Necessity is the mother of learning acupuncture points
One of the things I have noticed in my scant 20 or so weeks of hands-on clinical practice is the great difficulty of accurately locating acupuncture points. At times the body seems an intolerably huge landscape - full of unfamiliar landmarks and confounding convolutions. Yes, at other times the complications diminish and it seems as easy as anything. I find the latter times become more frequent as I go along.
Along with a general increase in my confidence and ability comes a deep interest in REALLY learning the points and channels. Before clinic, acupuncture very obviously played second fiddle in my hierarchy of my interests in Chinese medicine. I have always recognized its power, but simply didn’t feel drawn to study or understand it that much. Now, with my struggles in clinic, I find myself fascinated by each point and driven to learn more on multiple levels. I am also developing my non-intellectual skills, my ability to feel Qi, to palpate channels and to connect with the patient. I note this because most often when I relate my problems I have people telling me that I need to get out of my head and just “connect” with the energy of the patient. While I recognize the importance of that, it certainly isn’t the whole answer.
My methods
Before I talk about how I’ve been working with the points, I’d like to make one small note. I’ve divulged various study methods and tips before on Deepest Health. With the exception of a few suggestions, these have all been methods I’ve used. However, they were methods that I learned directly from others or developed after reading ideas in a book or on a blog. This is a great way to pick up new strategies, and I certainly will continue to use it. On the other hand, the methods I list below are different. They emerged organically to solve particular problems. What I mean is that in response to a particular experience, I desired some particular skill or understanding and worked out the best way to obtain it on my own.
This may seem to be a minor point, and I don’t want to hammer away at it. However, it definitely feels different. I feel more committed to consistently using these methods, and they seem to be more effective. Each new thing I learn inflames my desire to learn even more. A similar thing is happening to me regarding formulas, but the effect isn’t so dramatic since I’ve always been interested in understanding them. I expect clinical practice will create some new developments in that arena, however.
In essence, what I’ve been doing is simply making a list of all the points I use in a given week and then reviewing them in great detail. This is the bulk of my “method.” It has several parts, which I will describe in detail below. However, there are more subtle things that I’ve been doing in the treatment room. I don’t know if I’m quite ready to describe those pieces of the puzzle. One recent development was the return of very focused attention on sensing the layers of the body that the needle is passing through. This is something we learned in our first needling class, as one of our points Professors places a high importance on needling and manipulation in the various layers. I think being in clinic and having to manage so many things at once found me being a little neglectful in this realm - I’m glad I’ve remembered it now.
Anatomy : Descriptions, 2D, 3D, palpation and multiple sources
I’ve never been particularly interested in gross anatomy. In fact, this new revolution in my thinking has helped me to understand that I have an odd detachment from the physical nature of the body in general. Working with the anatomy has helped unravel that personal issue, yet another example of the many benefits of dedication to study. Anyway, we did take anatomy during our first year, but given my general reluctance described already and the fact that I was so enthralled with learning the cosmology and symbolism of Chinese medicine, I frankly didn’t pay much attention. I’ve used various sources to help deepen my understanding of anatomy.
Descriptions: Sometimes a word is worth a thousand pictures. While seeing what things look like on the body is very important, often it has been a stray description of a particular bony landmark in relation to a point that has really solidified its location for me. I use Deadman
as a primary source here.
2-D: Again, Deadman’s Manual of Acupuncture
3-D: I have an old version of Qpuncture that has 3D renditions of a needle in various commonly used acupuncture points. While some of the anatomical accuracy has been sacrificed, it is very helpful to see how the needle penetrates with reference to the anatomical markers we cannot see with the eye. I also subject my partner and daughter to infrequent channel palpation and point location (”Is this sensitive? What about this? This?”) which is often very helpful. Of course, while I’m studying the above sources, I palpate my own channels and feel the points on myself.
“Actions”, prescriptions and theory
The point location has been most bothersome for me, mostly because I’m obsessed with being sure that every needle has a real effect. That may seem to be a stupid statement. However, I’ve been needled by many interns and practitioners who don’t seem too interested in actually working with the POINTS - content just to needle anywhere on the body. I gather this from my perception of their lack of intention when needling, the obvious lack of accuracy based on where the needles end up as well as my conversations with them. I do believe that the “points” as they were laid out in ancient times are very special places on the human body that have powerful effects on the human being - I don’t think that “just anywhere” will do.
