Five Element Treatment Protocols

Five Element Treatment Protocols PDF
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The Constitutional Factor (CF) is the primary cause not only of the client’s illness, but of the client’s health. It is like a first domino in a long chain reaction. This domino did not fall down long ago in the past, leaving us the pieces to pick up now; it is continuing to fall down potentially every moment of the client’s life, thus every time knocking right back down again every domino that we pick up. This is why, although symptomatic treatments may bring dramatic immediate results, the effects are relatively temporary. The root disharmony will keep on producing a chain reaction of illness, until it begins to heal.

Healing is not a removal of illness; it is journey toward virtue, or greater and greater alignment with Tao. Once the CF is oriented towards this journey of healing, this too has a profound chain reaction effect. If, at any time, there is any way that we can access the deep power of the core virtue to help shift another Element towards virtue, this is always preferable, and most likely to be an enduring shift.

Color, Sound, Odor, Emotion (CSOE)

Color, Sound, Odor and Emotion are the sole means accepted by the Five Element community for diagnosing CF, or Constitutional Factor.

Color: The subtle hue appearing off the skin, primarily near the temples and around the mouth.

Sound: an intonation in the voice independent of verbal content, which remains fairly constant despite modulations reflecting momentary emotional content.

Odor: a subtle scent usually detected at the nape of the client’s neck or back, or when lifting a sheet or blanket which has been covering the client’s gowned body for some time, or when re-entering a room that the client has been sitting in alone for some time.

Emotion: the primary emotion organizing the client’s response to life.

Confucian Transformations of Virtue

Given where I habitually fall from the Tao, what route back to the Tao makes it worth having fallen, and worth having suffered? Our CF virtues most exalt us if we cultivate them, and make us most ill if we don’t.

Water: Fear to Wisdom/Empowered Know-How

Wood: Anger to Benevolence, Visionary Creativity, Constructiveness

Fire: Joy/Anxiety to Propriety/Connection

Earth: Pensiveness/Neediness/Self-Pity/WorrySympathy toFidelity/Integrity/Sincerity/Loyalty/Caring/Dependability/Sympathy

Metal: Grief/Dissatisfaction to Righteousness/Appreciation/Beauty/Justice (Just Is)/Impartiality.

The Elements Within

A Five Element diagnosis traditionally includes a primary Element (CF or Causative Factor), and two Elements Within.

1. These “Withins” may be two Elements other than the CF Element. For instance, someone could be a Metal CF with Water and Fire Within. In this case, these other Elements are of great significance in the client’s make-up and will deeply influence how the primary element is expressed.

2. One of more of the Withins may be the same as the primary Element. For instance, someone could be a Water CF with Water and Wood — or even Water and Water — Within. In this case, the issues of the primary Element are even more focused and emphasized in every aspect of the client’s life.

3. Both of the Withins may be the same as each other, but different from the CF. For instance, someone could be an Earth CF with double Metal Within. Metal will appear thematically throughout the person’s life, but at the causative level, Earth is the primary motive force in the person’ life, for both the creation of illness and the return to health.

Distressed Elements (Pulse Qualities)

A Distressed Element is an Element that has received such abuse or wear and tear from life circumstances that it is overwhelmed, and becomes seriously dysfunctional. Although it may appear to be the CF or a Within because of its prominence in the client’s presentation, it is NOT a constitutional imbalance — it is occurring strictly because of overwhelming life circumstances.

When treated, this Element responds favorably in terms of its own healing, but it does not have the healing “domino effect” of treatment on the CF.

Conversely, because the Distressed Element is not rooted in the person’s constitutional make-up, it may not respond significantly to CF treatment. It may be necessary to treat the Distress Element directly, to clear the discordancy and return to CF treatment. Sometimes this is referred to “clearing a Quality on the pulse.”

Patterns of Disharmony

There is a web, often a wild weave of patterns of disharmony at play in a person. Our most important task is the elucidation of the primary, causative pattern i.e, the root pattern. Where did it all begin? We can analyze the pattern presentations and perhaps come to clarity about what is root and what is branch; but often with complex presentations, there are many possibilities, and it can be difficult to identify with assurance the crux of an existing dynamic of imbalance. Once we have identified the CF, however, we can “skip to the front of the line” with the Pattern of Disharmony of the CF.

