Beyond Styles of Practice 

Over the last fifty years, our understanding of what Chinese medicine is and how it should be studied and practiced has fundamentally changed. We once thought it was a single system. Now we know that Chinese medicine is a family of many different styles of practice. 

In acupuncture, for instance, there are the Tung style, the Tan style, various styles of Japanese meridian therapy, Worsley five element acupuncture, stems and branches, Korean hand acupuncture, TCM acupuncture, and various types of scalp acupuncture to name just a few. In herbal medicine, popular styles include various types of jingfang or “classical formula” practice, TCM, Japanese Kampo, Korean constitutional therapy and many more. 

The question is how do we relate ourselves to this multiplicity. Should we study all of these approaches? As many as possible? Only some of them, but then which ones? And why those and not others? Should we leave it all to chance or let ourselves be enchanted by the charisma of the most popular teachers (which, of course, will not be the most popular ones in a few years time)? 

This problem is not new, of course, but has vexed practitioners of Chinese medicine since time immemorial. Over that period, they have proposed three basic solutions:

1. Stick with one style.

2. Synthesize different styles into a single new style.

3. Develop a meta-practice approach that allows you to work effectively with different styles.

All of these solutions have advantages and disadvantages. Sticking with one style solves the problem of choice but will ultimately limit you. Synthesis gets rid of differences but in the end simply creates just one more style. Developing a meta-practice approach gives you flexibility and deepens your practice in a way that the other approaches cannot do, but it also requires more time and effort.

 

What is Meta-Practice? 

Meta-practice is a tool for working effectively with different styles of practice. This has four distinct advantages.

1. It puts your patients in the center.

2. It significantly increases your diagnostic and therapeutic skills.

3. It deepens your understanding and access to the Chinese medicine tradition.

4. It provides you with a firm basis for life-long learning.

In meta-practice, what drives the treatment process is not your style of practice, into which you have to fit your patients, but the needs of the patients themselves. If you always seek to link a patient’s problem to their constitution because that is what your style of practice demands, it is highly unlikely that you will be able to effectively treat an acute epidemic or serious disorders involving toxins. If the only formulas you use must have been written down in the Han dynasty, it is unlikely you will become very good at treating phlegm or damp-warmth because these concepts were only developed much later on.

Meta-practice helps you to become a better clinician because you have more tools at your disposal. Different styles of practice emphasize different diagnostic modalities such as pulse, tongue or abdominal diagnosis, inspection or listening. Meta-practice demands you to use all of them, though not necessary all the time. Here, too, the patient and context are the primary drivers, but you are also better able to employ your own personal strengths. Some of us just are better at processing visual information, while others work better with palpatory referents.

By working with different styles of practice, meta-practice forces you to be more precise in the definition of the concepts you employ. Any single style of practice can get away with ill-defined concepts. Bringing different styles into conversation with each other demands that we find common ground. This can be challenging but ultimately expands our knowledge. It certainly deepens our access to and understanding of the sources of our tradition.

Finally, meta-practice allows you to systematically extend your clinical skills without ever being limited by what you have already learned.

 

The Elements of Meta-Practice 

Meta-practice, in as much as it is explicitly articulated, revolves around three core elements: 

1. Principles (li 理) referring to conceptual knowledge including an understanding of how such knowledge has changed over time.

2. Strategies or methods (fa 法), referring to a toolbox of diagnostic and therapeutic tools including the herbs and formulas we use in daily practice.

3. Intention/attention/judgment/meaning-giving (yi 意), referring to the ability to constellate principles and methods in a clinically effective way.

Put all of this together and everything flows and makes sense (tong 通) in both you and the patient you treat. 

 

This course is designed to help you develop such knowledge, tools and skills by providing you with:

1. intention/attention/judgment/meaning-giving (yi 意) deeper understanding of Chinese medicine anatomy, physiology and pathology.

2. a deeper understanding of key concepts in Chinese medicine and their change over time.

3. diagnostic and therapeutic methods that build from the simple to the complex to which you will be able to add further elements as your skills as a practitioner develop.

4. skills for putting it all together.

To this end, Volker will draw on his extensive knowledge of Chinese medical history and literature and almost forty years of clinical practice.

 

Course Organisation

The course consists of thirteen two-day modules taught over three years that will be delivered in a hybrid or online only format. 

1. Six modules will be taught by way of in-person seminars (classroom teaching) over twelve hours on two subsequent days (Sa/So). These modules are also live-streamed and can be attended online.

2. Six modules will be delivered online over two days in two subsequent weeks (Saturday in Week 1 and Sunday in Week 2).

3. Modules 1-11 will be supplemented by a two-hour online tutorial. These tutorials are organized to ensure that all course participants have understood the information delivered in the seminars. Tutorials will be conducted by practitioners who have studied with Volker for many years and are themselves engaged in meta-practice. 

4. All lectures will be recorded and made available to course participants for the time between successive seminars on a professional learning platform (Moodle).

5. Self-study is another integral part of the course. We will provide guidelines for what you should revise before each module to ensure you can follow the material presented.

The different modules build on each other. Our experience from previous courses is that it takes about 12 to 18 months for participants to get meta-practice. By the end of the three year period, participants are able to do meta-practice in their own clinics with confidence.

 

Module Descriptions

Modules 1 to 5 are centered on qi and its relation to bodily substances (fluids, blood, essence). We will examine the physiology and core pathologies of the ‘three qi’ (zongqi, weiqi, yingqi), and define the core treatment strategies required to deal with these.

Once the principles of these treatment strategies are clearly understood, we will then examine how they can be realized in clinical practice through the usage of a small number of key medicinals and synergistic pairings (duiyao). These medicinals and synergistic pairings will then become the building blocks for the composition of more complex formulas. We will examine famous formulas as exemplary examples of such composition but not of what one necessarily has to do in one’s own clinic.

Modules 6 to 9 shift perspective by focusing on specific bodily regions and structures (the exterior, the triple burner, the conduits and networks) and their disorders. We will examine how the different qi and substances (which by now we know quite well) interact with each other in these regions and structures and how these structures, in turn, mediate the physiology of bodily substances.

Modules 10 and 11 focus on bodily substances (fluids, blood, essence). In many ways, this is a revision of the previous modules from a different perspective. Besides helping us to better understand the physiology and pathology of these substances as well as the strategies for treating them, it allows us to integrate what we have learned so far and move deeper into meta-practice.

Module 12 returns us to what normally stands at the very beginning of studying Chinese medicine: the viscera and bowels (zang fu). It is an opportunity to integrate what we have learned into what we already think we know but which may look different now that we can see it in a different light.

 

To facilitate participants' progress through the course as a group, there will be a written test/quiz for each of the nine modules. These tests will help Volker to monitor the progress of individual participants, while providing participants with an incentive to review and internalize the course content.