POCAfest Keynote: Dangerous Potential

Thank you all for coming.

I'd like to acknowledge that we're on the traditional territory of the Miwok people, and I'd like to acknowledge and thank everyone who made it possible for us to be here, including the people who built these buildings and who clean them and care for them every day, and all the volunteers, especially from the Events Circle, who put so much time and work and love into organizing this POCAfest.

Let’s talk about liberation.

A million years ago, when a lot of people were first being introduced to the community acupuncture model, there was one theme that kept coming up in different conversations: the idea that CAN (that’s the Community Acupuncture Network, or the proto-POCA for all of you who weren’t there), that what CAN really gave acupuncturists was permission. It’s not that our ideas were brand- new, it was that we gave people permission to do acupuncture the way that they had always, in their heart of hearts, wanted to do it anyway.  Simply, inexpensively, unpretentiously, efficiently. We would get emails from all kinds of different people that said, I’ve wanted to do acupuncture this way for such a long time but everybody told me that I couldn’t. More than one student who said, I brought this up in my practice management class and my teacher told me I was devaluing the profession. A Chinese acupuncturist who said, When I moved here people told me it wasn’t possible to do acupuncture this way in America but I never stopped wanting to. And now I’m going to.

I think Keith from Tucson Community Acupuncture was the first person to actually use the word permission, and it’s interesting, a synonym for permission is liberty. So there’s been this undercurrent the whole time, but until this last year we hadn’t used the word liberation.

The truth is, there are a lot of things about the model, things that we all come to take for granted, that are liberatory. For example:

A lot of us acupuncturists were taught that you have to be a great Master, and also present yourself as one to the world, if you want to get good results. You have to know everything about everything before you can do anybody any good. Finding out that that isn’t true, and that acupuncture in its simplest form really works, was a tremendous relief. And very liberating.

A lot of us acupuncturists were also taught that you have to DO everything for everybody if you want to get good results — you have to do cupping, and moxa, and tui na, and prescribe herbs, and maybe add some aromatherapy — the list goes on and on. How do you know when enough is enough? So it was liberating to find out that acupuncture on its own can be enough. It can be a lot. It can change people’s lives.

And the weird corollary to this “you can never do enough”  that we were also taught is of course that in spite of all that you do, if your patient doesn’t do enough, if they don’t change their diet and start meditating and do qi gong and exercise every day and drink 8 glasses of water and go to bed earlier and quit smoking and drinking coffee, well, how can you HELP them if they won’t HELP THEMSELVES, we all know that story, let’s just say it’s very liberating to not have to lecture your patients and harangue your patients and ultimately fire your patients for non-compliance. It’s very liberating to just shut up and give people acupuncture when they want acupuncture, without making it conditional, without making a federal case out of it. I’m sure it’s liberating for patients, also, to just be able to get acupuncture when they want acupuncture without being told, you’re not doing enough.

And on the economic side, those of us acupuncturists who tried to have practices where we billed insurance remember what it’s like to have a third party in the room with you and your patient, a for-profit company that decides whether or not your patient has a valid form of distress (in the form of a billable diagnosis); and if so, how much acupuncture your patient can have; and then tells you how you have to chart to justify it all. Getting rid of that annoying, intrusive third party? Also very liberating.

Along those lines, a little more subtle but for many of us very profound, is the way the model freed us to be able to have relationships with people we would never otherwise have had relationships with, people who don’t have a lot of disposable income. When you’re charging $50 and up for an acupuncture treatment, there are so many people, so many different kinds of people, who can never come into your practice; there might as well be a wall between you and them. When the price of acupuncture comes down, the wall comes down too, and all these amazing people flood into your life. This is how a lot of us met each other, how patients became volunteers and staff people, not just passive consumers but participants in clinics, and how so many of us became part of POCA. Once the wall was down, we were free to create relationships with each other. It was liberating.

OK, so this is the part of the speech where I’d like to publicly acknowledge that Acupuncture Today was right back in 2007 when they fired me as a columnist.

(Bet you didn’t see that coming.)

After I’d been writing columns for them for about a year and a half, I got an email from their chief editor that said, “After several conversations with my publisher and others, we are concerned about continuing your column under its current “theme”, for lack of a better word. While the concept of social entrepreneurship, particularly the “pay according to what you can afford” aspect, is admirable, it has DANGEROUS POTENTIAL from the perspective of professional advancement.”

For a long time I thought that email was pretty funny. Now I think, OK, they’re right.

Liberation has dangerous potential.

And it starts with having relationships with people you would never otherwise have relationships with, people who don’t have a lot of money.

All of us who work in clinics — acupuncturists, receptionists, volunteers — all of us have heard patients say, “I love what you’re doing here! Why can’t the rest of the world be like this?”

Well, why can’t it?

That question has dangerous potential.

Paolo Freire (more about him in a minute) says that it is everyone’s vocation to become more fully human. Injustice, exploitation, and oppression make us less human — whether we are in the role of oppressors or of oppressed. And we know that in this society most of us, often, are both. We have so many opportunities, here in late capitalism, to treat each other and ourselves as if we weren’t actually human beings. But for the most part, community acupuncture clinics are the opposite. They’re set up so that we meet each other primarily as human beings rather than as numbers or roles or images or income streams. We recognize that everyone suffers, everyone has needs, everyone is struggling with limited resources. And so for the most part, at least on our good days, our POCA clinics are humanizing environments.

Which means they are also, potentially, radicalizing environments. Once you start GENUINELY believing in and valuing the human dignity of people who don’t have a lot of money, people with whom you would not otherwise be having relationships, people of different ages and genders and ethnicities and races and backgrounds, people with whom you share, despite those differences, an awareness of suffering — at that point, my friend, the work you’re doing as a volunteer or a receptionist or an acupuncturist, at that point your work has dangerous potential.

