To Treat, Or Not To Treat? That Is The Question

When it comes to healthy behaviors, I try my best to meet people where they are. I know a lot of health practitioners who feel that patients are the ones who need to take responsibility for their health, and that is true, but these acupuncturists will refuse to treat those who aren't helping themselves.

I can see their point, but I view the situation differently. If these patients are unable to break away from these self-defeating behaviors, isn't that a part of their overall pathology?

Here is an example: In my medicine, Dampness is both a causal factor and result of being overweight. (You may have noticed that I've capitalized the word "Dampness" - you will see this when I am referring to Traditional Chinese Medicine terminology.) Dampness is thick, sludgy, slow and heavy. If there is excess Dampness in the system, the patient will feel that heavy slowness in his mind and body. He may be constantly sluggish, have muddled thinking and be slow to react to situations. Extra weight can lead to Dampness, but Dampness can also lead to extra weight. If you lack the energy necessary to get moving, the weight will pile on.  

There are those practitioners out there who will simply tell the patient, "If you don't change your lifestyle, I can't help you." I have had many patients come in and ask about acupuncture for weight loss, and I am always honest with them. Without other changes, those pounds won't be shed. However, acupuncture is medicine for the spirit and mind, as well as the body. If we eliminate some of that Dampness through acupuncture, the patient will feel lighter and clearer. His thinking will be sharper, and he won't feel as heavy and weighed down. That in itself might inspire him to get off the couch more and to move around. And once you start moving, you tend to keep going ... an object at rest, and all that. As with all endeavors in life, momentum is our best friend.

So what about those patients on the opposite end of the spectrum? Those marathon runners who suffer through tears and sprains and strains?

"If they're just going to keep ruining all your hard work, what's the point?" one colleague grumbled to me the other day. "The next time she comes in after pulling something, I'm not treating her."  

Again, I could see his point. But that sort of drive to keep going stems from an imbalance, as well. These overacheivers often have too much "Yang" in their systems. The Yang is the heat, drive and force we need to keep us going. The Yin, on the other hand, is the part of us that is cool, quiet, restful and serene. We need to strike a balance between the two states in order to stay healthy and happy. In the case of excessive Yang, excessive exercise can feel good because the patient needs an outlet to burn off all that extra energy. The problem is, they often burn out, as well.   

Rather than getting fed up with patients who continue these patterns of overdoing it, it's important to find where that imbalance is and to work with it. The patient might come in for a torn hamstring, but what he really needs is some work on his Yin/Yang balance. Calm the mind, and the body will follow.