What We’re Working On Now

Sometimes "the creative process" is really "the creative mess." The process of writing books, for instance. After I wrote The Remedy, it was clear that more books were needed, and so Skip and I worked for over a year on writing a book for community acupuncturists. That book was a mess, such a hopeless mess that we eventually gave up on it. After leaving it alone for six months or so, I figured out how to salvage parts of it, stew and season them, and finally serve them up in finished form as Noodles. And lo, it was good -- or at least I thought it was good. Good enough, anyway.

And meanwhile the process of getting our second WCA clinic up and running was lurching along, which caused me to realize that some of the fragments of the original book, fragments that didn't make it into Noodles, would really come in handy right now: the fragments that had to do with training acupuncturists, the fragments that had to do with how to think about acupuncture as a job rather than a self-indulgent hobby. I dug out old drafts of the book, looked at them, cursed, put them away. It didn't help that I knew also that I was not the only community acupuncturist gnashing her teeth at the lack of training materials for new hires. Heck, plenty of practitioners who are opening community clinics by themselves would probably be grateful for some actual job training. But I couldn't figure out where to begin.

And then I went to the NADA conference and came home with a hopeful, though messy, idea.  A long time ago I wrote a blog post about seeing a documentary about some people I used to work with: Finding Normal, by Brian Lindstrom. It turns out that the documentary is now available on DVD, and Brian was selling the DVDs at the conference. I bought one, of course, and watched Finding Normal three times in three days. After the third time I thought: I want to show this to all of the acupuncturists I know, because everything we wish that acupuncturists would do at work, the recovery mentors in the documentary do beautifully. I asked Lupine, Moses, Matt and Skip to watch it, to see what they thought, and they agreed. I thought about it some more and asked Brian Lindstrom how he would feel about us writing a study guide to Finding Normal for community acupuncturists. He felt enthusiastic about it and gave me the official filmmaker's OK to proceed.

So what we are working on now is that study guide. This is not an ideal time to do this, particularly, because we have so much else to do, but it's the time when it needs to be done.  As Moses posted below, a group of current and prospective WCA acupunks have been getting together every Sunday night for the last few weeks to discuss what it means to be an acupuncturist, to have that be your full-time job. We're talking about the energetics of attracting and retaining patients; we're talking about how to be with people in the clinic; we're talking about handling failure. We watched Finding Normal together and talked about the people skills that the recovery mentors are demonstrating on camera. After every class, I go home and start typing up notes. I'm hoping to have the study guide done and ready for public consumption by the end of the summer. In the meantime, though, I thought maybe you all would be interested in following our progress as we develop the study guide. If you are, I'll post regular updates as we work our way through the film.

So first, here is the new (longer) trailer for Finding Normal:

http://www.findingnormal.org/?page_id=7

Watch how the mentors talk to people, how they are with people -- even in that 5 minute clip you can see it, hear it:

I will have your back, like nobody's had your back in a long time.

So, what are you committed to?

What you really need to understand, man? I give a fuck.

And here is my first batch of notes. Please discuss!