Because liberation is a process. Once it starts, it doesn’t want to stop. Once you start treating all kinds of different people as human beings, it gets harder to stop, it gets harder to turn it off when society tells you to. You’ve put yourself in a situation where you can’t quite look past people who are supposed to be invisible. When you’re in the grocery store, you notice that the checker is wearing wrist braces and you realize she’s in pain. You think about her working conditions, about whether she has to stand all day and besides her wrists, how’s her low back?

You get to the point where you can’t look at another person without wondering, what hurts?

If more people wondered that, if they acted on it, capitalism might not function. What would happen if we insisted on treating people like people, and stopped treating people like things?

My coworker Whitsitt Goodson said once that the thing about working in a community acupuncture clinic is that you see how the violence of our economic system is written on people’s bodies, minds, and spirits. Once you’ve seen that, you can’t unsee it.

Dangerous potential.

As many of you know, we started talking about liberation acupuncture in part because of the demands of our school, POCA Tech. We needed to speak the kind of language that other educators would understand, and Paolo Freire, who wrote the book Pedagogy of the Oppressed, really helped with that. In some ways the person who helped the most with the whole project is someone none of us will ever meet; a professor of psychology named Ignacio Martin-Baro . He lived and worked in El Salvador and only one of his books, Writings for a Liberation Psychology, has been translated into English.

Martin-Baro created the field of  Liberation Psychology in part because he had a very definite critique of his own profession. He said, “Latin American psychology must stop focusing attention on itself, stop worrying about its scientific and social status, and instead propose an effective service to the needs of the majority of the population.”

Hey, what does that remind you of?

He also said that one of the big problems with psychology was that it was founded on an unexamined assumption of individualism, and “individualism ends up reinforcing the existing structures, because it ignores the reality of social structures and reduces all structural problems to personal problems.”

So by focusing on all the ways that patients need to change their lifestyles, we’re missing an opportunity to notice and speak up about the ways that the violence of our economic system causes our patients to suffer.  Martin-Baro’s ideas about how psychology had to change in order to be useful to ordinary people in his country are directly and acutely applicable to our project of changing acupuncture to be more useful to ordinary people in our countries. Try this: acupuncture in the West must stop focusing attention on itself, stop worrying about its scientific and social status, and instead propose an effective service to the needs of the majority of the population. These ideas are a very sturdy academic foundation for POCA Tech.

Ignacio Martin-Baro’s ideas had dangerous potential. They had dangerous potential to the repressive regime in El Salvador, and they had dangerous potential to him. In 1989 he was murdered by a death squad,  along with five of his colleagues, their housekeeper and her daughter. This particular death squad was a rapid-response, counter-insurgency battalion created at the U.S. Army's School of the Americas.

If we’re going to make use of Martin-Baro’s ideas, we need to remember that he was essentially killed by our government. Along with that, we need to recognize that we are not the originators of the the idea that acupuncture can be applied in a social context, with a critical social lens. That would be the Young Lords and the Black Panthers, and if it were not for their work, all the acupuncturists in  this room would probably be boutiquers. Think about that for a minute. And remember that the Young Lords and the Black Panthers were also targets of violence by the US government.

So one of the things that Paolo Freire says is that when people first get excited about liberation, or about revolution, there is a temptation to make it their private revolution. It’s tempting to think, oh, the community acupuncture model has liberated me from all these weird ideas imposed by the conventional acupuncture model, now I am free, free to do whatever I want! That’s understandable but it’s not fair. It doesn’t recognize the debt we owe to people who truly suffered for their commitment to bring healing to their communities. Community acupuncture didn’t fall out of the sky into our laps; it’s not a blank slate for us to write on; it’s deeply connected to people struggling against oppression.

Both Ignacio Martin Baro and Paolo Freire were influenced by Liberation Theology. One of the central ideas in Liberation Theology is the idea of accompaniment, or companionship with people who are oppressed. Instead of trying to lead people down a particular road, you walk with them on their journey. Taking the idea of accompaniment seriously means being willing to be present with suffering that we can’t fix, suffering that no one can fix. It also means being present with the impact of oppression on our patients. It means staying connected to them and not leaving, not retreating into a more comfortable position in society where we don’t have to see or feel or comprehend what people’s lives are really like, as a result of certain aspects of our society that we often take for granted. There are a lot of -isms that can seem abstract — racism, disablism, capitalism — until you see their effects close up, through relationships with people that are hurt by them, and then those -isms become concrete. They become real to you, as people’s suffering becomes real to you.

That’s what the framework of liberation acupuncture gives us: an overarching perspective on the ways that the relationships we have in our clinics begin to change us. It’s nice that the community acupuncture model has liberated us acupuncturists from doing a lot of pointless, frustrating things like trying to make everybody stop drinking coffee, but ultimately what it does is to show us, if we’re open to seeing it, how much other people need and deserve liberation.

Paolo Freire wrote: “Liberation is thus a childbirth, and a painful one. The (person) who emerges is a new person, viable only as the oppressor-oppressed contradiction is superseded by the humanization of all people. Or to put it another way, the solution of this contradiction is born in the labor which brings into the world this new being: no longer oppressor nor longer oppressed, but human in the process of achieving freedom.”

So the question that I’d like to leave you with, if you feel that community acupuncture has liberated you from anything, anything at all, where is it that liberation wants to take you next? This was never meant to be anybody’s private revolution. The Young Lords and the Black Panthers didn’t do the groundwork for this model in order to help us become, personally, more comfortable in capitalism. You could say that the real purpose of community acupuncture is the humanization of all people. All people. That’s its dangerous potential. How would it free you more, if you let it? And who would YOU be, if you were less oppressor, less oppressed, and more human in the process of achieving freedom?

Author: lisafer