teaching diagnostic thought process

January 6, 2010

I've changed the thread title because I think we're on a different

subject now.

On Jan 3, 2010, at 6:35 PM, swzoe2000 wrote:

> I think more must be taken into consideration than the " pattern " in

> clinical work with Chinese herbalism. And maybe we should be clear

> on what " pattern " means to us.

>

Thank you for taking the time to elucidate this whole schema formally

and completely. I'm taking some time to play with it all.

I'm fascinated by the schemata and processes by which we derive data

and organize perceptions into meaningful information. In my role as a

teacher of herbs at a 5 Element school (AFEA), this was a major

exploration and mutual challenge, because the perceptual/cognitive

processes involved in making a 5 Element diagnosis are so different

from what is required to prescribe an herbal formula. I used to make

many-pages long worksheets outlining step by step protocols for

gathering data, and discerning what the data signifies. It was like

Left Brain 101. I was privileged over the years to teach some truly

brilliant right-brained dominant students, and the thing about right-

brained people-- genius or otherwise-- is that they often have no

idea how they came to their conclusions. There is no sequence of

thought; there is perception and synthesis, and that's it. The

problem, of course, is that even when it is clear that they are

totally on track, they can't explain it; and worse, when they are off

track, they often cannot figure out how they got there, or how to end

up some place else. It's an amazing holism, an ability to sum up and

grasp the gist, but at the sacrifice of the little moving parts. The

biggest challenge for me, as a teacher, was to teach them how to do a

left-brain analysis without losing their right-brain genius. Because

that would happen sometimes! It was like taking a " natural " musician

and filling him/her up with conservatory theory, and all of a sudden

they get stiff and dorky.

We've all seen examples of the incredible brilliance of practitioners

who have both the seemingly direct apprehension of inductive synthesis

and the incisive analysis of a rational framework for explicating,

communicating and verifying their diagnoses. I dare say we have seen

the opposites, too--- people with uncanny knack at penetratingly

accurate summary diagnosis, and people who've got all the logic and

data processes but somehow miss the " soul " of the situation. Many

students seem to have the makings of either an artist-type

diagnostician or an engineer-type diagnostician. As educators, how do

we address the different needs of these different kinds of students?

I am interested in hearing from other educators, about how we train

the 'artists' to think logically without turning them into machine

minds, and how to teach the engineering types how to 'feel' the

pervading thematic gestalt of the client's presentation a.k.a. get

into the groove.

I've certainly thought about this a lot-- it has been the focus of my

professional life for the past 10 years-- and I would love to hear how

you and other teachers work with nurturing these different skills and

cognitives style in different kinds of students.

Thea Elijah

>

> There are the " disease factors " such as blood stasis, Yin

> deficiency, Qi stasis etc. Even if it is the pattern giving rise to

> the pattern, it seems like this is what you are referring to as the

> pattern? For the sake of this discussion, I am calling this the

> disease factor. (this is from the Qin Bo Wei anthology translated by

> Chase)

>

> Then there is the " location " of the problem. So if someone comes in

> with chest pain. We may diagnose the disease factor a blood stasis

> but, unless we direct the formula to the right location, we will be

> pretty ineffective. So the formula would need to be directed to the

> chest in this case. Locations could be anything from the shoulder to

> the chest to the Kidney to the luo vessels to the Shao Yang etc.

>

> Then there is the " symptom " . The symptom might be pain and then we

> want to make sure we are stopping pain. A patient may have hot

> phlegm (disease factor) in the chest (location) causing cough

> (symptom) or it could be causing shortness of breath or chest

> oppression. The formula would be a least somewhat different for the

> different symptoms.

>

> Then there is the " person " . One person who has a hot phlegm in the

> chest cough may be treated very differently from another type of

> person who has the same disease factor, location and symptom. One

> person may be a weak person who sweats easily and tends to

> constipation. Another person may be robust and never sweat.

>

> Then there is also what Trevor is talking about which is the

> " disease " . Though of course we treat according to all the above and

> put and " disease " in the context of all of the above, diseases exist

> and are really important in Chinese medicine. So Trevor mentions

> psoriasis vs. eczema. There are also Chinese diseases such as lilly

> disease and lung wilt. There are certain herbs that are especially

> good for certain diseases. When one's foundation in diagnosing and

> applying formulas for disease factors, symptoms and locations is

> sound, then there is a lot of subtlety to be learned regarding the

> treatment of diseases themselves.

>

> I think when Trevor was referring to people treating any dry skin

> issue as blood deficiency, he was also showing how a rudimentary and

> simplistic understanding of diagnosis that 1. makes dry skin and

> blood deficiency forever linked 2. does not see beyond the disease

> factor - is pretty low level herbalism and will most often obtain

> poor results. Am I right Trevor? On the other hand, very often in

> the clinic, we don't need to take diseases into account.

>

> A " presentation " is a group of signs and symptoms that can indicate

> a particular formula and they indicate certain disease factors,

> symptoms and locations. But even a presentation is taken in context

> of the type of person, the acuteness or chronic nature of the issue

> etc.

>

> I'll give an example from my own clinical experience that happened

> to be successful (I don't want to give the impression that I always

> get results like this because I don't!) In Yang Ming Stomach

> presentation there is big thirst, big sweat, big fever and big

> pulse. We generally think of this in terms of acute illnesses.

> However, I recently worked with a woman who was diagnosed with

> Hashimoto's hyperthyroid syndrome. She had a pale complexion, soft

> voice and a pale tongue. Her symptoms were agitation/insomnia,

> frequent bowel movements, an aversion to heat, tendency to sweat,

> thirst and a moderate pulse. From my point of view, based on

> studying with Dr. Huang Huang, this was a Yang Ming Stomach chronic

> presentation with thirst, sweat, heat and a bigger pulse than her

> constitution represented. So, in this case I gave her Bai Hu Tang

> modified to supplement her Spleen Qi. (I actually don't think of Shi

> Gao as cooling or damaging to the Spleen but rather as venting

> stagnant heat from Yang Ming but that's another discussion) This was

> very effective and within two months her thyroid levels were normal

> and all her symptoms were better.

>

> So in this case the " disease factors " were heat and Qi deficiency.

