The patient-practitioner relationship in acupuncture PDF
Preview The patient-practitioner relationship in acupuncture
ToPaulHammer,mybelovedson The Patient—Practitioner Relationship in Acupuncture LeonI.Hammer,MD ChairmanoftheGoverningBoard DragonRisesCollegeofOrientalMedicine Gainesville,Florida USA Thieme Stuttgart·NewYork IV LibraryofCongressCataloging-in-Publication Importantnote:Medicineisanever-changing Dataisavailablefromthepublisher. scienceundergoingcontinualdevelopment.Re- searchandclinicalexperiencearecontinually expanding our knowledge, in particular our knowledgeofpropertreatmentanddrugthera- py.Insofarasthisbookmentionsanydosageor application,readersmayrestassuredthatthe authors, editors, and publishers have made everyefforttoensurethatsuchreferencesare inaccordancewiththestateofknowledgeat thetimeofproductionofthebook. Artist:JaquelineBühler,Basel,Switzerland. Nevertheless,thisdoesnotinvolve,imply,or [email protected] expressanyguaranteeorresponsibilityonthe Cover:“Voneinemzumandern” partofthepublishersinrespecttoanydosage (Fromonetotheother) instructionsandformsofapplicationsstatedin p.5:“DieUnzertrennlichen”(Inseparable) thebook.Everyuserisrequestedtoexamine p.83:“HarmonischesPaar” carefullythemanufacturers’leafletsaccompa- (Harmoniouscouple) nyingeachdrugandtocheck,ifnecessaryin consultation with a physician or specialist, whetherthedosageschedulesmentionedthere- inorthecontraindicationsstatedbythemanu- facturersdifferfromthestatementsmadeinthe presentbook.Suchexaminationisparticularly important with drugs that are either rarely usedorhavebeennewlyreleasedonthemarket. Everydosagescheduleoreveryformofapplica- tionusedisentirelyattheuser’sownriskand responsibility.Theauthorsandpublishers re- questeveryusertoreporttothepublishersany discrepanciesorinaccuraciesnoticed.Iferrors inthisworkarefoundafterpublication,errata willbepostedatwww.thieme.comontheprod- uctdescriptionpage. ©2009GeorgThiemeVerlag, Someoftheproductnames,patents,andregis- Rüdigerstrasse14,70469Stuttgart, tereddesignsreferredtointhisbookareinfact Germany registered trademarks or proprietary names http://www.thieme.de eventhoughspecificreferencetothisfactisnot alwaysmadeinthetext.Therefore,theappear- ThiemeNewYork,333SeventhAvenue, anceofanamewithoutdesignationaspropriet- NewYork,NY10001,USA aryisnottobeconstruedasarepresentationby http://www.thieme.com thepublisherthatitisinthepublicdomain. Thisbook,includingallpartsthereof,islegally Coverdesign:ThiemePublishingGroup protectedbycopyright.Anyuse,exploitation,or TypesettingbyZiegler+Müller, commercializationoutsidethenarrowlimitsset textformfiles,Kirchentellinsfurt,Germany bycopyrightlegislation,withoutthepublisher’s PrintedinGermanybyOffizinAndersen consent,isillegalandliabletoprosecution.This NexöLeipzigGmbH,Zwenkau appliesinparticulartophotostatreproduction, copying,mimeographingorduplicationofany kind, translating, preparation of microfilms, ISBN978-3-13-148841-1 1 2 3 4 5 6 andelectronicdataprocessingandstorage. V Foreword Thesagehealersofancienttimeswereabletohealtheheartofhumanity,and thuspreventdiseasefromarising.Today(cid:2)sdoctorsonlyknowhowtotreatdisease whenithasalreadymanifestedinphysicalform,anddon(cid:2)tknowanymorehowto workwiththeheart.Thissituationcanbecomparedtotheprocessofpruningtree branches while neglecting the tap root, or to working downstream without awarenessofthepropertiesofthewellspring.Isthisnotanignorantwaytogo about the business of medicine? If you wish to bring about real healing, you mustfirstandforemosttreataperson(cid:2)sheart.Youmustbringtheheartonthe