The Community Acupuncture Clinic as a Third Place

There’s this pub in our neighborhood.Mike and I walk down there every Friday evening for a beer or two to unwind.The staff know our names, our favorite beers and our taste in music.We’ve made friends there.I run into patients there.We always talk about how lucky we are to have this fun, friendly place just two-tenths of a mile from our house.It is our third place.

In his book The Great Good Place, sociologist Ray Oldenburg celebrates the virtue of “third places” and laments their rapid disappearance from the American cultural landscape.The third place is any informal public gathering place where one goes mainly to socialize and interact with others in the community, a “hangout” if you will.As Oldenburg defines it, “the third place is a generic designation for a great variety of public places that host the regular, voluntary, informal and happily anticipated gatherings of individuals beyond the realms of home and work.”Oldenburg uses the term “third place” because it underscores the significance of the tripod and the relative importance of its three legs in creating stability.The first place in an individual’s life is the home; the second place is the work setting; the third place is wherever you go voluntarily, whenever you choose, with no agenda other than to enjoy yourself and the company of others.Think the German beer garden, the English pub, the Parisian café, the Italian piazza, the Japanese teahouse, the American…


Americans don’t have many great third places.The television show “Cheers” is probably our best example…yet.A new breed of third place is popping up in cities across the land, something you might not expect: a Community Acupuncture Clinic.

While the third place is often a haven of escape from the stresses of home and work, it is selling it short to describe it as a merely so.According to Oldenburg, “there is more than shelter against the raindrops of life’s tedium and more than a breather on the sidelines of the rat race to be had amid the company of a third place.”The third place builds cohesion and camaraderie among members of a community, by exhibiting certain attributes all third places share:

On neutral ground.At a third place all may come and go as they please, all feel at home and comfortable.It brings together people who may not otherwise meet.

The third place is a leveler.It is accessible to the general public and does not set formal criteria of membership and exclusion.Worldly status claims are set aside as one passes through the doors of a third place.“The surrender of outward status, or leveling, that transforms those who own delivery trucks and those who drive them into equals is rewarded by acceptance on more humane and less transitory grounds,” states Oldenburg.“Leveling is a joy and relief to those of higher and lower status in the mundane world…They are accepted just for themselves and on terms not subject to the vicissitudes of political or economic life.”Is any of this starting to sound familiar?

Conversation is the main activity.Oldenburg states that, “Nothing more clearly indicates a third place than that the talk is good; that it is lively, scintillating, colorful, and engaging.”Okay, so maybe this is where a CAP doesn’t quite fit the third place model.After all, people don’t come to us for scintillating and colorful conversation.But I still think that an awful lot of social interaction happens at our clinics: patients lingering at the front desk to chat with your friendly receptionist; friends unexpectedly running into one another in the treatment room.Or patients who, treatment by treatment, needle by needle, tell you a little more about their lives.And let’s not forget the silent conversation that happens among patients in a treatment room full of people in acu-land.Sure, we may not have bar conversation, but we have conversation.

Accessibility and Accommodation.Oldenburg argues that access to third places, “must be easy if they are to survive and serve, and the ease with which one may visit a third place is a matter of both time and location.”Yeah, CAPs are pretty much all about accessibility and accommodation.

The Regulars.“The third place is just so much space unless the right people are there to make it come alive, and they are the regulars,” says Oldenburg.Oh yeah, we’ve got regulars.

Low Profile.Physically a third place is rather plain, not elegant, and without fanfare.Plainness discourages pretention among those who gather there and encourages the attitude that the place is an ordinary and expected part of life.This reminds me of Lisa’s descriptions of the Zen-Spa Noodle and Medical Doctor Noodle in Acupuncture is Like Noodles.Third places aren’t fancy; they’re just plain, basic, nourishing noodles.

The Mood is Playful.Again, this isn’t entirely true of a CAP – people don’t come to us for displays of wit and boisterous laughing.But Oldenburg does describe the playful mood this way, “Here joy and acceptance reign over anxiety and alienation.”Sounds like a CA clinic to me.

Home Away from Home.The third place is one where people feel rooted; there is a reassuring routine there.It is a place of restoration and regeneration; it is warm and inviting.

So now we see that even though a CAP may at first seem vastly different than “Cheers,” they actually share a number of important qualities that draw people in and bring them back again.But are third places all that important?Have we as a society evolved beyond our need for them?After all, we enjoy more creature comforts at home than ever before.And now the internet makes it possible to connect with anyone and anything in the world, anytime we choose.Do we really still need the neighborhood pub?

Oldenburg argues that third places fulfill some basic human needs that can’t be met elsewhere. True, the first and second places of home and work provide the essentials of food, water, clothing and shelter.But we humans are social animals; most of us thrive in the midst of others, and third places are where we are at our most social.

