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On greeting a friend - By Chip Chace

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AS A LONG-TIME STUDENT OF acupuncture, …

AS A LONG-TIME STUDENT OF acupuncture,
I have had the opportunity to observe and
experience the needle technique of many skilled
practitioners of the art. Without exception, I have
found that those who are the most effective seem
to do the least. They simply address the needle to
the point, in many cases without even inserting it
into the skin, and things begin to happen. I must
confess that I am not at all sure what it is they
are doing, but I am reasonably confident that
their fundamental orientation is rarely based on
principles of active qi propogation. Simply put,
they are not just zapping their patients with their
awesome qi-power. Moreover, whatever the visible
method or form these acupuncturists may
be using, it is largely a means to an end.

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  • 1. feature feature On greeting a friend An approach to needle technique A friend of seclusion arrives at my fence their techniques. In general, they have been very We wave and pardon our lack of decorum articulate regarding the details of their stance, the positioning of their hands, and the relation- A white mane gathered back ship of the needle to the skin. Beyond this the Patched robe loosely draped words typically trail off. It is obvious that their Embers of leaves at the end of the night method is a form or vessel within which some- Howl of a gibbon breaking the dawn thing much more profound is happening and yet it is at this crucial point that their vocabulary for Sitting on straw mats facing in quilts what they are doing falls short. To be sure, the Language forgotten we finally meet. problem may well lie with the listener. It may be that they are speaking in terms I cannot hear. Shí Wü ( )1 Then again, perhaps what happens beyond the form of a needle technique is something that can only be demonstrated or pointed at, something that each of us must discover for ourselves. Still, By Charles Chace I’m not convinced that this must necessarily be a wordless teaching. In the course of work- ing on my own needling I have had to develop an Charles Chace has studiedChinese medicine and its literaturefor over 25 years. He graduated A S A LONG-TIME STUDENT OF acupuncture, I have had the opportunity to observe and experience the needle technique of many skilled personal vocabulary for the experience of what lies on the far side of the mechanics of a needle technique, to verbally define the ground neces-from the New England School of practitioners of the art. Without exception, I have sary for me to be effective. It has been immenselyAcupuncture in 1984. He is the found that those who are the most effective seem helpful to me in so far as it has enhanced theauthor and translator of a variety to do the least. They simply address the needle to efficacy of my practice and enriched my under-of books including A Qin Bowei the point, in many cases without even inserting it standing of the medicine. It may be a languageAnthology, translations of the into the skin, and things begin to happen. I must spoken by one, but then again, perhaps it’s in awritings of one of the architects confess that I am not at all sure what it is they dialect that others can understand.of modern Chinese medicine, with are doing, but I am reasonably confident that One of the most elegant passages I have en-Yang Shou-Zhong, a translation of their fundamental orientation is rarely based on countered anywhere in the Nei Jing speaks di-the first textbook of acupuncture principles of active qi propogation. Simply put, rectly to the relationship between mindset andfrom 100 C.E., The Yellow Emperor’s they are not just zapping their patients with their technique.Systematic Classic of Acupuncture awesome qi-power. Moreover, whatever the vis- I have read it again and again over the courseand Moxibustion (Huang Di Zhen ible method or form these acupuncturists may of many years and its meaning, or at least an in-Jiu Jia Yi Jing), and with Miki Shima, be using, it is largely a means to an end. terpretation that is meaningful to me, has slowlyChannel Divergences, Deeper The individuals I have had the privilege of but profoundly influenced my practice. ChapterPathways of the Web. Charles main- studying with have invariably been generous in Nine of the Ling Shu describes the state of beingtains a clinic in Boulder, Colorado. their willingness to describe the mechanics of necessary for effective needling. 4 Vol 3–3
  • 2. feature ‘Chapter Nine of the Divine Pivot ( ) means of directing one’s attention entirely on nee- dling. In needling from this place we simply wait for “the qi to arrive and then stop” ( qìIn all methods of needling, one must examine the zhì ér xiü). This is a pivotal point. The author of patient’s form and qi. this passage makes it clear that needling is not This is a bit of a paradox about going forth and acquiring the qi. As he de- because the moment we fines dé qì ( ), we simply await the arrival ofIf the form and flesh have not yet deserted, there is the qi in a state of attentive and receptive stillness. begin looking for something little qi, the pulse is also agitated ( ) and the We are not focusing our qi and attention inward to happen is when we patient has irascible reversal ( )2, then one with the intention of then directing it into the