Posts Tagged ‘Acupuncture’

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Science, Scientism, Healing and Medicine

Friday, January 27th, 2012

Today I had a mooch around Waterstone’s. I meandered past the section on religion, where the first book I noticed looked something like an anti-religious polemic; part of the blurb was an endorsement by Richard Dawkins, warning any religious apologist not to risk getting into a debate with the author, who would presumably run rings around their pathetic and irrational arguments. I wandered on to the science section, replete with several titles by the aforesaid Professor Dawkins, but nothing I noticed along the lines of an anti-scientific polemic. Science gets all the good PR these days.

Now I’ve got a physics degree and a healthy respect for the scientific method. But working as I do now in healthcare, I’m not altogether sold on the ability of modern science to make life better and people healthier. In their book ‘Why Do People Get Ill?’ Darian Leader and David Corfield suggest that doctors would be better prepared for their profession if they did an arts degree, rather than a science degree. What leads them to this radical suggestion is their belief, which their book aims to substantiate, that key factors in what make people get ill lie in their emotional life, and thus a good doctor is one who can meet the patient on this emotional level, with understanding, empathy, humanity. (Of course, one might want to question whether people graduating from arts courses have any more humanity than their scientific colleagues!)

 In other words, healing is as much art as science. People cannot be understood if they are just understood as a set of numbers, a set of data. Can illness really be fully understood by science? (It is a sad fact that the word ‘clinical’ connotes a kind of cold rationality.) Of course you want a doctor, a healer, to be able to think clearly: this is no apology for the worst kind of woolly minded alternative therapists. But you also want them to have humanity, even compassion. Not just because it makes the treatment experience more bearable, more civilised, but because it is an essential part of that treatment.

 Good medical treatment isn’t entirely reducible to numbers. In traditional acupuncture, for instance, a lot of emphasis is placed on the Qi of the acupuncturist. The Chinese word Qi is impossible to translate accurately into English – it is something like the vital energy of the individual, which in a healthy person is free-flowing and abundant. (For a more detailed explanation, click here.) The Qi of the acupuncturist includes such things as the quality of the attention of that acupuncturist, their freedom from distraction and sense of presence. Included here is the rapport between the acupuncturist and the patient. Included here is the ability to find the exact right spot to insert the needle, the exact right depth for it, and the ability to sense what lies at the end of the needle, how the needle interacts with the patient’s own Qi. (Of course there are guidelines about where to put the needle and so on, but the fine tuning relies on the Qi of the acupuncturist.) These things are not measured in most scientific trials of acupuncture, probably because they are not so easy to measure, but there is a world of difference between having an acupuncture needle inserted by someone who has been on a few courses and is thinking about what they are going to have for their dinner, and by, say, a serious traditional acupuncturist who practises Chi Kung (a traditional Chinese form of meditative exercise and health preservation) for two hours every morning, and is able to focus his entire attention on what he is doing. Medical treatments of this kind are very complex interactions between two very complex entities: human beings.

 One can distinguish between science and scientism. Scientism is the belief that science is the only valid form of knowledge, the reduction of all forms of knowledge to that which is measurable. My fear is that scientism is invading the world of medicine and healing, so that any form or aspect of treatment which is not measurable (or perhaps not easily or cheaply measurable) is disregarded or downplayed, when in fact it is an essential part of that treatment. 

 I remember reading an article by a surgeon who described how he had postponed an operation by a day for no other reason than he had an intuitive sense that it would be better to wait 24 hours. Personally, if a good surgeon told me he had a gut instinct that we should wait an extra day before my operation, I would be glad to go with that. Some of the most important things that happen in a healing context are not measurable by scientific means. Science, therefore, should know its place! In its place it is fantastic, but it is not the be all and end all of medical treatment.

 

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The Myth of Getting ‘Old’

Monday, January 16th, 2012

Having spent the last 15 years observing what makes one 80 year old ‘old’ and another ‘young’ and indeed witnessing the transformation of some ‘old’ ones into ‘young’ ones, I’ve been pretty humbled.  I never cease to be amazed by human potential. Through a gradual process of mental reflection, dietary and lifestyle changes and therapy, some have been able to turn their circumstances around by realising they had more control over how they felt than they realised and that they had succumbed to the popular myth about age.

Many of our patients are content merely with the removal of pain from their arthritic joints. Some, however, realise that they have become what they have through their choices and actions. They then make different choices and experience different outcomes as a result.