Public life has moved indoors at a shocking rate.Why go to the movies when you have a state-of-the-art home theater!Why go browse through the selection at a locally-owned bookstore when you can just order it from Amazon!Or better yet, download it on your Kindle!No waiting required!Why hang out with your friends at the local pub when you have your very own man-cave!Home offices, home schools, hell, even home churches are pulling us out of public spaces into the safe haven of our home.The world is a scary place, we’re told; a bigger better home will save us.Except that the insular life ultimately disappoints.As we get closer and closer to reaching that “American Dream,” we are becoming more and more unhappy.A host of reports on well-being have concluded that Americans have grown continuously more depressed over the last half-century.An analysis of the World Database of Happiness found rising levels of happiness in 19 out of 26 countries from the years 1946 through 2006.Guess what?We weren’t one of those countries.(Actually, by saying “we” I’m betraying my typically American mindset – Canadian comrades, y’all did exhibit an increase in happiness over the last 60 years).Economic gains, bigger houses, flashier cars, more possessions, instant gratification – they haven’t made us any happier.What we need is social contact.We need novelty – a place where we might see some new faces or have a new experience.We need perspective – a place that supplies human association that is pleasurable and gratifying, not stressful and irritating.We need spiritual tonic – a place to relax, a place where we’re not hurried.We need our third places.

Third places, along with their many social benefits, are rapidly disappearing from our cultural landscape.“Hanging out” in the company of others in an informal public place is not considered to be a productive use of time.Yet we crave it as a respite from our isolation, loneliness and boredom.That’s why third places appear again and again as entertainment – the bar on “Cheers,” the coffee shop on “Friends.”Anyone remember the hilarious barbershop scene in “Coming to America” where Eddie Murphy plays all those different characters?Perfect example of a third place.Third places are interesting; that’s where the action is.But if you’re not a character on a television show, where do you go to hang out?We don’t have many options – our public spaces aren’t exactly teeming with people.Most of the time when we see someone walking, they’re going to or from their car.We load up our homes with diversions and attractions because they’re so hard to find in the outside world.Where does one go to participate in a rejuvenating and enlivening exchange with one’s neighbors?

The geniuses at Starbucks have figured this out – it’s the closest thing our society has to a third place, yet it is an ersatz one.It meets some of the criteria but it doesn’t breathe life into your day.You know what does?A visit to your neighborhood Community Acupuncture clinic.And lucky you if you can walk there from your home or workplace.I’ll be talking more about third places and how CAPs can fill that role at the CANference.I’d love to hear your thoughts too.

Author: alexa

Hey y'all!  I opened my CA clinic here in beautiful Music City, USA, in January 2010.  I love hanging out with other community acupuncturists, so come visit!

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  1. It brings together people who may not otherwise meet.

    CA clinics are an important ingredient in braking down barriers of race, class, gender, religion, sexual orientation, ability, age, language, and many other social identifiers in the world today. When all is silent, a lot is going on. The world gets smaller, people’s minds get bigger and more inclusive.

    Great piece Alexa.

  2. Happiness is…

    When your work place and a third place are the same place 🙂

    Reading this was a great way to start my day.  Thanks Alexa. 

    Steve Kingsbury

    Ashland Community Acupuncture, LLC

  3. this is a terrific blog

    and I am SO glad you wrote it.

    The first time I read it, I immediately thought about how acupuncture is delivered in Asia and if it could be considered a 3rd place there. I remembered hearing an American acupuncturist describe his visit to a famous Japanese acupuncturist (I think it might have been Shudo Denmai), whose clinic was a cozy little space with a television playing soap operas at full volume. The famous Japanese acupuncturist went around the room, spending exactly 3 minutes with each person, and then the famous Japanese acupuncturist’s wife followed that up with exactly 5 minutes of moxa. Meanwhile all the patients chatted and watched TV.

    How much of acupuncture’s failure to “take” in America has to do with it mostly not creating a 3rd place?

    And then I read your blog again and I thought, this is such a perfect way to convey to people what you need in order to have a successful clinic. A community acupuncture clinic is NOT the same thing as a conventional acupuncture clinic with more capacity and lower prices. The ones that are, I think, mostly don’t do any better than conventional acupuncture clinics, which is to say, usually, not very well. Because a successful community acupuncture clinic isn’t just about the acupuncture or God forbid, the acupuncturist. The acupuncture is important but what allows a clinic to really take off is that 3rd place vibe.

    I thought about how many times over the years I’ve explained WCA’s success the same way: basically we’re just really happy to see people when they walk through the door, and we show it. But maybe the important element is that we show it in a 3rd place way, not in an acupuncture-y way. We don’t act like we’re in control, particularly; we’re just there to put in the needles and keep the party humming along so that everyone else can relax.

    I wonder if there is a way to quantify a clinic’s ability to build that 3rd place vibe, if we could identify how the essential elements that you listed should look specifically in a community acupuncture setting, so that people can get them in place if they are missing.

    I can’t wait to hear more, Alexa, and I’m really excited that you are doing a conference workshop on this. Thank you.

  4. .

