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.
Importance of Intention and Alchemy of Cultivation
As healers we devote our lives to helping others. We help ease pain, fortify function and support the ability to overcome life challenges. We "partner" with our patients to face the inevitable suffering that accompanies the trials of life.
There are many types of healers and healing modalities. As acupuncturists and herbalists, we've chosen Chinese medicine as our "way." It is the language we use to describe human physiology and pathology; it also presents a story about the path of the soul, the movement of the mind-emotions and the evolution of the human species.
The Power of Intention
The most important element a healer brings to his/her craft is presence, followed by intention. For some, intention is the prayer said to invoke change, ideally for the patient's greatest good. For others, intention is a strategy carried out through specific techniques. They can be techniques we've learned from someone else or something we intuitively create. Our technique is a type of ritual practice – the practical application of our intention.
Essentially, all technique is an attempt to focus and strengthen intention. Every healing modality describes intention differently. Put a group of healers in a room with a patient and each will describe their intention slightly differently. Some may say they are trying to expel a virus; others may say they are trying to get the lung to "diffuse its qi." Others may say they are trying to exorcise a ghost or "parasite." Another may be trying to call in spirit-helpers or "harmonize" the person with their environment.
All these intentions (or strategies) exist within the vast expanse of Chinese medicine. Some acupuncturists and herbalists come from a scholarly-medical background; others from apprenticeship, carrying a family lineage. Others are shamanistic in their approach, focusing on the "spirit" or forces of nature. Still others practice the Chinese medical arts using Western medical wisdom as their basis.
The Nei Jing is the basis of all Chinese medicine. It is composed of two texts. Within the first text, Su Wen, we are given the core theoretical tenants of Chinese medicine: description of physiology and pathology. The second text, Ling Shu, gives us healing techniques and tools via acupuncture. Ling Shu also describes the "Jing Luo" (channels and collaterals) – roadways by which our qi and blood circulate.
Throughout history, many more books have been written debating and commenting on information presented in the Nei Jing. Some, like Shang Han Lun, describe disease, while others, like the Jia Yu Jing, detail treatment and technique.
When a patient comes to us, they are asking for something – some sort of help or support. Presence is the most important aspect of ourselves we bring to any patient or healing experience. Presence is the ability to see and hear the patient. We sit with them in their suffering, confusion and pain. We work with them to discern what is wrong, and empower them to find the will to correct the problem.
Some say presence in itself is enough. Others believe we also need intention and technique to channel and direct the healing. For many of us, study is essential. We gather knowledge of the body and its elements: the organs, the channels, tissues, aspects of the spirit and soul, mind and emotions. We become acquainted with the terrain in which we are working; we develop a relationship with it. Then we develop proficiency with techniques to work with this terrain.
Cultivating the Art
One of the major comments Chinese medical practitioners make about the Nei Jing is its lack of concrete treatment techniques and protocols. As modern Americans hear more about the subtler aspects of the body's terrain, such as the collaterals – Sinew Channels, Luo Vessels, Divergent Channels and Eight Extraordinary Vessels – there is greater desire to know how to work with them.
All of us must create an individual relationship with the terrain of the body and the physiological processes that occur within them. Our individual rituals of healing become our unique gift to the world. We must make them our own.
Some say the most cultivated healers don't need to do anything more than simply be themselves; it is their mere presence that heals those around them. As we are learning to heal though our presence, however, we must cultivate – expand our hearts, open our minds and generate wisdom: learn to channel and direct our healing intention through all of our actions and gestures. We cultivate through practice. Our practice occurs through study, use of manual technique, implementation of strategies, and the continued attempt to focus and direct intention. Cultivation occurs in our clinic rooms, as well as in our family and social lives.
As human beings, we are intricately connected to the environment around us: social and natural. We absorb nourishment from the Earth and inspiration from the air. We observe the people around us; their behavior and attitudes allow us to reflect upon our own. This is the basic physiology of the "heart-kidney" relationship in our bodies.
Learning From the Masters
As healers, we can benefit from the wisdom of those who've been in the field for many years. This is why we study classical texts. We are joining a tradition. Within this tradition, we are invited to learn from great clinicians who've devoted their lives to understanding the human body, many of whom have left behind their knowledge in written form.
It is also beneficial to learn practical techniques from masters in the field. There are many styles we can learn. In my experience, a combo of the complex and simple makes for a rich cultivation experience. It is both instructive and inspiring to read books by contemporary Chinese medical scholars and practitioners, especially those who write about cultivation and healing technique.
Mariam Lee was a much-beloved acupuncturist who, in Insights of a Senior Acupuncturist, writes about the need for simplicity and clear intentionality within the treatment room. She speaks of her practice, in which she used five favorite acupuncture points to treat everyone she saw – with great results.
In my training, I was taught that it's important to understand and utilize all the points on the Primary Channels, as well as all six channel systems to fully appreciate the power of acupuncture as a complete system of medicine. However I've been treated by practitioners whose practice consists of using only a few favorite points within one channel system, and who achieve miraculous clinical results.
