The medicine of east Asia is based on a science that does not hold itself separate from the phenomenon that it seeks to understand our medicine did not grow out of Petri dish experimentation, or double blind studies. It arose from observing nature and our part in it east Asian medicine evolves not from the examination of dead structures, but rather from living systems with their complex mutually entangled interactions. Welcome to qiological. I'm Michael max, the host of this podcast that goes in depth on issues, pertinent to practitioners and students of east Asian medicine. Dialogue and discussion have always been elemental to Chinese and other east Asian medicines. Listen into these conversations with experienced practitioners that go deep into how this ancient medicine is alive and unfolding in the modern clinic. We are trained to know a lot about a person from looking into. And while we have our 10 questions or other interviewing checklists, there's a lot that can come from an interview in relationship with the patient that can help us to better understand them and hopefully be of service to them as well. On the other end of the microphone today, I've got Margo Rossi. I've known Margo for as long as I've known about acupuncture, because Margo was the first person to ever put an acupuncture needle into me. We talk from time to time about our practices. And one of the reoccurring topics that comes up is about the kinds of connections that get created in our clinic and with our patients that allows us to better understand our patients from their own point of view. In today's discussion, we are circling around how the connection with our patients and the information we get from our exchanges with them. Can help to inform our clinical iron hand. I always enjoy my conversations with Margo and I once tried to interview her for everyday acupuncture a few years ago, but she turned the microphone back on me at that time. What can I say? That's Margot for you? It's episode 15, by the way, if you're interested, just pop over to everyday acupuncture podcast, you can listen to it. Anyway, today I'm delighted to be sitting down with a cup of tea across the space of 12 times zones with Margo and sharing our conversation with you. Let's see what we get into here today. Margo. Welcome to qiological.

Hi, Michael max in

Taiwan. Yeah. This, this show is coming to you live on tape from Taiwan, Taiwan, Taiwan, actually lower part of the island. So I, you know, you might hear some background scooters and stuff like that. Um, I've tried to get into a quiet place, but uh, it's Taiwan, baby.

Yeah, over here. You'll just hear some backyard. But

all right, well, I've got Margot Rossi with me here today, and I've known Margo for as long as I've known about acupuncture, because Margaret Rossi was actually the first person to ever stick an acupuncture needle into me. Like, I don't know, 25, 26 years ago.

Yeah. I think that's my only claim to fame, Michael.

Well, I think you're stuck in acupuncture and the color me you've been doing it for as long as you've been doing it.

No, that, that I, that I treated you. You're in my book. You're a famous person. So

I bring my book. You're the famous person. That's why you're on the show. You know, one of the things I really remember from long ago is you're not just getting treated with needles and such, but. The way that I was listened to attended, to cared for the way that I was spoken through the way that I was invited into a conversation about, you know, not just my health problem, but who I was. And so one of the things I wanted to talk with you about today is, is because, uh, I mean that was something that's been a part of acupuncture for me from the get go. And I always think about the way that you used, let's call it the relationship, the connection with the patient as a way of getting information so that you knew how to help. You know, I mean, we learn about tongue. We learned about Paul, especially here in Asia. If someone finds out that you're a Chinese medicine practitioner, they stick their wrist out. Like, you know, tell me who I am, which is, you know, I mean, there's a lot that we can get, but I don't want to talk with you about what you get from being with.

