“Heavenly Pivot” is the name of an acupuncture point that lies on the abdomen beside the naval. The name reveals the purpose of the point used in treatment. It is a pivotal place between the earth and the heavens at the mid-point of a human being. The effects of needling that point are multi-dimensional: physical balance, improved digestion, mental and emotional groundedness. The name “Heavenly Pivot” captures the spirit of this point and in many ways, acupuncture practice itself. It implies the capacity to pivot easily with feet on the ground and a connection to the heavens, to breath, to inspiration.
Sometimes I tell people the names of points I use to give a broader understanding of the purpose of the treatment. One day I chose to use the point “Heavenly Pivot” on a man who is a professor of philosophy. He also loves baseball. As I leaned over to needle the point on the stomach, I mentioned the name “Heavenly Pivot.” Before I could explain he said, “Oh, wow, sounds like a great play from third base!”
I paused,”Why yes,” I said, “It does. A heavenly pivot!”
Consider a baseball player making a play from 3rd base. The player fields the ball, whips around, pivots, and throws the ball without having to think about it, making a smooth, practiced move.
The practitioner of acupuncture must also practice. She practices seeing, listening and observing, to gain a steady inner state as a way to maintain balance in the presence of all manner of symptoms and concerns. In the practice of acupuncture the practitioner prepares for the unexpected or the sudden shift that catches us by surprise. In Western medicine too, we speak of physicians as “practicing” medicine.
The unexpected is actually to be expected, a paradox. The third base player can expect a ball but doesn’t know how or when it will come. In nature a sudden shift in weather, like a storm, can be unexpected and yet within the cycle of things. Acupuncture practitioners have to respond in the moment. We work with nature’s laws and seek to attune to the cycles.
Isn’t it true in any profession or aspect of life that to be grounded helps us to function better? To be present and clear-headed helps us to work well at whatever we do? The practitioner of acupuncture develops the moves and flexibility for what comes our way. Like the baseball player who practices moves over and over, we need to practice a steady inner state no matter what happens. Acupuncture gives support for this steadiness by bringing a person into balance with the self and the environment. People are, then, more able to gain relief of symptoms, and to respond to the challenges that arise in life.
The Five Element style of acupuncture
There are several styles of acupuncture. In this piece I refer to a 3000-year-old tradition from China called Five Element or Classical Acupuncture. Based on natural law carefully observed, this tradition of acupuncture addresses symptoms as signs of imbalance. My primary teacher, Dr. JR Worsley of the UK, practiced this form of acupuncture and studied for years with several revered Chinese practitioners. I love this style of treatment because I find it seeks a depth of comprehension of all aspects of the person in order to give relief of physical symptoms as well as a building up of energy and the capacity for resilience.
A system of healing: a context for health
Acupuncture is a system of healing that predates many modern tools and treatments, including penicillin, x-ray, and blood pressure cuffs, to name a few. The time of year and time of day have bearing on the treatment. Everything is in a context of the year, day, and for the person, age, roles in life, cycles of expansion or contraction. This is about context. What is the context for this person’s symptoms? What season helps them feel better or worse? What about time of day?
Acupuncture can address complex and puzzling symptoms. Natural law is the foundation of treatment. The ancient Chinese observed nature and noted how its patterns are echoed in human beings. These natural laws are simple: trees grow upward toward the light, water flows downward and rises up in mist. These principles manifest in us and we can work with them. The practitioner is like a gardener. She reads how the elements within the person are in sync or not. She notes what is out of balance and addresses the issue with needles.
Thin, stainless steel, pre-sterilized needles are the main tools of treatment. Diagnostic assessment through an initial conversation with the patient begins the session. Practitioners listen carefully to the complaints and symptoms the person describes. A practitioner must be a sensitive listener to comprehend what the person shares, to hear all the details and relate comfortably with different kinds of people. They must sense when to lean in or away, to laugh and joke, or to examine a particular issue that is especially troubling to the person.
After the conversation about how they are doing, the person lies down on an exam table. The practitioner holds the person’s hand and places fingers along the radial side of both wrists to read the twelve pulses, six on each side. These reveal information about balance and imbalance. Then the practitioner chooses points to needle. Often there are points along the legs or arms, the back or belly. Sometimes, just a few needles in and out can be enough. On occasion, there is heat used on the points as well through the use of a small cone of moxa, a spongy herb that is placed on the point, briefly set alight, then extinguished.
The needle is the tool that redirects or releases energy along pathways in the body and prompts changes in the energy’s flow. Usually, any pain is minimal, something like a pinprick. Since acupuncture is body-mind-spirit medicine, the treatment can effect changes in all those aspects of the person. This is a mysterious process that made a deep impression on me in 1975 when I first had treatment. Not only did I feel more energy, I felt happier and almost giddy. The other tangible change was a relief of intense pre-menstrual symptoms. This was something I struggled with for years. After a few treatments with needles, my symptoms lessened significantly.
