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Q: How well regulated and safe are practitioners licensed under ATCM? Do practitioners generally have both registration under ATCM and the BAcC or is only one required for legality?
A: The members of the ATCM (Association of Traditional Chinese Medicine) are all well trained and qualified. The majority of its members trained in China, and often have a five or even seven year training which in may cases includes a training in western medicine to degree level and beyond. You can be reassured that ATCM members are competent and safe. The ATCM also has regulatory systems very similar to those developed by the BAcC, and holds its members to account for their standards.
There is actually nothing in law which requires a practitioner to belong to any professional association. We have argued for many years that professions such as ours should be regulated by statute, but we have been deemed relatively low risk and very efficiently self-regulating, so the immediate prospect of legal registration is remote. The best guarantee that a prospective patient has of their interests being protected is only to visit a practitioner who belongs to a body like the BAcC or ATCM, both of which take their role of protecting the public interest very seriously.
As for joining both, this would be unnecessary. Each provides similar benefits for its members, and to join both would be to add cost without gain. That said, there are an increasing number of practitioners who do join both, and we are engaged in high level talks with the ATCM about working more closely together for our mutual benefit and for the benefit of our members.
Q: I visited a qualified acupuncturist today. She mentioned different elements involved in Chines acupuncture. Fire, water, she suggested I 'represented' metal. it was a very good session but ran out of time so please what does my personality of metal mean?
A: The Five Elements, or more accurately the 'Five Phases', are a way of understanding the energy of the body as a microcosm which reflects the macrocosm, the world around us. The elements, which are Fire, Earth, Metal, Water and Wood, represent, for example, the different qualities which each season brings to the year but are also thought to be a way of understanding all phenomena. There are elaborate tables of correspondences which you can easily obtain by googling 'Five element acupuncture', which show how each of these elements represents an aspect of the whole.
The Five Element system appears in some form or other in all systems of Traditional Chinese Medicine, and can be as prosaic as a description of certain body shapes and as sophisticated as the central basis for a diagnostic system. In the UK one of the major founding schools of acupuncture was based on this as its core concept, and although this school has now closed, others have incorporated the system in their work and have graduated practitioners who choose to use this as their primary tool.
It is quite difficult to encapsulate in a paragraph or two a system of considerable sophistication, but when Five Element practitioners describe someone as a Fire person or a Metal person, they are often paying homage to the work of J.R.Worsley who pioneered what he called the 'causative factor' as a way of understanding the person and treating them. In his view, in each person one of the elements was the one which was primary one out of balance, and treating this part of the system would restore overall balance. This did not necessarily manifest in physical, mental or emotional problems which were associated with this particular element in the table of correspondences, because the complex inter-relationships often meant that the strain was expressed elsewhere. Worsley often likened the system to twelve people working in an office. It is highly unlikely that the two most incompetent would be showing serious signs of stress, but everyone covering for them would. Once you put the incompetent ones right, however, everything else would settle down.
We all 'contain' all of the elements, but the one which represents our primary area of imbalance often leads to certain characteristics which define us and which alert the diagnostician to what is really going on. These are not the same as 'faults' or 'defects', more a kind of unevenness in certain areas of behaviour. Having a problem with the part of the system which governs decision-making is unlikely to lead to no decisions or too many decisions, but much more likely to manifest as small decisions taking ages and life changing decisions being done in a trice. 'Inappropriateness' is a key word in Chinese medicine; when an element is out of balance parts of the system will react inappropriately at all levels, body, mind and spirit.
The Metal element, for example, being associated with the season of autumn is often seen as the part of the system which is responsible for letting go what has been finished with and reabsorbing the essential and valuable traces which we re-use. The emotion most closely associated with the Metal Element is grief, and there are also strong associations with a sense of value and self-worth. If this part of the system is not working as well as it might one would expect to see challenges or problems in someone's life which reflect an inability to deal with some of these issues 'appropriately'. Some people might find it difficult to let go of people or things, and grieve long after the time for grief has passed. Others may have a poor sense of their own worth and seek solace in material possessions or in searching for teachers to give their lives meaning. There are so many possibilities, however, that it would be unwise to list out too many like this. We are all individual and unique, and rule one is that there are no rules. Diagnosis is a subtle and taxing art; one cannot go backwards from a single physical, mental or emotional trait and draw an immediate conclusion. That's why it takes a long time to train.
However, it must be said that most people,when confronted with a description of what they are told is their main element out of balance are not at all convinced and can even feel quite insulted. The reality is that we are all so complex that it is very rare for one part of the system to stand out as the only thing out of kilter, and the real skill of the practitioner lies in making sense of the whole.