> The " location " was Spleen and Stomach, the " symptoms " were thirst,

> agitation/insomnia, aversion to heat and frequent bowel movements

> and the " disease " was Hashimoto's hyperthyroid. The " presentation "

> was Bai Hu Tang presentation. In this case I did not need to treat

> the disease but I did need to make sure it was getting better.

>

> In other words, there is so much more than the " pattern " that we

> must take into account. To summarize:

> Disease factor

> Symptom

> Location

> Type of person

> Presentation

> Disease

>

> Sharon

>

January 7, 2010

I consider intuition and conscious thought to be in a Yin-Yang relationship.

Regulation

One can be used to temper the evaluation of the other.

Opposition

They are different enough to be polar opposites.

Mutual Nourishing

One creates Qi to fuel the other's tasks.

Inter-transformation - one becomes the other.

e.g. Intuition yields a thought of such strong or abundant Qi that the conscious

shen must try to understand it.

" Four Stages of Learning, " a theory of psychologist Abraham Maslow, proposes

this set and sequence for learning.

Unconscious Incompetence

The individual neither understands nor knows how to do something, nor recognizes

the deficit, nor has a desire to address it.

Conscious Incompetence

Though the individual does not understand or know how to do something, he or she

does recognize the deficit, without yet addressing it.

Conscious Competence

The individual understands or knows how to do something. However, demonstrating

the skill or knowledge requires a great deal of consciousness or concentration.

Unconscious Competence

The individual has had so much practice with a skill that it becomes " second

nature " and can be performed easily (often without concentrating too deeply). He

or she may or may not be able teach it to others, depending upon how and when it

was learned.

If this is the way learning occurs, our teaching methodology should include

equal emphasis on intuitive and conscious learning, teaching that both are

equally important to the art of diagnosis.

As to the brilliant outliers on either end of the spectrum...they're like the

young man who asked Mozart how to write such powerful and beautiful music.

Mozart advised him to go to school and then study with a master. The young man

protested, " That would take years! And you didn't spend years in school. "

Mozart's replied, " I didn't have to ask how. "

Joe

January 7, 2010

HI Thea,

I appreciate and understand your thinking here. It is important to see the whole

of the person and not just focus on the isolated phenomena we call disease. The

human body is obviously a matrix of many interconnected parts all working in

some majestic harmony. The skill of the practitioner, really, is to re-store

this harmony.

I'll give an example of this. From a western point of view, allergic asthma has

been linked to an imbalance of Th1 and Th2 immune cells. In allergic disease I

believe it is Th1 that becomes quite elevate above Th2, thus triggering the

release of high amounts of IgE immunoglobulins and the allergic response.

Now one of the traditional Western approaches to alleviate asthma is to use

internal steroids like prednisone. The steroid quickly calms down the

inflammatory response and the patients breathing rapidly improves. So from a

" lets just focus on the disease " point of view, the symptoms of asthma improved.

The problem is that when the steroids are stopped the asthma comes back, perhaps

even stronger than before treatment. When they do blood analysis of the Th

profiles, they notice that the Th1 and Th2 levels are still out of balance- with

Th1 still much higher than Th2. The steroid suppressed both of them, but did not

change their relationship to each other.

Now when three chinese herbs were given to control the same symptoms of asthma-

Ling Zhi, Ku Shen, and Gan Cao- the symptoms of asthma improved. Most

importantly the blood work revealed that the Th1 and Th2 levels came back to

normal relationship. Th1 was lowered and Th2 was increased. Thus the possibility

of a " cure " was recognized.

So what does this study (which was released in the American journal of

immunology and allergy last year, indicate? It shows the importance of

poly-pharmacy and physiology. That the matrix of many different chemical

compounds working on multiple bodily networks leads to better results than just

using a single chemical compound, like predisone, to work on an isolated

physiologic process, like inflammation.

Which then comes to diagnosis and the understanding that the " wholistic "

thinking is critical for good outcomes.

But..........

I still feel it is important to name the " disease " we are treating. I already

talked about how the understanding of certain disease traits is critical to

treatment outcomes, like fungal disease, so below I will point out another

reason I feel it is important;

By naming a disease we have a goal to measure for future change during our

treatments. When patients come to see us, they usually have very defined

symptoms, or even a disease name, that they want to see change. That is why they

have come to see us. If they have menstrual pain they want to experience less

menstrual pain through our treatments- plain and simple...... or is it?

I have seen countless patients over the past several years who have come to me

after, or while still seeing, other practitioners- be it TCM, Homeopathy, Energy

healer, Naturalpath, etc- who have told them some story about the nature of

their problem and why they are experiencing the " menstrual pain " , which is fine.

But when I ask them if their menstrual pain has ceased with that practitioner

treatment, many times the answer is " No " - and this may be after seeing a

particular practitioner for 2 or more years!

I always ask, " So you saw this practitioner for 6 months, or 2 years or

whatever, and your main complaint of menstrual pain did not change? " . The usual

response is, " No it did not change, but that practitioner is really NIce and I

feel like I have more energy. " ....... Great they have more energy and the

practitioner is really nice. But what about the menstrual pain? Did this get

forgotten through all the " diagnostic " theory and language?

This is why I think it is important to label the problem and then re-check in

from time to time to see if that problem has changed. If we don't, then I think

we are wasting the patients time.

I mean in the end, we can tell our patients anything we want about whatever

energy imbalance we see or not, but if their problem has not changed then what

are we doing?

Trevor

January 7, 2010

This whole idea of intuition versus conscious thought can be quite murky, as it

seems intuition is the ability to pull out ideas from a pool of already learned/

memorized facts. So if this is the case, can not logical analysis be an

intuitive process? What is truly the difference?

One of my early martial arts teachers used to have us practice the same move

over and over again, saying " a thousand times slow for one time fast " . Meaning

our ability to make quick intuitive responses is better when we have installed

the memory of what to do, when.

Intuition seems to be a learned process. Can intuition not be from an internal

logical process where by we are looking at all the possible scenarios and

deciding the best way to go. What tells us the best way? A learned memory, which

thus becomes intuitive.