Well that I think that is the most nourishing aspect of the work that we do for me is that moment of being in relationship with someone, you know, I'm not a great pulse diagnostician. I'm happy to admit that. And I admire my colleagues who are really good at that. Um, I've got, you know, all those diagnostic skills. I understand them. And I understand the strategies of our medicine pretty well, and that's a great framework to have. Uh, but I definitely rely the most in my practice on my relationship that I have with my patient during that interview process, that's probably where I get the lion's share of information. Um, my treatment will come to me in that moment. I'll know exactly what I want to do. And then when I get into the treatment room with the patient, I have mostly. Often do check the pulse. I do look at the tongue. I often do hard diagnosis as well, but sometimes I don't sometimes I just let all that go and just go with what came to me in the interview process. And that's probably the thing I most passionately like to share with acupuncture students. I don't know if you know this, but, um, since 2004, I was teaching at Dallas traditions college of, uh, Chinese medical arts in Asheville, North Carolina. And I started there when the school started and I taught everything. I taught Chinese medicine theory at times. Five elements. I taught hard diagnosis. Um, uh, the main thing that they kept calling me back for was to teach needling techniques and the adjunct techniques, which of course is profound. That's a profound study to teach someone else how to do. Uh, so what I started sneaking into that class would needling techniques, you know, talking about the link shoe and talking about the, the comport of the practitioner or the relationship that you're having with the needle, inserting the needle, et cetera. And then of course all the clean needle technique that goes along with that and the anatomy and the, uh, function and indication of the points. And then, you know, the technique that you're actually using on the needle lifting and thrusting, if you're working on the divergent channels, here's the technique. If you're working on the sinew channels, here's the technique, et cetera. Uh, but what I started sneaking into that was the, the treasure and the preciousness of creating a relationship with your patient. And of course, for students, that's the most terrifying part of working with someone, you know, in those first couple of years is how do you sit in a room with someone and nurture this intimacy? How do you know when not to go forward in that? How do you even establish rapport with someone we don't have? We don't learn those skills in school. It's just not something that we get in America is how to build rapport with someone. Unless you take a, you know, a neuro-linguistic programming course, you won't, we just don't learn that stuff.

Or maybe unless you learn psychotherapy or, you know, Those particular or, you know, even really good sales training.

Well, they, they use neuro-linguistic programming for sure.

Yeah. It's just part of the way humans naturally effectively communicate, right?

Yes, yes, yes, absolutely. It's if you're paying attention, you don't need to have those classes, you know, that we get most in rapport with people, with whom we feel like we're similar, you know, if there's something familiar. Yeah. If you're paying attention. So

tell us about paying attention.

Uh,

I hear your evil laugh.

Well, can I back up a little bit and just, um, cause I, again, just as I'm not, I don't pride myself on being a great pulse diagnostician. Uh, I'm not a scholar either. Though, I though I certainly have read some chapters out of the link shoe and the SU one. I can't say that I know these things, but, um, there are, there are a couple of chapters out of the doubted Ching that speak to this and certainly in the Suwon and the link shoe, uh, they talk about this importance of the relationship between the practitioner and the patient as being the key to your diagnosis, to understanding what's happening for this other person. And of course that influences your treatment, but you know how there's that saying? The Dow B got the one and the one, one began at the two and then the two, we got the three and the three, we got the 10,000 things.

Yeah.

The three caused all the mistress.

Yeah. Well, of course, when I first studied that, I thought it was kind of like the. The Tootsie roll, pop, like how many licks does it take to get to the center of the tips? You know, 1, 2, 3, you know, the world may never know. I just thought they kind of gave up, you know, the Sage is just gave up at three and said, okay. And then everything else comes after that, but whatever. Yeah. But if you think about it, you've got the Dow and then you have the yin and the young, just like having an earth patient practitioner and then between them is created this other thing, this third thing. And that third thing of course is the relationship that you have. So, yeah. And from that relationship, you know, if you can really connect with someone, the possibilities are, I'm assuming infinite. Of where you can go together, what you can do, how things can change, what you can create from that, that triad of me, you and our relationship. So when we were first learning that, that just caught me on fire, like, oh, that's really what it's about. Is there really, it has nothing to do with, uh, my diagnosis. It has nothing to do with where I put the needle. It has nothing to do with my technique. It has everything to do with my relationship. There are our relationship that we're creating together. And when I was working with you, Michael, I think I've shared this with you once upon a time when we were having a conversation that I apologize to my supervisor in student clinic, because I was always running late because I was talking to my patients. One day I came out of the room and it was with you, you had had, um, something profound happened while you were having the treatment and it touched you deeply and it was unsettling. And so we talked for a while when I came out of the room, I apologize to my supervisor. And he said, no, this is, this is a cornerstone of Chinese medicine. Of course this was Dr. Young. I don't know if you remember him to him. That was paramount. That relationship, that talking to the, talking with the patient listening and responding whisky. So he didn't, he didn't mind at all that I was late. It was, and that was a real pivotal moment for me, because I was so excited about this idea of, I think Lani. Oh my gosh, I'm going to say something in Chinese now. And you're in Taiwan, big Lani, Jarrett calls it, the. The she, the, um, that's what's happening between the practitioner on the patient. That relationship is like an infusion of tea leaves and water. So you have the water and you have the tea leaf, and then you have this infusion and you get the tea from that, which of course is very therapeutic and delicious and delicious.

