ARTICLES:
- Nourish the Body, Ease the Mind, and Brighten the Spirit
- Transforming Physical Symptoms with Acupuncture and Mindfulness
- "My Leg Is Attacking Me!" - Mind and Body Integration Methods to Align Patient and Symptom Into a Cooperative Whole
Nourish the Body, Ease the Mind, and Brighten the Spirit
by Kamala Quale, MSOM, LAc, CHT
Editor’s Note: The subtitle for this article could be “Transforming Physical Symptoms with Acupuncture and Mindfulness.” In it Kamala Quale demonstrates a seamless way of weaving mindfulness into what is evoked in body work to effect a powerful mindbody healing compatible with the principles of Hakomi and Chinese medicine.
Kamala Quale has a master’s degree in classical Chinese medicine and is a licensed acupuncturist and herbalist in Eugene, Oregon. She is also a teacher for the Hakomi Institute. For the past twenty years, Kamala has specialized in the practice of combining the principles and techniques of Chinese medicine with the internal focusing methods of Hakomi. She teaches workshops for acupuncturists and Asian bodyworkers, and is a contributing author on the subject of enhancing bodymind awareness in “A Complete Guide to Acupressure.”
ABSTRACT: This article explores an approach to health care that combines the principles and techniques of acupuncture and Chinese medicine, with the self study methods of Hakomi. The three cases in this article demonstrate that this approach catalyzes a process that starts with physical symptoms and leads to a journey that unifies soma, psyche and spirit. The acupuncture points mobilize vital energy (qi) that transforms the internal landscape, and mindfulness opens the gateway to the subtle intelligence of spirit (shen).
Introduction
The results of combining the principles and techniques of acupuncture and Chinese medicine with the self study methods of Hakomi show significant changes in health conditions illustrated in this article through case studies including asthma, allergies and migraines. In each case the patient had an experience of internal resource that guided her to make the life changes that improved her physical health and emotional well-being.
In “A Healing Journey With Asthma,” a young woman discovers how her breathing is connected with her own expectations, her disappointment with her father and her dance with intimacy. Her bodymind exploration leads her to her quiet inner strength that she finds in her belly.
“Tide Pools Of Love And Consistency” shows an interesting correlation between allergies, the immune system and boundaries.
In “I Don’t Have To Hunt“ a woman explores how she can relax her eye focus and expand her perspective to prevent migraine headaches.
The acupuncture points are chosen for various reasons, either based on my learning and intuition, or as a result of mindful exploration between myself and the client. Some of the reasons for choosing points are:
- The point, as indicated by its name represents a potentially nourishing catalyst for the process, i.e. Gate of Hope, Inner Pass, Spirit Gate, Palace of the Child, Original Source.
- The point releases muscular tension and is used as a focal point for self-study.
- The point calls out as a result of the process and the confluence of mind and body.
- The associated function of the point is indicated for the health condition of the client.
Acupuncture points are places where the bioenergetic activity of the body comes to the surface. The balance of energy in the meridian system can be adjusted though the stimulation of acupuncture points with touch or needles. The meridians are conduits for life energy (qi,) and form an interdependent network that connects the outside of the body with the internal organs, and the person with his or her external environment. Each of the 12 meridian networks (i.e. Lung, Kidney, Heart) functions in the physical body, as well as in the psychic, emotional and spiritual levels of being. Thus, through the acupuncture points associated with each meridian it is possible to interact with and influence body, mind and spirit.
In my experience, the focusing methods of Hakomi are invaluable in guiding the healing process from the physical to the underlying mental and emotional roots. Additionally, the combination of the qi (energy) movement and relaxation that comes from acupuncture, and the focused mental state that mindfulness brings, opens the door to intuition and internal resources in a very special way, as the following cases demonstrate.
A Healing Journey with Asthma
This story is about a young woman’s journey with asthma, and her discoveries about how her breathing is connected with her own expectations, her disappointment with her father, and her dance with intimacy. Her bodymind exploration leads her to her quiet inner strength that flows like a river in her belly, and her bubbly personality that most people see. The theme of our work is finding new ways to nourish herself by releasing expectations and opening her heart to the quiet inner stillness and self confidence she finds in herself and others. Each week after our session she comes in with new insights, and her breathing keeps improving.
