Installment 3 of the “Finding Normal” Study Guide

The Energetic Anatomy of a Magnetic Community Acupunk

To pick up where we left off:

What you really need to understand, man? I give a fuck. If you was suffering like I was suffering, as I know it and I felt it -- it ain’t got to be like that.

The first few times I watched this scene, all I could think about was David Fitzgerald’s intensity.  And his commitment to his job, to these people in recovery: the “giving a fuck” part of his speech. When I watched it again recently, I looked at his eyes, as he is looking into the camera, and this time, I saw the “suffering” part of his speech. You can see pain in his eyes. Or maybe the memory of pain --  but nonetheless, a lot of pain, and still vivid.

Lupine and I were talking a few weeks ago about what makes acupuncturists attract and retain patients. It’s a subject we never get tired of, because acupuncturists attracting and retaining patients makes it possible for us to keep them on our payroll. If they don’t, we can’t, because patient fees support WCA. So why are some acupuncturists magnetic, and some are not?

If I had to draw a diagram of the energetic anatomy of a magnetic practitioner (presuming I had the artistic skills!), this is what I would draw:  a big empty space, let’s say sphere-shaped, surrounded and contained by a delicate iron filigree. A metal lacework globe, with nothing at all inside it. OK, you’re probably wondering, where on earth did she get THAT?

I think the most important thing that practitioners do for patients is to hold space for them to heal. Acupuncture itself is actually not the most important thing we do. Why? If you do acupuncture for someone without holding space for him or her, the odds are high that he or she will not stick with the process, and will not get enough acupuncture to do any real good. Holding space means being present for the person and for the process of his or her healing,  being simply aware and attentive and there. When you do this successfully, you allow people to trust you, to trust themselves, to trust the process. When you hold space for someone, you are not necessarily DOING a lot, because most of what really needs to be done does not have that much to do with you.  Much of what you are doing is simply showing up for people, and that helps them to show up for themselves.

To hold space for people, you need to have space for people. You need a large, still space inside of you, like an extra chamber of your heart. You need a reservoir of quiet energy that is not being consumed by the other demands of your life. You need to have room for other people inside of you,  room to pay attention to people who are not your friends or your family; you need room to care about people who are not in a mutual relationship with you, and who might not be giving anything back to you. What I’m trying to describe is something different than just being a good, caring person. There are plenty of jobs that don’t require you to have an extra chamber of your heart, and plenty of good, caring people who do them. Being a good acupuncturist means, in part, being able to be a container, to be the kind of person whose presence makes it easier to heal.

Being this kind of person means practicing a  certain species of love: impersonal, unconditional, and selfless. Some Christians, including C.S. Lewis, call it “agape”.  Some Buddhists call it “relative bodhicitta”. I don’t think it matters what you call it, or if you call it anything at all. Essentially it means that you show up with a desire to be useful to someone else, and with a willingness to set yourself aside.

A container is not much use if it’s already full.We’ve talked in other places about how you can run out of space for people: by being distracted, being fatigued, being overwhelmed. If your attention and your energy are consumed by things other than your acupuncture practice, you won’t attract patients. We know that you have to maintain a certain amount of empty space as a core for your practice. But what I’m interested in getting at here is, what creates that kind of space in the first place? Where does it come from? Which gets us back to the look in David Fitzgerald’s eyes.

I don’t pretend to be an authority on the structural engineering of acupuncturists’ hearts, so I can’t list, for sure, all of the possible ways that somebody’s heart expands to the point that impersonal love is possible for them. I am pretty sure that I know one way to create space inside of a person, though, and that is pain.  I can’t quite say,  the more pain the better, because it’s possible for pain to simply crush people instead of opening up space inside of them. However, the kind of pain that leaves a crater at the center of a person is potentially the kind of pain that makes for a really good practitioner. Devastation can create a lot of empty space, which you can put to use for other people, if you want to.

...if you was suffering, like I was suffering...

One of the problems with acupuncture schools is that they often create the impression in students that what will make them good acupuncturists is being shining specimens of perfect health themselves. They will then presumably be in a position to offer guidance to all of the less-than-healthy patients who will be irresistibly drawn to their perfect example. They will provide help, healing, and long lectures to the poor benighted American masses, with their food allergies, their poor posture, and their weakness for caffeine and carbohydrates. The idea of perfection as applied to human beings tends to be problematic in general, and in the case of acupuncturists, the unhappy outcome is what one of my coworkers describes as  “Malibu Barbie, L.Ac.”:  a practitioner who is fake, plastic, rigid, shiny, and impossible for normal human beings to emulate.