pa- typically prevent anything must use cross needling so that the scattered tient in the hopes of somehow prodding, goading, from happening. ’ [zheng] qi may be retained ( ) and the accu- or coercing the arrival of their qi. mulated [pathogenic] qi may be dispersed. Throughout his Exposition on the Eight Ex- traordinary Vessels ( qí jïng bä mài kào) (1577), Lî Shí-Zhën ( ) emphasises the importance of stillness as the basis for activating the extraordinary vessels. His book presumes a[The practitioner must] deeply reside in a place deep familiarity with both medicine and alchemy, of stillness ( ) and divine ( ) the as well as a capacity to blend the two disciplines. comings and goings of the spirit with one’s Li is especially fond of quoting the 11th century [sensory] doors and windows shut. The prac- Daoist adept Zhang Bo-Duan ( ) whose titioner’s] ethereal and corporeal souls must own book on the use of the extraordinary ves- not be scattered, his mind must be focused, sels, the Eight Vessel Classic ( Bä Mài Jïng) and his essence qi undivided, and undistract- states: ed by human sounds. By concentrating ( ) his essence, he must unify his mind and direct his will entirely toward needling ( ). The restoration of yin and transformation of yang is what facilitates the return to the origin. [By means of] utmost emptiness and utmost qui-[In this way, the practitioner may skillfully prac- etude those who follow nature will fly up and 3 tice] shallow insertion while retaining the become transcendent. needle, or gentle, superficial insertion so as to successfully transform the patient’s spirit For Lî Shí-Zhën, any interaction with the ex- ( ) and as the qi arrives then one traordinary vessels must be rooted in emptiness. stops ( ). He says nothing to suggest that they can be willed open or manipulated by force. It seems that a ground of stillness is essential to whatever levelFor males [needle] more deeply [ ] and females we are needling. more shallowly [ ]. Firmly resisting ( ), Needling not only requires that we be still with- don’t [let the yang qi] emerge, carefully har- in ourselves. Though we must remain attentive, bouring ( ), don’t [let the pathogenic qi] we must not have any agenda about what is going internalise. This is called obtaining the qi ( to happen. This is a bit of a paradox because the ). moment we begin looking for something to hap- pen is when we typically prevent anything from There is a lot going on here. However we chose happening. Lacking an agenda, we must trust theto needle, we must first examine the patient’s body’s intelligence. We are midwives to its ownphysical form or structure, as well as their qi. reorganisation, not surgeons seeking to take con-This information determines the nature of the trol and fix something.technique that will be applied. In needling, we The basis for the sensibility described in themust reside in a place of stillness with our sen- medical texts mentioned above is well developedsory doors and windows shut. This is an allusion in an earlier work, the Inward Training ( Nèito the Daoist cultivation discipline known as re- Yè), a text devoted exclusively to internal cultiva-turning the senses ( fân guan, translated by tion that probably predates even the Lao Zi. InCleary as “turning the light around”): a conscious simple and elegant verse, the Inward Trainingexclusion of the sensory input from our external speaks directly to the manner in which we shouldenvironment. In practice, however, the return of engage the qi.the senses is more often interpreted simply as theinward direction of one’s attention as opposed Therefore this qi,to the active exclusion of external stimuli. It is a Cannot be halted by force, The Lantern 5
  • 3. feature ‘ Yet it can be secured by virtuosity. welcomed the arrival of qi we should then “stop” . Cannot be summoned by speech Perhaps this literally means we should remove the Yet it can be welcomed by awareness. needle. Perhaps it is simply a way of emphasis- Reverently hold on to it and do not lose it. ing that the most important part of the process 4 This is called developing virtuosity. has already been accomplished. Whatever furtherWe need only be still, and needling we may choose to perform is merely anintroduce the needle, a The principle of welcoming the qi in a state of expression of this pivot.tangible expression and quiescent awareness is almost the antithesis of ob- If we are listening, after a while the patient willextension of that stillness, taining it, of dragging it kicking and screaming to begin to tell us what is next, not just from changesand the patient’s system the point. Perhaps more than any other, the sensi- in their pulse or abdomen, but from the totality bility suggested in this passage has transformed my of their qi. Yet even in our attentive stillness, wewill reorganise itself practice. It’s not the word “welcome” that I keep in must take care not to listen too hard, to get tooaround it. Once we have my head so much as a feeling of welcoming that I interested. We should not try and peer into theidentified the precise place store in my belly, and it is the core of my approach patient’s channels as if we were looking up their 5for that to happen, there is to needling. We need only be still, and introduce skirts. This is almost invariably irritating, even if the needle, a tangible expression and extension of patients are not consciously aware of it themselves.little to do but greet the qi that stillness, and the