Acupuncture and Trauma

As I continue with my pre-medicine studies this year, I have come full circle back to one of my initial interests in acupuncture: treating trauma.  When a person has gone through a traumatic event or events, the brain may have difficulty processing what has happened.  This may leave a person with both lingering psychological and physiological symptoms that interfere with daily life.  There are many methods in acupuncture and Chinese medicine that can aid people, enhancing both the therapeutic process and recovery.

While using acupuncture directly to treat trauma is the most direct way for an acupuncturist to help healing, some people may find the idea of needles themselves to be fear inducing.  Needles don’t have to be involved in order for the system behind acupuncture and Chinese medicine to be of service.  Acupressure, acutonics (the use of tuning forks at acupuncture points), Japanese-style acupuncture, tuina and shiatsu can all be utilized to work around this, minimizing exposure to a triggering medium.

Bessel van der Kolk, one of the leading experts on trauma in the United States, passionately expounds on the need for integrative methods in treating trauma in his book, “The Body Keeps the Score“.  In it, he finds that one of the most common methods that people used to recover from the trauma of 9/11 was acupuncture.  While he doesn’t specifically explore acupuncture and Chinese medicine directly, massage and treatment methods that involve helping body and mind integrate and relax are. It is in this way that East Asian medicine can benefit people who have gone through trauma.

While I don’t currently have a practice set up as I study and prepare to get into medical school, I am excited about continuing my journey as a practitioner while going in this direction.  I am passionate about remaining up to date on integrative and complementary methods of treating trauma, and look forward to being a part of people’s healing process.

Counter to…

I read an opinion piece today in the New York Times titled “How to Counter the Circus of Pseudoscience”.  As a practitioner of “pseudoscience” who aspires to go to medical school, many conflicting thoughts ran through my head, ranging from defensive to sympathetic.  The author is a medical doctor who is highly critical of naturopaths and Goop-inspired natural medicine.  Her main problem seemed to be the overconfidence of many “practitioners” (her quotation marks, not mine) in their scientifically questionable knowledge and methods.  While dismissing and invalidating the entire field of natural medicine and it’s “practitioners”, she also enthusiastically trumpets her own fields ability to reflect on their mistakes and know their limitations– “especially the good ones”.

What about the good practitioners of natural medicine?  Are they allowed to exist in this doctor’s paradigm?  Are we all quacks, with medical doctors alone holding the light to the afflictions of humanity?

What I found this author failed to acknowledge was a very common situation when a person goes to their doctor, and the doctor either can’t find anything medically wrong with them, or possibly even fails to address their needs.  It is here where natural or complementary medicine can be quite effective.  In my own practice over the years, I’ve seen many people with unresolved health problems, whose tests come back from their doctor negative, but who then find results through acupuncture and Chinese medicine.    Can I explain my treatment scientifically?  No, not completely.  Do people find relief from it?  Many times yes, and sometimes no.  And if I can’t help them after a couple of session, I refer then to someone who I think can, and suggest terminating the treatment.

Where I feel like this author went astray is her failure to recognize that people want help with their problems, and if doctors don’t have the softer tools to help them, they’ll look for someone who does.  Neither does she differentiate between natural health “practitioners” who are reckless with their belief that supplements and right living are cure-alls, and those of us who know the limits of our chosen medicine.  We do exist as a breed of natural medicine practitioners, who refer people back to their doctors, who don’t feel comfortable treating people without having the diagnostic testing to rule out more serious underlying conditions, who keep a vigilant eye out for red flags, and who are aware, for better and for worse, that the medicine that they practice isn’t and can’t necessarily be validated by science.

Like many in my field, I got into natural medicine because I wanted to help people, just like many M.Ds.  I thought natural medicine would make a good tool with which to partner with patients to find a preventive healthcare regiment that worked to keep them healthy, and would enable me to spend more time with patients than the average doctor.  I envisioned partnering with a patient’s primary care provider and any specialist they had to help keep track of the patient’s total wellness, each field complementing the others.  This was idealistic and somewhat naive of me, as that sometimes doesn’t even happen within the medical field itself.    So often, we find ourselves “counter to” the medical establishment, and the medical establishment often counters us.  But what if we worked with each other?