Malibu Barbie doesn’t know anything about suffering, and somehow, I don’t think she gives a fuck.

The Malibu Barbie, L.Ac. theory of attracting patients is that patients are drawn to your (perfect) image. In my experience, that isn’t true. Most patients are not seeking perfection in their own lives or in yours. They are seeking relief from suffering.  Here is my personal experience: I have always been a patient magnet, and I have never put any energy into my image. This is my theory about why: I know about pain, and I have space for people in pain. People can feel this.

I don’t want to get overly confessional, but I think it’s worth saying that, like David Fitzgerald, I’m motivated by my own experience. One thing that created  space inside me, an extra chamber in my heart, was the sudden loss of someone I loved, when I was twenty, in a mass murder. Right after that, I went and worked for an AIDS service organization. This was in 1989, before the drugs that turned AIDS into a chronic illness, so in the year that I was there, a lot of the people I met died. Not only my clients, but also my coworkers, my friends, my supervisor, and the volunteers I supervised.  And right after that, I went to acupuncture school.

In hindsight, I think this might be why the professional acupuncture culture didn’t do as much damage to me as it did to lots of other people; I was inoculated against it by pain. There was no chance for me to become Malibu Barbie, L.Ac --  perfection isn’t attainable when you have to concentrate, every day, on not falling apart.  And while I might complain about the professional acupuncture culture being evil, it really doesn’t have anything on mass murder or the plague. I already needed to decide, and I had decided, what my response was going to be to those two things. I was going to use my life to relieve suffering. And OCOM could not distract me, although it tried.

Another benefit of pain, for me, was that I had to learn to have a functional practitioner persona: I had to figure out how to be at work, because my personality as it was at the time was clearly not going to cut it. I couldn’t be myself, unvarnished, because I was too much of a mess. However, there was also no way I could be something very different from myself, because I didn’t have the energy to pretend. I needed something that was close to who I was, but not identical; something genuine, but stripped as much as possible of my neuroses and upsets. I think that every practitioner needs this, no matter what the details of their personal history; I was just lucky that I had to figure it out immediately.

Getting back to the image of the globe of empty space encircled by the iron filigree, that’s what the filigree is: a functional, consciously constructed practitioner persona.  It  represents structure, including good boundaries, but there are openings in the structure so that the empty space inside is accessible. It represents discipline, both mental and emotional. It represents a sturdy, stabilizing set of beliefs, decisions, and habits.  (It would probably be worthwhile to make a list of the beliefs, decisions and habits that go into creating a functional practitioner persona. Here, in no particular order, are some of mine:

My job is to love, it has nothing to do with liking people or being liked by them. Those things are nice when they happen, but they are not the point.

As St. Francis said, “grant that I might never seek so much to be loved as to love” -- because seeking to be loved makes me crazy, while seeking to love keeps me sane.

Love is grounded and energizing. If being at work doesn’t feel grounded and energizing, figure out why.

Consciously putting myself aside for other people is great, because it gives me a break from myself.

I can’t give anything if I don’t take care of myself, so I will take care of myself.

Martyrdom means being not much use to anyone in the long run; effective altruism is, paradoxically, kind of selfish.

Blame is pointless.

Truth should feel like a relief; if it doesn’t, figure out why.

Somewhere, deep down, everybody knows what they need.

There’s nothing here that I need to fix.

Very important habit: daily meditation. Because it keeps me sane.

Etc.)

A functional practitioner persona requires conscious effort to establish and to maintain. People who are not fully committed to doing acupuncture as a job often have trouble constructing one, because it takes work and practice. It requires a lot more effort than just putting on a white coat. The iron in that filigree is seriousness of purpose; a filigree made out of, say, playdoh is not going to be much use to you in the long run. And what about the magnetism? What makes this empty metal lacework globe magnetic to patients? Love does. Love, otherwise known as giving a fuck.

This story was posted on July 5 2009 by Lisafer.

Comments

  • July 5 2009 at 11:39 AM
    Nora writes:

    so many thoughts

    This is so helpful…not least because “Malibu Barbie, L.Ac.” had me ROFL…it helps to have a shorthand for it, I was talking about with another practitioner/dear friend recently, how it’s better to be middle-aged, to be not perfect, not too “glowy” etc. - which is not to say not without some kind of radiance, which I think is kin to the magnetism you’re talking about, the pilot light of which I suspect might be anger.