Years ago, my wife used to see an " intuitive healer " for her eczema, who was

considered to be one of best in Vancouver. At $150.00 an hour you would think

so. This healer told my wife that her skin problem was stemming from a deep

emotional imbalance of unresolved anger towards her father. The healer convinced

my wife to come for several treatments to work on the emotional imbalance and

that her " intuition " told her that my wife should also use colloidal silver

externally on her skin.

Well after many months, wife's eczema was no different. She had lost almost 2

thousand dollars on treatments. Why did the healer suggest the Colloidal silver?

Well it was probably because she had read an article about it in a health

magazine, so the memory of it's use was installed, from which she pulled out

during her intuitive process, as needed.

Now what if this healer had actually studied Chinese medicine? Well then she

would have more info to choose from for her intuitive process. What if this

healer went even further and actually studied particular protocols for the wide

range of differing skin diseases. Then her intuitive process would be that much

more refined wouldn't it be.

My wife went on a year later to see my mentor of , Dr Kingson

Wu, and guess what? Three months of herbal treatments, with no mention of the

anger towards her father, and her skin cleared completely. 8 years after

stopping treatment and she has not had any recurrence of eczema. She was

basically cured.

Sure prodigies like Mozart exist, coming into this world with amazing abilities

to master their craft without much external guidance. But I would say that they

are the exception, not the rule. The reason the Chinese wrote out so much theory

on herbal medicine, using case study and mentor ship to teach, was because they

realized the importance of having grounded/ memorized/ consciously gathered

information from which to choose from when needed.

Intuition is mostly a learn and recall system. Logical analysis is not

necessarily a separate process.

A thousand times slow, for one time fast.

Trevor

January 7, 2010

Yah I hear you it is ridiculous for the client's actual illnesses,

especially the ones most serious, not to be shifting noticeably in

treatment-- to me this goes without saying-- anything else is either

(possibly) a very stubborn illness or a practitioner wasting precious

time.

What I am finding most fascinating, though, is this whole notion of

disease-oriented treatment-- I have been playing with it over the last

several days and it is quite foreign to me but I can see the aspects

of elegance and precision in it, and that in balance with the rest of

the picture, it is a worthwhile pursuit. It's just way way way not my

style-- which means it is all the more interesting to play with.

An example of how I treat recognized " disease " -- and of course not

all of my cases are as gloriously successful as this one, but it

illustrates the point quite well, so I might as well swank it:

I had an herb student who was an M.D. acupuncturist in his late 40's.

He was quite the hard-headed rationalist in many ways, but also very

open-minded. He had contracted glomerulonephritis as a 20-year-old,

and was now being told by his doctor that he would be looking at

dialysis or kidney transplant options in about 5 years. He tried

herbal approaches with a number of highly reputed Chinese herbalists

out on the West Coast, including one who was a specialist in kidney

diseases. The formulas seemed to help somewhat, but not very much,

plus they gave him diarrhea, and he was discouraged. He had come to

me as a student because my results with another client came to his

attention, and now he approached me as a client.

I diagnosed him as a Metal constitution, with Wood as his first Within

and Water as his second Within. His Metal was exacting, tough,

incisive, no-nonsense, and dedicated to " only the highest " priorities

and actions-- which meant that he had a very slow, perfectionistic,

almost stodgy evaluation period about absolutely everything. His Wood

was impatient and activist and wanting to do something NOW, never mind

if it was " the best thing " or not. Let's get moving. His Water was

caught between the two, literally and figuratively, and stressed out.

In diagnosis, I draw a sharp distinction between what I call the

schlemiel organs and the schlemazel organs. OK this is Yiddish rather

than Chinese terminology, but hear me out. A schlemiel is defined as

the person at the table who spills the soup. A schlemazel is defined

as the person on whom the soup is spilled.

I teach my students that one of the most important diagnostic

awarenesses is this distinction between schlemiel and schlemazel. The

schlemazel organ system is the one that is screaming its head of, and

generating all sorts of disease symptoms, but it is not necessarily

the cause of the problem. It may need a lot of help as far as rehab,

but it is not going to lead to long-term relief for the client unless

the actual schlemiel is addressed.

This man had a kidney schlemazel in big trouble, but his

constitutional schlemiels were the constant warfare between his own

lung and liver.

This was almost 8 years ago so I am not positive what I did-- it was

a series of modifications of yi guan jian with things that took points

of dirty fire out of the kidneys-- I don't know your words for that--

but herbs like han liao cao and che qian zi and others. The bottom

line was that I treated him for getting along with himself better, and

my guiding signs for what that might look like came from pulse and

tongue and palpation, physiognomy and presence-- and a focus on

discerning from them to the best of my ability the specifics of his

potential health-- what that health would uniquely look like and feel

like for a person of his constitution-- rather than on the specifics

of his fancy disease name.

I did look at the formulas the other docs had written for him. But

they looked nothing like him. They looked like just expertly bailing

a leaky boat. They treated the disease, but not why it was able to

thrive in this person.

Well, my formula was a roaring success-- as measured by serum

creatinine level tests and other tests I can't even remember-- I am

not a Western medical person and that sort of thing does not concern

me except that it gives me good firm evidence as to whether I am on

track. We were, over the next 6 months, getting results that blew his

doctor's mind, and seemed " impossible. " Since he was a doc/acu/

herbalist himself, after 9 month he took over his own care, and now

almost 8 years later he is not on dialysis, no kidney transplant, and

is doing very well. The disease is not gone, but it seems to be only

barely progressing by some measures, and not at all by others. Also

he is a helluva lot more at ease with himself, and is able to find way

to express his activism and his high standards in a manner that does

not tax or burn out his kidney energy. (He has become more wise, in

short!)

In all cases, my aim is to see distinct measurable and noticeable

physical improvements-- even if the client is coming in for depression

or anxiety or any other psycho-spiritual ills. The physical realm is

relatively unambiguous, and it is there that we can course correct and

confirm that our diagnosis and treatment plan is correct. This is the

case no matter what the client is coming in for. Thus while I am not

focused on disease, I want to see it changing. The measurable is not

the only aspect of reality, but it is the aspect we can measure-- and

so we must measure up!