Opposition often breeds estrangement, resentment, and lack of trust.  The more the allopathic medical profession fails to see what natural medicine has to offer, the more natural medicine in inclined to dig in their heels and put blinders on.  What would things look like now, if instead of prescribing opioids as a blanket remedy for pain, doctors took the time to really investigate which types of pain issues tended to respond well to acupuncture, massage and chiropractic? What if instead of dismissing the entire natural medicine field as full of  “practitioners”, MDs, ARNPs, and PAs and nurses worked to find the ethical practitioners in the field?  Both fields have their bad eggs, but neither does itself or its patients any favors when it dismisses or downplays the other.

Grit and Your Health

 

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Angela Duckworth is a bit of a hero of mine.  Her book at TED talk on “grit”  has dramatically changed the way I look at myself and whether or not I’m “good” at something.

“Grit” is a funny word to stand in for tenacity, perseverance, determination and belief in oneself.  Before I came across her work, when I heard the word “grit”, I would think of sand in my swimsuit when I was a little kid, not a positive character attribute.  Now as someone who is trying to become “grittier”, the part of the word that implies an abrasive surface has become lessened.

As I’ve been thinking of grit recently, I’ve started to wonder about other applications for it than simply achievements.  What about grit in terms of health and healthcare?  What can patients, doctors, and other practitioners do to cultivate grit in the face of health concerns?

It’s easy when we’re told we have a health problem by a doctor or other medical provider to feel discouraged.  Why did it happen, we wonder, could it have been prevented, did we do something wrong?  It may feel like an affliction and cause us to feel depressed, or become an irritant that we try to ignore.  This may be part of the process of coming to terms with a health problem, but how can we as patients and practitioners shorten that time of grief and start building grit?

The way I’ve been thinking about it, “grit” in terms of a health problem is a steadfast determination to not remain limited by whatever condition you’re diagnosed with.  A condition like chronic pain can be extremely difficult to live with, and may lead people to depression and, as we’ve seen with the opioid epidemic, drug abuse.  We don’t want to have to deal with it, we want it gone.  However, this may not be realistic for everyone.   The road to minimizing pain in daily life may be long and arduous.  To deal with this optimally, multiple changes in how the pain is thought of may have to occur.  It may no longer be realistic to think of being entirely pain free.  Instead, days of minimal pain need to be appreciated for the relief that they are.  Multiple modalities of therapy may need to be consulted–physical therapists  and yoga to build up strength, massage and acupuncture for relaxing areas of tension and pain, and possibly even nutritionalists to make sure the body is being nourished in the way it needs.

Most of all, the spirit needs to be fed.  This may sound hokey, or possibly even new age-y, but it’s something essential in cultivating the belief that we as people in our bodies are worth working for.  In whatever spiritual context that fits most with an individual’s world view and paradigm, we need to tell ourselves that we can do it, that we have what it takes to make the most out of our lives whatever obstacle comes our way.  If we don’t have something that nourishes our spirit, it’s so easy to flag, to start off strong only to wind up feeling defeated.  To combat this, we need to find ways to inspire ourselves and keep our motivation going.  It’s a hard prescription, as its so individualized, but a necessary one.

Happiness?

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I think there is a general misconception about the state of happiness.

Here in the US, written into one of our founding documents, we find the phrase : “We hold these truths to be self-evident: that all men are created equal; that they are endowed by their Creator with certain unalienable rights; that among these are life, liberty, and the pursuit of happiness.”

