Community : We Really Mean It
The most radical thing about community acupuncture is that it approaches acupuncture within the context of community rather than within the context of the individual. This is one of the most basic mental shifts an acupuncturist needs to make in order to be successful within a community clinic, and it’s one of the hardest aspects of deprogramming potential employees.
In the opening scene of Finding Normal(https://www.findingnormal.org/), David Fitzgerald says: “All these guys are different. You got to meet them where they’re at, you got to figure out where they’re at so you can meet them there and work with them from that point. Some people are more tired than others. Everybody has different issues. Some guys have done a lot of time, some guys haven’t. Some guys shoot methamphetamine, some guys smoke crack cocaine, some guys drink alcohol and some guys shoot heroin. But the common thing about it all is, we’re all addicts. There’s more similarities than there are differences. And just finding them similarities, and getting them to recognize it, and then finding a point that you can work from. I love my job, man, believe that. I was born to do this shit.”
This one-minute speech at the beginning of the movie refers directly or indirectly to most of the skills, the mindset, and the qualities of character that you need in order to be a successful community acupuncturist. You could translate David’s speech something like this, for community acupuncturists: “Your job is to treat all kinds of people. On the surface, there are all kinds of differences: age, gender, class, race, culture, language, disability, religion, personality, you name it. You need to be able to see those differences and understand how those differences affect your patients’ lives. You can’t ever fully understand what it’s like to be, say, of a different race, and so you need to approach everyone respectfully and without judgment. Since you can’t necessarily fully understand, you need to try to recognize and appreciate what your patients are dealing with in their lives that may be very different from what you are dealing with. You need to meet them where they are, or whatever is your best understanding of where they are, rather than where you think they should be. But what matters even more than the differences are the similarities: everyone experiences pain and stress. As a community acupuncturist, your job is to appreciate the differences amongst your patients but to focus your acupuncture on the similarities. Learn what works for everybody, what simple approaches will be valuable to all kinds of people, rather than trying to reinvent your approach with each new patient. This way you will be able to help all kinds of people, connect with all kinds of people, and that is the most wonderful experience you can imagine.”
Here’s something else about David’s speech: note that he says, “we’re all addicts”, as opposed to “they’re all addicts.” A community acupuncturist needs to think in terms of “we”, not in terms of “they”. You can’t build community for other people, you have to be fully part of it yourself. You have to put your heart into it.
Thinking in terms of “we” rather than “they” has some concrete implications for how you are in the clinic. Check out this set of conversations from the film:
David: So, Louise. Who is he (nods head at Ray) and why are you referring him?
Louise: This gentleman has been through several treatment programs and appears to have done well in the programs.
David: How old are you?
Ray: I’m forty-five.
David: Forty-five? Is that what you said?…You don’t look that old. (Ray smiles.)
Louise: Problem is, he has no skills for the life after treatment.
David: What’s your drug of choice?
Ray: Crack and alcohol…I’m forty-five years old, here I am, I’m on the streets homeless, and I felt like what you said, it was time for me to do something for myself.
5:39 David talking to Ray about his own initial resistance to getting a sponsor:
But anyway, my sponsor’s standing out there right now. (Grins.) I got to be real careful, he might toss me up. That’s my sponsor. For real, Tom Young. (Tom waves at the camera)
David at Hooper Detox: So I’m here to get Mr. Daniel Winters out.
David meets Daniel in a group of clients waiting in the hallway.
David to Daniel: So, you getting signed out? I’ll be waiting for you out here.
David to other client, out of camera range: Hey man, what’s your other brother’s name? Brad? Hey, Brad’s ornery, man. (shaking head, laughing)
David and Daniel in the car.
Daniel:…I know what I need to do. It’s good knowing some folks down here, too.
David: We’re going to put you in a position to be successful…Anybody can come up, we’ve all come up a million times, but what THIS time is about, it’s about coming up and staying up. And that’s a different game. You know, you know some things, you’ve been exposed to some of the recovery process, but there’s some things that you missed.
David: So what we’re going to do, is get you to slow down, pay attention, and I want you to evaluate me as much as I’m evaluating you, and you figure out who the fuck I am and what I’m really talking about, and check out what my motives are and what my intentions are. OK? And you can be skeptical, it’s OK, you don’t know me and I don’t know you.
David: But what you’ll come to find out is, I’m pretty genuine about helping somebody get clean.
Daniel: Right on.
David to Daniel: Sarah told me to watch out for your girlfriend. Are you tripping?
Daniel: A little bit, man. (Describes his history with his girlfriend).
