A few reflections on the practices that influence my practice of acupuncture…

Before I was 30 I loved spinning kicks. It was the loss of vision, I think, the inability to track my movement through space with my eyes that I liked so much. Without clear vision there is nothing so clear as the sense perception that rises from the belly like a cyclone. With the extension of a side-kick added to that spinning momentum the boundaries between self and target find each other effortlessly, like rain finding a puddle.

To create the same sensation my dojo friends and I would play a game we called ‘drunken monkey.’ Two of us would stand facing one another, and we would begin turning around, faster, and faster. Someone would call the count,

One, two, three, go!”

(in Japanese, ichi, ni, san, hut!”). On the word go we would stop spinning and move drunkenly towards one another, blurry-eyed and low in our stances, and we would spar. We’d get in a few moves in that altered state before our eyes would dominate again and our vision would climb at least in part out of the belly and into the head. We would try not to lose the sense of moving from our center, following the inevitability of our movements and of our partner’s movements. Sometimes we’d get in the zone and continue sparring with eyes that were clear but not dominant. When we could sustain it, it was a real high. That state of being in which eyes are open but not dominant is a state of heightened awareness. We called it ‘soft focus.’

My martial arts practice made me feel like a kid in a new world. Even training full-out for 10 years, obtaining black belts in two styles, and teaching others did nothing to change that feeling of exhilaration, awe and appreciation for something beautiful and larger than me. I may have been strong, flexible, eager and possessed of a fighting spirit, but still I gawked at the edges of this world aware of how little I understood it. What if I walked around every day with my mind in my abdomen, with the heightened kinesthetic knowing of a ‘drunken monkey?’ I did not then nor do I now glamorize blindness as some sort of guaranteed entrance to higher perception. But there’s a fine line between using one’s visual abilities to one’s benefit and becoming stuck in the way one sees. Drunken monkey was the 2nd experience in my life to teach me that my eyes (read ‘way of seeing’) could actually lessen my access to energetic intelligence.

The first experience was when I was in high school and I had a recurring dream that I could not open my eyes. I would strain to get my lids to open but as I did so my eyeballs would roll back in their sockets making it impossible for me to see anything, and causing me to strain even harder. These dreams left me with a strong sensory-memory of the physical struggle I engaged in while I slept.

A good friend of mine, June Wolfman ( may God bless you, wherever you are) suggested that we go up to the cliffs. They were rocky precipices on the Hudson River with a view of the George Washington Bridge. There was a good bit of woods between the road and the cliffs. She offered to blindfold me up there and lead me through the woods. Kind of her, eh? In fact it was brilliant. The point was for me to let go of my panic around not seeing, to give into the blindness, to retrain the sensory-memory from one of physical struggle to one of relaxed acceptance. It worked. Something new opened in me. In some ways puberty had turned me into a removed observer rather than a participant in my own life. After walking blindfolded in the woods I embarked on a long journey home to myself.

The process of discernment which led me to study the traditional healing arts of Chinese Medicine was tied up in my martial arts practice, went further back to the blindfolded walk in the woods, and those things carried me through the years of overwork and over-study that characterize medical school . ( I’m amazed at the intelligent reflections of my friend Eric Grey who is in his last year at NCNM and blogs at Deepest Health. I am only now, 10 years out of school, able to reflect on my evolution as an acupuncturist and to write about this magnificent medicine).

Some of the things I bring from the martial arts to the acupuncture table (literally) are stance, breath, soft focus, and that kinesthetic abdomen-driven falling into the point like rain into a puddle (or spinning side-kick to its target).

I don’t kick anymore. Nor do I spar. But I still practice soft focus away from the office in two forms of movement practice. In the first, I practice belly rolls, undulations and circles, hip drops and shimmies. I follow my belly’s movement to it’s inevitable resolution into a flow of more movements, letting the belly lead, not the mind. I’m older, wiser and fleshier. Belly dancing suits me now more than sparring.

Rosina-Fawzia-Al-Rawi, in her book Grandmother’s Secrets, wrote,

We dance to become one with a rhythm that was here before us and will remain after we are gone.”

