I was talking with a colleague the other day and it got me thinking: what is my therapeutic process? How do I come up with a treatment plan for my patients that is truly the best thing for them? What is it about what I do that makes them feel better?
Acupuncture often follows something called the Root and Branch Theory, where the Root is the cause of a particular condition and the Branch is how it manifests. For example, someone could come in with headaches (Branch) but they are due to stress (Root). By treating the Root, the Branch often goes away. But what do you do when you don't know what the Root of a condition is? Following Traditional Chinese Medical (TCM) theory, you come up with a Pattern of Disharmony based on the full constellation of patient symptoms. In theory, when you make your TCM diagnosis, you pick points that will help balance that diagnosis and the patient should improve. You look for confirmation from the patient in terms of symptom improvement and you might also check the pulse and possibly the hara (abdomen) for confirmation as well. Then sometimes you hit that plateau point where the patient is better, but not completely. What then?
I listen to the body. The body has all the answers, you just need to know how to communicate with it. When practicing yoga you can notice your breath, your thoughts or pay attention to the sensation in your muscles to get feedback on how much to push or not push your body; when gauging someone else's body, I'll check their pulse. So many times I'll feel the pulse on someone, after I've put the needles in, and a particular organ is still not balancing the way I would like. At that point I start checking points on the organ's corresponding meridian (energy channel) that I think should correct the problem. Usually it works but sometimes it doesn't. So then I start checking points that I wouldn't normally think to use, often still on that same meridian, and I'll find the one that is exactly what the patient needs. I treat that point and the pulse improves and so does the patient. The body knows what it needs.
I also listen to my gut. Here is where the water gets a little murky. Sometimes I'm treating a patient and something inside me starts telling me to use a certain point. There may or may not be a "theoretical" reason behind it, but that little voice gets louder and louder until I either use the point or I ignore the voice and leave the treatment room. I've found over the years, however, that if I end up ignoring the voice that I always end up being wrong. Flat out. Sometimes something happens during the session where the patient feels good except for one area that is still bothering them; if I had treated that point it would have affected that exact area and it would no longer bother them (kick self for not listening). I'm not sure if it is universal wisdom that is entering my consciousness or if it is just me being present with the patient and tuning in to their needs, but in any case I've learned to listen to my gut.
I try to remove my ego from the treatment room. When I can be fully present with a patient, the solution reveals itself in some way. Sometimes the patient tells me which points to use: "It hurts here" as they are pointing to an exact acupuncture point or meridian. Sometimes a concept comes to me out of the blue that exactly applies to this person at this moment (universal wisdom streaming in? Good neuronal firing?). Sometimes I just have a sense that this person should not be treated directly and I will use points that will affect the necessary area without actually needling that area. Those treatments often have the most powerful results. How do I know when to do that and when not to? I'm not sure. I guess my inner voice just knows her stuff.