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 different, elemental DNA of our patients, there is clearly 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.