    Very nice blog Alexa. It put in to words for me this feeling I get with brand new patients sometimes  as I’m explaining how everything is set up. something inside me says to them, “You are going to love it here, and will be coming back much more than you probably think.”

  5. Agree

    …about happiness being as stated above.

    After reading this I thought about my third places.  I have been working on making CCA a third place, and lately there seems to be a lot of hanging-out and tea-drinking going on, which is so enjoyable.  I often hear squeals as people recognize friends and neighbors they didn’t know were also patients here. 

    Anyway, one thought that came into my head is the kind of criteria I have for my third place (I like kind of dirty, slightly noisy, with energy that doesn’t race around too much) and trying to put that together with what CCA is like (I wouldn’t say dirty or noisy…)  Looking at it that way might help me figure out how the environment of the clinic can help people slow down a little more and hang long enough to relax into neighborliness before or after treatments.

    Awesome blog.

  6. Fantastic post!

    Thank you so much for this.  My husband and I talk about 3rd spaces a lot (and the lack of them and the need for more).  Little did I know that I was working in the middle of one this entire time!


  7. ditto!

    I was just thinking that, Steve!  What a great post. I think it should be published… maybe you should send it out to your local weekly.  Thanks for making my day!

    Julia in Berkeley

  8. Thanks

    for the comments everyone.  I got so excited when I started reading about third places – I thought, “this is what CAN clinics have been doing for years!”  We all feel the need to connect with our fellow humans and we CANners, I think, feel called to create a space to do that – acupuncture is our vehicle for creating connections.  Yes, we love the medicine but I think even more so we all really love people and have a strong desire to be social (and I say this as an introvert who loves to spend her days off reading in bed).  And, since we’re a pretty enterprising bunch, we’ve made this collective effort to create this third placeness that’s so hard to come by these days.

    @Jordan: yes, there is such a need to bring together people with differences and so few places to do so, and what I love about CAPs is that we’re bringing people together with absolutely no agenda, other than to use our skills to help ease suffering.

    @Lisa: yes, I agree that this third-placeness is an important component in creating a successful CAP and is what draws people in.  It’s like going to a coffee shop where the vibe is relaxed vs. going to one where it’s totally pretentious.  It doesn’t matter how good or bad the coffee is.  Coffee is pretty easy to make at home.  People go to coffee shops because they want to be around other people.  So as creators of these places, we can indeed be very intentional about fostering third placeness.  We just have to follow the criteria in our own wonderful CAN way. 

    All of your comments have gotten me thinking even more so I’ll plan to do a follow-up blog after the CANference with more specifics about how we can meet the criteria.  Y’all are awesome.  Thank you.

    And @Steve: I love your definition of happiness.  Professor Oldenburg may disagree; he may insist that a third place has to be separate from the work place, but then again, he never was a community acupuncturist :). 

  9. What a great post. Thank you

    What a great post. Thank you for writing it. My patients and I have often discussed that this is the only place they have to “just be themselves” with no expectations, no need to talk, plenty of listening and conversation if they want to talk and no judgment. They don’t have to dress up and don’t have to be around a practitioner who dresses up either. What a relief! Patients sometimes give a big sigh when they come in and say “Oh I’m so glad to be in this space!” The other day I felt so good when my patient said to me, “This is my safe place.”You are absolutely right. We have acupuncture to give people, but the space surrounding them heals and is much needed too! I had never heard of a “third space” before and now have this wonderful concept in my head to better frame the community acupuncture experience (which I benefit from as well!). Thanks so much.

  10. love this blog!

    thanks so much for posting it, Alexa. lots of great reminders in here.

    Kelly and I got through crazy acu school and did a lot of birthing our clinic at our then third place, a neighborhood pub called Second Street. the clinic ended up right down the block!

    also re-affirms our need for some additional interior walls to create a front lounge area for more chatting. i just love when people run into friends unexpectedly in the bliss zone.


    Good health is not a measure of adapting to a sick society.

    When the power of love outshines the love of power, the world will know peace.

  11. I keep thinking

    I’ll wait to comment till I have something smart to add, but then I keep not having anything smart to add.  I just think this a wonderful and helpful post, and the fact that you used the word “ersatz” only makes me love it more.  Thanks, Alexa!

  12. Lovin’ this too….

    ….and just what I needed.  I was falling into that stupid place of thinking that it was about the “acupunture”…..ahhh, relief from self importance.  I’m so glad this blog exists….haven’t checked in recently, and I start to feel so alone in this when I don’t.  To work tomorrow with a whole new perspective as noticing the “third place” gathering that does so naturally happen in my cozy clinic if i just get OUT of the way….



  13. Third places

    Great blog! It’s making me rethink how big I should make my waiting room since I have a choice where I put my wall. I went for my 1st tx today at WCA, and loved their huge waiting room! Really a third place supreme!

  14. Is it ok to reproduce this article for my CA FB page? Or would that constitute a ‘wiki-leak’…sorry, bad joke – apologies if it’s been done to death.