Transmitting Engaging Vitality

Transmitting Engaging Vitality

Chip Chace & Dan Bensky

One of the things we like best about the Engaging Vitality approach is that it is an excellent milieu for examining our own process, our assumptions about what we are doing at every stage of our practice. We are not only cultivating our capacity to listen to our patient’s qi, we are also fostering our capacity to listen to our own inner workings. It’s only natural then, to cast this gaze on the way in which the Engaging Vitality perspective is transmitted, received and cultivated. Let us explore this a bit. 

When we started teaching this material, we tried to simply transmit a repertoire of osteopathic palpatory techniques that were relevant to practitioners of traditional East Asian medicine (TEAM). Our thought was that we should simply leave it to the practitioner to determine what to do with the information and skills we taught.  Our ultimate goal was and remains that acupuncturists integrate these techniques in their own unique way.  That goal has not changed.

However, it soon became apparent that this approach just did not work. Students required more structure in order for them to glean an idea of how this material should be applied.  Despite an inherent aversion to fixed ideas of this nature, we invented protocols as teaching tools so that learners would have a conceptual framework in which to begin using the techniques. The protocols have been quite helpful to learners and at the same time have helped to shape our own understanding of the material. 

Of course, in practice we have actively worked to eliminate the protocols as soon as learners were competent to operate without them. Yet it became clear after not too long that we had failed to successfully address a larger issue in our transmission of the work. Engaging Vitality is in fact primarily a particular repertoire of techniques, but a way of thinking and working that utilizes a variety of techniques. For a practitioner to make good use of any of these techniques it is essential that they integrate this perspective into their own.

We would describe the Engaging Vitality approach as follows: 

  1. First, we appreciate a palpatory experience without any attempt at theoretical or therapeutic interpretation. Our hand does X or it feels Y. 

  2. Next, we apply one interpretive framework or another to that palpatory experience. For instance we might interpret a strong yang rhythm with an expansion phase that is larger than its relaxation phase as reflecting a relative excess of yang. The crucial point for the Engaging Vitality approach is that this is framed as a question. “Does it serve the therapeutic process to interpret this finding in this manner?” There is no particular presumption that one interpretive model is inherently more valid than another. So if one interpretive framework does no appear to be helpful, we switch to another.

  3. This does not mean that any interpretive model can be effectively applied to any clinical situation. On the contrary, we rely on the feedback provided by our palpatory techniques to tell us whether that model is correct. Our willingness to be wrong is what makes our use of any interpretive perspective question, a test, as opposed to a simple imposition. We test to see if our hypothesis is correct, not to validate any of our ideas.

  4. *We continually cross-reference our palpatory findings with one another at every step of the treatment process. Sometimes, a single finding may stand out as particularly clear and serve to propel the treatment forward. At other times, a number of vague findings may coalesce into a coherent palpatory assessment.

  5. Our focus is on the dynamic relationship between form and function, qi and structure. We are orient to either one the other at any given moment as the situation demands, but our overall attention is directed toward the harmonious relationship between form and function (or any pathological disharmony in this relationship). This is always grounded in palpatory feedback.

This questioning call and response approach is the defining feature of the Engaging vitality, more than the palpation itself. For some practitioners, this inquiry and its accompanying willingness to be proven wrong is a fundamentally alien way of thinking and makes them feel uncomfortable. Based on our experience, this open-ended approach with its lack of fixed protocols takes most practitioners a fair amount of time to truly integrate into their acupuncture work. This is true even among those who so seem to understand this as an abstract concept. 

Learners struggle with this mindset, which requires them both to be fully engaged and yet simultaneously getting out of the way,  long after they have developed a rudimentary competency in the Engaging Vitality palpatory techniques. This is commonly the main problem that impedes their progress. It is helpful to acknowledge that this takes time and to be patient with it.  

The Engaging Vitality repertoire is open ended in it is applicable to most styles of acupuncture practice and we hope it will be applied flexibly according to the needs of the individual practitioner. we like to say that Engaging Vitality work should work for the acupuncturist, and the acupuncturist shouldn’t work for Engaging Vitality. And yet, we as we have seen, it must be presented with a certain amount of structure if it going to be taught effectively.  So how might we think about that in the larger context of the transmission of information?

Top Down 

When an Engaging Vitality teacher presents a specific technique, it is essential that it is transmitted accurately and that students learn to do the technique correctly. Otherwise, learners will either fail to get the kind of information they are looking for, or in fact any information at all. The quality of contact, posture and mindset are essential ingredients in this process. Another big part of this phase is learning to filter out a specific palpatory phenomenon from the noise of all the other things that we could be feeling.  At this stage, the exchange of is a top-down transmission. The teacher teaches, the learner learns. You are either learning it correctly or you are not. Of course, it is incumbent on the instructor to transmit information effectively. This relies to a significant extent on feedback from the learner.

