As modern medical standardization continues, the field of traditional Chinese medicine has the advantage of comprehensive personalization. For rare or complex cases, deeper consideration of constitution is invaluable. Proper constitutional assessment, especially with first-time clients, can guide desirable and predictable outcomes. This leads to a higher rate of return, and greater trust between you and your patient.
Teaching Through Translation
For our book, my colleague, Debra Duncan Persinger, PhD, and I interviewed Maryanne Travaglione, LAc, who teaches at Touro College of New York and runs offsite clinics at New York's multilingual Lutheran Medical Center in Brooklyn. Because Maryanne speaks Italian, she was the only person who could help explain the hostile behavior of an Italian patient who refused all physical therapy following knee replacement surgery. Maryanne discovered the patient was embarrassed because she hadn't showered for two days. Once those problems were sorted out, the patient was more than happy to accept physical therapy. Similarly, Maryanne described working with a British patient who preferred the phrase glowing in the dark to night sweating, as she associated sweating with horses and laborers.
In my own clinics, I ask students who know other languages and cultures to behave in that persona as though they know no English, and then convey their problems via other languages and gestures. It's hilarious and we all learn a lot. We also learn to break assumptions and stereotypes, all of which is essential when we teach in different countries. The following is a conversation I had with Debra on the topic of teaching in foreign countries and cultures.
DDP: What's your initial advice for teachers invited to give workshops in Europe?
PEF: Before teaching in a foreign city for the first time, do some prior research. Walk the streets or visit an art museum before you teach, so you can weave some local references into your workshop. This seems obvious, but too often, I have heard workshop participants complain about the discourtesy of visiting teachers who just drop in and fly out. Also, exchange e-mails with new translators in advance. They will be your voice, not an appendage! Some impatient and arrogant instructors have been known to reduce translators to tears.
Send your translator copies of your articles or samples of your work in advance so they can tune into your speech rhythms and terminology. I always spend time with a new translator before the workshop so we can exchange thoughts. Fortunately, I have worked with most of my translators (all shiatsu graduates) for years, and relish our team spirit. Translators can also be a great local resource, tuning you into subtle shades of taboos and ironies in different languages, dialects and customs.
Also, where it is relevant to the language, ensure your translator uses both feminine and masculine endings for frequently used terms in our teaching, like patient, student, doctor, etc. These are all genderless in English, but require different endings in other languages.
DDP: What other tips do you give teachers preparing for a foreign class?
PEF: When you are meeting new participants, spend a little time learning names, backgrounds and specializations. Tuning into a group dynamic from the start immediately enhances qi and interaction, and makes it easier for a new teacher.
I also open each class with vigorous paired and solo stretching, which requires no translating. Not only does this energize everybody, but also sets a crackling pace and makes it easier for latecomers to weave in. Classes in Germany, the Netherlands, Austria and Switzerland start punctually, as most participants arrive early to change their clothes or they are meticulous about sending word in advance if they may be delayed because of train schedules. Many participants travel long distances. However, if you teach in Ireland, be prepared for folks to drift in late and spend time socializing before they settle down.
Many of my colleagues in Europe open their classes with meditation. I don't. For a new class, I find it far more effective to plan vigorous exercises before quiet qi exercises to enhance focus.
DDP: Do you always use translators in Europe?
PEF: Always, except for Amsterdam, where participants all speak excellent English. I have worked with advanced groups for more than two decades in Europe, and have been translated into seven different languages including Romansch (one of Switzerland's four official languages), and Lithuanian. I know enough German and French to pick up on a mistranslation or misunderstanding. (like the time during a class on menopause when my translator misheard "dry vagina" as "drive to China," believing I had used an idiom!) Certainly there is an art in tuning into a group dynamic, facial expressions and reactions, to sense the moment a term or word has been mistranslated. A group discussion around a mistranslation, especially when this involves humor, can become an invaluable teaching moment. I've had compass (kompass) mistranslated as compost (kompost), and ki (qi) energy mistranslated as schlussel (key).
American teachers often need to be reminded that most of their translators in Europe learned British English, so it is vital to avoid slang or colloquialisms. I remember attending a workshop taught in Zurich by a boisterous therapist from New York, when I had to chip in quickly to explain WASP (slang for White Anglo-Saxon Protestant) after the translator used the German word for a buzzing wespe, much to the bewilderment of everyone trying to figure out how a wasp suddenly had flown into an epidemiological report.