These words have had a profound effect on the psyche of our country.  While originally, as the phrasing implies, the word “happiness” meant more the pursuit of wealth and a good situation in life, it’s meaning has morphed as time has passed.  Now that many of us take finding a decent situation for granted, the meaning of “the pursuit of happiness” has become something less tangible, more of a state of mind than anything else.  We should be joyful, we think, it’s our right to feel happy most of the time.  We want to follow our bliss, find endless affirmations around us, employ positive thinking to attract what we want in life.  After all, “happiness” is our right.

The thing is, life in the world isn’t a streamlined experience.  If you expect conditions that are conducive to your happiness to be present all the time, you’re going to be let down.  Crappy things can happen out of the blue, “ruining” what may have started out a good day/week/month/year, regardless of the positive thinking you’ve employed.  Nature is not predictable, and rarely is thinking things will continue on as they are indefinitely a good long-term strategy.  I don’t mean to sound bleak or like a downer.  If you look at it scientifically, a static system is a dead system–we’re all meant to exist in a continual dance of finding equilibrium.

In less obvious ways, I think this “pursuit of happiness” can affect the way deal with our health, physical and emotional.  Rather than a long hard slog to feeling mostly alright with a few crappy days every now and then, we want our pathological symptoms to go away, the sooner the better.  We want to be cured from what ails us, to overcome our flaws and endlessly improve ourselves.  Then, maybe, we can start getting down the the business of being happy.

But what if happy is learning to work with those symptoms, of accepting our limitations, and within those confines, appreciating, if not loving, our strengths?  What if happiness is that moment we stop trying to be this glowing, radiant magazine cover version of ourselves and reinvest that energy inward to taking a good long look at ourselves and being ok with that, however messy?

I’ve lately started to re-work what I consider to be “happy”. Maybe this is odd, but personally, I’m not a big fan of feeing giddy happiness–it feels too fragile, like sumptuous dessert to be enjoyed only every so often.  I much prefer to feel a calm sense of resiliency, the feeling that regardless of what happens, good or bad, I’ll be able to assimilate and adapt as needed.  Happiness as an appreciation of inner strength.  That way if today happens to be a cruddy day, or if illness befalls me, it becomes less of a catastrophe or set back than something that I can deal with, moment by moment, without feeling like I’ve been pulled away from my previously happy state.

This is a work in progress, an aspiration, but it feels useful.  It gives the sense that, bar anything horrible, I’ll be ok, and that’s a good place to be.  And the thing is, most of us are already there, if we just let ourselves appreciate that fact.  We’ve got this.

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HALT SAD

“Winter is coming…”

I’m not a Game of Thrones fan, but I did watch the first season before the brutality and violence towards women turned me off.  One of the facts of the world that this author created is that winter comes only every so many years, but it also lasts for years.  Even as a Pacific Northwesterner, where the winters are more dreary than freezing cold, the thought of a winter that stretches for years is slightly horrifying.

Here, more than enduring months of subzero temperatures and having to protect ourselves from the dangers of frostbite or hypothermia, we have Seasonal Affective Disorder, or SAD.   Today, when I was thinking of SAD, another acronym popped into my head, one taught to me by my godmother, who happens to be a therapist: HALT, which stands for Hungry Angry Lonely Tired.  The acronym is there to help people remember that if they’re feeling any permutation of those four sensations, it’s probably a good idea to stop and check in with yourself  before you act on how you’re feeling right then and there.  It’s interesting to think of how SAD and HALT are linked.  Both have a central commonality, which is to forget how things are when we’re not in the current state we’re in.  So, for my breakdown of how to deal with SAD here in the grey Northwest winter, I’ll divide it into H A L T.

Hungry:

Winter is so often a time of comfort food.  We crave the warmth and insulation that starchy, carb-y, fatty foods give us.  While I don’t believe in stressing out too much about what we’re eating unless it’s a radically unhealthy diet (check out this article from the New York Times), it is a good idea to check yourself to make sure that some of those warm, nourishing comfort foods are well-balanced.  Warm salads and soups are a good way to get in the vegetables that we might get in the summer through a nice crunchy lettuce based salad.

