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Acupuncture Is Having an Identity Crisis

By David Simpson

Growing interest in acupuncture has led to several unfortunate attempts to label it. Complementary and Alternative Medicine, Acupuncture and Oriental Medicine, Traditional Chinese Medicine… Acupuncture gets tossed willy nilly among these different rubrics.

Not only is this inconsistency confusing for patients, but all of these names present a number of difficulties in accuracy, cultural respect, and sensitivity.

The argument against CAM, biomedicine’s preferred name, has to do with its dismissive connotations. Patients often expect CAM treatments to be free—indeed, “complementary” sounds a lot like complimentary. As for “alternative,” acupuncture critics jump on this as an opportunity to accuse acupuncturists of influencing unsafe medical decisions. While some people opt for acupuncture in lieu of certain routine medications (to avoid debilitating side effects), I have never met an acupuncturist who touts his offerings as a cure for cancer.

AOM, despite the acupuncture professional community’s warm embrace of it, is inappropriate for its pejorative reference to “Oriental.” The term belittles not only the acupuncture profession but also nearly half the planet.

The Trouble with ‘TCM’

Within this tyranny of language it has been posited that acupuncturists rally around Traditional Chinese Medicine, or TCM. It’s true that acupuncture is thousands of years old, has origins in China, and is a form of medicine. However, TCM is merely a subset of acupuncture theory, making it too an inadequate moniker.

From 1940 to 1976, under Mao Zedong’s leadership, China experienced its Great Leap Forward and Cultural Revolution. China was revamped completely in order to compete with Western civilization. As part of this movement, Mao created the Ministry of Public Health, facilitating the elimination of a centuries-old lineage-based model of acupuncture. He supplanted it with a nationally standardized version—TCM.

TCM is an appropriated term and model, representing an amalgamation of theories to better interface with Western medicine. The benefit is that it gives previously disparate practitioners a common language with which to discuss patients. For example, someone with asthma might be diagnosed with Lung Qi Deficiency.

However, “Lung” under the TCM model diverges from its true acupuncture meaning, which has just as much to do with the Lung’s function as with the physical organ. TCM is heavily based on pathologies of six Yin and six Yang organs, and places great emphasis on specific point indications.

True “traditional” acupuncture favors the interdependent relationships of meridians and organs over set-in-stone points’ effects on organs. Instead of function begetting form and vice versa, as is true of pre-Mao acupuncture, form and function were differentiated with the advent of TCM.

TCM also eliminates China’s beautiful pragmatic holism. Pre-TCM acupuncture theory was not just a form of medicine. It was a way of describing and understanding the entire universe. But China’s Cultural Revolution, in an attempt to mimic Western ideals, did away with anything that incorporated intangible realities.

For example, Five Element acupuncture, a style that focuses on emotions and spirituality, is grounded in many of the precepts of pre-TCM China’s principle acupuncture texts. Despite its popularity in the West today, Five Element acupuncture is explicitly invalidated by TCM.

Given the pluralist and syncretic traditions of acupuncture, neither TCM, CAM nor AOM are appropriate labels for our medicine. However, the failure to secure a defining name for acupuncture may be a good thing.

The Dao De Jing, a principal acupuncture text, says, “The Dao that can be known is not Dao.”

Perhaps we’re searching for something that cannot be found. Perhaps the best name for acupuncture is, well, acupuncture.

Photo by Sara Calabro

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Comments

Eddie Young
Reply

Young David,

A throw back to class, when your wisdom, line of argument and thoughtful processing of the information were always a pleasure to hear, is well represented here. I too am of the opinion that Acupuncture should be called, well, Acupuncture – great last line. Hoping this finds you well and enjoying the harvest of your hard work.

Eddie

David Simpson
Reply

Eddie,

Yes, a throwback indeed. I’m hopeful that I’ve graduated into a more respectful line of argument on the whole matter – same passion, less bite. I appreciate your reading and your agreement on “calling it like it is.” I hope to have more like this in the future. We open people’s perspectives all the time, what better a group of perspectives to open than our own?

Best,
David

abby miller, l.ac
Reply

Seriously, not sure if all continents in reference to medicine don’t have their own special identity crisis going on as well. There seems to be a race to the top, and yet, no clear definition what the “top” is?
Our need to pigeon hole this medicine is possibly an offspring of a different dysfunctional thought process all together.
I am just so thankful we can learn the theories and practice this amazing medicine.

David Simpson
Reply

I don’t think there is a continental, or geopolitical identity crisis going on with any other field besides our own. This is evidenced I feel, by no other medicine referencing its point of origin or any location for that matter. Egyptian surgery? Nope. German pharmacy? Nope again.