Despite my obsession with fully knowing where the points are, I haven’t lost sight of the importance of understanding “what they do.” I put “what they do” and “actions” in quotations for a reason. Acupuncture points are not like buttons on a machine. It’s not as if you press the red one and you get a cherry candy, blue one and you get a razzleberry one. It’s not as if some little ghost in the machine stands behind the point ready to report your instructions via the CNS with exactness and machine-like one-to-one correspondence. If a person asks me for “a point for asthma,” I’m reluctant to report the points we all know to be commonly used in prescriptions for that Western defined condition. It isn’t that points don’t “do something” and it isn’t that I’m afraid to talk about certain points as unequivocally treating some particular pathological state, it’s just that the way we try to simplify things for easy consumption result in overly simplistic ideas about how Chinese medicine works.
I think about acupuncture points like areas where one can access a river. They come in big and large sizes, they have varying ranges of ease of access, some put you in at a furious current, others at gentle pools. The direction you’re heading when you put in at any given point makes a difference, as does your intention when you do so - will you paddle upstream or let the current carry you down? Are you fighting the flow or not? Are you dredging the channel a bit to allow greater flow in a given area? Are you moving boulders that have obstructed your path?
The river metaphor breaks down a bit when we drill down a little more. Each point has its particular characteristics based on its location on the channel, its symbolic power given the part of the body and its physical features as well as a whole range of correspondences that fit the channels and points and the human being in with the consistent patterning of the universe. Thus five elements, yin-yang, six divisions and all their permutations and combinations are peppered throughout the system in remarkably predictable and usable ways. When we needle a patient, we are not pushing buttons, but mixing colors and flavors, textures and spirits in alchemically beautiful ways with the purpose of influencing the body in particular ways for the creation of health.
You know, no big deal. :D
All that being said, I’m not just going to abandon myself to studying nature and meditating as a way to understand what KINDS of mixtures are effective in what kinds of situations. I’m not comfortable with that, frankly. Instead, I look to the classics and the theories passed down by the ancients. I use Deadman and some sources given to me by my teachers to understand the Classical point prescriptions. I study closely the theory of the five elements and six conformations as well as point categories to fully comprehend the effect of a given point within a particular clinical context.
All of this is really helping my clinical confidence a great deal and I find that more often than not I am able to recall most of this information when I next encounter a particular point. Sweet! I’ve talked enough about this for now, but I would like to pose a couple of questions. Have you encountered the kinds of troubles I started out this article by describing? If so, how did you get past it? Do any of the methods or ideas above resonate with you? If so, how? If not, why not? I’d really like to hear about others’ experiences. Reply in the comments!
Thanks!
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Tags: Acupuncture, channels, clinic, confidence, focus, Learning, student, study-methods, studyingRelated posts
Chinese medicine and the troubled economy
It’s a natural thing for all of us to be thinking about the economy right now. While I think that people often pay too much attention to the news, allowing their Shen to get seriously disturbed, there’s really no question that we’re in a bit of an economic downturn. I have seen that our school clinic seems to be drawing relatively fewer patients, and my practitioner friends have also seen an overall reduction in patient visits. Some students in my class, facing immanent graduation, are getting a little nervous.
Deepest Health reader Jason suggested that I write an article about this topic, which spurred me to action. He writes:
“With the economy in a very precarious situation, what does that mean for practitioners of Chinese medicine, or indeed any CAM therapist? What would be some good strategies for weathering an economic downturn (or heaven forbid, an economic meltdown)? And for people like me, is this even a good time to invest the time and money for an education is Chinese medicine? In my perfect world, I’d do it anyway, and then I would treat anyone regardless of what they can pay. Just can’t ignore the money though, can you?”
Indeed.
There are a number of issues embedded in Jason’s statement. Before I offer my observations, I’d love to pose the two main questions to Deepest Health readers - post your responses in the comments. I look forward to a lively discussion!
1. From a practitioner perspective, what are some good business strategies for weathering an economic downturn?
2. From a student perspective, is this a good time to pursue education in Chinese medicine?
Tags: Business, economy, graduate school, moneyRelated posts
Deepest Health Chinese Medicine Podcast : Episode 7 : Clinical confidence and memorization
In this episode of the Deepest Health Chinese Medicine podcast, I discuss what it means to have confidence in clinic and why I believe memorization is so important for Chinese medicine practitioners. I do go into a little detail regarding best practices around memorization, and I hope this information will be helpful for everyone.
