The most common reason why a patient doesn’t immediately respond to treatment is because the practitioner has not yet discovered the patient’s CF. Below are the most common reason why CFs can be confused.

Some Wood CFs cover up their anger with sociability and laughter. If this is the case they are more likely to stay ‘up’ and laughing for a prolonged period of time. The laughter is likely to be more loud and raucous than that of the Fire CF. Some Wood CFs also love poking fun at others as their humour often has an aggressive edge.

When Wood CFs are depressed they can also descend into deep gloom. This could be mistaken for a lack of joy. The depression of a Wood CF is caused by internalised anger that is unexpressed. Because of this Wood CFs often feel somewhat better when the source of frustration has been removed whilst a Fire CF is more likely to brighten up when given warmth or a compliment by someone else.

When Earth CFs want sympathy but feel that no one is giving it to them they may feel angry. This can give a practitioner the impression that they are Wood CFs. However, when Earth CFs are then given the support and consideration that they want, they change and feel better (see Shifrin, Chapter 15, p. 169, in MacPherson and Kaptchuk, 1997).

When Earth CFs tend to reject sympathy they may appear to be hard and angry and can also be mistaken for Wood CFs. This is because they find the sympathy difficult to deal with and harden themselves in order to keep it away.

The qi of many Wood CFs naturally travels outwards. As a result they may be very giving and benevolent by nature. This may make it easy to mistake them for sympathetic Earth CFs. The object of their sympathy is frequently a cause they are supporting and their motivation is seeking justice. It is important to assess their colour, sound, emotion and odour to ascertain whether their behaviour is pathological or not.