patient’s system will reorgan- We end up assessing an irritation that we haveand marvel at its ise itself around it. Once we have identified the pre- created ourselves: some funk in a patient’s Liverintelligence. Nothing could cise place for that to happen, there is little to do but channel, maybe, that we’ve actually put there. Bybe simpler and yet few greet the qi and marvel at its intelligence. Nothing patiently remaining rooted within ourselves thethings are more difficult. could be simpler and yet few things are more dif- channels will talk to us. ’ ficult. For me anyway, it’s hard to do nothing. Our passage from the Ling Shu begins by telling It is harder yet to become still and to continue us that we must consider both the form and the paying attention when there is quite literally noth- qi when needling. It is worth remembering that ing to do. I think that what the Ling Shu is describ- it is speaking in both general and specific terms. ing here is a potent expression of effortless action The specific technique it refers to is cross needling ( wú wéi ). We must first discern the disposi- ( mìao cì), a method used for relatively su- tion of a situation, the specific propensity ( shì) perficial musculoskeletal problems affecting the our patient has toward health or disease. This al- network vessels. Yet, the state of being it describes lows us to position ourselves in the optimal place. is clearly a prerequisite for needling at aspects of Effective influence arises from providing a pivot of form, qi and spirit. We must therefore have some stillness here. The rest takes care of itself. idea of what facet of the channel system we need The thing that took me so long to understand to contact as this will have some bearing on the about this approach is that we have to really “show depth of needle insertion. After all, we have to be up” It does not work to stick the needle in and in the right place to properly welcome the arrival then get on with thinking about the formula that of qi. In my experience this has little to do with needs to be written, or what is for dinner. We have the actual depth of the needle. In practice, the to be willing to stand there and attend to whatever depth of needle insertion varies from practitioner is or is not happening. to practitioner and from patient to patient. I rou- This is especially hard when there is indeed tinely mobilise the motility of the Lungs and other nothing happening, and yet that is precisely when, viscera with an insertion of less than 2mm and if we are able to maintain our awareness, useful often with simple contact needling. This is not an things begin to occur. Even when we just put the expression of the magnificence of my own awe- needles in and exit the room, leaving the rest to some qi power. It is simply a matter of bringing the patient, we must remain present enough to one’s contact, through the needle, into conversa- greet the qi with every insertion. The real trick for tion with the level or tissue of interest. To be sure, us as clinicians is retaining some seed of this still- it requires a familiarity with the channel system ness as we move around the table and on through and some basic anatomy but if I can learn to do it, the course of a busy practice day. In this regard an nearly anyone can learn it. acupuncture treatment is more akin to taijiquan, The Inward Training also speaks to the question than it is to shikantaza or sitting meditation. of the form of one’s needle technique. Its passages When we are still enough to attentively welcome have helped me to better understand the focus of the arrival of qi, we enter into a conversation with many of my teachers on the mechanics of a given the patient. Their system knows more about itself technique. Form matters. Proper alignment is, of than we could ever hope to and it begins to talk to course, connected to the internal environment nec- us. We do not presume to tell the patient’s qi what essary for effective action. One cannot do an end to do; we are simply providing it with an axis or run around the physical form and still hope to get hinge around which it can sort itself out. We our- to the essence of the matter. I have learned that the selves quite literally become a divine pivot ( hard way, having tried and failed to do just that. líng shü). Chapter Nine tells us that once we have According to the Inward Training: 6 Vol 3–3
  • 4. featureIf you can be aligned and be tranquil, terms really mean. Are we draining in the senseOnly then you can be stable. that we are actively sluicing out a channel path-With a stable mind at your core, way or are we draining in the sense that we areWith the eyes and ears acute and clear, providing the body with a means for more effec-And with the four limbs firm and fixed, tively redistributing its resources? My personalYou can thereby make a lodging place for the essence. orientation is toward the latter. To whatever de-This essence; it is the essence of the qi. gree we may intentionally facilitate such a redis-When your body is not aligned, tribution, we are still doing so in a manner thatThe virtuosity ( ) will not come will allow the body to decide for itself preciselyWhen you are not tranquil within how that is going to happen.Your mind will not be well ordered. An ideal way to begin to experience this ap-Align your body, assist the virtuosity, proach is by working on the musculature, chan-Then it will gradually come on its own. nel sinews and network