In our last Tarot blog we looked at The Empress card, this is our mother archetype within the tarot allowing us to progress to the next card, which is the father archetype called The Emperor.
The Emperor is the fifth card out of the 22 Major Arcana cards within the tarot, remember the first card is “0” with the fool, and labelled card number 4. The Emperor closely flows on from the previous cards in the Major Arcana as the Major Arcana describes our overall cycle of life and spiritual development. Within the Major Arcana we started out with The Fool and this is the energy of the limitless possibilities that the universe can deliver, this then flows into the Magician allowing us to actively channel this energy into our pursuits. The High Priestess allows the more internal, instinctual or creative qualities to flow through and utilise the active energy from The Magician. The Empress then brings forth this energy into a more feminine dynamic relating to yin, growth and abundance and flows into balance with The Emperor. Just like the Magician and the High Priestess represent a ying/yang dualistic complementary dynamic, so does The Empress and The Emperor cards.
In the traditional Waite-Smith deck, The Emperor sits on a throne surrounded by rams’ heads, two carved into the arm rests of his throne representing the astrological sign Aries, rules by the planet Mars with his red robes representing the element of fire. He wears a gold crown to show his authority, carries a sceptre with an ankh in his right hand representing life or his rulership and an orb in his left hand to symbolise the world in his hands with the breadth of his realm. Behind him is a great mountain range to demonstrate his majesty or aspiration for bigger and greater things. From a Mystical Qabalistic perspective The Emperor represents the path between Chochmah (Wisdom) and Tiphareth (Glory or Splendour) on the Tree of Life. Tiphareth is the force that combines the energies from the sephira Chesed (Compassion) and Gevurah (strength or judgement) to balance itself in the glory or splendour, thus the attributes of wisdom or deep thought and this is taken into consideration when giving advice the spectrum that moves from ultimate compassion to severe judgement whilst remaining balanced between the two forces.
The Emperor represents the father figure and a masculine dynamic energy, this is regardless of gender and refers more to the archetypal qualities. It is about protecting and defending love ones, stability or security and can represent leadership qualities of an individual with a clear vision. The Emperor can represent a situation bound by rules and regulations, excellent navigating and helping your path through a tricky situation. The emperor is a straight shooter and will think through a situation giving strategic and sound advice that takes into consideration factors others may not be aware of. Selecting The Emperor in a reading can indicate success through self-discipline, careful planning or seeking out the advice of knowledgeable experts to navigate through a situation.
Tarot is used within each Esoteric Acupuncture session at Mornington Chinese Medicine with Simon Altman. He has had the wonderful opportunity to train personally with Dr Mikio Sankey the developer of Esoteric Acupuncture and completed all levels of Esoteric Acupuncture training. Simon uses tarot as an adjunct to give direction, purpose and meaning to the session as well as Sound Therapy, Reiki and Astrology. Tarot within the session can be concise, or if there is a specific interest, a longer interpretation can be arranged.
Esoteric Acupuncture is a style of heart centred acupuncture that works on the deeper levels of the body to promote balance and direction in life. It can be used as maintenance or a tune up and incorporates a more spiritual esoteric acupuncture pattern on the back of the body, then a complementary esoteric acupuncture pattern on the front of the body, which can then be combined with a standard Chinese Medicine to help with core issues.
If you have any questions, please feel free to contact me for further information or to discuss these amazing topics.
In this blog we are exploring one of my favourite Tarot cards The Empress, which is an appropriate card for Mornington Chinese Medicine as she is one of the main cards representing fertility, the mother, abundance, living life to the fullest, feminine power, pregnancy and love.
We have previously looked at the earlier cards starting with The Fool, The Magician and The High Priestess. The Empress is the fourth card out of the 22 Major Arcana cards within the tarot. The Empress closely flows on from the previous cards we have investigated as the Major Arcana describes an overall cycle of life and development. We started out with The Fool which is the energy of the limitless possibilities that the universe can deliver, this then flows into the Magician allowing us to actively channel this energy into our pursuits, then The High Priestess which allows the more internal, instinctual qualities to flow through.
