A new insight into the relationship of Fire to Metal

 I love it when I get a sudden new insight into an element, or, as happened recently, into the relationship of two elements to each other.  I use myself as the source of many of these revelations, and have always done so.  I’m not sure how far other practitioners look to themselves in quite so studied a manner as I do.  It may, after all, be one of the characteristics of Inner Fire that, in trying to sort out its encounters with the world, it is constantly querying its own reactions to what is going on around it, as I always do.  It may well be that other elements are not so intent on looking inwards to discover an explanation for their relationships to other elements. I just know that everything I am aware of has to be filtered carefully through my own interpretations of the significance of what I am experiencing.

One of these acts of filtration occurred whilst I was planning future work with our Chinese students.  Much of my current teaching in China is now done with my good friend and former student, Guy Caplan.  Together we have developed many quite innovative ways of helping our Chinese students learn as much as they can in an environment where they only have few opportunities to learn in person from experienced five element acupuncturists, as Guy and I had the fortune to do over many years.  To help our students overcome this handicap we have developed many creative approaches.  What has, of course, also contributed to our success in doing this is the fact that much of the groundwork has already been laid for us because of what each Chinese student absorbs from birth as part of their cultural inheritance. 

 

Their understanding of the elements, for example, is so ingrained in them that I have no need to go through the often laborious procedures with which I try, sometimes unsuccessfully, to help English students to an understanding, not only of the existence of the elements as a philosophical concept, but of their practical and visible presence in each one of us.  Often I have been asked, “But are you sure that there are qualities called elements which we can feel, see, smell or hear?”  Some of my English students could not make the initial leap of faith necessary to allow them to accept the existence of the elements.  I myself never needed to convince myself of the truth of what I was learning because the startling effects of my first acupuncture treatment had confirmed to me that five element acupuncture did indeed base itself on a truth about human nature.   

 

In China, the elements are symbolic qualities which define all life and determine human behaviour as much as they dictate the cycling of the year from season to season.  Chinese students are therefore already well on the way to an understanding of the basic principles of five element acupuncture.  This is a blessing when we consider that all we can offer them are the few weeks of our twice-yearly seminars.  It is therefore very encouraging that in the 12 or more years of these visits, they have developed so rapidly in their understanding of five element practice that a large group of them is now running their own introductory seminars all around China in preparation for our visits.  

 

They will therefore be pleased to discover that I have made a further step in my understanding of the two elements which Guy and I represent.  I always like to make us living examples of our elements so that they can, if they are attentive enough, gain a deep personal insight into those we display so clearly in front of them as we teach.  These are the Metal element, which is Guy’s, and the Fire element, which is mine, and specifically both the yang officials of these elements, Guy’s the Large Intestine and mine the Small Intestine, the yang of Inner Fire.

 

I think it is no coincidence that these two officials are so tightly linked together by name, which represents not only their close physical relationship in the human body, but their much deeper emotional relationship. When I realised this, which I did only recently, it made me smile, because it helped explain why the two of us have worked together so closely and so harmoniously over many years.  The physical link, where the Small Intestine joins the Large Intestine, is reflected in the deeper mental and emotional associations.  So I set myself to work out exactly what this close relationship told me about the nature of both elements, and particularly of their yang officials, and how they interact with one another.  Here then is what I consider to be one of my most significant findings.  

 

We are both extremely sensitive to those aspects of our relationship which our close association over the years has taught us might well be areas of tension or disagreement between us.  I can only look at those which I have personally had to deal with, leaving it to Guy to explain his side of things if he chooses to do so at some point.  I know what he finds disconcerting is my, to him, disturbing habit of suddenly confronting him with having to deal with what is often a series of new ideas which I have come up with in the most fertile time of my day, which is the early morning.  It is then that all sorts of new ideas crowd my mind, and I am eager to discuss them with him when we next meet.  Guy, on the other hand, quite understandably needs time to absorb these new ideas, whereas I have learnt that my mind is quite able to dart from idea to idea quite easily.  Having seen the strain this puts on our relationship, by observing the somewhat startled look on his face as I launch into what I want to tell him, I have learnt to interpret this as a sign that I must hold back and give him time  to absorb each new project of mine at his own speed and definitely one at a time.

 

I see Guy’s reaction as an expression of his Metal element, and specifically his Large Intestine, which is the Metal official in control of expelling what it feels it needs to discard.  It needs longer than I do to assess new ideas to give it time to decide which it thinks should be kept and which should be rejected.  I used to want him to match my multi-dimensional thought processes, whereas what he needs is the time to work out his response to my ideas one at a time.  This has made me see that one of the Metal element’s qualities is that it needs to work on what is there, on what it is presented with, rather than what it itself initiates.  In our relationship, it is I who tend to initiate, and Guy who tends to work upon the ideas I present him with  In our work together over the years, I now recognise that it has been my task to initiate new approaches to teaching five element acupuncture, and it has been Guy’s to work upon what I have initiated, by modifying it or also quite firmly setting aside what he does not consider to be useful.  By contrast, I am much more concerned with formulating new ideas, but often forget to work out the implications and ramification of what I have formulated.  It is precisely at that point that Guy comes into his own, often with his Metal sword cutting my suggestions down to size or completely rejecting them. 