Of course, this doesn’t just apply to old people. These same processes occur in younger age. At the time of writing, I’m 43 and setting myself physical and mental goals that my contemporaries have clearly convinced themselves they can’t achieve. Of course, they can achieve them!They just need to engage in the lifestyle that supports their achievement. They’ve succumbed, like the majority, to societal norms and assumptions that say “you’re getting old now and so you’re going to be weaker, have poorer health and generally start going downhill”

Of course, age does play a significant role in our wellbeing. The older we get, the more time we have had to practice the habits that have determined our health in the first place. In turning things round, it might be a slower process because of this. You’ve been letting yourself go over a longer period of time. However, change you certainly can!

Our minds are far stronger than most of us are willing to admit. One just needs to watch a few episodes of Derren Brown to get an idea of this. Countless studies on the placebo affect also provide fascinating food for thought. Even ignoring the obvious dietary, exercise and lifestyle choices that are proven to affect our health, our minds can convince us into high or low levels of physical and mental performance or health states. So, its not enough to just regulate our diet, and lifestyle. We have to train our minds too. Good health is not a matter of luck, its crafted! I’m  reminded of what Gary Player is noted for having said: “It’s funny, the more I practice the luckier I seem to get”.

And that’s not even considering the amazing folk with significant, life-limiting circumstances who still remain positive.  Like Chris Moon, 49 at the time of writing, the ultra runner who had one leg and one arm blown off by a land mine, then ran the London marathon within a year of the incident!!! Check him out at:

http://www.ultralegends.com/chris-moon-bathurst-to-sydney-1997/

Geneticists estimate that our genes are responsible for about 15% of our health outcomes. The other 85% is down to our lifestyle. In other words, the choices we make in life have the largest effect on our health, by far.

So, check out your self-limiting beliefs, engage in some positive thinking training, and start releasing your latent potential now. Commit to a programme of regular exercise, whether it includes Tai Chi, running, squash or whatever. And guess what, once you’ve got over that initial inertia that inevitably exists when you’ve been inactive for so long, its really enjoyable and feels great! Go get some…you’re more than you think you are!

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Acupuncture and Oppositional Defiant Disorder

Tuesday, June 7th, 2011

Recently there has been some degree of outrage about a 14 year old “asbo yob” receiving taxpayer funded acupuncture treatment in an attempt to moderate his behaviour. One senses that some of the outrage may stem from the belief that “yobs” should be punished, not given what may be perceived as “feel-good” treatments, but this misses the point completely – if the treatment works and the boy in question stops causing such mayhem, then everybody wins.

However, opposition to the acupuncture treatment also comes from the belief that there is no evidence that acupuncture works for “Oppositional Defiant Disorder” which is – apparently – the diagnosis which has been made in this case. My colleague Sean Barkes was recently asked to discuss this case on BBC Radio Humberside. The debate became one of research availability. Whilst the detractors argue there is no evidence to suggest that traditional acupuncture might be helpful for ODD, Sean argued that there was. My colleague’s point was that there is an abundance of research to show that acupuncture is helpful in improving health in humans, including mental health. Inevitably, physical and mental health status affects behaviour. The other point he was trying to make was that, even if positive research evidence were available relating to the acupuncture treatment of ODD, it would not be relevant for this specific case as it is the cost to society that is the key point here.

There is a lot of research to show that acupuncture has a positive effect on people both mentally and physically; for example, it is at least as effective as anti-depressant medication in treating depression (1), it is more effective than hypnotic drugs (sleeping tablets) at treating insomnia (2), and is at least as effective as drug-therapy for managing migraines (3). Therefore we can say that it is likely to have a beneficial effect in this case. If orthodox solutions have been tried and not been effective, something needs to be done. If we know that acupuncture may have a positive effect on this individual’s mental states, it may well be that acupuncture is worth trying. What, after all, is the alternative? The alternative is probably to lock him up. This, I don’t doubt, would be a whole lot of a bigger financial burden on the tax-payer than a mere £40 a week acupuncture treatment. So there is a case to be made that trying acupuncture may well save the tax-payer a lot of money; furthermore, if it is successful, it may encourage further research in the area, which might just mean that the tax-payer saves an awful lot of money.

It is too simplistic to argue that there is no research to support the use of acupuncture in this case. Evidence for the efficacy or otherwise of any treatment for any condition does not just appear. If you have a condition for which you do not have an effective treatment, you have to try something. If you have positive results, and you can repeat these in a few other cases, you can start thinking about doing some proper research. I would think that the people responsible for trying acupuncture here deserve some credit for a bit of initiative, and in fact for looking for a solution which is much more economical than most.