It stands to reason that dancing makes me a better acupuncturist. The most profound difference between Chinese Medicine and Western medicine is that Western medicine has not evolved a theory of health, or a way of identifying parameters of wellness, except in terms of absence of disease. On the other hand, Chinese medicine from the start has had a theoretical understanding of health as a balance of energetic forces, and a methodology to gauge minute alterations in that balance. I believe that the balance we know as health is

…a rhythm that was here before us and [that] will remain after we are gone.”

If we are lucky–if we are healthy–we get to ride that wave. It almost makes me want to take up surfing. From spinning kicks to belly rolls to riding under the breaking curl of a wave…What do you think? As for my old bones braving the cold Maine waters, that’s why they make wet suits, eh?

The 2nd movement practice I engage in to heighten the sense of moving with a soft focus from the center of my being is harder to describe because it is something new and experimental and collaborative. It involves a collaborative listening, following, leading, empty space, a group of people, martial arts and dance. Our focus most recently has gone so soft that we are motionless, but we wait. We wait for the pulse, for the rhythm, the knowing to take hold of one of us, or all of us, which will move us to the next level of understanding. We are patient, aware of an abundance of time in which to let the underbelly of our undertaking to surface. It feels luxurious to be in this place. We have watched our weekly meetings focused on collaborative movement (drawing on martial arts, dance, and spiritual practices) devolve into motionless stillness. A pregnant pause. We have no idea how our shared intention will evolve. I only know that this practice, even as it seems to have ceased to be, is evolving, and that the stillness in its wake is part of my evolution as an acupuncturist.

The Iraqi Vet referred by the Veterans Administration for acupuncture for severe headaches, which his doctors believe are caused by high cerebrospinal fluid pressure, has been back in my office a few times. After initially referring him for only 3 treatments, the VA authorized 8 more treatments, and my contact has shown a willingness to work with me to get more treatments authorized after that, if need be. The first time we met again after a hiatus full of negotiating phone calls and mailings to the VA, my client was at a point of extreme pain in which he’d been in bed for three days. He walked with a slow, somewhat wide-based gait, and wore dark sunglasses that wrapped all the way around his face, covering every millimeter of his peripheral vision, even though it was a gray, late winter day.

His voice was guttural. He did not smile. The connective tissue on the outer (yang) sides of his body were extremely tense while the inner (yin) sides were soft. His tongue was pale and scalloped and it quivered. His pulse was rapid and wiry. He preferred the room to be cool.

I treated the palpable imbalance in his connective tissue. My theory was that the increased energy in the yang meridians was forcing too much Qi and heat to his head. The concomitant deficiency in the yin meridians meant his energy lacked the means to flow downwards through the connective tissue matrix, and become grounded. This treatment strategy seems to have been effective. He had mild pressure on his right cheek after the treatment, which he did not think was related to lying face-down in the face cradle, which lasted about a day, but aside from that the treatment triggered a steady, gradual improvement in symptoms over the following 24 hours. When I saw him again about 4 days later, he exhibited some more personality, being somewhat chatty and bordering on (but not quite) cheerful. He had hope. That’s a beautiful thing.

We worked again on the same premise. The imbalance was still present only not as severe, and this time he actually smiled once as he was leaving. My strategy, based on the teachings of Mr. Koei Kuwahara, a master practitioner of Japanese acupuncture and my teacher while I was a student at the New England School of Acupuncture., basically involves returning to palpation frequently, sometimes after every needle is inserted to follow the progress in relieving tension in the yang meridians, and redirecting that energy to the yin meridians. This type of treatment can not be done quickly.

I’ll keep you posted about how this works in the long run.

Prism glass 1
Originally uploaded by tanakawho

I got into treating skin rashes with acupuncture and herbs because my son developed a nasty, itchy rash when he was only 5 months old, while his only food was breast milk. I intuitively knew that gluten (which can be very damp) played a role, as I had been hungrily devouring the bagels my brother sent from Zabars and not cooking my beloved greens because of the demands of mothering a kid under three, and a five month old, while also working (as an acupuncturist)–I know, excuses, excuses. I knew better, I just lacked the resources or drive to do better. So I got myself off gluten (and back on greens and garlic and rice). I had already been dairy-free for a number of years. And I gave my son Chinese herbs, which I cooked up in my kitchen and froze in ice cube trays. I used a pipette to shoot the watery, warm concoction into his mouth. He got better. To this day, we periodically test him with gluten or dairy to see if he has outgrown this sensitivity, but he has not. I have also stayed off gluten as I had my own problems when I reintroduced it. The body sends such clear messages when it is relatively clear of toxins.