1) What is the CF? This is identified by CSOE. Let’s say Water.

2) What is the pattern of disharmony of the CF? Is it frozen, boiling, unconsolidated — what’s the problem, what’s going on instead of virtue?

3) What other patterns is this primary, first-domino, causative pattern causing?

For example, let’s say the person is Kidney yin deficient, lacks the basic faith in the universe to support him, can’t relax, leading to never eating on time and eating late, gobbling food. This is Kidney yin deficiency leading to Stomach yin deficiency and Stomach qi stagnation, which over time may lead to heat from deficiency (from the yin def) which can easily become excess heat (because it is also stagnant in there). Maybe hot phlegm will develop, maybe hot congealing of blood. Let’s say it becomes full-out ST fire over time, and that scorches the HT making HT Fire, with (HT and Liv) blood deficiency too because the digestive system is a wreck. The client shows up and says, I have raging insomnia and I have an ulcer. Pathology is ALL OVER Earth and Fire, but CSOE is Water. If he’s a Water CF, this is the first domino, and although you may or may not choose to run a triage rescue mission on the other elements, the bottom line is that if you do nothing abut the shaky quaky Water which underlies all the rest of the pathology, you’re bailing a leaky boat.

This DOES NOT make Earth and Fire the Withins. Their pathologies are simply patterns manifesting in other elements, unfolding from the initial causative pattern. Because of this underlying causative relationship, the healing journey might begin and end right there with direct treatment of the causative pattern, which sends a chain reaction of healing through all the resulting patterns. In this case, the Withins don’t even come into the conversation — and they don’t need to. Just treat the CF, and the client gets well.

This is the clinical reality for many of our simpler clients.

Patterns of Withins

In the last scenario, we had a Water CF whose existential problems rendered him first Kidney yin deficient, and then a long chain of pattern-causality unfolded from there. If all patterns present can be traced back to that original cause, well and good; that’s all you need to treat.

But what if he also is Wood Within, and the nature of his Wood is blood deficiency, low self-esteem, inability to take up space and feel OK about it. Because of this inner smallness he feels like a victim in life, seethes at the injustices done to him, and ends up with heat in the blood, and a rising sense of pressure and futility that manifests as internal wind (causing high blood pressure and violent temper fits).

THIS IS A DIFFERENT CHAIN OF CAUSALITY. Once again we need to get to the first domino in the chain of causality, and transform it into the corresponding virtue, and everything down the line falls into place — and, as Jeffrey Yuen loves to say, he will have conquered one of his karmic tasks for this lifetime.

Repeat: withins are not further down the Pattern of Disharmony chain of causality from the CF. They are a different layer from the CF. They may or may not be generating their own pathology-pattern chains. They are independently existing, and timeless like the CF. Patterns of Disharmony come and go; Withins last a lifetime, and may be healthy or unhealthy, just like the CF.

Distressed Element Patterns

The difference between a Within and a Distressed Element is that the pathology and resultant pattern-chain from a Distressed Element is purely from Posterior Heaven (i.e. it is acquired via circumstances not innate). A Distressed Element is an element which is a mess, causing trouble and not coming into line with regular treatment, and needs some direct attention — but once it comes into line, it’s done. Its mess was a one-time thing, responsive to life circumstances. The CF/Within pathologies are karmic, i.e. a meeting of Anterior and Posterior Heaven, or ‘essence’ meeting ‘world.’ Thus a Within, like a CF, is what perpetually causative, or perpetually generative of karmic interplay. We are either cultivating the virtue of those elements (positive karma) or they are making us ill (negative karma).

Example: If I am imprisoned by a lunatic who keeps me in a small cage and feeds me nothing but scotch and french fries for a year, no matter who I am in my essential nature, I am going to have a highly distressed Wood Element. On the other hand, my response that is from who I am, and the pathologies that stem from it if I do not respond from virtue, are from the constitution. CF and Withins are rooted in Anterior Heaven. Distressed Elements are a completely Posterior Heaven phenomenon.

