6 Ways for Chinese medicine students and practitioners to learn lifestyle counseling

After yesterday’s introductory post about Chinese dietary therapy and lifestyle counseling as one of the profession’s available modalities, I got to thinking about the difficulty of lifestyle counseling.  It is undoubtedly an important part of our medicine – it’s in the Classics!   The Neijing began this proud tradition in Chinese medicine when discussing the way that a person should behave with regards to shifting seasonal energy. Here is an example from Maoshing Ni’s translation of the Neijing – in Chapter 2:

“In the three months of summer … One may retire somewhat later … while still arising early. One should refrain from anger and stay physically active, to prevent the pores from closing and the qi from stagnating.”

Later, in the same chapter, “Emotionally, it is important to be happy and easygoing and not hold grudges, so that the energy can flow freely and communicate between the external and internal.”

So, while lifestyle counseling can be a very challenging part of any Chinese medicine doctor’s practice – we should all be motivated by the fact that it is a key to unlocking health as well as being something advocated from the very earliest times of our medical tradition.  But how can we learn how to do this?  I have some preliminary ideas.

1.  Doctor heal thyself:  Your best experimental laboratory for new techniques is yourself!  I’ve got a long standing policy of not asking others to do anything I wouldn’t do myself.  If you can’t demonstrate by your own life experience the importance, effectiveness and do-ability of what you are recommending – why are you recommending it?  Now, it may be that some of you out there lead a perfectly healthy life – good for you.  ;)  For the rest of us, going through the experience of changing your own behaviors to benefit your health provides valuable information on the best strategies to do so.  It also gives you anecdotal evidence to share with your patients, which can help them to trust you and to feel like they are not alone in their struggles.  Of course, every person is different and what works for one person may not work for another – but working through your lifestyle troubles is a great starting point for research and development.

2.  Talk with family and friends:  Although they might not like being referred to as such, your family and friends are your second best laboratory! I can tell you that I’ve learned more from my mother about how and how not to do lifestyle counseling than I could ever learn in a classroom environment.  As you begin learning this medicine, and probably especially when you start practicing, your family and friends will be asking you about their own health problems all the time.  Giving them simple advice when they ask for it and watching how they respond can teach you valuable lessons.  You can also simply have conversations with those close to you about what works for them and what does not with regards to making changes in their behavior.  Just remember to always avoid doling out unsolicited advice.  :D

3.  Study up on psychology: Although a fair amount of Western psychology is based on principles that are not concordant with Chinese medicine, there is a lot we can learn from this discipline.   Read books about motivation, social psychology and the power of advertising.  Also read classical and contemporary literature in Chinese medicine about the psychological element of human beings.  This study will inevitably lead you to trying to understand the five spirits and the Shen.  There may be ways to work with this information that will lead you to spectacular insights into your patients.

4.  Learn your explanations front and back, be able to explain them to a ten-year-old: In my clinic shifts, I’ve seen well-meaning doctors attempt to give lifestyle advice to patients, yet fail to have much impact.  In my opinion, those failures had a lot to do with the quality of the explanation behind the suggestion.  In my experience talking with friends and family, I’ve found that the most important element of a good explanation is its lack of jargon-filled language.  Established patients, or those who have a keen interest in Chinese medicine, may enjoy learning about Shen and Jing – but the average patient is going to be mystified by these terms.  You should make an effort to construct excellent explanations that are true to the theory behind the medicine but that are also accessible to the average Western patient (assuming you are practicing in a Western country).  If you feel that using medical terminology is necessary or preferable, then find a simple and succinct way to describe that concept.  In general, if my ten-year-old doesn’t understand my explanation, I’m not going to use it on a prospective patient.

5.  Work on developing compassion: Probably the most important trait a doctor can have is a well-developed sense of compassion.  This is especially the case in lifestyle counseling.  People are coming to you with suffering that may be based on long entrenched personal habits.  Asking them to give up these habits “cold turkey” or being unsympathetic about the difficulties people face in making life changes is not going to help you or them.  Study your patient carefully and try to understand what they are capable of – and ask no more from them than that.  Of course, we are rarely the best judges of what we are capable of so you may ask something of a patient that they think they cannot do but you are certain they can.  There is a tightrope to be walked here, for sure.  No matter what, hold a deep feeling of compassion in your heart for their circumstances and be willing to take baby steps with them if necessary.

6.  Practice letting go:  It’s a sad fact that some people are going to suffer and die because of the way they treat their bodies.  Some of these folks are going to seek treatment from you – sending a mixed message of wanting to change but not wanting to work for it.  They deserve your compassion.  But to help our own peace of mind we, as practitioners and future practitioners, need to get good at letting go of outcomes.  Our patients may find full recovery or they may simply tread water – some of them may sink.  This skill is hard to come by.  I feel that a strong spiritual practice will help develop this faculty, as well as compassion.  Another reason why self-cultivation is key in the process of becoming an excellent physician.

Are there any more you would add to this list?  Think I’m off base on any of the above?  Let me know in the comments!

Eric

Tagged as: Learning, lifestyle-counseling, Personal Development, professional-development, seasonal-living