In 2001, I was working at Portland Alternative Health Center, an alcohol and drug treatment program which used acupuncture both for acute detoxification and long-term sobriety support. Most of the counselors who worked for PAHC were in recovery themselves, while most of the acupuncturists were not. Most of the acupuncturists were working at PAHC for basically the same reasons that I was: an inability or a lack of interest in supporting ourselves in “private practice” ( we didn’t call it boutique acupuncture back then) plus a desperate desire to have a job, any job, that allowed us to practice acupuncture. Nonetheless, a lot of the acupuncturists complained openly about all aspects of their jobs: the hours, the pay, the clients. Some of those complaints were grounded in reality, and some were the kinds of things that people say about any situation that they are not are particularly committed to.
In hindsight, I learned a tremendous amount about how to be an acupuncturist from working at PAHC. Much of what I learned from my chronically dissatisfied  acupuncturist -coworkers was in the category of what not to do. And much of what I learned from the non-acupuncturists I worked with was about how to be with people in pain. Many of the non-acupuncturists at PAHC were very, very good at that, in part because, unlike the acupuncturists, they were passionately committed to their jobs. What I realized eventually was that there are a lot of “clinical skills” involved in being a successful acupuncturist that have nothing to do with needles or pulses or tongues or any of the other things that we associate with acupuncture. And I got great training in those non-acupuncture clinical skills from my non-acupuncturist coworkers.
One of the people I learned the most from, though neither of us realized it at the time, was David Fitzgerald. David and I worked a lot of shifts together; he was the evening UA technician, which meant that his job was to watch guys pee into cups, either before or after I put needles in their ears. David and I didn’t talk all that much, but I learned an enormous amount just by watching him be who he was. Who he was, and is, is so extraordinary that I was not particularly surprised to find out recently that he had starred in a movie, playing himself. The movie is Finding Normal, and it finally occurred to me that I should use it to train acupuncturists. I learned to be an acupuncturist in part by watching David, and I bet other people could too.
Some of what I learned from David eventually led me to quit PAHC and start the community acupuncture movement, though of course I had no idea at the time that’s what I was doing. I knew that I wanted to be more like David, and it wasn’t going to happen at PAHC. I wanted to be myself in my work in the way that he was himself in his, and in order to do that, eventually I had to deconstruct and reconstruct how I practiced acupuncture.
We are going to create a study guide to Finding Normal for acupuncturists, and go through the entire movie, scene by scene, to identify and discuss the non-acupuncture clinical skills that he and the other counselors in the movie are demonstrating.  We at WCA often complain that acupuncturists can’t see the forest for the trees, that they are overly focused on what points to needle or what techniques work best while they are overlooking the fact that they don’t know how to connect with people. It occurred to me after watching Finding Normal for the third time that maybe the reason acupuncturists get so narrowly focused on acupuncture, at the expense of everything else that goes into a “clinical interaction”, is that they are overwhelmed and scared by all of the other skills they don’t have. They know that they don’t know how to deal with people, but they don’t know what to do about it, so they ignore the problem in hopes that it will go away. The problem doesn’t go away, of course; what happens is that patients go away. There is no place for acupuncturists to learn basic skills of how to relate to patients, so they can’t retain them.
The first step toward making this study guide, I thought, would be to make some general lists of what the mentors in Finding Normal do, have, and are. Those lists are a way to identify the skills that go into creating a way of being which allows someone to be an acupuncturist. I started the lists, let’s add to them as we watch the film.

What the mentors do

connect with people
help people connect with themselves

tell the truth
help people see, and tell, the truth about themselves

pay attention
help people pay attention to themselves

hold space for people to heal


What the mentors have

intensity
integrity
passion
commitment
detachment
discipline
compassion
empathy
boundaries


What the mentors are

consistent
systematic
attentive
clear
direct
able and willing to connect with other people
humble
honest

This story was posted on June 22 2009 by Lisafer.

Comments

  • June 22 2009 at 9:41 PM
    melissa writes:

    i’ve seen this somewhere

    i’ve seen this somewhere before—look forward to seeing the whole thing and am really excited about this whole study guide idea. even as new pratitioners, it’s just so different than we were conditioned—thank god! we get to be ourselves and genuinely just try to connect with people!

    and in talking to other practitioners so far, the differences are sort of unquantifiable and difficult to explain.

    thanks for your work on this, and for keeping us in the proces. love some updates on junior, alos!

    a few days ago, someone sent me a link with a quote from a young boy in africa, who was dying of aids, it somehow fits here for me:

     

    do all you can

    with what you have

    in the time you have

    in the place you are

    do all you can

     

    Melissa

    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.

      0 likes
  • June 22 2009 at 11:48 PM
    andy wegman writes:

    Another copy sold.

    I just watched the trailer, and can’t shake the feeling Mr. Fitzgerald reminds me of Danny Aiello’s benevolent (fictional) character ‘Louis’ in Jacob’s Ladder, who played a certain role in my choosing to gravitate towards the acupuncture trade, back when.

    Thanks to you and the Saturday Night Crew for keeping your eyes on the horizon.

     

     

      0 likes
  • June 24 2009 at 1:30 AM
    Lisafer writes:

    lovely

    That reminds me—another non-acupunk employee I learned a lot from at the public health clinic was Gwen, the lead receptionist. Also in recovery. She had a quote taped to her desk that read:

    Do all the good you can, by all the means you can, in all the ways you can, in all the places you can, to all the people you can, as long as ever you can.

    And she did, too.

    I looked it up on line to figure out whose quote it was, and found out it was John Wesley. Apparently he also said, When you set yourself on fire, people love to come and see you burn. Which I think finally explains to my satisfaction why our workshops are so popular.