Determining CF and Withins

Instead of saying that there is a CF and two Withins, perhaps it would be more clear to say that there are three layers to the CF: a Yuan layer, a Ying layer, and a Wei layer. Of the layers of the constitution, Yuan is of course the deepest, and pre-natally determined. It is the level of jing and astrology, the first marriage of Heaven and Earth in our being, and it is the first Elemental bias to be expressed in our infancy. The Ying level, or first Within, develops next, in the deep mixing ground of our early childhood, as nature and nurture combine post-natally. Finally the Wei layer develops, and we become Somebody, a mixture of innate tendencies conditioned by life experiences.

When I say that these other two layers “develop,” I mean something like a telescope unfolding; the inborn aspect of each layer was/is all inherent in the Yuan, but latently until mixing with Posterior Heaven brings them into manifestation. Just so the ability to speak and walk are inherent in the unborn child, but need the living process to materialize them. The Yuan layer is the least conditioned by Posterior Heaven; the Wei layer, the most. Because the Yuan layer is the box it all unfolded out of, it “rules” the others.

Many people live their lives on their own surface, only aware of their Wei layer identity — I am who I am because my father beat me and my wife left me and now I’ve won the lottery. Beneath that is the ocean of the Ying, with its unconscious / semi-conscious emotional terrain, where deep impressions and then deep choices are made determining how we receive and respond to life. Below that, the Yuan layer, is who we are that we were before we were born, inviolate, unchanged by life, a read-only file. When we are brought in contact with — and hopefully anchored in — this layer of selfhood, our whole life is incidental to our essence and does not determine us; rather it is the medium for the expression of our essence, and the cultivation of the potential virtue in our nature. From this level there is only one question: What would I do in this situation?” Life history doesn’t come into it — cheap superficial (Wei) identities like 4th degree black belt in Tai Kwon Do don’t come into it — nor even, mirabile dictu, being raped at the age of 9 (Ying). You are you, fundamentally incapable of violation or distortion — yes certainly capable of self-distortion in our expression, and that is a kind of self-violation — but the Yuan is our bedrock, our constitutional nature, which is always here to be accessed for as long as we live. When we are rooted here, our original nature directs the process of healing/rectifying the other layers, because it holds the blueprint for the whole of us. No matter where the pathology began, the Yuan can potentially sweep it all clean — including Pattern of disharmony causal chains rooted in the Withins, since the CF also holds the original template for the health of the Withins, and can presence from its depth a “reminder” of this aspect of our original nature.

Of course for triage purposes, one might still choose to tx non-CF layers/chains of causality such as a Within — or a screaming Distressed Element — especially if they are screaming so loudly that it is hard for the client to anchor in their CF/Yuan. Of course, too, more than half the time when we first begin to tx someone we have no idea what the heck we are doing or who they are. We just treat whatever we think will heal them most right now just in case they die tomorrow. Julie Measures says, “Give me 20 treatments, and I’ll tell you the CF.” Subscribing to the theory doesn’t mean we always have the skill to apply it correctly on the first shot. We must understand the client as deeply as we can, and then keep an open mind about it.

CF and Layers of CSOE

While I never heard of Worsley saying anything about layers of CSOE, it certainly seems implied that there is a deep CSOE that is basically constant and relatively unchanging, available to be perceived no matter what state the client is in — Stomach flu, auto accident, divorce, high-pressure multiple choice exam… If the client is Water, then theoretically there is an underlying continuous blueness groanness putridness and fearfulness, no matter what, but this deep CSOE is modulated by what is happening on other layers — all the bile you swallowed from watching your sister win all those prizes for horseback riding while you grew up, still corroding your Ying; and the Pink Panther movies you’ve been watching all afternoon, stressing your Fire element in your Wei layer, pinking you up and giving your voice a more joyous lilt that it might not otherwise carry. Mixed CSOE is frequently a result of reading a mix of layers, e.g. Wei level emotion, Ying level sound, Yuan level color — or any other mix.

The issue of layers of CSOE is a major teaching point. For instance when teaching Sound, first I just have the students listen to each other’s voices and describe them in any terms they can come up with. Then we name the 5 sounds, and see if we can find clear examples of them. Then we imitate the sounds, making them deliberately as clearly as we can. Then — and this is the part that always hits ’em like a twister at first — we start listening for the sound that is still in the voice, even when we are trying to make all the other sounds. This is a first moment of attunement to layers of CSOE. What does it sound like when a Water CF sings, laughs, weeps, shouts? We attune to hearing the underlying sound, the sound beneath the sound, the Yuan sound.