Look for an interview with Heiner Fruehauf as next week’s podcast, assuming all things go according to plan!
Thank you as always - please do leave comments on this post if you would like to start a discussion about the podcast.
Eric
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Tags: clinic, Learning, memorization, Podcast, student
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Deepest Health Chinese Medicine Podcast : Episode 6 - Schools of Chinese medicine and learning
Sorry to get this podcast out so late, folks. There’s been a heat wave in Oregon, and I’ve just been worthless for work. Things are still moving and changing here at Deepesthealth and you can keep looking forward to more great content. :)
This week’s podcast is a fairly quick one where I talk more about my clinical experience. The topic of this one concerns the different schools of Chinese medicine and how students should look at the possibility of “choosing” between them. It’s also the first podcast with the new equipment, tell me what you think in the comments!
Look forward to more great content next week - as well as a post coming out tomorrow that started out small and then grew into a monster!
My best to everyone - Eric
Tags: clinic, Learning, Podcast, schools, shang-han-lun, students, wen bingRelated posts
Technological teaching : social networking for natural medicine practitioners and a study update
I’ve been working with Saturday features these last few months. I like the idea of a links post, but they don’t get much traffic and they’re sort of boring to write. I figure it makes more sense to offer something of real value while enjoying the process myself. So, on this cloudy Oregon summer morning, I’d like to try something new. On Saturdays, until I find something that works even better, I’ll offer a technological teaching geared toward the natural medicine crowd. Remember when I wrote about why every healthcare provider should have a blog and the ensuing discussion about the apparent misgivings most natural medicine practitioners seem to have about technology? Well, I have a passion for bringing our profession up to speed - we belong on the Internet - people need us! Every week, I’ll try to think of something new to point out. It will still be links-based, but the links won’t just be stuff I think is interesting. Instead, the links will be part of the teaching.
—-
Before I continue with the technological teaching, I wanted to refer back to another post I made recently about studying Chinese medicine. As school approaches (my last year!) I find myself being forced to think increasingly of how to get myself back into the mindset for institutional education. I’ve also continued to notice my knowledge deficiencies while in clinic. Not to mention, I’m supposed to be working on the thesis required for my Classical Chinese Medicine degree at NCNM. I find that in the summer, I naturally turn away from intense study and towards other things (like blogging) but now it’s time to turn back. In the article referenced above, I decided to try a new method of studying that would allow me to cycle through topics each day. As usual, I bit off a little more than I could chew. In this case, I simply picked too many topics. I found that it was too difficult to keep the categories discreet, and often because of the natural flow of my weeks I was “into” particular topics on particular days.
To refine the process, I will suggest the following topics be studied each day - with the complete group to be studied at least every two weeks. This allows for a more natural decision making process when I sit down to study, yet still ensures that I actually work on each topic. This last part is important, because I find that sometimes I get a little too obsessed with one topic and my knowledge and skill in the other crucial areas suffers.
Topics:
- Formulas : names, dosages, signs/symptoms (especially pulses) and all associated information
- Points : mostly just location and categories for now
- Diagnostics : working more closely with pulses, tongues and other diagnostic information
- Pathology : six conformations/shang han, 19 lines/5 evils, Zangfu/TCM and Western when desired
- Physiology : working with the information I have to keep diving deeper into the physiology of Chinese medicine organ systems and their interrelationships
- Symbolism : working more explicitly with the information I’ve gleaned from Classical texts and my professors at NCNM
If this succeeds, I’d like to see how it works to share something I’ve learned from each topic each week. I know that some of you students out there have been missing the more basic posts I used to write, and my explicit study in these various areas might bear some fruit as far as sharable content is concerned. Stay tuned.
—
Now, what about technology? To keep this post as short as possible, I won’t launch into any diatribes. I hope to just show people how valuable the Internet can be and how crucial it is that we, as healthcare providers, link into this rapidly growing method of connection and communication. Today, I’d like to talk a little bit about…
**Social networking**
Human beings are social animals. Some have lamented the invention of the computer, and then the Internet, claiming that it negatively impacts social relationships between people. Now, of course, I think this is a bit of a chicken-or-the-egg question since for our society to accept such a technology implies that we had already gone far afield. That is, of course, if this lamentation has any basis. I’m not ready to deliver a proclamation on that just yet, but I do believe that any such insinuation is probably overstated. Anyway, the thing has doubtless been improved by the invention of blogging and, most recently, the flourishing of social networking tools.