A further relevant point here is the way that research is done on the effectiveness of a holistic treatment such as traditional acupuncture. Such treatment is targeted at the individual patient, rather than at the specific condition, such as ODD. However, the usual research methodology, epitomized by the Randomized Controlled Trial, focuses down onto the condition, and pretty much ignores the larger context of the patient’s general health. An RCT investigating the effectiveness of a drug to counteract high blood cholesterol, for instance, may conclude that the drug in question is effective in lowering cholesterol levels, but it does not measure or take into account such things as the side effects of that drug. The question such a trial should really address is, do people live longer when they are on the drug in question – and, perhaps, do they have a better quality of life. If people’s life expectancy is not improved by the drug, and if their quality of life is impoverished, then the fact that their cholesterol levels are lowered is of little consequence. This example illustrates the main weakness of modern western medicine, which all too easily falls into the trap of treating the condition rather than the person. It is no good improving one isolated aspect of the person’s health if their overall health suffers.

So similarly in a case like this, one would want some research which investigated, say, whether traditional acupuncture treatment reduces the cost to society of young offenders, rather than whether it helps with ODD specifically. After all, it would be of little consolation to anyone if the lad in question displayed improvement in the symptoms of ODD, such as fewer angry outbursts and less resentment, but continued with a life of crime anyway.

So, far from outrage, a more reasonable response to this story would be to welcome the possibility that a very economical holistic therapy such as acupuncture may have an important part to play in managing these kinds of anti-social behaviours in a cost-effective way. But the research which needs to be done to find out whether this indeed may be a viable approach needs to avoid over-focusing on conditions such as ODD and measure whether there is a reduction in violent and anti-social behaviour.

1. http://www.acupuncture.org.uk/research-fact-sheets/1277-acupuncture-and-depression.html
2. http://www.acupuncture.org.uk/research-fact-sheets/1283-fact-sheet-acupuncture-and-insomnia.html
3. http://www.acupuncture.org.uk/research-fact-sheets/1148-acupuncture-and-migraines.html

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ACUPUNCTURE: CHINESE OR WESTERN, TRADITIONAL OR MODERN?

Wednesday, March 16th, 2011

Acupuncture is a form of medical treatment which has been practised in China for over two thousand years and which is becoming increasingly popular in the West. Because of its evident effectiveness, it is now utilised by some western medical practitioners such as GPs, physiotherapists and chiropractors; however, most of these practitioners, whilst utilising acupuncture as a technique, discard the traditional Chinese context in which acupuncture has been practised. This article elaborates on the difference between acupuncture as practised within this context and without it. It is important to understand this difference: for example, it would be wrong for someone to conclude that ‘acupuncture doesn’t work’ after a session of acupuncture with a physiotherapist had not produced any improvement in their condition – what the physiotherapist is doing with the needles they use may well be significantly different from what a traditional acupuncturist does with them.

WESTERNISED FORMS OF ACUPUNCTURE

Acupuncture shorn of its traditional context is sometimes known as ‘dry needling’, to distinguish it from the usual way in which needles are used in western medicine – injections! ‘Dry needling’ is usually used as a method of pain relief by chiropractors, physiotherapists, GPs and others; an acupuncture needle is inserted into a tight band of muscle fibre known as a ‘trigger point’, with the aim of releasing the tightness and relaxing the muscle. Usually dry needling is used in conjunction with other techniques such as chiropractic manipulation or massage therapy.

A small number of GPs and other western medical practitioners also practice acupuncture; whilst a very small fraction of these are trained in and utilise classical Chinese medical ideas, the majority of them practise what they call ‘medical acupuncture’. ‘Medical acupuncture’ involves an attempt to understand the mechanisms of how acupuncture works using the framework of western medicine, rather than the classical Chinese framework. ‘Medical acupuncturists’ mainly use acupuncture in the treatment of pain, but also use it for a few other conditions such as nausea and menopausal problems.

TRADITIONAL CHINESE ACUPUNCTURE

There are two kinds of acupuncture practised in the West which continue to utilise the traditional Chinese ideas which gave rise to acupuncture. These are Traditional Chinese Medicine (TCM), and Five Element Constitutional Acupuncture (FECA), which are based on a system of medicine whose roots date back at least 2500 years, and which is still evolving today. Within these forms, acupuncture is used to treat a very wide range of ailments. In this article we shall refer to these two forms as ‘traditional acupuncture.’

