Archive | March, 2012

So how does acupuncture work?

28 Mar

Over my life as an acupuncturist I’ve put together a number of flyers.   When you come out of college physically and mentally exhausted, painfully aware of just how little you know, the first thing you do is design a flyer.  It’s a comforting grounding process  The end result provides you with something of a metaphorical fig leaf. Something that confers a modicum of personal protection in the face of the cold winds  that blow through the world of private health care provision and making a viable living from complimentary therapies.

This flyer reads thus: ‘acupuncture is an ancient healing practice, over a thousand years old that functions by the insertion of fine needles into pathways that run in a network across the body called meridians which contain life energy or ‘qi.’  And there it is. There is, aside from minor syntax changes, no deviation from this basic formula.   Lets not knock it, from this, great and successful practices have sprung.  But what does this flyer actually tell us?

The first thing that is important to note is that the needles are fine.  Well that’s fair enough, the needles are fine, really fine, so fine that they will fit down the inside of a hypodermic.  If you’re writing a flyer for a hypothetical person with some persistent physical or emotional problem, who has tried everything except acupuncture ‘cos of the scary needles’ then ‘fine’ needles are going to be an easier sell.  Easier than just ‘needles’, or perhaps ‘fat scary painful needles that make you bleed, go really deep and leave visible holes.’  Sometimes, rather cheekily in my opinion, those early flyers suggest that acupuncture is pain free.  Ok, I have done that.  I’m not proud and I wouldn’t do it again   My line now is roughly ‘Acupuncture is probably going to hurt a bit.  Get over it people. Life hurts sometimes and if it doesn’t ,then you’re probably not doing it right.  Change most definitely hurts, because you’re going to have to move out of your comfort zone and who likes that.  One basic constant in all acupuncture is that it attempts to forment change, ergo it’s gonna hurt.  Hell homeopathy is going to hurt at some level.  Healing hurts, end of.’  But I probably wouldn’t put that on a flyer.

‘Ancient healing practice’ is comforting.  It suggests that some fly-by-night didn’t just come up with this.  It wasn’t recently invented by chancers and that public declaration of involvement with the strange man with the comforting room and the pins, will not call down dinner party mockery.  This is a respectable activity that has been going on for some time.  To the ‘skeptic’ of course this simply means that it’s ‘primitive’.

There is no pleasing some people.

Now the bit that makes absolutely no sense at all.  The bit about meridians and ‘energy’ called ‘qi’.  I personally have a big issue with the word ‘energy’.  Writing this has made me think we should probably institute some sort of swear box in clinic for use of the ‘e’ word by practitioners.  We just have to develop a language that goes beyond ‘energy’.

See what I did there? I started to slip, everso slightly  into powerful vortex of new age bullshit that swirls around the very word.  Use of the ‘e’ word is powerful and seductive, it blurs boundaries and collapses meaning into a vague inexact world of assumed mutual knowledge and baseless intuition, and promotes the dodgy little power games that can be played there in. Probably by hippies.  The trouble is, of course, that the english language, historically the tongue of bastards, conquerors and pirates has a lot of ways of expressing going out and doing things to things and seeing results, and rather fewer for the mediation of the inner and personal, one to another. Frankly, It isn’t a great language for communicating the nuanced world of the self.  If language shapes and defines reality then that explains a lot about the world around where we are at now.  And what are we as acupuncturists or whatever doing stepping up with, words like ‘energy’?  The word does nothing to further the transition of acupuncture  the ‘ancient healing practice’ into the modern world of celebrity big brother, flat screen tv, cililit bang, on line banking, out of town super stores,  Gstar raw, boxercise, skinny latte, dubstep and the new lexus  We simply have to make better use of language or shut up.

Anyways how does one begin to explain ‘qi’ without resorting to words like ‘energy’?  Well it’s really difficult and frankly a subject best not engaged with.  Qi is neither here nor there.  Lets just ignore it for the time being. If  we don’t have a language for it yet, just keep it experiential.  Banging on about it just invalidates the project and draws fire from some of those out there who are, for various reasons, out to do acupuncture harm.  I might go further and say I have a suspicion that the extent to which you talk about qi is frequently inversely proportional to your ability to actually move it in your own or another’s body.