Following on from The High Priestess we enter the card of The Empress, a card with lots of depth and some amazing symbolism included within the Waite-Smith deck. The Empress sits on her throne comfortably surrounded by cushions with a heart shape pillow by her side that has the astrological symbol for Venus, the roman goddess of femininity, beauty and love. She has a forest with a flowing river and waterfall ending at her feet, with this water bringing emotional fulfillment and life to the nature around her. The Empress has wheat in front of her representing fertility as the seeds are ripe for harvest taking on the waters of life that are flowing around her. Her crown has 12 stars representing the various cycles of life including the zodiac, the months of the year, and time in general. The red cushions represent love and the pomegranates on her dress represent fertility with its free-flowing nature alludes to pregnancy.
Within a Tarot spread The Empress can signify a time of abundance, prosperity, creativity and passion is surrounding you. It can represent happiness, security, emotional fulfilment and pregnancy. Aside from fertility it can also represent domestic harmony and stability, a home that if there are already children, may be used as a hub to support, feed and nurture those around you. It resonates with the number 3 in numerology as it combines card number 1 The Magician with card number 2 The Empress. Through this combination of energy, it signifies the path between Chochmah (Wisdom) and Binah (Understanding) within the Hermetic Qabalistic tree of life and merges these two special sephirot’s spheres of influence.
Tarot is used within each Esoteric Acupuncture session at Mornington Chinese Medicine with Simon Altman. He has had the wonderful opportunity to train personally with Dr Mikio Sankey the developer of Esoteric Acupuncture and completed all levels of Esoteric Acupuncture training. Simon uses tarot as an adjunct to give direction, purpose and meaning to the session as well as Sound Therapy, Reiki and Astrology. Tarot within the session can be concise, or if there is a specific interest, a longer interpretation can be arranged.
Esoteric Acupuncture is a style of heart centred acupuncture that works on the deeper levels of the body to promote balance and direction in life. It can be used as maintenance or a tune up and incorporates a more spiritual esoteric acupuncture pattern on the back of the body, then a complementary esoteric acupuncture pattern on the front of the body, which can then be combined with a standard Chinese Medicine to help with core issues.
If you have any questions, please feel free to contact me for further information or to discuss these amazing topics.
In this blog we are continuing the story of the Major Arcana in the Tarot. Previously we covered The Fool and The Magician. Now we have The High Priestess which is the third card within the 22 Major Arcana cards of the tarot. The High Priestess closely follows from The Fool which takes that leap of faith into the current cycle of events, to The Magician bringing about the enthusiasm, energy and motivation at the beginning of your journey. Following on from the external forces The Magician represents moves into The High Priestess presenting the more internal nature of reflection, meditation, looking within and taking time to reflect whilst trusting your intuition or gut feelings.
She holds onto a scroll of inner knowledge, representing our true purpose or our destiny and the cross at the level of her heart slightly hidden refers to looking inwards for deep spirituality. The Moon at the feet of the High Priestess can signify the subconscious or unconscious mind, hidden knowledge, the need to look within and use the more feminine aspects of our psyche. The two pillars on either side of The High Priestess are Jachin and Boaz and represent the two pillars from the entrance to King Solomon’s Temple. These pillars can symbolise the three pillars of the Qabalah which are Mercy and Severity and the High Priestess sits right in the middle represented by the middle pillar or balance between Jachin (masculinity) and Boaz (femininity). The High Priestess is sitting in front of a veil stretching across the two pillars decorated with pomegranates, these mythologically symbolise the fruits of the underworld and are also symbol of fertility.
The High Priestess is associated with Pisces and is a card of possibilities, looking inward and using your intuition to achieve the results you desire. Whilst the Magician has the outward energy to achieve results, the High Priestess is a card of using your gut feelings and intuition to transverse a situation. Trust your gut is one of the messages of the High Priestess, if you trust your intuition and your gut feelings it is very hard to stray of the correct path in life. Trusting your intuition as you may need to use that feeling because some aspects of the situation could still be hidden, however your inner world can navigate this map without effort. It is also a card for psychic and spiritual development, as this requires you to go within and meditate or for a relationship it suggests one that psychic or spiritual development can take place.