Jane is a very attractive and engaging young woman. She is a graduate student and teacher who just relocated to Eugene after living on the East Coast. Jane has had asthma since childhood, and has been on medication since age three. Her mother and grandmother also have it. Jane reports that she has many allergies to dust mites and mold. Recently she has had increased problems with facial acne. It is easy for Jane to feel frustrated. She has a close relationship with her mother. However, her relationship with her father is very poor. Her parents divorced when she was three, and starting in sixth grade she had trouble with her father.
When I palpated her diaphragm, it was very tight and her upper chest was sore. Her shoulders and neck were also tight. When we inhale, the diaphragm descends in order to assist air movement into the lungs. If the diaphragm is tight, it is hard to inhale deeply. My impression was that due to emotional stress and breathing problems Jane tenses her diaphragm, tightens her chest and raises her shoulders. In order to relax her breathing, I suggested that we work with her diaphragm tension and explore it in the process.
I started by doing a shiatsu-like pressure along Jane’s diaphragm. I asked her to exhale when the pressure was applied, and notice the qualities of the tension. As the tension began to release, Jane felt her breathing start to free up. This created a contrast between the way her breathing usually feels, and a more open state. I asked Jane to voluntarily explore this contrast by slowly and mindfully letting her diaphragm tense in its usual way, and then slowly let go into the open state and see what she noticed.
After a few moments she became aware that she tightens through her solar plexus in response to internal pressure to perform well and meet expectations. I asked Jane to gently stay with and acknowledge her discovery as we continued our session.
Before she left that day, Jane decided to focus on her exhale as a way to let go of her inner dialogue about deadlines. She would then be able to decide what activity would be most nourishing for her. I also taught her how to release the diagram tension herself as we had done. In our second session, Jane reported that the practice of emphasizing her exhale and working with her diaphragm tension was extremely helpful for her. It was an active reminder to reprioritize her activities.
The focus of the second session was neck tension. I held an acupuncture point on the side of her neck, in the sternocleidomastoid muscle, along with some related points in her arm. These points are part of the Large Intestine meridian. In Chinese medicine the Large Intestine and Lung meridians are partners, and belong to the metal element. The metal element governs respiration and body energy (qi). One of the functions of the Large Intestine is to help the body let go of negative influences (as well as body waste).
While applying gentle pressure to her neck, I encouraged Jane to focus on the relationship between my finger and her neck point. Jane became aware of a desire to tense and push my finger away. She said the tension felt protective, as if she wanted to keep something out. I encouraged her to stay with the impulse to push and even intensify it voluntarily, while she mindfully noticed her response. She soon associated her neck movement with a desire to protect herself from the hurt she felt from her father. She was disappointed and sad about his inability to connect with her in a supportive way.
At our third session Jane became aware of an inner strength that manifested as an opening in her belly. The session was about relationship, and letting people come and go.
When she came in, Jane reported that her breathing was clear and good. “I seem to be doing better and better. This is one of the best times in my life. I’m on a path in my life that I like. Teaching is good and I have a great boyfriend. I do want more women friends though.”
Jane went on to say that in the past week as she continued to emphasize her exhale, she realized that a part of her does not want to fully inhale and exhale. “I associate it with letting people in and letting them go. It’s hard for me to let people in close, and once someone is in my heart it’s very hard to let them go.” I could see that tears were close to the surface.
I asked Jane to go to the table and stay with her insights and feelings while I placed some needles. Her chest and throat were tight, and her breathing was shallow. I used points that release diaphragm, chest and neck tension, as well as points that send healing energy to the heart, and activate the Kidney meridian.
Jane stayed mindfully aware of her sadness and the sensations in her chest and torso. After a short time she said, “there is a part of me that is bubbly, and most people see that. I also have a side that is quiet, but not many people know that part of me.”
When I asked her to feel where the quiet part of her was in her body, she said, “I feel it in my low abdomen below my navel.” I knew that this was an opening to inner resource, and I wanted to support it and help Jane mindfully explore it.
“What’s it like?” I asked. “It’s deep and peaceful,” she replied. I asked her to feel into the qualities of the deep and peaceful experience and see if there were any other words that described it. “It’s still, strong, and self confident. It’s a quiet strength.” I encouraged her to feel the quiet strength for a while and really let her body and mind savor the experience.
