People meditate in all kinds of ways. There are those who sit in full lotus position surrounded by sound bowls; they light candles, put on ethereal music, hold prayer beads, and sit for an hour. Some lie in bed and listen to guided meditations with Matthew McConaughey. Others walk the dog, knit, or even weed the garden for meditation.

All of these methods are great ways to relax our central nervous system, and doing so on a regular basis is what makes for a balanced life. We may reach a meditative state, but what does this actually mean?

From my studies, and from learning from teachers like Pema Chödrön and Joel and Michelle Levey, I’ve come to see meditation as this:       

Meditation is the practice of discovering who you are at your deepest core self,

without a relationship to the mind.

Most of us are living fast-paced lives and are continuously flooded with information. We’re navigating work, kids, relationships, climate change, politics, eating well and exercising, all while trying to ensure we get enough sleep, too! For many of us, our minds are beyond busy and we may sometimes feel like we’re overwhelmed and drowning. Slowing — or parking — the mind is so valuable for our central nervous systems and for our ability to prioritize what is important.

What is the point of meditation?

I often get asked this very important question!

Our minds, as essential and capable as they are, can also sometimes cause problems. The mind is not comfortable with unknowing. Often when we don’t understand something, our mind helps us by drawing conclusions or making up a story. This story may empower us or keep us stuck.

This is where therapy and talking through things is highly beneficial for many of us. When our minds get into a jumbled mess, having a professional help us to see the bigger picture can be an invaluable service for our minds and central nervous systems. Meditation complements this professional help by giving us another tool we can use to support our health and well-being.

A comment we sometimes hear when someone is facing a dilemma is “I will meditate on it.” The irony of this statement is that if you’re meditating on an issue, then you’re not actually meditating. This is because the art of meditation is about separating from all thought and feeling — and the beauty of meditation is that, apart from making time for it, it requires no actual effort.

Letting wisdom come through

Meditation is to “know” nothing and yet still have the emergence of wisdom.

The mind has often been made synonymous with “the ego.” I’m not sure I would say they are interchangeable, but there is certainly overlap.

For many of us, our mind is the primary driver behind our decisions and reactions. It’s what is steering the ship. When someone or something obstructs our plans, a multitude of thoughts and feelings emerge and our mind reacts accordingly to reconcile things, such as adapting with stories and justifications. This is not a bad thing — in fact, it’s vital for survival! But what if our stories stop being true? What happens when we are stuck in a loop because the explanations we are using no longer serve us? We may feel frustrated, fall into depression, or retreat from society. In some cases, we may get sick or turn to addicting substances.

Imagine if we allowed wisdom to come through more than being driven by our minds? What if we parked our minds more frequently, allowing space for our truest self, our spirit, to emerge?

When this happens, we may notice we become less reliant on the stories and have a new awareness of how to deal with a tough situation. We may find we have less road rage, and are able to connect with people better and more meaningfully. We might sense or question what our body needs from us instead of blindly following what we are told on Instagram. We may realize we naturally choose to eat better without it being a chore and drink more water without forcing ourselves.

Essentially, we begin to have more “knowing” and may be more comfortable with the unknowing. We can relax into a complex problem because we trust that we have the wisdom to know what to do.

A simple technique for meditation

The simplest of meditation techniques requires nothing except to sit for 15 minutes twice weekly. It works to “park” the mind by focusing our attention on the breath. By observing the rhythmic nature of the breath, the mind can rest.

I find that meditating first thing in the morning is the most beneficial — before looking at my phone or emails, before talking to anyone, before my mind begins its busyness.

Here’s a basic structure to follow:

1. Upon rising in the morning, have a glass of room temperature water.

2. Do a few stretches or sun salutations.

3. If you can, practice in a location where you’re facing a window or some source of natural light. This is great for when you open your eyes at the end of the session.

4. Sit in a chair that supports your back and keeps you sitting mostly straight (you can use cushions to prop you up). You can sit cross-legged or with your feet on the floor. Sit comfortably, but not so comfortable that you doze off!

5. Your hands should rest comfortably in your lap.

6. Close your eyes and soften your face.

7. Focus your attention on the breath passing through your nostrils. If you have sinus congestion, simply breathe through your mouth and feel the air passing over your lips.

8. Sit as still as you can for 15–20 minutes.

9. If your mind wanders away, gently re-focus its attention to the small area of breath passing over your nostrils. Resist judging yourself when the mind wanders — that’s just what it does!

When we first start practicing this technique, we may find that our mind settles for only a few seconds in the 15-minute period. Inevitably, the mind will keep running off to think about emails we need to answer, ponder relationship issues, or plan out dinner. As soon as we think we have it, our mind wanders away again! This is the nature of the mind. In fact, I went to a lecture by a Buddhist nun who had done a year-long silent meditation retreat. She confessed that the longest her mind was truly still in that entire year of meditating every day was 30 seconds!

So what do you do when your mind wanders? Without getting angry at your mind, gently keep taking it by its hand and bringing it back to rest.

Meditation is a practice and like all practices, some days you will be “pleased” with your ability to park the mind while on other days, your mind will drive you around the bend! Just keep practicing and try not to be attached to describing or judging your meditation. Resist thoughts like, “Oh I had the worst meditation today! I could not get my mind to stop!”

Remember that the act of sitting down and doing the practice is the most important part.

Moving forward with meditation

If you find it easy to manage twice-weekly meditation, then of course try to do three or four days per week. Fall and winter are good times to delve deeper into this practice. The energetic nature of these seasons drive us to go inward and to conserve. During spring, you may find yourself wanting to be outside more and sitting less as this season motivates us to rise and move.

Summer is a time when our lives are naturally more social, fun, and buzzing with activity. During this season, your times of practice may be far and few between and that’s normal. The great thing about meditation is that it’s a practice you can always come back to at any time.

I've committed to meditating on Tuesdays and Thursdays from September until March. Who wants to join me? Which days did you choose and why? What are the biggest obstacles for you when it comes to meditation? Let me know how it goes in the comments below. I look forward to practicing with you!

UPDATE: March 9th, 2020

The author of this compilation is a pharmacist and Chinese Medicine practitioner. The following herbal formulas are for different stages of disease and this is the PRIMARY form of treatment being used in China currently.

