A History

Introduction to Acupuncture and Traditional Chinese Medicine

 

There is a growing trend towards the use of alternative therapies in the treatment of chronic pain and disease.  The popularity of alternative medicine has emerged as consumers have become more informed, (ie: articles in Life Magazine, a feature story on Turning Point on NRC, local newspaper articles and T.V.). People are recognizing that Western Medicine has it’s limitations, particularly in the treatment of chronic disorders. This may be due to their frustration with the medical system. But, the trend appears to reflect the consumer’s need to have control over their healing process and access to a variety of therapies. As patients seek out alternative health care, their expectations and goals are clearly articulated and health care practitioners providing these services need to pay particular attention to whether the consumer is an appropriate candidate for that particular type of therapy.

Western medicine has its limitations and so does alternative therapies, particularly with regards to acute disorders. When is it appropriate for a patient to seek out alternative therapy? What is the process? How do they access this type of service? What are the political and economic concerns? What if any risks are involved? These are the more frequently asked questions about Acupuncture and Traditional Chinese Medicine.

Acupuncture and Traditional Chinese Medicine Historical Background Evolves as the 21st Century Medicine

Fourteen years ago Joanne Pritchard-Sobhani, and Darab Sobhani, established their practice in Brockville at Chelsea Court.  In 1997 they established the Institute of Acupuncture & Traditional Chinese Medicine, serving both as a teaching and clinical facility.  It seems just like yesterday, but, the future of Acupuncture and Traditional Chinese Medicine is no longer in question or perceived as an alternative practice.  The Profession has rapidly become one of the more widely used medical systems within Canada the United States, England and Australia. It is a primary care profession that is totally integrated within China and throughout Asia.

Traditional Chinese Medicine is a unique, comprehensive medical system that includes the use of:  Acupuncture, Herbal Medicine, Dietary Therapy and manual therapy (tuina- chinese massage,tai chi and qigong) within the scope of practice of the TCM profession.  It should be clarified that the practice of Traditional Chinese Medicine is not defined by culture or ethnic background, but rather by the specific body of knowledge or theoretical framework from which TCM emerges.

A  Traditional Chinese Medicine Practitioner typically confers a TCM diagnosis and then develops a treatment protocol. Within this conceptual framework, IATCM, established curriculum, which at that time taught different levels of competency in anticipation for registration as an Acupuncturist and or a TCM Practitioner, once regulation occurred.  Be aware that the TCM profession is not a limited practice as it currently reflects the legislative vacuum for which many practitioners have academic credentials as Doctors of Acupuncture, TCM practitioners or Doctors of Traditional Chinese Medicine who have outstanding training, Internationally.  However, they cannot be appropriately recognized as such, until the new College can establish what the standards of education and practice will be. Ontario is in a transition period, and until regulation is complete, the patient just needs to be cautious.

It is estimated that more than $3.8 billion dollars was spent in Canada in 1996/97 on Complementary Forms of therapy.  Surveys by Eisenberg (1993;1998)(for the United States) and Ramsay et al. (1999) (for Canada), appears to be the most sophisticated  study thus far of general populations and the usage of  Complementary Medicine.  A public opinion poll by the Angus Reid Group (1998B) found that 42% of Canadians used Complementary Medicine and practices. It also reports that 1 in 5 Canadians had started using Complementary Medicine in the last 5 years.  For those respondents reporting use of Complementary Medicine; acupuncture, herbal medicine, chiropractic care and homeopathy were some of the more common types of therapy used.

The results of the studies cited above portray a clear pattern in terms of use of these therapies and practitioners.  The use of such therapies and providers are not insignificant, and their use is growing in popularity.  This is a trend that is expected to continue as the demand for these therapies focus on the prevention of illness and the treatment of chronic disorders, viewed by many practitioners as bridging the gap between Western Allopathic medicine, which is more traditionally an Intervention model.