After a while Jane said that she was looking for these qualities in people who she wants as friends. I asked her how she would recognize it in other people. “It’s a light they have that shines in their eyes, and quiet strength that makes me feel calm.” I acknowledged that she had a clear picture of the qualities she is looking for in people who she wants to call into her life. I suggested she put it out as an intention and be open to those who come her way.
Jane’s body, breath and awareness were in a relaxed and flowing place. The transformation from the beginning of our session was very apparent. In this session we discovered an in-road to strength and confidence for Jane, and identified how she can recognize these qualities in others. At the end of this session, Jane decided to make it her intention to be look for new friends with these qualities. She would also practice bringing her awareness and breath to her belly as a way to ground and center herself during her daily activities.
As a result of our work together Jane was able to consistently release her diaphragm and relax her neck, chest and shoulders in response to stress. As her body let go, she also let go of unrealistic expectations that she had of herself and others. Her health, her vitality and her social network continued to improve.
Tide Pools of Love and Consistency
Lois is an elementary school teacher in her thirties who came to my office wanting to get help with her allergies. During the time we have worked together, Lois reported that her allergies have been much less of a problem. The following story happened during a session where we explored the idea that her overactive immune system may be like boundaries1 that are farther out than they need to be. I asked Lois if this pattern felt familiar to her in any way. She resonated with this idea and wanted to explore it further.
Lois told me that she feels very loved and supported by husband and family, and has lots of love in her life. However she is aware that she often pushes family members away, gets defensive easily, and has a short temper. “On the contrary, I also fall in love with people and let them in very quickly. It doesn’t make sense to my rational mind but I have a need for reassurance, and to know that people love me. I am afraid they will find out that I’m really a boring person,” she said.
I suggested that these conflicting parts often come from ways we cope with affronts to the heart that we experience during life. I asked her if there were any events in her earlier life that may have triggered heartbreak or betrayal. She said that as a kid her mother was in and out of the hospital because of attempted suicide. She also said that her mom, father and sister were alcoholics. “I lived in Africa when I was 17 years old for about 18 months, and I was raped by a friend. That felt like betrayal.”
I acknowledged that these events certainly held great potential for confusion of boundaries and needs for reassurance. I asked Lois to check in with the physical sensations in her body to see how our conversation was affecting her. She placed her hands over the center of her chest and belly. “The first place I notice is my belly. It feels like a churning sea,” she said. “My chest also feels tight. I feel cold, but my hands and feet feel hot.”
There is a primary energy channel that flows up the center of the front of the body called the Conception Vessel. As implied by its name, it is said to originate in the uterus and have a dominating effect on the reproductive system. The Conception Vessel has an alternate name, Great Mother Flow. On an emotional level it is connected with bonding issues with mother. I had a hunch that opening this vessel would lead to some transformation. I told Lois about my reason for choosing this energy channel for acupuncture. When she heard the explanation she said, “I don’t think I told you that I was adopted.” When she said that I felt the Mother Flow was the right choice for today.
I enlisted her feedback before I placed needles by gently palpating down the channel from chest to belly and asking her which places felt right. We chose CV 17 (Central Altar) in the center of the chest. This point is calming and softens the feelings of the heart, CV14 (Great Palace) in the upper abdomen under the ribs. This point helps to clear negative influences on the heart, and CV 4 (Original Gate) that is connected with the uterus and the life force you inherit from your parents. I then added Lu7 and K6 which are points that specifically activate this channel.
Lois said that she saw a deep, dark blue color in her belly and a red color in her chest. I asked her to look at the colors internally and feel them in her body to see if there was anything else that came up. The blue is like the ocean she said, and the red is like a kite flying over it. I asked her to tell me about the internal image. What was the condition of the ocean and the kite? At first it was stormy and the kite is blowing back and forth, but soon both the ocean and the kite had calmed down.
I asked Lois to check back with her body and see if there were any changes. She said her hands and feet felt tingly but cooler. She felt herself relaxing. “As you feel your body, go back to the images and see if they are changing,” I said. “Now I see a tide pool in my belly. It’s an ecosystem all on its own.” She was attracted to it and I suggested that she let herself float in that tide pool in her belly and see what happened. As she did her eyes filled with tears. I asked her about the quality of the tears, and she said they were tears of relief and comfort.
