37. Using points to treat the spirit
Chapter contents
Treating the spirit in Five Element Constitutional Acupuncture288
Specific groups of spirit points292
Conclusion – using points to treat the spirit level297
Treating the spirit in Five Element Constitutional Acupuncture
Practitioners of Five Element Constitutional Acupuncture place a high value on generating change at the level of a person’s spirit in order to alleviate many chronic health problems.
To have the spirits (de shen) is the splendour of life. To lose the spirits (shi shen) is annihilation.
(Su Wen, Chapter 13; Larre and Rochat de la Vallée, 1995, p. 33)
When discussing the use of points to treat the person’s spirit, the word ‘spirit’ is used in the same sense as it is used in Chapters 3 and 27. When practitioners attempt to bring about a change in a person’s ‘spirit’ through treatment they are endeavouring to initiate deep and fundamental changes. These changes manifest in how patients feel in themselves and thereby how they interact with the world.
Treating at the appropriate level
Choosing the correct level of treatment is of prime importance. Some patients, for example, have purely physical symptoms that are causing pain, impaired function and/or lowered vitality. In this case a few simple treatments may bring about sufficient balance so that the physical symptoms are cleared. However, even simple symptoms like these may be arising from a deeper level.
For example, a person with pain, impaired function and/or lowered vitality may also have had an anxious disposition throughout his or her life. In this case it is important to ensure that treatment addresses the anxious disposition. If the patient is a Water CF the practitioner may start by re-balancing the ‘descending’ movements of the Kidney qi to allow him or her to feel more settled inside. If this can be achieved by using simple treatments such as ‘command’ points, transfers of qi, back shu points, etc., on the Water Element, there is no need to use points that treat the spirit specifically. Some patients can experience a radical transformation in their state of health in body, mind and spirit from very simple treatments.
If, on the other hand, simple treatment does not generate significant improvement in the patient’s spirit, then the practitioner may need to choose points that affect the spirit more directly. Practitioners know that the spirit level has been affected if patients report feeling better in themselves. There should also be an improvement in the colour, sound, emotion and odour as well as the symptoms.
Health and the spirit
What constitutes ‘health’ is different from patient to patient. Increased relaxation, vitality, happiness, strength, creativity, spontaneity, decisiveness, clarity, purpose, hope or many other aspects of the human condition are all possible changes that patients need to experience in order to have a sense of well-being. If the root of the problem lies in the spirit but only the physical symptoms respond, they will continue to live a diminished life. Their physical problems may also return or new ones emerge.
Choosing spirit points
It is usual to choose spirit points that are on the channels of the CF. Spirit points are usually only used on Elements other than the CF when a person’s spirit has been especially affected by traumatic and difficult situations involving intense emotions. For example, an Earth CF who has just suffered a bereavement may be unable to return to her or his previous level of well-being and happiness. In this case it might be necessary to treat points on the Metal Element whose main effect is on the spirit. Without supporting the Metal Element, the patient may be unable to return to their previous level of balance.
Reaching the spirit level
For every needling, the method above all is not to miss the rooting in the Spirits.
(Ling Shu, Chapter 8; Larre and Rochat de la Vallée, 1995, p. 81)
It is all too easy to say that it is important to treat the patient at the spirit level, but reaching the level of the spirit is not always possible.
How does a practitioner initiate improvement in a person’s spirit? There are no easy answers and all practitioners are familiar with the experience of frustration at seemingly being unable to generate the changes that they feel are required. Two main factors interrelate with each other when treating the spirit: the inner development of the practitioner and the choice of points.
The inner development of the practitioner
This is the subject of Chapter 6, this volume, but its importance can hardly be overstated. The key factor in the practitioner–patient relationship is the trust and depth of rapport established. Practitioners will often be unable to evoke changes in the spirit if they fail to establish sufficiently deep rapport with the patient. This is especially true when patients are suffering intensely from sadness, frustration, anxiety, grief and other emotional states. If rapport is limited to just ‘getting along fine’, patients continue to hide away the parts of their spirits that suffer. They are never revealed or touched in the therapeutic encounter.
That is not to say that practitioners should spend their whole time dragging up patients’ unhappiness and suffering. It is more that the practitioner has contacted those aspects at some stage. Patients then know that those parts of themselves have been seen and acknowledged. When patients come for treatment knowing that their inner struggles are recognised they can allow themselves to discard much of the mask they wear during their daily life.
Only practitioners who have an awareness of these areas of suffering in themselves and genuinely care for the suffering of others are capable of this level of rapport. That is why practitioners must strive to hone their skills and refine their spirits. Patients can then bring the level of suffering that most needs to be healed to the treatment room.
Intention
The intention of the practitioner is crucial to the practice of acupuncture. The response in the patient is hugely affected by whether the practitioner needles Kid 25, believing its effect to be limited to the physical indications of cough, asthma and chest pain (see Cheng, 1987, p. 187), or if they use it in the context of its time-honoured name as Shen Cang, the storehouse of the shen. As Sun Si-miao wrote, ‘Medicine is intention (yi). Those who are proficient at using intention are good doctors’ (quoted in Scheid and Bensky, 1998).