Yeah. Yeah. And it speaks to kind of an alchemical thing too. I mean, when you talk about making tea, you've got water, you've got fire, you've got heat. You've got, you know, something melding with something else.

Yeah. Yeah. And I'm coming back since you mentioned the water that's that was another, that was another piece out of the doubted Ching that really caught me. I think the chapter. Eight speaks about being like water, which is something, um, that my beloved teacher, Jeffrey Yuen off often talks about is to be like water. That that's the ultimate because the water can go into any space and it goes where most people might not want to go. And to me, that's, that's also what we want to do in this relationship in the clinic is to be able to infuse into places that may be unconscious for our patients. Maybe even

they're often really unconscious.

Yeah. So that it

might be partly why they're there. There's this thing that they're not attending to. And now they've got these.

Yes. And of course we can't solve a problem at the same level of the problem. So if, if something is going on the subconscious and we're don't have any awareness of it, we really are kind of limited and changing it. I might be able to, uh, you know, give an herbal formula or do a treatment. Um, but it's not until that issue becomes bubbles up into consciousness. I think that it can really start to shift that, that personal actually start to change their lifestyle or start to change their beliefs or their thoughts or their attitude or the things that really are going to make that transformation happen. So being able to communicate with that subconscious is really key and we can do that through certain skills. And that's what I like to share with my students are what are those rapport building skills that you can take into clinic? And use so that you can create a link between yourself and the consciousness and the subconscious of your patient. And then once you go there, once you, once you move like water into those places, then you can draw things out so that they can have an awareness of them and things can really start to change. Does that make sense?

Yes. Yes. And, and, and the way that you're talking about water seeping into the cracks and going to the lowest levels and, you know, seeping down, down, down, I find this happens in clinic. A lot, people come in with something and they're not even sure they should say something about it. Yeah. And sometimes actually they don't want to say anything about it. They're hoping they can get by without doing. Right. So there's that element of respect that sometimes we have to give people that they're not ready to say something. Yes. But there's areas of life. And this is my experience as well, both personal and in clinic, where if we can inhabit with some awareness what's happening in our life, we can do something about that. Yes, absolutely. And even if it's something we can't do anything about, even if it's like a stage four cancer and you're dying well, inhabiting stage four cancer while you're dying is different than not inhabiting stage four cancer while you're

time. Yes, yes. Yeah.

Right there may not be a cure, but there can be healing.

Absolutely. Yeah. I think the Sioux one talks about that as the difference between death and perishing.

Ooh. Wow. Well, do you know, what, do you know what Sue number that is the difference between death and perishing? Holy smokes,

Margaret Ross. I could look it up. Yeah.

If you could look it up, I'd like to have it. Okay. Yeah. Um, so yes, that, I mean, that does make sense. Yeah. I don't want to jump too far ahead, but I do want to come back and talk about treating things unconsciously, um, when it's time to treat unconsciously and, and treat unconsciously when it's time to do that. But before we do talk to us a bit about rapport and talk to us a bit about how it is that you seem to listen people into a, into a place where you know what to do, and maybe they even know about what they need to do.

