What is sickness and what allows for healing? Students at the Academy for Five Element Acupuncture may find themselves asking these questions again and again. The clinical residency inspires students to challenge their assumptions about health as they begin to explore the power of the medicine they have been studying.
At the Academy, students learn to see the mind and body in a new way. Western medicine certainly recognizes some degree of mind-body connection, especially when it comes to stress. Chronic stress is known to negatively impact health and contribute to many major diseases. The Five Element system takes this idea many steps further, with a nuanced spectrum of emotions and experiences that might show up in the body or the spirit.
If health and vitality are based on natural movement and change in the flow of life, then emotions and experiences that halt that movement can contribute to illness, pain and other manifestations of poor health.
Each of the five elements—Wood, Fire, Earth, Metal and Water—moves in a different way. Simply put, Wood is the forceful forward burst of spring. Fire is the upward rise of a flame. Earth is the centering and stability of the ground beneath our feet. Metal descends. Water spreads and moves through the spaces that contain it.
These types of movement show up in the qualities of the seasons, times of day, and different aspects of nature. The five elements also move within each of us, through speech, thoughts and actions. If one or more of the elements are not moving in the way they should, we feel it in our minds or our bodies.
When discomfort or illness strikes, where do we look? Instead of lab tests and MRI’s, Five Element Acupuncture might ask where we have gotten stuck in our lives. Is our vital energy not moving in the way it should? Are we holding something in? What beliefs are keeping us from living our full potential? These types of questions can lead to deep healing in the acupuncture clinic.
One interesting example of stuck-ness transforming to movement happens when patients speak about their lives during treatment. Maybe a conversation happens when they first come in, seeking help with a physical or emotional issue. Or within a treatment, a certain acupuncture point might move the patient to speak about an experience they have kept inside. Through speaking their experiences out loud, patients can sometimes restart the movement of their body and spirit. This is an opportunity for healing.
Under the guidance of clinical supervisors, students get to witness the healing process in action. They become an instrument of change for their patients. Symptoms that might have had no apparent cause or easy solution can dissipate, sometimes fairly quickly, through acupuncture treatment. The process is often awe-inspiring, and challenges students to rethink their ideas and open to new viewpoints on healing.
Here at the Academy, we are preparing for holiday break. The clinic will be closed and the interns will get some hard-earned rest. While the end of the year is often a busy time of parties, friends and family, it’s also a time of ending, closing down, and quiet. The days are shortest, and nature is coming into stillness. This is the Water element, the time when nature is completing the year’s cycle of life.
Patients coming for acupuncture at this time of year sometimes talk about the contrast of two states of mind: the outward expansion of the year’s social grand finale, and the quiet inwardness at the darkest hours of the year. It’s no wonder that the holidays can raise so many emotions. It helps to remember that outside, nature is embracing the quiet of winter even as we are dancing and toasting the year to come.
This time of dark and stillness resonates with a point on the Kidney meridian: Kidney 21 or Dark Gate. Each of the body’s acupuncture points is said to have a “spirit of the point” — a particular gift held at that place, which a skillful practitioner can open at just the right time to help his or her patient receive this gift.
The spirit of Kidney 21 is all about passing through the darkness and quiet in order to rejuvenate for a new cycle soon to come. The Dark Gate is a passageway that takes us from our deep interior before we reconnect with the light of our lives.
In her book Characters of Wisdom, Debra Kaatz translates the name of Kidney 21 as “A Dark Hidden Secret Doorway.” It is, she says, a place from which we can “see deeply into both the light and dark of our lives.” She reminds us that according to the Chinese view of nature, we cannot have darkness without light and vice-versa. When the sun shines, it also creates shadows. You might even say that because we have shadows, we can truly see and appreciate the brilliance of the sun.
Kidney 21 can be used at any time for a person of the Water constitution who needs to be reconnected with the gift of the darkness. But for all of us, it is a reminder that darkness is, in fact, vital to our well-being.
In the spirit of the Water element and Kidney 21, we hope during this holiday season that you can wind down and appreciate the quiet of your own depth and darkness. It is the beginning of the return of the new year’s light.