After the insertion of needles, the patient is left to rest for five to ten minutes before the session ends. The practitioner returns and reads the pulses again to assess whether energy is freely flowing through the body. A final, brief exchange allows the patient to share their experience and state of symptoms.
Meridians of “ch’i” energy within the human being
As they noted patterns and cycles around them, the Chinese observed specifically how energy flowed through pathways within the human being. They mapped out the pathways of energy in channels through the body and called them meridians. It was through these pathways and points along them that they were able to affect the balance of the Life Force or ch’i energy. Each one of twelve main meridians relates to and runs through an organ. The energy also moves along the surface of the body. Specific acupuncture points along these pathways allow access to the ch’i or life force.
When the ch’i is blocked or compromised, appropriately placed needles can begin to set the balance right. The needles start the process. The body-mind-spirit of the person takes the suggestion and achieves a new balance as a result. This is much like gardening. The gardener works to bring things into harmony and counts on nature to carry on so that plants can flourish. Just as we plant a seed in spring and wait for summer for it to come to flower, so in acupuncture treatment, we must pay attention to the season and appropriate time to expect change to occur.
What does it mean to “attune to nature?”
Imagine that you are in another country in ancient times and want to find a certain village. Assume you speak the language and ask someone for directions. They might be given: “Continue a day’s journey due east through this valley. There is a grove of maples that always turn color early. You’ll see them–a bright red near the ravine. They’ll be in the shadow of the mountain by late afternoon. And you’ll smell the persimmons ripening nearby. Travel south along the ravine until you come to a clearing.…
In urban, suburban, and even rural America, we find our way mostly by street signs and road numbers, perhaps buildings for landmarks. In most ancient cultures, including our own Native American, keenness of all the senses was a part of life. In the healing arts, these senses are vitally important. In Five Element acupuncture, development of the senses is a priority. The practitioner uses these senses as they listen to the person. She observes how the elements are functioning or out of balance in the person.
The modern physician must draw on the extensive technology available. Yet when sophisticated measurements are front and center, like road numbers and street signs, we tend not to notice the messages from nature that are still available to our senses. Years ago, Western physicians tended to develop more capacity for reading people through their senses.
The senses as diagnostic tools
The practitioner uses all the senses to hear, see, feel, touch, even smell what the person is communicating. As I listen to the person’s story, I am also listening to the sound of the voice. Continual laughter may be a clue, or there may be a weeping quality to the voice. These are distinct though subtle sounds.
The practitioner of acupuncture observes carefully. She notes facial expressions, the eyes. She observes the body and examines parts where there is discomfort or some other kind of symptom. She notes the tongue, skin, hair, eyes and observes colors that emanate from the face. These are subtle and may appear to flash for a second. They also relate to the elements. Each element has a color associated with it, red with fire and green with wood. The earth element color is yellow, which we see a lot in late summer, the associated season of earth. Blue is associated with the water element and white with metal. The metal element includes stone and rock, precious metals as well as the elements in the air such as oxygen and nitrogen. The human body contains minerals as well as oxygen and nitrogen. A color may appear on the face as the element’s way of sending out a distress signal, much as a particular sound speaks for an element.
Each element has a corresponding odor. Fire has a scorched odor. This is subtle, not really a body odor, but a faint essence coming from the person. Years ago doctors put more emphasis on the sense of smell when they had less sophisticated equipment. They could identify a state of disease by the smell in the room. The odor often changes with acupuncture treatment and intensifies when the person is ill or stressed. Other odors include a fragrant richness with earth, like topsoil; rotten with metal; putrid with water, like a stagnant stream; and rancid for the wood element.
Emotions out of balance may be flags of distress. Depression is a symptom. So is chronic anger. Emotions all have a place in life. To be able to pivot through various emotions is a sign of health. Grief is expected in response to loss, joy in response to blessings and love. Practitioners note if an emotion is lacking when it would be expected. Sometimes, there is an excess of an emotion. A person may be fearful out of proportion to the situation. To assess these imbalances is challenging, yet combined with the information from other senses, the reality of emotions out of balance can be significant.
Besides relief of physical symptoms, a person may note a difference in their emotional self. Assessment includes the observation of these changes. This can manifest in many ways, even in dreams, thoughts, changes in mood or energy. Someone who was often irritable may find themselves calmer and clear headed. Another person who can’t make decisions finds that these come more easily.
