Posted by: corneliadavies | November 12, 2018

Is Acupuncture Like Counselling?

Is acupuncture like counselling?

No, acupuncture is not like counselling.

The nuts and bolts of acupuncture work via neural messaging to the brain, which responds by sending neural signals back to the rest of the body. Modern scientific research is ongoing in ascertaining exactly how this fascinating mechanism works.

There is a significant consultation period at a first acupuncture session, as it’s important for the acupuncturist to gain a full a picture of the patient’s health issues and history. However, this consultation is not counselling.

The consultation may or may not include questions about the patient’s emotional or mental well-being, depending on their reason for seeking acupuncture. Many people seek help simply for musculoskeletal issues, while others may be having acupuncture for all sorts of different reasons, such as skin or menstrual problems, headaches or anxiety.

Here’s an assumption I often hear

“Surely, acupuncture really works because you have time to talk your problems through with someone and that makes you feel better?”

Actually, no.

It is true that:

  • We spend longer with patients than GPs do.
  • We have more time to ask questions.
  • We may ask how patients are feeling about their illnesses.

However:

  • We are not like GPs, who may be triaging patients in the direction of the right consultant or diagnostic process for their problem. People come to us specifically for acupuncture treatment and all it entails.
  • After the first, information-gathering appointment a small portion of each follow-up session will be consultation, while most of the time will be taken up with the acupuncture treatment itself.
  • If someone consults an acupuncturist specifically for anxiety or depression issues inevitably some of each consultation will be taken up with asking the patient how they feel. (More on this below.)

Why acupuncturists ask some patients how they are feeling, mentally or emotionally

Sometimes we need to know exactly how someone is feeling, in order to tailor the treatment individually for them. Here are two examples:

1. Someone consults an acupuncturist for an emotional issue, such as anxiety or mild to medium depression.

In this case, an acupuncturist needs to ask the patient specifically how they are feeling, in order to choose the correct acupuncture points for treatment. A person who feels vulnerable will be treated differently from someone who is feeling grief, or a person who is anxious, exhausted and bad-tempered.

If someone says, “I’ve been feeling a bit wobbly this week” we need to know what they actually mean by that. For instance, “A bit wobbly and constantly bursting into tears” would be treated differently from “A bit wobbly and feeling empty inside,” or “A bit wobbly and surprisingly grumpy with the kids.” In fact, each of these statements would lead to further questioning, along with looking at the patient’s tongue and taking their pulses, using techniques within acupuncture diagnosis.

Treating people as individuals is one of the very strong features of this system of medicine.

So, when someone looking for help with anxiety or depression explains to their acupuncturist how they are feeling this is not a counselling session. They are being questioned in order that the acupuncturist can work out the best possible treatment plan to address their problems that day.

2. Someone with a physical issue comes in one day with a new trauma, incidental to the physical problem

An example of this might be that someone who is receiving acupuncture treatment for back pain comes in for treatment one day and they have just lost their job or have a new family problem.

You may think this is irrelevant, as the patient is having treatment for a very physical problem. However, modern scientific research is beginning to show that our bodies do, indeed, respond to what we are thinking, so this new emotional trauma might slow down their physical improvement unless it’s addressed. Acupuncture has long worked on this basis, so if someone who is already responding to treatment for back pain comes in with an additional emotional trauma their acupuncturist will be able to construct a better treatment for them that day if they have more than a rough idea about how the patient is feeling.

So, there may be more questions, such as, “How do you feel about this?” or “Where in your body do you feel it?” or “How are you dealing with it?” There are many more questions that may be asked, and each answer will lead the acupuncturist closer to identifying the best treatment strategy for that patient at that time. Sometimes this sort of incident will bring an existing emotional problem to the acupuncturist’s attention, which may result in more precisely tailored treatment for the patient in future.

Acupuncture history goes back millennia, and diagnosis is comprehensive

Acupuncture has thousands of years of history, with the oldest written reference dating from 300 BC (this reference is, in fact, an entire book) and there are many, many further texts written since then. Therefore, symptom pictures and their possible treatment patterns are noted very precisely. Some of these symptom descriptions include details about attendant emotional or mental states.

There are numerous different diagnostic patterns in acupuncture, with diverse pointers within each pattern. For example, one diagnostic syndrome has a whole list of possible symptoms, including “dry cough or with sticky sputum, low-grade afternoon fever, insomnia, dry mouth, inappropriate grief.” I’ve chosen just a few of the symptoms stated under this particular diagnostic pattern. It’s notable that, alongside a whole host of physical symptoms, are the words “inappropriate grief.” What this means is that someone might be feeling grief when they haven’t been bereaved or lost a significant relationship or life feature (e.g. job). In other words, this person feels an inexplicable grief or sense of loss.

Many diagnostic descriptions within acupuncture texts include emotional or mental symptoms at the end of descriptions of possible physical symptoms, highlighting the importance for acupuncturists to gain as much varied information from each patient as possible, in order to optimise each treatment.

As a result of this balancing of the whole person a significant number of patients report emotional improvements alongside physical progress from their treatments.

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Not counselling, but consultation

So, in our persistent questioning of patients, we acupuncturists are not counselling. Rather, we’re investigating.

It’s true that each acupuncturist is a different individual with a different skill set, and some practitioners may have had training in counselling or psychotherapy too, but acupuncture as a therapy does not include counselling as such. Sometimes, when a patient repeatedly tells me that past events are continuing to bother them I will mention that they might need to go to someone who specialises in a talking therapy as well as or instead of receiving acupuncture. I make it clear that I am not that person, so that there’s no confusion. Also, if I were to spend too long talking with someone it would impact on the time we can devote to the acupuncture, the reason they are in my treatment room in the first place.

Many of us are extremely interested in the human condition, or we wouldn’t be doing this job. Therefore, it’s not surprising that many acupuncturists, when undertaking this potentially forensic questioning do so with great respect and compassion. As individuals within the profession, we do care greatly for our patients.

Consequently, it’s inevitable that some patients will tell other people how supported they feel during their acupuncture treatments. I believe that this is how any healthcare session should be. It’s important, though, to note that the main part of an acupuncture session involves the acupuncture treatment itself, i.e. the settling or balancing of the patient’s mental-physical system, via the insertion of tiny needles, with the intention of leading to an improvement in health and well-being.

© Cornelia Davies 2018

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