Getting angry in the CA clinic

For months now I’ve been trying to write about anger in the community acupuncture clinic, and specifically how my own anger relates to my practice. It’s hard. Not only am I a woman, and therefore not supposed to get angry (and if I do, I am characterized as shrewish and/or unbalanced) I’m also a soft-voiced healer who works in whispers and handles other people’s bodies. Definitely not supposed to experience or express rage, and especially at work. Right?
I attend a monthly community activist solidarity group run by Vikki Reynolds. It is typically comprised of about a dozen social workers and counselors, many of them front-line workers on the Downtown East Side, and one community acupuncturist. Vikki offers the kind of clinical supervision that I crave – it is neither clinical, nor is it supervision. It’s intelligent, empathetic support, a space to unburden, to talk about struggle and self-doubt without being judged.
The theme last time, for me, was rage. I’d been harassed and followed on the street one evening. It was brief, and I got away before I was physically harmed, but it scared me, and as a result my anger about gendered, sexualized violence and bullying was a bit closer to the surface than usual. Later that week in clinic, it broiled up and out. A long-term patient, a woman I have good rapport with, had just had a particularly awful experience with a medical doctor. My incredulous, unfiltered response was “I could throat punch that man!”  I related this to the group, somewhat chagrined, and Vikki asked if I thought I’d harmed the client by expressing anger. No, actually, I didn’t. I think my patient was heartened by my response. Vikki then asked how I’d know if I’d harmed a client by expressing anger. Damn good question. If they trusted me less, I said. If they trusted me less with their experiences and with their body, that could indicate to me that I’d harmed a patient by expressing my own emotions to them in the context of their treatment.
I can think of good reasons to not express anger, or any other strong emotion, while working in the clinic. My patients’ time in the chair is not about me. One of my favourite things about the CA model is how it gets the practitioner’s ego out of the room, as much as possible. We endeavour to set the needles with minimal fuss and chatter, cover with a blanket and get out of the way. But the expression of anger can be a compassionate response. Ever noticed the difference between hearing “I’m so sorry that this has happened to you” and “I’m really angry this has happened to you”? The latter can be a lot more validating, particularly for those of us who are heavily socialized to not feel or express anger. (I am grateful to the Queens of Inappropriate spoken word duo, Elyse Maltin and Kyra Harris, for articulating this.)
We are human, and we can get triggered in clinic  – and by triggered, I do not just mean having a quick response that you don’t like. I mean having a visceral, physiological, stress-hormone-inducing reaction to being restimulated around previous trauma. I mean sitting in your little red rolling chair, calmly noting* an internal chemical cascade of hot-cold from chest to knees, as someone crumples into the recliner urgently in need of care.
This doesn’t happen everyday, or even every week (I have entire days of treating mild back pain, low moods and sniffles) but I do notice that it comes in waves, and especially when I am personally struggling with a flare-up of PTSD symptoms. Like the universe is saying “Let’s put a lot of trauma survivors onto Lisa’s shifts this week, just to make things extra interesting!”
This whole spring has been interesting. Some of the G20 defendants were sentenced in early March, and are now doing time for demonstrating against the G20 in Toronto in June of 2010. Another ‘punk and I offered free drop-in acupuncture aftercare for 5 weeks that summer following the incredible levels of state-sanctioned violence at the protests. We treated people for mental, emotional and physical injuries, witnessing the damage first on Youtube videos and then on our patient’s bodies as people trickled back from Ontario.
All this was swirling in my mind one damp Monday morning at a demo outside a Vancouver courthouse where several neo-Nazis were being sentenced, 4 years after vicious hate crimes. The priorities of the Canadian government and law enforcement could scarcely be more clear. Billions of dollars spent infiltrating, intimidating, harassing and hurting organizers before, during and after the G20 protests, but actively violent neo-Nazi groups receive a fraction of the attention.
Later that afternoon, one of my patients arrived with fresh bruises and lesions, including the familiar markings of handcuffs. They’d missed their appointment the previous week because they’d been beaten and hospitalized by the police.
Well, I’d reached my quota for being-enraged-about-systemic-injustices that week; the very next morning, my neck seized up, and I did my next two shifts rolling very slowly about the treatment room as the ‘punk in Poke who can’t do check her blind spot.
I’d really rather not get to the point of overwhelm where my body shouts at me like that. I don’t question the necessity of emotional boundaries, and I know that the more personal healing I do, the less I will struggle to stay fully present with someone else. Working out my own stuff, outside of the clinic, will help me to “get out of the way” in clinic.
But I don’t need to stop getting angry about harm. To do that, I’d have to forget that although I do live an exceptionally comfortable life, sometimes it’s me crumpling into the recliner. To stop getting angry about harm, I’d have to switch off the sense that we’re connected, and that there are links between police brutality, gendered violence, and racist attacks. I’ve come to believe that anger can be a fierce expression of love, can say: I am with you, and this, between us right here, is not just money exchanging hands and a service provided.