In a macrocosmic way, the clinic “body” sends clear messages, too. What I have to offer, based on experience, energetics, or knowledge makes its way to people who need what I have to offer, in ways I do not pretend to understand. I merely marvel at it. I marveled when people started coming to me for help with eczema, psoriasis, shingles and chronic itching, undiagnosed celiac, and food allergies. I have not helped all of them, but I have helped most of them.

…So ends my (egocentric) lead in to the topic at hand: less ego, more light….

One of my first clients with eczema (after my own son) was an 11 year old boy who also had severe asthma. His parents had both been allergic as kids, with histories of asthma and eczema. But they showed few symptoms if any as adults. This young kid was an athlete and at every game he frequented the team’s snack hut, chock full of junk food. He and his mom weren’t willing to prepare herbs in the kitchen which smells up the house, nor was he willing to drink a bad tasting herbal concoction made by mixing powdered herbs with hot water. He was willing to take tea pills. He couldn’t swallow larger capsules. His eczema was very dry and very itchy. His asthma responded to acupuncture very quickly and his frequent attacks dwindled to zero almost immediately.

But the rash held on, only mildly mitigated by patent herbal formulas I prescribed. I spoke to the mom about my son’s experience, and explored her willingness to control her son’s diet, but it seemed impossible to her at the time. Not surprisingly, they stopped getting acupuncture, stopped taking herbs, and continued with an unstructured diet full of common allergens for atopic individuals. I ran into the mom recently and learned some very distressing news: her son continued to struggle with eczema, and it only got worse. At 19 he became intolerant of almost all foods, and required hospitalization due to severe malnutrition. Mom didn’t seem to remember our conversations about diet eight years earlier. I refrained from reminding her. But I thought about it a lot later, about my approach to people when discussing lifestyle choices. I am gentle and understanding. I don’t expect people to make huge changes right away, just small ones, one at a time.

But this doesn’t work for everyone. It didn’t work for this family. Some people respond better to a stronger hand. This family found a strong hand to school them in the shape of a feeding tube. Could I have altered my approach 8 years ago, in such a way that I would have been able to intervene in this dire course of events? The Worsley 5 Element style of Acupuncture excels at this sort of flexible approach to clients based not on the practitioner’s strength but on the practitioners ability to read the client’s “Causative Factor” or CF, described in terms of one of the 5 Elements. The practitioner then adapts her approach to the client, even in the way she speaks to the client, in an effort to reach through the client’s barriers of self to a deep connection with each individual’s innate desire for healing. Had I reached that deep place with my client and his mom, and fired up their desire to do whatever it would take to heal–even if it meant no more greasy fried cheese tortillas, and Mounds bars–maybe he wouldn’t have ended up in such a severe state of toxic overload. And she wouldn’t have ended up stooped over with worry, overly pale, and herself way too skinny–as she was when she described her son’s condition to me. But I wasn’t able to filter out myself, my way, and approach her in a way that worked for her.

The deeper I get into Chinese Medicine the more I see it as a pervasive intelligence as simple yet majestic as light. The different schools of thought–TCM, Classical, Japanese Meridian, Kiiko, Toyo Hari, Medical, Worsley–are merely prisms, which can refract the light in spectrums visible to the human eye. The important thing isn’t the prism, it’s the light. Each practitioner is also a little mini-prism. What is important isn’t how gentle and compassionate I am “as a healer,” it’s how much light is actually getting through to my clients. Less ego, more light.

veins & capillaries
Originally uploaded by kreativekell

Acupuncture treatments can provide a safe and effective outlet for the release of traumas that have become lodged in the body. I know this because a significant number of clients who come through my door for acupuncture are folks who identify as trauma survivors. And some of them have experienced a release of trauma in a very physical way, as a result of acupuncture. I’ll tell you of one such instance in just a minute. First, I have to give a shout out to Michael Given who recently posted over at Deepest Health. In his article he said:

classical holism is a dynamic interplay between function and matter, internal and external, time and space. It is based on the concept that matter follows energy, and energy follows consciousness…

Thanks, Michael! Those words got me thinking about writing this post. I would just add that consciousness sometimes follows energy, just as energy sometimes follows matter. The interplay is bidirectional! The example I’ll give in a minute illustrates this.