Similarly, I made a silly mistake recently in Berlin by describing a meridian a very thin patient or child as being fine as "angel hair pasta." I noticed the puzzled expressions when this was transliterated as engelhaare (sparkly little silver strands spread over Christmas trees in Germany.) The correct local term for angel hair pasta is spaghettini.
DDP: Tell us more about the art of working with translators.
PEF: Teach in short, complete, sentences. Maintain a momentum and avoid running off onto tangents. Nothing is more boring than a teacher who drones on in longwinded sentences that the translator finds hard to summarize or that need explaining. Participants lose the thread.
Pace is vital. This is especially important when you are being translated into German because a short sentence in English often requires double the time and length in German. Bilingual participants really appreciate a methodical pace because the translation quickly reinforces everything they hear in their own language.
In short, rethink the way you teach before jumping cold into a classroom in a foreign country: Break your lesson plan into short segments. Don't make the mistake of assuming the translation will be simultaneous like the United Nations. This doesn't happen in a didactic and practical class dynamic in our field. Condense theory, and maximize practical work, demonstrations and the use of your own body language, mime and gestures that require no translating. Participants get very restless when you teach hours of theory without exercises and a lot of space for practical work. Make sure you remind everyone to pause so the translator can clue you in when a sudden heated discussion breaks out.
Perfect the art of demonstrating techniques in clear step-by-step segments so participants can see everything that is being described verbally. Remember to demo each segment twice, so the translator's words match what you are showing. Many teachers make the common mistake of moving on to technique # 2 while the translator is still translating technique #1. Ask participants to hold all questions until the end of a sequence to avoid a break in continuity.
DDP: How does humor translate as a teaching tool?
PEF: Avoid insider jokes or puns. Avoid stories that may be OK in English, but culturally offensive in another language. Don't be afraid of being very visual or using props or Five-Element-related colored dots or happy faces to teach acupoints. Play the comedian from time to time. This is easy for a foreigner - it gets a lesson across in a snap, helps breaks the ice and re-energizes qi, especially at the end of a long workshop.
I always create catchy names for some of my techniques and enjoy seeing how descriptions shift from country to country. As we mainly work on mats on the floor, I sometimes grab a receiver's ankles in the supine position, raise his/her legs perpendicular to the floor and swivel her/his legs in wide circles to stimulate poor circulation and harmonize left/right imbalances. Here in the U.S., my students dubbed it stirring the mashed potato. In Zurich, it became stirring the fondue. In Vienna and Berlin, they preferred stirring the chocolate mousse.
Similarly I use terms like garlic press that work well in all languages to activate a meridian when I move a receiver's ankle toward and away from their thigh. I've developed other terms like water pump and salt shaker to explain activating techniques for Bladder and Kidney meridians (Water Element). Fun names prompt memory.
DDP: Do you incorporate role-playing?
PEF: Absolutely! When a participant has a question about a patient in their clinical or hospital practice, I ask them to get up and mime the patient's posture, walk, body language or specific physical challenge, so we can stimulate a group discussion. This is invaluable in any class, as it helps the therapist feel and experience the patient's actual challenge or distortion. It's doubly valuable in a foreign class because it adds theatre to the translation.
Because most of my participants in Europe are physical or occupational therapists, RNs and some MDs who are all certified shiatsu therapists and/or acupuncturists, we delve deeply into newly creative treatment procedures for complex neurological challenges and post-accident rehab. I also twist and turn my own body in an exaggerated way to demo the effect of some meridian or postural distortion and a correcting technique. Participants find this refreshingly liberating especially in countries where they are accustomed to more formal teaching styles.
DDP: What other differences have you noted?
PEF: Participants in Europe tend generally to be more meticulous note-takers than most Americans, and spike their notes with endless stick figures in different postures and techniques. Not one single participant where I teach in the Netherlands, Germany, Austria or Switzerland has ever asked for handouts or videos. Generally they are not as spoon-fed as many Americans and do not expect workshop notes to be handed to them in convenient bite-sized sentences.
But I have discovered that my American and Canadian participants tend to learn faster with their eyes and by watching, perhaps because of the long influence of TV. I tell participants in Europe to put their notebooks down sometimes and just watch my demo. In America, it's the other way around; I always find myself saying, "Don't you guys need to take notes?"