Acupuncture wasn’t my first career. I started out in the arts, another field entirely, but after a while I decided I wanted something different for myself. I wanted to feel more satisfied personally with my work, and I wanted something that was a truer reflection of me.
I wanted to go into a helping field but I wasn’t sure which one. So I decided to ask different kinds of professionals about their work life. I had learned from experience that there is a big difference between the fantasy and the reality of any career. I wanted to know about the day-to-day experience of a chiropractor, a physical therapist, a psychologist, and an acupuncturist.
A profound moment came for me when I was speaking to a physical therapist who was top in his field and very dedicated to his work. He said, “you need to look in the mirror and ask yourself who you really are.” I thought about this for weeks afterwards. It was this comment that helped me to choose the profession of acupuncture.
I decided that the daily work of acupuncture would suit me well. And I learned along the way that there is more than one kind of acupuncture.
Five Element acupuncture requires presence, patience, and listening. In short, it is medicine with heart. You need logic and structured thinking to manage a treatment plan. But there is also room for intuition, symbolic experiences, and connection with nature. This is how I see the world, and I felt it was important for me to own all of these aspects of myself within my professional life.
In Five Element acupuncture, the heart helps us determine what a patient needs. In our tradition, the heart is considered the “emperor” of the body, mind and spirit. As a practitioner, the best way to understand what your patient needs is to allow that wisest part of you to see the truth of who your patient is. From there, you can determine a course of action that will help them heal and be happy.
Modern life gives us few opportunities to be seen in this way. Most of us have only brief moments to sit and talk about our personal experiences with another person. Even then, we may not give ourselves permission to say what we genuinely feel.
The clinic is a space where patients can take a break from life and be deeply cared for and heard. In the treatment room, patients often say “I have never told anyone this before…” and sharing that story might open a space for the body’s systems to flow in a healthier way. Because Five Element acupuncture practitioners are trained to listen with the heart, deep and profound healing can occur. There is no other medicine quite like it.
Autumn is upon us, even here in Florida. The light of the sun is changing from the heavy, rich and round feeling of late summer to the sharper, clear brightness of fall. Night comes earlier, and the air feels a little more crisp. As a nature-based medicine, Five Element Acupuncture teaches us to notice these small changes.
Some people adapt to new seasons without even realizing it. If you have been cleaning out your house in the last few weeks, throwing away things you don’t need anymore, guess what—you are right in tune with Autumn!
Just like leaves drying up and falling off of their branches, many people feel a natural inclination to let go of old and useless things around this time. We might feel the melancholy in remembering people and moments passed. But we are also creating a fresh space for the new.
Of the Five Elements, this is the essence of Metal. Lung and Large Intestine are the organs of Metal. Both are vital to our wellbeing. Our large intestines clear out stuff we no longer need, and our lungs exhale the old just before taking in a new breath of air. On the spirit level, Metal works just the same. It refines our being on all levels and connects us with what is most valuable in our lives.
Many of us enter a new phase at this time of year. Kids go back to school and businesses begin to pick up with the hum of the new season.
Here at Academy for Five Element Acupuncture, Class 32 has just started their clinical residency. Many of them have relocated to Gainesville for a year. They have said goodbye to friends, family, jobs, and their old lives as they step into their new profession. In a sense, the students are letting go of who they were to become the person they will be.
Clinic year is the moment when Academy students are first able to treat patients. With the guidance of their supervisors, they can finally put all of their learning, theory, and hard work into practice. And they begin to see how Five Element Acupuncture can transform their patients’ lives. They have the opportunity to witness patterns of illness resolving at all levels of body, mind and spirit. It’s a humbling experience.
Inevitably, the clinical residency also brings personal evolution for the students themselves. Every year, students must meet the challenges of clinic year by shedding old habits that have held them back, and recognizing the best of who they are.
In the spirit of Metal, we honor class 32 as they begin their clinical year.
Academy for Five Element Acupuncture is delighted to announce our newest project and how you can be part of a growing tradition!
