2018 June
“A map is not the territory it represents, but, if correct, it has a similar structure to the territory, which accounts for its usefulness.”
— Alfred Korzybski, Science and Sanity
In school to study acupuncture and East Asian medicine, we start with the fundamentals. We study East Asian medicine’s understanding of the body. We learn about the pathways of the meridians, the concept of the Qi dynamic, the theory of Yin and Yang, the Daoist understanding of humans and their relationship to nature, as well as some of the cultural, historical, political, philosophical and spiritual ideas that influence and undergird this medicine.
If your education was anything like mine, you learned all of the specifics of acupuncture point location. Hours upon hours of memorizing point prescriptions out of the Chinese Acupuncture and Moxibustion textbook (CAM). Shang Han Lun, Jin Gui Yao Luo. The relationship of the five elements.
While in school, if we had enough sanity and bandwidth left over, we started studying the other systems that so many of us use and draw from today: Dr. Tan, Master Tung’s Magic Points, Kiiko Matsumoto’s clinical strategies, 5 Element acupuncture, specific auricular protocols, Jeffrey Yuen’s tradition, amongst the many others out there.
Practicing in more advanced clinics while still in school, I started to feel quietly unnerved. More times than not, patients did not come in with the sort of clearly defined patterns and diagnoses laid out in our TCM textbooks. Not even close. Sometimes treatments were successful, sometimes they were not, and it was very difficult for me to discern why this was. When a course of treatments didn’t seem to make much of a difference, privately I worried that I had gotten myself into the wrong profession. Absolutely worst of all I was starting to become secretly blameful towards patients, critical of their lifestyle or questioning their desire to work in the service of healing. I was tasting the makings of burn out and I wasn’t even out of school yet.
I could theorize and read up and draw on my understanding of East Asian medicine, sure. I could try different point prescriptions, balancing different meridians, working both local and distal style acupuncture. But I wasn’t sure if I was just telling myself some kind of elaborate, made-up story. People and their bodies are so unique and they present with such diversity. They can’t even begin to be encapsulated and described in all of the textbooks and medical theories and treatment systems in the entire world. Plus, I’m a very tactile person and I needed a grounded, perceptible and detectable way in the clinical encounter to discern if my treatments were having an effect.
So much of this is to say, and I’m coming to discover this more and more everyday working with the Engaging Vitality material, that the map is not necessarily the territory when it comes to the practice of East Asian medicine. They are useful and necessary and very helpful, but they can’t completely outline, nail down, and describe every person, condition, and presentation that walks into our clinic. Having a glimpse of this reality in school was terrifying for me. Very gradually through my involvement with the Engaging Vitality work, this has become very interesting and actually almost exciting.
Maps are very useful. Navigating through parts of Denver I’m unfamiliar with, I would be in big trouble if I didn’t have the Map function on my iPhone. It even lets me know in real-time which sections of I-70 or I-25 are backed up due to traffic or an accident. It’s an indispensable tool for living in a city, one that I would struggle without in very real and tangible ways. It saves me valuable time and energy each and every day.
Similarly, I am very reliant upon my maps in East Asian medicine. Distal style treatments, 5 Element acupuncture, strategies that I’ve picked up on from the Japanese tradition, continuing studies in pulse, tongue, and abdominal diagnosis. The maps I studied in and after acupuncture school and continue to study are incredibly valuable and I utilize them regularly.
But the human body is so incredible and diverse and mysterious. Textbooks, theories, teachings, protocols, and prescriptions are all very necessary and useful. But from what I have learned and am continuing to learn and discover everyday is that they are only capable of outlining the tip of the iceberg. When a patient comes in to see me for the first time and however many times after, it is so very interesting, compelling, and undeniably useful to try to engage the patient’s own qi in a dialogue and try to understand what the patient’s qi is asking for in that moment, opposed to placing or imposing my map or system or treatment strategy on that patient from the get-go.
In the Engaging Vitality work, we orient with this understanding that the human being is a functional unit comprised of body, mind and spirit, and that the body is capable of self-regulating and healing. Many of the ideas come from the osteopathic tradition here in the West, and they in many ways synthesize very agreeably with our understanding of East Asian medicine. In the Engaging Vitality work, we think about using all of the tools we have developed in East Asian medicine - acupuncture, moxibustion, e-stim, and so forth - to work in the service of supporting and encouraging the body’s innate capacity to self-regulate and heal.
Part of working in the service of the body’s healing mechanisms is understanding when you’ve given the body more information than it can adequately process in a treatment session. This is commonly referred to as “over-treatment” in the practice of acupuncture. And in Engaging Vitality, we have some very useful, immediate and direct ways of discerning if a patient is nearing over-treatment: the pulse becomes disorganized, the Channels start to feel buzzy, the tongue may develop more defined teethmarks, and the body’s fluids will start to feel like a thick, viscous liquid, like molasses. This is an incredibly valuable tool to have for more reasons than need mentioning.
And that doesn’t even begin touch on the usefulness of the Engaging Vitality work. Old injuries, strains, and ailments can lead to tension, constriction, and systemic disharmony in the body. With the Engaging Vitality tools, we can start to actually discover and pick up on this through our palpation skills. You come to learn that acupuncture points and very often channels may not necessarily be in the exact location that they were outlined in the texts. Recently having taken the Visceral Course, I’m starting to cultivate a tactile understanding of why we say that the lungs are responsible for the function of “descending and diffusing” in East Asian medicine. I’m continually discovering why certain acupuncture points are given their very unique, interesting and oftentimes perplexing point functions as outlined in Peter Deadman’s Manual of Acupuncture text. I might have certain preconceptions about what is going on for a patient based on their constitution, presentation, and main complaints, but those preconceptions might be completely vaporized once I start doing an examination.
The map might not necessarily be the territory, and this is good news for me. Learning the Engaging Vitality tools and mindset has helped me to be curious and interested in the face of ambiguity, complexity and confusion, as opposed to fearful, anxious, or feeling overwhelmingly impotent. It is incredible to think that as practitioners of East Asian medicine practicing with the Engaging Vitality material, in addition to all of the information we can glean from our pulse, tongue, and abdominal findings, there is this ability to receive so much palpatory information from our patient’s bodies and their qi. This information can help us come into dialogue with a patient’s qi, get feedback in the clinical encounter if we are truly working in the service of the body’s innate capacity to move towards healing, and helps us to more elegantly address, while holding a very large and open perspective and an appreciation for the wisdom of the body, the reasons why patients are coming to see us for treatment. Practicing the Engaging Vitality work helps me to more skillfully, attentively, and reverently practice my values and serve my entire reason for getting into East Asian medicine in the first place - to help people and to help people feel better.