What Went Wrong with Acupuncture in the West? A Theory

Casual conversations that include the question, “so, what do you do?”  often turn into lengthy, involved discussions when you’re a community acupuncturist.  What sometimes happens to me, especially with patients or potential patients who have some knowledge of acupuncture, is that people will say something like, “Hey, that sounds great! But, uh, that isn’t really a new idea, is it? Isn’t that how it's done in China? Everyone gets treated together and it's inexpensive?” “Yes, mostly,” I say.  They look puzzled. “Well then, how did it all get so messed up here?  What happened?”

            My response to that question has usually been, “I wish somebody would explain that to me” or “well, isn't that the $64,000 question”. And often the conversation ends  there, because I shrug and they shrug and that's that — or they move on to, “hey, does acupuncture work for ____?” But for some reason, a few weeks ago, instead of shrugging, I realized that I needed to think about that some more. How didacupuncture get so messed up in the US? How did we end up with overpriced, overly long schooling and legions of failing graduates and virtually no jobs?  How did we end up with a dominant business model and clinical model that exclude more patients (and practitioners) than they include? What force could warp such a good thing as acupuncture so thoroughly?  What could have such a big impact on an entire field and yet go undiscussed, unidentified, maybe even totally unnoticed from certain angles?

            OK, granted, in the real world, it’s rarely just one thing that goes wrong. There are almost always multiple factors at work. But, I thought, what if there was a useful, meaningful answer to the question what happenedthat I just couldn’t see for some reason, despite 18 long years of knocking around this messed-up profession and otherwise being a reasonably smart person? Oh. Hey.How about white privilege?

            Trying to assess the impact of white privilege, as a white person, feels to me something like trying to look at your own eyeball. But I think it's worth trying because  those times when I can actually get a glimpse of my eyeball, it's like WOW! And also, WELL, DUH. And also OUCH! But still, WOW! Because the distortion is so astonishing, and it's just amazing to be able to see around it, even for a moment.

            Disclaimer #1: I am not going to use this post to argue about the existence of white privilege, because as far as I'm concerned, that argument is not useful. See the POCA posting policy for more information on things that are not useful and what you can expect to happen to them here.

            Disclaimer #2: This post is only about the potential relationship between white privilege and the overall dysfunctional economics of the profession. There are a lot of different posts that could be written about the role of white privilege in the lives of white acupuncturists in the West. I tried to write this post about various aspects of white privilege reflected in my own acupuncture career, and it started to get really long and unwieldy; that topic possibly could fill a book. So in the interests of staying focused, this post is not intended to be a comprehensive treatment of the topic of white privilege and white acupuncturists.

            If, however, anybody is thinking, wait, what does she mean by white privilege? There are lots of writers out there who have addressed it much more eloquently and entertainingly than I can. Check out these links:

            Entertaining and addictive: https://yoisthisracist.com/ ; see also:  https://colorlines.com/archives/2012/01/yo_is_this_racist_andrew_tis_tumblr_has_the_hilarious_answers.html

            Multiple perspectives: https://whitepriv.blogspot.com/

            Tim Wise has plenty to say: https://www.timwise.org/tag/white-privilege/

            A big list! https://www.godblessthewholeworld.org/whiteprivilege.html

            If you are a white person and you haven’t given white privilege much thought, I highly recommend that you dive down this particular rabbit hole.

            So this is what belatedly occurred to me a couple of weeks ago:  if ideas and technologies are passed between cultures all the time, and they are, how did the practice of acupuncture in the US come to look so incredibly different from the practice of acupuncture in China? In ways that don’t make sense and, over time, are showing strong evidence of not working? Why wouldn’t American practice just track Chinese practice from the very beginning — doesn’t it seem like there had to be some unexamined assumptions that  OF COURSE we couldn't just do something here the way they do it in China, regardless of the fact that it works better when you do it that way? Because we might have to admit that non-white people actually know what they’re doing?

            One of the things that I notice about white privilege for myself is the way it gives me totally unearned authority, including in my own head. White privilege both shows me a world that revolves around me, and makes my perspective synonymous with objectivity. So here’s a medical practice that’s happening in a social and cultural context that’s largely oriented around community; white people get interested in it, and a couple of decades later, it’s totally individualistic (and economically unsustainable) and nobody even wonders why. That’s a profound change, and it seems to me like it couldn’t be possible without a profound distortion in perspective.