WHAT’S THE DIFFERENCE?

The main difference between traditional acupuncturists on the one hand and GPs, physios and chiropractors who use acupuncture on the other, is that the former practice acupuncture broadly within the context in which acupuncture was developed in China, whilst the latter abandon this context and attempt to relocate acupuncture within a western medical context.

Thus when you go for treatment to a traditional acupuncturist, you are going to someone who will understand your health and any health problems you have from a very different point of view from that of a western medical practitioner. A traditional acupuncturist will probably have completed a degree or postgraduate level course in traditional acupuncture, and thus will have spent at least three years studying and training in acupuncture and its application within its classical Chinese medical context. Western medical professionals who use acupuncture may have only done as little as a few days training in acupuncture.

To begin with, the traditional acupuncturist thinks in terms of ‘Qi’ (pronounced ‘chee’.) Qi is a key concept in understanding how acupuncture has been used over the millennia in China and other parts of Asia, but it is quite difficult to translate into English. Broadly speaking we can say that a healthy being has abundant Qi which flows freely – a living being is characterised by constant movement on all levels of their being. Qi is an important concept not only in classical Chinese medicine, but in things like martial arts and philosophy. What a traditional acupuncturist is doing when they insert a needle into the skin, is seeking to influence the Qi; the needle is usually inserted at an ‘acupuncture point’, a specific site on the body at which the Qi can be influenced in various ways. Most traditional acupuncturists will insert the needle until the patient actually feels their Qi responding, when a dull achy feeling, or perhaps a numb or tingling sensation, is felt in the vicinity of the point. Sometimes, especially if the acupuncturist is experienced and skilful, the Qi will be felt to move along a local pathway, called a meridian. The attention of the acupuncturist is focused on the tip of the needle, which provides a point of communication between the Qi of the acupuncturist and the Qi of the patient.

Western medical acupuncturists and dry needlers do not, on the whole, think in terms of Qi. They may be thinking rather in terms of needling into a trigger point to loosen a tight muscle, or possibly in terms of influencing the peripheral and/or central nervous system. Whilst to a casual observer what the western acupuncturist is doing and what the traditional acupuncturist is doing may look similar, there is a considerable difference in what each thinks of themselves as doing. At least from the point of view of traditional acupuncture, this is important; traditional acupuncture stresses the necessity of the acupuncturist having a focused intention on the needle and the effect he or she is trying to have on the patient’s Qi; it also stresses the importance of the acupuncturist’s Qi being free flowing, as the treatment is seen very much as an interaction between the Qi of the clinician and the patient. Many traditional acupuncturists practice disciplines such as T’ai Chi, Chi Kung and meditation which they see as virtually indispensible support for the healing work they do with acupuncture. Of course a good western medical acupuncturist may indeed have this kind of focused intention without thinking of it in these terms; however, the framework of modern western medical science, still not free of the Cartesian separation of mind and body1, might be considered to undervalue the effect of the mental and emotional state of the healer, so that acupuncture can come to be seen as a mere technique not significantly affected by the mental state of the person administering it.

Another one of the hallmarks of the traditional Chinese medical context is that it is holistic. So, for example, suppose you have an ache in your low back. (This is one of the main complaints which acupuncture is used to treat in the UK today – in fact the National Institute for Health and Clinical Excellence recommends that a course of acupuncture is one of the ways in which persistent non-specific back pain is treated within the NHS.) A traditional acupuncturist will, of course, examine your back and ask you about the pain – how long have you had it, what it feels like, what makes it worse, whether there is anything that relieves it, and so on. But they will also be interested in most other aspects of your health – including your digestion, any breathing problems you have, how well you sleep, even what kind of temperament you have and what your emotional life is like. This is because they want to see your back pain in the context of you as a whole person. Let’s say they discover that your digestive system is not working quite as well as it could – maybe you don’t have much of an appetite, but you do have a sweet tooth, you bloat easily and your stools can be a bit loose. Now this has nothing to do with your back ache – or does it? The traditional acupuncturist would consider it likely that there is a knock on effect from this digestive weakness which is affecting your back. After all, the nourishment which the muscles, ligaments and bones of the back need if they are to function properly largely comes from the food we eat – and if we are not digesting that food as well as we could, this will impact negatively on the degree of nourishment. In fact in Chinese medicine there is a well known connection between an impaired digestive system and muscular weakness.