Thea Elijah

January 7, 2010

On Jan 7, 2010, at 2:31 PM, trevor_erikson wrote:

> This whole idea of intuition versus conscious thought can be quite

> murky, as it seems intuition is the ability to pull out ideas from a

> pool of already learned/ memorized facts. So if this is the case,

> can not logical analysis be an intuitive process? What is truly the

> difference?

>

> Intuition seems to be a learned process. Can intuition not be from

> an internal logical process where by we are looking at all the

> possible scenarios and deciding the best way to go. What tells us

> the best way? A learned memory, which thus becomes intuitive.

>

I must beg to differ radically, and I will ponder how to express in

this written medium what comes across so much better and more easily

in " oral traditions. "

there is now much accessible research that points towards the very

distinct differences between cognitive modes-- it really truly is not

nearly so simple as this (above)! Most of the really exciting work

these days is in the emerging field of neurocardiology-- it is

fascinating to discover how very differently we can think, depending

on whether we are entraining from the 60% neural tissue of the heart,

or entraining from the brain. There are huge differences both in our

own physiology in different cognitive states, and in the resultant

perceptions.

The Heartmath Institute has some decent leads on this.

Have you read Stephen Buhner's book " The Secret Teachings of Plants " ?

The title is, to my mind, very regrettable-- I am always embarrassed

to recommend it because it sounds so flakey-- but it is actually a

good book and the first section includes a lot of reference to this

research.

Joseph Chilton Pierce especially recently is doing some good writing,

too, about neurocardiology and cognitive modes.

It's a whole field of study these days with some interesting work

being done, and it is nothing like what you are talking about above.

If we were in person, I could give a lot of very direct guidance and

examples, but I don't yet know how to assist people in shifting

cognitive modes by written word alone.

>

> Years ago, my wife used to see an " intuitive healer " for her eczema,

> who was considered to be one of best in Vancouver. At $150.00 an

> hour you would think so. This healer told my wife that her skin

> problem was stemming from a deep emotional imbalance of unresolved

> anger towards her father. The healer convinced my wife to come for

> several treatments to work on the emotional imbalance and that her

> " intuition " told her that my wife should also use colloidal silver

> externally on her skin.

>

> Well after many months, wife's eczema was no different. She had lost

> almost 2 thousand dollars on treatments. Why did the healer suggest

> the Colloidal silver? Well it was probably because she had read an

> article about it in a health magazine, so the memory of it's use was

> installed, from which she pulled out during her intuitive process,

> as needed.

>

Forget it. That's not an intuitive healer; that's a silly idiot. One

cannot judge a modality by its charlatans and flakes. Every modality

has examples of this. You must find intuitive healers who are

exceptionally good at their work, as shown by their clear results, and

then a fair study might be made of their methods.

>

> Sure prodigies like Mozart exist, coming into this world with

> amazing abilities to master their craft without much external

> guidance. But I would say that they are the exception, not the rule.

>

Intuition and other non-linear cognitive modes need training and

honing just as much as linear ones. It's worth being extra-wary of

healers who just have a " gift. " I much prefer to work with those who

have extensive training and practices (such as the qi gong masters and

Sufi master healers whom I admire). It's not about magical

abilities-- it is about rigor and training and honing and consistent

feedback and WORK. Ask any qi gong healer. It's not about

memorization and logical deployment of acquired data, but it's also

not miraculous. In any responsible qi gong or Sufi or other non-

linear healer, there is method and rigor, but not the same kind.

In person, we could go much further with this. The whole point of the

more experiential modes is you can't really write about it. Haven't

you spent time with really impressive qi gong healers in your sojourn

in studying Chinese medicine? Tremendous self-cultivation is involved

in the acquisition of various perceptual abilities. Really, it is

worth basing your opinion on recognized masters of these arts, not

quacks.

Thea Elijah

January 7, 2010

Hi Thea,

Your story validates my point. You and the patient measured success based on the

symptoms he presented when he came to you, and which changed via your treatment.

The way in which you gathered your information and the process by which you came

up with a pathomechanism is irrelevant, ie the bit about " Metal constitution,

with Wood as his first Within and Water as his second Within " , as these are only

attempting to explain why the patient is having the symptoms that he is having.

As far as the reasons for a particular problem manifesting, there is an endless

way of looking at this.

The main point is that your patient came to see you with a complaint, ie

disease, and then experienced relief of his complaint, disease, from your

treatment. One can fill in the blanks in regards to pathomechanism as one

wishes.

If your patients symptoms of kidney disease did not change, what would you have

to prove to him that your treatment was successful? I don't think that he would

be that happy if you told him that his wood was more patient. His collection of

symptoms, that constituted his particular disease, is what gave you the very

basis to measure change.

Trevor

January 7, 2010

Hi Thea,

I have seen, met, and worked with many Qi gong masters throughout my sojourn.

Everyone one of them worked hard to achieve the level of ability that they had.

The perceptions that they had of the world were trained, which thus implanted

into their subconsious memory, methods from which to draw upon.

As I said " a thousand times slow, for one time fast " . The moves that an aikido

master will use when jumped are ones that he/ she had practiced over and over

again until it was second nature.

Once a herbalist has read a book on plant usage, listened to a teacher/ healer/

doctor/ human describe a plants usage, that herbalist now has information within

them to draw upon when needed. This is much different than one who has only

gained their info via meditation and communion with the plant, and has not

received any other external input that would other wise taint their subconscious

thinking. And to tell you the truth, in my 20 years of herbal practice, I have

yet to meet one of the later.

Trevor

January 8, 2010

Hey Trevor. I see that we are having different conversations. I was

discussion methodology; you are discussing only results. To me, unless

a healer is getting results, there is no point in discussing

methodology with them-- they are not even a healer.

So, your " main point " and mine are very different here. Ah well.

Thea Elijah

On Jan 7, 2010, at 8:02 PM, trevor_erikson wrote:

> Hi Thea,

>

> Your story validates my point. You and the patient measured success

> based on the symptoms he presented when he came to you, and which

> changed via your treatment. The way in which you gathered your

> information and the process by which you came up with a

> pathomechanism is irrelevant, ie the bit about " Metal constitution,

> with Wood as his first Within and Water as his second Within " , as

> these are only attempting to explain why the patient is having the

> symptoms that he is having. As far as the reasons for a particular

> problem manifesting, there is an endless way of looking at this.