This is for your information only!

This is not meant to be a list for the layperson to go out and try to treat themselves or a family member. If you or a family member is sick, seek out medical care and if you are in an area where you can also see a Chinese Herbalist, take this to them.

If COVID-19 becomes more of a drain on the current medical system and hospitals are overwhelmed, a larger part of the population may have to seek out other treatment options such as this. I will keep you informed. In the meantime, you know what to do….wash your hands, don’t touch your face and try not to freak out stockpiling toilet paper!

I refer to it as Myofascial Cupping Therapy (MCT) because this name better explains the technique of using suction cups to release the myofascial complex: “myo”= muscle and “fascia”= connective tissue. Fascia is pronounced “fa-shee-ah”. 

Research suggests that acupuncture’s effectiveness has to do with the fascial communication system. Channels or energy pathways almost always follow fascial lines and major acupuncture points occur at bifurcations of fascial planes. 

Dr. Helene Langevin at the University of Vermont has researched connective tissue as it relates to acupuncture. A very good 10-minute explanation from Dr. Langevin can be heard here

https://oshercenter.org/2017/09/18/acutalks-interviews-dr-helene-langevin-connective-tissue-plays-role-acupuncture/

Why do it?

MCT is used to:

• open acupuncture or fascial channels, breaking up adhesions

• decrease inflammation, relieving pain

• improve perfusion and nourish the tissue

Say someone comes in with severe back pain and stiffness. They have had x-rays that have revealed no structural abnormalities. They have tried anti-inflammatories, massage therapy, physiotherapy, and nothing has given them any relief. Now they are starting to experience sciatica symptoms of tingling and burning pain down the legs. 

When I palpate, their tissue feels hard and immoveable from the base of the skull, all along the spine and the backs of the legs to their ankles. They have the most tension in the lower back from L2-L5 vertebrae. In Chinese Medicine, we would call this Qi and Blood stagnation along the UB (urinary bladder). I could choose to do acupuncture points all along the UB channel but MCT is often more effective in this case.

How is it done?

I put some massage oil on the skin, along the spine and on the backs of their legs. Using a pair of hemostats, I soak a cotton ball in 99% alcohol and light it creating a large flame. Then quickly, I put the flame inside the glass cup for a second to remove oxygen within the cup and place it on the skin. The amount of suction created can be adjusted by letting some air into the cup to lessen the pull. 

On either side of the spine, I often will slide the cup slowly from occipital to sacrum, releasing the tissue along this fascial plane. This may sound painful but it is not! It is incredibly relieving and I find that people who don’t like massage, LOVE this type of moving cupping. It is not as comfortable doing this on the back of the leg, however occasionally the IT (ileotibial) band can be released this way. 

Then I may leave cups on the legs in specific areas following the sciatic nerve route for about 5 minutes each, then moving them slightly to release the entire fascial line. 

Cups may stay on for up to 10-15 minutes, after which I would do acupuncture at points to assist in further release of the UB channel. It is not uncommon for the patient to get off the table and feel immediately 50% less pain, less tingling in the legs and more mobile in general. 

Do the purple marks always come up and are they necessary?

No and no. The purple marks that may come up depend very much on the patient’s constitution and the severity of injury. 

If for example someone has been in a car accident and has severe shoulder pain and immobility, we can expect the cups to leave dark purple marks. Of course, patients who bruise easily or those on blood thinners, we take caution with and may not be able to use MCT in these cases.

The marks left by MCT are also dependent on the practitioner’s intention. I often use only medium-strength suction with the cups so as to release the fascia without unnecessarily leaving marks on the patient. If I am addressing scar tissue at a deeper level due to long term injury, I may make the suction cup strength stronger. 

Are more cups better?

No. I’ve seen many posts with patients sporting 30 cups all over their back. Maybe this feels relieving initially, but often will leave patients feeling discombobulated and fatigued. Focused MCT is the key. Practitioners should focus on the problem area and channel(s) affected. Like acupuncture, we consider the person’s constitution (robust or weak), the season (in winter, cupping should be used sparingly because it is a time for restoration) and their stature and age.

Although these notes are meant for practitioners, I think there is plenty of wisdom to share with anyone who has had an interest in ancient aspects of medicine and healing.

 Thanks for reading,

Erin

The Practitioner-Patient Relationship

Wisdom from the Chinese Classics

Notes from a seminar by Claude Larre, s.j., and Elisabeth Rochat de la Vallee (May 26, 1990)

Compiled by Edna M. Brandt, RAc with special thanks to Jeanne Anne Whittington, Chan Zang, Zoe Brenner and Sarah Stang.  This article is transcribed from a. Copy of the Journal of Traditional Acupuncture, Winter 1990-91, pp 14-17 and 49-50.

 Father Claude Larre,s.j., studied Chinese in Beijing and Shanghai and lived in Japan and Vietnam for many years. He has a doctorate in Philosophy and Sinology from the University of Paris and degrees in Chinese, Japanese and Vietnam studies and Languages. He has written extensively on different aspects of Chinese culture, specializing in translating Daoist texts and Chinese medical texts. He is the founder of the Ricci Institute in Paris and director of the European School of Acupuncture.

Elisabeth Rochat de la Vallee is the senior lecturer of the European School of Acupuncture and a member of the Ricci Institute. She holds degrees in Philosophy and the Classics and in Chinese studies. Elisabeth has worked with Claude Larre for nearly twenty years as a researcher and translator and has exceptional knowledge of the medical classics, grounded by her experience as an acupuncture practitioner.

The texts for this seminar are chapters from the Huang Di Neijing (Yellow Emperor’s Classic of Internal Medicine) which has two sections, the Su Wen and the Ling Shu. The Neijing is the oldest-known document of Chinese medicine. Its author unknown, it was compiled sometime between 200B.C. and 800A.D. Its contents are certainly much older, summing up the knowledge of many centuries.

 _______________________

 “The most important thing for healing is the relationship of the practitioner, the spirits and the patient.”

The Neijing tells us that the healing process is not just mechanical- it is not simply the placing of a needle. The most important thing for healing is the relationship between the practitioner, the spirits, and the patient. This relationship begins with the personal attitude and inner behaviour of the practitioner. Your own spirits and forces must be in good concentration in order to be able to evaluate the patient and to be able to rectify what is wrong in the movement of his or her vitality. It is your spirit which enables you to be able to make the diagnosis, choose the points, and give a feeling of rightness to the patient at a high level- without interfering with the patient’s freedom. The treatment always takes place inside of this practitioner-patient relationship.

