How Does Chinese Medicine Work? A Journey Through the Phases of Healing (Part II)
Last month, we shared with you the differences between Western and Chinese medicine and the causes of disease. If you missed Part 1 of this discussion in last month's newsletter, you can read it here. This month we continue that discussion with the treatment process.
When we take on a new patient we have a high degree of confidence that we can treat that patient to “resolution.” In order to understand what we mean by this, let's go back to last month's article to review a little bit about how we approach our work in the clinic and how Chinese Medicine views the body.
All systems operating in a cyclical pattern, including the human body.
One observation we have made over the years is how hopeless people often feel when they come into the clinic. They may feel broken and beyond repair. For some reason we have convinced ourselves, or rather allowed ourselves be convinced, that we, as humans are somehow different from all other natural organisms or systems in the world. As amazing, beautiful, wonderful and exceptional we are as humans, one of the central principles of Chinese Medicine is that we still operate under the same laws as any other system or organism. All systems have a built-in or innate healing mechanism.
As we mentioned last month, our system is designed to self-maintain a level of health and vitality throughout our entire life. Ecologists call a system’s ability to self-regulate “homeostasis”. Another term we borrow from ecology that mirrors the Chinese Medicine paradigm is that of the tipping point. A tipping point is the threshold that, when crossed, an ecosystem is unable to maintain its own integrity or homeostasis. Most of the patients that come into the clinic have a system that has fallen below the "tipping point" which means that their body is unable maintain it's equilibrium without "help."
Western Medicine attempts to "help" by using a surgical or pharmaceutical method, while Chinese medicine seeks to strengthen the body's ability to handle the problem unassisted.
Western medicine will often see the cause of a disease as a specific item, while Chinese Medicine will not see a specific cause or thing that failed, but will rather look at a large area of the body’s physiology that is not working optimally, or see one system that is not supporting another. As many people have observed as they have been referred form one specialist to another, to another, to another, addressing one symptom at the time. It appears that looking so granularly at a problem can lead to missing the issue (not seeing for forest through the trees). In contrast, Chinese medicine starts small and works big through an associative process by looking at all the individual pieces and finding the relationships between them. Symptoms are addressed in the context of the high-level imbalance and as the high level imbalances are corrected, symptoms resolve and cease to be an issue.
Root and Branch
This process of treating both globally and specifically is sometimes referred to treating both the root and the branch. There is an old axiom that states “nourish one root many branches are nourished.” In the treatment process, as the patient’s primary symptoms resolve, the practitioner is also looking for other related branches to resolve and improve as a result of treatment, regardless whether or not the patient indicated that as an area of concern. As we examine the symptoms, the patient's pulses and other diagnostic information like the tongue or the abdomen, we are identifying these branches as well as the underlying or “root” cause. This allows us to treat the source of the imbalance as well as the primary symptoms. The better the assessment and treatment of the root, the more effective the branch treatment will be. Our method of determining how to treat is rarely, if ever, based on a Western Medicine diagnostic, whether it be a lab report, imaging or a Western Medicine diagnosis of this disease or that syndrome.
With each treatment there is a portion of each treatment that is devoted to treating both the root and the branch of the imbalance.
The root treatment is tied to identifying the cause or source of the deregulation of the system that caused the patient to seek help and is tied to the Chinese Medicine Diagnosis, not a Western Medicine disease designation. For instance, in Chinese medicine there are three different ways that a system may be imbalanced that would lead to a diagnosis by a Western Medical Doctor of Diabetes. Strictly speaking Chinese Medicine does not treat diabetes, but the causes and conditions that lead to it.
Phases of Treatment
As the clinic approaches it’s ninth year in existence, we apply our understanding of the Classical Medical texts to how we work with our patients, as well as observing how patients best progress through the treatment process. Consistent with the principles of the formative texts and traditions of our medicine, the goal of the clinic is to restore the patient’s ability to heal. Stated another way, at the end of the treatment process, the gold standard is for the patient to either not be dependent on outside help, or significantly less so. Notice, that this even includes dependence on our services. We love our patient’s, however, the best outcome for everyone is that they don’t “need” to come in for treatment.
Phase I - Stabilization
When people have been below the tipping point for awhile, life can feel very out of control and dark. People loose hope - perhaps they have received a dire diagnosis, or, as often happens, there is no diagnosis, as the medical community cannot find anything specifically wrong. This is the place that many people find them selves when they call the clinic.
The first order of business is to get the symptoms better such that the person begins to regain hope and confidence in their ability to regain their health. During this phase we will work with the patient at a more frequent interval to make sure that the patient’s condition stabilizes as quickly as possible. We will give specific advice on when the next treatment should be. If the condition requires herbs, we will let the patient know and follow up more frequently to monitor their progress. In addition, our office will be more likely to call just to check up with you and see how you are doing.
Transition between Phase I and Phase II
The practitioner is trained to observe when the condition is stabilizing and the patient will usually notice that between treatments that the symptoms are largely or completely better between sessions.
Phase II - As little treatment as possible, with improvement.
During this Phase the patient is experiencing significant improvement between treatments. The practitioner will start to extend the treatment process for three reasons: 1) this allows us to see how long the patient’s own physiology is able to “handle it” without our “help.” 2) this prevents the patient from physiologically becoming habituated to need our treatments and 3) and, perhaps most importantly, allows the patient to experience that they are, in fact, getting better by observing that they are, in fact, getting better. This is similar to taking the training wheels off of a child's bike. Generally, patient’s enter this phase with very little confidence on their own body’s ability to heal, and exit with a general feeling of “I’ve got this!”
Phase III – Maintaining Balance
After Phase two, many patients will want to discontinue treatment for a variety of reasons, then come back to the clinic if something else presents as a problem. However, some patients want to continue treatment. Some patients like to come in while they are healthy periodically to stay that way. While we encourage this as it gives us a chance to reconnect with our patients, we are very careful not to push “maintenance plans” as it should be your choice as to when you want to or should come in for treatment. It's satisfying to see patients that we have not seen in a long time. Rather than give them a set interval that meets our needs, we encourage the patient to “play around” with different treatment intervals to learn what gives them optimal results. For some patients, this might be every four weeks and for others, it might be seasonally There is no right or wrong interval here, rather the important aspect is that interval is patient-driven, rather than directed by the practitioner or the clinic. The time and place for the more hands-on, practitioner-directed ended when the patient entered Phase II. By focusing on a patient-directed interval, the the patient has the opportunity to focus on how they are doing and observe their own miraculous healing process in action. During this phase, the clinic, the practitioners and staff at our clinic become a resource and a support structure for the patient, if they need or want it, It’s the difference between a patient saying “as long as I come in once a week, I’m okay,” and “I came in to get help and now I know I am fine and I know the clinic is there for me, if I need it.”
Understanding where you are in the treatment process is important to us. If you have any questions about this, please let us know. Next month we will continue this discussion of the treatment process with the pathway to resolution of a health problem.
Posted in Acupuncture