In the Weeds: Suggestions on How to Proceed When You Get Stuck
By Kailey Brennan L.Ac.
Competency in the Engaging Vitality (EV) palpation techniques takes time to develop. If you are at a place where you are overwhelmingly in the weeds when it comes to practicing this material, and fantasizing about dancing around a bonfire and lobbing your EV notes into it, take heart. We have all been there.
Outlined below are some common issues practitioners come up against when working with the EV material, some suggestions to think about how to proceed when you get stuck, and thoughts on how to re-engage with the palpation techniques in an inspiring way if and when you lose the inspiration for practice.
1. “I can’t (insert crying face emoji) do Global Listening.”
First of all, you can. As Dan is fond of saying, “A big part of doing this stuff is unlearning this idea that you think you can’t do this.”
Global Listening is a technique to bring you to the general location of the Problem Place that the body is orienting around. It’s meant to bring you to a generalized location. Very often you might feel a hazy, fuzzy, of subtle pull to the front or back, left or right, or down into the body. Sometimes you may experience a very distinct and robust pull. If what you are feeling under your hand feels slightly amorphous or non-distinct, that’s okay. Sometimes that is just how it is. That does not mean you are doing the technique incorrectly.
Paramount to using the Global Listening technique is doing the technique correctly. You want to make sure you are engaging with the patient’s system. If your contact is too soft or ephemeral, you won’t be able to get a feel for what is there. It’s important to settle yourself before making contact, make sure the center of your palm is over GV20, and making sure your wrist and forearm is straight and not torqued. Hands are soft and receptive but engaged.
It’s also important to not get ahead of yourself when doing this technique. Focus on what does my hand do? Keep it extraordinary simple in that sense. If you try to interpret what you are feeling right off the bat, you are liable to getting yourself big time confused. Focus on what does my hand do?
Executing Global Listening with supreme confidence every time is 1. Not very likely or realistic and 2. Not an absolute prerequisite for mastering before being able to move on and find more useful palpatory information from the other EV techniques. There will definitely be times when you don’t get a clear read from Global Listening. At the same time, if you do not give yourself the opportunity to regularly practice the technique, you’re not giving yourself a chance to grow.
One of the EV teachers in Europe told me that it took him seven years of consistently practicing Global Listening before he started to get comfortable with it. I remind myself of this whenever I want to throw a big fit about working with this technique.
2. “I find too many Local Listenings and I start to get confused and overwhelmed.”
Although a patient can and very likely will have multiple Local Listenings, there is most likely one (the “Problem Place”) that the body is primarily orienting around and, when engaged optimally, will lead to the the most beneficial and healthful effects on the patient’s system.
Try to stay with and follow the thread and navigate your way to the Problem Place through the sequence of palpation techniques. If you start to get distracted by something else that grabs your attention in the course of palpating, make a mental note of it but then proceed with what you were originally doing. If you start to notice yourself looking too hard or getting anxious, take a second to re-settle yourself and feel your feet on the ground. If you start to doubt or question what you are feeling, thank your mind for offering up it’s never-ending commentary and criticism on everything that you do, and proceed forward and palpate on.
If you find two distinct Listenings where the qi really isn’t moving well and you are unsure which one will have a bigger effect on the body, Transiently Open (TO) one area to see if it makes the other go away. Keep your hands soft and your perception softer in the course of navigating this.
3. “I’m not getting an optimal response from the body when addressing the Problem Place.”
This can require some creative problem-solving. It may be that multiple channels are involved in a Problem Place and in order to initiate an optimal response in the body, you may need to think about more than one channel in the process of treating. For example, say you find that the Problem Place for your patient is localized at their sacrum. Maybe you find that both the Gall Bladder and Urinary Bladder both connect with the Local Listening. Needling GB40 bilaterally may start to loosen things up and improve the Yang Rhythm slightly. Then needling an active local point on the sacrum may cause the most optimal systemic effect and overall improvement on Yang Rhythm.
This is one way how I have come to understand acupuncture treatments playing out as a
“call and response dance.” Placing a needle, checking in to see how the body responds, placing another needle, tuning in to see if the patient is approaching “overtreatment,” proceeding accordingly until I feel that the optimal conditions have been reached for the patient’s body to be able to do what it needs to do to self-correct, and then stepping back. This requires paying attention and being fluid in your response.
Needle location, depth, and angle can also factor into not getting an optimal response while needling. Taking your time, showing up, being with and listening through the needle can create the right conditions for an optimal response to occur.
4. “I’m not exactly sure how to integrate this into the way that I already practice acupuncture.”
This is a huge topic and much could be said about it. I’ve spent some time talking with other practitioners about how they integrate the EV material into their way of working, as well as shadowing some in their clinics. Practitioners integrate the palpation techniques into their treatment flow and way of practicing in a multitude of ways.
Which is all to say, you can’t really do it the wrong way. If you are oriented to working in concert with the intelligence of the body and setting up the conditions for an optimal response to occur, depending on the way you like to treat, there are many ways you can proceed. Remember, the treatment is the response.
You may even find yourself practicing and treating differently depending on the kind of patient who is on your table. This is why it is so useful to be familiar with different styles and ways of treating. One patient might require trigger-point style needling and a higher needle count in order to get an optimal response. Another patient may respond very well to only teishin work and channel stroking in the style of Takahiro Funamizu. Orienting your treatments from the EV palpatory referents can have you being flexibly responsive and dynamic in your treatments in a variety of ways that can prove very helpful to the patients you see.
5. “This really deviates from how I typically practice in my clinic, and I would NEVER have thought to have started with or do xyz (putting in that needle, addressing that part of the structure, using that specific point, etc).”
BINGO! Palpation is most useful when the information is unexpected.
6. “I’m WAY too slow at this.”
That’s okay. You will start to get faster as you stick with it.
7. “I’m not feeling anything.”
Amen to all that. I am very familiar with it. There are few things to take into consideration if you aren’t feeling anything:
I brought this up with Chip at one point. I told him that very often during the first treatment I didn’t get much in terms of palpatory information, but three or four treatments down the line I started to get information that proved very helpful. His response was, “Yeah, that’s how it works out sometimes.” And I was borderline incredulous in responding with, “Why didn’t you say that was a possibility from the beginning?!?!” I had spent way too much time thinking I was doing this all wrong.
From my personal experience, my understanding with this kind of dynamic is that, especially with patients who are completely new to acupuncture and new to seeing you as their practitioner, it can take a few treatments before a patient starts to feel really relaxed and comfortable with the process of receiving treatment. It may take the first few treatments to negotiate the kind of contact that is most comfortable for the patient. When this kind of contact has been optimally negotiated, more palpatory information will start to come through and become available. It’s not really a process that you can force or rush. It develops at its own pace.
Another possibility to take into consideration is that you may be trying too hard. Learning the EV techniques comes from repetition, not from trying harder. On many levels we can be so conditioned to try harder when we’re struggling with something, we may not even be aware that we are doing it. Some indicators for me when I am trying too hard is that I start to feel a tenseness and a sense of low-level agitation, annoyance, and impatience in my body. And importantly, I stop having fun. If you’re not having fun, you may be trying too hard!
I also know that I am trying too hard when I am overly focused on getting it right. Dan has reminded me on multiple occasions that it is more important to be helpful to the patient than it is to be right. I have to remind myself, time and time again, that it’s really about trying to work in partnership with the intelligence of the patient’s body so that it can do what it needs to do to self-regulate and heal. It’s very easy to forget at times.