and there is rarely need to repeat the procedure. Even if I feel that sedation has cleared the block I still tonify the needles before removing them, as a fall-back procedure just in case possession is still there.  Better safe than sorry, I think to myself.

 

So when a practitioner recently pointed out that what I said about possession treatment in a video lesson I gave was different from what I had written in my Handbook, this gave me pause for thought, and made me realise that since my clinical experience had modified the procedure I had been taught as a student, it was sensible to reflect this change to my thinking in future editions of my Handbook, which I am now doing.

 

The second example of a change in clinical procedure which has been pointed out to me by a student concerns the procedure for an Aggressive Energy drain, and specifically the order in which the needles are inserted.  What I have written in my Handbook is based on what I learnt as a student.  We were told not to insert the needles in the AEPs (back shu points) of the Heart unless there is first erythema around the needles of the two points immediately above them, those of the AEPs of the Heart Protector.  Like the good student I was, I continued to do this until one day, after I had been in practice for quite a while, I thought I would speed the procedure up a little by inserting all six sets of needles including those in the Heart AEPs, which I did very carefully.  Since I noticed no ill-effects from this, I have continued to do this as a matter of course, making sure that I am particularly careful not to insert the needles too deeply into III (Bl) 15.  

 

To my surprise one day I found that erythema appeared around the Heart AEPs in one patient but not around those of the Heart Protector AEPs, something which seemed at odds with what we had been told.  This was that Aggressive Energy could only reach the Heart AEPs if it was passed through from the Heart Protector.  This made me all the more determined to needle all six sets of points.  I also found that it was only after the AE appeared on the Heart AEPs that erythema gradually emerged around the two Heart Protector needles, almost as though I had summoned Aggressive Energy to emerge by stimulating the Heart AEPs.

 

The discovery of Aggressive Energy on the Heart but not on the Heart Protector still puzzles me, but I have only found this to happen in very few cases in my many years of practice.  I therefore assume that these were very rare examples of something slightly inexplicable, or perhaps I did not position the needles correctly on the Heart Protector AEPs, and missed detecting the AE that was there.

 

I still feel it is a safer procedure to defer putting needles into the Heart AEPs until the Heart Protector is given time to reveal whether it has Aggressive Energy or not.  This is particularly the case for novice practitioners whose needling skills may not be sufficiently good to avoid inserting the needles too deeply.  After waiting a little while, it would then be perfectly safe to insert needles very shallowly in the Heart AEPs just to make sure you drain any Aggressive Energy which might happen to be there.

 

All medical traditions change and develop with time, as they benefit from the experiences of all the many practitioners who have passed through over the years and the centuries.  This is right and proper, otherwise practices would atrophy.  I myself observed the changes JR Worsley made to clinical protocols he developed during my years observing him.  It is therefore always good for practitioners to be prepared to incorporate changes in their practice if they wish to learn from those with greater experience.  The important thing here is that we should make such changes only if we are sure that any new protocols suggested to us are based on the experiences of those with clear clinical expertise.  


I am sure that five element acupuncture will continue to benefit from the adaptations future generations of acupuncturists may feel they should make to today’s practice.