            And if you factor in the general tenor of objectification and fetishization of Orientalism — some of the ways that the West likes to relate to Asian cultures when it can — doesn’t it seem like there’s an echo in the way that acupuncture in the West often looks like something to display, rather than something that has an important function? Why does acupuncture in the West often look like an acupuncture diploma hanging on some privileged person’s wall, as opposed to a vitally useful tool that a person uses to help her neighbors? How much of the conventional acupuncture model in the US is about white people fetishizing (and commercializing) what is  superficially appealing to us about another culture while totally ignoring its core?

            Yeah.  And now that I’m wondering about that, I have to wonder about my own role. Would anybody have listened to me about the community acupuncture model if I weren’t white? Would there be a community acupuncture movement if the owners of WCA had been people of color? What are the odds? Anybody else feeling the irony of a white person persuading a bunch of other white people that the people of color were right all along?

            OK, I know I said I wasn’t going to get into this part of it, but I have to say it here. Would there have been a WCA at all?If a couple of non-white acupuncturists had rented a shabby old building in a marginal neighborhood of Portland and slapped a FIVE FOOT FIST on the outside, do you really think they would have ended up with the busiest acupuncture practice in the state of Oregon?  Would they have ended up on National Public Radio, and in Utne Reader? Could they have attracted hundreds of people to workshops, if they were a couple of Chinese acupuncturists saying, hey, why don't you do this the way we've always done it?

            Tim Wise and other writers suggest that white privilege was, originally, all about economics. The concept of whiteness was deliberately created in order to keep structures of economic inequality in place; it was a clever trap for low-income, disenfranchised white people to keep them from acting in their own economic interests by allying with other low-income, disenfranchised people of color. So it makes some sense to me that community acupuncture got some traction in part because it was about addressing economic inequality. If white privilege warped acupuncture in the West, paying attention to the root of white privilege, economic inequality, would lead back towards solutions for acupuncture in the West.

            And finally, for all of us who have wondered why it’s so hard to get the word out about such a useful thing as acupuncture and such an effective delivery model as POCA clinics — how much of that is not because acupuncture is “unscientific” or because it’s “unfamiliar”, but simply because it’s identified with Asia? There’s a history of vicious racism toward Asian people in the US. These days it’s not as overt as putting people in concentration camps; it often looks more like making them into an invisible model minority. https://www.modelminority.com/joomla/index.php?option=com_content&view=article&id=230:asian-americans-under-the-model-minority-gaze-&catid=36:coolies&Itemid=56

            Everybody that I know who owns a community clinic feels, at times, as if they’re invisible. Maybe that’s just how it feels to be on the wrong end of white privilege.

            I decided to ask a couple of my smart friends, Jade and Nora, what they thought about the theory that white privilege is what went wrong with acupuncture in the West, because I knew they would say smart things. And they did. Below is a summary of our email conversation.

Jade:

I guess I got really inspired from Lisa talking about Miriam Lee at POCAfest. It really made me think. At the same time I was working on HR related project about deprogramming acupuncture students. I know I didn't need to be “de-programmed”. I am second generation Chinese acupuncturist. My parents told me not to buy into any of that “BS” at the school. Just to pass the boards and learn what I needed to know to do acupuncture. I spent most of my life working at an acupuncture clinic and I worked at a clinic full time while I went to school full time.

I guess the first things I know about is about speed and volume. That seeing one to two patients an hour is definitely BS. I don't know any “successful” Chinese acupuncturists that see patients this way in the US or in China no matter if they were acupuncturists or herbalists or some disciples of ancient lineage that had their special system. Taking a long time is BS. Getting to know patients over a series of treatments that work a little better or little worse is what it is. I don't know any “successful” Chinese acupuncturists that run clinics that have less than 4 beds.

I also don't know anyone who tries for perfect treatments. None of the old masters I trained with ever went for perfect treatments so I don't know what that is about. I mean they looked over clinical results and shifted treatments but they never sat and pondered for more than 5 minutes.

You use your clinical experience, the teachings of your lineage, and what you know about your patient and build your acupuncture or herbal treatment quickly.

I don't know anyone that had to be taught that acupuncture or Chinese medicine is work. That's pretty obvious I mean it's hard being Chinese whether it's in competition with billions of people for work in your own country or being an immigrant in the US. Working is a privilege. Seeing lots of patients successfully is the aim. What are you going to do? Sit around and read all day and not work and not eat? We don't have that privilege.