Lois opened her eyes and said, “I usually don’t like water, so I’m surprised I like this feeling of being in the tide pool.” I asked her to go back to her internal experience and see if she felt alone there. “No,” she said. “I feel like part of the tide pool community.” “What are the feeling messages from the tide pool?” I asked. “Love and consistency,” she answered. I asked Lois to imagine what the tide pool would say to the part of her that gets defensive and worried that she will lose love. “Relax and float,” she replied.
Lois was floating in the direct experience of internal love and consistency, which equated with belonging in her family and community. This experience is consistent with the energy of the “Great Mother Flow.” In subsequent sessions, Lois reported that when she feels defensive, she can internally return to her tide pool and encourage herself to “relax and float.” As her defensive attitude softened, her immune system improved also. Her allergies have been much more manageable this year.
I Don’t Have to Hunt
Diane comes in for acupuncture for tension headaches, chronic migraine headaches and severe neck pain from degenerative disk problems which were aggravated by a car accident a few years ago. Despite her pain level, she is a very active and sensitive person. She has high standards for herself and a strong sense of integrity. Diane also has a bright sparkle in her eyes and an engaging laugh.
In this session we explored tension and relaxation in her eyes with the help of acupuncture points and internal focusing. The tension in her eyes is a trigger for her migraines.
Diane reported that she felt increased neck tension and the onset of a migraine soon after she returned to school from a two week vacation. She also said that she was getting a new prescription for her contact lenses and she was not comfortable with them yet.
I had Diane lay on the table and I stimulated acupuncture points around her eye with a hand-held electro-stimulation device. As I was working, Diane said that she could feel her head and the back of her neck relax as we stimulated these points. When I finished with her right eye I asked her to compare her right eye to her left and notice any differences in sensation, level of relaxation, or the way the eye was holding itself in the socket. She said, “my right eye is softer and more open.” I asked her to stay with the sensations of softening and opening as we continued. This exercise of creating a contrast in the body with points and then comparing the left to right helps to anchor the experience of relaxation in the mind and body.
I did the same points on her left eye. She felt her jaw relax and her entire upper back. I then placed acupuncture needles in other points on the Gall Bladder meridian that relate to the eyes and headaches. These were GB20 (Wind Pond) just under the occipital ridge where the head meets the neck. This point is said to clear internal wind, which is associated with the throbbing pain of headaches. GB 21 (Shoulder Well) is on the top of the shoulders. This point helps to release shoulders that move up towards the ears as a result of stress. GB37 (Bright Light) is located on the outside of the mid calf. This point is used to “brighten” and “open” the eyes.
I asked Diane to describe how it felt in her eyes now. She said they felt more relaxed and open, “like the blue sky”. I encouraged Diane to let her eyes be the blue sky as she relaxed for a few minutes with the acupuncture needles in place. I explained that this was different than picturing the blue sky with her eyes. This was allowing herself to savor and allow the sensation of “blue sky” in her eyes so that she could find the sky in her eyes, and let her eyes and the sky become one.
As is common in acupuncture practice, I left the room and returned 15 minutes later. I asked Diane to check in with the sensations in her eyes. “My eyes feel happy,” she said, “and very spacious. I can see more by being relaxed. I feel like I’m an eagle soaring above, and I have more perspective. I don’t have to see every little leaf. It’s not important. I’m not hungry, so I don’t have to hunt,” she said with a laugh. “This is not about survival.”
It seemed like Diane was in a place of inner resource and I wanted to name and support that. I suggested that this experience might be about the joy of just being. That really fit for Diane, who is a person of action, and she described more of her internal experience. “It seems like the core of myself inside is larger and my skin is not so thick. The inside takes up more space, but that doesn’t mean I’m vulnerable. In fact I’m less vulnerable because I’m OK.”
Then she had an idea that gave her a way to integrate her insight into her everyday life. “I have a picture of an eagle flying in a bright blue sky, and I’m going to put it next to my computer at work to remind me that I don’t have to hunt.”
In a follow-up session four weeks later, Diane said that the past week had been very challenging. Work stress was increased. It was the end of the term and her students were restless. She caught the cold that her students had. Also a friend had died suddenly.
With all the stress, I wondered about headaches. I asked Diane if she had had any in the last week. She smiled and said that she had not had a tension headache, and that she was able to control the onset of a migraine with only ½ of her usual dose of medication. “Even though there was so much stress, I was able to get through it. I find myself sitting back more often and taking a break. I look at the picture of the eagle in the blue sky, which is next to my computer, and that reminds me to relax. I have associated the blue of the sky with relaxing and its becoming a habit.” Her integration insight from our previous session was having a very positive effect.
