Learning the skills needed to detect change

One of the skills of being a five element acupuncturist is that of learning to detect the changes in our patients as a result of treatment.  When I was a novice practitioner I had to use quite crude criteria for assessing whether my treatment was helping a patient or not. The most widely used, I admit rather shamefully now, was asking my patients themselves to tell me whether things were changing for them.  Questions like, “How are you feeling now?”, or “ Has your sleep (or any other symptoms they have told us about) improved?”  I am ashamed now of asking such questions because I realise that patients often don’t know how to reply, as I didn’t when asked by one of my practitioners whether treatment was helping me.  I felt I needed to encourage her by giving some positive response which might not be true, unsure what kind of improvement I should be experiencing, and worried, too, that she might lose interest in helping me.

A patient should never be the one to judge whether their treatment is helping them.   We should Instead develop an ability to detect often the slightest physical or emotional change as a result of treatment.  It is these which I would probably not have recognized early on in my practice.  The changes are often very subtle:  our hand held more firmly during pulse-taking, or a slightly softer outline or less tension to a face. They may talk less or more, or seem no longer to be so preoccupied with some symptom or another.  Any change, however slight, is significant confirmation that the patient’s elements are welcoming the direction of the treatment they are receiving.   

 

The flipside to this is, of course, our growing awareness when treatment is having no effect at all.  This is again a skill we need to develop.   As the years pass I have become more quickly aware that nothing has changed, acting as a warning sign that I may need to change the emphasis of my treatment to another element.  It requires some courage to admit to ourselves that we are on the wrong track, sometimes even wrongly blaming the patient for not responding to treatment as we think they should.  But if somebody comes back week after week with no evident change in themselves or their condition, we must be prepared to query our diagnosis, and be brave enough to pause and take stock.

 

I have learnt to do this by telling the patient that I am not yet satisfied with the effect of treatment, and asking them how they feel.  This is often the point where a patient will admit, with relief, that they, too, do not feel the treatment has yet helped them.  I then ask them to allow me some more time, sometimes even by coming more frequently, so that I can re-assess the treatment.  None of my patients has ever refused to do this.  Very often this honesty between us helps put our relationship on a better footing, which in turn gives me the time to work towards finding the correct guardian element: a win-win situation for us both.