Why I am True to 5E Acupuncture

If you have read some previous posts of mine this title is probably confusing. Let me be clear right away that I do not treat the causative factor. I also don’t clear IDs/EDs/AE (they use the back and I don’t do any points on the torso). I also don’t give lifestyle advice or engage in coaching.
Glad that’s out of the way. Now I’ll get to the good stuff. Here are some principles that I learned from 5E practitioners that come in really handy in Community Acupuncture. I’ll list them here for you.
1-Learn from observation
2-Acupuncture is what you make it
3-Acupuncture is easy and safe
4-The most important thing in acupuncture is to do acupuncture
5-Give it away
Learn From Observation-
If you have a 5E education you may or may not recognize these principles. That is because I learned them from observation. They did not come out of a book or from a class syllabus. Learning from observation is important in 5E and CA. In school we had a class called “Observation” this was basically the founder/ president of the school doing his thing. It was nicknamed “Bobservation” because Bob Duggan was that dude. I never met JR Worsley but my understanding is that he taught in a similar way. Bob was fond of saying that he teaches based on what Worsley did and not what he said. The rationale being– Worsley did not have the sophistication of language to fully express what he was doing. I would argue that none of us do when it comes to talking about acupuncture. Acupuncture is mysterious if nothing else. Nobody can fully explain it. Nobody fully understands it.
CA and 5E have similar philosophies when it comes to learning acupuncture. In CA there is an emphasis on doing a lot of acupuncture and seeing what works. This mirrors 5E talk about “knowing it in your body” and “experiential learning”. Some CA punks say that most acupuncture teachers don’t know what they are talking about. The teachers don’t have enough experience actually doing acupuncture and so what they say is often filled with superstition. They also tend to add in other modalities because they feel like acupuncture is not effective by itself. You can still learn from them you just have to sort out the nonsense. Just use the 5E notion of letting it “wash over you” and then “take what is useful”. You can also invoke the 5E questions of “is it useful?” or “will it serve?” Both systems are pragmatic.
Acupuncture is What You Make it-
The story of 5E is that Worsley learned acu-punking from a bunch of different dudes in Japan, Korea, France, China, as well as homeopathy (read “footsteps of the yellow emperor” for more details). He then took what he learned and created a system of acupuncture designed for the modern west. He saw internal/ emotional causes as more important than external causes. He created a style and way of treating to care for a certain group of people. CAN did the same thing with the goal of treating the big chunk of people that can’t afford $65-125 per treatment (most of America BTW).
Much like 5E, in CA we draw on many traditions yet don’t really follow any of them. Yet both systems have a claim to traditional practice. Acupuncture has always been a peasant medicine in Asia. This is because it’s possible to see lots of people, do simple treatments, charge a little bit of money, the patients will get better and the practitioner has a job. The quest for legitimacy in the west has led acupuncture astray. The first generation was privileged. They had the time, interest and ability to learn some exotic medicine and they formed it to appeal to their community. It’s time to reclaim it for the rest of us.
CA style is accomplished by striping acupuncture down to its essentials. It is simple and practical. No bells. No whistles. No coaching. No herbs, moxa, or bodywork required. Simple frequent acupuncture is enough. Frequency trumps cleverness every time! “CA style” relies on silence. Patients tell the punk their suffering and the acu-punk does what they can to ease the suffering. The pins go in and the patient can sit in silence. They tune into their body and sort it out on their own. The group magnifies the effect of the treatment. The systems of the clinic are more important than the individual treatments.
One of the most important goals of 5E is to bring the patient back to their body. To observe what is going on and let that be their guide in life. Instead of doing this with coaching let acupuncture do it! There is nothing like having needles in until you feel “cooked” twice a week for three weeks to bring you to your body. Once a patient starts to listen to their body they start making different life choices and things fall into place.
The infrastructure of acupuncture is what we make it too.
Bob told us the question his generation had to answer was “is acupuncture going to be allowed in America?” He explained that is the reason acupuncture looks like it does now. Think masters degrees and LAcs. They had to create some sort of legitimacy with those who had power and privilege. It is rumored that JR scoffed at the idea of having a 3-4 year graduate degree to learn acupuncture. He apparently said “what I have to teach only takes a year”. In addition Bob has said that in the future acupuncturists should give up their licenses and that acu needles should be available at the corner store. In England acupuncture is still not licensed. They just educate the public to search out a practitioner that is “qualified”. (Acupuncture is safe and easy) This fits right in with the charge from CAN and others that acupuncture school is too long and too expensive.
The question for our generation is: are we going to step up to the plate and use our medicine? It is no longer a question of existence but of access. The acu-establishment would like to answer this question with more of the same—raise our credentials in an on-going appeal to the privileged and hope for full insurance parity. Mandate acupuncture coverage on insurance plans! Acupuncture reimbursement from Medicare! To sum it up in a sentence: They want to enlighten the top. If only the top was enlightened everything would be ok! That is not how it works in America just ask the working class.