>

> The main point is that your patient came to see you with a

> complaint, ie disease, and then experienced relief of his complaint,

> disease, from your treatment. One can fill in the blanks in regards

> to pathomechanism as one wishes.

>

> If your patients symptoms of kidney disease did not change, what

> would you have to prove to him that your treatment was successful? I

> don't think that he would be that happy if you told him that his

> wood was more patient. His collection of symptoms, that constituted

> his particular disease, is what gave you the very basis to measure

> change.

>

> Trevor

>

January 8, 2010

Thea,

I've thought about this as well. Especially it seems the people who get

into Chinese medicine, tend to be more right-brained thinkers, more

right-brained than allopathic physicians anyway. This is dualistic

thinking, but correct, I believe. I've noticed that the students who can

utilize whole-brained thinking tend to become the best physicians. The

predominately left-brained guys have stern-faced difficulty in allowing

their bodies in connecting with Qi and have the hardest time trying to

understand the paradigmatic, fractal-type of diagnosis in TCM. (just my

opinion). The far right-brained type of thinkers have no problem connecting

with Qi and thinking about the big picture of diagnosis, but tend to

struggle with memorizing the myriad herbs, points and formulas that are

necessary to create the architecture of a treatment.

Left-brained thinking: small details, linear, analytical, more yang

Right-brained thinking: big-picture, fractal, creative, more yin

How do we integrate both sides of the coin? Games, partner-activities,

group-activities (encourage community building), doing presentations,

writing papers (encourage whole-brained thinking), doing Qi gong, meditation

(cultivates holism).

For teachers, telling stories, doing visual presentations, doing

demonstrations.

Listening to linear lectures and taking multiple-choice tests creates boring

people.

I've noticed that right-brained people especially love participation-type

activities, where their own creativity and interpretation can come into

play. Left-brained people would rather sit and analyze what the teacher is

saying. They would rather assimilate the information, than accommodate the

data. In other words, most of us are biologically programmed to input info

into our brains that makes sense with our conditioning. If the info doesn't

vibe with what we already know, we throw it out into the recycling bin. If

you filter too much, you become a mono-tone, mono-chromatic machine. If you

have no filters, you go crazy. The empty-mind idea is to keep the glass

half-empty and half-full at the same time.

How do we make whole-brained thinkers? I've been learning a lot from

watching my son's PBS educational shows... colorful images, song and

movement... combining positive emotional stimulus with cognitive growth.

ie... having fun and learning at the same time.

K

--

""

www.tcmreview.com

January 8, 2010

Trevor,

This is an interesting concept.... the non-dualistic thinking that logic is

not separate from intuition, but that they inform each other, as darkness

illuminates the light, per se.

It's been theorized that ancient peoples who heard the voice of God were

actually hearing the other side of their own brain, but weren't aware of

that. We superstitiously say that this info comes from past-lives, from

channeling the ether, from our psychic development etc.... but isn't this

just ego-thinking? Isn't all of this available to all of us, unveiling

itself from the other side of the curtain (the true meaning of the Wizard of

Oz).... from the other side of the corpus callosum? I agree that intuition

can be compared with creativity, as re-creation can be compared with

creation. Intuition is that thousand times of wax-on and wax-off, so that

the movement becomes second-nature. Creativity is bringing the

sub-conscious (chaos) into consciousness (order). How can there truly be

any separation?

A question is should we as medical practitioners also wear the hat of

priest, shaman, artist?

In tribal/ clan societies these responsibilities often fall on one person.

Is this still useful for today's societies? or should we let the priests

do their jobs and for the doctors do theirs?

K

On Thu, Jan 7, 2010 at 11:31 AM, trevor_erikson <trevor_eriksonwrote:

>

> This whole idea of intuition versus conscious thought can be quite murky,

> as it seems intuition is the ability to pull out ideas from a pool of

> already learned/ memorized facts. So if this is the case, can not logical

> analysis be an intuitive process? What is truly the difference?

>

> One of my early martial arts teachers used to have us practice the same

> move over and over again, saying " a thousand times slow for one time fast " .

> Meaning our ability to make quick intuitive responses is better when we have

> installed the memory of what to do, when.

>

> Intuition seems to be a learned process. Can intuition not be from an

> internal logical process where by we are looking at all the possible

> scenarios and deciding the best way to go. What tells us the best way? A

> learned memory, which thus becomes intuitive.

>

> Years ago, my wife used to see an " intuitive healer " for her eczema, who

> was considered to be one of best in Vancouver. At $150.00 an hour you would

> think so. This healer told my wife that her skin problem was stemming from a

> deep emotional imbalance of unresolved anger towards her father. The healer

> convinced my wife to come for several treatments to work on the emotional

> imbalance and that her " intuition " told her that my wife should also use

> colloidal silver externally on her skin.

>

> Well after many months, wife's eczema was no different. She had lost almost

> 2 thousand dollars on treatments. Why did the healer suggest the Colloidal

> silver? Well it was probably because she had read an article about it in a

> health magazine, so the memory of it's use was installed, from which she

> pulled out during her intuitive process, as needed.

>

> Now what if this healer had actually studied Chinese medicine? Well then

> she would have more info to choose from for her intuitive process. What if

> this healer went even further and actually studied particular protocols for

> the wide range of differing skin diseases. Then her intuitive process would

> be that much more refined wouldn't it be.

>

> My wife went on a year later to see my mentor of , Dr

> Kingson Wu, and guess what? Three months of herbal treatments, with no

> mention of the anger towards her father, and her skin cleared completely. 8

> years after stopping treatment and she has not had any recurrence of eczema.

> She was basically cured.

>

> Sure prodigies like Mozart exist, coming into this world with amazing

> abilities to master their craft without much external guidance. But I would

> say that they are the exception, not the rule. The reason the Chinese wrote

> out so much theory on herbal medicine, using case study and mentor ship to

> teach, was because they realized the importance of having grounded/

> memorized/ consciously gathered information from which to choose from when

> needed.