Oh, absolutely. I think we have phenomenal intelligence, innate intelligence, and it's just sometimes gets covered up by again, our, our beliefs and thoughts. And when you start peeling away, those layers, it it's, self-eval. What one can do. It's really common sense, which is what I love about Chinese medicine, the basis in common sense as profound. Um, so as far as rapport, basically, what we're trying to do is meet another where they are. So I can't, you know, if let's, uh, let me think of, I'm not think of a patient. This is somebody who I just adore. I adore all my patients, but I especially adore this person. He's over 400 pounds. He has diabetes, he's had kidney cancer, he loves sugar and he loves fatty foods. So, you know, the first time he comes in, I could look at his labs. I could obviously see that there are things out of balance in his life, from what he was telling me and just visually looking at his complexion and you know, his body mass. Um, and I could have said to him, Hey, you know what? You really need to change your diet. That would be a great place to start. Well, if I don't have rapport with this person, I might as well say, could you fly to the moon tomorrow? Because that would really help you. It doesn't land and it won't stick. And it, it, it may not make sense, make sense, and it might even shut down, uh, whatever rapport we did have. So the key to these rapport practices is how can I make myself more like you? And as I live more like you, I come to understand you in a different way, free of my judgements, perhaps free of some construct of what's good and bad. And let me just be you and see what that's like. So I'll give you an example of what you can do. This is something that I, I share with my students and have them practice. Uh, so I talk really fast like this, and I ran out, I've read fiddly. I don't know that I'm telling you that starting I can start to talk like that too. I mean, I'm not going to be, uh, very obvious about it, but I might start to increase the rate at which I'm speaking. So I start to match your rate of speaking, and then maybe I'll start to speak a little bit faster and at the end of my sentence and what you might notice, if you do that, if you start matching the speed with which a person talks or the volume with which they talk, or the cadence with which they talk, they're going to start to relax. So try it out while you're there in Taiwan, you know, when you're going out to eat breakfast or just start to match the voice of your waiter,

you know, it's funny, you should mention that when I'm here in Taiwan, I kind of do that naturally. Cause I'm trying to get my language down. And so I mimicked people a lot. Yeah. And that's, and that's, and that's partly how I learn.

Yeah. So you get into rapport with them. You can start to learn from them better. You get in rapport with them, they open up to you more. They're willing to talk to you. So, uh, that's one simple thing that you can do. Yeah.

I'm thinking of a couple of patients of mine and theirs. I'm thinking one guy in particular and every time he comes in, we just, we does not know that. I mean, we, we, we fall into this way of talking. We're like brothers, And it's always a delight to see this cat. Right. And I think it's because we're naturally, it's not that I'm trying to get into rapport with this, with this guy, but we just naturally fall into it. And we, and we speak a kind of way. And there's a kind of language that we use and there, and I found that there is other folks often what happens is I end up feeling like, oh, I don't really like this person. Or maybe, you know, or if I'm having a bad day, you know, they don't like me. I'm feeling insecure. It doesn't matter which one it occurs to me. Their way of speaking is I find, I it's like walking on very uneven ground. It's re I just can't settle into the connection. And I hadn't thought about it as trying, well, it brings some mindfulness to, can I just let go of me? Not completely, but enough to kind of be them in the way that they come here.

Exactly. It's quite profound and you can do the same with breathing. If they breathe shallowly or they breathe quickly or they breathe deeply or slowly, you can match your breathing rate and location with their, so while they're talking to you, you can breathe out because they're breathing out at the same time. Um, that's really, that's, that's a very powerful just to match someone's breathing

well, just to attend to somebody just to attend to another person enough to notice, how are they breathing?