We don’t have time to wait for the top to realize acupuncture is awesome and grant us power and status (if they ever do). There are lots of people that need our help now! And lots of acupuncturists that are underemployed or no longer working in the field! We need to take our role as healers seriously and put our social status second (that breeds trust and respect). Community Acupuncture has shown that it is a stable, replicable model for delivering acupuncture to regular people of modest income. We boast financially stable acupuncture clinics that can see a lot of people at a low cost and give jobs to acupuncturists.
The most important thing in acupuncture is to do acupuncture–
In CA we talk about the numbers a lot. Number of treatments a week is important to running a successful clinic. 75 treatments a week is the threshold at which a punk moves from hourly to salary at Working Class Acupuncture in Portland. 100 treatments a week is seen as a goal for an established CA punk. A common treatment plan for a new patient is to come twice a week for 3 weeks. If a patient has severe symptoms then they are asked to come daily until their symptoms have decreased by half. The experience of doing a lot of acupuncture is foreign to most acupuncturists—even those that have been in practice for years! A successful CA punk will do 4-5,000 treatments a year! That is a lot of experiential learning! If you want to get better at acupuncture there is really only one way to do that (doing acupuncture!)
Acupuncture is Safe and Easy-
You don’t think acupuncture is easy and safe? Back to Bob. Bob disliked the term “causative factor” he instead used the term “starting point”. This was usually when a student was concerned about “getting it right” or attempting to do the “perfect treatment”. He would advise them to pick a treatment and do it. He would say the patient will benefit. Movement will happen and you will have a better idea of what to do in the future. Just get the needles in and get out of the way.
In the student clinic, when someone had a “treatment block” it was often seen as pointless to talk to the patient. “Get them on the table and let the needles do the work” was the advice of the instructor at this point. I’m learning that is what we need to do all the time. Get out of the way and let the needles do the work. Acupuncture is powerful in itself and we don’t need to add on a ton of other modalities to make it more effective. We just need to make it accessible and do it more often.
Studies show that acupuncture will work to some degree even if you just make something up and do it. How easy is that? Skill is helpful but not a necessity. Acupuncture is like a starving plant in a cubicle. Acupuncture is so big that it needs a clinic with 12 recliners per punk! The clinic needs to be big and full of punks, patients and receptionist. It needs to be open all the time. Then you will see the blossoms of acupuncture. They are beautiful and all too rare.
Some 5E people warn against treating symptoms and seek to treat the root. Some (including Bob) think that it is potentially dangerous to treat the symptoms. (Just breathe. Let that wash over you and ask “is that is useful?” Remember that acupuncture is safe and easy). Then you can learn from other teachers like Jeffery Yuen and Dr. Tan (JR learned from lots of teachers and you can too!). They both teach that the physical symptoms are important to treating the root. Acupuncture is holistic by nature. The physical symptoms are a road map to selecting points that address the whole person. Jeffery Yuen says to honor the symptoms. That is where the patient’s Qi is. Partner with your patients. Trust that they will give you the information you need. Be open enough to accept it and again remember that acupuncture is safe and easy. And with this new perspective it is naturally holistic. There is no such thing as “fix-it” acupuncture.
Give It Away-
When a student would thank Bob for sharing his knowledge he would respond by saying “Give it away”. Well I have taken this very seriously. I have a sliding scale of $15-35 per treatment. In the intake I say “pay what you can afford on the scale. Only you can decide what you can afford. Your wallet is your own business. I don’t even want to know what you are paying.” If someone says they have further financial difficulties I don’t hesitate to tell them to pay $5 or $10 per treatment. After all a happy patient will drive word of mouth! I have a lot of chairs and needles are cheap. The main goal of the clinic is to offer a sustainable resource to the community and a living wage for the punks.
Give it away has another meaning for me. It means to be open and caring and help those that come to me the best way I know how. Lisa and Skip talk about Heart, Hands, Head as a way to learn and practice acupuncture. The first thing is to care, next to have the physical skills, and last to think about it.
No doubt I will be accused of picking and choosing. Well that’s fine with me. I let my 5E acupuncture education wash over me and I took what was useful. I asked the question how can I best be of service? And the answer was to open a Community Acupuncture Practice! I was attached to doing 5E acupuncture as I was taught in school and attempted to practice that way (for a few months). One thing changed my mind. My friends and family could not afford my rates. I knew acupuncture had (Untapped!) potential and wanted to share it with as many people as possible. I could not treat my community unless something fundamentally changed. It is only recently that I realized I did not “abandon” 5E. The core of what I learned is very much alive and thriving I just had to adjust my treatment strategies. There are lots of ways to heal and to deliver acupuncture and they all work. CA is the only what that I know to deliver affordable acupuncture to lots of people. Those are the important things to me and so what did not support that had to be let go of. Deep thanks to all of my 5E teachers!

