Applications of Shape of Qi Listening: Part 2
By Kailey Brennan L.Ac.
This is Part 2 of an exploration of the theory and clinical utility of Shape of Qi (SOQ) Listening. Part 1 can be found here.
The Engaging Vitality (EV) training offers an opportunity for acupuncturists to bridge the gap between what can very often feel like abstract and often inoperative theory in our East Asian medical tradition and the primacy and immediacy of our clinical reality as it unfolds in our own everyday, ordinary workaday life in the clinic. What can help to bridge this divide is the diligent and dare I say very joyful practice and cultivation of our palpation skills.
The practice of palpation can open up a new door of learning and clinical engagement for us as practitioners. The three-dimensional reality of the human body, with its various rhythms and tidal flows, channel pathways and viscera, can all start to show up and come through in a more potent, immediate, and alive way.
Importantly, the opportunity that palpation presents for the East Asian medicine practitioner is that rather than solely basing our treatment strategies and entirely relying on running our therapeutic interventions through the filter of our East Asian medicine diagnostic models, theoretical orientations, and style preferences, we can learn how to develop a receptive orientation that will help us to engage with a patient’s qi through our own hands and our own sensory capabilities as practitioners.
As a palpation technique the utility of SOQ Listening is that it offers the ability to engage with a patient’s qi in an unmediated and unfiltered way, grounded in the immediacy of a treatment situation.
Developing these palpatory skills can help us to glean useful diagnostic information in the course of treatment as well as facilitate a more clinically effective engagement with a patient’s qi.
The right contact
Participants in EV seminars are given guidance on how to make a kind of receptive contact with a patient’s system as well as hold a wide perceptual field within themselves that will help set up the proper conditions for a patient’s qi to want to communicate with us.
In his article The Shape of Qi: Enhancing the Vocabulary of Contact in Acupuncture, Chip maps out three important aspects of making effective contact. The first aspect is that the contact must maintain the proper amount of pressure or firmness. Paramount to this is that it must feel comfortable to the patient. Second, the quality of contact should be soft and receptive. Finally, the contact should convey the right level of presence.
Working to create the right conditions for this relational field to be established can reveal interesting challenges for some of us practitioners given our own individual conditioning and personality quirks. I struggled mightily with this teaching instruction when I first started attending EV seminars. Because I have the tendency to focus my attention like a laser beam while working with patients, a patient’s system would understandably guard against this kind of intensity of focus and nosy intrusiveness. I could not even get off the ground in terms of being able to gain some helpful palpatory information from a patient’s system because the right conditions were not established for a patient’s qi to want to be able to communicate.
All of this is to say that making the right kind of contact involves not only a softness and receptiveness in our hands that conveys a sense of comfort and ease to the patient, but also a kind of openness, lacking any agenda, as it relates to our level of attention and focus as practitioners. This is partly what is meant by holding a “wide perceptual field.”
A word commonly used in EV seminars to describe the attitude held by the practitioner when making contact with a patient’s qi is appreciation. Appreciating what the patient’s qi is expressing. Appreciating the palpatory phenomena we may come upon. Even having a sense of appreciation (and patience) when we aren’t quite sure what it is we are feeling (which happens all the time). This kind of attitude also conveys a sense of warmth, which most certainly factors into this idea of presence that Chip has outlined as being requisite to making effective contact.
SSIO
The desired aim when working with SOQ Listening is to gently create the right conditions so that a patient’s qi can start to move towards SSIO. SSIO is an acronym that stands for settling, suppling, integrating, and opening. As outlined in Part 1, this is Chip’s rendering of the osteopathic concept of neutral (which is also sometimes referred to as holistic shift in the craniosacral tradition), which is when all the underlying tensions present in the human body start to relax and enter into a dynamic state of balance and coherence.
Rayén Antón, a Barcelona-based EV instructor explains how to think about this: “As we proceed with the (acupuncture) treatment, we track some changes in the qi as feedback and confirmation that we’re on the right track. When the system is being able to properly absorb the information and changes, the qi will become settled, more supple, integrated and open (SSIO). This is the initial state of quiescence that will allow the system to manifest the innate healing and ordering mechanisms.”
As Chip outlines in his revised article The Shape of Qi, qi is a phenomenon that can be felt everywhere in the body, not just in its’ mediated expression in the pulse, which we tend to give primacy to as East Asian medicine practitioners.
As the qi starts to settle, it starts to feel less stirred up and agitated, while also becoming more relaxed and grounded. Suppling produces a feeling of the qi becoming less tight, with more of a quality of fluidity, resiliency and healthy structure. As the qi becomes more integrated, it can have a sense of feeling more coherent and homogenized, lacking in a feeling of stratification or disorganization. Finally, as the qi becomes more open, it is more freely able to communicate with the exterior and the interior and for the conditions for the self-healing and organizing capacities of the body to come on board.
Chip describes this process even further:
“This is the settling of qi back to a state of stillness and clarity like the clearing of sediment in a stream. It is the ground in which all of the other positive changes occur and its full expression is described in cranial osteopathy as “neutral” or “holistic shift” wherein all the tissues and physiological functions of the body both settle and homogenize. The tissues reach a state of harmonic resonance such that distinctions between them become meaningless. The salient characteristic of neutral is an ever-deepening dynamic stillness. Everything becomes very integrated, undifferentiated, absolutely quiet, and yet vibrantly alive. It is from this place that the inherent intelligence of the self-regulating mechanisms of the body take over and do whatever needs to be done” (The Shape of Qi - revised, 2016).
Part 3 will look at some concrete and practical ways to start thinking about and using SOQ Listening in the clinic environment.