“I was reminded again about getting more perspective when I spoke to the vice principle at my school,” Diane said. “In regards to the classroom problems he suggested that we have to step back and take a look at the bigger picture. I chuckled when I heard the same message come from another source.”
Diane went on to say that she realized more about how important it was for her to relax her eyes. “I drive home along a street that used to be lined with trees. Recently they have cut down the trees and are putting up buildings. As I was driving, I heard my self say, ‘I have nowhere to relax my eyes!’ Looking at those trees helped me let go.”
As she reflected on the changes, she had more insights about her healing process. “I am going back to the way I used to be before the car accident and all this trouble with my neck and headaches. I think I have been compensating and over focusing because I was trying to make up for feeling that I couldn’t do as many things as I used to. Now I am accepting that things are different, and I am doing the best that I can.”
Diane’s process and imagery reflect healing in the Gall Bladder and Liver meridian networks, which are often involved in migraine headaches. Eyesight and inner vision are key aspects of these networks, as is the nervous system, and tendons and ligaments that give us the ability to move forward towards our goals. Even trees are associated with the Liver and Gall Bladder, from a Chinese medicine perspective. Trees are strong and flexible like tendons and ligaments should be. They are rooted in the soil and grow upwards towards the sky.
Gaining perspective and softening with kindness often help us move out of a stuck place. These attributes are said to help the Liver meridian network. Since one of the functions of the Liver meridian is to keep energy moving smoothly in body and mind, it is susceptible to stagnation. This can lead to frustration and anger. With perspective, we can relax the narrowing of vision that comes with stress and can literally lead to headaches. With kindness we can move towards our goals with less frustration and tension. As Diane gains perspective and becomes more kind and accepting of herself and her limitations, she is able to enjoy life without having to hunt.
Conclusion
In conclusion, I feel that the combination of energetic transformation via acupuncture points and focused self awareness is a more powerful force for healing than either of the two alone. In the cases above, not only were chronic health conditions improved and pain relieved, but the clients learned to access and trust a subtle wisdom that they experienced through their bodies. This method is an elegant form of self-cultivation that nourishes the body, eases the mind and brightens the spirit.
This article was originally published in the Hakomi Forum Professional Journal, Issue 18, Summer of 2007.
Transforming Physical Symptoms with Acupuncture and Mindfulness
by Kamala Quale, MSOM, LAc, CHT
In my acupuncture practice, I use an approach that combines the magic and mystery of meridian points and the energy networks, with mindfulness and self-study methods that come from Hakomi Experiential Psychology. These focusing methods are immensely useful in working with the confluence of mind, body, emotion and the movement of qi during a treatment. This synthesis guides the healing process from the physical symptoms that patients present to the underlying mental and emotional roots. It gives patients a direct experience of how their body, mind and spirit are connected in the presenting condition, and empowers them to acknowledge and move towards the next step for their healing.
I have seen significant transformation in pain, chronic physical conditions, stressful mental and emotional issues, and spiritual unrest. I am also better able to deal with challenging situations and people because the focusing skills help me, as a practitioner, improve my ability to recognize and resonate with subtle indicators of bodymind process, and embrace resistance and change.
My therapeutic relationship with my patients is one of collaboration and working together to get to the root of the problem. I look, listen and communicate in a way that sorts through the story and brings awareness to the underlying themes, feelings and physical sensations that are most important in the moment. This guides my choice of points and helps me direct my patient to focus on the way that psyche and soma open and change as the needles move the qi in the internal landscape.
I am always amazed at the inner journey. Intuition (shen) brightens for both the patient and me, and I know that the next step for healing will present itself. My job is to listen for and acknowledge beliefs that get in the way, longings that want to be met, and emotions that want to flow. When the mind settles and the body relaxes with the flow of qi, the subtle intelligence of spirit emerges in the form of healing insights. I acknowledge and help to anchor these in the person’s awareness and body felt sense.
I have written several case studies which chronicle these healing journeys. Some of the titles are:
“A Healing Journey With Asthma,” in which a young woman discovers how her breathing is connected with her own expectations, her disappointment with her father and her dance with intimacy.