 Su Wen Chapter 39:

Huang Di speaks to Qi Po:

Those who are good at speaking of heaven must have experienced it in man.

Those who are good at speaking of antiquity must have made the junction with the present.

Those who are good at speaking of men must be satisfied with themselves.

When things are like this, one can follow the Dao without confusion or distress and reach the summit of essential rules/numbers.

That is called illumination/radiance of life.

I would like to ask how to succeed in having knowledge of diagnosis through rules: how to hear and ask questions, how to succeed in seeing, feeling and palpating, how through the deep examination of self one can be free of confusion and lift the veil.

 Commentary:

 Those who are good at speaking of heaven must have experienced it in man.

Heaven (tian) represents Nature, the movement of the four seasons, which are present in the entire life of each person. In our body is the same life that is in a tree or flower or in the weather. The differences depend on our species- the details are different but the organization is the same. If we can observe how all life is at work, this is the first level of knowledge: to have the consciousness to observe the natural order and find it again in oneself and in another. If you know how life functions, then you know how disturbances show up, because diseases follow this movement also. Heaven is the unseen power that is directing everything, and all discernment of health and disturbances begins with this knowledge of heaven. If you understand that you must be in harmony with Heaven, you will practice clearly.

Those who are good at speaking of antiquity must have made the junction with the present.

Antiquity (gu) was the time when the sages could see how life was organized, so they could help people know how to behave. The most famous commentator on this passage says that antiquity is the mirror for the present time, and if you cannot see how one applies to the other, then you are only able to apply recipes without real understanding. However, we also need to make the junction of antiquity with the present, which means that we must interpret antiquity to find the deep meaning of what was said in the past in light of present circumstances.

Those who are good at speaking of men must be satisfied with themselves.

This is the third level of relationship, a consequence of Heaven plus antiquity. The first level (Heaven) is the unity of life in each being, the second level (Earth), the continuity of life from antiquity to the present. The third level (Man) is the multiple individual lives and their relationships. If you do not have a good relationship with yourself, you are unable to have a good relationship with another. You first must have a deep understanding of your own life before pretending to know life in another, especially the disturbances in the development of life in another.

You also must not be blocked in yourself, or full of desire to heal. You have just to do your best, very quietly, and then let go. You must not have inner agitation or desires, even the best of desires; if you do not have desire, then you have a real relationship with the patient and are not forcing the patient to correct his spirits to please you. To be satisfied with yourself means to harmonize yourself. If you are quiet within- as you must be while doing calligraphy or archery- you will do good healing work.

Yet if you have the desire to be empty and quiet inside (for the free circulation of your heart), the desire itself prevents you from being empty and quiet. There is then something wrong in your spirit and in the fundamental axis of your life, and hence you cannot succeed. The best way to cure a patient is to remain in the natural expression of your own power of life. To desire too strongly is stagnation and blockage in your intent and will, and it diminishes your ability to cure. Do not grieve if you cannot cure; just try without tension every day to become what you are, let the life of the spirit grow in you, and bring this to every part of your work.

The texts never say that you must desire to cure. They repeatedly say to be calm and quiet without special desire. Wanting something is always dangerous, even if you are wanting the best thing in the world- the tension in you is bad. Note, though, that willpower is not the same as desire; willpower is the right orientation of your life, which you must have, and it is sufficient.

This, of course, is the ideal. Every practitioner feels good when the patient is better (it makes a cure in the practitioner too!), but if it lasts longer than just today, it becomes the beginning of disease in you. So, be happy about it today, but tomorrow forget about it.

 When things are like this, one can follow the Dao without confusion or distress...

 If you can realize these three levels, then the Dao is without confusion. You can follow and express your own way of living without uncertainty. You can know something- not because you know from the exterior but because you know from your interior. You are self-sufficient, well balanced, quiet, and calm in yourself. Hence, you can apply the Dao, which is also the art of medicine, to your patients without confusion.

 ...and reach the summit of essential rules/numbers.

In this state, you are able also to follow to the end the essential rules (shu). These are the models of all activities, between the level of Earth in each particular person and the level of Heaven where all is unity. The character shu means both rules and numbers (and also technical applications). Rules are derived from what is true and common from many particulars, finding the unity where things are the same. Numerology expresses these fundamentals- the great unfolding of life which all the universe shares.

In studying medicine, we get rules for particular cases, but we also have to be able to go to the level of unity through our own lives in order to be able to understand how the rules given from antiquity can be applied to a particular person.

 That is called illumination/radiance of life.

To be in this state is illumination, understanding the patient through the light of knowledge between what you have learned and the pattern of life you experience in yourself.

 I would like to ask how to succeed in having knowledge of diagnosis through rules, how to hear and ask questions, how to succeed in seeing, feeling, palpating, how through the deep examination of self one can be free of confusion and lift the veil.

Diagnosis through the sense organs relies on the deep examination of yourself. Through that examination, you are able to clear blocks in understanding and to make a good diagnosis- to lift the veil. Even the tools of diagnosis (fingers, eyes, ears) must be in perfect condition. To see, for instance, is not just having enough liquids and blood in your eye, but also having the presence of spirits there. The presence of the spirits is due to the inner position of your own life.   

 Su Wen Chapter 11:

Make an examination at the physical level and at the level of the zhi and yi to estimate the illness.

If one believes in gui shen, there is no possibility of expressing the virtue.

If one is loathe to be needled, there is no possibility of expressing clever skillfulness.

If one does not accept being treated and cured, do not treat him.

 Commentary:

 Make an examination at the physical level and at the level of the zhi and yi to estimate the illness.

The general meaning is that there is an examination of bodily form: face, pulse, orifices, functioning of viscera, and so on. Then there is also an examination of the inner willpower (zhi) and purpose (yi) as they relate to the illness in the person. The zhi is anchored in the kidneys at the bottom of the trunk and gives direction, continuity, and orientation not only in outward activity but also in the deep mental and spiritual levels. Yi is the image, the thinking or the elaboration of the shape given to the oriented strength coming from the will. All are under the authority of the heart (xin). The distribution of essences and qi depend on these three, which make the inner central axis of the person. The correct rooting of the axis allows the good functioning of the viscera and all the particular details of the person.

