Paolo Propato, L.Ac. and Grace Rollins, L.Ac., licensed acupuncturists at Bridge Acupuncture in Doylestown, PA, sit down to discuss the energetics of acupuncture and what it is like to work and train in their field of medicine.
Paolo: Acupuncture is said to be a medicine that harmonizes “Qi” (“Chi” or “Ki”). Can you describe Qi from your experience as a practitioner?
Grace: Many people think of Qi as “energy,” but I think that’s too materialistic of a translation. It’s interesting that one of the many direct translations of the character for “Qi” is "weather," if you add the symbol for “heaven” just before it. In other words, the Qi of the heavens is weather. So to me, Qi is basically a very useful term that sums up certain complex processes that together, create recognizable phenomena in the body. If you try to think of Qi as some kind of literal substance or force you’re just going to frustrate people interested in an anatomical corollary, because you won’t find a measurable “energy” that corresponds to what people who practice Asian medicine and martial arts are talking about.
So how would you describe weather? It’s electromagnetic and gravitational relationships between elements and molecules; it's also the interaction of all those molecules with a wide spectrum of solar and celestial radiation, as well as with the gravitational and electromagnetic fields of the earth and moon. On top of that it’s the outcome of complex pressure systems, thermodynamics, fluid dynamics, so many chaotic processes, all overlapping and influencing each other. And even with all this complexity, we can study it, characterize it, make tenuous predictions about it.
“Qi” for acupuncturists is like “weather” as it relates to the body. And the same way that we recognize many patterns and phenomena in weather, we learn how to recognize patterns in Qi as acupuncturists, which aids us in influencing the functions of the body to promote health.
P: What do acupuncture methods actually do?
G: I get asked this a lot. The traditional answer is that it stimulates special points in order harmonize Qi in the body, thereby promoting proper function and health. Scientifically, stimulating acupuncture points with needles and moxa has been shown to generate complex responses.
Needling causes distortions in chains of connective tissue throughout the body, which link different muscle groups as well as organs. Connective tissue has a complex mechanical as well as electromagnetic role in the body that still is far from being fully understood by science. As recently as 2018, a paper was published describing the "interstitium," dynamic fluid-filled spaces throughout the body's connective tissues, and speculating that this was a previously unknown organ. It's highly likely that some of the effects of acupuncture are mediated via our complex network of connective tissue, though I doubt that this tells the entire story.
Needling acupuncture points also has been shown to therapeutically affect signaling in the brain. Different acupoints will influence different areas of the brain, in a way that is consistent but still not understood by anatomical studies. Changes in levels of neuropeptides, neurotransmitters and cytokines are also documented effects of acupuncture.
Some research suggests that dissipative electromagnetic structures in the body can explain the location of acupuncture points and channels, as well as the wide-ranging effects of acupuncture therapy. This is taking more of a physicist's view than a biologist's, requiring a pretty big cognitive leap. Think of it this way-- science understands us very well as chemical, molecular organisms, but hardly at all as electromagnetic ones. Nonetheless, we are undeniably electromagnetic in nature, every bit as much as molecular. It's such a new frontier for science that it still rarely enters into discussion, but I'm hopeful for what this line of inquiry will discover one day. After all, most of what we know about molecular biology is less than 100 years old.
I could go on and on about other measured acupuncture effects-- hormetic micro-injury, heat-shock proteins and infrared radiation from moxibustion, local vasodilation and mechanical stimulation of muscle tissue... With so many complex processes, it's starting to look a lot like trying to describe the weather, isn't it?
I think one of the challenges in studying acupuncture scientifically is that it’s methods do so much, all at once. So it’s hard to “pin down” one exact mechanism (excuse the pun). That’s why, even though I have a very scientifically oriented mind, I still prefer the traditional Chinese and Japanese pre-scientific theoretical concepts and terminology. We still haven’t discovered a better way to describing the complex processes of Qi and the affect of acupuncture techniques on the body.
P: What do you believe makes acupuncture unique compared to other modalities that work with the "subtle energy" of the body?
G: Possibly the most important thing that makes acupuncture unique is its age. Acupuncture is old, people! Over 2,500 years old! Moxibustion, the practice of heating acupoints with the ember of dried mugwort, is even older, probably over 3,000 years or more! So even though acupuncture is dealing with complexities that provide obstacles to scientific study, it has withstood a very important test with its continued use and evolution over such a very long period of time.