As we envision the future of our practice, our major focus is to provide services to our patients that effectively and safely responds to their health care needs.  Although, acupuncture is noted for it’s effectiveness in treating pain, our scope of practice is much broader and includes the treatment of chronic diseases and  prevention of disease.
In 2003 we suspended our Academic Program in favour of committing to a major expansion to our clinical practice to include an on site “Traditional Chinese Medicine Herbal Apothecary” which now incorporates the use of Traditional Chinese Medicine, Concentrated Extracts in the form of granules or powder. Although, we have always used raw herbs, botanicals, patented herbs in our practice; the demand for concentrated extracts have increased. WE use one of the largest Traditional Chinese Medicine Pharmaceutical that is the leader in TCM herbal extracts in both Taiwan and the United States.   Our choice of concentrated extracts is based on the fact they are standardized, safe and effective.  These companies are well known for their reputation for strict quality control that starts from herb origin. Our goals  reflects the utilization of the most advanced scientific process to bring  Safe, Consistent and Effective Chinese Herbal Extracts for the health and well being of our patients.  Some, patented products brought into Canada have been banned pending further investigation, which is the main reason that we have developed our own Herbal Apothecary. Our clinic was not prepared to subject our patients to unknown risks. Chinese Medicine has made its way into a number of products available over the counter in pharmacies and health food stores as well.  These are quite different .  We prepare our own herbal prescriptions based on TCM differential diagnosis, according to the individual’s condition.

The use of Concentrated extracts are available to  “TCM practitioners”  which eliminates Health Canada’s Division of Natural Health Products concerns, regarding the appropriate use of these herbs, contamination and  the use of endangered species. It should be noted that none of our products are available for sale for retail purposes.   Our clinic dispenses herbs, only in the context of the treatment process. They are available to patients by prescription which ensures that the patient is appropriately supervised.    Concentrated extracts also offer flexibility for patients in the form of decoctions or capsules vs. the tedious task of having to boil down raw herbs on a daily basis. 

How does TCM/Acupuncture differ from Adjunct or Anatomical Acupuncture?

 

The problem inherent in Canada is the lack of educational institutions to provide appropriate education in comparison to the United States, China, Europe and Sri Lanka. Consequently, many practitioners have studied extensively abroad to gain the valuable clinical experience they need. Many practitioners of Chinese Medicine are recognized as specialists in their field and as such have completed Doctorate programs, which are not available or recognized in Canada per se because the Profession is not regulated, yet. Until the new College of TCM is in a position to register practitioners, patients need to exercise due diligence in selecting a practitioner.  Once the legislative framework is operational and practitioners are licensed in the future, patients will be assured that the academic qualifications for Acupuncture/Traditional Chinese Medicine practitioners reflect entry to practice guidelines in Ontario and are therefore qualified to practice. For instance, TCM Practitioners and or Doctors of Traditional Chinese Medicine may study any where between 3,600 hours to 4,000 hours. Currently, some physio-therapists, massage therapists, chiropractors and naturopaths perform acupuncture, using it as an adjunct to their practices which may be referred to as “anatomical, medical or neural acupuncture”. Adjunctive acupuncture, used as a Western modality by other health regulated professionals, is theoretically quite different than acupuncture performed by practitioners of TCM.   The training they receive ranges from 222 hours to 300 hours.  However, complicated conditions require the expertise of more advanced training from a TCM practitioner.  It should be noted that once regulation is complete there will be a clearer understanding of each others scope of practice, better professional inter-collaboration and consequently, patients will benefit first by having the option to make an informed choice as to what type of treatment option is available and who is the most appropriate to treat their condition.

Contemporary Chinese Medicine incorporates ancient Chinese medical theories of Acupuncture, herbal therapy, dietary therapy and physical therapy that includes tuina  and  Qi Gong exercise/meditation. Traditional Chinese Medicine, (TCM), emphasizes that illness is an imbalance in the body. Treating illness is a matter of harmonizing the Qi (pronounced Chee) and restoring the natural balance in the body. TCM believes in the innate ability of the human body to heal itself by inviting the body back to health, rather than to forcefully impose change. The process involves developing awareness and responding to the body’s ability to adapt to change, physically, emotionally and spiritually. TCM is not an exclusive or ideal medical system. TCM’s strength lies in its ability to respond to chronic illness but is limited in the treatment of acute illnesses, some exceptions exist. It is at this time that a comprehensively trained TCM practitioner will refer to an appropriate medical practitioner This is a critical point. Seriously ill patients should be wary of any practitioner who claims to be able to cure cancer, etc. The best solution is an integrated approach, drawing upon the advances of Western medical technology and the wholistic perspectives of TCM.
We are obligated to ensure that the patient is aware of the entire process involved in receiving Acupuncture/TCM in order to grasp the complexity of Chinese Medicine or the fundamental principles governing diagnosis and the appropriate needling techniques. Acupuncture is not merely the insertion of a needle into an ash shi point or the point of pain. This type of technique depends on the differentiation of syndromes.

