The patient-practitioner relationship in acupuncture

137 Pages·2009·0.68 MB·English

by  Leon I. Hammer

ToPaulHammer,mybelovedson
The Patient—Practitioner Relationship
in Acupuncture
LeonI.Hammer,MD
ChairmanoftheGoverningBoard
DragonRisesCollegeofOrientalMedicine
Gainesville,Florida
USA
Thieme
Stuttgart·NewYork
IV
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V
Foreword
Thesagehealersofancienttimeswereabletohealtheheartofhumanity,and
thuspreventdiseasefromarising.Today(cid:2)sdoctorsonlyknowhowtotreatdisease
whenithasalreadymanifestedinphysicalform,anddon(cid:2)tknowanymorehowto
workwiththeheart.Thissituationcanbecomparedtotheprocessofpruningtree
branches while neglecting the tap root, or to working downstream without
awarenessofthepropertiesofthewellspring.Isthisnotanignorantwaytogo
about the business of medicine? If you wish to bring about real healing, you
mustfirstandforemosttreataperson(cid:2)sheart.Youmustbringtheheartonthe
rightpath,sothatitcanbefilledandsustainedbyauniversalsenseof truth.
Youmustgetittoaplacewhereitcansafelyabandonalldoubtingandworrying
andobsessinginsenselesslyloopingpatterns,whereitcanletgoofanyanxiety
provokingimbalances,andwhereitiswillingtosurrenderall“me,me,me”and
all“thisishis/herfault!”Tryandawakenthehearttoacknowledgeandregretall
thewrongthatonehasdone,tolaydownallselfishattachments,andtotrans-
formone(cid:2)ssmallandself-centeredworldforthegloriousuniversewhereinwe
areallone,andwhereinthereisnothingtodobutpraiseitsexistence.Thisisthe
mastermethodof theenlightenedphysician—healingthroughtheheart.Or,in
differentwordsfromtheancientrecord:theenlighteneddoctorintervenesbefore
physicaldiseasemanifests,whiletheaveragephysicianspringsintoactiononly
afterdiseasehasbecomeapparent.Totreatbeforethisstage,thisistheterrain
ofhealingthecore—theheart;totreatafterwards,thisistherealmofdietary
therapy,herbaltherapy,acupuncture,andmoxibustion.Althoughtherearethese
twotypesoftherapeuticpaths,thereisreallyonlyonecorelawofhealing:Alldis-
easecomesfromtheheart.
Thusthe16thcenturyKoreanmasterphysicianHurJunsynthesizesalifetime
ofclinicalinsightontheimportanceoftreatingtheheartinDongyibaojian
VI Foreword
(PreciousReflectionsbyanEasternPhysician).Icanthinkofnobetterquota-
tiontointroducethismodestyetvitallyessentialvolumebyLeonHammer.
TodayasduringthetimeofHurJun,theprofessionofChinesemedicinehas
becomeatechnique-orientedmétier.Dr.Hammer’sbookontheclient–practi-
tioner relationship in acupuncture, therefore, may strike us as the personal
musingsofanaccomplishedpsychiatristturnedChinesemedicinepractitioner
thatarenotdirectlyrelatedtothemainstreamofourfield.Nothingcouldbe
furtherfromthetruth.AswithhisclassicpublicationsonChinesemedicine
psychologyandpulsediagnosis,ThePatient–PractitionerRelationshipinAcu-
punctureistheworkofaseasonedclinicianwhotransmitswithgreaturgency
andtrademarkhumilitythevirtues,skillsandattitudesthatareindispensable
foranygenuineengagementwiththetimelessartofChinesemedicine.
WhileDr.Hammerhasrepeatedlydemonstratedhisgenerositytoyounger
generationsofChinesemedicinepractitionersbyrelatinghisclinicalknowl-
edgeandexperienceinprolificdetail,thisvolumeexhibitsmoreofazen-like
quality.Thereaderfindsabookletbyawiseandcompassionatephysicianwho
describeswithgreatclarityandsimplicitytheessentialsofhiscraft,inthis
casethesacredspaceoftheclient–practitionerinteraction.WuTang,the18th
centurycompilerofFeverSchooltherapeutics,oncewroteofthisessencein
theprefaceof hislandmark Wenbingtiaobian(SystematicDifferentiationof
WarmDiseases):“Medicineisthewayofcompassion–ledbywisdomandhu-
mility,assistedbycourage,andcompletedbycompassion.” Bytransmitting
andpalpablymodelingtoustheunassumingqualityofatraditionalChinese
medicinesaint,LeonHammerremindsallofusofthedeepcommitmentthat
broughtustothisprofessioninthefirstplace—thedesiretocareforothers,in
themostwholeandcompletewaypossible.Forme,thisbookrepresentsan
authenticechoofSunSimiao’s7thcenturydescriptionofthegreatphysician
(Dayijingcheng):
Thegreatphysicianservestoliveinharmonywithnature,andteacheshispa-