Both blogging and social networking tools share something in common - they encourage conversation among people. You are all mostly familiar with blogging, I assume. You may be less familiar with the various social networking tools. There are quite a few types, and those who are more detail oriented than myself could probably explain them in encyclopedic fashion. But, to keep it real, I offer these simple categories and definitions:
1. Social networking sites that are more about keeping people updated and sharing more static information: These sites are usually larger and more feature-rich. They invite people to develop a very full profile, often include advertising and other monetization, and frequently connect with other types of content (like static websites containing large amounts of information). Most of these do include aspects of the second type, but most people don’t use them that way. I’m thinking here of sites like Facebook, Linkedin, Myspace, Gaia.com and Rootdown.us (links to these sites that allow you to add me easily as a friend are below).
These sites require some set up to be most functional. You go in, set up a profile and add a picture, add groups and interests, find your friends and colleagues and gradually over time will build a group of people (a network) that is easy to connect with. In my experience, the social aspects of these sites are relatively deemphasized. What I mean is that there’s not much conversation going on and often, particularly among the over-25 set, updates are infrequent. They are still very valuable, however. I have found lots of long-lost friends using these tools, plus the integration of microblogging tools (see below) allow for more conversational interaction. The more robust nature of these tools allows for a wider range of functionality as well. For instance, on Gaia.com - a social networking site for “conscious living” - you can write blog entries, list your favorite books, search for information on a variety of alternative lifestyle topics and be informed of upcoming events you may be interested in.
2. Social networking sites that are more about conversing and sharing developing information : These tools are often grouped under the word “microblogging.” Microblogging is a way of sharing short bits of information (under 150 characters) frequently. Using these sites, you set up a small profile and add friends. You can easily update the services (eventually even using your mobile phone) and read others’ updates and in doing so, you have a good sense for what your contacts are doing in any given day. Lots of news bytes are shared using this service - it can be interesting to watch the unfolding of a given story as percieved by people all over the world in all different socio-political circumstances. It’s also an easy way to share links to your latest blog content or ask people for support for charity causes or for promoting your content on sites like Digg and Stumbleupon (which are also, technically, social media sites - but are very different so I won’t cover them here). Twitter and Plurk are the two most popular microblogging services. See links below.
Why should you get involved?
These sites are a great way to start establishing yourself as a presence on the Internet. The conversations you have with others will gradually introduce you into the online flow - which can be very helpful if you ever plan to promote yourself or your clinic online. It’s also a fantastic way to meet people from all over the world and to begin to see things through eyes other than your own. I also find it a very helpful way to keep up with friends, family and colleagues that I otherwise would need to have an hour-long “catching up” conversation with each time I met up with them. Some may say that this is degrading normal human interaction, but I’ve found it only to enrich the relationships I have with people “in real life.”
Join me in the social media revolution - add me as a friend!
Here are my links for the various social media sites. You can click here to add me to your profile and we will be able to see one another’s updates. If you have any questions or anything to share about social media, go ahead and leave a comment at the end of this post and I’ll answer any and all questions as well as participating in any ensuing conversation. I look forward to seeing you all there. :) Note: Some of these links are not going to lead you to my profile, but to the page where you can sign up for an account. Once you do that, you can add me - sometimes using the links below or just by searching for me by my username or password.
- Facebook (I think I’m found as Eric Grey in this service)
- Myspace (I should note that I don’t use this service as much as the others, I’m pylonian here)
- Gaia.com (I’m pylonian on this service)
- Rootdown.us (I’m deepesthealth on this service)
- Linkedin (I believe I’m just Eric Grey on this service)
- Twitter (I’m pylonian here)
- Plurk (I’m deepesthealth here)
It’s worth noting that there are a variety of social networking sites that are specifically aimed at particular groups of people or particular kinds of content. For instance, there is a social networking site for Muslims, as well as one just for sharing information about Travel. There are also photosharing social networks like Flickr. Rootdown.us (listed above) is one such type of site - geared particularly towards people interested in Chinese medicine. I should note that Rootdown isn’t a social networking site as such, but incorporates some of those elements - a practice becoming increasingly common on the Internet.
If you’re interested, here’s a Wikipedia list of most of the popular social networking websites.
Thanks for reading,
Eric
Tags: Blogging, education, fun, internet, links, student, study, studying, Technology, websites
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