And acupuncture is a business of course. The only Chinese people that have trouble understanding THAT are doctoral students. We go to acupuncture schools so we can work for ourselves and eat. We do so because we are disadvantaged in this country. Get a job? Who would hire us? We have to communicate with patients as best as we can with our limitations. Facing distrust and doubt at every turn. That is what life is. We have to build a business facing limitations everywhere.

I don't know. Every day I am at my own clinic I run in to the limitations of being an single minority woman business owner. And I just think. I just deeply realize what complete craziness it was for my mom. I have so many more resources at the same time I run into walls and glass ceilings all over the place. She was brave enough to speak about acupuncture even though her English was limited and she was teased about it at every turn by doctors and patients who thought she didn't understand a thing. She didn't know about sending postcards, flyers, and emails. We just sat and waited and waited and waited for a long time hoping coming in super early and staying super late. There's no pretending to be the perfect acupuncturist at our clinic. We just worked and hard as we could. Making mistakes and trying again.  

Lisa:

 OK, another couple of lightbulbs just went off in my head. The idea of “best practices” being the ones that are the most time consuming is all ABOUT privilege – privileged patients and privileged practitioners. So is that why it’s so hard to deprogram people – not just because we’re asking them to do something that they weren’t taught to do in school, but because the underpinnings of the programming itself are all about race and class?

Jade:

I was driving to work today and thought about this a little more. It sounds like we're just crazy workaholics, but we're not. Being non-white you have to work harder than anyone else just to be privileged enough to have the same results. So I guess working and working extraordinarily hard is never a question. You do so just to keep your job. There's no slacking.

Nora:

Oh my gosh you guys.

I have been thinking about this stuff for weeks, there's so much here. And people keep posting what feel like related links, see below:

 https://whatever.scalzi.com/2012/05/15/straight-white-male-the-lowest-difficulty-setting-there-is/

 And a friend of mine recently posted this: https://pink-scare.blogspot.com/2012/02/some-reflections-on-concept-of.html  The way class and race are so wrapped up together has my head spinning; and I'm still trying to parse out where white privilege ends and racism begins – or perhaps how they reinforce each other.  I mean, not *having* to think about the economic context of how acupuncture is done in China is a function of privilege – but *refusing* to think about it seems to be to really be a function of racism (as well as classism).  Then you're really committing to not dealing with something. 

Around the same time, a local activist/energy worker/occasional patient posted a link to an interview with Mutulu Shakur about acupuncture in the context of the Lincoln Detox days (e.g. the “birth of NADA” days) and, while I was already familiar with the story, it finally occurred to me to really wonder whether COINTELPRO is to some degree responsible for there not being more Black acupuncturists in the US.  I mean, you WCAers probably have an FBI file just for that five-foot-fist, but you're not getting deported, or incarcerated, or infiltrated or whatever (so far as we know)!  I mean, knocking over Brinks trucks also is not a sustainable way to fund clinics, but thinking about the lengths people go to on both sides of “low intensity warfare…”  This was especially poignant to me because it was right before I had to give a “career day” talk at a highschool 2 blocks from the clinic – one of the guidance counselors was a patient and was fairly desperate for presenters.  The students are all African-American.  So already it was weird to be this white girl presenting about Chinese medicine to a Black audience, but it was frustrating because I NEED acupunks, but with the economics of the program being what they are I couldn't encourage them to go to acu school. 

And then there's also this dear Sugar column that Melissa recently linked to:

https://therumpus.net/2011/03/dear-sugar-the-rumpus-advice-column-69-we-are-all-savages-inside/ : “Privilege has a way of fucking with our heads the same way a lack of it does…  I believe our early experiences and beliefs about our place in the world inform who we think we are and what we deserve and by what means it should be given to us…

You might, for example, be interested to know that the word prestigious is derived from the Latin praestigiae, which means conjuror’s tricks. Isn’t that interesting? This word that we use to mean honorable and esteemed has its beginnings in a word that has everything to do with illusion and deception and trickery… Could it be possible that the reason you feel like you swallowed a spoonful of battery acid every time someone else gets what you want is because a long time ago—way back in your own very beginnings—you were sold a bill of goods about the relationship between money and success, fame and authenticity, legitimacy and adulation?”

As Melissa pointed out, you could replace the “writer” in this column with “acupuncturist”, etc. and it would be really, really useful.

We decided that we could go on and on like this for awhile but we might as well continue the conversation in public. Let's see how it goes. Comments might be heavily moderated to ensure usefulness.