Tarot is used within each Esoteric Acupuncture session at Mornington Chinese Medicine with Simon Altman. He has had the wonderful opportunity to train personally with Dr Mikio Sankey the developer of Esoteric Acupuncture and completed all levels of Esoteric Acupuncture training. Simon uses tarot as an adjunct to give direction, purpose and meaning to the session as well as Sound Therapy, Reiki and Astrology. Tarot within the session can be concise, or if there is a specific interest, a longer interpretation can be arranged.
Esoteric Acupuncture is a style of heart centred acupuncture that works on the deeper levels of the body to promote balance and direction in life. It can be used as maintenance or a tune up and incorporates a more spiritual esoteric acupuncture pattern on the back of the body, then a complementary esoteric acupuncture pattern on the front of the body, which can then be combined with a standard Chinese Medicine to help with core issues.
If you have any questions, please feel free to contact me for further information or to discuss these amazing topics.
In our previous post we looked at the first Major Arcana Tarot card, numbered 0, The Fool. The Fool represented the first step in the beginning of a new journey or cycle in life. This is then followed by The Magician, numbered as card 1, is the second card in the Major Arcana.
The Magician generally depicts a person holding a magic wand with esoteric tools laid out in front on a table or altar. In the Waite-Smith deck, four tools are displayed which are also the symbols for the four suits of the Minor Arcana, these are Wands, Cups, Swords and Pentacles. This symbolises the power you now have to manifest plans into the world. It could be new opportunities in life such as changing or finding a new job, new emotional opportunities, new intellectual pursuits or simply putting those plans into action. The magicians hands traditionally (in Waite-Smith symbolism) have one pointing up holding a wand and one down pointing to the ground empty. This represents active and passive energies or the transmission of information and the transmitted.
Each tarot card contains within it a vast system of symbolism, meaning and correspondences. The Magician relates to the Philosophical Mercury (different to the traditional mercury), its colour is yellow, Qabalistically its number is 2, Beth, representing a house giving a hidden clue as to making a structure or tangible impact on your surroundings. On the Qabalistic tree of life, the path of Beth travels from Kether (Crown) to Binah (understanding), or the inspiration coming down from divinity and being transformed into Knowledge or understanding. The infinity symbol above The Magicians head is positioned at Kether, or the Crown Chakra, symbolising the universal energies coming down from divinity into the Magician and allowing that energy to transform from the immaterial to the material.
The journey of the Major Arcana started with The Fool, a card that indicates taking a leap of faith, trusting the universe will support you at this point in time, or with your current endeavours and shows a new beginning or cycle in life. Following this new start and burst of inspiration flow into The Magician, a card that allows that inspiration to manifest and enter our lives. It is about putting that initial energy or motivation into action, and succeeding in that particular endeavour, or time in our life. Having the energy to complete a task and also follow through with it is one of the themes of the Magician. Using your own inner and external power to manifest and bring about positive change in your life. Being a Major Arcana card, representing those big spiritual sign posts in life, means this event is one that can encourage learning a lot so that it becomes an unforgettable stage in your life, whilst demonstrating a change in a situation that then leads down a more spiritual or meaningful path.
The Magician is an excellent card within a Tarot spread, it is an exciting time and step in the journey of life with new ventures beginning and starting to take shape. It allows spiritual, emotional and mental growth as well as the manifestation of a new stage in life. Currently we have looked at The Fool (0) and The Magician (1). The card that follows on from The Magician is The High Priestess which will be discussed in our next blog on the Tarot.
Tarot is used within each Esoteric Acupuncture session at Mornington Chinese Medicine with Simon Altman. He has had the wonderful opportunity to train personally with Mikio Sankey the developer of Esoteric Acupuncture and completed all three levels of Esoteric Acupuncture training. Simon uses tarot as an adjunct to give direction, purpose and meaning to the session as well as Reiki and Astrology. Tarot within the session can be concise, or if there is a specific interest, a longer interpretation can be arranged.
Esoteric Acupuncture is a style of heart centred acupuncture that works on the deeper levels of the body to promote balance and direction in life. It can be used as maintenance or a tune up and incorporates a more spiritual esoteric acupuncture pattern on the back of the body, then a different esoteric acupuncture pattern on the front of the body, which can then be combined with a standard Chinese Medicine to help with core issues.