    Junior is doing great! Open for six weeks, they started out the first week (May Day) with 40 visits; the last two weeks, they’ve been up above 70. (And that’s with being down to 2 acupunks, after starting with 4. Thus my increased enthusiasm for hiring and training materials…) I think this week they’ll be out of the 70s, up to 80 or 90.  One patient who says acupuncture has changed her life already and is making curtains for the clinic. In another month or so I promise to do a more detailed post about Jr’s progress. Thanks for asking!

      1 likes
    • urbanapuncture
  • June 24 2009 at 6:38 AM
    royg writes:

    This is exactly what new

    This is exactly what new acupuncturists (and some older ones aswell) need to learn and develop. I know i need it. Just thinking about this issue would be far more beneficial than another technique or point combination.

    Thanks Lisa for hitting the nail on the head, yet again.

    Roy

      0 likes
  • June 24 2009 at 1:07 PM
    Justine writes:

    I think it’s ironic (or

    I think it’s ironic (or serendipidous?) that you posted this now, because I’ve been thinking about this a LOT lately. The interaction and communication piece is something I could most certainly benefit on with the help of some instruction and direction… sometimes I find myself a bit clueless as to what to say to a patient or how to respond to them.  Having knowledge for the need of compassion and boundaries is one thing, but implementing it in a way that seems natural and having the “right” answers for people is another and sometimes difficult.  I’m really looking forward to your work on this and I can’t wait to check out the movie!

      0 likes
  • June 24 2009 at 4:58 PM
    David Lesseps writes:

    Thank you.

    Lisa,

    I look forward to this.  I need this.

    Recently, at Circle, we had some conflict amongst ourselves.  I acted like a great self-involved ass and suggested that one of my partners wasn’t doing enough because she had not invested a lot of time learning particular styles of acupuncture.  Wrong.

    I am quick to talk the CAN-talk about how we do this for the patients, and that the most important part of what we do is making sure the patients are there, sitting, with others, in silent dialogue with themselves.  Unfortunately, while I can say that, and believe that, I often have trouble putting that into practice. I am still wrapped up in the idea of the “perfect treatment” from the practitioner. I am good about thinking about points and plans, and quick to forget about the human. My partner, who I wrongfully attacked, may not always create the perfectly balanced Tan-Tung-I Ching-Seasonal-Super-Dooper-Calculus-Treatment, but she does a great job of connecting to patients.

    I am looking forward sitting down with this movie and your study guide.  Once again, I find myself saying thank you to Lisa.

    -David 

     

    Circle Community Acupuncture

    San Francisco

    http://www.circleca.com

      0 likes
  • June 24 2009 at 11:33 PM
    JuliaC writes:

    this is perfect

    I co-teach AIMC’s Counseling and Communication course (while my biz partner, Mary, was busy causing trouble as the interim prez this term!), and when we do role playing with various patient scenarios, I’m always amazed at how absolutely terrified these students are in their role as the practitioner.  I watch them gather an aura of expertise or power or control to cover for their fear at not knowing how simply to BE there with someone in pain.  It’s a delicate dance that’s actually quite difficult to teach.  I think watching people do it over and over and practicing it in situations where the pressure is off might be the key to success. I absolutely honor the work I did at a methadone clinic as part of whatever success I manage to have when holding space with patients.  Those recovery counselors were some of the finest bodhisattvas I’ve run into this time around…

     

    Your guidebook will be so useful in so many ways, Lisa.  Thanks again for your selfless (although I hear you say that it will also serve you) giving to this righteous (in a good way) movement you started.  I can imagine there being group sessions and workshops based on what comes out of this. And I look forward to somehow participating in it.

     

    blessings,

    julia in berkeley

      0 likes
  • June 24 2009 at 11:56 PM
    Nora writes:

    This is really interesting,

    because it seems like this is the main argument some acupuncturists use to claim WHY acupunctur(ists) are special and why you have to spend 20+ minutes talking with patients.  But I think this:

    “how to be with people in pain”

    is the crux of the matter.  Very simple, which is not to say easy.  

    This too is helpful: “Many of the non-acupuncturists at PAHC
    were very, very good at that, in part because, unlike the
    acupuncturists, they were passionately committed to their jobs.”  I’ve been thinking about this a lot in the past year or so, but especially since the NADA conference.  There’s something there about credibility, too (they’ve been there) and maybe a real deep understanding about survival that might undergird that passionate commitment.

      0 likes
  • June 26 2009 at 1:52 PM
    Joseph writes:

    What about the patients role?