 

lisafer
Author: lisafer

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Conference Keynote: Breaking the Ceiling

The theme for this conference is “Breaking Barriers”. You know, there are so many barriers to break in acupuncture that it was really hard to choose which ones to talk about for this speech. But since I’ve spent so much time talking about classism as a barrier, I thought it might be fun to shift gears a little and talk about numbers.

Responses

  1. When Michael Smith spoke about the history of acupuncture in the U.S., he related that the first documented evidence of acupuncture outside of Chinese immigrant communities was in rural group settings. The roots go deeper than what those white hippies came up with, even if they’ve since been obscured. I guess that’s the real privilege, to project that whatever they are doing is not only normal, but actually innovative, as though they came up with something new, not just new to them.

  2. such a great discussion! but also want to address Kerri’s question, because it’s one many of us ask ourselves and is so important for any hope of dismantling systemic racism, white privilege, classism.

    “so how can I hope to be deprogrammed from white privilege?”

    I think the simple answer is that it takes some effort and is totally worth it. Reading is a good place to start to get some more awareness, but live workshops really help work through more. There are whole institutes and university programs devoted to this work, so lots of source information and events available. Below is a little more stuff to peruse, all with great links, further reading etc.

    And, just a reminder, asking someone of another race to explain this 101 stuff to you is rude/not fair, is a giant act of entitlement, and a bad idea. It’s not their job, it’s ours, simple as that.

    racism 101 stuff with links
    https://fuckyeahethnicwomen.tumblr.com/racism101

    https://racismschool.tumblr.com/Racism 101: The Basics
    https://racismschool.tumblr.com/Racism 102: Statistics
    https://racismschool.tumblr.com/Racism 103: Language
    https://racismschool.tumblr.com/Racism 104: Ally, Step-by-Step

    older and amazing:
    https://books.google.com/books?id=kjo9KtF2jqEC&printsec=frontcover&dq=bell+hooks&hl=en&sa=X&ei=Viz6TtH4DuGpiQLrvbSUDQ&ved=0CFMQ6AEwBjgK#v=onepage&q=bell hooks&f=false

    this is an older classic, good place to start from a white woman examining her privilege:
    https://www.nymbp.org/reference/WhitePrivilege.pdf

    https://www.youtube.com/watch?v=b0Ti-gkJiXc

    https://www.youtube.com/watch?v=MbdxeFcQtaU

    https://www.wpcjournal.com/

    https://www.uccs.edu/~matrix/

    https://www.witnessingwhiteness.com/Witnessing_Main/Witnessing_Whiteness_Home.html

    https://www.uccs.edu/~knapsack/
    https://www.uccs.edu/~knapsack/curriculum.htm

    I also found this article helpful to keep us all humble and able to help others with the learning curve, because there’s never really a moment of “done.” We can always get better about this stuff.

    https://www.wpcjournal.com/article/view/10106

  3. Just wanted to add here that my post above was definitely not directed specifically at Kerri, just that she had asked the question that I think many of us living with privelege are too shy/afraid to ask/admit out loud. A few people had emailed me to ask about links and it seemed easier to post them here. I am by no means anything but a beginner on any of this stuff, so these posts are self-directed as much as anything. But I do believe that this is some of the most important work we will ever do as individuals and as an organization.

    Also, to bust myself. Was it an act of privelege to redirect the conversation back to this, from it’s fascinating labor discussion? Is this an example of talking long/more/last, making it about us/me? If so, I do apologize. (retreats back to the links to learn more)

  4. After listening to this recent podcast about what is happening in terms of acupuncture advocacy, I got another sense of what went wrong with Acupuncture in America.

    The AMA wouldn’t let some acupuncture organizations join without meeting their criteria, and then they kept changing the goal posts, according to lobbyist and acupuncturist, Kallie Guimond. Hence why we have really long and expensive acupuncture education compared to when it was 2 years, part time in the 80’s and early 90’s.

    She also confirmed what I’ve suspected since I went to an ASA conference in 2017. Acupuncturists from Chine move to the US. They are doctors. They do not understand why we, American L.Acs. aren’t doctors. This may also by part of why there was a push for most education by people who don’t understand the financial ramifications because they probably didn’t have to pay much, if anything, for acupuncture and medical education in China.

    https://www.blogtalkradio.com/chinesemedicinethatworks/2019/11/08/interview-with-kallie-guimond-lac?fbclid=IwAR3IDjoA7cf8BfcgP3r-TJxeyXxdcsrfrhh_5g3ZiXOAbmyx-xzlq8kcCKE