Perhaps also you are under a fair bit of stress – and of course low back pain may add to this. The traditional acupuncturist will probably take your pulse during his or her examination of you, and if they find that the pulse feels ‘wiry’ – a bit like a taut guitar string – and if you report being short-tempered or moody, and get frequent headaches, they will probably conclude that the stress you are under is inhibiting the free flow of your Qi; in plain English, you are uptight and tense. It is again no great surprise that this kind of thing can exacerbate any kind of pain, including back pain. In fact it may even be that the main reason you have got low back pain is because of this up-tightness combined with the digestive weakness.

So what the traditional acupuncturist will probably do is to treat your back with acupuncture, aiming to smooth the flow of Qi through your back, but also will use acupuncture to strengthen the digestive system and promote the smooth flow of Qi throughout your system. That is to say, they will treat the back pain locally, but also address systemic underlying issues which may also be contributing to the back pain and undermining your body’s natural ability to heal itself. They can do this utilising acupuncture points on the lower leg, abdomen and back which in classical Chinese medicine are known to be able to effect the digestive Qi; similarly there are points on the hands and feet which can be used to smooth the flow of Qi throughout the system.

In addition to this they may also suggest dietary changes you may be able to make to help support your digestive system and things you can do, such as Chi Kung exercises or meditation practices, which will help you relax more fully and be able to deal with the stress in your life more effectively. They may also use other classical Chinese medical treatments to help your back, such as moxibustion – the use of mugwort, a warming herb, to improve local circulation and warm and relax the muscles, Chinese massage and cupping therapy.

So when you go to see a traditional acupuncturist for your back problem, you will receive a treatment which addresses the pain directly, but which also seeks to restore balance and harmony to your system as a whole, so that the back pain is less likely to return – and, incidentally, other aspects of your health improve too; in this example, perhaps your bloating disappears, your stools firm up a bit, and you feel more relaxed in general and better able to cope with the strains which life is bringing you.

Of course some chiropractors, physiotherapists and GPs may also be thinking holistically, and they too are unlikely to use acupuncture as a stand-alone treatment. But hopefully the above example makes it clear that there is a considerable difference between western medical acupuncture or dry needling on the one hand, and traditional acupuncture on the other. The point is that it is incorrect to see acupuncture as a technique divorced from the system of medicine in which it is embedded. Traditional acupuncture is acupuncture embedded within the classical Chinese medical context, a holistic form of therapy which seeks to rebalance and strengthen the Qi of the patient through the use of acupuncture and related techniques as well as dietary and other advice; dry needling and ‘medical acupuncture’ use acupuncture as a technique to release trigger points in tight muscles and modify the central and peripheral nervous systems, whilst attempting to understand acupuncture within the framework of western medicine.

1. The Seventeenth century French philosopher Rene Descartes is considered to be at least partly responsible for the way in which western science has tended to view the mind on the one hand, and the body on the other, as separate entities. One consequence of this for medical practice is that people trained in western medicine, which is of course rooted in the western scientific tradition, are not often inclined to consider that their state of mind will have much effect on the treatment they administer. The western doctor, like the western scientist, may tend to think of themselves more as a detached observer who interacts only in a more or less mechanical way with their patient. Although modern scientific advances, such as those in quantum physics, have shown that this tendency to view the scientist/doctor as detached is illusory, the Cartesian legacy remains.

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When Positive Thinking is Not So Positive

Tuesday, November 16th, 2010

A while ago I was treating a woman whilst she went through an IVF procedure. She was telling me that a friend of hers was encouraging her to ‘think positive’. This seemed to mean believing that the procedure was going to be successful, but I could sense a tension in my patient; after all, she knew that the chances of it being successful were some way below being 100% – so, how could she believe it was definitely going to work? It seemed to me that she was trying to make herself believe. This made me wonder about what we mean by the phrase ‘positive thinking’.

 

Can it really be so positive to ignore what we actually know (in this case, that the chances of success was somewhere between 20% and 30%)? To me, a key aspect of being in a positive frame of mind involves being as realistic as possible, being clear and objective about our situation.  And then it involves responding to that clearly perceived situation as positively as we can.

 

Thus it seems to me that ‘positive thinking’ in a situation like this involves a clear acceptance that our chances of success are 20%-30%. It involves doing everything we can to maximize those chances (like having acupuncture treatment!), and then it’s in the lap of the gods, so to speak. We can neither believe that it is definitely going to work, or believe that it is definitely not going to work. We have to learn to dwell with the uncertainty of that, happy that we have done everything we can to get the result we want, reconciled to the end result being out of our control.