Just so with color — I hear people speak all the time about seeing people’s color change. If CF is a constant, and CSOE reflects CF, how then could someone’s color CHANGE!? I don’t care how scary the movie or how bad the meal. Clearly, though, colors et alia reflect to some degree the Elemental distress-prominence of the moment. This is unlikely to shift on the yuan layer, slow to shift on the ying layer, and fairly easily to shift in the wei layer — it’s easy as a change of mood in some people. Add to this the wild joker of the Distressed Element, and how do we sort through the CSOE for the CF? When someone is laughing, is it their soul laughing, or their persona? Wei or Ying or Yuan?

CSOE shifts so significantly when someone moves from one layer to another. The voice rings truer, the face seems clearer, as we meet on deeper levels. To sort CSOE effectively, we must know on what layer we are meeting the client — and we must become effective at bringing our clients into their own Yuan swiftly, unobtrusively and naturally in the tx room so that we can diagnose them accurately. I see good practitioners doing this all the time. Worsley just did it with breathtaking ease and immediacy. I only had one real interaction with Worsley myself, but it was incredible how he just GOT me down deeper even than where I usually live — zap to the core. These moments of soul (Yuan) level meeting between client and practitioner, when the CSOE of the deepest layer of the constitution is exposed, are what the Worsley tradition calls Golden Key moments. In these and only these moments, does CSOE unequivocally express the CF. At other times, the CSOE of the CF often predominates with “tints” from the other layers, but can potentially be overshadowed by other Elemental disturbances — hence the importance of Yuan level contact (Golden Key moments) in diagnostic interaction.

The CSOE of the Withins can also be evoked by the practitioner by making clear contact with the client respectively on the Ying and on the Wei level. I am personally fascinated by studying the differential variations in CSOE for the various Patterns of Disharmony. For instance the Groan of a Kidney yang deficient Water (dial tone drone) is so different from the Groan of a Kidney yin deficient Water (relentless busy signal). Same with Colors. Yang deficient colors tend to be more shiny, more of a gloss finish — while yin deficient colors are more dull, like a matte finish, and don’t glow out from the face so much. E.g. a yang deficient blue is more like the face of a person who is watching a black-and-whiteTV in the middle of the night — you know that pale blue glow? While yin deficient Blue is more dark black sooty-looking, more close to the skin. With all the CFs and all the Patterns of Disharmony, I have noticed very specific CSOE. Lung Fire voices Weep so very differently from Lung qi and yin deficient voices. The Shout of Liver Blood deficiency is like a hammer hitting a nail far too gently to drive it in; the Shout of Liver yin deficiency is like an avalanche in a chopstick factory. They are real and different sounds which can be pointed out in examples, and taught by one person to another. It saves so much confusion on WHAT DOES GREEN LOOK LIKE, especially among intelligent students, if you can show them that it does not always look the same. Blood deficient Green is very pale, like nitrogen deficient grass. Damp Heat in the Liv/Gall Green is a dark yellowy-green crocodilian color. And of course we all know that on the level of Emotion, expressive variety is tremendous — and also reliably reflects Pattern of Disharmony.

Point Categories and Groupings

There are many ways of grouping points:

by Element

by meridian

by name (e.g. all points with the character shang/merchant)

by function

by area of the body, e.g. head (back of head, top of head), face, near sensory orifices, back, front, chest, pelvis, joints, limbs — all of these area groupings have significance.

Command Points

Command points are the group of points located on the limbs from the elbows out to the fingertips, and from the knees down to the toes.

What is significant about this area, i.e. lower legs/arms?

These are the parts of our body that most closely interact with the world in a very direct, very concrete way, e.g. walking, holding, all the worldly doing.

Body points are more about me accessing my inner world, the part of me that is covered and private.

Command points address and regulate my ongoing exchange with the outer world — including the Five Elements.

Outer limbs regulate daily life as we live it, ongoing exchange with circumstances — how we receive and how we contribute to the world around us.