 

Acupuncture & TCM treatment protocols: What can I expect?

The ability to communicate in a language that is comfortable to the patient is the key. This involves the ability to be able to translate the Chinese theories simply and if necessary interface this with Western terminology. If the practitioner is unable to communicate in a language that is understandable, then patients should consider requesting the presence of a translator. Communicating a TCM diagnosis is absolutely essential in the treatment process where established treatment protocols will be clear and the patient will be aware of anticipated outcomes and the approximate length of their treatment.
No patient should continue with acupuncture for extensive periods of time without review of their progress and evaluation of the efficacy of their treatment. There are treatment protocols that must be individualized to the patient’s need.
The Power of Chinese Medicine is about balance, harmony and order!
If  you expand your concept of healing to include the Chinese way of thinking, you may experience a subtle but powerful change in how you take care of yourself. Chinese medicine theory describes illness differently. You don’t catch a cold, rather you develop a disharmony. Diagnosis of disease is distinguished by the differentiation of syndromes that emerge quite differently in the human context which require different treatment modalities.
Chinese medicine envisions healing by using natural methods. You don’t kill a bug with a drug or suppress symptoms; rather you use acupuncture and herbs to dispel disharmony. Chinese medicine offers a new approach to treating physical and emotional problems by treating the mind/body/spirit as a whole in relation to the external environment.

 

What do we mean that TCM offers a Wholistic approach to treatment?

As a patient you must be aware that no particular Chinese Medicine therapy, such as acupuncture or herbal remedies can deliver its full healing potential, if is separated from the concept of the Tao in which the body is treated as a whole, which is what we refer to when we say TCM is a wholistic approach.  In the Western scientific model, life is dissected and separated into separate, discrete parts, within the context of a fixed, stable environment that must be measured objectively. Philosophically, this is what separates the West from the East as two opposing forces that have antagonistically aroused skepticism for many who embrace the world in such away. Embracing Chinese medicine involves a process of viewing life as a dynamic, constantly shifting relationship of one functional system within another. No aspect of the body functions as an independent, discrete entity. In other words, our emotions shape our body and our body generates feelings.
When it comes to selecting a practitioner you may be surprised to find out there are many different types. We have referred to those who perform adjunctive acupuncture as outlined above, TCM practitioners, Japanese, Five Element, Korean and Constitutional. Each approach has a theoretical basis that is considered a form of effective therapy. There is no one way that is absolutely right. It should be noted that many of these are rooted in Chinese Medicine. The Chinese have never believed their  was only one truth and in fact Chinese Medicine has always acknowledged the existence of opposing forces existing simultaneously. A good example of this is Yin and Yang Theory.