“Tide Pools Of Love And Consistency,” in which a woman discovers that she can sink into an internal energy of love and belonging. This helps her maintain healthy boundaries, soothe her need for defensiveness, and decreases her allergies.
“I Don’t Have To Hunt,” shows how a woman explores ways she can relax her eye focus and expand her perspective to prevent migraine headaches.
“My Leg Is Attacking Me,” which shows how to align patient and symptom into a cohesive whole.
For me, the blend of acupuncture with mindful self-study gives me a practical way to work collaboratively with my patients. It is empowering for them and makes my job easier. I can quickly access information that otherwise takes many sessions to become aware of. This information guides my assessment and treatment. The combination of point work and mindful self study during a session moves mind, energy and spirit in a powerful way. It opens the door for perspective, intuition and motivation to change.
gives practical skills that can.
I have been teaching these methods to Chinese medicine practitioners for twenty years. The skills are easily learned and are not specific to any style of acupuncture. Thus, they can be incorporated by all practitioners.
I will be teaching a class called, “Mindfulness and the Body” in Portland, Nov. 2-4, at the Pettygrove Clinic, a teaching clinic of NCNM, located at 2232 NW Pettygrove St., Portland, OR.
If you would like more information or would like a copy of the case studies cited above, please contact me at kquale@moonandlotus.com.
You can also attend the TOO that I am giving the first evening of the class, Friday, November 2nd, 6:30pm – 8:30pm, at the Pettygrove Clinic.
Appeared in the Oregon Acupuncture Association Fall, 2007 Newsletter, on Page 14.*
OAA Fall, 2007 Newsletter, Pages 1-14. (PDF Document)*
OAA Fall, 2007 Newsletter, Pages 15-28. (PDF Document)
"My Leg Is Attacking Me!"
Mind and Body Integration Methods to Align Patient and Symptom Into a Cooperative Whole
by Kamala Quale, MSOM, LAc, CHT
Attending to emotional and psychological issues, as well as to the body, is an important skill for acupuncturists. These factors influence not only how we experience illness, but also our capacity for getting well. We hear our patients say things we know have deeper emotional implications, but we often do not know how to address these issues directly. For the most part, we incorporate the emotional aspect by choosing points on an appropriately related channel and hoping they will do the work.
However, exploring the immediate physical, mental and emotional experience of the patient often reveals hidden factors underlying an illness. The key is to help the patient turn their mind toward their present experience. When we discover the underlying process, the necessary steps toward healing become clear.
This article demonstrates a way of working directly with the patient's psyche as it manifests through body symptoms. It shows how to align patient and symptom into a cooperative whole to reduce pain and promote healing.
"Rose" (patient's name changed to protect confidentiality) came into my office to receive acupuncture for pain in her hip and leg. She told me she had hip replacement surgery last year, and had been in pain ever since. She had gone for physical therapy, received chiropractic adjustments and consulted with the surgeon who performed her surgery. None of the treatments or advice that she received had helped. In previous weeks, the pain had increased, making it difficult for her to do her office job, or even to feed the animals on her small farm. Rose winced at the slightest touch to her hip and thigh.
At our first session, I concentrated on the gallbladder meridian and placed acupuncture needles in her hip, thigh, lower leg and foot. When she returned for her second session, she said that she felt some relief after the first treatment, but it was not lasting.
As we spoke about the pain she was having in her leg, Rose said she experienced a sudden sharp pain. "I feel like my leg is attacking me," she said. Nevertheless, she would try to push through her day, coping with the pain and accomplishing as much as she could.
As I listened to Rose, I learned several things about her. She is an energetic person who works hard and does a lot during her day. She is in charge of many projects, and it is hard for her to let go of some of her responsibilities. She considers the leg pain an inconvenience and feels impatient with the slow progress of her recovery from surgery. Additionally, she feels vulnerable about slowing down. Another thing I heard was that Rose experiences her leg as separate from herself.
I wanted to acknowledge her concerns and build more rapport with her. "Rose, I know it's hard for you when you can't do all the things you usually do," I said. "You're right," she replied. "I feel like I have to do my part."
Building rapport with patients implies that I am listening closely to and reflecting back both the content (words) and process (feelings) of their presentation. Reflecting back what I had heard makes Rose feel like I understand her and gives her the opportunity to clarify what I may not have understood. It also enables me to align myself with her, in her desire to move toward healing.