Author: Ztrukn

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  1. Dude.

    You just summed up our entire 3+ year program for me.  And boy did I need it!  You rock – I sure wish Kansas and DC were closer!  Thanks for posting this.

  2. wow.

    i’m not sure i can get words to explain it. this post is just so clear and so…satisfying. thank you, NIck!




    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.

  3. rock on


    you did a very nice job of explaining your 5E education to the masses. Thank you, i often find it difficult to explain or to put it into words- you have done so with such grace and clarity.  i cherish my 5E education and i love my CAN clinic.  keep giving it away brother.


    take good care. 

  4. Just came across this

    I was checking out some old forum stuff, and on this thread I saw something that resonated with me deeply.


    I read Skip’s comment at this link (quoted below).  I LOVED it…. without knowing it, he could be channeling Bob Duggan. Perhaps once you’ve treated enough people, this is just the wisdom that comes through??

    “I strongly maintain (and I’ve said elsewhere) that although knowing the
    technical aspect of acupuncture is important its way overrated. One can
    memorize everything by Worsley, Tung, Tan, Meridian therapy, etc and
    still be clueless. We can have all the classics memorized and they’d be
    useless. All of that information is usless, dead, without the
    relationship you have with your patient. Its those relationships that
    are of first importance and by relationships I’m talking about what Nora
    is going through. How many people come through our doors and only have
    a complaint about some pain somewhere and nothing else? One in a
    hundred maybe and if you dig just a little you find those exceptions
    aren’t. We are treating people here, not symptoms.”

    The last sentence, word for word, could be an exact quote from Bob, but I think all that is written above Bob would agree with.

    I want to be able to do CA (continue to do CA) and also use what I have learned in my 5E training. As a new grad, I know I have so much to learn, and for now, while I’m learning more, I need to start where I am when the next patient walks in.  


  5. Great post that resonates.

    Great post that resonates.  Thanks.

    One addition having re-read your post — I do sometimes orient treatments to the CF or whatever you want to call the patients energetic.

    There is a clear correlation between the “CF” and the pathology — how could there not be ? — so in my case that means I needle points like 88.17-88.19 to treat Earth CF’s — and the points happen to be located on the ST meridian, and happen to treat fatigue due to Qi deficiency very well.

    And for Water CF’s I am more likely to needle 77.18-77.21 Three Emperors, which happen to be on the SP channel but are used in Master Tung’s acupuncture to tonify the KD.

    And I am more likely to needle 11.17 Wood (Anger) on a Wood CF, etc. 

    I know I am not the only TAI trained practitioner who combines systems like this — but I certainly don’t disregard Five Element diagnosis when I treat, though I also obviously do not treat only on the element.

    This teaching by J.R. Worsley at the end of his career (to ONLY treat on the CF meridians) was not how he actually practiced, according to one of his senior faculty members (who I won’t throw under the bus here).  His challenge at the end of his career was what he thought he could sucessfully teach to others, and his treatments were more “shamanic” as in no specific rules.  Amazing but not replicable.