As a consistent reader of Acupuncture Today, I noted that most of the articles in the publication are written by acupuncturists. Because I am a reader who is not an acupuncturist, I found the emphasis on the practitioners' perspective insufficient, as the acupuncturist is only half of the equation in the patient/clinician relationship. Thus, I thought it would be worthwhile for acupuncturists to hear from a patient about the experience of acupuncture. While I cannot provide information on point selection to treat various ailments, I have the ability to share what the untrained, uninitiated patient might experience when coming under a practitioner's care.
I might be characterized as a reluctant acupuncture patient. A little over a year ago, I was complaining to a friend of mine, who happens to be an acupuncturist who has practiced TCM for more than a quarter-century, about a medical condition. When I was done with my complaining, he said simply, "Acupuncture can help with that." His calm irritated me. However, I asked him to give me a referral to an acupuncturist in my local area. He did, and I made an appointment.
The only word that described how I felt before my first visit to my acupuncturist was terrified. It wasn't the needles that frightened me. I had seen an acupuncture needle and knew that something that small and thin could do me no real harm. What scared me was that I didn't know anything about acupuncture. In school, I had excelled in science. I understood the scientific method and the ideas that underpin Western medicine. The linear relationship between symptom and treatment in Western medicine was logical. But the discourse on meridians and qi made no sense to me at all. I had not been educated in Chinese philosophy and did not understand the ecological metaphors I began to read about in books on Chinese medicine. I was being asked to place my health in the hands of healer I did not know and a system I did not understand. At the time, it did not feel outrageous to think that in doing so, I just might die.
While my friend is trained in TCM, he chose a practitioner for me from the Classical Five-Element school. When I asked why he made this particular referral, my friend said that he chose this specific practitioner based on our personalities, and my temperament and medical needs. I was surprised to find that while I complained of definite physical symptoms, my acupuncturist friend believed my ailments to be primarily psychospiritual in nature and chose a practitioner for me who placed little emphasis on physical symptoms. I wasn't sure why, but this emphasis on the underlying reasons for illness, rather than a symptom-based approach to healing, soothed me.
I was fortunate that my acupuncturist had a Web site for his clinic. I spent hours online learning everything I could about Classical Five-Element acupuncture. I read at least a dozen articles that my acupuncturist had written, as well as the work of his teacher, JR Worsley. I also examined photos of the clinician. I found that he was a rather average-sized, mature man; even if he wanted to, he could not stand between me and the door if I needed to bolt. I wish I could say otherwise, but this shallow physical assessment was the most important evaluation I gave both the practitioner and his practice, prior to my first treatment.
I was so scared as I walked into the acupuncture clinic that I seriously considered throwing the money for the first session on the reception desk and running out the door. I wasn't sure I could go through with the consultation or treatment. I had been asked to wear no make-up or perfume; I felt as if my social mask had been left at home. I knew that I would be asked to tell the acupuncturist about issues I don't regularly talk about, and then to submit to a physical examination. I wasn't sure I could do any of it, but I remained in the waiting area, breathing deeply to keep my heart from jumping out of my chest.
A few minutes later, a well-dressed man with salt and pepper hair invited me into his office. He asked if I wanted water or tea, which I declined, as he pointed toward two leather chairs just inside the entrance to his treatment room.
The office was square, small, and though not fancy, orderly with a homey feel. As one entered, there were two comfortable leather chairs angled slightly toward one another with a small table between them, barely large enough for two tea mugs. Across from the chairs was a large wooden desk and chair. The desk and shelves atop it were filled with all sorts of objects: photos of the acupuncturist's children, Buddha statues, books, plants, files. It reminded me of my desk at home. Opposite the desk was an adjustable bed, made up with sheets, a pillow, and with a warm looking blanket folded neatly at the foot. The room was a comfortable temperature with a great deal of natural light shining through the windows. Again, I breathed deeply. The clinician had created a place that felt both welcoming and safe, yet also professional. I tried to relax.
I saw that the acupuncturist had placed his clipboard on the arm of the chair on the far side of the door. I quietly moved it to the near chair and took for myself the chair in the corner. I wanted to have my face, not my back to the door. The acupuncturist accepted this change of seating arrangement, closed the examination room door, settled into his chair, and began to ask me questions.
It was only a few minutes before I was asked the dreaded: "What brought you here to see me today?" I didn't care that this man had been in practice 28 years, that he'd probably seen and heard just about everything, or that he was there offering his skill to help me. All that may have been true, but what clouded my mind making me so afraid I thought I might vomit, was that I had to tell a complete stranger the truth about me. At first, I couldn't do it. I said, "Your colleague sent me." He smiled, saying it was nice to get the referral, and then asked the question again.
As I tried to form the words, he reached across the small table and took my hand. I had read enough about the Classical Five-Element system to know that he was testing my emotions to see how I responded to him so that he could diagnose my "causative factor."1,2 But in that moment, the reading and research I had done on the system meant nothing to me. There was something grounding in his touch that made it possible for me pull myself together and talk with him. The information came in fits and starts, but it came. By the time he was ready to conduct his physical examination, I was no longer afraid and submitted to both the examination and initial treatment without hesitation.
This practitioner did several things that enabled me to trust him and return for subsequent treatments.
Professional treatment room: The treatment room was both inviting and professional. It lacked the impersonal sterility of what I expected to find in a doctor's office and yet was not so homey as to be inappropriate. The temperature was comfortable, and I was offered something to drink.
A conversation among equals: By having the initial conversation take place with the chairs turned slightly toward one another with no barrier between us, the acupuncturist presented himself as my equal, as someone in the healing process with me rather than an expert doing something to me.
Talk before touch: Many times when working with a Western medical doctor, intake questions are abbreviated or done in conjunction with a physical exam. With this practitioner, I was allowed to warm to, and interact with, him before I was asked to strip down and be poked and prodded without understanding what was being evaluated.
Assessing my needs: What impressed me most in my initial consultation with my acupuncturist was that he did not focus on my symptoms, but my needs. He sensed that I was frightened and offered comfort. He knew when I was having difficulty speaking, and waited for me. His empathy and patience, more than anything, allowed me to let him help me and return for subsequent treatments.
References
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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