When Rose said she has to do her part, she meant she takes a lot on herself alone. I knew that feeling supported by someone else would mean a lot to her. "Let's work together to pay a little closer attention to your leg today," I said. "I would like to help you focus on your leg muscles and see if we can get a sense of what they think they are doing. When you say that your leg is attacking you, it sounds like you and your leg are at odds with each other. If we can get the two of you to cooperate, it is better for healing." Rose agreed.
After Rose got situated on the table, my goal was to help her become more mindful of the kinesthetic experience she was having in her thigh muscle. "Feel the muscle tissue in your thigh and tell me any words that describe the tissue itself, such as knotted or stretched," I suggested. "The muscle seems dense and grabbing," she replied. "Stay with that feeling of dense and grabbing for a moment and see if there is anything else you notice about that experience, such as how strong it is or how much of your leg is involved." "It's mostly the middle of my thigh and it feels like it's holding tight to the bone," she said. "Is there a mood that goes with that holding to the bone?" "Well, it feels protective." "Keep feeling the protective mood of your thigh muscles. Your cells are intelligent. What do these cells seem to be doing? What do they think their job is?" "They feel that they are protecting me. When they get activated, they grab hard, all of a sudden, and then I feel a lot
of pain." "So they are protecting you. That's different than attacking you. When you are going about your day and your muscles are at their limit, they start grabbing and protecting you." "Yes," she agreed.
With that interaction, Rose became aware of herself in a different way. The leg that was her enemy had now become her friend. The next step was to acknowledge this information and let it percolate within her as she rested with the needles.
I inserted needles in her hip, thigh and foot. The treatment was much like the first one I had done. I asked Rose to relax with the needles and acknowledge the information she had just discovered. I suggested that, as she exhaled, she could imagine that she was sending her breath down the outside of her hip, thigh and lower leg, and then out through her toes. This simple qigong exercise, which traces the route of the gall bladder meridian, gave her a way to have a different kind of relationship with her leg. When I returned, Rose was very relaxed and told me she was going to listen to herself in a different way.
At Rose's next visit, she reported that her leg was 60 percent better than last week. "I have been paying attention," she remarked. "I work until I feel my leg, then I say I have to stop for the day. I go home and relax. One day, it got pretty painful and I was afraid, but the next morning it was fine. I kept doing the breathing down my leg exercise, and it felt like it lengthened the muscles and soothed them."
Rose has continued to get better and has not had a relapse in two months. She is very excited about her recovery. At her last visit, she said the pain in her hip and leg was completely gone.
The powerful thing about our second session was Rose's awareness of her kinesthetic in-the-moment experience. As practitioners, we rarely take a person to this depth because we are focused on the assessment and treatment protocols of our practice. We may also feel we don't have the time or experience to go to this depth. However, once we develop our skill base, we can accomplish a lot in a short amount of time.
The skills needed to do a session like this start with an attitude of respectful attention and mindfulness on the part of the practitioner. We can learn to follow and attend to what has meaning and energy for our patients, as we perceive it through their body language and style of communication.
Next, we need to create an attitude of curiosity and a state of mindful self-awareness within the patient. Pain and other difficult physical symptoms often cause people to block or avoid their experience. This avoidance can also block understanding and awareness of the meaning of physical symptoms. With skillfulness, we can direct our patients into their physical and emotional experiences long enough for them to perceive the inner workings more clearly. As the thinking mind quiets, the light of awareness shines with increasing brightness.
Finally, we need to clearly perceive and stabilize the inner resource that arises for the person. It may manifest as something that is said, or as a subtle gesture or facial expression that lets us know something important has just occurred. In Rose's case, it was the "aha" that occurred when she realized her leg was protecting her. For her, the switch in perception of her leg as an enemy to her leg as her friend and protector was an important part of her recovery.
When we recognize the healing message, our role is to validate it and help our patients savor it for a while. We can then suggest an exercise that will help integrate a new way of being. In Rose's case, the visualization of her breath flowing down her leg was an exercise she found very useful. She also decided to pay closer attention to the pain signals from her leg and to stop work earlier.
The integration of mind and body skills with acupuncture work is more powerful than either of the two alone. These skills are precise and attainable. They can easily be incorporated with any style of acupuncture.
This article was originally published in Acupuncture Today, September, 2007, Vol. 8, Issue 9.
© Kamala Quale 2009