The other thing to remember is that being out of balance is not in itself a pathological state. All of us are to a degree and it is the small degrees of movement away from the centre line which make us who we are. It is only when life changes and stresses push aspects of our being too far away from the centre line that the strain starts to show and we need help to restore our balance. A world full of perfectly balanced people might just be a little too uniform for our taste!
There are a number of extremely good websites which you can find very quickly by googling 'five element acupuncture', all of which will help to give you a better understanding of the whole.
Q: Can acupuncture help manage a skin condition on my forearms, topical treatments are not effective. Currently I am being kept awake by constant itching arms. I am unable to work due to flare ups and I become very distracted.
A: It is very difficult to answer your question without a great deal more information than we have here. There is no doubt that the evidence for the use of acupuncture treatment, while far from conclusive, is encouraging enough to warrant seeking advice from one of our members about whether they may be able to help you. Looking at the condition at first hand, and also making a few basic diagnostic soundings, should give you a better idea of whether treatment would be of benefit.
Our website has a number of sections under the 'research' area in factsheets such as this one:
which speak of a few trials for eczema and psoriasis. Our experience, however, is that most presentations of skin problems are unique, not because they manifest differently but because they have to be seen in the context of someone's overall health and patterns of energy, and this can make a huge difference to how a problem is treated. Each one of a number of people with the same western named condition might be diagnosed differently in Chinese medicine, and this would lead to individualised treatment, not simply the application of a formula treatment.
We also tend to recommend that people with skin problems consider the possibility of seeing a BAcC who also uses Chinese herbal medicine. Most members of the RCHM, one of the main Chinese herbal medicine associations, are also members of the BAcC, and members of the ATCM, another leading body for Chinese medicine, use both modalities. Our experience is that skin problems seem particularly well suited to Chinese herbal medicine, and while we are sure that acupuncture treatment may be able to have an effect (at least to some extent) the daily regimen of herbal preparations seems to suit these kinds of problem where sustained daily treatment seems to pay off.
Not all problems of this nature are amenable to treatment, though, and we recommend that you make sure that you have some form of face to face assessment before committing to treatment. Progress may be gradual and that may mean a considerable financial outlay. You need to ensure that you have clear and measurable outcomes and regular review periods if you decide to go ahead with treatment.
Q: I had acupuncture and the needle was placed in my sternum for sleep problems. I felt an intense pressure and tightening and the the needle had to be removed. Is this normal?
A: We always say in these situations that what you experienced isn't normal but it isn't unknown either.
The usual, sensation people feel when needles are inserted are a slight tingling sensation or a dull ache. The latter is regarded more as a reaction understood in Chinese medicine terms than in orthodox physiology and is called 'deqi'. On rare occasions the reaction to a needle can be as you describe. The western trained physiologist would describe this as a neurophysiological reaction, possibly involving a spasm in the local musculature such as it is in the area, and the Chinese medicine practitioner would describe this as a kind of 'needle grab' where the needle feels like it is being pulled into place.
Whichever way you describe it, removing the needles immediately is the appropriate course of action if the patient feels either incomfortable or anxious. We strongly suspect that this was the only needle which produced this kind of reaction, and that the practitioner was able to insert other needles without this kind of reaction. From our perspective, the energy of the points in this area can be very powerful and induce slightly greater reactions, but as we said, this is quite an unusual reaction. We hope that it hasn't put you off further treatment.
Q: I have hyperasrousal insomina. I can't fall asleep because of my hyperarousal nerve system. Can accupunctre treat my insomia?
A: As our factsheet shows
there have been a number of studies which seem to show encouraging results for the treatment of insomnia with acupuncture, although they fall short of the standard required for us to make definite claims. Studies such as
make for interesting reading, and participants for a large prospective study are currently being recruited in Pittsburgh.
However, hyperarousal insomnia is not simply about not being able to sleep but usually a much more complex pattern affecting many other systems of the body. A practitioner of Chinese medicine would be looking very carefully at all aspects of someone's functioning to get an overall picture of what was happening. Although Chinese medicine has an entirely different theoretical basis, and is supported by theories about energy and its flow and balance, the symptoms which people describe and the signs they display are not new, and the kinds of discomfort and stress which hyperarousal creates would have been understood for the last 2,500 years within the Chinese medicine system. This means that there will probably be a number of treatment options based on some of the other diagnostic evidence which a practitioner might identify.
However, we have to sound a note of caution based on our practical experience of treating problems such as yours. They are oftenvery complex and with a variety of interlocking causes, an acupuncture treatment alone may not be able to deliver a result. The problems can also have a spiral effect - the sleeplessness can often generate new problems, both physical and emotional, and these can develop a life of their own.
We can do no better than recommend that you contact a BAcC member local to you for a chat and informal assessment of the potential value of acupuncture treatment.