David: So, not for one minute am I going to try to be the relationship monitor, and tell you who to be with and who not to be with. But what I want to talk to you about is, here for a little while, Daniel, take your time, slow down, you know, we’re putting you in a room, getting you in a place where you can re-evaluate what’s going on with you, how things serve you, and where it is that you want to go. I’m not telling you to cut the girl loose, I’m not telling you anything but, what I’m telling you is, take some time for yourself to re-evaluate what’s going on.
David: All right?
David: Don’t go running off to go hang out with her, don’t go find her, take some time for you because this is all about you. It’s not about her, it’s not about your mom, it’s not about your dad, it’s not about anybody BUT you. If something goes on with you, you need to figure out what the fuck it is, so that you can do some work around it, so that you can get a handle on this stuff, so that you can start to get some sanity and manageability around your life. (Pauses) You understand anything I just said?
Daniel: I do.
David: All right.
All of these conversations locate healing and communication in the context of community. In the first one, Daniel and Louise are talking about Ray in the third person in front of him — without any disrespect or weirdness. There’s no difficulty at all for David to move from talking about Ray to talking to him and to connect immediately, in a way that allows Ray to open up. There’s no awkwardness for David to move from talking to Ray about sponsors to pointing out his own sponsor — who of course is right there, in David’s workplace — and to joke about David himself getting “tossed up”. There’s no uncomfortableness for David in joking with someone that his brother is giving David a hard time. There’s a lot of freedom, honesty, and connection; there’s no pretense or posturing. Because all of these people are clearly in this together.
Community demands a certain kind of transparency. David encourages Daniel to be skeptical, to check him out; in this context that means to watch him interact with other people and to analyze who he is by observing his relationships. This is one of the great things about being a community acupuncturist: your patients see you interacting with other patients. You can’t become a different person with each interaction, you can’t morph into what somebody wants you to be, because you are continually responsible to the entire community. As anyone who has gotten burned out on years of one-on-one treatments can attest, it’s much better to be responsible to a group of people than to be at the mercy of individual demands. The pressure to become or to do whatever someone wants, because that person is paying you a lot of money, vanishes in a community context. In return, you have to figure out who you really are and be that person all the time. You have to be very clear about what your boundaries are — as David says to Daniel, “not for one minute am I going to try to be the relationship monitor”, something he can’t be and doesn’t want to be — because your boundaries are on display for everyone to see. This is a good thing. Community creates “sanity and manageability”. Community reinforces integrity. Community means that you’re not juggling a series of relationships with individual “they”s , until you’re exhausted; you’re participating continually in an experience of “we”, which keeps you nourished and supported.
And a side note, some stuff that isn't going to go in the guide, because it needs Internet links, but which I can't resist because it is SO DAMN CLARIFYING:
Lonnie Jarrett seems to be doing something structurally similar to CAN — and yet, oh so different. I stumbled across this site while I was in the process of writing this installment, and I'm going to link to it extensively because it's just so perfect. If you click on the “About” button on the Nourishing Destiny site, you get a list of their values. Note #17 especially: “The vertical development of the practitioner is the most significant factor that makes possible a patient's healing”. I glanced through some of the discussions on the site, and they are true to their principles. Like this thread, for instance: Hierarchy in the Treatment Room. (They're for it.)
OK, folks? Especially people new to CAN? This is the opposite of what I am talking about. In theory, it doesn't have to be the opposite, but in practice, it is. In theory, there is a continuum of what to emphasize in acupuncture: at one end is the practitioner, at the other is the patients, and in the middle is community. The Nourishing Destiny folks believe that by focusing enormous energy on the development of the practitioner, the patients will be transformed. On the other end, you could suggest that by practitioners putting all of their focus on to patients, they themselves will be transformed. David Fitzgerald occupies the (in my mind) perfectly balanced middle, where by putting energy into the community, everybody is transformed. An all-out emphasis on the practitioner shouldn't necessarily mean ignoring patients, but in practice, in the world of American acupuncture, it usually does. And that's probably because of class.
Here is a nifty example of what we're talking about: the Nourishing Destiny thread on Addiction. Basically, this thread deals with the question of whether it is possible for a healer to drink alcohol, ever. That is the important point: the healer's level of purity, clarity, and integrity. Contrast this, say, to the example of Lincoln Hospital, where the point about addiction is how it destroys communities, disproportionately communities that are poor and/or made up of people of color. The question on the ND thread is whether someone who has two drinks a week is really giving themselves to creating the future. The question is, as an acupuncturist, when you think about addiction, are you thinking about your own ability to have two drinks a week and create the future? Is that what addiction means to you? If so, I'm suggesting that you will not be happy doing community acupuncture.
Maybe you could argue that what David Fitzgerald is doing is influencing people, including me, by means of his superior vertical development. Funny though, he just doesn't act like it. And I'll gratefully follow his example, any day, over anybody who claims to be spiritually evolved.