    Since David’s post earlier this week I’ve been thinking about what it means to connect to patients and to offer the “perfect treatment”.  Another aspect that I am starting to understand in our community acupuncture culture is the role of the patient.  Recently I had a couple that have started to come regularly. I got the sense from watching the room when they come that somehow they set the tone for other patients to follow their lead into deep relaxation. That particular night all of them woke up together and came staggering out of the treatment room.  I’m donig the same thing, but somehow their chemistry created a shift. I think we can call that community acupuncture in action. When I get too concerned about doing a “perfect treatment” I think that maybe we are only renting out chairs, a space, and the time for people to come do their own inner work.

    -Joseph
    WCA-Hillsdale

      0 likes
  • June 29 2009 at 8:41 PM
    LarryG writes:

    couple thoughts

    Thank you so much Lisa for starting this. Timely and necessary.

    What the mentors do
    identify strongly with newly recovering addicts
    identify strongly as a recovered addict
    establish meaning through relationship
    encourage a here and now practicality
    establish a sense of belonging
    What the mentors have
    credibility
    sincerity
    authenticity
    “your back”
    trust
    faith in people
    faith in the program
    What the mentors are
    supportive
    operating from a working class culture and value base
    I think it would be helpful to recognize these qualities we are compiling, what the mentors do, have and are, within the context of class identity and class values, to consciously articulate these qualities and skills and their relation to class.   
    Perhaps the challenge for middle class CA punks will be in understanding and acting from a value base that may be foreign and uncomfortable, especially when working with working class patients.   It is my opinion that many, if not most acupuncturists are from the middle class and their way of relating to people, as well as their self sense are based on a middle class upbringing and values steeped in individual achievement, accomplishment and the meaning generated from these things.  While not bad things in and of themselves, these attributes get in the way of connecting with people if they are the primary motivators in ones practice.  Helping to sort these things out with the study guide should be invaluable to hiring clinics or any person looking to develop their skills as a CA punk.
    Of course, this skills and values differential between working and middle class people is  probably a problem for middle class raised people in regards to understanding CA when the inventors of CA are working class people and have found a way to make acupuncture work that is grounded in working class values.   I don’t think that being raised middle class precludes one from practicing CA.  I do think, however, that it is important for middle class people to understand the difference between working class culture and values and middle class culture and values and that understanding and honoring these differences will be critical to ones success as a CA punk, whether as a hire or an owner.  This film and the resulting study guide should be instrumental in highlighting these differences and helping us all understand, whatever our class background, either what we are or aren’t doing well, hone those skills that matter and discard those that don’t. This can help us sharpen our awareness while also illustrating the impact of class on acupuncture practice in a way that is not abstract and is quite tangible and obvious.
    Lisa’s description of the discontent amongst acupuncturists at PAHC as being rooted in a lack of commitment to the situation there versus the passionate commitment displayed by the non-acupuncturists speaks to the class problem that acupuncturists have in general, and more specifically in a CA setting where we are actively trying to work with working class people.  It also points to the power of group-based recovery models, their emphasis on relationship and mutual support, on the practical understanding that addicts need other addicts for recovery and the models roots in working class values.
    In CA practice what is important is the group, not you or your skills or special acupuncture knowledge.  The emphasis on belonging is so strong in working class culture…you can see it in the eyes of that gentleman mentor talking to the new person in recovery in the car.  His eyes say that he would take a baseball bat to the skull for that mans sobriety, happily.  He is genuinely committed to him.  This, to me, is what best represents working class culture and values:  the strong emphasis on the value of relationship, downplaying the individual for the sake of the group, honoring your brothers and sisters with unwavering support, the sense of belonging.  Or, as more eloquently put, “I’ll have your back like no ones had it in a long time.” This is grounded in knowing that there are people that have your back too.   May we all understand the conviction in that mans eyes when he says, “I give a fuck”.  My friends and I watched Good Will Hunting maybe a million times, because more than anything we felt it identified these things about us, how we loved and cared for each other, how committed we were to one another.  What are friends for?

      1 likes
  • June 29 2009 at 10:33 PM
    Lisafer writes:

    thank you thank you thank you

    It’s funny, I was just thinking that the reason *I* like the movie Finding Normal so much is because the mentors are working class, sound working class, think working class—listening to all of these people talk, I just relax internally. In a way that I can’t relax when I’m listening to anybody from any other class background. But  I didn’t have anything about that in my notes. And if you hadn’t written this comment, I think I was actually probably going to leave working class values and culture out of the manual altogether. How’s that for some internalized oppression?

    And you’re right, it totally needs to go in. And it’s so difficult for me to articulate that I am going to need lots of help. Please keep the comments coming.

