I like adventuresome acupuncture.

When I treat in the student clinic, I first mark points on a patient’s body with a pen and have a supervisor check them for correct location before I can begin inserting needles. Some supervisors are more fastidious about point location than others; some are more exacting about needling technique than others. But by and large, the process of marking points, getting a supervisor to check them, then needling them has become somewhat rote. Once the points are decided upon, there’s not much spontaneity in it anymore.

Which is actually somewhat contrary to the spirit of acupuncture, in my opinion. The classics of Chinese medicine describe the superior physician as one who carefully monitors the the ebb and flow of qi at a point.

According to the Ling Shu (the Spiritual Pivot, which is the second half of the Huang Di Nei Jing or Yellow Emperor’s Inner Classic),

The skillful physician clings to the “Go” (movement, driving force). These movements do not detach from the [points]; they are delicate and sublime.

At the moment the energy arrives, he does not stray by even a hair; and if he is unaware of it, no results are produced.

Therefore it is necessary to discern the arriving and departing movements of energy in order to intervene in time. The mediocre physician ignores this rule; the skilled physician respects it.

Needling performed at the moment energy departs is “contrary,” and needling at the moment of arrival is “favorable.” To comprehend contrary and favorable, and to use this comprehension to achieve regulation, is to reach the summit of the acupuncture technique.

This demands a mental posture of great poise and attention toward the state of the patient.

Recently a supervisor has begun encouraging me to feel the qi at the point even before needling — to open my awareness of my energy sensitivity, and feel for the flows and whorls. That’s exciting. I also have observed him change the point prescription we had decided upon mid-stream because he saw that the patient needed a bit more balance in a certain direction. Another move toward greater spontaneity.

These are the kinds of things I like: a spontaneous practice based on an in-the-moment sense of flow.

Today I had a pretty cool experience. A patient came in with moderate neck and shoulder pain. I jumped at the chance to use a new technique that is sort of a gunslinger approach. A guy named Richard Tan teaches it nationwide, among others. Anyway, the idea is to imagine any limb or bone or virtually any size segment of the body as a microcosm of the larger body, and then to treat accordingly. It’s called “imaging.” For instance, the whole body can be imaged on the hand; or on the whole forearm; or on the foot, or the leg — or even just the thumb. Then you locate a corresponding channel and palpate for tender points, and you treat those.

If one image doesn’t work, you can immediately try a different one. The thing is, it can be difficult to plan exactly which points you’re going to do beforehand because the points you think you’re going to do may not be tender or reactive, and your image may not work; so you have to try a different one. It’s a very in-the-moment technique.

We imaged her neck onto both her lower leg and her arm, and needled tender points that were on corresponding channels (Lung 9 and Spleen 9). We also added some more points to move qi.

Within twenty minutes, her pain had improved by 60-70%.

Not only was I impressed by the result, but I had a lot of fun trying to figure out what points to do. And we’ve barely started with this stuff. I’m excited to learn more.

And by the way, the Toyohari technique I’ve signed up to learn is also a very in-the-moment technique, based on qi sensitivity and pulses.

I guess you can see which way I’m leaning, in my practice of acupuncture.