Charles Chace: "One of the things I like best about the Engaging Vitality approach is that it is an excellent millieu for examining my own process, my assumptions about what I am doing at every stage of my practice of medicine..."

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Charles Chace – The Process
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One of the things I like best about the Engaging Vitality approach is that it is an excellent millieu for
examining my own process, my assumptions about what I am doing at every stage of my practice of
medicine. We are not only cultivating our capacity to listen to our patient’s qi, we are also fostering our
capacity to listen to our own inner workings. It’s only natural then, to cast this gaze on the way in which
the Engaging Vitality perspective is transmitted, received and cultivated. I want to explore this a bit.
At the beginning, we tried to transmit a repertoire of osteopathic palpatory techniques that were
relevant to practitioners of Chinese medicine. Our thought was that we could simply leave it to the
practitioner to determine what to do with the tools we provided, based on their own predilection and
skill set. Our ultimate goal was and remains that acupuncturists integrate these techniques in their
own unique way.
It very quickly became apparent that this approach didn't work. We needed to provide participants
with more structure for them to glean an idea of how this material should be applied. Despite an
inherent aversion to fixed ideas of this nature, we invented protocols as teaching tools so that learners
would have a conceptual framework in which to begin using the techniques. The protocols helped
learners even as they helped to shape our understanding of what we were teaching.
Of course, in practice we actively worked to eliminate the protocols as soon as learners were competent
to operate without them. It soon became clear, however, that we had failed to address a larger issue in
our transmission of the work. More than any particular repertoire of techniques, Engaging Vitality is
fundamentally a way of thinking. The integration of this perspective actually essential to making any
practical use of any of the techniques.
The Engaging vitality approach may be described in the following manner.
1) First, we appreciate a palpatory experience without any attempt at
theoretical or therapeutic interpretation. Our hand does X, or it feels like Y.
2) Next, we apply one interpretive framework or another to that palpatory experience. For
instance we might interpret a strong yang rhythm with an expansion phase that is larger than
its relaxation phase as reflecting a relative excess of yang. The crucial point for the Engaging
Vitality approach is that this is framed as a question. “Does it serve the therapeutic process
to interpret this finding in this manner?” There is no particular presumption that one
interpretive model is inherently more valid than another.
3) This does not mean that any interpretive model can be effectively applied to any clinical
situation. On the contrary, we rely on the feedback provided by our palpatory techniques to tell
us whether that model is correct. Our willingness to be wrong is what makes our use of any
interpretive perspective question, a test, as opposed to a simple imposition. Such a falsifiability
criterion is actually the basis of the scientific method.
4) Our focus is on the dynamic relationship between form and function, qi and structure. We are
orient to either one the other at any given moment as the situation demands, but our overall
attention is directed toward the harmonious relationship between form and function that is
grounded in palpatory feedback.

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Charles Chace – The Process
More than the palpation itself, this questioning call and response is the defining feature of the Engaging
vitality approach. In our experience, this inquiry and its accompanying willingness to be proven wrong,
along with the lack of fixed protocols takes most practitioners a fair amount of time to truly integrate
into their acupuncture work. Learners struggle with this mindset long after they have developed a basic
competency in the Engaging Vitality palpatory techniques and this more than anything else impedes
their progress. It is helpful to acknowledge that this takes time and to be patient with it.
The Engaging Vitality repertoire is open ended in it is applicable to most styles of acupuncture practice
and we hope it will be applied flexibly according to the needs of the individual practitioner. I like to say
that Engaging Vitality work should work for the acupuncturist, the acupuncturist shouldn’t work for
Engaging Vitality. And yet, we as we have seen, it must be presented with a certain amount of structure.
So how might we think about that in the larger context of the transmission of information?
Top Down
When an Engaging Vitality teacher presents a specific technique, it is essential that it is transmitted
accurately and that students learn to do the technique correctly. Otherwise, learners will either fail to
get the kind of information they are looking for, or any information at all. A big part of this phase is
learning to filter out a specific palpatory phenomenon from the noise of all the other things that we
could be feeling. At this stage, the exchange of is a top-down transmission. Teacher teaches, the learner
learns. You are either learning it correctly or you are not.
Of course, it is incumbent on the instructor to transmit information effectively. This relies to a
significant extent on feedback from the receiver. We will revisit this dynamic later.
Once learners have a felt sense of what is being conveyed, we very roughly situate that palpatory
experience in the context of Chinese medicine. This first-order interpretation is grounded on our own
experience with the application of the technique. From a teaching perspective, we present this level of
interpretation as a given not only because that’s how we personally think about it but because it
provides learners with a context for working with the technique themselves. Moreover, it is essential
for teacher and learner to have a common language for discussing what we might do with a palpatory
experience. This basic level of interpretation is also top-down. We are actively pointing the practitioner
in a general direction for making sense of what they are feeling.
Assimilation and Adaptation
Beyond this, the rest is up to the practitioner and here is where the questing really begins. Could we
map an extraordinary vessel, channel divergence, six-warp or five- phase interpretation onto whatever
we are feeling? Perhaps. We might have the most beautiful idea imaginable as to how to best engage the
qi at that particular moment, but that engagement must be framed as a question, not an assertion. To
whatever extent we may be looking for a positive response, we must remain equally attentive to a
negative one. We listen, we engage, we listen to the response, we engage again, and listen again, over
and over, all the time questioning in a spirit of open and friendly interest. The qi leads, we follow.
Practitioners may develop perspectives that are not part of the engaging vitality repertoire and indeed
make sense only to them. For instance, one may use some combination of astrology, numerology, and
crystal divination to arrive at an acupuncture treatment for a given palpatory presentation. At this
level, it is irrelevant how incoherent it might seem to Dan, Marguerite, Chip or anyone else, provided
that