I think any scientist worth their salt needs to be open minded to all of the things that science still doesn’t have the tools to measure and explain. That applies to a lot of what happens in healing. But that doesn’t mean you have to be open-minded to everything. Honestly I think much of what’s out there these days in the world of “energy modalities” derives its effect from simply helping people to relax, tune into their body and think positively. There’s nothing at all wrong with that, but I think people who put acupuncture in the same category as all other "energy" modalities are confused. Acupuncture has been going on for a very long time and there’s a lot more complexity to it.
Even in the field of acupuncture there are many different styles and lineages. People introduce new methods every year, which I always approach cautiously. Innovation is good, it helps our medicine get better and better, but in a methodology that isn’t bound by objective measures you have to be careful not to be led to far astray by what sounds good on paper but has no real backing other than charisma and positive thinking.
The ease of going astray in “energy medicine” is one of the reasons I gravitate towards traditional systems and reputable teacher lineages. Lineage, reputation and careful apprenticeship was the original way to differentiate the quack from the master.
P: When with a patient what is that you are feeling for before, during and after needling?
G: Patients like to ask me if I can “feel the energy” and if you think of it like Qi, the summation of complex processes, then the answer is absolutely yes. We rely on touch, smell, sight, and sound to collect information about the patient-- especially touch in Japanese acupuncture. If I have to wear a band-aid on just one finger, I feel like I have a hand tied behind my back-- it affects what I can feel! Subtle changes in smell, or even in the gaze and breathing rhythm of a patient, also stand out a great deal diagnostically. In other words, gathering very subtle information and processing it as a whole, is important during an acupuncture treatment.
Before needling, I’m feeling diagnostically for areas of restriction, imbalance and dysfunction in the patient. This might be structural, as in certain muscle groups or vertebral bodies that are too tight, twisted or compressed. Often internal imbalances will also be represented by certain qualities in the pulse, on the tongue or in reflective zones of the abdomen and back. For example, people with acid reflux usually present with tightness in a certain region of the upper abdomen. Cardiac problems may show up with specific reactive points on the upper torso and back.
Next I’m feeling for an appropriate acupoint location, which is based on the traditional anatomical location as well as certain qualities which identify the point as a “live” one. A “live” point refers to the best point location for that individual, on that day. It might be a recessed area, a tight or tender spot, thicker skin or connective tissue-- these are some of the different qualities that indicate a more effective point.
When I find the right point and insert the needle, there is a feeling I seek that acupuncturists call the “arrival of Qi.” To me it’s like a certain density on the end of the needle, like it’s connected well with the body. You can have a needle in shallowly or deeply, it doesn’t matter unless there’s this certain feeling of connection. Learning to recognize it is part of our craft. Sometimes we want the patient to feel needle sensation as well to heighten the therapeutic effect.
I’m also feeling for the Qi of the person on the whole. This is the intuitive part, synthesizing the input from all of my senses.
P: What kind of training did you do and continue to do to cultivate these skills?
G: I started studying acupuncture around the same time I started studying the martial art of Aikido as well as Zen meditation. These interests complement each other well. Aikido has a lot of similarities with acupuncture in that it’s training the various senses of the body to respond to and harmonize another person’s Qi, although on a different sort of playing field than what we’re doing with acupuncture. I do think over time Aikido and Zen helped me to be more introspectively attuned to the physical and mental body in a way that helps me empathize with people that arrive to my office with problems I’ve never experienced. At least I hope so. Zen and Qi Gong practice still help me on a regular basis to cultivate my focus, determination and centeredness, which are very helpful in a clinical setting.
I also voraciously pursue continuing study and apprenticeship. After getting my license I apprenticed for about a decade under Kiiko Matsumoto, a practitioner of international renown, and have followed her to Japan many times to study with practitioners there. I've also been lucky to study with several other great masters here in the US who are rooted in solid lineages and a track record of clinical success. These teachers have offered me not just technical knowledge, but also the Qi of practice-- the complex combination of qualities that allow me to be a dynamic, effective practitioner. This helps me immensely, and by extension, my patients.
Taking my own health seriously is also a critical way that I stay attuned to the balance of Qi in others. It’s not just practicing what I preach-- I believe in it, I live it. I work on my posture throughout the day, and study how to move in a way that’s healthy and natural. I try to eat in a way that’s balanced ecologically, that doesn’t do me harm and that fills me with vitality. I get outdoors and experience the natural world to help keep my humanity alive. I meditate and exercise a lot, and I try to play and have fun! Last but not least, I get regular acupuncture!
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