Working with chronically ill patients entails acknowledging the reality that not all patients will survive their diagnosis. Chinese medicine and acupuncture play a crucial role in palliative and end-of-life care, addressing medication and disease side effects, alleviating pain associated with death, reducing anxiety and stress, and helping patients find peace during the dying process.
Acupuncture’s elemental theory encompasses the transition from birth to death, emotional states, and opportunities for healing. By recognizing the connection between acupuncture and the physical body, mind and spirit, practitioners can support patients in experiencing relief, meaningful transitions and a good death.
Defining a “Good Death”
The concept of a “good death” or “successfully dying” has gained popularity, although a definitive definition remains elusive. Generally, a good death entails minimizing unnecessary suffering and allowing patients to transition according to their wishes, which may include completing unfinished business and fulfilling last wishes.
Acupuncturists can contribute to a patient’s successful death by alleviating suffering and providing non-judgmental, present support throughout the spiritual, mental and physical transition.
Acupuncture and the Role of the FIve Elements
Effective communication surrounding acupuncture’s potential to aid in end-of-life transitions has improved outcomes in hospice settings. Raising awareness about the holistic nature of health and well-being has contributed to better deaths among patients receiving acupuncture treatments. The role of acupuncture truly shines in bridging the body, mind and spirit during the death transition.
Five-element acupuncture theory offers a holistic perspective on the death and dying process within Chinese medicine, compared to the more symptom-focused TCM zang fu pattern diagnosis. While the conventional model taught in acupuncture schools and allopathic clinical care settings can benefit symptom management, it often overlooks the complexities of the patient experience, particularly spiritually and emotionally, missing opportunities for support in these areas.
By examining the five elements, we gain a deeper understanding of the transitions and emotional, mental, and spiritual experiences patients may undergo during the dying process. These elements and transitions also apply to the various “seasons” of life, as individuals cycle through them multiple times.
The water element represents the beginning and end of the elemental cycle, encompassing death and rebirth, and symbolizing the time of conception. The wood element represents the growth and development of early childhood. The fire element embodies the carefree experience of adolescence.
The earth element signifies periods in life during which individuals undergo a living death, leaving behind their old selves to embrace who they are becoming. The metal element symbolizes the dying process, when patients can evaluate what is beneficial and let go of what no longer serves them.
The Emotional Connection
Each element corresponds to specific emotions, offering insight into patients’ experiences and aiding in their support. While treating associated points can be helpful, providing presence, cultivating safety and offering compassion are essential. Understanding the emotional connections to the elements provides profound insights into the death and dying process; and the possibilities for healing in these areas.
The emotions of sympathy, worry and shame are connected to the earth element, with empathy as its virtue. The earth element represents universal mother energy, and feeling alone or disconnected during the dying process indicates an imbalance within this element.
Healing the earth element allows patients to experience gratitude for what they have received, and feel grounded and connected to others and the process of life itself. Nurturing the earth element during the time of death brings about peace and a sense of completion.
Grief is associated with the metal element, with integrity as its virtue. The metal system focuses on inhalation and exhalation, release and letting go; and is associated with the physical process of death. By healing the metal element, patients can fully release, say their goodbyes, let go of unfinished business, and work through their grief. Acknowledging the worth and richness of one’s life becomes possible with a healed metal element.
Water flows with the journey of the transition from fear to wisdom, surrendering to the tao, the unknown and the vastness of the collective unconscious. By healing the water element, the patient can experience more free flow and less grasping with the experience of fear.
The wood element involves the transition from anger to forgiveness. Anger is a common emotion during the dying process, often accompanied by the repression of intense feelings. Addressing the wood element helps initiate the smooth flow of qi, releasing anger and repressed emotions. With a balanced wood element, forgiveness becomes possible, leading to peace and closure.
Finally, the fire element represents joy and encompasses the shen, our spirit that connects us to the universal consciousness. The virtue of the fire element is compassion and connection, characterized by an open heart and receptiveness to all that is available.
The shen is an aspect of the spirit that continues beyond the physical body’s death, and a strong connection to it aids in a soft and joyful release during the transition. This is often described as “going home,” whereby individuals experience open-heartedness, peace and familiarity with their next destination.
Vulnerability is another aspect of fire emotions, and during the dying process, individuals can open themselves to being truly seen by their loved ones.
What You Can Provide
Acupuncture and Chinese medicine play a vital role in palliative and end-of-life care. By recognizing the interconnectedness of the physical body, mind and spirit, practitioners can support patients not only in alleviating pain and suffering, but also in experiencing meaningful and impactful transitions.
Understanding the five elements and their associated emotions provides valuable insights into patients’ experiences during the dying process, allowing for targeted support and healing. Acupuncturists have the opportunity to contribute to a patient’s good death by providing compassionate care, holding space without judgment, and helping individuals transition on their own terms.
By embracing the holistic nature of health and well-being, practitioners can empower patients to find peace and closure, ultimately facilitating a successful journey toward the end of life.
Resources
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The Oregon College of Oriental Medicine (OCOM) has announced it is closing after 41 years. Pending accreditor approval, OCOM will cease offering classes after September (fourth-year OCOM students graduate Aug. 26). All current / incoming OCOM students have the option of continuing their education at the National University of Natural Medicine or Five Branches University, or transferring to another school altogether.
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