Two quite different ways to learn and practice Chinese medicine

Chinese medicine is a field where many different points of view are respected. Dialogue between sometimes directly conflicting traditions is a part of the history and contemporary practice of the medicine. Some people are quite disconcerted by this - becoming frustrated when they can’t get a “straight answer” from a group of practitioners about some basic issue. As a student at National College of Natural Medicine (NCNM), I have definitely experienced the double edged sword of diversity in Chinese medicine thinking. On the positive side, I am learning to see issues from many different angles and I believe this ability will allow me to be a flexible and effective practitioner. I’ve also been able to sample a number of schools of thought and choose to investigate more carefully those that resonate with me. On the more challenging side, I still feel that I don’t have a full grasp on even the most basic concepts of the medicine simply because I haven’t been able to construct a coherent and consistent answer from the diverse information I have received from my esteemed teachers.

There are many schools of Chinese medicine, as I have mentioned before. There are representatives of diverse traditions at NCNM, but because they are all conversant in one anothers’ traditions - these differences haven’t been much of a challenge to navigate. More difficult has been adjudicating between two ways of approaching the study of Chinese medicine that are each strongly represented at my school. I’ve thought quite a bit about how to characterize these two methodologies and would like to present some preliminary thoughts here. However, I want to make clear that proponents of each generally respect the other approach and sometimes even dabble it. The division is typically clear, however, and it causes students some problems from time to time.

Methodology A: Symbolic thinking

This way of studying Chinese medicine is more intuitive and even spiritual in nature. It is characterized by an emphasis on introspection, innovation, etymological analysis and deep study of patterns in information. This is the first method we are exposed to as students at NCNM and it can be quite a shock for people raised in a Western-thinking home. Being thrust into this at the beginning definitely gets us ready to delve into the sometimes convoluted and always non-dualistic basis of Chinese medicine as a whole.

This methodology is typically based in Classical sources. However, it incorporates Classical literature that is not strictly medical - such as ancient Daoist cultivational texts - and it does not restrict thinking to these sources. As I’ve said, it encouraged innovation. In a way, the methodology works by breaking the Western boundaries of your mind and teaching you to think symbolically and then letting you loose to see what you can find.

Some strengths of this method:

  1. Effective in getting you to “think Chinese” when you weren’t able to do so before.
  2. Pays attention to the less material aspects of the medicine which is surely one of its strengths.
  3. Encourages the further development of Chinese medicine, but not in a way that is beholden to Western materialistic dogma.
  4. In the hands of a very strong practitioner, could extend the effectiveness of the medicine by leaps and bounds as it has for the founder of our Classical Chinese Medicine program, Heiner Fruehauf.

Difficulties I have with this method:

  1. It’s really difficult to know where to stop - especially for students. There’s a point at which you aren’t sure if you’re just making things up or if you’re really working with the symbolic language in a way that is valid.
  2. It brings you into very strong friction with people who aren’t accustomed to this way of looking at things. If one isn’t facile with switching between different ways of looking at the various problems in medicine, one could become quite isolated from the rest of the CM community.
  3. Seems to involve a lot of clinical “experimentation” insofar that you may be working with formulas that aren’t grounded in the thousands of years of recorded clinical trials. The danger of this can be offset by excellent practitioners using careful reasoning processes.

Methodology B: Canonical textual analysis

We are introduced to this method in the second year, increasing our exposure as time goes on. At the same time we are introduced to the fairly rigid (yet not very rigorous) TCM methodology. It’s quite a shock for most of us to go from the much more inward looking far less scholastically rigorous (but in many ways still just as difficult) work in Method A. Using this method is much more academic in the sense that it involves plenty of memorization and the grasping of richly complicated texts and seeking to understand them. I think of it as more Confucian.
It’s important to note that sometimes Method B does require some imaginative thinking because we don’t have a full complement of texts (due to loss through time) and sometimes we have to fill in gaps in the record. To offset the problems involved in this, we can check for consistency against others’ interpretations and whether our ideas fit into the overall fabric of the canon. In general, this method relies heavily on studying with masters and extremely careful interpretation.

Some strengths of this method:

  1. Everything is supported by the thousands of years of clinical experience and theoretical wrangling that make Chinese medicine so unique. This support is explicit, though still based on textual interpretation.
  2. The theoretical elements fit together well which supports any innovation that occurs. In other words, because the theory is so tight and so well supported any departures from it start from a firmer foundation.
  3. Although extremely complex it is relatively easier to learn well because it has a solidness that one can grasp.

Some difficulties people have with this method:

  1. Sciences are meant to evolve and dogmatic adherence to a text seems to stifle innovation that creates evolution.
  2. Textual analysis is still interpretation so despite the fact that it is seemingly more solid it may not be as solid as adherents claim.
  3. Not as much fun as Method A.

If it isn’t apparent, I prefer Method B. However, I have seen and experienced the powerful results that people using Method A can create. For myself, I am leaning towards using Method B in my schooling and early practice. I feel that it is a safer way to proceed as a student and I have seen such incredible results from it that I cannot deny its power. However, I can see myself deepening the insights I have gained from my very superficial steeping in Method A and using those insights to work through recalcitrant patient problems. Further, I have gleaned a lot of personal benefit from the skills I learned in my first year - particularly in my application of symbolic thinking to parenting, spirituality and personal productivity.

Eric

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July 19, 2007 · Filed Under Learning, The profession, Theory

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