Before giving the example of a release, here’s my take on how trauma gets lodged in the body in the first place. Trauma, broken trust and boundary violations cause (imaginary but nonetheless energetically strong) boundaries in the quiet spaces of the heart –the netherworld of dream, myth and archetype, where the lively, constantly changing, evolving and engendering energies between form and function naturally “play,” or “interplay.” Perhaps those boundaries are an instinctual attempt at protecting what in Chinese Medicine we sometimes call, the Emperor–the heart (without which we do not live). The energetic effect, however, is to prevent some of the spontaneous interplay of form and function. Thus, integration of experience in the life-blood of being becomes an enormous challenge. The life-blood which should carry that wisdom of integrated experience to the rest of the body, carries instead blood that is stagnant with non-digestible energy.

I always imagine that blood burdened by the non-digestible energy of trauma is “sticky,” almost as if it contains little velcro-like points looking for another sticky surface to grab onto. This is how I imagine trauma gets stuck in the body. Sticky blood! Now, I confess, I completely made up this term–I’m not using the language of Chinese medicine here, as I think most clients don’t get that much out of it; instead I’m using images that my clients seem to respond to. When sticky blood is carried through the blood stream it either finds a sticky spot to which it is naturally attracted just as velcro attaches to itself. The sticky spot is an area of the body that may already have been weakened by some sort of a pathogen (and trauma can be an example of a pathogen in this sense). It there are no sticky body points (or sometimes even if there are, if there is an abundance of this sticky blood, it can travel in a circuitous loop of negative emotions and thoughts, and never become resolved or integrated. What follows such a state of irreconcilable energetic information is, inevitably, illness.

Here I have to give another thanks to a writer at the Helfgott blog, Michael McMahon who posted an article about an English country doctor who believed that the nature of illness was related to a person’s inability to find ‘confirmation of oneself in’ the outside world. The book about this doctor, which Michael quotes, is called “A Fortunate Man,” and a book I definitely look forward to reading. That beautiful quote just brings to mind that unending circuitous loop of emotion and thought I’m talking about. The loop is a closed and exhausting circuit which could be interrupted by “confirmation” of one’s self in the world. That confirmation is not easy to find for traumatized people.

That doctor lived in the 60s, a traumatic time for our country, war time, and a time of great upheaval and change. I think the cultural phenomenon of identity politics, which arose in the 80s, arose out of a deep need within individuals for “confirmation of self” in a world that had not regained it’s equilibrium since the widespread unrest of the 60s. Identity politics was exemplified on college campuses by the diverse identity-oriented groups that were popping up all over the place. I was in college and living in Northampton Massachusetts at the time, where there was an explosion of Gay and Lesbian groups, followed soon by Gay, Lesbian, Bisexual Groups, followed a little later by Gay, Lesbian, Bisexual and Transgendered groups! These groups played a large part for many people in interrupting a closed circuit of isolation–however, the identity groups (I believe) often became an albeit larger, but nonetheless still closed circuit– which failed to find confirmation of itself in the outside world. Some of the groups were in fact somewhat based on keeping out the outside world. I think identity politics (at its height in the 80s?) is giving way to a cultural politics more comfortable with sharing space and dialogue among people of vastly different experiences– a healthier, more open system, in my opinion…but I digress.

Oh-oh, reign me in…OK, I’m back…Here is the example I promised to give:

A few years ago I had a client who, among other noncritical ailments, suffered from constipation. On one day in particular she felt her “midsection was blocked.” I did a very simple treatment (St 25, Cv 4, CV 6, Liv 3, Liv 14) and the client experienced an unexpected phenomenon–whole body trembling. She asked me not to take the needles out but to sit with her while she described to me the memory that had suddenly flooded her consciousness the moment the shaking began. I will always remember the gist of what she told me about her experience. When she was a very young woman, a teenager, she became pregnant and received an abortion in a manner that can only be described as cruel and unusual punishment. Saline was injected into her womb, and then she was left alone in a room, experiencing excruciating physical and mental anguish, for 18 or more hours. She wept as she spoke but again asked me not to remove the needles as she felt that they were facilitating a final exodus of this trauma from her body.