>

> Intuition is mostly a learn and recall system. Logical analysis is not

> necessarily a separate process.

>

> A thousand times slow, for one time fast.

>

> Trevor

>

--

""

www.tcmreview.com

January 8, 2010

Hi Thea and Trevor,

While I was reading what you were writing I thought about Einstein and how he

would imagine something that was totallyÂ ridiculousÂ to most people, like what

would it be like to travel on a light beam at the speed of light. I think this

type of imagination has a lot to do with intuitive healing.

Patrick

--- On Thu, 1/7/10, trevor_erikson <trevor_erikson wrote:

trevor_erikson <trevor_erikson

Re: teaching diagnostic thought process

Thursday, January 7, 2010, 5:17 PM

Â

Hi Thea,

I have seen, met, and worked with many Qi gong masters throughout my sojourn.

Everyone one of them worked hard to achieve the level of ability that they had.

The perceptions that they had of the world were trained, which thus implanted

into their subconsious memory, methods from which to draw upon.

As I said " a thousand times slow, for one time fast " . The moves that an aikido

master will use when jumped are ones that he/ she had practiced over and over

again until it was second nature.

Once a herbalist has read a book on plant usage, listened to a teacher/ healer/

doctor/ human describe a plants usage, that herbalist now has information within

them to draw upon when needed. This is much different than one who has only

gained their info via meditation and communion with the plant, and has not

received any other external input that would other wise taint their subconscious

thinking. And to tell you the truth, in my 20 years of herbal practice, I have

yet to meet one of the later.

Trevor

January 8, 2010

HI Thea,

I actually think we are discussing something similar, which is whether or not

the name of a disease is important or not. From the example you gave, I

suggested that the disease name is important because you yourself used the

symptoms of your patients " disease " to validate progress.

All I am trying to point out is that we need to have a somewhat clear point A

from which to start and then, through treatment, arrive at a somewhat point B.

The A and B may not be super clearly defined, but the difference between them is

somewhat measurable and appreciated by the recipient of the treatment.

Basically a disease name needs to be established. Any name will suffice,

particularly if it somehow conforms to an already agreed upon set of signs and

symptoms. This gives us a place from which to start our search for the

underlining patterns of the particular individual that is manifesting them. Then

treatment is applied and we hope for a resolution of the originally defined

starting point- or disease name.

Because Chinese medicine is full of so many different and rich currents of

tradition there is of course going to be differences, perhaps in;

1) the defining of disease, as different schools may see different signs and

symptoms, or collections of them, to mean different things, and may have

different names for them.

2) the language around pathomechansim and pattern differentiation, which

describes the process by which the individual is displaying the collection of

signs and symptoms

3) the particular treatment style- types of herbs, their respective doses,

length of treatment, etc.

It can be a truly exhausting experience to try and actual study and learn ever

different traditions approach to medicine, if not impossible!

The commonalities that I see and which is what I am most interested in, is that

every one has to start somewhere. The starting point has a name, which I would

call the disease name. That could be: headache, depression, insomnia,

constipation, etc. They may even have several of these starting points all

grouped together, and perhaps this group even has a name for itself.

So any ways, to me this is a methodology. One that requires constant openness,

awareness, learning, study, analysis, intuition, and reflection.

As for your comment, " To me, unless a healer is getting results, there is no

point in discussing methodology with them-- they are not even a healer. " This is

actually a big topic that I don't think many dive that deeply into. How many

practitioners really know how well they are doing in clinic? What kind of self

evaluation method are they using to judge?

I have met many practitioners who become so busy with their professional lives,

running a clinic, running a business, caring for their families and trying to

balance everything, who really do not take the time to reflect back on their

cases. Patients come and go through their clinics who are so easily forgotten.

I have chatted with many Doctors who actually do not know what their overall

success rates are like. They know they get some successes in some people and

they know that they don't in others. But they have no idea of where that line

is. They have been basically swept up in there busy-ness.

I remember a Teacher telling me (actually perhaps it was Sharon) that, unless

we take the time to reflect on our past cases- see what worked and what didn't

and why, then we could let 30 years of valuable clinical experience pass through

our finger tips and basically retire without learning anything. I remember Jason

writing how he likes to keep a clinic journal to scribble down his thoughts on

individual cases, which truly is a brilliant idea to be able to make sense of

the work we do.

I know that I am personally guilty of this at times, and that I have to

consciously make a strong effort to step back and reflect. Not an easy thing to

do, but definitely humbling and necessary.

Thoughts?

Trevor

, Thea Elijah <parkinglot wrote:

>

> Hey Trevor. I see that we are having different conversations. I was

> discussion methodology; you are discussing only results. To me, unless

> a healer is getting results, there is no point in discussing

> methodology with them-- they are not even a healer.

>

> So, your " main point " and mine are very different here. Ah well.

>

> Thea Elijah

>

> On Jan 7, 2010, at 8:02 PM, trevor_erikson wrote:

>

> > Hi Thea,

> >

> > Your story validates my point. You and the patient measured success

> > based on the symptoms he presented when he came to you, and which

> > changed via your treatment. The way in which you gathered your

> > information and the process by which you came up with a

> > pathomechanism is irrelevant, ie the bit about " Metal constitution,

> > with Wood as his first Within and Water as his second Within " , as

> > these are only attempting to explain why the patient is having the

> > symptoms that he is having. As far as the reasons for a particular

> > problem manifesting, there is an endless way of looking at this.

> >

> > The main point is that your patient came to see you with a

> > complaint, ie disease, and then experienced relief of his complaint,

> > disease, from your treatment. One can fill in the blanks in regards

> > to pathomechanism as one wishes.

> >

> > If your patients symptoms of kidney disease did not change, what

> > would you have to prove to him that your treatment was successful? I

> > don't think that he would be that happy if you told him that his

> > wood was more patient. His collection of symptoms, that constituted

> > his particular disease, is what gave you the very basis to measure

> > change.

> >

> > Trevor

> >

>

January 9, 2010

A couple days ago, Trevor began a posting with the following:

" This whole idea of intuition versus conscious thought can be quite murky,

as it seems intuition is the ability to pull out ideas from a pool of

already learned/ memorized facts. "

People are not random access cognitive machines. Intuition comes from the

feeling aspect of being -- based on the totality of one's experience. Facts

are discrete bits of info, and intuition provides relationships. It's like

the difference between digital and analog.

