Beyond Styles of Practice
Over the last fifty years, our understanding of what Chinese medicine is and how it should be studied and practiced has fundamentally changed. We once thought it was a single system. Now we know that Chinese medicine is a family of many different styles of practice.
In acupuncture, for instance, there are the Tung style, the Tan style, various styles of Japanese meridian therapy, Worsley five element acupuncture, stems and branches, Korean hand acupuncture, TCM acupuncture, and various types of scalp acupuncture to name just a few. In herbal medicine, popular styles include various types of jingfang or “classical formula” practice, TCM, Japanese Kampo, Korean constitutional therapy and many more.
The question is how do we relate ourselves to this multiplicity. Should we study all of these approaches? As many as possible? Only some of them, but then which ones? And why those and not others? Should we leave it all to chance or let ourselves be enchanted by the charisma of the most popular teachers (which, of course, will not be the most popular ones in a few years time)?
This problem is not new, of course, but has vexed practitioners of Chinese medicine since time immemorial. Over that period, they have proposed three basic solutions:
- Stick with one style.
- Synthesize different styles into a single new style.
- Develop a meta-practice approach that allows you to work effectively with different styles.
All of these solutions have advantages and disadvantages. Sticking with one style solves the problem of choice but will ultimately limit you. Synthesis gets rid of differences but in the end simply creates just one more style. Developing a meta-practice approach gives you flexibility and deepens your practice in a way that the other approaches cannot do, but it also requires more time and effort.
What is Meta-Practice?
Meta-practice is a tool for working effectively with different styles of practice. This has four distinct advantages.
- It puts your patients in the center.
- It significantly increases your diagnostic and therapeutic skills.
- It deepens your understanding and access to the Chinese medicine tradition.
- It provides you with a firm basis for life-long learning.
In meta-practice, what drives the treatment process is not your style of practice, into which you have to fit your patients, but the needs of the patients themselves. If you always seek to link a patient’s problem to their constitution because that is what your style of practice demands, it is highly unlikely that you will be able to effectively treat an acute epidemic or serious disorders involving toxins. If the only formulas you use must have been written down in the Han dynasty, it is unlikely you will become very good at treating phlegm or damp-warmth because these concepts were only developed much later on.
Meta-practice helps you to become a better clinician because you have more tools at your disposal. Different styles of practice emphasize different diagnostic modalities such as pulse, tongue or abdominal diagnosis, inspection or listening. Meta-practice demands you to use all of them, though not necessary all the time. Here, too, the patient and context are the primary drivers, but you are also better able to employ your own personal strengths. Some of us just are better at processing visual information, while others work better with palpatory referents.
By working with different styles of practice, meta-practice forces you to be more precise in the definition of the concepts you employ. Any single style of practice can get away with ill-defined concepts. Bringing different styles into conversation with each other demands that we find common ground. This can be challenging but ultimately expands our knowledge. It certainly deepens our access to and understanding of the sources of our tradition.
Finally, meta-practice allows you to systematically extend your clinical skills without ever being limited by what you have already learned.