 

In a way it is the same with all sorts of health issues.  Suppose we have some serious disease.  Positive thinking does not mean we make ourselves believe that we are going to recover; it does not mean we pretend that this is the case.  It means facing our situation as clearly and as honestly as we can, bringing as much of love and courage and patience to bear as we can, and doing what we can to heal ourselves.  After all, forcing ourselves to believe something that deep down we know we cannot be sure of surely creates an unhealthy internal conflict which negates being in a truly positive frame of mind.

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“It’s Just Arthritis”

Saturday, July 31st, 2010

Recently I’ve seen a few older patients who have had pain in their hips. Often they have put up with the pain for quite a while, reasoning that it is “just arthritis”. Often this seems to go along with the idea that as you get older you will inevitably get arthritis, and there is nothing much you can do about it, short of stoical endurance or a hip replacement operation. Some of these patients therefore have been somewhat surprised to find that the pain has substantially reduced, or even disappeared, after just one or two treatments. Sometimes I have been a little surprised myself, given that often I have just done a simple acupuncture treatment involving just a few needles judiciously placed in the hip area and one or two further down the leg, perhaps backed up by a little bit of cupping therapy, which seems to have virtually got rid of a pain that has been there for several years. One of these patients was indeed on the verge of having a hip replacement operation, but now finds that he may not need it.

So one of the morals of this story is, just because you are old does not mean you need to be in pain. Of course not all pain will be as easy to get rid of as in these cases, and probably these patients will need to come in every now and then to keep their pain levels low or non-existent. Also I can’t help from wondering how many people are having expensive and complicated operations for things like arthritis of the hip or knee, when in fact they could have a few relatively inexpensive acupuncture treatments instead. I know what I’ll be doing when I’m getting on a bit (more!), and my hip starts to ache (although I also know that my hip is less likely to ever ache if I get enough of the right kind of exercise!).

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‘Fighting’ cancer or other life-thereatening diseases

Sunday, July 11th, 2010

I was just reading a Telegraph article today entitled “Socialising with others ‘can help fight cancer’”. The headline led me to ‘put pen to paper’.

From my clinical experience, one of the most prevalent causes of disease, whether it be a bad back or whether it be heart disease, is the unconscious refusal or inability to freely and honestly express ourselves as we truly are. The most common example of this is in the work we choose to engage in to earn a living.

The whole idea of recovering from a life-threatening disease, like cancer, being a ‘fight’, I find difficult to get my mind round. My appreciation of disease processes is clearly influenced by my style of medicine, Traditional Chinese Medicine (TCM) with its range of therapeutic techniques, such as acupuncture. TCM is holistic in its approach to healthcare. Holism states that body and mind are inextricably linked so what happens to one will have an inevitable knock-on effect on the function of the other. Holism understands that disease is not some random, chance occurrence that we have little or no control over. Even geneticists attribute only 25% of our state of health to our inheritance. My own personal experience of scrutinising my state of health, and intermittent fall from good health over the years, has yielded a clear connection between this and my thought processes. Scrutinising the health of thousands of others in my professional capacity, and studying research and the clinical experience of others far more experienced and talented than me, has corroborated my conclusions.

Gradually, modern medicine is starting to fully appreciate the huge influence our state of mind has on our health. This is really well summarised in Adrian Leader and    book “Why do People get Ill?” ), available from our online shop. Literally, we are what we think. It is becoming increasingly evident that our thought processes create our diseases, whether they involve physical or mental symptoms, or both. We can say that our heart condition has been brought on by working intensely under stressful circumstances for a prolonged period of time, but what thought processes have led us to work like this in the first place. For example, if during our upbringing, we have thought, for whatever reason, that we needed to ‘achieve’ in order to gain ‘acceptance’ or ‘love’ from our parents, then this might have trained the habit of ‘flogging’ ourselves in our work life.

Holistic healthcare is about helping each individual bring their unconscious motivations into conscious awareness whilst using tried and tested techniques to facilitate recovery from the current disease-state. We do this by stimulating the body’s own, already amazingly well-equipped self-preservation systems. When an individual understands their disease process as part of who they are, they see that there can be no ‘fight’ against cancer because the cancer is a part of them. There is no external ‘enemy’ to fight. They have literally created their circumstances by their thoughts words and deeds in their life to date. Therefore, the only long-term, sustainable solution is through new thoughts, words and deeds. So, in my mind, self-understanding is the key. As far as I can see, achieving self-understanding is a process, often long and arduous, which is why we are often well-advised to seek external help when experiencing a life-threatening disease state.