If you have any questions, please feel free to contact me for further information or to discuss these amazing topics.
The Fool is the very first card in the Major Arcana sequence of the Tarot Deck. A standard tarot deck consists of 78 cards and they are split into two categories; the Major Arcana consisting of 22 cards and the Minor Arcana consisting of the remaining 56 cards.
The Minor Arcana cards describe mundane aspects of life including work, relationships, finances and general decision making. These cards are similar to your playing cards consisting of four suits Wands, Cups, Swords and Pentacles which can be transferred to the modern Clubs, Hearts, Spades and Diamonds.
The 22 Major Arcana cards deal with more spiritual life lessons than everyday matters and can show you the overarching reason why a situation is happening. These are the spiritual signposts that direct an individual to understand the meaning behind the card and its importance at that particular moment.
The Waite-Smith tarot, or Rider-Waite as it is commonly known was the first modern tarot deck originally published in in 1910 and used the symbolism, numerology, astrology and Qabalistic correspondences taught by the Hermetic Order of the Golden Dawn, a mystery school active around that time. It was originally published by William Rider & Sons, designed by Arthur Edward Waite, an occultist, mystic and member of the Golden Dawn. Waite commissioned artist and Golden Dawn member Pamela Coleman Smith to draw and design illustrations for each Major Arcana card.
One of the most unique aspects of this tarot deck was that Arthur Edward Waite and Pamela Coleman Smith designed images and symbolism all the cards within the Tarot Deck. Previously Tarot cards only contained pictures on the 22 Major Arcana cards, the remaining 56 cards would simply have 4 swords, or 7 pentacles drawn on the card, rather than a pictorial representation of the mystical meaning of the deck. The Waite-Smith deck was the first deck to include pictures on all cards and tarot decks of today have Arthur Edward Waite and Pamela Coleman Smith to thank for this great innovation as many are based on their specific symbolism.
The first card in the Major Arcana is known as “The Fool” or “Jester” and is often listed as card number “0”. In some sets “The Fool” can act as a wild card either starting the journey of the Major Arcana in which case it comes in at the number “0” or ending the Major Arcana set coming in at number “22”. In most common tarot decks, based around the Waite-Smith symbolism and ordering, The Fool starts our journey of the Major Arcana as the first card.
The Fool represents taking a leap of faith into the unknown and trusting that the universe will support and guide you. It is the beginning of a spiritual journey that starts our progression in life and through the trumps of the Major Arcana. It is a time in life when anything is possible, and simply taking a leap of faith will succeed in your endeavours. It is not a time to dwell on possibilities or problems that you think may occur, or internally rationalise why you shouldn’t complete a task or start a new venture, this is the moment where we can delve into challenges or goals head first with confidence. The fool represents opportunities available to you that you can see, which acquaintances may overthink or be cautious, and the importance of trusting your own instincts to begin your own spiritual journey and life path.
The journey of the Major Arcana begins with The Fool and ends with The World, it is a cycle that repeats numerous times throughout our lives as we evolve, learn and develop both physically and spiritually. The Fool represents taking that initial step into this world, or a new chapter in life showing the beginning of a new and exciting journey of discovery. It represents exciting opportunities that you may be hesitant to pursue, but it is a great indication to take that leap of faith and start that venture, relationship or chapter of your life as you move into a new phase that may be unexpected.
Tarot is used within each Esoteric Acupuncture session at Mornington Chinese Medicine with Simon Altman. He has had the wonderful opportunity to train personally with Mikio Sankey the developer of Esoteric Acupuncture and completed all three levels of Esoteric Acupuncture training. Simon uses tarot as an adjunct to give direction, purpose and meaning to the session as well as Reiki and Astrology. Tarot within the session can be concise, or if there is a specific interest, a longer interpretation can be arranged.
Esoteric Acupuncture is a style of heart centred acupuncture that works on the deeper levels of the body to promote balance and direction in life. It can be used as maintenance or a tune up and incorporates a more spiritual esoteric acupuncture pattern on the back of the body, then a different esoteric acupuncture pattern on the front of the body, which can then be combined with a standard Chinese Medicine to help with core issues.