Based on the Five Element philosophy of the cyclical flow of vital energy, the elements of Wood, Fire, Earth, Metal, and Water have been blended in a true reflection of the school’s teachings. With a brand new sign placed at the entrance of our building we feel this distinctly represents the quality of Qi energy that is vital to the continual health and flow of nature.
We now offer you an invitation to be part of this expression. With a donation of $250, each brick may be customized to commemorate you as an alumni! These bricks will create a lasting legacy for you as well as the school.
Prefer to honor another with an inscription? Did you have a particularly inspiring teacher or practitioner who influenced your practice? Donate a brick in his or her name. Would you like to honor your parents or someone who has passed away? Honor them with this lasting memory. You could also purchase a brick to reflect the name of your acupuncture practice and its location.
Regardless of whom you choose to honor, your brick will be a lasting part of the school and will be incorporated into a stunningly beautiful sign that represents the core of who and what we are.
A limited number of bricks are available. For more information or to purchase a brick, please call us at 352.335.2332 or you may make your donation online here.
Written by Angela Xistris, reposted from 2012
Ah, Spring Break. There are no intensives in session and Class 27, our resident interns, headed for their respective hills last Friday. Their plans ranged from everything to the beach, camping, seeing family, and absolutely nothing but rest. And believe me, they’ve all earned this 10-day break!
In the meantime, back at the Academy, it’s been very quiet. The administration took advantage of the quiet uninterruptedness and addressed the bigger projects that tend to fall by the wayside when students are in session or clinic. The biggest project of all? Cleaning our offices.
I like to think that this blog answers questions as well as provide a window into life at the Academy. But today I want to be the one to pose the question. In the midst of the filing, reorganizing, and dusting, I had plenty of time to contemplate what it is that we do here at the Academy. And as I archived old admissions files, correspondence, and paperwork I had the opportunity to get a greater perspective on both student and administrative progress – greater in the sense of overall picture. So my question to you is, are you ready for graduate school?
A Master of Acupuncture is not medical school. We don’t ask our interns and residents to work 100 hour weeks and 30 hour shifts with no sleep. And yet the goal of both practitioners is the same: to heal and prevent illness. A Master of Acupuncture is still a graduate degree requiring students to invest themselves in thousands of hours of didactic and clinical work. Learning the diagnostic techniques required in Five Element Acupuncture to effectively treat with acupuncture and herbs takes extreme focus. Developing a practitioner’s CSOE skills requires cultivation of one’s senses- practitioners rely on their senses in ways not expected in our highly digital world, and in many cases must relearn trust in sensory perception.
Our catalog lists the courses, hours, and credits that our students must complete for graduation, so I’m not going to throw more numbers out here. In the end, the numbers don’t tell the whole story, because there is more work being done than what students do in the classroom. When I write about “investment” and “commitment to an acupuncture program, there is an underlying expectation of the investment and commitment that a student must make in order to be a successful practitioner (and not just a successful student). It’s about what the investment a practitioner makes in their own health and well-being in addition to the commitment a practitioner makes to their patients’ health and well-being. Patient and practitioner are intimately connected. In order to heal, Five Element acupuncturists must commit, invest, and connect.
So, when you start to envision your life, think about what you want your life’s work to be.
A recent email from one of our faculty members reminded me that Spring is quickly transitioning into Summer, the season of the Fire element. It is the season of the Heart, warmer temperatures, expanding social engagements and, hopefully, a period of simple, heart-felt joy.
A few years ago I was sitting with some of our students at a school-sponsored barbecue after Class 27 had passed their Year 1 exams. I was still learning the basic nuances of Five Element acupuncture, so I was busy soaking up as much information as I could while getting a chance to talk with our students outside of the office environment. I learned that evening what was perhaps the most profound aspect of Chinese Medicine (for me at any rate): the Official that rules all of the others in the body is the Heart. It’s not the brain. In fact, the brain is not one of the Officials helping to govern the body. What we feel, what we sense, is privileged over what we think. Having been ingrained with the Western principle of I think, therefore I am, this idea of Heart-governance was extremely novel. It was actually freeing to know that my emotions and perceptions did not need to be subjugated to my logic.