tientstodothesame.Hewillstaycalmandcompletelycommittedwhentreating
disease.Hewillnotgivewaytopersonalwishesanddesires,butaboveallelse
holdandnurtureadeepfeelingofcompassion.Hewillbedevotedtothetaskof
savingthesacredsparkoflifeineverycreaturethatstillcarriesit.Hewillstriveto
maintainaclearmindandbewillingtoholdhimselftothehigheststandards.He
Foreword VII
willconsiderittobehissacredmandatetodiagnosesufferingsandtreatdisease.
Hewillnotbeboastfulabouthisskillsandnotdrivenbythegreedformaterial
things.Aboveall,hewillkeepanopenheart.Ashemovesontherightpath,he
willreceivegreathappinessasarewardwithoutaskingforanythinginreturn.
HeinerFruehauf,PhD
FoundingProfessor
SchoolofClassicalChineseMedicine
NationalCollegeofNaturalMedicine
Portland,Oregon
VIII
Preface
Thisbookforacupuncturistsonthetherapeuticrelationshipisnotfocusedon
pathology;onlyontheissuesweencounterwithotherhumanbeings,noneof
whomiswithoutsomepartofthemselvesthatisaproblemtothemaswellas
toothers.
Acupuncturistsmayquestiontheneedtoreadaworkonthetherapeuticre-
lationship.Afterall,bylawtheyareonlyrequiredtomakeaChineseMedicine
diagnosis,prescribeherbs,andplacetheneedlesinappropriateacupuncture
points.Thisistheirlegal“scopeofpractice.”The“Traditional”ChineseMedi-
cinemodelarisingfrommainlandChinadiscouragesencounteringpeopleon
anyplatformotherthanonethatinvolvesinsertingneedles,dispensingherbs,
andalliedtechniquessuchasmassage,exercise,andnutrition.Emotionalis-
sues,withrareexceptions,arereferredout.
However, acupuncturists work with people, not charts or manikins. And
peoplewho work with “energy” have a special obligation to considerall of
theimplicationsthatenterintothetransfersofenergybetweenthespecific
roleofthetherapistandtheroleofthepatient.
Whiletheimplementationofsomeoftheprinciplesinthisbookmayre-
quireattimesareferraltoamoreprofessionallytrainedpsychologist,theprin-
ciplesthemselvesarenecessary ingredientsin the successfulencounterbe-
tweenanytwohumanbeings.Thisisespeciallytrueifoneis“helping”and
theotherisbeing“helped.”Mygoalisnottoteachpsychotherapy,buttoen-
hancethepractitioner’spropensityandinnatetalenttoheal.
Whenpractitionersmakeanyformofcontactwithsomeoneseekinghelp,
theyhaveenteredintoatherapeuticrelationshipthatinevitablyinvolvesall
ofthecontentsofthisbook.Thosewhothinkotherwisedosoattheirown
risk,anddosoevenmoreatthepatient’srisk.Thereisnoescapefromthisre-
alityinthesuccessfulpracticeofthisprofession.
LeonI.Hammer,MD
IX
Acknowledgments
With regard to the subject of this book I am especially grateful to Augusta
Schlesinger,PhD,acourageous76-year-oldwomanwhomadearemarkable
metamorphosisfromretiredhousewifetobecomethefounderoftheBureau
ofChildGuidanceintheNewYorkCityschoolsystemandcourts.Shewasmy
firsttherapistfrom1946untilherdeathin1951.Sheisthemodelforthecon-
tentofthisbook.
IalsooweadeepdebtofgratitudetotheWilliamA.WhiteInstituteofPsy-
chiatryandPsychoanalysisinNewYork,whereIreceivedmypsychoanalytic
training, andtomy teachersClara Thompson,MD, GerardChernowski, MD,
EricFromm,PhD,ErnstSchactel,PhD,HarryBone,PhD,HarryStackSullivan,
MD, Florence Powdermaker, MD, Asya Kadis, PhD, Anina Brandt, PhD, Ana
Gourevitch,PhD,andRalphCrowley,MD.
IamalsoindebtedtoAlexanderLowen,MD,JohnPierakos,MD(bioenerget-
ics),andtoFritzPerls,MD(gestalttherapy),allofwhomIstudiedwithinmy
post-psychoanalytictraining.
ForthepresentIamgratefultoPamelaSmith,AP,andHamiltonRott,AP,
whomadehelpfulsuggestions;toCandiceNelmswhowroteanintroductory
sheetforthepublisher;andtoallthosewhoovertheyearschallengedmeto
answertheirquestions.
IalsowishtoacknowledgeJaquelineBuehler,aSwissartist,forhergeneros-
ity in contributing her marvelous sculptures for the cover and the section
openersofthislittlebook.
IamgratefultoThiemeforacceptingthisbookforpublication,andmostof
allIwishtoacknowledgeAngelikaFindgott’ssensitiveandintelligentguid-
anceinthisproject,forwhichIamendlesslygrateful.Asmyeditorshemade
thisprocessajoy,andhercreativityturnedaroughmanuscriptintoahighly
readableandwell-organizedbook.Thankyou.