Angry:

Taking care of your emotional self during the winter months is incredibly important.  When it’s cold and rainy outside, we’re less likely to go out and exercise, which can negatively impact our mood.  Though not really anger, depression can feel worse in the winter when it’s dark at 4 o’clock and the world outside the four walls of our home is uninviting.  Depression, anxiety, and other mood imbalances can throw off our reactions to the outside world, and we can be reactive in ways we’d otherwise be able to work through.  Seeking the appropriate therapy for this is essential to being able to actually enjoy the seasonal introversion that winter promotes.  Talk therapy, exercise, art, herbs, meditation, or drugs can all be helpful, depending on the severity of the mood disorder you’re experiencing.  Too often people put a stigma on seeking the level of help they need either from a therapist or taking the medication they need.

Lonely:

Ah, loneliness.  Even worse than the stigma asking for psychological help, admitting to loneliness, even to oneself, can be hard.   Human beings are a strange species, both trapped in the essential isolation of their own minds, while simultaneously being completely dependent on one another to care for each other.  The internet age has offered us the illusion of social contact via websites like Facebook or Twitter, but for many people, social media can also be a trigger.  This wonderful article from Psychology Today gives some excellent tips on how to deal with loneliness whenever it rears its sad face.

Tired:

The dark days of winter can make some want to hibernate, but be aware of any overall drops in energy levels.  Vitamin D deficiency here in the Pacific Northwest can be a real problem for people.  The lack of sun and being outside in the winter can deplete the levels you spent the summer building up, so make sure to talk to a healthcare practitioner about what dose of D.

Your most constant companion

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Often, when beginners are given meditation instruction, they are told to pay attention to their breath, the feeling of air rushing in and out of their nose. While I occasionally like this method, it also trips me up.  I can become hyper-aware of my breathing, and it starts becoming forced and irregular.  Additionally, guidance may also be given to place ones hands on top of each other in your lap, touching your thumbs together.  I’ve always preferred to place my hands face down on my knees, feeling the pressure and stability of my palms as they rest, supported.

This past Saturday in my physics class, we began learning about dynamics, which is the sum of all the forces acting on us at a given time.  Forces do not come out of nowhere–they are the relationship of two or more objects.  While the teacher listed the various types of forces on the whiteboard, my thoughts latched onto the last one: gravity.  Gravity is the force acted on us by the earth; except in a rarified environment, we are always subject to it. My daughter, like most small children, performs a multitude of experiments to test gravity, dropping things from her high chair and other random places, watching as time and again, they do indeed drop down.  By the time we’re grown, we take gravity for granted, a banal fact of our existence.

When I thought of it, how gravity is a force and where there is a force there is a relationship, I was awestruck at the thought of gravity’s origin.  To picture the earth is to visualize it on some grand, cosmic scale-the view of astronauts looking out their window.   Yet when thought of in this context, the earth becomes intimate, something that we have a continuous relationship with from our first moments alive on to our last breath.  To take the time to feel the weight of our feet on the ground, our body as lies in bed, the feeling of our seat in a chair, is bring our minds into closer contact with that relationship we have with gravity, and consequently with the earth.  This isn’t mysticism–this is scientific fact.

As we go about our day and our lives, we endure many moments of hardship and stress.  Mindfulness is helpful for this, if you can catch yourself before being totally overwhelmed.  In these moments of strife, however, a meditative space can be hard to enter into, seemingly remote, reserved for monks and sacred places far from us.   Finding tools that remind us of those calm, clear moments are essential.  When I thought of gravity as a reminder of our relationship with the earth, it seemed to be a useful way of making that meditative peace and clarity both immediate and accessible.   When we’re feeling caught up in crap, disconnected from ourselves and struggling, we can sink our thoughts to our feet, to that point of contact with the ground below us.  When we feel that weight, the force of the planet’s gravitational pull, why not take the time to appreciate the force that holds us, the earth that connects and sustains us and all the other beings with this most constant of companions?

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