I was absent-mindedly scrolling through my Facebook feed this week when I saw a post that made me stop skimming and start actively thinking. Among the images and phrases of support for the communities of Boston and West, Texas was a message from one of our acupuncture students. A member of Class 29, Banghan Nabi Kim*, had had the opportunity to observe with long-time practitioner Thea Elijah in Vermont. Here is what she posted about the experience:
Loved spending the day observing the work of Healing in the form of Acupuncture. People coming in, being seen, listened to, held in the big Tao, and offered the gifts of points that symbolize Deeper Truths of their own inherent Wellness.
I’m learning how to use needles as symbols of this Love. But we can use anything. What’s your tool(s)?
I’ve been sitting with these words for almost a week now, trying to explain why they stood out to me amid all of the statements of love and support that flowed on social media sites after the Boston marathon bombing. These few lines encapsulate the idea that the work of healing is ultimately an act of Love. Acupuncture and other healing modalities operate through the love, honor and respect of the individual.
I don’t think many people outside of acupuncture would describe needles as symbols of Love. But it is an accurate and beautiful assessment of the intention of the acupuncture practitioner. But the more important message is that we can use anything as a tool of healing. The point is the intention. The point is the desire to help, to heal, to face adversity and be compassionate.
Last week was a week of adversity and also a week of fierce compassion. Symbols of Love were showing up all over the media and social media pages as the country threw its digital (as well as physical) support to the residents of Boston and West, Texas.
The healing process is slow, sometimes arduous. It requires patience. It requires faith. It requires connection of our inner selves to the greater good. At AFEA, we use needles to help people make the connection.
Amid all of the news reports of explosions and suspects from the past week, there have also been many reports of communities banding together. The word resilient keeps popping up, and I would characterize Boston’s response as nothing less than defiant in the face of tragedy. The fans at the Bruins game who sang with one voice this week certainly demonstrated this. And Facebook posts have been surging with images and phrases of communal strength, just as they did after Sandy Hook. As a country, as a community, we find ourselves again faced with the need to heal a collective wound.
We have decided to replace the sign in front of the building with a beautiful new one, with parts that represent each of the five elements. Here’s where you come in: we are offering the sale of bricks to commemorate you as alumni. The bricks are $250 each and will create a lasting legacy for you as well as the school.
Besides buying one for yourself, you can also purchase a brick to honor someone. From an amazing teacher who influenced your practice to your family who supported you through your studies, you can buy a brick and inscribe it to honor those sentiments. You can even purchase one to reflect the name of your acupuncture practice and its location.
Regardless of whom or what you choose to honor, your brick will be a lasting part of Academy for Five Element Acupuncture and will be incorporated into a stunningly beautiful sign that represents who and what we are.
For more information please email us or call us at 352.335.2332. To purchase a brick, please click the graphic above to pay online, or you can call us any time to pay with a credit card over the phone.
There are many questions and some debate around choosing which way to prescribe herbal medicine, especially for the Interns during their clinic year. I urge the Interns to try different methods of taking herbs themselves so that they experience the assortment of options out there.
For our patients, different factors are at play for prescribing herbs. Cost is often a factor, along with patient compliance. For most of the history of AFEA, the dispensary consisted only of loose or bulk herbs. Students now can be hesitant to use loose herbs, and often cite that they don’t think their patients will take loose herbs. But for many years—they did.
In this blog, I’ll attempt to give pros and cons of the different styles of prescribing, including loose herbs, granulated herbs, and prepared herbs also known as patents that come in pills, tablets or capsules. Let’s compare three types of water-based herbal preparations: the loose herb decoction, granules, and patent pre-made capsules.
Loose / bulk herbs
For those herbalists who are attached to their connection to the plants or those who favor tradition, loose herbs are often a preferred way of prescribing to patients. In a class taught by Chanchal Cabrera, I learned that she gives loose herbs to her patients even if they are also getting herbs in pills or tinctures. It becomes about helping the patient connect to self-care, to cooking and taking care of themselves, and to the ritual of a hot mug of something good for them (even if it doesn’t taste like sweet tea or orange juice!) For the length of history of Chinese herbal medicine, this has been how herbs were by and large taken (although there are exceptions to this, of course). Another benefit of decoctions is that all of the herbs are cooked together, as a formula or team, enhancing their communication with each other and in turn the patient. Many feel that loose herbs are the strongest, most effective way of giving herbs to patients, as well as being the most easily digested.