As in this example, the potential exists for acupuncture treatments to spontaneously dislodge stored trauma from the body without requiring the patient to undergo lengthy sessions in which she holds the trauma in her consciousness, as is required of many psychological approaches to healing such as psychoanalysis and other talk therapies. Nothing wrong with those therapies, and if fact in the given example my client not only had engaged in significant therapy in her life, she was also a therapist by profession; who is to say if the combination of therapy and acupuncture is not what lead her to the readiness of that moment to release the trauma. But it is also true that it was the release of the trauma in her case, which brought the trauma to consciousness. It wasn’t the other way around. The body, not the mind was the initiator in the letting go process. The consciousness that followed was accompanied clearly (as described by the client) by a new sense of the trauma as something exiting the body.

The realization that this sort of healing is possible with acupuncture led some acupuncturists to New York City after 9/11, to New Orleans after Hurricane Katrina, and to Southern California after the recent wide-spread fires. These compassionate acupuncturists have been on the scene to provide stress-relieving auricular acupuncture treatments to survivors and aid workers alike. For more information about the work of one organization dedicated to this sort of service, and teaching other acupuncturists how to set up mobile acupuncture clinics visit Acupuncturists Without Borders. According to the AWBs home page,

Acupuncturists Without Borders’…vision is to foster the creation of stable, peaceful global communities through its community-based acupuncture services and training which interrupt the cycles of unresolved trauma.

I went to one of their trainings in Portland Maine. They do good work. If so moved, please donate to their organization (Besides attending one of their trainings I am not affiliated with AWB). Peace!

As an acupuncturist and a gluten-free mom raising a gluten-free child, I have wondered quite a bit about gluten from the perspective of Chinese medicine. Of course, Chinese medicine has no monolithic perspective on gluten intolerance. But I enjoy this sort of cross-cultural musings, and reflecting on commonalities among different aspects of my own experience.  Nothing much came of my musings, until…

…today, while riding a stationery bike at the YMCA, while simultaneously reading a book (I know! Terrible multitasking!), the point of connection occurred to me suddenly and without warning (and me on a bike without a pen): Wu, which translates as non-being is the point of connection between Chinese medicine and gluten intolerance.

If you haven’t snorted, rolled your eyes and left his post (post-haste), bear with me while I try to tease this little insight out into the light of (a now dwindling and snowy) day.

Gluten is a protein in certain foods that makes the food puff up, swell and become sticky.  It’s a primary ingredient in all mass-produced baked goods–breads, crackers, muffins, cookies, pies, etc. as well as an ingredient in many unexpected places:  vinegar, salad dressing, soy sauce, and others.   In metaphorical psychology it is kin to egotistical and arrogant thinking,  to a “puffed up” view of one’s own self-importance.

You have to have a little perspective on Wu (non-being), if you’re going to follow this strange correspondence all the way there. As I understand it non-being (Wu) is a fundamental underlying principle of Chinese ontology, which informs both Chinese philosophy and Chinese medicine.  Ontology is the study of being.  In the ancient text of Taoism, the Tao Te Ching, Lao Tzu says

All things in the world come into being from Being (Yu); and Being comes into being from Non-being (Wu).

(Chapter 40).  I read something quite funny the other day about the Neo-Taoists (many of whom thought Confucius a greater sage than Lao Tzu or Chuang Tzu).   This is from “A Short History of Chinese Philosophy” by Fung Yu-Lan, a book I bought back in 1978 or 1979 when my high school boyfriend, Jeffrey, and I used to go to Samuel Weiser’s bookstore in New York City.   Years later, after Jeffrey and I lost touch we simultaneously graduated from acupuncture schools on different coasts.  It was a number of years later when we learned of our similar paths.  Here Fung Yu-Lan is quoting the Shih-shuo Hsin-yu (Chapter 4):

Wang Pi [226-249], when young, once went to see P’ei Hui.  [P’ei] Hui asked him why, since Wu [Non-being] is fundamental for all things, Confucius did not speak about it, whereas Lao Tzu expounded this idea without stopping.  To this Wang Pi answered: “The sage [Confucius] identified himself with Wu [Non-being] and realized that it could not be made the subject of instruction, with the result that he felt compelled to deal only with Yu [Being].  But Lao Tzu and Chuang Tzu had not yet completely left the sphere of Yu [Being], with the result that they constantly spoke of their own deficiencies.

