“Trauma Informed Care (TIC) recognizes that traumatic experiences terrify, overwhelm, and violate the individual. Trauma Informed Care is a commitment not to repeat these experiences and, in whatever way possible, to restore a sense of safety, power, and self-worth.” Trauma-Informed Oregon
As I followed the trial and sentencing of Larry Nassar, the doctor who molested young female athletes for decades, I was reminded of how often private medical settings can be places for traumatic events. Whether allopathic or holistic, small private offices can be triggering for people who have experienced sexual assault during what was supposed to be a routine visit. Even if the trauma wasn’t physical, it may have been verbal or emotional, as when a practitioner berates a patient for being overweight or not being able to stop smoking.
What does this have to do with community acupuncture, you might ask? Well, POCA clinics have been discussing ways to address trauma in our communities and all of us are working to provide trauma-informed care. In this blog, I’d like to focus on two aspects of community clinics that help us learn to support people with trauma histories: the group setting and distal needling.
The main defining factor, other than cost, of community acupuncture from current private models is the group treatment room. Not only does it enable us to keep our fees as low as possible but it can allow patients to feel safe because they are not alone with a practitioner in a small private room. Depending on the traumatic experience, a group setting might not work, but often in a community space, patients experience a sense of safety; they can easily see others, and if a patient is new and nervous about how needling might feel, watching people get treated, seeing them relax--even sleep--can be calming.
Best of all, patients do not have to disrobe. This is good for practitioners and patients alike. Even in holistic offices, disrobing and lying on a table while the practitioner remains dressed, standing over the patient, can be re-traumatizing. Most often at LBCA, we ask that patients expose forearms and lower legs, so that we can treat their issues “distally”--meaning away from the site of pain or organ system. This approach initiates one of the main questions we get. When we treat back pain, for example, someone always asks: How you can treat my back, if you aren’t going to put needles right where it hurts?
As a practice, acupuncture acknowledges that body parts and organ systems are interconnected and that the pathways of the acupuncture channels (or meridians) are inter-related. Some of our best points for back pain are on the hands and feet! As a POCA volunteer writes, “While there is an emerging body of research on the efficacy of acupuncture in general, there is no research or data that compares the efficacy of different styles or systems of acupuncture. Anecdotal reports suggest that all systems and styles seem to work equally well.”
Distal needling offers us many advantages. In general, it is safer than “local” needling, especially around the chest and shoulders; there is little possibility of puncturing organs, like the lungs. And in terms of trauma as a “wound”--whether it’s physical or emotional--I prefer not to stick a needle right into a wound. After providing over 15,000 treatments myself, I know that distal treatment works more often than not and I learn more and more every day. Sometimes I treat locally, depending on the problem and how it has responded, but my favorite treatment styles are those of Master Tung and of Richard Tan--distal treatments that can address almost any issue from musculoskeletal problems to organ dysfunction.
Distal treatment allows us to be transparent with what we are doing: patients can watch, if they want, when we insert and remove needles. As a mutual experience, we encourage them to let us know if there is discomfort or pain and honor requests to remove or adjust needles if they are uncomfortable
Any practice is a learning process and as we work to implement TIC into all of our systems, from the front desk to the treatment room, LBCA consciously adheres to the principles of TIC: safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment.
Whenever anyone seeks help from a doctor, acupuncturist, chiropractor, massage therapist, reiki master, or psychic, they are admitting that they need help, which is not always easy for people to do. It is a vulnerable position to inhabit and people, generally, do not feel empowered. Our goal is to empower patients and establish trust. Treating in a quiet, common space, and using effective distal treatment are two of the ways we try.
This is the first in a series of installments on TIC and community acupuncture. Stay tuned!