Uncertainty is a condition that exists as a clinical reality for every practitioner, regardless of their level of experience. There is a range in the degree of uncertainty – from a clear state of diagnosis and understanding of treatment to a situation where it is not possible to decide how to classify the case and how to address the main complaint.
The question arises as to how one handles a situation in which there is no complete certainty as to the problem the patient suffers from. In the Western world, we are used to thinking that a particular problem fits in one specific solution. In Chinese medicine, the situation is different – even if there is no clear diagnosis, it is still possible to treat and help the patient.
Various masters in Chinese medicine have proposed acupuncture protocols that affect certain areas of the body or cause movement that can also be used in a condition that is not completely deciphered. This is similar to general conditions in Western medicine where antibiotics are prescribed in the case of infection or cortisol in the event of inflammation, even if no further details regarding the patient’s medical condition are known. Similarly, St 36 can be used for stomach issues and Bl 40 for back pain. Acupuncture creates a healing mechanism in the body that regulates itself and so even a point that is related to the general condition of the patient will trigger the process. In this way, it is possible to move from a state of non-diagnosis to a state of general treatment formula.
When it comes to mental states, one can use questions that are addressed to the patient, such as “what do you need right now?”. “If there was a magic needle, what would you choose to change?” Depending on the patient’s answer and mood, the points can be chosen. It is useful to include in the treatment Earth points that balance and control the fear of Water. For example: Liv 3 can be used to treat a state of difficulty in making decisions, Pc 7 for loneliness, and Lu 9 to the state of mourning. These points are also source points, and as such are related to Yuan and Shen.
In mental states, one can also move to thinking that focuses on Chinese medicine’s symbols such as Wood and Fire. There are several directions in which the problem can be solved and all are good as long as they are directed towards the core imbalance in the patient. The effect of the treatment can be monitored immediately by examining changes in the pulse, changes in the patient’s appearance, and a change in his or her feeling. You can also wait for the next treatment and see if there has been an improvement in the symptoms.
Treatment in the state of lack of knowledge can be done both by a veteran therapist and a young therapist. The more experienced the practitioners are, the more likely they are to feel safe in the healing possibilities of Chinese medicine, as a result, they are more convenient being in a state of uncertainty. Over time you realize that the healing power lies in the patients themselves and trust grows in the treatment, the healing ability of the patient and yourself as a therapist.
Trust is an important factor that enables the therapist to be better without the need for a safe place that forces certainty. The transition between uncertainty and certainty passes through trust that is vital to the clinical situation. Chinese medicine is rooted in the concept of the Dao, which gives birth to the concept of Wu Wei, doing without action, the lack of action and the response to what is happening are more important than the action. Thus, in a situation of uncertainty, it is possible to reach a treatment that will bring about a deeper change than a state of certainty and control.
First published in Hebrew in the ICCM Journal, March 2016.
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