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Charles Chace – The Process
1) We all agree on the palpatory phenomena we are orienting to and that
2) Phenomena improves with whatever intervention is being applied.
This principle applies not only to any conceptual model that one uses, but also to any therapeutic
techniques one might administer.
For instance, if one can produce a meaningful and lasting change across a range of listenings with a
teishin, scraping tool or off-body hand waving, then that’s fine, that’s Engaging Vitality. Our approach is
an optimal tool for assessing whether what one is doing is real, or whether one is indulging in wishful
thinking. Of course, if you don’t regularly catch yourself indulging in wishful thinking, then you almost
certainly are not paying enough attention.
The creative application and critical testing of one’s own ideas is crucial a sign that one’s palpation
practice is maturing. Present that idea to your engaging vitality partners in the spirit of “lets test this.”
At the beginning, it really doesn’t matter whether your peers understand or are able to reproduce what
you are doing. Because you share a common palpatory language your Engaging Vitality colleagues
should be able to appreciate positive changes in our repertoire of assessment techniques. As your
friends, they should be at once receptive and ruthlessly critical.
Groundswell
Any effective approach to teach responds and adapts to feedback from its target audience. This is
especially crucial when transmitting relatively subtle palpatory techniques. Beyond that, feedback from
learners has been a potent force in actively shaping our understanding and the application of the
techniques themselves. In this regard, channel listening is a good example. Channel listening is the only
technique in the core engaging vitality repertoire that was not already an osteopathic palpatory
technique in some form or another. Dan essentially invented it.
Channel listening really began to evolve when I started trying to teach it to a small group of my own
students in Colorado. Their ongoing feedback regarding what they were feeling and what it meant
gradually shifted how we presented the technique and its practical application. Students at the Seattle
Institute of Oriental Medicine helped to consolidate these gains when Marguerite, Dan and I jointly
channel listening there. It was here that we realized that we were actually two different but
complementary forms of channel listening. In Seattle, it also became clear how channel listening was in
many ways the crucial node linking all the other Engaging Vitality techniques. The development of the
technique has been bottom-up in so far as it has been driven primarily by the response of the receivers.
Moving Ahead
The palpatory techniques of the Engaging Vitality repertoire are bound to evolve over time and this is
probably essential to the survival of the work. Such development will be driven as much by the ever-
increasing number of people doing the work as by Dan, Marguerite and myself. We are now at a point
where more experienced practitioners are beginning to experiment with their own interpretations of
what they are feeling, and innovate palpatory techniques of their own. Whatever the techniques we
employ, the extent that Engaging Vitality work remains Engaging Vitality will be defined by the
characteristics defined above. We feel first and interpret second. Whatever interpretive models we
employ are framed as questions subject to refutation based on palpatory feedback from our patients.
Our fundamental orientation is on the dynamic relationship between form and function. That is the
heart of the work.