The word ‘fight’ often implies a struggle. Because of the negative connotations this idea holds, this is just likely to make the process of recovery that much more difficult. So, I believe that our best chance of survival is to embrace the symptoms we are suffering as messages sent from deep inside us as an aid to reaching fullness. This way we can utilise the healing power of love, love of our self and the people around us and of life. Being diagnosed with a life-threatening illness is probably one of the best wake-up calls we will ever get in helping us to express ourselves as we truly are. So let’s embrace it. Or, as the motif on one of the Tai Chi students in my class says: “make tea, not war!”

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Traditional Chinese Medicine and ME

Monday, May 24th, 2010

ME:  How External Causes Affect Our Health – The Traditional Chinese Medical Understanding

 When as Chinese medicine practitioners we meet patients with ME and its associated conditions, our first priority is to establish a diagnosis. For millennia the Chinese have understood that different diseases can have the same one cause, and that one cause can result in a variety of diseases.  To understand each patient’s particular illness, we analyse in detail the patient’s history and in doing so reflect on the current symptoms and, as importantly, the reason why the symptoms have occurred.

 In Chinese medicine, ME is often seen to be the result of an invasion of external forces which remain in the body long after the original illness has gone.  This is similar to the Western theory which links ME to viral illness.  Where do these external forces, referred to as retained pathogenic factors in Chinese medicine, come from?  And why do we retain them in our body? 

 Well, the main pathogenic factor is Wind, which is usually accompanied by another agent such as Heat or Cold.  We can physically feel these agents – a hot sunny day or a cold winter night alters the way we feel about pain for example.  Some pain is better for heat, some feels as if it needs to be cooled especially if there is any itching present.   Damp, another factor, is often accompanied by Heat, causing us to perspire more than usual.  We use these terms as a shorthand to describe a diagnosis which includes many symptoms such as sore throat, thirst, shivers/fever, obesity, pain relieved by warmth and so on.  We can also be aware of Wind – maybe on the beach or under air conditioning. When Wind enters the body we find pain that moves about, or a runny nose, or itching.  Damp is found both in the environment and in the food we eat – think how soggy a sausage roll can be!  We also produce Damp internally by worrying too much. 

 When you have a cold, it’s likely that your body’s “wei qi” – similar to the immune system – has been compromised in some way.  Perhaps you’ve been overworking, or taking on too much, or worrying too much.  Your body becomes weakened and susceptible to these pathogenic factors and so you become ill.  Generally we throw off these infections, but sometimes they become lodged in the body, or even appear to be expelled but the body has merely suppressed the agent.  This happens when we take suppressive drugs to combat disease – including cold remedies and antibiotics. 

 The seeds of weak wei qi are sown in the past.  Every illness has its own cause.  For example, in clinic we often see people who have overworked in every single area of their lives.  The majority of people with ME are women – and so many women have been working at full time jobs, running a home, caring for children and aging parents, that it should come as no surprise that eventually their body just has no energy to carry on. Alongside this is the pressure that both men and women are under to work more, play harder, achieve the next goal – and maybe we’re not all cut out to achieve success from a material perspective!

 Furthermore, in many cases an acute illness is regarded as an inconvenience and not a reason to slow down.  During an acute fever, as much rest as possible is required to ensure that the body recovers properly.  Many of those with ME reported that it began after a severe infection during which normal life continued apace.  There is no research to show that such patients habitually overworked, but anecdotal evidence indicates that this may be the case.  

 Another reason that these factors develop is the inappropriate use of antibiotics.  In Chinese medicine antibiotics kill bacteria but do not clear the underlying cause of the disease.  Antiobiotics are described as cold in nature, and using cold to alleviate heat can slow down our energy.- think about how we are affected by cold in winter when we leave a warm building – our tendency is to shrink into our clothes for warmth before we begin to shiver. As it slows, we develop heat and this can contribute to further infections. Antibiotics are particularly inappropriate for viral infections as they are ineffective.

 For children with ME, overwork, lack of sleep and poor nutrition contribute to the effects of retained pathogenic agents which may arise from childhood illnesses such as chronic earache, tonsillitis, catarrh, sinusitis and frequent mouth ulcers. 