They are also a pivotal place of influence for how we are affected by circumstances:

With what in our environment are we resonating?

What are we receiving, rejecting, overlooking, failing to harmonize with?

How are we finding our place and our balance in the dance of life?

The Command Point areas are the fulcrum for dance partners —

The whole body takes its cues for movement from the lower legs/feet and lower arms/hands.

Types of Command Points

Sources
Junctions
Xi Clefts
Element points
Horary points
Some entry and exit points
Other points

Sources

Source points are the most important points on the meridians. They access the primordial blueprint (jing) of the unique and perfect design of each of your Officials. When source points are needled, the client is put directly in touch with the experience of the “original nature” (te) of that organ.

Junctions

Junction points connect the “inner” and “outer” aspect of an Element. They help adjust the balance between the functions of the paired Officials. For instance, needling I-5 brings energy from SI into HT. Sometimes junctions are needled on both paired Officials, to increase the spirit of co-operation and communication between the two. When there is an akabane imbalance on a meridian, the junction point on the deficient side of the body is needled.

Xi Clefts

Xi clefts are also called Accumulation points. They represent a “pocket” or cleft on the meridian where energy can gather. Because of this, they can be needled to clear an accumulation (like a backlog of work piled on the desk of a particular Official). The xi cleft is also a place of health accumulation; it can be needled to provide an energetic tide-me-over when an Official is temporarily very deficient (like an emergency cash stash to help you pay rent due TODAY when your paycheck isn’t coming until tomorrow). Xi clefts are often considered to be ideal points for addressing acute conditions because of both of these functions.

Horary Points

Horary Points are the “same Element” points within each meridian, if used either

1. during the 2-hour solar time of its increased circulation, or

2. during its corresponding season.

It is most especially powerful when it is used during both at the same time, i.e. the time of increased circulation during the season of correspondence. It places the Element within a person into the context of the Element in nature.

http://aa.usno.navy.mil/data/docs/RS_OneDay.html is a site that gives you, among other information, daily sunrise and sunset times for any particular city world wide. Put in the day and location you want the time for, get the sunrise and sunset times, calculate the time that is exactly in the middle between those 2 times and that becomes your “noon” time.

Pulse

Five Element pulse-taking is the same in terms of finger position as a TCM pulse, but the client must be lying down (head and Heart at the same level). Because the needle action will only be either tonification or dispersion, a Five Element practitioner assesses pulse quantity rather than quality, i.e. a pulse is either “plus” or it is “minus.”

CF is diagnosed by means of color, sound, odor and emotion. It is confirmed by a “universal pulse shift” when the CF is treated.

Dispersion

Dispersion requires the needle to be placed tilted against the flow of meridian qi, given a quarter-turn counter clockwise, and allowed to act for a minimum of 20 minutes.

Tonification

Standard Five Element tonification is done with a decisive, swift insertion of the needle, strong de qi, a swift clockwise quarter turn of the needle, followed by removal of the needle and covering of the hole.

Moxa

Odd numbers of small cone-shaped moxa are burned on points in order to tonify. Burning moxa is removed before the burn reaches the skin.

Reunion Points

Reunion points are places of confluence between two or more meridians. By treating reunion points, we are able to harmonize the relationship between two Officials, or bring to bear the influence of one Official upon another.

Treatment Blocks

Five Element constitutional acupuncture works on the principle of sending a simple yet vital message to the core of a person’s being. Therefore, in order for treatment to be effective, it is of vital importance to consider whether there are any treatment blocks. A treatment block is anything that might serve to block the client’s ability to receive the simple yet profound message we are sending to the depth of our client’s body mind and spirit.

There are many possible treatment blocks — from lifestyle, diet, structural imbalance or even some deeply held beliefs. All of these must be considered in order to assure the efficacy of treatment. Here we will consider some treatment blocks which are specifically recognized within the province of acupuncture.

Aggressive Energy

Aggressive Energy — or AE as it is more commonly referred to among practitioners — is a kind of polluted, toxic energy which may be present in one or more organs. It is considered to be of a potentially highly destructive, almost poisonous nature. If it is present in an organ, it is important to clear it before attempting any treatment which might transfer this polluted energy from one organ to another.