 THE INNER AXIS

  Heart (upper jiao)   Heart shen

 Spleen (middle jiao)         Purpose yi

 Kidneys (lower jiao) Will zhi

There is also a great importance given to the spirit of the heart (shen) and of the yi and zhi in the practitioner. You must be upright yourself to be able to discern the axis of the patient in order to diagnose not just the symptoms but the fundamental center of the patient. Only then can you appreciate exactly what the illness is. In other words, the illness occurs not only because the qi is weak or the blood is stagnated; it is not sufficient to diagnose only at this physical level. You must discern whether the central axis, which commands the physiology of the patient, is strong enough. When you can see both the qi/blood and the central axis together, you can obtain the correct appreciation of the gravity of the intuition. One or the other is not enough.

 The patient needs to feel that she has a will and a purpose in life when she leaves your office. This is not only part of the diagnosis; it is part of the treatment too.

 If one believes in gui shen, there is no possibility of expressing virtue.

Shen are the spirits of Heaven (through which the influx of Heaven comes to each person). Gui are the spirits of Earth (supernatural forces connected with the Earth). The meaning here is that if someone believes only in these external spirits and not in the spirit inside himself, he cannot be rectified. If someone is possessed by the idea of external spirits, and sees himself only at the mercy of those spirits, then his own spirit is not governing his life. Thus, he cannot be healed.

 Virtue (de) is the activity in you coming from your deep relationship with yourself. If as a practitioner you are waiting for magic forces from outside to help you, you cannot express your own virtue because you cannot touch your own spirit. Thus, you cannot touch the virtue of a patient.

Great healers go straight to the point and lose no time- they solve the problem. If they are gifted, they can treat without much diagnosis because they have an authenticity that connects directly with the authenticity of the patient. Then there is joy in the practitioner (which is usually suppressed- it is not good to show how powerful you are) that is received with joy by the patient. If the spirits are adjusted well, the healing will hold and the results will be amazing.

When we needle a point or give herbs, we are doing a physical thing, but the goal is always to make a signal to reach the spirit of the patient. Only by signalling the spirit can we rectify the blood or qi.

Re-establishing the balance in any condition always depends on the spirit. Even if someone is wounded, there is not only pain and bleeding, there is always also an emotion of fear or surprise that puts a disorder in animation and thus affects the spirits. The spirits are not wounded themselves, but they are affected, because they work at the highest level in the person and thus are present at the tiniest level of life. With intact spirits, recovery will be faster. The classics say that life is conducted by the spirits- not just sometimes, but in all cases.

If there is no shen, yi or zhi, a person might have a successful operation and still die. The surgeon might have been perfectly correct in his action, but the surgery should not have been done. Without the cooperation of the patient inside, you cannot do your work. Psychology is part of the work to be done: assessed in diagnosis, seen to in surgery, looked after in recovery. Thus, become what you are as a human being, and it will be good for your patient. Healing is not nursing or mothering. The way to care for a patient is just to be yourself and be with him, looking into his eyes. When both patient and practitioner are in communication with their own spirits, the communication with heaven is open. Thus, making your own spirits powerful is sufficient.

 If one is loath to be needled, there is no possibility of expressing clever skillfulness. If one does not accept being treated and cured, do not treat him.

 If the person has a tremendous aversion to the needle, the strong focus on the needle disturbs the inner balance. Other texts say not to needle a person who is very emotional (angry or fearful, for instance), because the circulation of the qi is disturbed by this strong feeling, and thus the signal by the needle cannot be received very well.

If the patient does not accept being treated and cured, you cannot do anything and it is better to stop treatment. If he or she cannot accept cure, there is something very wrong in the axis. If the zhi is not well rooted, for instance, we cannot correct the circulation of life. You assess this rooting not by what the person says to you; you must diagnose whether the zhi is rooted or not.

Ling Shu Chapter 8:

The five zang master and store the essences, so they must not be injured.

If they are injured, they will lose what they have and the yin becomes empty (yin xu).

If the yin is empty, there is no more qi.

If there is no more qi, there is death.

When you needle, you must examine and consider attentively to the attitude of the patient and all the patient’s signs in order to know king, shen, hun and po.

 Commentary:

For the Daoists, there is a difference between dying and perishing. Dying is not necessarily bad- you can die and still subsist in spirit after death. To perish is much worse- it is to separate from the spirits that make life in you. In an extreme case, a living person may have already perished.

If you are called to treat a dying person, you might not want to save the person at any cost. You might want to let the person go because he is ready to go in all parts of his being. Why should we disturb the natural process? You have to know destiny in this case, not just medicine. In other words, what is good for the patient can be seen differently from just keeping him alive no matter what, as is often our practice in the West. Knowing what makes the identity of a living person takes time and learning.

 Su Wen Chapter 54:

Needling is like looking at a deep abyss, take care not to fall...

Your hand must be like a hand grasping a tiger. One desires a kind of firm strength. The spirits have no disorder coming from numerous beings. The willpower is quite full. See the patient without turning the eyes from left to right. Without rerouting the movement, you just desire the rightness or rectification of the spirit. Doing that, you succeed, in making qi circulate easily.

 Commentary:

Needling is like looking at a deep abyss, take care not to fall...your hand must be like a hand grasping a tiger. One desires a kind of firm strength.

This chapter has some nice images of needling! Know that you are on the edge of the mystery of life. Walk on the edge of the abyss without fear, but have caution and circumspection (shen) not to fall. Many texts use the character shen, circumspection, for the correct attitude of the practitioner; it includes the character for heart plus the character for authentic.

 As a practitioner, you must be deeply anchored and assured in your life. Yet the communication with the exterior passes through your prefixes and your hand, which is holding the needle like a  hand trying to hold a tiger. The tiger is an image for vital power.

The spirits have no disorder coming from numerous beings.

Your inner state of mind must not be disturbed from the exterior. You must have good concentration and have no surprise. If the telephone rings while you are needling, for instance, you do not move your hand or the needle, you do not tremble in the least, and then you go slowly and calmly to the phone. If things happen in this way, it is proof that you are in a good state.