If you have any questions please feel free to contact me for further information or to discuss these amazing topics.
Brad Whisnant and Simon Altman at the Tung distal Acupuncture Workshop.
Pain is the number one reason most people are introduced to acupuncture as a therapy. Acupuncture has been used in pain management for centuries and continues to this day in modern China. Hospitals and acupuncture clinics are always effectively handling pain and creating management plans for individuals who are in distress. Acupuncture is excellent at diminishing pain levels right on the spot and can have instantaneous results at reducing pain levels.
The methods used within distal acupuncture have been described in Traditional Chinese medical texts for well over a millennium. Distal acupuncture involves inserting needles away from the painful areas, going distant/distal from the injured site as opposed to proximal/close or needling the target area. For instance, for back pain you may needle a hand and forearm or foot and calf. If the points are inserted correctly and at the precise location, a change should be felt on the spot. The pain level should start diminishing with flexibility increasing, as muscles are softened or loosened and an increased sense of wellbeing at the targeted site of discomfort is achieved.
Distal Acupuncture works using the meridian system and modern anatomy through targeting specific muscle groups and areas of pain. It allows the injured or sore area to relax and heal without causing any further trauma to the area.
These systems focus on using the correlation between the muscles and the meridian. This is the distal treatment which improves blood flow, oxygen, nutrients, and anti-inflammatory chemicals that your body needs to heal. – Brad Whisnant author of numerous books on distal acupuncture.
The two main pioneers of distal acupuncture were Master Tung with his family lineage of specific acupuncture points now known as “Tung Acupuncture” and Dr Richard Tan who created what is now known as the “Balance Method” based on the I-Ching and Traditional Chinese Medicine meridian theory. It is through a combination of these two systems using distal methods of acupuncture which allows a practitioner to shift and change pain at a specific area on the body.
Using the Balance Method and Tung Acupuncture for pain allows you to observe any changes in the condition straight away. Distal acupuncture generally requires a few treatments to determine how low the pain can be reduced and as with all acupuncture treatments the therapy has a cumulative effect with all prior treatments building momentum on the condition. The main benefit of these systems is you should feel some relief from your pain instantly within the treatment session.
Children’s Acupuncture or Shonishin is more commonly known as Japanese Paediatric Acupuncture and it literally translates as “Children’s Needle”. Both Traditional Chinese and Japanese acupuncturists have been treating children for centuries. The Shonishin system, more specifically, dates back to the 17th century Japan in the Osaka region and then passed down through the generations until it was popularised through medical journals and publications in 1960s Japan.
Shonishin is designed to be able to treat children up to about 12 or 13 years old in a gentle, comfortable and caring manner, with the child remaining calm and reducing any stress for both the child and parents.
A basic Shonishin treatment involves asking questions, observation of the child, pulse or stomach diagnosis and the treatment. Home treatments are often taught to the parents after one or two sessions so that the Shonishin therapy can continue between sessions. This allows the parents to continue treatment under the supervision of the practitioner with some regularity and also encourages the bond between a parent and their child.
The Shonishin approach uses a range of tools and is generally needle-less. The tools used within Shonishin are often blunt and used for techniques that stroke, tap and press the various meridians of the child. The techniques are gentle and the procedure is often completed fairly quickly without any discomfort or distress to the child.
A Shonishin session uses these tools in combinations to stroke, massage, press and tap over a range of meridian lines or specific acupuncture points known to promote health and balance within the child. An experienced practitioner knows how to use these techniques to produce a variety of gentle stimulation and sensations within the child and this allows healing through the return to homeostasis.
Shonishin Tools (Spring Loaded Teishin, Enshin, Yoneyama and Teishin)
Some of the tools used in Shonishin (from left to right) is the Spring loaded Teishin which is used to stimulate acupuncture points without needling, for rubbing the Enshin is used and looks like a metal ball on a stick that glides over the meridians, the Yoneyama is used for tapping or rubbing certain parts of the body and finally the standard Teishin which is a non-inserting blunt needle used to press or stimulate acupuncture points.