 So, how do Chinese medical practitioners treat ME?  It can be hard to dislodge the pathogenic agents especially if the individual is a chronic sufferer from ME.  The practitioner aims to help the patient to understand how their  condition developed and can offer other forms of therapy alongside acupuncture – dietary and lifestyle advice, for example.  Our goal is to help you, as a patient, to deal with your condition in a more positive way. We can offer a helping hand and a listening ear whilst you are taking the road to recovery.

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Healthcare for the New Millenium

Monday, March 8th, 2010

I was asked to provide comment for the Sunday Times Style Magazine about illnesses that modern medicine has a tough time trying to diagnose and treat. Of course, I draw mainly upon my own clinical experince in making such comment. However, it seems to me that there is a lesson to be learned here on how we manage anything in this country of ours, not just healthcare. Anyway, here was my submission (I wonder how different it looks when it is published?):

“Modern medicine is utterly impressive if you are critically ill, have a  broken leg or some very clearly defined medical problem. The challenge for modern, NHS medicine is where the sufferer’s condition less easily lends itself to simple categorisation into broad groups for generalised treatment, with drugs say. In my experience, healthcare problems such as Chronic Fatigue Syndrome, food intolerances and Irritable Bowel Syndrome, for example, seem to pose difficulties for the GP that Acupuncturists and Traditional Chinese Medical clinicians do not seem to experience. That is not to say that we have a quick-fix solution for patients. It is just that we have certain advantages over NHS methods. For example, we have the luxury of time, generally spending much longer with the patient than is possible in an NHS setting. Also, our diagnostic framework enables us to make a unique diagnosis for each individual followed by a very tailored treatment plan. In this way, the treatment is much more targeted and will involve a process of self-understanding for the patients in terms of development of the illness, its root cause in terms of what they have or have not done to precipitate it, and by deduction, a route out of the situation. It’s a healing process that they can have an active involvement in rather than being prescribed a ‘pill’ and returning to the mêlée of life that has probably caused the problem in the first place.

We have many patients that consult us with a range of disparate symptoms for which they have been prescribed a variety of medications. Each symptom has been treated as an entirely separate problem. However, when we re-diagnose from a Chinese Medical perspective, it becomes very obvious that all these symptoms are part of the same disease process that has been initiated by an unsatisfying job, abusive personal relationship or just a sedentary lifestyle.

Because the NHS is ‘medicine designed for the masses’, the diagnostic approach has become ‘for the masses’. In other words, all sufferers have to fit into a pre-defined medical category. Moreover, the result of this medical categorisation is a standardised approach for all sufferers. This is compounded by the sheer volume pressure that our NHS doctors are faced with. Our quick fix society has seen to it that the doctor’s work is never done. The general attitude to health seems to be “I’ll break myself, but you can fix me” shifting the whole responsibility of healing to the doctor.

There is a parallel here with the business world. Businesses that manage by fire-fighting at the very least fail to grow and at worst they just fail completely. A longer term, big picture strategic management approach to business often reaps rewards that far outweigh the initial investment in terms of time and other resources. I think that our public healthcare systems need to follow a similar approach. As a country, we have proved to ourselves that we cannot just listen to a symptoms and prescribe a symptomatic solution for the patient. If we do, even if this symptom disappears, others follow as the root problem within the life of the individual has not been addressed. A famous Chinese physician, Li Shi Zhen, said “all illness is rooted in life”. I think that public healthcare needs to embrace this philosophy pretty soon if it is to manage the huge demand that it is experiencing for healthcare in this country”

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Cold weather affecting joints

Saturday, January 9th, 2010

Remember when your mother, or grandmother if you are that young, warned you to keep your back covered so as not to let the cold or the wind get to it? Well, it’s not just us in the UK who got all worked up about that. The Chinese have a long tradition of the same belief. The weather can invade our bodies and cause unpleasant symptoms.

With the weather like it is at the moment in the UK, acupuncture clinics like our own generally see an influx of new patients sufferring from a variety of musculoskeletal conditions. Acute lumbar pain, aggravation of arthritis symptoms, frozen shoulder, stiff and painful neck and shoulders etc., they all start coming out of the woodwork in their droves.

When problems like this are caused by Cold invading the joints, our main line of attack as acupuncturists is the use of moxibustion. Moxibustion is the use of a herb, often in the form a cigar-like stick, that is burned like incense close to the area of the body that has been invaded by the cold. The sensation is extremely comforting and can often bring about immediate benefit.

For more information on the technique of moxibustion, check out http://www.theseanbarkesclinic.co.uk/pages/patient-services/moxibustion.html

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