 The willpower is quite full. See the patient without turning the eyes from left to right. Without rerouting the movement, you just desire the rightness or rectification of the spirit. Doing that, you succeed in making qi circulate easily.

 As a practitioner you must be in a state of mind with the five wills from the five zang in rightness, quiet and calm. This state is visible in your eyes, which are the messenger of the heart and which have the power of emission (ears receive while eyes can emit). The pupil indicates the relationship between fire and water, between willpower and spirit, between heart and kidneys. All of these are best visible in the eyes of a person. (Ming men, “gate of destiny”, is a nickname for the eyes.)

As a practitioner, manifest your inner rectitude at the level of your eyes and hands in order to rectify the disturbance in the patient. Your regard must be straight and without deviation to the right or left, and your hands must be steady. Thus, your orifices and your needling manifest your own spirit. Your own rectitude inspires the feeling of rectitude in your patient. Your needle can then give the appropriate signal to the patient’s spirit according to the point you choose.

 Ling Shu Chapter 9:

Close windows and shut doors. From this quiet place, the practitioner will take care of the hun and po and give the best expression of the shen.

 Commentary:

 Acupuncture has to move the patient’s spirit to be successful- it is not merely mechanical. Spirits are the “conductors of the chariot of life”, moving everything on the right path.

 At the level of the practitioner, to close windows and shut doors means to close your orifices in order to keep your essences and qi at work inside, and not to use up your essences and qi in exchange with the exterior. Thus you use all your power for the expression of the zang at the level of the inner spirit of the zang (as in the Daoist texts), so you perceive reality in the inner world-with inner taste, inner hearing, inner seeing. You use your vitality to perceive your inner reality and to make the unity of your own life. Thus you concentrate your purpose, using your essences and qi internally, so you have an inner unity, which is the unity of your spirit. Then you have one shen; you are one with the spirits, and you are in unity through contact with the enlightenment of the spirits.

For the treatment room, to close windows and doors means that you need a room calm and quiet enough for concentration, so that you can stimulate the possibility of the relationship and unity between your spirits and your patient’s spirits. Through your concentration, you are able to put willpower in the needle, not forcing and violating the inner freedom of the patient; but communicating through the needle (of course with good technique at the right moment) and giving the patient a signal for concentration, quiet and calm. The result is that the spirits of the patient are moved.

Ling Shu Chapter 27 explains this movement of the spirits. Pain is the pressure of perverse energies. When the qi of wind, cold or damp enter the exterior of the body between the muscles (where the passages for meridians, luo, blood and so on, are found), they make pressure, and the normal body fluids in these passages are charged from good liquids to a kind of foam (a perverse state, something like phlegm). When these liquids are thus perverted, they  cause trouble. If they encounter cold, they condense and create pressure in the passages, so that cracks are caused, which cause pain. The pain is a signal for the spirits to come. When the spirits are attracted, then the painful place gets warm, and the pain disappears. (Ling Shu chapters 1 and 8 and Su Wen chapter 27 have descriptions of the coming and going of the spirits in their assigned passages.) If you do not cure the reason for the penetration of the perverse energy, the pain will reappear elsewhere. Needles attract the spirits to rectify the circulation of qi, so normality is restored.

When you and your treatment room are quiet and harmonious, you make the needling more powerful and exact. Zhuangzi says, In the empty room white is produced. In the quietness of body/mind, the illumination comes. You need peace in the room in order for the patient to be at ease in order to dispose himself or herself to the acupuncture. This is difficult in our society where it is awkward to be peaceful- we are supposed to run around chasing money and goods. Yet, to practice good acupuncture, we must be peaceful.

The spirits move because all the surroundings of the treatment room encourage them to be moved in order to rectify the pattern of the vital animation of the patient. The spirits move also because the right signal is given by the point (which is chosen), by a needle technique or movement (which is also chosen), and because there is present in the practitioner a well-rooted and upright direction of her own life. All these operate together to try to give a pattern for the equilibration and calming of the essences and spirits in the patient. The only way anyone can be cured is by the movement of the spirits.

Remember, though, that you cannot make the spirits move. You can only let the spirits of the patient rectify themselves. If you create the correct conditions, the spirits will come. You can not force them to move- you can only make it an attractive alternative. (In other words, offer the spirits what they like!) The birds choose the trees, not the other way around. Just try to be the best possible kind of tree for the sake of your patients, and then leave it up to the spirits/birds to come.

 Su Wen Chapter 14:

Huang Di: When the body is exhausted and the blood is exhausted, then nothing can be done, really. Why?

Qi Bo: The spirits are not acting.

Huang Di: What does this mean?

Qi Bo: The needles of metal (shen) and stone (shi) are the way (dao), but if the essence and spirits do not enter the way, if will and purpose do not work, there is no action. Then the disease cannot be healed.

 Commentary:

If you just displace the qi in the treatment, you’re not doing much. But if you can entice the spirits back where they belong, then you are a great acupuncturist! You are caring for the ability of the spirits to return to make their beauty of ruling that particular life. Thus treatment is a question of the ruling of life, not of qi or blood.

Suppose you face a serious illness in a patient, but not an incurable one. Perhaps the treatment is good, but it does not succeed. Why? If the spirits are not operating, no treatment will succeed. Or, you may be able to make the patient a little better but not totally well.

“Needles are the way” means that they are the treatment and the technique (recipe) of the treatment. When the essences (jing) and spirits (shen) cannot enter or offer something, or if the purpose (yi) and zhi (will) cannot govern or rule, then the patient is unsuitable to offer to herself a response from her own essences and spirits. Often this situation comes when there is too much emotion- desire, craving, concern, worry, sorrow, or the like- in the patient. It is fine to have these feelings sometimes, but when there is no limit, no break from them, the incessant blows finally bring about the departure of the spirits. You as a practitioner may not be able to adapt a treatment to this person. If you cannot put your own will power in the needles to rectify the spirits and give the patient an opportunity to re-enter into possession of herself, or if you make an error or misinterpret something or are not perfect, then the treatment will not succeed.

The end of Chapter 14 says that the practitioner and patient are like the branches and root of the tree- the same image as the branches and root of diseases. The patient is the trunk, the situation. The practitioner has to become like the high branches of the tree and be in that intimate relationship with the patient in order to understand the real situation of the patient and to assist him.