Yes. Yeah. Blinking as another thing, if you know, some people blink rapidly and frequently and others don't so matching their blinking, or if they I'm Italian, I use my hands a lot when I talk. So if I'm with someone who uses their hands a lot, I feel really comfortable. It's like, oh, I, I get you. There's a, there's a, there's a subconscious meeting of the minds there. Yeah. And then the other really powerful thing for building rapport is to listen to the words that your patient uses. You can even notice where they move their eyes. When they're talking. Some of us look up a lot. Sometimes I look up so, so strongly that people will look where I'm looking because they think I'm seeing something. But it's, it's really just the way I'm accessing thoughts. In my mind. Some people look more side to side at the level of the ears. Other people look down. And so each of those ranges where you put your eyes, if you look up, it kind of belies that you're a very visual person. If you look more side to side level with your ears, it might indicate that you're more of an auditory learner or you experienced the world most clearly through its sounds. And then if you look down with just with your eyeballs, maybe not with your head, that indicates you're kind of more of a somatic kinesthetic feeling. That's how you make your way through the world is through how you feel. So if you notice where their eyes are placed, when they're talking, you can start using words that reflect that. So if I have a patient who's clearly very visually oriented, I might use words like, oh, I see what you mean. I can really visualize what you're saying. I can imagine that in my mind, whereas if they're, if they're more of, um, kinesthetic person, then I'll match my language to that and say, uh, dude, I really feel you on that. I, I get it. That's the God I, you know, and I might, I might put my hand on my body somewhere, like on my belly or on my chest. And just say, I really feel that I can really sense that how that might be, you know, and these are all just really small ways of communicating with their unconscious mind, getting out of your own ego and not holding fast to your world, but to really seep like water into theirs. And then of course, just like water and something goes into solution in the water and then the water can carry. You know, it'll can move that substance somewhere else because it's now in solution. And then the medicine that we have to give can really be received. If it's appropriate for that person, they have a better chance of utilizing what we've got to give. Not that they have to, and not that they will, but the chances are higher when you're in rapport.

How does this inform a diagnosis or a treatment you were saying that you don't particularly pay a lot of attention to the polls? You get more out of the relationship. So how does, how does this rapport and how does, what comes out of it help you to go, oh, we're gonna, we're going to use this direction.

Yeah. So let's say, um, this is one of my favorites actually. And it's, it was what my acupuncturist. Did for me, she, she too has studied some neuro-linguistic programming and she's very astute that way. I had gone to her after oh boy. Um, it was after I had decided to stop teaching at the college. And that was a really hard decision for me because I, I loved being with the students and I really loved the school and I Revere my teacher and it was, it was just hard to kind of let go of that community. So I wanted to see her and I was telling her just kind of the ravages of, of that job and how I had done it, you know, for 13 years. And, um, she said he knew what it sounds like. It sounds like you need to take a walk on the veranda. It's an acupuncture point. And so she needled that point for me. Yeah. Yeah. I have to look it up now because I can't remember it has a different name, but that's the that's um, that's one of the names that the five elements school uses, if I'm remembering it correctly.

All right. See if you see if you can dig it up. Cause I want to put that in the show notes page

anyway, when she said that, oh my gosh, I just took a big breath and the point had nothing to do with what was going on. It was just the name of it. And that's, that's one example of how, when I'm interviewing someone, the names of the points will come up to me in, in relationship to what they're talking about. So it, you know, if they're, if they're sounding really stuck in their life, I might do something like you know, I'd ha have anything to do with anything that relates to the uterus or the digestion. Elimination, but that's the point that comes up from the conversation. So that's water path. So that's, that's one example of how just the interview might start to pull a point. This will happen with herbs to where, as they're talking the herbs, just start coming to the surface, like, oh, that's really interesting. You know, um, all roads open, do they really, does it match the function and the indication of that? Or maybe not, but it, it relates to the, the spirit of that. Or, or if there's, if it's becoming evident that they really don't trust themselves and they really want to, they want to have more faith in themselves, then kidney seven, something or kidney eight that builds, that builds that trust for that. So that's kind of an example of how a treatment might come up from just talking with them, you know, and often in that relationship, you can, you can start to, I'm going to say guess at what the root cause of the issue might be. Yeah.

I'd like to think of it as a hypothesis, you know? I mean, we call it a diagnosis. Right. Which sounds very, you know, sort of, oh, it's a diagnosis, it's medical sentence stone, but I really think of it more as a hypothesis. Here's what I think is happening. And it's partly my job to prove it. Right. But it's partly my job to prove it wrong.

Yeah, exactly.

No. And keep that open stance of inquiry.

