What is real, anyway?

Moving into the realm of the untouchable (uncomfortable?).

Chinese medicine can be a controversial subject. What is 'qi', anyway? Where are these channels they talk of? Can you point to them in a cadaver? Can you dissect one out and examine it under the microscope?

As a result I have been in an ongoing quandary since starting acupuncture school. The very aspects that drew me to it were also major causes of uncertainty and doubt that I was doing the 'right' thing. I was, and remain, very intrigued by its esoteric nature and the emphasis on spirit and soul and destiny, as well as the importance of emotions as an etiological factor in illness and disease. Even without knowing much about the details, this made so much more sense to me than the widespread Cartesian model of mind as distinct from matter. But at the same time I really had no desire to be someone who could be accused of quackery, or the entertainment of fanciful ideas, or the selling of snake oil. Unfortunately this is a field that attracts a lot of bullsh*tters. If you are talking about something that very few people know much about or understand, it is easy to get away with talking rubbish, and to sound convincing in doing so. I was determined to understand what I was doing (even if I remained slightly fascinated by the bits that were unexplainable) and so gravitated towards a very physical style of practice.

I found a teacher who taught and practiced what he termed 'tangible acupuncture'. Solidly grounded in years of arduous worth-proving, Mandarin-mastering and genuine apprenticing under several excellent classical Chinese medicine doctors throughout his decades of living and studying in China, Andrew Nugent-Head is a rare entity in the field of Chinese Medicine education. A highly charismatic and fiercely intelligent individual, he is well versed in the classical texts that form the basis of this incredible medicine and also (with his equally talented wife JulieAnn) runs a busy and highly successful teaching clinic in Asheville, NC, treating dozens of patients each week in between teaching commitments in the US and across Europe.

Very few teachers will willingly demonstrate their skills in front of a live audience, invite students into their clinics to see them in action, and openly discuss their 'failures' for the sake of other's development, but Andrew is one of those few. For me, one of the most refreshing aspects of learning with him was his recognition of the value of making a patient worse. "At least you know you did something, and you know what not to do next time!". This was so much more satisfying than my college tutors explaining magical and dramatic effects of certain acupuncture points, who when asked "but what if you get it 'wrong'?" responded with an assurance that that wasn't possible and the patient would be fine. How could that be possible? If you can have all this wonderful positive effect from needling surely the opposite was also a potential outcome? Truth is, with the kind of needling we were taught at college we were really doing very little. And any magical outcomes would likely be the result of other contributing factors.

I am digressing from my topic slightly (I may write more on this in the future). But the point is I didn't want to have to delude my patients (or myself for that matter) with stories of magical points, and qi balancing, and vague analogies of the channel system being like your body's underground tube map (a common one in our student clinic). I wanted to have a genuine explanation for why I was doing what I was doing, and what they could expect to feel as a result. When done skilfully and with proper attention, needling can have dramatic effects on the structure of fascia and muscle tissue (which essentially is just highly vascularised and innervated fascia - just as bone is also fascia in highly mineralised and dense form - but that topic deserves an essay of its own), as well as on blood flow and on the nervous system. And these effects can be strong and even slightly shocking, as much as they can be subtle and soothing. Strong techniques will present a challenge to tightly bound, restrictive tissue, forcing it to twitch and release, while gentler ones will calm and reassure, tenderly coaxing resources (qi, blood, and consequently awareness) into an area.

However, as much as I can stick to the very tangible, physiological and rational explanations of what I am doing in each treatment, there is undeniably always something else at play. What might feel like an excellent treatment may have an unexpectedly poor effect, whilst another session may deliver remarkable relief despite my having felt distracted and off my game throughout. Inevitably we have to ask ourselves what exactly is it that we are doing for someone, and how much of an effect are we actually having in amongst all the other life factors contributing to their current state of health? What is also undeniable is the power of the mind and the emotions - and here we run out of easy explanations. One patient's cancer diagnosis can spark a journey of astonishing soul searching and statistic-busting recovery, while another's mild shoulder injury may trigger a downward spiral into depression and helplessness. I remain fascinated by why this might be.

Chinese medical theory has ways of interpreting the detrimental effects of extreme emotions and what we in the West now love to call 'trauma', and also contains the idea of fate and destiny and the human experience being an opportunity to fulfil the latter and make the most of the former. There is an elaborate and astoundingly accurate horoscope system called Bazi, which will describe the constituents of your character and identify your strengths, weaknesses, tendencies and relationship styles. However in amongst all of this is also the idea of spirit, and Spirit. and what this is remains unique to each individual whilst also being part of something far greater and more cosmic than our earthly orientated minds can comprehend. It is real, but not part of our 'reality' and hence difficult to explain.

More recently I have embarked on a course of study within the Chinese medicine realm that errs on the side of this more magical, spiritual and esoteric aspect of the theory. Scoffed at by many, but also used by many others to great and positive effect, I have yet to make up my mind as to its authenticity, applicability and value, but it has kept my attention so far (no mean feat for someone prone to clutching at multiple straws and jumping between them in her search for the answers) and just feels right in my gut. Can I point to that? No. But if life is teaching me anything so far it is to trust those sometimes indistinct but undeniable feelings of right and wrong that emanate from somewhere deep within. I will forever be grateful for my very physical grounding in the tangible aspects of this medicine, but still have many more questions I want answered. Let's see where this next chapter takes me!