    I love that line, too, about giving a fuck (which also, while being about love, has a fierceness to it; again that slight edge of anger, or something like it?) - that slightly edgy way that community-building is about love, often in spite of not-liking…

    ...and just as important, perhaps, is the open-endedness of “it ain’t gotta be like that.”  In other words, it ain’t gotta be like THAT, but I don’t know what it IS going to be like.  For now: don’t steal, don’t hurt anybody, don’t get high, and beyond that it’s up to you.  There’s no agenda.  Projecting a feeling of “I know you can heal, and/but I don’t know what that’s going to look like for you” - that kind of spaciousness (as opposed to filling it with lots of lifestyle advice, etc.) can be scary for people too, I think (like Peni?)  Sometimes people are not ready, the timing is not right (and sometimes you/they don’t know until you try), but part of holding the space is just being there when the timing IS right.

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  • July 5 2009 at 4:30 PM
    bottley writes:

    Illuminating My Failures

    This spoke very strongly to me, Lisa. After many years of detox work and BA, this was my first week as a CA clinic. It all went very smoothly, but your article made me realize I got a lesson that I missed until now. Friday was slammed full, with between 6 and 8 chairs occupied for the entire shift. CA creates a magical energy, and I was enjoying it, and so were the clients. Then, well into the shift, a new client showed up. Lots of problems, deeply identified with her symptoms and her disease names, unwilling to change her overwork and her shitty diet, was snippy and bitchy all through the intake conversation, didn’t laugh at my jokes and frankly, she reminded me of my ex-mother-in-law and…just pissed me off. In other words, I became Malibu Ken, L.Ac. Slid back reflexively into my old training, which is that I was in the business of “knowing” the “right” way for her to live and worse, charged with showing her the error of her ways (insert sound of healing space collapsing HERE). GAAAAWWWWDDDDDDD!!!!!!!!!! Needless to say, she bitched and moaned through the entire treatment, didn’t get any relief, and didn’t rebook. The 50 other people we saw this week poured excitement and happiness and relief and love all over us and filled up next week’s schedule, and if I only failed with one, I guess that’s not bad, but looking back on it, it was totally unnecessary. It would have been easy to offer her some help, right where she was, even just a little bit of help. It would have required nothing from me except…well….you know. Instead,  I got caught in the old pattern of thinking it was about ME. That’s why she wouldn’t leave my mind all weekend. I wasn’t thinking about all the people we helped and all the suffering that DID get relieved. I was obsessing about the ONE that I couldn’t offer at least some rest and space to, and your post dropped it together for me nicely. THAT’S the real art of the practice, and THAT’S the stuff they should be teaching us in school. Thanks for filling the gap for us so beautifully and consistently.

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  • July 7 2009 at 2:35 PM
    Lisafer writes:

    Moses and I were just talking about this…

    the other night when we worked together: the challenges of working with patients who push your buttons, the patients who remind you of other people in your life who also push your buttons, or who CREATED those buttons in the first place. Those are the really tough ones. If I’m lucky, with those people, I realize what’s going on and pray for that practitioner persona to hold up under stress—I guess that’s why I like to imagine it’s made of iron. If I’m not lucky, of course, it all goes to hell in a handbasket. You’re right, it’s an art. 

    I think one thing that makes it harder is the total lack of clarity in the profession in general about what an acupuncturist’s job is. I have a patient who I’ve been seeing for a while who recently started seeing another “alternative medicine provider” to help him work on a “problem” that acupuncture hasn’t helped him with. This “problem” is not something that I think of as a problem, but it’s something my patient is sort of obsessed with. As I listened to him telling me about what the other practitioner was prescribing, I felt this rising sort of horror: oh my God, this person sounds like the worst kind of snake oil salesman. I had to literally bite my tongue. Also, I had to vent for a while to my coworkers. They listened sympathetically and also said some helpful things about the limits of our job. And that is the part I had to remember: my job is not to set goals for my patients. If my patient has a goal that doesn’t make sense to me, it is not part of my job to say so. Even when I think, as I do in this case, that pursuing this goal is probably not good for him.  If I do my job well, eventually my patient may lose interest in pursuing things that aren’t good for him. And so for a couple of weeks, whenever I treated this patient, I would have to silently recite a mantra: not-your-job-Lisa-shut-up-shut-up. Just-put-the-needles-in-send-him-love-and-shut-up-shut-up-shut-up. I thanked God many times for the conversational limits of the community room and the time constraints of treatment; if we had been in a one on one setting, it would have been hell. (Shutting up is not one of my strong suits.) The truth is, my patient is really invested in this other practitioner and in this “therapy” that I think is damaging, basically because he thinks there is something wrong with him that needs to be fixed. This other practitioner agrees that there is something wrong with him that needs to be fixed. I disagree, but there is absolutely nothing I can do about it without alienating my patient, who I care about. My point: if I didn’t have some clue about the fact that I am here to do a JOB, a job that is clealy defined enough that other people who have the same JOB can actually help me think about how to do it well, I would be up a creek in this situation. Because it pushes my buttons. 