AE is diagnosed, and treated, by placing needles in the inner Associated Effect points (shu points) of each of the zang organs. Needles should remain in at a 45 degree angle to the skin; if they are perpendicular they are too far in, and if they hang down they are not in far enough. If there is AE, a red circle will appear around the needle within 5-10 minutes. When the redness clears completely, the AE is clear. Always put in an extra “test needle” on the back, usually between an inner AEP (shu point) and the spine, to be sure that your client is not showing redness just because of skin sensitivity. It is safest to save the Heart AEP for last, after the others have all been shown to be clear.

AE should be drained with the client sitting up, if necessary leaning forward against the back of a chair or the treatment table.

Exit/Entry Block

There is a point on each meridian pathway where the Wei-level circulation of qi enters the meridian. This is the entry point. There is a point on each meridian pathway where the Wei-level circulation of qi exits the meridian. This is the exit point. As the circulation of qi exits one meridian and enters the next, there may be clogging or obstruction holding up the flow of energy into the following meridian.

Exit-entry blocks are diagnosed via the pulses. The pulse of the “clogged exit” meridian will feel full, with a tense puffed-out feeling. The pulse of the correspondingly “empty entry” meridian will feel concave, empty.

Traditionally, an Exit-Entry block is broken by TONIFYING first the affected exit point (bilaterally), and then by tonifying the subsequent entry point. Effectiveness may be verified immediately on the pulses.

The Entry and Exit points on a meridian are also needled in order to “clear through” the meridian.

*NOTE: THESE EXIT POINTS ARE NOT THE LAST POINT ON THE MERIDIAN.

Exit/Entry blocks in the head have a tendency to manifest in relation to disruption or impairment of outer sensory awareness.

Exit/Entry blocks in the chest have a tendency to manifest in relation to disruption or impairment of inner luminous awareness.

Head / Sensory / Outer Orifices of the Heart Exit-Entry blocks are as follows:

SI‑9 to BL‑1

CO‑20 to ST‑1

TH‑22 to GB‑1

Chest / Luminous / Inner Orifices of the Heart Exit-Entry blocks are as follows:

SP‑21 to HT‑1

LIV‑14 to LUNG 1

KI‑22 to HM‑1 or 2

Akabane Imbalance

Akabane imbalance is an imbalance of wei-level meridian qi from one side of the body to the other, i.e. there is more qi in the Spleen meridian on the left leg than on the right leg. This generally manifests as one-sided symptoms either along the affected meridian, or associated with the function of the affected meridian.

Akabane imbalance is diagnosed with a lit incense stick, waved back and forth over the jing/well point of each meridian, first on the left and then on the right for each in turn. The practitioner moves the incense stick at a steady rate, counts number of passes, and compares how many passes on each side before the client says, “Hot!” If there is a discrepancy of more than 5, the deficient side (the side with the bigger number) is tonified on the junction point. Then the akabane is re-checked.

Husband/Wife Imbalance

A Husband/Wife Imbalance is considered to be a situation of great immediate concern. It is considered to be a state of deep resignation which may manifest in serious physical illness, or in a vanquished spirit. It is diagnosed from the pulses; an H/W pulse is one in which the pulses on the right wrist are qualitatively stronger than on the left. On the right wrist you will feel pulses that are dominant, hard, and pushing; on the left wrist you will feel pulses that are resigned, weak and capitulating.

Treating an H/W takes precedence over anything except AE. If possible, it is highly recommended to find out the cause of the H/W, e.g. is there a serious physical illness, or a deep resignation of spirit? Whether or not the cause is known, the treatment should be immediate. The protocol is as follows:

1. Tonify Bladder 67 and Kidney 7, bringing Metal into Water.

2. Tonify Kidney 3, bringing Earth into Water.

3. Tonify Liver 4, bringing Metal into Wood.

4. Tonify Heart 7 and Small Intestine 4, to strengthen Sovereign Fire.

Possession

“This is a condition in which there is a deep disturbance in the energy which acts as an invading [or occupying] force. The effects of this can range from total insanity, where the person is literally beyond reach, to something barely noticeable which nevertheless is a barrier to successful treatment by any therapy.” — JR Worsley

© 2018 Thea Elijah