rightpath,sothatitcanbefilledandsustainedbyauniversalsenseof truth. Youmustgetittoaplacewhereitcansafelyabandonalldoubtingandworrying andobsessinginsenselesslyloopingpatterns,whereitcanletgoofanyanxiety provokingimbalances,andwhereitiswillingtosurrenderall“me,me,me”and all“thisishis/herfault!”Tryandawakenthehearttoacknowledgeandregretall thewrongthatonehasdone,tolaydownallselfishattachments,andtotrans- formone(cid:2)ssmallandself-centeredworldforthegloriousuniversewhereinwe areallone,andwhereinthereisnothingtodobutpraiseitsexistence.Thisisthe mastermethodof theenlightenedphysician—healingthroughtheheart.Or,in differentwordsfromtheancientrecord:theenlighteneddoctorintervenesbefore physicaldiseasemanifests,whiletheaveragephysicianspringsintoactiononly afterdiseasehasbecomeapparent.Totreatbeforethisstage,thisistheterrain ofhealingthecore—theheart;totreatafterwards,thisistherealmofdietary therapy,herbaltherapy,acupuncture,andmoxibustion.Althoughtherearethese twotypesoftherapeuticpaths,thereisreallyonlyonecorelawofhealing:Alldis- easecomesfromtheheart. Thusthe16thcenturyKoreanmasterphysicianHurJunsynthesizesalifetime ofclinicalinsightontheimportanceoftreatingtheheartinDongyibaojian VI Foreword (PreciousReflectionsbyanEasternPhysician).Icanthinkofnobetterquota- tiontointroducethismodestyetvitallyessentialvolumebyLeonHammer. TodayasduringthetimeofHurJun,theprofessionofChinesemedicinehas becomeatechnique-orientedmétier.Dr.Hammer’sbookontheclient–practi- tioner relationship in acupuncture, therefore, may strike us as the personal musingsofanaccomplishedpsychiatristturnedChinesemedicinepractitioner thatarenotdirectlyrelatedtothemainstreamofourfield.Nothingcouldbe furtherfromthetruth.AswithhisclassicpublicationsonChinesemedicine psychologyandpulsediagnosis,ThePatient–PractitionerRelationshipinAcu- punctureistheworkofaseasonedclinicianwhotransmitswithgreaturgency andtrademarkhumilitythevirtues,skillsandattitudesthatareindispensable foranygenuineengagementwiththetimelessartofChinesemedicine. WhileDr.Hammerhasrepeatedlydemonstratedhisgenerositytoyounger generationsofChinesemedicinepractitionersbyrelatinghisclinicalknowl- edgeandexperienceinprolificdetail,thisvolumeexhibitsmoreofazen-like quality.Thereaderfindsabookletbyawiseandcompassionatephysicianwho describeswithgreatclarityandsimplicitytheessentialsofhiscraft,inthis casethesacredspaceoftheclient–practitionerinteraction.WuTang,the18th centurycompilerofFeverSchooltherapeutics,oncewroteofthisessencein theprefaceof hislandmark Wenbingtiaobian(SystematicDifferentiationof WarmDiseases):“Medicineisthewayofcompassion–ledbywisdomandhu- mility,assistedbycourage,andcompletedbycompassion.” Bytransmitting andpalpablymodelingtoustheunassumingqualityofatraditionalChinese medicinesaint,LeonHammerremindsallofusofthedeepcommitmentthat broughtustothisprofessioninthefirstplace—thedesiretocareforothers,in themostwholeandcompletewaypossible.Forme,thisbookrepresentsan authenticechoofSunSimiao’s7thcenturydescriptionofthegreatphysician (Dayijingcheng): Thegreatphysicianservestoliveinharmonywithnature,andteacheshispa- tientstodothesame.Hewillstaycalmandcompletelycommittedwhentreating disease.Hewillnotgivewaytopersonalwishesanddesires,butaboveallelse holdandnurtureadeepfeelingofcompassion.Hewillbedevotedtothetaskof savingthesacredsparkoflifeineverycreaturethatstillcarriesit.Hewillstriveto maintainaclearmindandbewillingtoholdhimselftothehigheststandards.He Foreword VII willconsiderittobehissacredmandatetodiagnosesufferingsandtreatdisease. Hewillnotbeboastfulabouthisskillsandnotdrivenbythegreedformaterial