*I’m grateful to Vipassana meditation for giving me the tools to stay present with my patient when this happens. I’m also curious about how other ‘punks deal with similar challenges at work. Do you meet regularly with other practitioners? Do you debrief? Shower directly after a really challenging shift?

Lisa B.
Author: Lisa B.

Lisa prefers fireflies to fireworks, reverts to bluntness in stressful moments, would happily wear legwarmers year-round, and probably wants to be your friend.

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  1. I learned some good things in 5E school about anger. It has to be expressed or it keeps churning. Sometimes it shows up when the person who could be very rightfully be having it isn’t – that’s a common one showing up in the treatment room. For me, I’ll often write letters I never send, and find that as soon as I get to the core of what is angering me, it quite literally vanishes into thin air. Then I delete whatever I wrote. I was very angry a lot of the time in the first few months after I opened my clinic last year – all I could think about were the thousands of people just like the people coming to see me, who would never get acupuncture, never get help, because there aren’t enough punks, not enough clinics, and I knew all these people I’d just graduated with, who all went the boutique way, but they could be helping all the wonderful people just like my patients, all the elderly ladies with walkers and canes and tremors who couldn’t make their own sandwiches, the stroke survivors who couldn’t swallow, the people with no solution to the pain they’d been living with for a decade or more. They would never help them because they’d never see them, and I was and am still angry about that, although now it is the source of my drive when my energy flags, or I get stressed, or whenever life throws a curveball I’m not prepared for. It’s fuel now. Letting anger fuel whatever you need to create keeps it from stagnating and being poisonous.

  2. Thanks for sharing Lisa 🙂
    +1 on expressing anger. In whatever way is appropriate and helpful.
    I also go and play with the dogs. They are always so enthusiastically present in the moment.

  3. Two things about anger I learned doing wilderness rites of passage work, both best done privately away from sensitive eyes and ears. They both need wild places, really:

    1. the healing power of smashing the shit out of big rocks with old bits of tree until all that’s left is kindling. The rocks can take it and well, it gets the qi moving….

    2. go somewhere away from people. Find a stick and dig a hole in the ground, big enough to put your face in. Lie down on the ground and scream into the hole. Keep screaming until the screaming feels like it’s being sucked out of you. Pull yourself up, fill in the hole and thank the earth for taking your emotional overflow. Walk ten paces. Repeat as necessary, and it’s usually more than you think. This one really gets stuff going.

    Neither of these things stop me getting angry about things I feel righteously angry about, but they do move the anger that is stuck and toxic.

    Dogs and vipassana are also good.

  4. Thank you for this post. Anger is an emotion we all need to own, live up to, express and sometimes let go otherwise it gets into your neck. We see this everyday, we live it everyday and it is a good subject to speak about often. For me, anger settles into my lumbar spine and makes it hard to get up in the morning. I like that screaming into the earth idea, I think I’ll try it. Mother Earth provides as long as we appreciate her gifts.