The Mind of An Acupuncturist

Subjective - This is where patients describe their complaints. They will often recite their Western medical diagnosis and may even present medical reports. The acupuncturist teases out useful information and asks questions that seem irrelevant. A patient’s pain associated with a “lumbar disc herniation³" says little about the patient’s qi dynamic but “chronic, achy low back pain that is worse during the morning, night sweats, and frequent urination is much more revealing.

Objective - This includes the patient’s general countenance and includes posture, facial appearance, voice, scent, tongue, and pulse. The moment the patient walks through the door the objective assessment begins. These observations are interpreted from the Oriental Medical perspective.  Objective findings may also include Western “range of motion”- measuring the movement of the body part that hurts- temperature and blood pressure as well.

Assessment/Diagnosis - The emerging collage of subjective (symptoms) and objective (signs) are organized into a “pattern” or syndrome. Different diagnostic systems/schools of thought have different patterns; each reflecting their perspective.

A TCM practitioner may diagnose the above low-back pain “herniation” as Qi and Blood Stagnation of the Du and Urinary Bladder meridians with Kidney Yin Deficiency patterns. This suggests that the low back pain (Qi and Blood Stagnation) is a symptom of more systemic disharmony (Kidney Yin Deficiency).

Medical reports and medications may influence treatment and diagnosis. Medical reports provide more detail about the physical dysfunction and may help determine if treatment is long or short-term.

Medications add complexity to understanding the qi dynamic. Medications can mask relevant signs and symptoms and/or create side effects; another influence on the qi dynamic.

Plan - After a pattern has been identified, treatment goals are developed and treatment plans are chosen. The plan for the above case is to “Promote the flow of Qi and Blood of the Du meridian and Tonify the Kidney.”  “Restoring the integrity of the lumbar disc” is not a treatment plan because that is the job the chiropractor, physical therapist, medical doctor, physiatrist, surgeon etc.

Treatment - The beauty of acupuncture is that there are a wide variety of methods to choosing points. The acupuncturist is not limited to the local area and just a few points can treat several problems simultaneously. In fact, acupuncturists are not limited to needles^.4

In order to bill an insurance company or interact with Western providers (and often other acupuncturists to simplify speaking) the acupuncturist uses Western terms once again. However, the acupuncturist may use slightly different wording in writing. They may say “lumbar myofascitis”- “low back pain of the muscles” and not Western Medicine’s “herniation.” After all, the acupuncturist treats qi-imbalances and the consequences of those imbalances not herniations.

The mind of an acupuncturist is complex. They listen to the Western complaint, convert it to TCM terminology, treat the patient, and then translate their findings back into Western terms in order to interact Western-minded people. In summary, there’s a whole lot more going on an acupuncturist’s mind than “sticking a pin where it hurts.”

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Lawrence Howard, LAc, MSAc is a New York State licensed acupuncturist since 1998 and a Rei Ki practitioner as well. He practices a unique style he calls “Energetic Acupuncture” a style that integrates energetic healing techniques into the acupuncture treatment.
lhoward@irondogenergetics.com