In 2011 I was asked by Kris Carr to talk about what I had learned studying integrative oncology in China.

In the spring of 2010, I traveled to China to complete my residency for Bastyr University’s doctoral program in Chinese medicine. Our team studied and worked in Chengdu and Shanghai, specifically in the oncology departments of two local hospitals.

I noticed three startling differences between cancer care in China and the United States and Canada. The first is how diagnoses may be kept from the patient in China, the second is that cancer is treated as a chronic illness in China, and the third is the integrated use of chemotherapy and Chinese herbal medicine.

CANCER? WHAT CANCER?

Often when people are diagnosed with cancer in China, they are not told. The family may be told, but they keep the news from their loved one. The underlying motive is to remove the stress element of the diagnosis. This would obviously never be done here in the West for legal reasons (holy lawsuit, Batman!), but it goes without saying that patients are far more relaxed.

Even for the patients who knew of their cancer diagnosis, there was generally a mindset (among both patients and doctors) that this would be a chronic illness requiring a long-term approach. Patients would often check into a hospital and stay for a few weeks of chemotherapy on a revolving schedule depending on their type and grade of cancer.

I will never forget one patient with pancreatic cancer. She had been given this diagnosis 12 years earlier! She was thriving and took Chinese herbal medicine between her cycles of chemotherapy. She continued to work and had a very positive outlook on life.

Another remarkable patient had liver cancer. Every few months he would check into the hospital for his treatments, faithfully drinking his Chinese herbal medicine at home between treatments. He also worked, and his condition remained stable.

MIX ME A COCKTAIL

As a researcher and herbalist, it was so inspiring to learn how doctors were combining chemotherapies with Chinese herbal medicine. While in the hospital, patients would drink a decoction of Chinese herbs specific to their condition and may also have received “herbal chemotherapy.” Ironically, this herbal chemotherapy might consist of toxic herbs, Ya Dan Zi (Brucea fruit) or Chan Su (toad venom), given intravenously in addition to a typical chemotherapy drug. These are toxic herbs that are not available in the United States or Canada.

It was exciting that doctors did not fear combining certain herbs with chemotherapy and saw improved results as compared to using herbs or chemotherapy alone. Some studies had been done or were underway, but I got the impression that most decisions were based on empirical evidence. Because of the different medical paradigm in China, most patients are ready and willing to be treated with herbs. Consequently doctors are getting more and more proficient and experienced in the art of combining. Since patients are closely monitored during their hospital stays, adjustments in dosage could be easily made.

In Chinese medicine, there are two goals of treatment:
1. Fight the xie qi (translated as “evil qi”), meaning kill cancer cells.
2. Boost the zheng qi (translated as “true qi”), meaning rebuild the body’s core energy.

It is generally agreed that surgery, chemotherapy, and radiation are currently the best techniques around for fighting the evil qi. But we are challenged by the fact that these techniques are killing normal, healthy cells including cells needed for strong immunity and digestion. In the East, they consider this an absolute insult to our essential zheng qi. In the West, our oncologists have no prescriptions for rebuilding this core energy.

Chinese medicine is close to 5,000 years old but is modernizing. In modern Chinese medicine we use herbal formulae and acupuncture in addition to chemotherapy and radiation. The herbs and acupuncture both work to do what conventional medicine does not do: boost immunity, reduce cancer growth, improve digestion, improve immunity, and decrease the side effects of chemotherapy and radiation.

Understandably, many oncologists are not comfortable with herbs being taken during active chemotherapy (due to the lack of reliable studies of such combinations).

MOVING FORWARD IN THE WEST

My recommendations if you are considering using Chinese herbal medicine during cancer treatment would be:
1. Work with an experienced Chinese herbalist, one who is licensed or has completed an accredited program and who will support you during your chemo and radiation. An elegant and simple herbal formula may be called for to help manage the sometimes difficult side effects of drugs and to rebuild your system.
2. Ask your oncologist what they are comfortable with. If your oncologist does not agree with you taking herbs during chemo, inquire about taking them when you have finished.
3. Always let your Chinese herbalist know of any side effects you may have related to the herbs. Natural does not equal safe!
4. If herbs are not right for you, consider acupuncture. Acupuncture and moxibustion can greatly help the zheng qi bounce back. Other methods to rebuild include eating well, practicing qigong or tai chi, letting go of emotional pain and grudges, meditating, and surrounding yourself with positivity. 

I WAS ALWAYS GOING TO BE A DENTIST

It was my dream career from the age of 11. The summer before my 12th birthday, my father, a dentist, needed someone to fill in for his dental assistant for a few weeks. He taught me how to mix amalgams, develop x-rays in a small darkroom, sterilize equipment, and do suction. It was a fun job! Eventually, word got out that I was available to sub for assistants during the summer holidays (it was the 80s, so dental assisting was not as regulated as it is now). For the next several years, my summers were spent in dental offices. I even worked for an "old school" stand-up dentist.

After high school, I went to the University of Western Ontario and majored in biology. Then, much to my father's chagrin, I was not accepted into the dentistry program at his alma mater, McGill. So I took the year off to travel and ended up working most of the year at a macrobiotic restaurant in Bermuda, the first of its kind. It was there that I learned about the benefits of a healthy diet. Every day, I ate miso soup and platefuls of vegetables, and drank fresh apple ginger juices. I felt remarkably different and internally "clean". My mind felt sharper and my moods were better. Maybe there really was something to this "eating well" thing! 

AN ASTOUNDING RECOVERY

A few years earlier, my Uncle Frank had been diagnosed with an inoperable astrocytoma brain tumour. He was told that they would try chemo and radiation to shrink it, but that he should get his affairs in order (translation: you've got six months to a year to live). He followed the prescribed course of treatment, but he also went on a macrobiotic diet and changed his lifestyle completely. He moved to Gabriola Island, where he ate small meals of broth, vegetables, lean protein, and green tea. And he played his flute.

His oncologists were shocked to find the size of the tumour decreased significantly. "Wow! Our treatment really worked!" they must have thought. They didn’t realize all the other things that he had done to enhance his body's healing ability. Diet and lifestyle had played an enormous role. My Uncle Frank went on to live over 20 years longer.