A primary argument against using loose herbs is that it is too much work for the patient. For patients at the Academy, it used to be they had to spend 90 minutes cooking their herbs (two 45 minutes decoctions that were then combined), but our addition of a grinder has shortened that time to 30 minutes in most cases. As we mix a formula for a patient, the last step is to grind the loose herbs into smaller pieces. Another argument is the taste, which can be a hinderance to the standard American palate but is also one of the ways that the herbs work.
Prepared herbal formulas, aka Patents
Prepared herbs, patent herbs: These are often seen as the easiest for patient compliance. Sometimes this is a necessity—if it’s the only way we can get the herbs in the patient, then it’s what we need to use. And, for some formulas, even the ancient Chinese used pills. An example is Liu Wei Di Huang Wan, or Six Ingredient Pill with Rehmannia. A yin tonic formula, they knew that building and maintaining yin substance in the body is a long-term undertaking, and that pills are well-suited for this purpose. Pills have a longer shelf life than decoctions and loose herbs. However, some argue that it is more challenging for patients to extract and digest all of the good stuff from pills, tablets and capsules. Patients also miss the experience of the TASTE of the herbs, which is part of their medicine and their personality. We should experience all the flavors in daily life, and in American culture flavors like bitter are rarely eaten. An herbal formula may be the sole bitter flavor a patient gets in a day.
Granulated herbs are somewhat of a new thing. Coming about in the last decade or so, practitioners like Eric Brand are publishing and educating on the production and use of granules. Granulated herbs are concentrated, and in the AFEA dispensary we use 5:1 granules, meaning the granules are five times stronger than the loose herb equivalent. There are examples of when this isn’t the case, and there are always exceptions, but that’s the premise under which we operate. One caveat with granules is that patients can be allergic to the excipients in them. And, unlike how loose herbs and many patent herbs are prepared, in a dispensary like ours all the herbs are singles compounded together. They never ‘mingle’ as a formula for very long, as patients simply pour hot water over the granules, stir and drink. Is something lost by not having the formula cooked together? While it is possible to purchase formulas in granules, you might still want to modify, and carrying formulas and singles both increases cost as well as space needed for inventory.
A seven day supply of loose/bulk Liu Wei Di Huang Wan from the AFEA dispensary is a base cost of $18.00, for 240 grams. That base cost includes the shipping and handling of the herbs. That is an average dosage that we give to patients for a 7 day period. In real life, patients often forget a couple of doses or have a little too much water, so they often last 8 days. Ten is the maximum they can keep the liquid herbs before going bad. This cost is by weight—with no expensive ingredients in the formula, like Ren Shen ginseng or Mei Gui Hua rosebuds, then the formula is calculated at the average per gram cost, .075 per gram.
For granules, if giving the patients a dose of 12 grams a day (again, in the range where we most often prescribe in clinic) a day, then 120 grams of Liu Wei Di Huang Wan (3 parts Shu Di Huang with 2 parts of everything else Fu Ling, Ze Xie, Mu Dan Pi, Shan Zhu Yu and Shan Yao) is $13.50 base cost. We use KPC granules.
To give an example of prepared herbs, I picked Blue Poppy. For a bottle of 120 capsules, 500 mg each with a 10:1 concentration, one bottle would last the same as granules for approximately 10 days. The cost of a bottle is $15.95. While there are cheaper brands like Golden Flower and Great Nature, they are a lower concentration and a smaller bottle (often 7:1 concentration and a bottle of 90 capsules.) So choosing a more expensive Blue Poppy bottle actually can be less expensive in the end, because of needing to take fewer capsules per day. However, the $15.95 does not include shipping and handling, as most practitioners, whenever possible, order large quantities together.