      0 likes
  • June 30 2009 at 2:44 AM
    LarryG writes:

    glad to help

    it’s funny, Lisa.  i’ve been journaling a lot of stuff that relates to hiring because, well, we need to hire soon.  here are some more thoughts that may be of use. they are rough thoughts not fully developed but i think they can help.  this study guide is important and i am happy you are on the case!

    Class Location/Identity Markers- Income, Values, Roots, Power
    Income- objective income marker
    Values- sense of what gives meaning, ideals and motivators

    Roots- personal connection to sense of history, family ties, community ties
    Power- economic and political power associated with occupation, degree of autonomy in workplace, independent decision making capacity and the impact of those decisions
    Race, ethnicity, gender, age, sexuality, religion, education, ability and psychological stage of development all inform our class location and identity.  So does growing up in a dysfunctional/abusive household and or community.
    If we consider that class location/identity determines the degree of autonomy and freedom in the workplace for adults, how does this impact the culture of the family and the degree of autonomy and freedom that children in particular classes enjoy?  How do the children of different classes understand political, economic and personal power and autonomy?  It has been said that the middle class enjoys a considerable degree of workplace autonomy and freedom in the decision making process where as working class people have little autonomy, are the bosses of no one and have little decision making capacity in the workplace. (Zwieg: What’s Class Got To Do With It?)I would state that middle class experience translates into teaching children that life has choices, encourages a sense of personal entitlement, allows for greater sense of self-confidence and encourages self-expression.  One working class author claims that she would rather not be upwardly mobile due to the emotionally constrained culture of the middle class, but desires the aspects of middle class culture that encourage options in life, as well as the financial security involved (Kadi: Thinking Class). Delineating income, values, roots and power allows for a more flexible sense of self and can help us to appreciate the desirable and pathological aspects of each class.

    Freedom within structure: the essence of CA acupunking. 

    How does class association impact the requirements for being a CA acupunk?  What are the advantages and disadvantages for each class (being mindful of the impact of race, gender, etc.)?  Are middle class CA punks hampered by their difficulty staying within the bounds of structure?  Are they more drawn to hybrid practices?  Do they find it difficult to let go of practice modalities/techniques that they feel enrich their sense of self expression and entitlement (“But I love moxa/tiuna/reiki!”)?  Are they harder to train?  Will CA owners from working class backgrounds have a harder time identifying with and training middle class employees?  Are the majority of acupuncture students and graduates middle class?  Do they need to express their personal freedom in such a way that it impairs efficiency?  What difficulties will middle class punks have in connecting with working class patients?  What middle class behaviors are likely to alienate working class people?  Are working class people more adept at following the forms of structure than middle class people due to their experience with power and autonomy growing up?  Are they less creative in treatment plans?  If so, does this matter?  How does your class experience inform your ability to do high volume acupuncture?  Is CA acupuncture a working class job or a middle class job when we consider power?  How does ones position as an owner versus an employee of a CA clinic determine class position in regards to power? I think we need to be clear that CA owners, in regards to power, are different from employees.  While the work is similar and clinically owners and employees are crafts people with the ability to make independent decisions in the clinical arena, someone has to make and enforce the general rules (the owners).  It appears that the power of decision making separates the owner from the employee at least in regards to business steering capacity.  To what degree? To what degree can owners expect employees to act independently in regards to non-acupuncture duties in the clinic?  How will this impact efficiency and what factors contribute to inefficiency, confusion and chaos?

    Class division can only weaken us if we are unaware of our differences or refuse to acknowledge them.  How can we have honest conversations about our class identities in such a way that it helps progress the CA movement and work experience for all involved?  We must understand that many people drawn to CA will be middle class and there is no need for middle class people to be ostracized.  On the other hand, we must consider that the life experience of working class people is fundamentally different from middle class people.  One working class crossover author stated that the essential difference between working class culture versus middle class culture is belonging versus becoming, respectively (Barbara Jensen: Across The Great Divide).  In acknowledging and understanding these differences, especially in the realm of power, autonomy and personal expression, we strengthen and support the CA movement. 
    Ultimately, the CA movement exists to create a sustainable and healthy workplace, while providing acupuncture/support for people making a working class wage.  Understanding how class relates to power and autonomy helps us all to realize this vision.

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  • Roppy commented on the blog post 'The Acupuncture Profession has 99 problems, but NADA ain’t one of them.' in the blog 'Prick Prod and Provoke Blog' - Tuesday, December 25, 2018
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