Actually the idea of the acupuncture meridians being pathways that contain qi is rather going out of favour.  The modern revision of this position, derived from a greater understanding of classical chinese medicine is that the ‘meridians’ are great big fat pathways that are full of blood and lymph, interstitial fluid, hormones, fascia nerves and muscle which relate back to the internal organs.  They form layers of the immune system and are part of the structure of movement.  Six of them make up an arm and six of them make up a leg and they all cross connect across the body. All of which makes far more sense than some nebulous circuit board of an invisible, intangible and immeasurable mystical ‘energy’.

Right, then, so.  How does acupuncture work? Well I invoke the right to change my mind on this in case it comes back to haunt me.  A link for this is going up on facebook, things you put up on facebook can do that, so one has to be careful.  What I would say now, in as much as explanatory language is,as discussed a bit problematic is……. Well I spose it’s quite peculiar  It starts, comfortably and scientifically,with the idea of ‘homeostasis.’  The constant balancing act that the body does to keep things just right.   We constantly strive to keep the right temperature, p.h, pressure, luminosity, ambient humidity for optimal body function, by making changes both internally and externally big and small.  Look, there’s a big thing on wikipedia about it, you’re on a computer, google it. It’s a pretty fair western description of the eastern idea of the balance of yin yang balance in the body.    It’s that and that has a tendency to go awry and gets stuck on the wrong path.  Acupuncture is there to assist with that move towards a comfortable space for physical and emotional operation.  It assists with the balancing act.  What the insertion of a needle does  is  to make a small discreet suggestion that perhaps this isn’t quite the right way to go.  The body/mind may blithely ignore the suggestion and carry on on in the same direction.   Perhaps the provocation is particularly captivating or powerful, or your suggestion wasn’t couched in quite the right terms to be appealing.  There is a tendency in the body and mind for little feedback loops to occur keeping someone in the same stagnant place.  Like one of those people who feels miserable and parties hard to make themselves feel better only the hangover and tiredness makes them miserable, so they….. and you get the idea.   As in everyday life, these can be  tricky to persuade someone out of. Uncomfortable even.  It’s worth also pointing out that the key issue for the body/mind is survival so that states that are far from optimal or even remotely desirable can be a comfortable norm.  Places of diminished function but where a balance of sorts can be maintained. Utterly familiar to an individual, who has long forgotten anything different.  Life is unbelievably adaptable. Layer upon layer of  body/mind response to crisis and disharmony can accrue creating new twists and turns in what was once a straight path.  Homeostasis is still an issue, that’s pretty much a base line of organic function, but some possibilities are more limited.  Like a tree hit again and again by lightning, life prevails. The challenge for any therapy is to support the day to day and open up new horizons.

Relatively speaking I think we are all living in these far from optimal states……Arguably though this is the path to wisdom

The needle is a small prompt, occurring in one of these fat pathways that engages with the endocrine and nervous system of a patient and suggests resetting things.  To do that effectively you have to have someone else on the other end of things making the suggestion. Essentially  I think the way this works is to do with nervous and endocrine systems patterning the resonance of  other nervous systems.   Human interaction is a massively infinitely complex world with relatively little happening verbally, and most of it being unconscious.  This two-thirds-below-the-surface iceberg of the unconscious is where the action is and an acupuncture needle is a focus of that communication. You can’t get a machine to do it and you can’t really do it to yourself in any meaningful way because it is about someone else’s observation of you and interaction with you.

The ability of the practitioner to stay mentally still in themselves and the way they put the needle in is as much a part of the treatment as the place the needle is put.   That is how the information is conveyed and the place you put the needle is simply a somewhat easier place to make the suggestion.  The body is more receptive at that point, to that kind of input.

So the acupuncture is a very small thing and the real wonder is the bodies response.  The input is the spark that starts the forest fire, the carelessly rolled snowball, that wipes out the classy ski resort, the butterflies wing that causes the storm in china .  It’s going to be very difficult to quantify and observe, it’s going to tend to elude verification, because there are too many variables and end up dumped in the placebo sin bin for invalid theraputic methods that weren’t visceral and mechanical enough to make the grade.  Although all that said, acupuncture usually doesn’t do bad on it’s own terms……….

And why do we not enquire more thoroughly, as a culture, into quite what it is in us that can make us spontaneously heal and become well with no input beyond whatever the hell ‘placebo’ actually is? Look a little further into this and away from the exciting world of doing things to things with clear results……….

Basically acupuncture is one of many practical applications of developing stillness and physical awareness that we are constantly trying to sell not just to individuals but to the community as a whole, because from this there is the real opportunity for change, both personal and societal.  The possibilities are literally infinite.

Just don’t expect it to be pain free, and please, please, please, don’t use the ‘e’ word.