To review: loose was $18, granules $13.50 and patent $15.95. This is before your practitioner mark-up (you know, that profit you have to make to help keep the doors open and the lights on.) These are all prices as if you were doing the work yourself. Companies like Crane Herb offer compounding pharmacies, and the prices go up significantly because you are paying their fees, plus adding in your mark-up, plus shipping to the patient. These services are incredibly convenient, however, and the practitioner has no worries about the rules and guidelines for GMPs.
I did not include tinctured herbs in this scenario because all of them are purchased as patents in our clinic at this time. There are some practitioners who are beginning to tincture Chinese herbs singles and formulas, and developing compounding pharmacies with them. Companies like Blue Poppy and Kan sell liquid versions of many formulas—a personal favorite is the tincture version of Dispel Invasion, because you want to get the herbs absorbed and working as quickly as possible. But the tincturing of Chinese and Ayurvedic herbs raises some question. There is some precedent for alcohol extraction with medicinal wines, but that is a small category. How do we know an alcohol extraction has the same medicinal benefits and actions as a water- based preparation? Do we know what we are changing when we alter the preparation? I am by no means a purist, and I rely heavily on glycerin preparations for pediatrics, but I have yet to fully embrace the trend to tinctures of Chinese herbs. Perhaps that’s another blog for another day, as I have heard talks from herbalists on both sides about tinctures.
To conclude, my thought is that the most important factor in prescribing herbs to patients is the herbalist’s personal preference. What are you enthusiastic about? What do you prefer to take? What ignites your passion for herbal medicine? How do you feel most connected to the plants and herbs you are using? Your excitement and belief in the form of herbal medicine will translate into patients acknowledging your authenticity, your belief, and will comply more readily. Our enthusiasm will shine through. So no matter how the math comes out, the most important part is getting the patient to actually take the herbs. And that has a lot to do with our connection to the botanicals.
Learning from the Unknown
Catherine A. Hollingsworth
When I enrolled in AFEA two years ago, I expected initiation into a precise field of knowledge that I would soon be using to treat patients for diseases of the body, mind and spirit. This is a rational idea of education, and it made perfect sense to me based on the standards with which I was raised. This was medicine, was it not?
Around about year one, I was struggling to understand why we were not rigorously drilling points and protocols and causes of pathology. We were more likely to be sitting around in a circle talking about our feelings or the dynamics of nature. “What kind of school is this?” I thought. “They aren’t teaching us anything!” I was frequently prone to airing my frustrations to the school’s administration, and the Academic Dean patiently listened to my every complaint. And then one day he said, “the problem is that we are living in a Confucian society, but we are learning a Taoist medicine.”
I put the brakes on my search for knowledge, paused, and began to rethink my perspective. Over the course of the next year, I slowly realized what he meant. It was in the spaces of the questions, the students’ experiences of each other, and our crises of personal transformation that we were learning the most. Academic effort as I understood it was not going to get me anywhere. In fact it had been impeding my learning. At this school, in those circles of conversation, were lessons that can’t be learned from a book, one of the reasons why Five Element is considered an oral tradition.
Now, my classmates and I have begun our clinical year. We have been granted the privilege to use needles and work on actual patients. As we attempt to shape what we’ve learned into concrete treatment plans, I can’t say that I am settling into any kind of certainty. The subtle cues that reveal a person’s nature and imbalance are becoming more familiar. Yet I’m still mystified, maybe more so.
Every new question represents an experience that I haven’t integrated into my concept of reality. How is it that patients can process their treatments through dreams? How can multiple styles of acupuncture, with vastly different protocols and ways of manipulating needles, be so dissimilar and yet simultaneously true? How can a single needle release tears so long-held that the patient can’t even name their source? What are these points anyway?
Apparently I’m in good company. Even masters with fifty years experience will honestly say they still don’t know how acupuncture works. Among styles of acupuncture, there is a particular subtlety to Five Element. A practitioner of this medicine must enter into the space of not knowing, confident that answers will be found there. Or not. And the patient is likely to feel a drastic shift in his or her way of living for essentially indescribable reasons. I owe great thanks to my teachers for holding an open space for me to continually reorient myself in this mystery (sometimes kicking and screaming).