ACROSS THE POND

Meanwhile, I was waitlisted at dental schools at Columbia, Penn and UConn. I had also visited and was accepted to some schools in the UK—University of London, Newcastle, and Cardiff. When I was awarded Bermuda's Nichol Postgraduate Scholarship, I needed to make a decision. Although my top choice was Penn, their dental school could not give me an answer in time, so I decided to attend the University of Cardiff.

Cardiff is a lovely small city where I was able to mountain bike from castle to castle! The program was challenging and I had some excellent professors there. First year dentistry does not have much to do with the mouth—we endured a full year of cadaver anatomy, physiology, microbiology, and pharmacology. On weekends, I explored the UK on the train and even joined the medical school women's rugby team and got roughed up a bit during practices and the occasional game against other universities in the UK and France.

Halfway through that first year, I received a letter from my old roommate. She was living and working in Washington D.C. and would soon be moving to New Mexico to study Chinese medicine. I wrote back, half-joking, "you're going to study what?! Acupuncture? Isn't that quackery?!" As it turned out, I was on my way to visit my grandparents in Maryland in a few weeks and we planned to connect while I was there. 

A TURNING POINT

Immediately upon my arrival in the States, I came down with a horrible virus. My immune system had been low since starting dental school. I think that working in cadaver labs with poor ventilation and no masks (in those days) was the primary cause. In addition to that, I'd gone from a clean diet to that of a UK university student. I felt terrible, showing up at my friend's house with a 104 degree fever… What a wonderful guest! She kindly fed me miso soup with extra green onion and did acupuncture on me, then covered me with heavy blankets until I broke a sweat. In a matter of hours, I was feeling much better.

I was amazed, to say the least!

She told me how, after being in a car accident, acupuncture had been an integral part of her recovery. Then she gave me a book to read on the plane: Spontaneous Healing by Dr. Andrew Weil.

I was not an avid reader back then, but I read the entire book on the 7-hour flight back to England. I remember getting off the plane and looking at myself in the restroom mirror. My eyes were gleaming with excitement and were the clearest I had ever seen them. They were saying "This is it. This is the beginning."

A NEW PARADIGM

The first step in this new direction was figuring out how I would transition from "real" medicine, based in science, to alternative medicine, based in the empirical method. There were many moving parts: finding an accredited school, holding onto my scholarship, retaining any credibility I had built up thus far (!), telling my father… It was all quite overwhelming, but somehow I knew that things would fall into place.

It was 1996, the year us common folk got access to the internet. I began researching alternative medicine paradigms online and searching for accredited universities. Having no idea what I was looking for, it took quite some time to understand all of the various areas of study—naturopathy, homeopathy, Chinese medicine, Ayurvedic, and herbalism. The simplicity of Chinese medicine really spoke to me, not to mention its ancient roots.

I learned that Chinese medicine sees the body as a garden, whereas conventional medicine sees the body as a machine. In the Chinese medicine paradigm, balance is achieved by nourishing substances or enhancing relationships between physiological systems. Conventional medicine is able to determine whether something is not working properly and to target the faulty organ or system with medication or surgery. Of course, we need this type of medicine—it saves lives. However, what can conventional doctors do when a patient says "I feel lousy," yet their bloodwork and all other tests come back normal? Generally, not much. This is where Chinese medicine excels.

My research on accredited universities took me to Seattle, Washington. Bastyr University was the most established naturopathic college in North America at the time and had an accredited doctoral program in naturopathy as well as MSc degrees in Chinese medicine and nutrition. After speaking to the admissions office and learning that, with one year of dentistry under my belt, I would be exempt from some of the science courses, I made the decision to take on both the Chinese medicine and nutrition programs, hoping to complete them in four years.

Meanwhile, I spoke confidentially to my guidance counselor at dental school in Cardiff. She tried to convince me that I should finish my dental degree and then "go off and study these other things." But I knew that I couldn't wait to begin my studies in Chinese medicine, so I thanked her and told her I would finish the year before pursuing my new goals. She was not the only one who tried to talk me out of this "insane" idea. I confided in a few others and most of them said it was a huge risk; they thought I had worked too hard to throw it all away to study quackery.

MOM, DAD, ABOUT THAT DENTISTRY THING ...

I was accepted into both programs at Bastyr, finished up my requirements, and then it was time to discuss my plans with my parents. I told my mother first. It was good practice for the appeal that I was planning to present to the scholarship committee. I told her I felt that this was the way of the future: conventional and alternative medicine working together. She could see how passionate I was and she shared my excitement.

My father and I had lunch plans the next day. I was so nervous, I waited until he was on his second glass of wine to drop the big news. "So, Erin how was your first year?" He asked. "Yeah Dad, so that's what I wanted to talk to you about," I replied. "I am dropping out of dentistry and going into Chinese medicine and nutrition."

He was not as shocked as I expected him to be. He said that he knew too many dentists who hated what they did. He was one of the lucky ones who really enjoyed it. After a few jokes about quackery (it was 1997 and acupuncture was not mainstream), I apologized for not being able taking over his dental practice, as I had originally planned. He said he simply wanted his kids to be happy in their work, but that he also did not want to be paying our bills when we were 40!

THE FINAL HURDLE

Now that I had the support of my parents, I needed to convince the scholarship committee that my new educational goals were just as legitimate and valuable as my original educational goals. I was nervous as I walked into the room and stood in front of eight well-respected committee members waiting for me to explain why I was changing my career path. I took a deep breath and spoke passionately about the need for a more holistic approach to medicine. As it turned out, the wife of one of the gentlemen on the scholarship committee had just gone through cancer treatment and had used acupuncture and other modalities to assist in her treatment and recovery. His wife was doing well and, as a result, he saw the value in my vision.

I was on pins and needles after the interview but, within an hour after getting home, I received a phone call telling me I would be allowed to keep the scholarship as long as my grades continued to be high enough. What a huge sigh of relief! I was thrilled and couldn’t wait to get started.

Everything was falling into place. I cancelled my dental school registration and started preparing to move to Seattle. During my flight out West, a strange thing happened… I got a toothache! Not just one but both of my wisdom teeth began to ache unbearably. What a cruel karmic joke, I thought! So the first thing I had to do after arriving in Seattle, before the usual things like setting up bank accounts, finding a place to live, or buying a car, was to find a dentist! Isn’t life funny?