The goal in treatment is to restore balance so that the person heals and strengthens from within. Then the symptoms change naturally. Often, the first experience following an acupuncture treatment can be a sense of well-being.
The conversation, assessment and acupuncture treatment all happen within a comfortable and easy relationship. It is natural. To hear what a person experiences is basic to making a useful assessment. To be in the flow with a person is to better understand them. This feels good and is enjoyable to patient and practitioner.
Core principles and values
Balance is a key word. In nature there is a continual flow and change that seeks balance—enough water, yet not too much, enough sun for growth, yet not too much. The ancient Chinese recognized that there is constant movement and change in nature and that there are certain directions in which the ch’i energy or life force naturally moves. They noticed that spring always cycles into summer and fall into winter, never the reverse. Animals and people tend to thrive when raised in a secure, loving environment. These principles were recognized as consistent throughout nature. When the balance was threatened or the flow blocked, then disease or symptoms appeared.
These simple observations became what the Chinese called the Law of Five Elements. The seasons always flow in a certain direction and function in relationship to each other. Winter allows rest and going within in preparation for the birth and new beginnings of spring. The summer allows flowering of plants that got their start in spring. Late summer, the fifth season according to the Chinese, is considered the time of harvest after the peak of summer. Fall is a time of letting go—the leaves from the trees, the abundant growth of summer dying down. Each season and its functions relate to a particular element. From this we begin to see how the corresponding elements move in the same patterns on many levels.
In the link to the Law of the Five Elements* below you can see the seasonal and elemental relationships. The flow is in a clockwise direction and is called the shen cycle or creative cycle. Each element creates the next. There are other relationships between each element that are easy to see in nature.
The points on the body
Once the practitioner determines the source of weakness, she chooses acupuncture points to address the imbalance. “Palace of Weariness” is a point on the palm of the hand on the meridian of the heart protector or pericardium. This point may apply when weariness is overwhelming, providing protection, strength and warmth. “Happy Calm” lies on top of the foot on the liver meridian. Sometimes a liver imbalance is accompanied by agitation or irritability. This point can sooth and calm such a person. And it may provide cleansing energy to a compromised liver. Someone struggling with grief or lack of self worth as well as asthma or compromised lung function may respond to the point called “Cloud Gate” on the lung meridian. Every point has a name though not all of them are so poetic. There is also a point on the stomach meridian called “Leg Three Miles” which provides stamina and steadiness in the face of ongoing stress or strain. Acupuncture points are like places in nature and have particular qualities. There is one called “Orbit Bone” which is next to the temple along the side of the face. The practice of acupuncture includes choosing appropriate points based on accurate assessment.
The challenges inherent in healing
Healing is not always easy. Sometimes people reach a certain equilibrium within the underlying imbalance. To move out of that as healing progresses may sometimes involve aggravations, though these are ultimately in a positive direction, towards balance. For example, a person with eczema as a child may initially feel better and more balanced. The old symptom may reappear for a short period, surfacing from within on its way out. This is a manifestation of a principle that the Chinese called the Law of Cure in which signs of brief recurrence of old symptoms, or even old feelings, signal that healing is progressing. This doesn’t mean that everyone goes through all of life’s symptoms. Sometimes the Law of Cure manifests in a dream or a split second experience. For many people there is no recurrence of old symptoms. This should reassure people that uncomfortable symptoms are short-lived and may be a positive sign in overall healing.
How can we live in balance?
To find balance in life is no small task. Life is not static. The modern world is not aligned to natural cycles. A person may work hard into the night when they should be asleep. Our world is full of stimulation with little time for relaxation or for fun and laughter. The early practitioners of acupuncture and Chinese medicine knew that human beings may not always live in a balanced way, but we are adaptable and resilient.
We can do well even if it is not possible to maintain balance in all aspects of life. It can take years for the system to break down enough to show serious symptoms. When people are able to pay attention to symptoms and honor the cycles of nature, they will be resilient in response to stresses that inevitably arise in daily life. That is why practice as a concept is so important. We practice like athletes or musicians. It helps to think of living life as a practice. We keep at it. We keep working. Like a good third base player, we keep practicing our moves daily throughout our lives.
A basic assumption of Chinese medicine is that things continually change. Seasons ebb and flow. In any moment there is something changing. Our ability to flow with these changes is one of the most important capacities we can develop. That is the Heavenly Pivot.
The world seen through the eyes of Chinese medicine is a fertile world. The same principles of nature still underlie everything as they did 3000 years ago. Whatever happens, including illness, physical challenges and emotional ups and downs, as well as joy, laughter and abundance, provides an opportunity to realign and gain insight. It gives a context for our life purpose and an opportunity for healing of the whole person: body, mind, and spirit.