 

I also need to remind myself of the place in the cycle of elements taken up by Metal and Fire, because this reflects the focus of their activities, and helps add to my explanation of how well Guy and I work together. Although the elements create a never-ending cycle, without an actual starting- or end-point, we like to think of it as beginning with Wood, as a reflection of spring in the cycle of the seasons in nature, followed by Fire, Earth, Metal and Water.  There is a logic to this, because in nature the buds which Wood displays start the cycle of activity ending in autumn.  Each element in this cycle represents a particular aspect of every activity, just as much of a thought as of a season.  My Fire builds on Wood’s energy as it emerges from Water’s slumbering seeds bringing the cycle to full blossom, as nature shows in the blaze of a summer’s day, before passing this on to Earth to bring to full fruition.  Earth than hands over to Metal to draw meaning and value from all this activity, as autumn draws nature down towards the yin of the year.  I see Guy’s and my relationship in similar terms.

 

 

 

Helpful hints for the novice five element acupuncturist: 4 A five element practitioner must be sure of their own element

One of the most important demands placed upon five element acupuncturists is the need for us to be as certain as possible of our own element.  This is because this element colours the whole world as we see it.  I have often said that it is as though we each see life wearing the particular spectacles of this one element.  We only really become aware of this when we try to help patients of elements which differ from our own, and realise that they see the world through the lenses coloured by these other elements. 

Each of us as practitioners must therefore constantly recognize how far our own element determines how we view the people we come into contact with, and that includes, of course, our patients.  My element being Fire means that I see the world through Fire's spectacles, and I have had to learn to put these to one side, as I put on those of the other elements.  Although we all do this to some extent when we interact with those around us, it is only when we are alone in the practice room with one patient after another, each often of different elements from our own, that this need to adapt ourselves to the demands of the other elements comes into such clear focus.

 

To help ourselves deal with this, we have first to recognize our element's particular qualities as expressed within ourselves so that we can respond appropriately to the differing needs of patients of other elements.  Since we are all likely to err on the side of emphasizing our good qualities and playing down those that are less flattering, that requires a great deal of critical self-knowledge and introspection.

 

Helpful hints for the novice five element acupuncturist: 2 Curiosity

One of the most essential qualities a five element acupuncturist should aim to develop is the gift of curiosity.  If we want to help other people, we have to be curious about what is going on inside them and what makes them tick.  This also means that we have to be just as interested in what goes on inside us, too, so that we are able to relate their experiences to our own.  With every therapy there is a risk that the therapist will, often quite unconsciously, stand apart from their patient, viewing them as though through a glass screen.  This can create a kind of "them and us" divide which ignores one of the simplest, most profound truths underlying all human interactions.  It is that we all, therapists and patients alike, form part of a common humanity,

 We must therefore use what we have learnt about ourselves to help us understand our patients.  We, too, are formed of the interaction of the five elements, amongst which we have one dominant element which imprints us with its signature.  We, too, show, in balance, this dominant element's strengths, and in times of imbalance, its weaknesses.  But being therapists, whose task is to help patients representing all the elements, we have to learn to adapt ourselves to the needs of elements apart from our own, and that requires much insight.  We must learn to accept that everything our patients may be experiencing is to some extent also something that is familiar to us from our own life experiences.

 

Helpful hints for the novice five element practitioner: 1 Learning to be alone with a patient

There is nothing more daunting than to find ourselves alone in the practice room with our first patient, just the two of us.  There are no reference books we can take with us into the room to remind us of what we need to do; all we have is ourselves and the experience we have gained during our training.  Nor, unlike Western-trained doctors, do we have any physical information to help us make a preliminary diagnosis, such as blood or other clinical tests.  We just have ourselves, and our senses of seeing, hearing, smelling and, above all, feeling to guide us.

 What novice practitioners often forget, however, is that we should not think that it is diagnosing the element which is the main purpose of our initial interactions with our patients.  Instead, we should first concentrate on establishing a warm and caring relationship with them.  The more at ease a patient feels, the more comfortable they will be in telling us what is really going on in their lives, and this in turn will allow their guardian element to reveal itself more clearly.  And the more relaxed we feel with our patient, the more we give ourselves time to explore the feelings our patient evokes in us, and the sensory impressions we are receiving from them.  All this will gradually point us in the direction of the right element.

 

I would therefore advise each novice five element practitioner to worry less about trying to diagnose the patient's element, and concentrate instead on making sure that their approach is making their patients feel safe and at ease.  It is by doing this that their element will also reveal itself more clearly.   

Publication of our second Net of Knowledge course

On Being a Five Element Acupuncturist

I am happy to announce that our second Net of Knowledge course, On Being a Five Element Acupuncturist, has now been published. This adds to our first course:  The Handbook of Five Element Acupuncture. 

Here is the link to this new course:

On Being a Five Element Acupuncturist

https://netofknowledge.com/Link/Course/c1999439-4b1d-4138-b9a9-5a0598749cfc  

 

And here is a brief 90 second promotional video for it: 

‘https://youtu.be/xhc2iyekXpY’

It is available through Acupuncture World in Europe, CPD Cert in the UK and Ireland, China Books in Australia and NZ, Lhasa OMS in the U.S. and Eastern Currents in Canada.

 

Both courses are also available through the following link:   

https://netofknowledge.com/Discover?search=Nora+Franglen

 

 

 

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!

  

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.

 

 

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.