Relative to CM, I believe there are many important type of experience to

nourish intuition. Certainly, one of those is study of information (facts),

but that is certainly not the only one, and sometimes not the most

important. Information alone without an embodied relationship with CM can be

very misleading. That relationship comes in part through practicing CM,

though it is also supported my deepening one's relationship with one's own

being and healing process. I believe that intuition is peculiarly important

in CM, because our individual experience as embodied spirits can inform it

so profoundly -- we are each living exemplars of the Dao in microcosm.

Steve

January 9, 2010

On Jan 9, 2010, at 10:05 AM, Steven Alpern wrote:

> Facts

> are discrete bits of info, and intuition provides relationships.

> It's like

> the difference between digital and analog.

Can you say more about this? I am still slogging my way through the

creation of an article about euclidean versus fractal mind, and it is

right on this beam. I'm having trouble writing anything shorter than

a book, and maybe you can help me out here. Yes it is exactly the

difference between digital and analog, literally-- and figuratively,

but only to a fractal mind!

thanks--

Thea Elijah

January 9, 2010

My message about intuition was really only trying to say that much of intuition

involves memory, which is the same for cognitive analysis. Sometimes it is hard

to differentiate the two from each other.

As an example, in High school I won the Grade 12 electronics award for ability

to " diagnose " pretty much every other students project that didn't work. Every

one thought I was some type of brilliant genius with super skilled intuition.

But in reality all I was doing was using a memory of past experiences I had had

with other projects, combined with logic to determine a step by step

understanding of what could go wrong. Most of the time it was just a simple

break in the power supply.

Why do certain ideas come to us in the clinical setting, when faced with a

person who is suffering. Where does the diagnosis, pathomechansim, and treatment

method come from? Can anyone here say that they learned via

direct transmission with the ether, and did not receive any training from any

person, video, computer, book, etc? I truly believe that No one can. Everyone

has been influenced by someone else and has received information that they

utilize in clinic.

I agree that Humans are not computers, or machines. Our memories are stored in

very complex methods. Facts and feelings are often times mixed together, so that

ones ability to recall a fact is via an emotional experience, and vice versa.

As John pointed out, the whole left brain/ right brain dualistic thinking can be

tricky. They are not as separate and isolated as Man wants to make it to be. Our

mind and body are a united whole, existing in unison with one another. Intuition

and conscious analysis may be different terms/ experiences, but they are not

necessarily separate from each other, and in fact support each other.

In order to make intuitive decisions, I may need a basis of learned facts from

which to base my decision on. If I have an intuitive feeling that my patient has

such and such a diagnosis, then to even mutter such and such I need to have some

type of learned terminology from which to explain my process. That terminology

will have been defined, learned, and memorized.

Let's say we see a patient who is very agitated, angry, and is buckled over in

abdominal pain, or whatever. We may get this intuitive image in our minds and

feelings that this persons anger is causing the stomach ache. To put that

feeling into something useful, in terms of treatment using Chinese medicine, all

of us learned a system of terminology. That terminology defines certain

phenomena for us, so that when we are having these intuitive moments, we can

quickly name it, " ah yes, this is wood attacking earth " or whatever.

Perhaps when we were growing up we witnessed our father always complain of

stomach pain, right after he had a fight with our mother. We had already

witnessed and memorized a relationship that became part of our intuitive process

for us to use, years later in a clinical setting.

Emotions, facts, intuition, conscious or unconscious analysis, memory; are too

easily mixed up. To me they truly support each other and are necessary for good

clinical judgment.

Trevor

, Steven Alpern <stevenalpern

wrote:

>

> A couple days ago, Trevor began a posting with the following:

>

> " This whole idea of intuition versus conscious thought can be quite murky,

> as it seems intuition is the ability to pull out ideas from a pool of

> already learned/ memorized facts. "

>

> People are not random access cognitive machines. Intuition comes from the

> feeling aspect of being -- based on the totality of one's experience. Facts

> are discrete bits of info, and intuition provides relationships. It's like

> the difference between digital and analog.

>

> Relative to CM, I believe there are many important type of experience to

> nourish intuition. Certainly, one of those is study of information (facts),

> but that is certainly not the only one, and sometimes not the most

> important. Information alone without an embodied relationship with CM can be

> very misleading. That relationship comes in part through practicing CM,

> though it is also supported my deepening one's relationship with one's own

> being and healing process. I believe that intuition is peculiarly important

> in CM, because our individual experience as embodied spirits can inform it

> so profoundly -- we are each living exemplars of the Dao in microcosm.

>

> Steve

>

January 9, 2010

On Jan 9, 2010, at 2:18 AM, trevor_erikson wrote:

>

> As for your comment, " To me, unless a healer is getting results,

> there is no point in discussing methodology with them-- they are not

> even a healer. " This is actually a big topic that I don't think many

> dive that deeply into. How many practitioners really know how well

> they are doing in clinic? What kind of self evaluation method are

> they using to judge?

>

Call me a fanatic, a hard-ass or a snob, but this is my idea of basic

rigor. I tend not to put a whole lot of faith in what anyone thinks

unless I am impressed by what they actually do (and how they interact

is part of what they do-- are you always a healer, or only in the

treatment room?).

One of my favorite but arduous ways of doing self-review is taking an

apprentice. My current apprentice is nobody's fool, and he busts me

totally if I am vague or lazy. He is hungry for mastery and so he

evaluates my work with an exacting eye. It makes me cringe sometimes

and it makes me grateful. I learn so much by having to explain myself

to someone else, and knowing that someone else is looking for reasons

to keep studying with me-- or not.

Small study groups with peers are great, doing case reviews-- or

what I love is actually seeing clients together with another

practitioner, maybe only just for one day twice a year, but it's so

incredibly eye-opening.

and, of course, posting here can be part of that exploration.

As to disease names,

On Jan 9, 2010, at 2:18 AM, trevor_erikson wrote:

> I actually think we are discussing something similar, which is

> whether or not the name of a disease is important or not. From the

> example you gave, I suggested that the disease name is important

> because you yourself used the symptoms of your patients " disease " to

> validate progress.