EVERYTHING IN ITS RIGHT PLACE

Bastyr University is located in St. Edwards National State Park. The road to campus meanders quietly through the forest. When I arrived, it had just stopped raining and the sun was peeking through trees. All of the sudden, I was overcome by emotion. I had made it. If I had any doubt in my mind that I had taken the right path, this moment erased it all.

I soon learned that studying Chinese medicine was not about simply memorizing facts and learning how to diagnose correctly. Chinese medicine is a lifestyle, and a system of medicine based in Taoism. Therefore, those studying it must make a commitment to embrace change within oneself and live more in accordance with nature. The lifestyle change did not necessarily come easily for everyone in my class. In our years at Bastyr, many of us had difficulties with relationships and coming to terms with our ideals and the world around us, as we tried to find our place within a system that was sometimes incongruent with our old world view. For me, the beauty and simplicity of the Chinese medicine lifestyle has made my life far richer and deeper than I could ever have imagined. 

Medical systems in Asia have been developing for millennia. Ancient wisdom was passed down through family lineages for generations and eventually, several schools of thought were developed around the best ways to treat illness.

THE ORIGINS OF TRADITIONAL CHINESE MEDICINE

The first medical text in Traditional Chinese Medicine, The Yellow Emperor's Classic of Internal Medicine or Huangdi Neijing, dates back to 2697 B.C. and contains the foundations of TCM and diagnosis. Over the next several dynasties, other ideologies of herbal treatment and physical therapies built on the foundation of the Neijing. People learned through apprenticeships and some recorded their empirical findings.

This medical system, based in Taoism, was rich with our connections to the world around us and the effects of our diet, lifestyle, emotional balance, and environment. The conversations around Yin, Yang, Qi, and Blood painted a beautiful picture of the interconnectedness of our internal and external worlds.

STANDARDIZATION OR ATTENUATION?

During China's Cultural Revolution in the 1960s, Mao Zedong decided to standardize Chinese medicine. The new government was beginning to choose Western medicine over its ancient medicine and, in developing a more modern Chinese medicine, they stripped away large pieces they felt were "unscientific" or "superstitious". Consequently the "Traditional Chinese Medicine" (TCM) that resulted was a watered-down version of thousands of years of wisdom.

The TCM currently taught in schools in the US and Canada introduces students to the foundations and diagnostic methods. There is great value in learning quick prescriptions of acupuncture points and herbal combinations. However, when it comes to chronic problems, in my experience, TCM is missing a vital component.

FIVE-ELEMENT ACUPUNCTURE

Many practitioners and scholars of Chinese medicine knew that the dilution of the ancient medical traditions in Mao's era represented the loss of a deep connection with roots in body, mind, and spirit medicine. Several of these scholars, from all over the world, went to China and worked to piece together the missing components. After many years, they developed "Classical Chinese Medicine" and "Five-Element Acupuncture".

J.R. Worsley brought the Five-Element Acupuncture (5E) School to the United Kingdom. Instead of treating only symptomatically, 5E treats the entire constitution of a person. In treating the constitution, we address the weak link where the body, mind, and spirit tend to become imbalanced. It is believed that this weak link is the root of most disease.

DIAGNOSTIC DIFFERENCES

In TCM, we use questioning, pulse and tongue diagnosis, and palpation to analyze a pattern of symptoms. For example, if a patient’s symptoms include lower back pain, where there is weakness and aching in the late afternoon, the pain gets worse with exercise and is accompanied by frequent urination, overall coldness, a pale tongue, and a deep and slow pulse, the diagnosis would be kidney Yang Qi deficiency. The treatment would involve using moxibustion and warming acupuncture on kidney-related acupoints.

However, if the pain had been more sharp, worse before her period, better with exercise and stretching, and accompanied by a purplish tongue and choppy pulse, we would diagnose her with Qi and Blood stagnation. In this case, cupping and acupuncture would be more indicated.

CSOE Diagnosis

In 5E, we ask more questions about the type of pain, the levels of pain, and a majority of TCM diagnostic criteria. However, as the patient is talking about their problem, we are also looking and listening to assess their main colour, sound, odour, and emotion (CSOE diagnosis).

Colour: The hue that radiates from a person's temple area.

Sound: The voice may have a sing-song nature or a slight groan to it, for example.

Odour: This one can be difficult to assess without making the patient uncomfortable! Generally, smelling the lower back can give us an indication of the person's elemental scent. It might be slightly sweet or of freshly fallen rain. I usually just note the scent upon entering the room when the patient is ready on the treatment table.

Emotion: What is the person's guiding emotion? Do they always seem to come back to an over-concern for others, or is there a tendency to get stuck in grief?

Essentially, the CSOE diagnosis helps us to identify the lens through which the person views life and where they may become physically imbalanced. We call this the causative factor. If we can come to a clear diagnosis about whether this person is a Fire, Water, Wood, Earth, or Metal "causative factor" (CF), we can proceed with treating both their symptoms and their CF.

Causative factors

Each causative factor is made up of a combination of organ systems or “officials”. Fire is composed of four officials, the other causative factors are composed of two officials.

Fire: Heart, Small Intestine, Pericardium, and San Jiao

Earth: Spleen/Pancreas and Stomach

Metal: Lung and Large Intestine

Water: Kidney and Bladder

Wood: Liver and Gallbladder

Pulses

As in TCM, we take the pulse, however the assessment is slightly different in 5E. By taking the patient’s pulses during the treatment, we can tell if we are on the right track or not. If we treat the correct points, all twelve pulses will be more balanced, which tells us that the Qi is moving more efficiently in the system. If we had solely used a TCM approach, there may still be a pulse change and symptoms may improve but, in my experience, the results are not as immediate, strong, or systemic.

FINDING THE BALANCE WITHIN

The beauty of using TCM and 5E systems together is the ability to address symptoms while at the same time reconnecting someone to their deeper self. This self is the part of us that remains untouched by difficult events of life. Often, when people return for a second or third treatment, they remark on feeling more "like themselves" and more happy overall. By reestablishing the balance of the nature within a person, we can assist in their body's true healing.