vessels on the upper back. Pick a knot or tight spot. By any defini- This passage describes the nature of the align- tion, indurations such as these surely representment, though not its specific form. For me, this is a localised excess of qi and blood that should benot about needling from some fixed quasi-martial drained. Find some little bit of stillness withinpose. In its essence, I understand the Inward Train- yourself and having contacted the tissue at theing’s counsel on alignment as an encouragement to- appropriate level with the needle, attentivelywards a harmonious integration of body, mind and welcome the qi. There is no agenda, no goal. Youqi. Depending on the individual, that can look like may feel nothing. The less you feel, the more youa lot of different things, but it should be comfort- should root within yourself even as you remainable and relaxed. The way in which alignment pro- attentive and in the present. At some point the qimotes tranquillity is that it should provide a physi- will arrive and you will probably feel things startcal basis for us to ground ourselves. Regardless of to move. The needle is not actively manipulated.how salutary the position is supposed to be, it is You are merely providing a pivot, an axis foruseless if it is not comfortable. Otherwise, we will change. The tension in the tissues under yournever become still enough to welcome anything. hand will begin to relax. It’s not uncommon forSome of the worst needling I have ever done was the person you’re working on to feel large planes Endnoteswhen one of my teachers in Japan insisted I adopt of fascia release. You have released a localiseda horse stance to accommodate a particularly low blockage of qi. Is that a drainage technique? 1. Translation by Red Pine, Thetreatment table. The experience was all the more Depressions and areas of flaccidity often lie Mountain Poems of Stonehouse,poignant in that I had just spent the previous year right next to such knots and indurations. Locate Empty Bowl, 1986.carefully working on my needling posture with the one of these and needle it in the same way. Once 2. Irascible reversal: a conditionhelp of almost obsessive adjustments in the height the qi arrives, you will probably feel the area of internal qi deficiency with anof my expensive electric treatment table. There were begin to fill out or become less flaccid. Is that a excess pathogen in the vessels,no such tables at that training in Japan and I am tonification technique? It would appear that you causing agitated movements to-just not a horse stance kind of guy. have accomplished two different things with the gether with cold hands and feet. So alignment matters but there are no fixed rules. same technique. Admittedly, it takes considerably 3. Chace, Charles, and Miki Shi-Personally, I find it useful to keep my head up. The more practice to effectively use this approach on ma, Exposition on the Eight Ex-needle does not need me to look at it and maintain- the primary channels and the extraordinary ves- traordinary Vessels, A Translationing an upward but inwardly directed gaze keeps me sels, but the principles are the same. At this point, and Commentary, Eastland Press,rooted within myself even as I attend to what is distinctions of tonification and drainage begin to (2007)going on underneath my hands. And I try not to lose their meaning. By simply greeting the qi we 4. Translations from the Inwardslouch. Similarly, the smaller details of any needle can sidestep some of the perennial conundrums Training are mine, with referencetechnique are still relevant. Closing the hole or associated with the ideas of tonification and to Roth, Harold, Original Dao: In-leaving it open, needling with the ostensible flow of drainage and to attend to our fundamental goal, ward Training (Nei-yeh) And Thea channel or against it, inserting with an inhalation which is to balance the qi. Foundations of Taoist Mysticism,or an exhalation all make a difference. But in my ex- I am not suggesting this approach is in any way Columbia University Press, Newperience, these things are not in and of themselves superior to qi gong-based techniques of active qi York, 1999, and Rickett, W. Al-guarantors of efficacy, regardless of how rigorously propagation. On the contrary, I see them as mir- lyn, Guanzi, Political, Economic,they are applied. They simply provide an optimal ror images, different means to one goal. My pre- and Philosophical Essays fromvessel for something deeper to happen. dilection merely draws me towards one rather Early China, Volume II. Princeton The approach to needling I have described here than another. I am cerebral by nature and I like University Press, Princeton Newis consistent with the basic goals of all tonification to take charge; fine qualities for an herbalist but Jersey, 1998.techniques: an arrival of qi fills a perceived insuf- not always the best way to practise needling. As 5. I am indebted to John Chitty,ficiency. What about drainage? To my mind, this a counterpoint to this I have tried to foster an one of my teachers of craniosacralperspective begins to blur the distinction between approach to acupuncture based on effortless ac- biodynamics, who first showedtonification and drainage even as it challenges us tion. Greeting the qi in a state of tranquil aware- me what it meant to welcome theto examine our assumptions regarding what such ness has been an effective means to this end. innate intelligence of the body. The Lantern 7