Self Empowerment

Community Acupuncture, Distal Treatment, & Trauma-Informed Care (TIC)

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!

Embracing Uncertainty and Finishing Well

…the three noble principles: good in the beginning, good in the middle, good in the end. They can be used in all the activities of our lives. We can begin anything we do--start our day, eat a meal, or walk into a meeting--with the intention to be open, flexible, and kind.
   Pema Chödrön, The Places That Scare You: A Guide to Fearlessness in Difficult Times

I don’t know about you, but 2017 has proven to be one of the most challenging years for me. My father passed away in February and that event alone pushed me up against discomfort, sadness, and fear in ways that nothing else has.

Like everyone else, I’ve watched daily as our nation struggles to comprehend and adjust to our new political administration. I’ve read the bios of people who have been murdered in mass killings, seen devastating photos of fires, floods, and earthquakes, and often just can’t believe that something else horrific is happening---again--this year.

I’ve treated people who are experiencing nothing short of shock and trauma from these and other personal experiences--some remembering harassment and assault, some mourning their own lost loved ones.

Throughout the year though, LBCA has held me steady and I know that it has been a source of stability for others. My colleague, Nirva, wrote eloquently of the radical acts that take place in our clinic every single day. Indeed, the wonderful moments we experience with patients are a salve, a balm countering the troubles and fears that exist beyond our concrete walls.

2017 has been a year of uncertainty. No one knew what to expect after the January inauguration and we don’t know what 2018 will bring. These are difficult times to be sure. Chödrön is clear: “we can never avoid uncertainty. This not knowing is part of the adventure, and it's also what makes us afraid” (6). I would like to be less afraid, learn to work with discomfort, and enjoy the adventure of not knowing.

As the year winds down, I am thinking about how to finish it well. In any part of a process, it’s important to be mindful at each stage though we tend to gravitate toward beginnings, ignore middles, and rush through or avoid the endings. How will you finish this year well? Being “open, flexible, and kind,” seems like a good starting place.

Healing in Community

Many social workers, massage therapists, and psychotherapists I’ve spoken with over the years—like acupuncturists—pursue the healing arts because we need healing ourselves. On February 3 of this year, my father died from cancer. He had been battling the disease since 2013 and was, in fact, diagnosed right around the time I signed the lease to open Long Beach Community Acupuncture.

He lived in Texas, and the distance compounded by invasive treatments from radiation and chemotherapy, to surgery and more chemo have been—to say the least—stressful for me. Living with a cancer diagnosis and treatment is a strange trip of intensity for caregivers and patients; it is a flux of emotions and physical symptoms with good and bad days. These past few years have been delineated by periods of shock and sadness, then those of waiting and hoping for optimal outcomes.

Working in this clinic daily has been a great source of healing for me as well as many others. We’ve given over 19,000 treatments to date. I am amazed at the sheer number of treatments and even more so at how much healing I’ve drawn from this environment. It was not something I expected.

Work that one enjoys is a salutary well. I have been soothed and comforted from treating people over and over; it comes in the form of the brief, casual conversations of our lives as I get the pins in and also in the successes we share in having symptoms improve if not resolve completely.

It was a conversation with a long-time patient that enabled me to take good leave of my father before he died and to appreciate how he had influenced my life choices in ways I could not recognize before. While another patient, who helps me clean the clinic sometimes, encouraged me to visit him multiple times in the final months of his life—not a simple choice as a business owner—but I did. Those last visits created some of my most cherished memories of him now. At the same time, our staff stepped in to cover for me, keeping the clinic open and accessible to patients while I was gone.

I wanted to share this at the time of our expansion of hours because our clinic staff and patients have been such an unbelievable source of support and these changes reflect the strength of LBCA.  It is difficult to estimate the value of a good team but we have one and I am grateful to you all. There is strength in numbers and healing in community.