In response to a post we put up on Instagram a couple of weeks ago about unexpected reactions after treatment, a strong and very kindly worded reaction came back. Responses of this nature are always welcome, by the way, especially if they elicit a hopefully helpful blog!
Here’s the post:
And here’s the response:
“Humble question: how is this answer not a convenient invention of the ego to deflect responsibility? How can you say this with such absolutely certainty when Chinese Medicine is so subjective? How do you know you didn’t misdiagnose?”
These are great questions. If we are to talk about ego, the place where ego rears its head is in the process of diagnosis, that is, before the treatment. Let’s say the practitioner’s ego pontificates: “Any dummy would know that this patient is presenting an internal wind condition. She has dizziness, headaches, some pain. Duh! No brainer. I’m going to cup the back and shoulders, needle some liver points and it’s a slam dunk.” So with certainty, the practitioner goes through the motions with the intention to provide relief. The next day, the patient reports by text that she is experiencing a prolonged episode of facial paralysis. The practitioner cringes, buries her head in her hands, wants to disappear through the floor, and questions whether she should hold a license or not. Confidence is dashed.
When I write about reactions to treatments, I’m not referring to this kind of scenario. What happened above was due to poor training, or forgetting one’s good training. That practitioner did not know, or missed the series of lectures at school where the teacher laid down a crucial rule of acupuncture: In cases of internal wind, you must build mediumship first because a key origin of internal wind is deficiency of mediumship (blood and fluids). If you simply cup and add perhaps add few “wind points” you’re going to upset the mechanism the body is using to hold that wind at bay. You’ll push the wind around in an deficient arena that cannot transport it out, leaving the body like a sail boat without a keel. It becomes erratic. If the practitioner had been better trained, she would have built mediumship first or at least at the same time. As you build mediumship, there is decreasing room for wind in the channels.
What I am writing about, in that post, is about the practitioner who is well-trained, practicing from principles rather than memorized data. The practitioner takes the pulses (in the room, or diagnosing remotely) and sees where the deficiency is. Is the liver pulse thin? Is the spleen pulse thin? Where is the deficiency? The practitioner treats that until the pulses become wide and replete. In most instances, the wind moves out on its own, as there is nowhere for it to be now that the channels are carrying much more mediumship. A patient who has been treated in this way may call the next day and report that he had a very brief sensation of tingling in the face, or a big shudder, or he became very itchy for a few hours, or he tossed and turned for one hour that night, or felt very jumpy for a while. He might be perturbed by that. The practitioner then asks, “Is it still happening?” This is a very important question. The patient generally answers “No, it’s over, but it was disconcerting”. In this case, the practitioner would explain to the patient that this is the wind moving out. Excellent. These responses are normal, even desired. Healing can be unpleasant, because these things must clear, and that is often uncomfortable. It’s not a reason for self-doubt on the part of the practitioner. Sometimes, in class, a new student will even be bereft at the response a patient had. When I ask the student whether it is still happening to their patient, the student, nearly always answers “no”. These are clearances, as are other temporary happenings: stinky urine the color of coca cola, shockingly smelly stools, worms in the toilet, frightening bright green or gray snot streams nine or ten feet long, blood clots pouring from the nose, huge blobs of wax on the pillow, yellow mucus-laden vomit. Should I go on? I’m not kidding, I’ve heard all these things and more. If these are only temporary, your patients are clearing what does not serve them, clearing what has been holding pathology in place, along with the pathology itself.
The time for doubt is during the diagnostic process. The practitioner must be in a questioning state throughout. Pre-formed certainty has no place during the diagnostic process. While taking pulses, the practitioner is encountering mystery. Silently, the mind might be noticing pulses something like this: “…hmmm, interesting…let’s go here….hmmm, rapid in the moderate liver…interesting…is it this?….nope….let’s look here, yes, there’s something….. hmmmmm….I’ll ask this question…well it’s not that then…you’re going to find what needs addressing…oh goodness, I think I’ve been expecting to find this in the left wrist but it could be in the right, let’s go back and look there again…will I find it at all today?…will it reveal itself?…maybe it’s not time…maybe I’ll just nourish…let’s put aside the assumptions again…a deep breath below the navel and clear my mind…ah! Here’s a clue…well look at that!…who would have thought it was under there…pulse taking is so amazing…got it…okay…next step…”. This is healthy and necessary questioning within the practitioner. You just don’t know until you feel into the patient’s being. Only then you can derive the treatment principle, and from there—and only from there—can you construct a treatment. Then, once you have the treatment path determined, all doubt is put aside. The treatment is conducted with complete confidence. Otherwise it cannot function. Effective treatment is entirely founded in intention. This is the chief responsibility of the practitioner.
Because the treatment is coming from a point of view of certainty, because the practitioner is certain that the treatment will yield benefit because she knows that she constructed a treatment founded in a conscientious diagnosis, the treatment will not be wrong. An adverse effect is going to be either a messy clearing of pathology, or it’s going to be an experience that is necessary in the healing journey of the patient. How do we know? Because it happened while the practitioner operated from heart-centered intention. We don’t know what the journey of a patient is supposed to be, or the rate at which that journey will be travelled. Sometimes the path is slow and tricky and it’s all necessary. The declaration of this reality is not a convenience of the ego, it is a spiritual truth.
I hope this is a satisfactory answer to your response, jj.acupuncture. Thanks so much for asking such a terrific question. And happy equinox!
Los Ranchos, NM
September 21, 2023