However you correctly point out that western culture is obsessed with “one answer” – one that can change over time, but one at any given time. Eastern culture and by natural extension, medicine, has never been concerned with that. “One formula, many diseases. One disease, many formulas.”

Whitsitt
Reply

5 Elements acupuncture has about as much to do with pre-TCM China as Wicca has to do with the indigenous spiritual practices of pre-Christian Europe. Not to say that 5E (or Wicca) doesn’t have something of value for folks, but it’s not any more authentic than TCM.

David Simpson
Reply

Whitsitt,

I don’t quite understand what you mean by this, and I believe your analogy of equating Five Element Acupuncture to a branch of modern Paganism to be both incorrect and incindiary. JR Worsley studied Five Element acupuncture in the mid-1900s in Korea, Singapore, and Taiwan with Classically trained teachers. Here, “Classical” is used to distinguish from “Modern,” i.e. “TCM.” Five Element acupuncture puts a central focus on a person’s mental and spiritual well-being, making frequent reference to the Shen and it’s five components. The concept of “Shen Disturbance” is not mentioned in TCM, and practices like Qi Gong were out-lawed. There is a wealth of information at the Worsley Institute and Tai Sophia that can elucidate the differences between this Classically-focused acupuncture paradigm and Traditional Chinese Medicine.

Additionally, the point of the article was not to argue the authenticity of any of the paradigms, but to show that TCM is an exclusive term that is insufficient to describe the entirety of the profession. To borrow your religious theme, it is the difference between the violent division between Christianity with Paganism, and the calm amalgamation of Buddhism and Shinto.

Ka Hang Leoungk
Reply

Very well said, David.

Over here complementary medicine encompasses therapies ranging from acupuncture to herbal medicine to reiki to crystal healing.

Push comes to shove I much prefer the label “alternative medicine” but I would rather we were known just under “acupuncture”. Most of my patients have no idea what TCM stands for although they do know about “Chinese medicine”.

My main concern is emphasizing the difference between traditional acupuncture and dry needling. I have had quite a few patients visit my practice claiming to have had acupuncture and then get quite confused (and/or emotional) because it feels completely different. It turns out that they’ve had acupuncture from physiotherapists for shoulder pain and certainly wasn’t expecting the effects of Taichong!

Sara
Reply

Thanks for sharing your perspective, Ka Hang. Such an interesting discussion!

Sara

David Simpson
Reply

Thank you for your thoughts. Indeed, many patients haven’t idea what TCM means, or they come in thinking that TCM is something that they can be given like an aspirin.

I personally shy away from “alternative” medicine because in actuality, the AMA brand of medicine is the “alternative.” Medical professionals were using acupuncture and herbology and their associated paradigms long before current “Standard Care” medical models were established.

And I agree with you that acupuncture vs dry-needling is a big issue, and one that threatens acupuncturists’ scope of practice. A physiatrist, physical therapist, or any non-trained or even 300-hour course trained physician is going to be a poor substitute for a true acupuncturist. Dry-needling techniques are in my opinion, a great substitute for procures such as trigger-point release that would otherwise be done with a more traumatic instrument such as a hypodermic injection needle, but are simply symptomatic and are no substitute for a complete acupuncture treatment.

That however, is a much bigger issue that deals with patient/PCP information and knowledge.

Rachel Hartstein
Reply

I so agree with this topic and your arguments! “TCM” leaves out so many people, and so much of what we do. However, “acupuncture” ay leave out much of what we do as well (cupping, moxibustion, bloodletting, etc which is well within our scope of practice – at least here in MA – as acupuncturists) and may also alienate those needle-phobes. I’ve been using the acronym TEAM (traditional East Asian medicine) instead of OM for the obvious reason, plus I really like that the acronym itself implies that I am part of a patient’s healthcare TEAM!!!

Sara
Reply

TEAM! Love it, Rachel! Thanks for sharing.

Sara

David Simpson
Reply

Rachel,

Thank you for your thoughts. You are right I think, in that “acupuncture” is the world’s best kept secret. My argument for acupuncture itself is both for simplicity and for precedent. As one example: surgeons use scalpels, retractors, forceps, drills, and a litany of other tools and are still just “surgeons.” I believe that professional titles carry with them their entire scope of practice.

As for folks who are needle phobic, they won’t come to an acupuncturist anyway. Acupuncture with needles I feel, is the “least weird” of what we do. Offering a needlephobe the alternative of drinking-glass sized bruises or burning herbs on their body, is not offering sufficiently comforting options.

As for TEAM, I think that is best used in individual practice, but not as an industry standard. The majority of practitioners I would argue, as TCM practitioners, are not “traditional” as I stated above. And based on my experience in that region of the world, “East Asia” does not understand what East Asia is as a concept, and it excludes European developments of the medicine.

But for your practice and as a way to differentiate, I say go for it!

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