Such differing views and practices are what make Chinese medicine so rich and textured. I recall Jeffrey Yuen, from class to class, saying completely different (often contradictory) things depending on which classical school of thought he was teaching at the time. Each tradition believes something different. The power of the tradition comes from its ability to make its theories work in clinical practice.
I've developed great respect for the individual traditions (schools) of Chinese medical thought. As practitioners, each of us will resonate with some traditions and not with others. Just as some strategies will work on some of our patients and not on others. It's helpful to recognize that some clinicians benefit from continually learning more and more; while others do best knowing little, yet knowing it very deeply.
For those of us who feel we benefit the more we learn, understanding the complete channel systems of acupuncture can be marvelously illuminating and quite exciting. Ann Cecil-Sterman recently published a textbook called Advanced Acupuncture, detailing treatment protocols for the Secondary Vessels of Acupuncture. The book is based on years of study with master teacher Jeffrey Yuen. Practical use of the Secondary Channels (also called the "collaterals" or "complement channels") is not widely taught in American acupuncture schools, nor published in modern Chinese medical texts. Cecil-Sterman's book is a welcome contribution to the field, illuminating work Yuen has done to bring awareness and appreciation to these often overlooked channels widely used in classical Chinese medicine.
There are many aspects to Chinese medicine. Each theory and clinical strategy is highly influenced by the history, culture and philosophies of the time in which they were created. Even the acupuncture point names are loaded with cultural and philosophical layers of meaning. A person can certainly gain a great deal of understanding through personal, intuitive reaction to point names and classical strategies.
However, there is another level of depth that can be gained from being "indoctrinated" into the secret "codes" contained within each tradition. There is often a language specific to each "school" of thought. If it's true that each of us sees the world uniquely, looking through another person's eyes (especially if that person is from an entirely different age and culture) can illuminate aspects of human nature, health and disease in ways we couldn't possibly access on our own.
We are here to teach one another. Confucianism places great emphasis on filiopiety (respect for the elders). Chinese medicine is interwoven with layers of Confucian philosophy. It is one of the major influences in the medicine. We could say it is our "Confucian duty" as Chinese medical practitioners to learn from the masters and honor their cultivation and wisdom as we develop our own.
Miriam Lee never quite admits the level of her own cultivation in her book. She seems much too humble for that. However, it becomes clear that she was able to achieve so much using so little through her deep understanding of the body, and the way acupuncture worked in general. She knew how to touch a person and help them find their way back to health. She was obviously a great healer.
She presents her philosophy on cultivation, saying: "Use all your might to treat patients. You study, you concentrate, you learn all you can. Then when you are with your patients, the best of your knowledge and technique comes to you ...There are many people practicing acupuncture now. Of all the important things they need to learn, the most important is how to give their whole-hearted attention to the patient's recovery."
When asked about technique, Lee writes: "I have a good feeling towards the patients. The intention I have for them to get well travels, as a wave travels on the sea, from me to them through the needles and through my voice and eyes and hands. I use my qi very consciously in a special way to do this...The needle technique I use is part of this intention ... This intention for the patient to get well travels like an electric wave to the person being needled. It is all my qi marshaled to meet their own intention to get well ... My intention for my patients to get well must awaken their own will and desire for recovery ... [Many patients] come from far away. I come from far to meet them."
As healers, we must do whatever we can to cultivate our ability to focus and direct our intention. For some of us, we cultivate through scholarly study, others through master classes on technique, others through spiritual practice. It is up to us to honestly assess what aspects of ourselves we need to develop, and find what works best in expanding those areas.
The first acupuncturist I ever worked with was a Classical Five Element practitioner. She has been practicing for more than 30 years. I was continually amazed with how much she could accomplish using only the Five Element "Shu" points during treatment. Working with her literally changed my life, and inspired me to practice acupuncture myself. When her needles touched my skin, an electric jolt would course through the acupuncture channel of the associated point. Her needling would literally "light up" the channel and change things very fast.
My friend and I used to lovingly call her "the dragon." Her work was so dynamic, unlike anything I've ever experienced. Her intention was obviously very strong. Looking back, after practicing acupuncture for some years myself, I am even more impressed with her skill and level of cultivation. Entering her office was a healing experience. My energy would change. Every word she spoke to me as the patient and every gesture was filled with intention, directed toward healing. It has become, for me, a living example of the advice Lee writes about in her book.
Some would say that in order to develop ability to practice in such a subtle, simple way, one must deeply understand the body's terrain and the craft of communicating with it. As acupuncturists, the terrain we are interested in are the acupuncture channels and points, the organs and the different layers of qi, blood and fluids. Within classical Chinese medicine of the Nei Jing, many different channel systems are discussed.
Classicists often criticize modern acupuncture training for its lack of understanding of the "Secondary Channels" or "Collaterals." A classicist would say to fully understand acupuncture, one must understand all of the channels and points, not just the Primary Channels. Further criticism says that modern Chinese medical training doesn't fully appreciate the Primary Channels, either. They are taught from a Zang Fu "herbalist" point of view, and not that of the Nei Jing. This lack of understanding diminishes the full power of acupuncture as a system as a complete system of medicine.