Whilst it is common for Shonishin to be totally needle free, there are occasions where absolutely pain free, gentle needling is used extremely superficially with extremely thin acupuncture needles designed for children. The technique is no more then a few seconds long and is generally completed before the child even realises what is going on.
Along with the Shonishin treatment involving rubbing, tapping and pressing, gentle cupping or indirect moxibustion may be used to complement the treatment. This will depend on the symptoms of the child and the condition being treated.
Shonishin, like Traditional Chinese Medicine, is a holistic means of treating an individual. This means that each child coming in will be differentiated and treated as a unique case and have their treatment tailored specifically for them.
Young Children are considered within the philosophies of Oriental Medicine to be in a more “Yang” phase of development and this means their “Qi” moves and responds a lot quicker in comparison to adults. A growing child’s body will naturally consume a lot more “Qi” or energy to allow for all the extra growth and development that is occurring. This often can deplete the organs responsible for producing “Qi” and in combination with other factors within our environment can leave a child open for a range of health issues.
There are many things to consider when administering a Shonishin treatment. The frequency, dosage and strength will depend on the age, health or illness of the child and presenting symptoms. Keep in mind that because Children are considered more “Yang”, that the treatment will often be shorter in duration and generally only take a few minutes to administer. The technique is most effective when combined with a home treatment that can be completed using household items and is taught using a spoon for rubbing or a toothpick for tapping.
You should always use Shonishin in combination and consultation with your paediatrician or General Practitioner. If your child has a fever and the body temperature is 37.8°C or higher (moderate or high fever) it is generally advised to see your child’s doctor or wait till the fever has subsided before coming in to administer a Shonishin treatment.
Shonishin is a wonderfully gentle and therapeutic method to promote healing within children and tackles numerous conditions or problems in a gentle, holistic and caring manner. If you have any questions about Shonishin or the treatment of children, please feel free to contact us for further information or to book an appointment.
Here’s a little article about Acupuncture and constipation taken from healthcmi.com a great TCM news site. It basically describes a new study that shows Acupuncture as an effective option for relieving slow transit constipation. Acupuncture is an excellent modality to treat a wide range of symptoms relating to disorders involving digetsion and gut functions such as IBS. The study used a range of standard acupuncture points that are commonly used in the clinic on a regular basis. Read the snippet below and please comment if you have anything to say:
Acupuncture is effective for relieving slow transit constipation (STC). Slow transit refers to the slow passage of feces through the large intestine. Acupoint ST25, Tianshu, and CV12, Zhongwan. STC is a type of functional constipation that is present in approximately 15 to 30% of constipated individuals and is characterized by strained bowel movements with lumpy or hard stools. STC involves fewer than three bowel movements per week and is accompanied by a sensation of incomplete evacuation. There may be concomitant abdominal pain, nausea, and low appetite. The incidence of STC increases with age.
All credit for this article goes to Kristen Horner Warren. She has graciously given me permission to repost her excellent article about the differences between Acupuncture and Dry Needling. To see her original article please click on the link in her name under the heading.
Keep Acupuncture Real: What You Must Know Before You Try Dry Needling
To this point I have not spoken out about this issue because I didn’t want to get embroiled in an ugly fight, but it has come to the point that I cannot in good conscience remain quiet about a serious threat to public safety and the integrity of a profession that I love. What is that threat? It is so-called dry needling, which is another name for acupuncture performed by physical therapists, occupational therapists, massage therapists, athletic trainers, physician’s assistants, and other allied health professionals, typically after 20-30 hours of training.
I feel that I have something unique to contribute to this discussion, given that I invested the time and money required to complete a 30-hour certification in “Dry Needling for Pain Management”. This experience gave me an inside look at the training that practitioners of dry needling receive in contrast with my training as a licensed acupuncturist. The bottom line? I am gravely concerned and see dry needling as a serious threat to public safety.
This is not about defending territory
When I first learned about dry needling I was open-minded. I am not by nature territorial or competitive. My primary goal is to offer my patients the most effective treatment and I am willing to entertain the possibility that people outside of my profession could have something clinically useful to contribute to my knowledge base. In the aftermath of a major car accident [http://www.liveoakacupuncture.com/my-story] in 2003 I worked closely with a physical therapist for about six months and was extraordinarily impressed his knowledge and skill. This experience caused me to have a generally positive attitude toward physical therapy as a profession.