Once learners have a felt sense of what is being conveyed, we very roughly situate that palpatory experience in the context of TEAM. This first-order interpretation is grounded on our own experience with the application of the technique. From a teaching perspective, we present this level of interpretation as a given not only because that’s how we personally think about it but because it provides learners with a shared context for working with the technique themselves. Moreover, it is essential for teacher and learner to have a common language for discussing what we might do with a palpatory experience. This level of interpretation is also top-down. We are actively pointing the practitioner in a general direction for making sense of what they are feeling. 

Assimilation and Adaptation 

Beyond this, the rest is up to the practitioner and here is where the journey really begins. Could we map an extraordinary vessel, channel divergence, six-warp or five- phase interpretation onto whatever we are feeling? Perhaps. However, while we might have the most beautiful and most cohesive idea imaginable as to how to best engage the qi at that particular moment, that engagement needs to be framed as a question, not as an assertion. To whatever extent we may be looking for a positive response, we must remain equally open and attentive to a negative one. We listen, we engage, we listen to the response response, we engage again, and listen again, over and over, all the time questioning with an open and curious spirit. The qi leads, we follow. Our willingness to be wrong is what enables us to be right. Perhaps this could more accurately be stated as our willingness to learn that we are on the wrong path is what enables us to be as helpful as we can.

Practitioners may develop perspectives that are not part of the Engaging Vitality repertoire and indeed make sense only to them. For instance, one may use some combination of a relatively obscure microsystem combined with visualization to arrive at an acupuncture treatment for a given palpatory presentation. At this level, it is irrelevant how obscure it might seem to Dan, Marguerite, Chip or anyone else, provided that:

1) We all agree on the palpatory phenomena we are orienting to 

2) That phenomena improves with whatever intervention being applied. 

3) The improvement is somewhat long-lasting, as if the improvement lasts only a few seconds, it would be hard to construe it as being of any real help to the patient.

For instance, if one can produce a meaningful and lasting change across a range of listenings with a teishin, scraping tool or off-body hand waving, then that’s fine, that’s Engaging Vitality. Our approach is an optimal tool for assessing whether what one is doing is real, or whether one is indulging in wishful thinking.  Of course, if you don’t regularly catch yourself indulging in wishful thinking in the creative development of your own practice, you almost certainly are not paying enough attention. 

The creative application and critical testing of one’s own ideas is crucial a sign that one’s palpation practice is maturing. Present that idea to your engaging vitality partners in the spirit of “lets test this.” At the beginning, it really doesn’t matter whether your peers understand or are able to reproduce what you are doing. Because you share a common palpatory language your Engaging Vitality colleagues should be able to appreciate positive changes in our repertoire of assessment techniques. As your friends, they should be at both receptive and ruthlessly critical.

Groundswell

Any effective approach to teaching responds and adapts to feedback from its target audience. This is especially crucial when transmitting relatively subtle palpatory techniques. Beyond that, feedback from learners has been a potent force in actively shaping our understanding and the application of the techniques themselves.

Channel listening is a good example. Channel listening is the only technique in the core engaging vitality repertoire that was not already an osteopathic palpatory technique in some form or another, as it was essentially invented by Dan in the late 1980s.  Channel listening really began to evolve when Chip started trying to teach it to a small group of his own students in Colorado. Their ongoing feedback regarding what they were feeling and what it meant gradually shifted how we presented the technique and its practical application.

Students at the Seattle Institute of Oriental Medicine helped to consolidate these gains when Chip, Marguerite, and Dan jointly taught channel listening there a few years ago. That was when we realized that we were actually two different but complementary forms of channel listening. Going through this process made it clear to us that in many ways channel listening was the crucial node that linked together all the other Engaging Vitality techniques. The development of the technique has been in some ways bottom-up, as many developments have been driven in large part by the response of learners to our teachings. 

Moving Ahead

The palpatory techniques of the Engaging Vitality repertoire are bound to evolve over time and this is probably essential to the survival of the work. Such development will be driven less by us than by the ever increasing number of people doing the work. We are now at a point where more experienced practitioners are beginning to experiment with their own interpretations of what they are feeling, and innovate palpatory techniques of their own. Whatever the techniques we employ, the extent that Engaging Vitality work remains Engaging Vitality will be defined by the characteristics defined above.

• We feel first and interpret second.

• Whatever interpretive models we employ are framed as questions subject to refutation based on palpatory feedback from our patients.

• Our fundamental orientation is on the dynamic relationship between form and function. 

This is heart of Engaging Vitality and we hope that it can continue to develop for the benefit of all or our patients for many years.