Ann Cecil-Sterman details in her book Advanced Acupuncture the step-by-step process of working with the "Collaterals": the Sinew Channels, Luo Vessels, Divergent Channels and Eight Extraordinary Vessels, from a Ling Shu point of view. She relates her clinical experiences working with the Secondary Channels, and her observations as a teacher of acupuncturists. She remarks that many acupuncturists she meets have been introduced to some level of the "Secondary Channels," but say they lack the confidence to use them.
Her book "is intended to fill this gap, to be a comprehensive introduction to the Channels and to be a guide to their use in the clinic." She offers detailed, step-by-step practical techniques for working with the Secondary Channels of Acupuncture, as well as basic troubleshooting guidelines. It is, to my knowledge, the first book of its kind available to modern Western acupuncturists.
Citing the great masters who have come before, Cecil-Sterman writes, "While I recognize that it takes lifetimes to thoroughly explore this rich and vast medicine ... I felt compelled to at least record and share the way in which I practice, to record an encapsulation of my understanding of what I have been given." Her practice "favors" the Secondary Channels of Acupuncture (coined "Complement Channels" by Cecil-Sterman). She believes focus on these underutilized channels within modern acupuncture treatment is "both timely and needed." Practical application of these channels has become her chosen area of expertise.
The point of view presented by Cecil-Sterman's book is to "assist practitioners in focusing their intention during an acupuncture treatment." She agrees that the most important component in treatment is intention. She believes deeper understanding of "the road maps" and process of "body engagement" allows the healer to focus intention in a more powerful and precise way.
Not everyone agrees that strong intention is created through scholarly understanding or "proper" technique. Healers who consider themselves "spiritually-focused," shamanistic or intuitive often say there is something deeper and more mysterious than our mental capacity that creates powerful healing capacity.
"Often when I tell someone how to use the needles, they do not get it," writes Lee. "Their intention is not right or it is not strong enough or focused in the right way. Very few people know how to direct their intention."
Cultivating power of intention goes beyond merely reading about it in a book or hearing about it from a teacher. We ourselves have to find out for ourselves what it means. It is a matter of attaining wisdom, which according to Chapter 8 of the Ling Shu, is not the same thing as knowledge. There's something deeper, almost alchemical that needs to occur.
In his book Rooted in Spirit, Father Claude Larre describes his vision of the acupuncturist, as described by the Ling Shu, as a type of medium or conduit for communication between "the spirits": our own and those of the patient. He states, "The Great Acupuncturist, manipulating the needle, goes all the way to the Spirits ... The acupuncturist treats according to both his immediate grasp of the patient, and the visualization of his own Spirits."
It is not really the practitioner who achieves the healing, implies Larre. Like a priest, we perform a ritual to arouse, contact or connect with the spirits, allowing them to do the healing. It is our pulse-taking, our needling, our words and gestures that create the ritual: they channel our intention to heal; our prayer for the patient's greatest good; our invocation for some sort of change. We needle a point, asking for this change.
To Larre, needling the point is the ritualized invocation to the spirits for insight, wisdom and ultimately transformation and healing. We are always beholden to the spirits, for they are what heal. Just as Lee says her job is to awaken "the will of the patient" to get well, Larre implies the will is governed by the Spirits of the patient. That is what we are trying to arouse.
Therefore, every aspect of our being is involved in being "the healer." Like a shaman or priest, we create a healing atmosphere. We use our "gestures" to continually evoke healing. All of our acupuncture techniques are part of these gestures. As Larre explains, being an acupuncturist in the spirit of the Ling Shu, we combine our knowledge-based training with intuition, full trust, humble reverence, and deep connection with our own Spirits. Then, like Lee explains, when engaging with a patient, we allow all of these aspects to flow for the benefit of our patient.
"The good practitioner's diagnosis is a connection from deep within himself to the Spirits of the patient, which are showing signs recognizable to the practitioner," says Larre. "The acupuncturist prudently, but without the least hesitation, controls the manner and the power of his gesture. This is what permits him to go with his Spirits to the Spirits of the patient. This is what makes his work a masterpiece: the faultless fulfillment of infallible inspiration." Larre makes the healing process sound similar to that of a Shaman calling the winds or communicating with the forces of nature.
From a classical Chinese medical point of view, this makes sense, as qi is a force of nature, and working with the human body is the process of communicating with the Five Elements, as well as the Spirit realms. It explains more clearly why in the Nei Jing, we are advised to "grasp the needle" as if we were "holding a tiger's tail." What we are working with is potentially that powerful!
Resources
- Cecil-Sterman, Ann. Advanced Acupuncture: A Clinic Manual. Classical Wellness Press, 2012; New York, NY.
- Larre, Claude and Rochat de la Vallee, Elisabeth. Rooted in Spirit: The Heart of Chinese Medicine. Station Hill Press, 1995; Barrytown, NY.
- Lee, Miriam. Insights of a Senior Acupuncturist. Blue Poppy Press, 1992; Boulder, CO.