In an effort to make a fair assessment of dry needling and out of a desire to learn, I traveled to Phoenix in 2012 to attend a three-day “Dry Needling for Pain Management Certification” course. The instructor is well-known in the field and is the author of two textbooks on the topic and I was eager to learn more about his “neurophysiological” approach to treatment.
My experience at the “Dry Needling Certification” course
There were approximately 60 other practitioners in attendance. Most of them were physical therapists, a few were chiropractors, two were physicians, and there was one other licensed acupuncturist. Friday and Saturday were devoted to lecture and the material was interesting and useful. I scribbled copious notes (we were prohibited from using laptop computers out of concern that we would surreptitiously record the class), was fascinated by the in-depth theoretical discussion surrounding how acupuncture works neurophysiologically, and was impressed by the knowledge and enthusiasm of the other students.
The practical portion of the course is where things got scary
Sunday was the practical portion of the course. We were given boxes of cheap acupuncture needles in lengths ranging from 30 to 50 millimeters. The entire group of 60 gathered around one massage table and stood on tip-toe to try to get a good view of the instructor as he needled a series of points on a volunteer subject. Then we broke off into groups of three or four to practice. Because there was only one instructor for the whole group, within a matter of moments I became the informal guide for my side of the room.
Like many things, acupuncture looks simple and easy when done by an expert yet is a lot more complicated than meets the untrained eye. Most of the other practitioners in attendance had never handled acupuncture needles before, so they were fumbling with basic skills such as how to open needle packages and handle guide tubes. This seems like a minor point but is not — clumsy handling of acupuncture needles and associated equipment can easily result in contamination of the needles and risk for infection.
As the day of needling practice proceeded, I became more and more concerned. In Chinese medicine school we spent over a year in the classroom learning about safety considerations surrounding acupuncture before we so much as touched needles. Like high school students in driver’s ed who are forced to view videos of high speed collisions and look at photographs of the mangled wreckage of a drunk driver’s cars, we spent weeks studying cases (rare as they are) of people who had been harmed by inappropriate needling.
We examined dozens of CT scans which showed how very close the apex of the lungs are to the underside of the trapezius muscles. We palpated the bodies of our classmates, learning to locate critical structures by feel. We discussed the fact that movements associated with respiration and/or digestion can cause a needle placement that was initially safe to become unsafe as the patient rests with the needles in place. We were encouraged to plan our treatments to make use of lower risk points on the extremities whenever possible.
In Chinese medicine school, when we did start needling, it was under the very close supervision of an expert. I inserted hundreds of needles in my own hands, feet, and legs before I touched another person and I inserted thousands of needles in my classmates’ hands, feet, and legs before I started practicing on points on the torso, neck, and face. I had been working with needles for two years (and hundreds of hours) by the time I touched a patient.
Now I found myself in a room full of minimally supervised individuals who were being encouraged to needle “assertively” into high-risk points located over internal organs less than 20 minutes after they touched an acupuncture needle for the very first time. I scurried between groups, answering questions, clarifying point locations or correcting angle of insertion, and exclaiming “hold on a sec, don’t do it that way!!!” over and over again. Although the other students were all experts in anatomy and musculoskeletal pathology, what they lacked entirely was the very subtle “feel” that is required to needle skillfully, safely, and painlessly.
Needling is a subtle skill that takes years to master
In Chinese medicine school, my early needling training was at the hands of a man who is the tenth generation acupuncturist in his family who had begun his own training in needling at age nine. He taught me that the acupuncture needle is a delicate instrument similar to the proboscis of a mosquito. He explained that, in the hands of a master acupuncturist, a needle is a living thing, an extension of the fingertips. The skilled and mindful acupuncturist can feel very clearly what is going on at the tip of the needle at all times. With this very careful attention, it is possible to feel when one’s needle tip is approaching structures that ought not be penetrated, such as nerves, blood vessels, the periosteum (the membrane surrounding bones), or the membrane surrounding internal organs.