Health Preservation and Maintenance in Chinese Medicine

Acupuncture and Chinese medicine is not well understood in the West. In China, United States, Europe and Sri Lanka it is considered a comprehensive form of medical care that is integrated with Western medicine, in the treatment of illness. Tremendous emphasis is given to the prevention of illness by maintaining healthy lifestyles. Although much discussion exists about this in the West, many, of our attitudes and beliefs prevent us from making the necessary adjustment to truly embrace Chinese medicine’s true potential for healing. In a world daunted by the use of prescription drugs and expectations for immediate cures, it often comes as a great surprise that many chronic illnesses are unresponsive to pharmaceuticals. How did such a perception emerge? Consciously, or unconsciously many patients attempting to pursue healthier lifestyles never realized the potential of the human body to heal itself. This is a process however, one where the individual must challenge strong socialization processes, institutional barriers and advertisements that imply instant relief to symptoms.  According to the theories of Chinese Medicine, health preservation means preserving the body condition to maintain good health, prevent disease and prolong life.  The key concept of health preservation in Chinese medicine is to prevent disease before it occurs. Some basic principles and method of health preservations includes the following:
Adapt to nature:  One needs to adapt to various geographical environments.  In warm and humid climates, drinking herbal tea that is cooling in nature can clear heat and eliminate dampness.
We need to adapt to seasonal changes and protect ourselves from getting cold in the winter and prevent heat stroke in the summer.
Exercise regularly:  Suitable and regular exercise is necessary to maintain health and wellness because it can strengthen the body constitution, increase vitality and improve physical and mental health.
Maintain a healthy diet:
Food needs to be properly prepared and cleaned whether it is cooked or eaten raw.  Eating a balanced diet is essential to maintaining proper nutrition and health. Avoid highly refined, processed foods because they are high in fat, and cause digestive disorders by altering our metabolism and nutritionally are nutritionally deficient.  Precautions and avoidance of certain foods are encouraged, depending on the individuals’ state of health.  Mutton for instance should be avoided when you are sick with the flu.  Eating regular meals, proportional to your body’s requirement is encouraged.
Maintain a healthy mental state:
One should avoid extremes of emotional stress and learn to maintain a balance state of mind.  Some helpful practices include listening to light music, practicing meditation, visualization, relaxation exercises using audio tapes or CDS and learning tai chi or qi gong.
Strengthening the body resistance to disease:
Food used as tonic to preserve health can be as simple as eating green bean soup in the summer to prevent heat stroke or drinking mutton soup in the winter to prevent the invasion of cold. Tonics are often used for older persons or individuals recovering from serious illness to strengthen the body and prevent disease.
Tuina Massage:
Incorporate into your daily routine the use of massage or acupressure.  Many school children in China alleviate the tiredness of eyes and protect eyesight by massaging the acupoints around the eyes.  Massaging certain point on the head, back of the neck and around the temples can provide relief from stress and prevent tension headaches.
Prevent Infectious Disease;
Chinese medicine is used to prevent infectious diseases in which many herbal decoctions are available.  Of course the best option is to avoid the source of infection and maintain strict hygiene habits such as washing our hands and covering our mouth if we have a cough.

 

The Patients’ Goals

As a patient you need to first examine whether you are looking for a TCM practitioner to deal with all aspects of your health. This is a difficult concept to imagine in the West because we have been taught that only Western medicine is capable of responding to our health care needs. This is true to a point, particularly if you require intervention such as emergency treatment. If you are looking for a TCM practitioner, ensure that the individual is knowledgeable about all aspects of Chinese medicine and Western medical procedures. The individual should recognize when to make a referral to the appropriate practitioner when it is beyond their scope of practice. They should be prepared to work with all other practitioners that is in the best interest of the patient. Others prefer to have Chinese practitioners work with the primary care physician. If the complaint is not complicated some patients may seek out treatment for resolution of just that specific complaint on a short term basis.
The decision to seek out alternative therapies is entirely dependent on the individual being informed as to his choices and recognizing his needs and goals.
Chinese medicine is a preventive form of medicine that attempts to intervene at all levels to change the course of a disease pattern that may become more serious and improve the quality of life for those who suffer from a variety of chronic disorders. In the West our focus is on disease and suppression of symptoms and repression of our emotions. Unfortunately you cannot separate these two aspects as repression of emotions may lead to physical manifestations and disharmony and/or physical manifestations may lead to imbalances emotionally and spiritually.
Chinese medicine, for 5000 years has insightfully recognized that treatment must focus on the whole person. This is a time consuming process, particularly in the West as cultural barriers and belief systems may initially prevent the consumer from being able to grasp the innate ability of the body to heal itself and that the individual can exercise control over their own healing process.  In fact, many well informed licensed practitioners have been on the cutting edge of facilitating research to explain the effects of acupuncture/herbal therapies on the human condition. The process of embracing Chinese medicine really is a life long commitment to viewing health as not merely the absence of symptoms and not giving up control of your health to someone else. You must be an active participant in your own destiny. We cannot blame the present medical system for failing to cure us. A surgeon performs open heart surgery to correct blocked arteries but we continue to smoke and eat foods that are known to have contributed to the  original problem.

The Treatment Process: What does it involve?