     “You know how people always say there’s a reasonable explanation for things like this? Well, there isn’t.” Daniel Pinkwater, The Neddiad

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  • July 7 2009 at 3:53 PM
    tatyana writes:

    ...

    If I do my job well, eventually my patient may lose interest in pursuing things that aren’t good for him. - this is key to me. thanks lisa for this amazing post. our new punk read it and so it saves me a whole lot of work. this is also a good response to chris’s questions in your previous post: http://www.communityacupuncturenetwork.org/blog/installment-2-finding-normal-study-guide#comment-16527

    -tatyana

      0 likes
  • July 8 2009 at 1:25 PM
    michael writes:

    Your text so brilliantly

    Your words beautifully express thoughts that ramble daily through my head, thank you!

    Michael Victoria, BC

    “sing’in rooty toot toot for the moon!”

    http://www.hemma.ca

      0 likes
  • July 9 2009 at 11:44 AM
    River Jordan writes:

    Great post LIsa

    I also worked with AIDS patients in the late 80s and was fortunate to receive so many teachings on how to have an open heart. I’ll always remember one moment - I showed up at a man’s house (for the first time) who was moving from his apartment to the hospital. His friend and his mother were there helping to gather belongings and fold clothes.

    His friend asked him, what he would like sung at his remembrance. He spontaneously said “Somewhere over the Rainbow”. I looked up and noticed that his mother had started to quietly weep.  I reached out and held her hand. Many moments like that.

    Often times, I would just get a phone call from the case manager telling me that I didn’t need to go to so and so’s apartment because he had passed on.  Still, it seems too easy to forget how precious and fragile life is. When we remember (or are reminded), the open heart comes easily.

    His Holiness the Dalai Lama has written a very accessible book called “An Open Heart, Practicing Compassion in Everyday Life”, which I would also recommend. 

      0 likes
  • July 11 2009 at 1:09 PM
    obnicole writes:

    Suffering

    Thank you for your willingness to keep teaching and exploring the issues of “identity” and love and caring and truth and appropriate, meaningful work.

    Something that has been helpful to me lately is rereading some books on buddhism. Right now the top of the pile is one by Pema Chodron: “When Things Fall Apart…”

    She addresses the idea that we are all dying and that if we would stop covering up this major fear and fears related to smaller ‘deaths’ (of relationships, or expectations of comfort, and so on), we would have more space to be in the moment. And live, and show ourselves loving-kindness, and be more open to showing loving-kindness to others.

    This relates to Lisa’s post in two major ways. First, in the knowing suffering is part of every human experience, and just knowing that and holding space for that is showing caring. “If you was suffering like I was suffering…” But the understanding of suffering is the important part, not trying to change it. Just, as Lisa says, holding space for it.  

    Second, the knowledge that we are dying (as if we all have a terminal illness but may yet live quite awhile) helps bring an awareness to what IS, rather than what COULD BE. Spending time meditating to create open space, acknowledging continually what we are doing (thinking, feeling, obsessing, judging…) creates more empty space. That expansiveness, I strongly agree, is very helpful in relating to people and offering help.

    My Tuesday morning yoga tacher at the Y closes every class after Savasana with these words, in a lilting dutch accent: “Always remember that you are of divine origin. You are one with the universe. And you are here to bring love, and light, to everyone.”

    She reminds me of the delicately filigreed steel ball with emptiness in the middle. She enters the class every week, tells us her name, and begins the class. There is no joking, no extra talking, no special adjustments for individual students. She may change some of the poses, but she always uses the same music, the exact same start and end, and the middle is run the same, even when the focus is slightly different. She’s offering space. That’s why her class is always overfilled.

    Thank you so much for this thread and the brave, honest work.

    ps Geshe Kelsang Gyatsu, founder of many kadampa buddhism centers, fully and patiently talks of suffering in all his books. Thich Nhat Hahn is also amazing. Sarah Napthali has an amazing book called I think Buddhism for Mothers, which really looks at how to handle and allow the suffering of your children. And if you can do that, you can do anything.

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