Many pianists can play the notes of a piece of music, but only those who are capable of allowing their own spirit to be present in the playing can touch the spirits and feelings of their listeners.
In order to reach the patient’s spirit the practitioner needs to be fully present. Otherwise the level of rapport between practitioner and patient may not facilitate sufficient change in the patient’s spirit. Acupuncture, relying as it does only on inserting fine needles into a person’s qi, is a powerful but extremely subtle form of medicine. It is an art as much as it is a science. If the practitioner fails to realise this, the value of the points referred to in the following section will forever remain a mystery.
The choice of points
Before discussing the choice of points it must be said again that, in the right circumstances, change can be initiated in a person’s spirit from any point on the body. Although some points tend to influence the spirit more readily than others, there are many patients who can change profoundly in themselves just from treating ‘command’ points. It is only when patients do not change in themselves that the practitioner uses points that primarily affect the spirit.
One of the underlying principles of point selection in Five Element Constitutional Acupuncture is that each point on a channel has a different effect on the Organ, rather like each hole on a flute produces a different note.
Frequency of using points
Just as patients can acquire a tolerance to some medications that, over a period of time, makes them less effective, they can also fail to reap the same level of benefit from some points if they are used too often. Constant repetition of the same points is therefore discouraged. In order to use these points with precision and elegance, practitioners need to explore the repertoire of points on a channel. They can then assess what changes different points can initiate. It may sometimes be necessary to use the same points frequently, especially on channels with few points or on patients who require long-term or frequent treatment. In this case the points are often used in different combinations.
Using points according to their names
The names of many of the points go back to the Han dynasty. The names of 160 of the points are found in the Nei Jing and therefore, not surprisingly, the influence of Daoism and Confucianism can be clearly seen in many of their names. The Daoist view of man and the human body as a microcosm of, and a link between, Heaven and Earth is especially evident in many point names.
The body as a landscape
There is a Daoist saying that, ‘The human body is the image of a country’ (Schipper, 1993, p. 100) and this is reflected in the point names – streams, marshes, mounds, valleys, mountains and seas. The names of stars and planets are found as well. Burial grounds, treasuries, palaces and city gates, some of the constructions and institutions of the dynamic and creative Han dynasty are also present.
The great physician Sun Si-miao wrote, ‘The names of the points are not nominal; each has a profound meaning’ (quoted in Ellis et al., 1989). The use of points based on the name of the point became a major aspect of the point selection of many Daoist practitioners and is described in the Yellow Court Classic (+ second century), a component of the Daoist Canon or Dao Zang (Eckman, 1996, p. 213). There are still Daoist practitioners who have maintained the tradition of using point names extensively in their treatments. 1
The use of points by anatomical terms
The Jia Yi Jing (+282), based on the Nei Jing and the Ming Tang (a Han dynasty classic of acupuncture and moxibustion lost in antiquity), added another 189 points, which accounts for the names of 349 of the points. Many of these names are topographical in nature, describing the anatomy to be found at or near the point. These names offer little or no help to contemporary practitioners as to the particular characteristics of a point. 2
2No versions of the original publication of Jia Yi Jing survive. The earliest extant version dates from +1601, so it is impossible to know how many of the point names originate from later eras. Joseph Needham thought that the naming of all the points was completed by +300; see Lu and Needham, 1980, p. 101.
The use of spirit points
Each channel also has points where the name carries some meaning that links the point either with Heaven or with some aspect of a person’s spirit. It is important, however, to also bear in mind the Organ and Element on which the point is located. A point such as Liv 14, the Gate of Hope, may be effective if the patient’s lack of optimism and inspiration is predominantly due to an imbalance of the Liver. If it comes from dysfunction of another Organ or Element, then the Gate of Hope will not be effective. Some points, such as the Windows of the Sky, Kidney chest points or the outer back shu points are grouped together. Some points have the word ‘spirit’ in their name, translations of either shen or ling. These groupings are discussed below. (See Appendix A for more on the different terms used in Chinese medicine to mean ‘spirit’.)
Interpreting point names
The major problem of relying on the name of the point for information about its characteristics lies in its interpretation. What was meant in antiquity when the point was named is not always clear. Practitioners need to be careful to not just place their own interpretation on the name of the point in such a way that they end up with a mistaken view of its characteristics. For more on the interpretation of point names, see Ellis et al., 1988; Hicks, 1999; College of Traditional Acupuncture, 2000; Willmont, 2001. 3
The use of points by location
Although many of the most powerful points are situated distal to the elbow and knee, there are also other areas of the body that have a large number of powerful points.
These areas are especially centred on the three dan tian of the body (see Figure 37.1). More emphasis has historically been placed on these three foci in tai ji quan, qi gong and Daoist meditation practices than in medicine. (There are similarities to, but also key differences from, the Indian concept of chakras.) There are, however, considerable overlaps that can be most clearly seen in the names and use of acupuncture points. These centres of qi are resonant with the Heaven–Humanity–Earth paradigm.
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