Once you make the decision to have treatment from a Traditional Chinese practitioner you must understand that this is just the beginning….a journey in some ways towards accepting responsibility for your own health. It’s important to inquire about the types of treatment available the risks it any, the pros and cons of the treatment modality and what kind of commitment is involved. Remember, you are not a passive recipient; becoming more aware of your body, it’s response to external stimuli in the environment, physiologically, psychologically and spiritually, are key aspects involved in the healing process.
There are basically four main treatment modalities that a TCM practitioner may recommend but variations within these modalities exist.
These include acupuncture which may be a combination of body acupuncture, auricular acupuncture, electro‑acupuncture, laser acupuncture, intra-muscular stimulation and scalp acupuncture.
Moxibustion, herbal therapy, dietary therapy and manual therapies and or Qi Gong/meditation complete the list.
Acupressure, tuina,and cupping are forms of manual therapy.
The use of advanced technology to stimulate acupuncture points with a specific type of micro-electric stimulation may be used.  Micro-current is often referred to as non‑ needling acupuncture which is different than electro‑acupuncture, where needles are first inserted and then an electric current is passed through the needle. Micro-current is used to heal muscle and nerve impairments, spinal cord injury, stroke, palsy, and aids in the recuperation from surgery or sports injuries by reducing the swelling and the inflammation. This type of treatment is also capable of increasing the integrity of the muscle and the skin and is particularly helpful in facial toning. TCM practitioners refer to this as non surgical facelifts.
Our clinic incorporates all these modalities as well as integrating where possible counselling, particularly in regards to lifestyle changes, management of stress, depression and anxiety related disorders.  Relaxation techniques, guided imagery and visualization may be used. Addictions require direct and indirect therapies that interrupt specific behavioural patterns, (Cognitive Behavioural Therapy or EMDR) that may be have been entrenched over a life time. In many respects our clinic uses an eclectic approach to responding to the patients needs. Counselling is often a critical component in the healing process, but it doesn’t emerge in the same form that we are accustomed to in the West.
In performing acupuncture in an atmosphere that is conducive to healing... trust and safety are essential components of the healing process.  Chinese massage, (tuina) often facilitates the release of tension and emotions. In the process many patients comments reflect that they suddenly feel a release emotionally; some may experience a sense of euphoria. Others depending on what part of the body or what channel your working with may elicit feelings of grief, tears or sadness. Chinese medicine according to Five Element Theory explains this phenomena, for instance if your treating a painful condition working on the Yangming channel of the hand, grief may be elicited as it is a coupled organ of the Taiyin channel of the Hand. (Lung Channel Metal elicits the emotion grief). From a Western perspective, the Theory of Muscle Memory Retention, refers to the fact that muscle has memory and in doing any kind of body work, trauma experienced and held within certain muscle groups may elicit a strong emotional reaction with a subsequent reduction in pain. In fact, it has been hypothesized that acupuncture may interfere with the muscles memory of pain or trauma and consequently interferes with the pain mechanisms involved in the continued transmission of that pain.
We offer workshops on a variety of topics that patient’s have indicated would be helpful to them; particularly in the area of increasing their understanding of TCM, lifestyle changes, coping with stress, use of food as medicine, herbs, and treatment strategies for coping with particular disease patterns.
Anyone wanting any further information regarding treatment, the types of therapies we offer, or the upcoming workshops may contact us.
We can be reached at:
574 Stewart Blvd., Brockville, Ont.  K6V 7H2                         
613‑498‑3906 or FAX 613‑498‑1886 or email us at: Acupuncture & Traditional Chinese Medicine www.acupuncture-tcm.ca

Useful links:

The links provided below are for references purposed only.  We do not assume responsibility for any error or endorse the content of any one site.

General Information

www.acupuncture.com
www.itmonline.org

National Association of Canada
Chinese Medicine & Acupuncture Association of Canada: www.cmaac.ca

Provincial Regulators of TCM Practitioners and/or Acupuncturists

College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario: www.ctcmpao.on.ca
College of Traditional Chinese Medicine Practitioners and Acupuncturists of British Columbia: www.ctcma.bc.ca
Ministry of Health & Wellness, Alberta:  www.health.gov.ab.ca
Ordre des acupuncteurs du  Quebec:  www.ordredesacupuncteurs.qc.ca

Provincial and Federal Government
Ministry of Health & Long Term Care:  www.health.gov.on.ca
Health Professions Regulatory Advisory Council:  www.hprac.org
Health Canada Natural Health Products Directorate:  www.hc-sc.gc.ca/ahc-asc/branch-dirgen/hpfb-dgpsa/nhpd-dpsn/index_e.html

Eye Movement Desensitization Reprocessing International Association: (EMDRIA) www.emdria.org

 

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