Qiological Community

Technical versus Contemplative Needling - Does it Matter?

Do you think it makes a difference to the clinical encounter and result whether while needling a Sa’Am Treatment you are either

(a) just methodically needling a well memorised set of four points or

(b) engaged in intimate contemplation of precisely what supplementation and drainage dynamic you are signalling to the patient

For example, let’s say you decide a patient needs a Kidney+ treatment.
And you have performed this treatment so many times, you just know you need to do
Kidney 7 + , Lung 8 +
Kidney 3 - , Spleen 3 -

and under scenario (a), you just needle the well memorised points as a purely technical set of four needling actions

and under scenario (b), as you approach the needling and as you needle the patient, you fully contemplate the notion that you are supplementing the Metal functioning in the patient to enhance and support the functioning of Water and you are draining the Earth functioning in the patient to relax overbearing control of Earth functioning on Water functioning so weakened Water functioning has more unconstrained room to operate.

Do you think it matters? Does it make a difference? Beyond your thoughts on the matter, have you explored this question for yourself in clinic?

I love your deep contemplation Daniel.

I never needle thinking in terms of the 5 phases and movements. And I believe I get good results. But maybe it would be better if I did think deeper. I do though strongly find that intention is important to properly treat IMO.

Occasionally (1-2x/week) I get lost in good conversation with a patient as I am needling and lose focus so need to ground and say “Ok we’ll talk later I need to focus”.When I needle I do strive to feel the intention of the points as a whole. I want to feel a connection to treatment intention. I want a resonation inside that says “this is what this patient needs. Yes!”
I am sometimes rushed and fail or I am just not focused for whatever reason (hungry, tired) and it is definitely not as enjoyable to do the work. It may be confirmation bias but it seems at these times my treatments may not be as effective.

Where I do feel it matters is in terms of point location. The times I am not sharp my needling can be sloppy. I was going to post a case where I knew a ST+ treatment was what this woman needed (it worked so well 1 year prior that I last saw her) but was rushed as I was running late so quickly put in the needles with a lack of focus. When I returned to remove the needles I saw that ST41 was next to the tibialis anterior ligament and I immediately got a sinking pit in my stomach. I checked in with her the next day but there was not change to her issue so I had had her come in for freebie a couple of days later and properly needled ST+ with happy results. Yes that was a big miss on point location moving to the GB channel)

So I would say for me it can matter if I am not connected and focused with what I am intending for the treatment. Having an intention on how I would like this to effect the physiology feels important.

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thanks George for your thoughtful reply.

It seems we are making a distinction here now between two different ‘contemplations’ . . . . one being very present with the act of needling - precisely locating the point is a contemplation, being present with the very act of needling . . . . the other being a contemplation of the 5 phase physiological dynamics we are signalling through our intervention which I think one can also deeply contemplate while needling . . . .

You ask a good question. I have contemplated this and have decided that intention is important. I focus on what it is I am asking the body to do with every point. If I am needling Liv 8 in LIv + then I focus on strengthening wood and the Jue yin. I think its a way of connecting with what we are asking of the body in that given moment.
I can’t tell you if there are better results with intention or without. THere are times that the patient is talking to me and so my intention is not as strong but I can’t say that I have noticed a difference in results.

Toby emphasizes precise point location, getting qi, proper tonification/sedation with needle insertion AND removal. The rest is icing on the cake. The contemplative approach could cultivate grounding and presence but could also get too internal and intellectual.

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Great point Kristin! A fine balance that could so easily tip either way!

What do you mean by proper tonif/sedation with needle removal? I think I recall Toby saying that we need to turn the needle in the opposite direction with removal so as to unbind the bound fibers.

For tonification- close the hole with your finger. Leave it open for sedation.

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there would also be . . .

the direction of the needle - with the channel direction or against it.


the rotation of the needle after insertion - clockwise or counter-clockwise

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Personally, I think presence is more important than internal visualization flow charts. To George’s post on another thread, we all have our particular “superpowers in knowing.” They are rooted in the 4 exams. I think being present to what unfolds before us (or not) is much more potent.

Well said. Presence is what takes the nuts and bolts of Saam and turns it into medicine. Presence happens in real life and real time and that is what we must attend to.

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well, attempting to clarify . . . . I was pointing to a contemplative presence significantly different from what I hear in the phrase ’ internal visualisation of flow charts '. For me, that does not capture what I was pointing to. This could be an interesting discussion . . . I used to understand for example, ‘meditation’ and ‘contemplation’ as different things. And in some ways they are . . . but after reading and thinking a lot about these matters over the past years, the distinction is not so clear, there is a lot of bleeding over between the two. In my original question, my intention was to explore the very subtle boundary spaces and overlaps between receptive presence and contemplative engagement . . . its ALL presence (as far as I am concerned) with very fine but significant shades of nuance to consider . . .