The nature of the dry needling course made instruction in these types of subtleties impossible. One of the advantages being so busy answering questions during the practical portion of the course is that I was not subject to much needling myself. The exclamations of those who were being needled made it clear, however, that “painless” is not a description that could be attached to the techniques that were being used. I saw several rapidly developing bruises resulting from blood vessels that had been nicked, as well as heard the howls of a couple of practice subjects whose delicate periosteum had been plowed into by an incorrectly angled or too-deep needle.
Ignorant people overestimate their knowledge and skill because they are so ignorant that they don’t know they are ignorant
By the end of the day most of the students had needled each point no more than a few times (and clumsily at that), yet in his closing comments the instructor encouraged all of us to leap into the practice of dry needling the next morning at our respective clinics. My heart sank at the thought of how many patients these new “practitioners” would come into contact with. At best they would provide a painful and ineffective experience with acupuncture and at worst they could cause serious injury.
There was no discussion of the fact that three days of training is a tiny drop in the bucket of what is required to become competent with needles. The other professionals in that weekend course left on Sunday evening believing that they were fully qualified at something that I am well aware that I have still not mastered after nearly four years of formal education and over twelve years of full time clinical practice.
The whole experience made me think of the Dunning-Kruger Effect. According to the Journal of Personality and Social Psychology:
The Dunning–Kruger effect is a cognitive bias wherein unskilled individuals suffer from illusory superiority, mistakenly assessing their ability to be much higher than is accurate. This bias is attributed to a metacognitive inability of the unskilled to recognize their ineptitude. Conversely, highly skilled individuals tend to underestimate their relative competence, erroneously assuming that tasks which are easy for them are also easy for others.
In plain English: Ignorant people overestimate their knowledge and skill because they are so ignorant that they don’t know they are ignorant.
Based on my experience attending a dry needling certification, this explains exactly what is going on with physical therapists and other professionals who are practicing (and teaching) dry needling — having made no effort to understand the rich history, subtle skill, and extensive training involved with real acupuncture, practitioners of dry needling assume that the training of Licensed Acupuncturists is limited to “superstitious” or “archaic” notions such as Qi, meridians, Yin, and Yang. Having made this assumption, they further assume that a physical therapist’s extensive knowledge of anatomy qualifies them to wield needles with nothing more than a weekend’s training.
It is dangerous when any medical professional overestimates their ability
This state of affairs is dangerous, a fact that has been borne out by several recent cases in which high-profile patients have been injured by practitioners of dry needling (although a couple of these articles refer to “acupuncture” as opposed to “dry needling” the training of the practitioners involved is similar to what I experienced in the dry needling course). You can read about these cases here:
Dry Needling and Violations of the U.S. Food, Drug, and Cosmetic Act (FDCA) and Food and Drug Association Rules [http://www.liveoakacupuncture.com/wp-content/uploads/2015/05/2014_02_28_09_23_12-2.pdf]
Asian Medicine and Acupuncture Society of Arizona Position on Physical Therapists and Non-Licensees Using Dry Needling [http://www.liveoakacupuncture.com/wp-content/uploads/2015/05/Arizona-position-paper.pdf]
CPT Assistant: Coding Clarification – Trigger Point Injections Using “Dry Needling” Technique [http://www.liveoakacupuncture.com/wp-content/uploads/2015/05/CPT-Assistant-Oct-2014-page-9.pdf]
National Chiropractic Council letter to Oregon Medical Board [http://www.liveoakacupuncture.com/wp-content/uploads/2015/05/National-Chiropractic-Council.pdf]
Doctor fined $35,000 for Medicare fraud related to dry needling [http://www.rutlandherald.com/article/20111025/NEWS01/710259964/0/business]
American Physical Therapy Association: Physical Therapy & the Performance of Dry Needling [http://www.liveoakacupuncture.com/wp-content/uploads/2015/05/DryNeedlingResourcePaper1.pdf]
Oregon Board Physical Therapist Licensing Board: Updated Statement Related to Physical Therapists Using the Intervention of Dry Needling [http://www.liveoakacupuncture.com/wp-content/uploads/2015/05/Oregon-Board1.pdf]
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