things.Aboveall,hewillkeepanopenheart.Ashemovesontherightpath,he willreceivegreathappinessasarewardwithoutaskingforanythinginreturn. HeinerFruehauf,PhD FoundingProfessor SchoolofClassicalChineseMedicine NationalCollegeofNaturalMedicine Portland,Oregon VIII Preface Thisbookforacupuncturistsonthetherapeuticrelationshipisnotfocusedon pathology;onlyontheissuesweencounterwithotherhumanbeings,noneof whomiswithoutsomepartofthemselvesthatisaproblemtothemaswellas toothers. Acupuncturistsmayquestiontheneedtoreadaworkonthetherapeuticre- lationship.Afterall,bylawtheyareonlyrequiredtomakeaChineseMedicine diagnosis,prescribeherbs,andplacetheneedlesinappropriateacupuncture points.Thisistheirlegal“scopeofpractice.”The“Traditional”ChineseMedi- cinemodelarisingfrommainlandChinadiscouragesencounteringpeopleon anyplatformotherthanonethatinvolvesinsertingneedles,dispensingherbs, andalliedtechniquessuchasmassage,exercise,andnutrition.Emotionalis- sues,withrareexceptions,arereferredout. However, acupuncturists work with people, not charts or manikins. And peoplewho work with “energy” have a special obligation to considerall of theimplicationsthatenterintothetransfersofenergybetweenthespecific roleofthetherapistandtheroleofthepatient. Whiletheimplementationofsomeoftheprinciplesinthisbookmayre- quireattimesareferraltoamoreprofessionallytrainedpsychologist,theprin- ciplesthemselvesarenecessary ingredientsin the successfulencounterbe- tweenanytwohumanbeings.Thisisespeciallytrueifoneis“helping”and theotherisbeing“helped.”Mygoalisnottoteachpsychotherapy,buttoen- hancethepractitioner’spropensityandinnatetalenttoheal. Whenpractitionersmakeanyformofcontactwithsomeoneseekinghelp, theyhaveenteredintoatherapeuticrelationshipthatinevitablyinvolvesall ofthecontentsofthisbook.Thosewhothinkotherwisedosoattheirown risk,anddosoevenmoreatthepatient’srisk.Thereisnoescapefromthisre- alityinthesuccessfulpracticeofthisprofession. LeonI.Hammer,MD IX Acknowledgments With regard to the subject of this book I am especially grateful to Augusta Schlesinger,PhD,acourageous76-year-oldwomanwhomadearemarkable metamorphosisfromretiredhousewifetobecomethefounderoftheBureau ofChildGuidanceintheNewYorkCityschoolsystemandcourts.Shewasmy firsttherapistfrom1946untilherdeathin1951.Sheisthemodelforthecon- tentofthisbook. IalsooweadeepdebtofgratitudetotheWilliamA.WhiteInstituteofPsy- chiatryandPsychoanalysisinNewYork,whereIreceivedmypsychoanalytic training, andtomy teachersClara Thompson,MD, GerardChernowski, MD, EricFromm,PhD,ErnstSchactel,PhD,HarryBone,PhD,HarryStackSullivan, MD, Florence Powdermaker, MD, Asya Kadis, PhD, Anina Brandt, PhD, Ana Gourevitch,PhD,andRalphCrowley,MD. IamalsoindebtedtoAlexanderLowen,MD,JohnPierakos,MD(bioenerget- ics),andtoFritzPerls,MD(gestalttherapy),allofwhomIstudiedwithinmy post-psychoanalytictraining. ForthepresentIamgratefultoPamelaSmith,AP,andHamiltonRott,AP, whomadehelpfulsuggestions;toCandiceNelmswhowroteanintroductory sheetforthepublisher;andtoallthosewhoovertheyearschallengedmeto answertheirquestions. IalsowishtoacknowledgeJaquelineBuehler,aSwissartist,forhergeneros- ity in contributing her marvelous sculptures for the cover and the section openersofthislittlebook. IamgratefultoThiemeforacceptingthisbookforpublication,andmostof allIwishtoacknowledgeAngelikaFindgott’ssensitiveandintelligentguid- anceinthisproject,forwhichIamendlesslygrateful.Asmyeditorshemade thisprocessajoy,andhercreativityturnedaroughmanuscriptintoahighly readableandwell-organizedbook.Thankyou.
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