>

The lines of conversation have gotten a bit muddied, which is

understandable, but if I read you correctly originally you were

speaking of something more subtle and exciting (at least to me). You

were speaking of rigor and precision in the naming of disease, and its

impact on differential treatment. The disease name was important, you

suggested, for much more than its simple effect of having an agreed

parameter for measuring progress towards wellness.

I respect and enjoy well-made fine distinctions, but my own focus has

not been so much in the fine distinctions of disease. I've been more

focused on the fine distinctions of constitutional wellness. I'm not

saying " My way is better; " I'm saying Oh, how interesting. Let's

learn from each other.

Your way, and the various ways that you speak about, are all different

ways of mapping illness. There is also mapping health. It's like

looking at the same situation from the other end of the telescope.

Clearly Chinese medicine is about both. So much of the classical texts

like the Su Wen etc are not about how to cure illness but about how to

create wellness. It's a different focus, one that is non-exclusive

and complementary. It takes your mind into a different discipline,

though... It makes a person engage and attune differently, like

switching your guitar from a classical to a flamenco style tuning.

My sense is that the left-brain types are much happier mapping

illness. It's a deductive analytical process. The more right-brain

types are happier using inductive synthesis to map and foster health.

Yin and yang left and right, it's a reciprocal process-- or should

be. Naturally, as we foster health, we should see illness falling

away. Just so, when we clear illness with Chinese medicine, we should

see wellness emerging. Western medicine has, by and large, completely

forgotten this-- and when we forget it, Chinese medicine will have

lost its soul in the West.

I've been playing around with more differential disease attunement

this week, though-- shall I send some of what I am playing with, and

you let me know if I'm getting the hang of it?

Thea Elijah

January 9, 2010

John, Thea, et al,

I have been lurking on the fringes of this thread reading the various

arguments and probing my own right and left brain to find a way to

contribute meaningfully to this conversation. The original arguments (mostly

between Thea and Jason, and later Trevor) were, honestly, not very revealing

to me. I found it mostly one person, Thea, who, for whatever reason, could

not fully express herself and that mostly one person (Jason) was hammering

her for the words she laid on the page without offering her a hand (at least

a kind hand) in fleshing out her ideas, instead forcing her to refine the

way she explained herself. Of course Sharon's discourse was likely the

clearest of the bunch, but I find that what I think Thea is staying is very

important to the profession and it was the post below from John that gave me

an easy opening for me to step through (and it's Sunday morning and I have a

few moments).

So, out of all this bantering John posed the following questions: " A

question is should we as medical practitioners also wear the hat of priest,

shaman, artist? In tribal/ clan societies these responsibilities often fall

on one person. Is this still useful for today's societies? or should we let

the priests do their jobs and for the doctors do theirs? "

This puzzles me in a way, I find that most of the best practitioners I know

are artists (of some sort or another) or have allowed themselves to be open

to both sides of the brain, whether they are willing to talk about it or

not, matters not. I think that if you look closely at people and the way

they conduct themselves it is not very difficult to see these attributes (or

not) in people. Jason is now saying, " OK, what are they? " and to that I

would say, " Slow your mind, close your eyes for a moment, breath deeply and

when you open your eyes, you tell me. " Of course he is now saying, " But if I

don't know what to look for how will I know if I see it? " and to that I

would say, " Repeat this exercise until you do know what you are looking

for. " Jason, please forgive me for putting words in your mouth, but you act

on this list as the analytical (left brain) archetype and thus the perfect

person to use in this example, hope you can accept this as a mere example

and I am not saying you said this only that you tend to say things like

this, and there is nothing wrong with the things that you say or the

questions that you ask, they are quite valid. I also think that Thea's

points are valid, but I think that she is not used to communicating them in

this style and thus does not always express accurately what she really

means/believes/feels/practices.

So, can we separate the right and left, intellect and intuition, scholar and

artist, etc. to that question I say, " yes and no. " YES, because modern

western society (Really it is not all that modern but modern western society

has created the largest separation in history.) pushes us to do so and so

many people do, and NO, because we are human and it is inescapable, or at

least it is my belief that it should be inescapable as I believe that to

work with only one side of your brain is to leave yourself short by some

half of your capacity as a human. I strongly believe that those who work to

develop both aspects of themselves will be the best at anything that they

endeavor in and I think this is particularly true for doctors/healers or

whatever you choose to call yourself. While it is true that I have met many

doctors here who are quite amazing and do not, to my knowledge, engage in

any sort of right brain activity, I would be willing to guess that most of

them do in the privacy of their own home, and certainly in the past things

like caligraphy and poetry were considered very important for the

development of a person's character and, although I don't have a source for

this at the moment, would be willing to bet the the vast majority of the

great doctors throughout the written language world have engaged is some

form of artistry as a way to " commune " with that right side of their brain.

And I would be willing to bet that most of them recognized that this

practice was very important to what they did clinically, whether they ever

expressed it or not, or even thought much about it.

So John, to your above questions #1-Yes; #2-Yes; #3-that is your personal

choice, but I lean in toward the No column.

And, while I agree that practice (repetition) informs intuition, I don't

think that simply practicing will allow one to freely access that intuition,

in order to do that you must also practice using that right side of your

brain.

So, in my eyes you have a choice. You can work with half your brain or with

all of it, to me this seems quite simple, but then I work comfortably with

both sides, integrating them as I believe works best for me.

In the end, I love a good debate and those of you who know me know that I

will fight tooth and nail in a debate, but that, for me, is just an exercise

for my right brain, while in the morning I prefer to get up around 5:30,

sit, have a cup of coffee, practice calligraphy (or at least writing

characters, whether anyone would call it calligraphy is questionable),

perhaps read some poetry or write some, etc. While most of my day is

relegated to the left brain, I strongly believe that what we do to engender

the right brain and remain open to allow the two to be connected makes us

better practitioners, and indeed, humans. And yes, I think that is

measurable, but I doubt anyone will be wiling to design a study to prove

it....it would take many years (read: a lifetime).

My two fen!

In Good Health,

Thomas