Fung Yu-Lan adds, “This explanation reflects the idea expressed by Lao Tzu that “he who knows does not speak; he who speaks does not know.” (Lao-tzu, ch. 56).”

But what does this have to do with gluten intolerance?  Gluten intolerance is growing like wildfire.  It’s almost as if this near epidemic is a canary in the coal mine, warning us of a major weakness in our microcosmic system (the body) and in our macrocosmic system (American culture).  We’re too full.  We need more space, more emptiness, less puffed-up-ness in our lives.  One of the basic healing principles of Taoist-informed acupuncture is that proper insertion of the right needles allows a person to recede from the complicated, often messed-up experience of being, and to journey, if only for a short time, into that realm of Being and Non-being.  Just as Lao Tzu said, “reversing is the movement of the Tao,” so too is going backwards to one’s source energy a movement which will heal.

Abstaining from gluten–that which fills, expands, makes sticky and full–can be a similar reverse movement towards an emptiness that is resonant with the deepest origins of being–Being, and deeper still with the origins of Being in Non-Being.  This is an idea that is also resonant with the school of thought in Chinese Medicine which arose sometime during the Jin/Yuan Dynasties (1115-1368 A.D.) with the Treatise of the Spleen and Stomach by Li Gong Yuan, in which the origin of disease is believed to lie in deficiencies of these organs.  It’s also resonant with current nutritional wisdom in which fruits and vegetables are the key to health, and with another fact established by Western medicine:  The single dietary feature proven to be linked with a long life is merely the low calorie diet; In other words, if you experience a little less fullness, you will live a little longer.

There is an acupuncture point a few inches from and on either side of the navel called Tianshu (translated as Celestial or Spiritual Pivot).  This name (and location of the point at the center of the body) reflects the cosmology underlying Chinese Medicine in which the person is the conduit or meeting point between heaven and earth. The relationship between person-heaven-earth is not just a theoretical construct but something that is embodied in the structure and functioning of the meridian system, of which Tianshu, the Celestial Pivot is a part.  The human body is a map not only of personal experiences and relationships but of cosmic ones as well.

Could the growing prevalence of gluten intolerance (including but not limited to celiac disease) be a symptom of something out of balance not only in the afflicted guts of so many individuals but also in the relationship of all humans with heaven and earth?  Is there a connection between gluten intolerance and global warming, massive pollution, depleted uranium and an overall lack of respect for the living planet on which we live?  If there is (and I believe so) then until we are comfortable as a society with reversing these deadly trends (reversing is the movement of tao), then what we eat and how our individual digestive systems react to what we eat, will be the least of our planetary survival concerns.

Words, and what they mean, are popular topics of discussion among practitioners of Chinese Medicine today.  We use technical terms (Qi, Blood, Yin, Yang, etc.) that arose in a different geographical, cultural and historical era, and we apply those same terms to patients who live here, now.  There are many different schools of thought among acupuncturists today about what the terms mean, and whether using the terms in adherence to original intent is more or less relevant to the goal of treating patients effectively with acupuncture today.

Often the terminology we use in diagnosis informs our treatment strategies.  When that is the case, the meaning of our terminology will have a profound impact on our actions, and therefore, arguably on the outcomes for our clients.  There are some outstanding approaches to treatment strategy however that are less concerned with terminology and more responsive to information gained through the fingertips–via palpation of the abdomen, the meridians, and the points.

I have been practicing for about 10 years now, and while I’ve had many inquisitive clients, none of them have wanted to invest much time in understanding the technical terminology that we acupuncturists spent hundreds of hours closely scrutinizing in spleen-weakening 3-4-year-long study binges.  I’ve had some clients go on to acupuncture school, but even they didn’t want the whole course of study condensed into their treatment hour.  They much preferred to relax on the table and feel the magic of the needles.  Good for them.

So I have come to believe that technical terms are enjoyable topics of conversation among acupuncture geeks but not generally useful in the treatment room.  I don’t hide the technical terms from my patients, but neither do I emphasize them.

Nonetheless the attention to words and their meanings tickles me and I’ve come up with a line of inquiry that requires no special technical training to appreciate.  And this is it:

What is the difference, if any, between health and wellness? Are they synonyms or do they represent separate, unique concepts?