A patient asked his acupuncturist,
"Can you treat me without those needles?"
The acupuncturist answered,
"Needless to say, needless is not okay."
Many students ask if acupuncture must be painful to be effective. It's hard to tell, but I used to say, "Acupuncture should not be painful, but more stimulation is better than less."
It sounds contradictory, but if you think of acupuncture as being like making love, the concept becomes easier to grasp.
Acupuncture as Communication
Acupuncture is a conversation between patient and doctor. Few things are more irritating than someone who simply speaks their mind and then turns around and leaves. Applying needles without checking patient responses is akin to that type of attitude. Without listening, you cannot make communication. In traditional Chinese medicine (TCM), these responses are called de-qi. The ancient Chinese classic 'Nei Jing' states about de-qi:
刺之而氣不至，無問其數；刺之而氣至，乃去之，勿復針
If there is no response (De-qi), regardless of how many times you've tried, continue trying until you achieve a response (De-qi). Once you obtain it, there is no need to apply the needle anymore.
- Neijing Suwen, 素問 -鍼解篇
From this, we can understand that acupuncture is not merely about applying 10-15 needles as planned, but rather involves engaging in a clear and responsive action, which is not optional. If you cannot detect this response, your treatment cannot be effective. Acupuncturists should be attentive to these responses, adjusting stimulation intensity, acupuncture points, or needle manipulation accordingly. De-qi isn't just a verbal response; it can manifest in various ways, such as a subtle sensation on the acupuncturist's fingertip, a patients' feeling of refreshment, or even an embarrassing involuntary bodily function.
The Art of Attentiveness:
To be a gentleman, you need to be a good listener. Similarly, being a good acupuncturist requires attentive listening. You need to focus on the patient's responses and be a good listener. Simply inserting(penetrating) a needle doesn't make you a good acupuncturist. Similarly, making love requires partners to listen to each other's emotional and physical cues, ensuring an enjoyable and fulfilling experience.
左手重而多按，欲令气散；右手轻而徐入，不痛之因
Palpate several times letting qi spread with left hand , then with right hand insert lightly and progress slowly the needle. There will be no pain.
- Biao You Fu (Lyrics of Standard Profundities), 标幽赋
7 Ways to be a gentleman in acupuncture
- Insert the needle very slowly. This is the best way to listen. If you insert the needle too quickly, neither you nor the patient will be able to feel anything. Slow insertion allows you to feel the different tissue textures.
- Sharp and intense pain is not a good response.
- Focus on your fingertip, and think of the acupuncture needle as an extension of your fingertip. Try to feel all the sensations during penetration.
- Frequently ask patients about their feelings regarding the needles, as they often won't share their experiences until prompted. Their answers may surprise you, as there are many different types of de qi.
- If it's challenging to listen due to faint sensations, use manipulation to increase the intensity.
- Do not apply strong stimulation to elicit a better response; subtlety is always the best approach.
- Most importantly, calm your mind and focus on the patient in front of you, not the one waiting.
Being a good listener is essential for both acupuncturists and those who want to excel in the bedroom. It's not just about the insertion of the needle or the intensity of the act; it's about focusing on the partner's (or patient's) responses, ensuring their comfort and relaxation. Remember, "harder is better" only when there's control and understanding of the thin barrier between pain and pleasure. So, whether you're seeing the patients or planning a romantic night, remember that the key to success lies in the delicate art of listening and responding to your partner's needs. Listen to this ancient wisdom.
神無營於衆物者 靜志觀病人無左右視也
Do not let your Shen (mind) be diverted by anything; rather, calm your Shen and attentively observe your patients without any distraction.
- Neijing Suwen, 素問 -鍼解篇
Hyungsuk Choi, PHD