Yes. So the hypotheses can start to bubble up and they do. I think they do for all of us. That's part of diagnosis is to listen using our interview skills, asking the 10 questions and then, okay. Going, okay. Looks like the pattern is kind of coming together like this, or looks like the strategies this person has been using in their life has gotten them to this point. And maybe we start to introduce different strategies.

Oh man. You know? Yeah, this is, this is one of the things that I find people get stuck on. I get stuck on it too, that we have something that has worked well in the past. It worked really well. It solved a problem. It saved our butt. It, I mean, whatever it was, it worked and we've used it up to the point where actually that strategy that helped us is now part of the problem. It's actually not helpful at all, but because at one time it was, we've got this link to it as being useful. Except now it's not

right. Yeah. And that's, what's so important too, about being able to, to connect to the subconscious mind, because you want to encourage that awareness to come up so that you're not even saying, Hey, you know what? That strategy kinda messing you up right now. Don't you think where you just connect with them through rapport and you take that to keep this analogy of the water. You take that water into that strategy and they look at it and go, oh my gosh, I bet that's not helping me anymore. You didn't say anything. You just kind of said, oh, let's just go over here and check the cell, put a little flashlight over there and look at that. And you know, maybe they'll see it. Maybe they want, but if they do, they have that opportunity to

change. Yeah. And, and, and to me, it seems so important that if anyone's going to see it, they're the ones that have to see it. Cause if we see it, you know, and often we can route we're on the outside. Right. If we see it in pointed out, sometimes, you know, I used to think that was a helpful thing. Oh, I've got this insight. This is going to help you. It's like actually know it now we're further away. Now we're sailing the great circle course around it instead of any kind of direction to it, because it was them who needs to see it, not me. Right. This is where I think acupuncture is so wildly helpful at times because there can be something unconscious going on or there's maybe an insight I have that gives me a thought of, oh, you know, I, some acupoint, you know, this point here or this treatment here might help to, you know, help with this situation. They don't need to have the insight. They need to have something connected up on the inside that at some point might come to a kind of fruition where they, they kind of get it. This is such, this is one of the things that's so powerful about, about acupuncture is that you don't have the patient. Doesn't have to like, get it with their conscious mind. They can kind of grow into, oh, actually it's I was mistaken. It's not like that. It's like this.

Yeah. And I th that is, that is the beauty of acupuncture. You know, I, earlier, when we started this conversation, I was saying how my belief back when I started was it has nothing to do with my technique or the point I pick it's all about this relationship. But what you're saying, I think is very true. You can just use acupuncture based on this very sophisticated system of medicine that we have, the strategies that we understand, and then the methods of it. And by placing those needles, something subconsciously starts to change in the patient. So, uh, has nothing to do necessarily with the relationship or anything that was brought to consciousness to awareness, uh, through awareness. That's why this medicine is so cool that it, it, um, it can be from the outside in, or the inside out, but it still works. I just happen to like, from the outside, in like that water can seep in and then it can come back out and, you know, bring things up to consciousness so they can change. Um, definitely a champion of. Heal thyself. I don't, I'm not interested in having patients keep returning to me for treatments. And I make that very clear when they first come to see me that, uh, there's nothing wrong with that. It's just not what I like to do. I'd like to give them an opportunity to get a new view on themselves and then give them some tools, send them home and see how it goes. And then if they need to come back, they do. Uh, but that's just how I like to practice.

We'll be back in a moment with the second portion of this conversation, but first here's the answer to the question that Toby from the Chinese nutritional strategies app posed at the beginning of the show. Hi,

Toby Harrigan. I use the Chinese nutritional strategies app to answer the question, what food is known as nature's by Hutong white tiger. Decoction the answer is watermelon because like by Hutong clears heat drain stomach fire generates fluids and alleviates thirst. The Chinese nutritional strategies app has information like this and its database of more than 300 common foods along with our clinical indications, temperature, flavor actions, seasonal recommendations, and differential diagnosis. The database is searchable by any of these criteria in sorting through it allows the practitioner to compile a list of recommended foods and then share those recommendations via email, or as a hard copy with the patient, more information Isabel, by Chinese nutrition now.com.

So we're taught, we've been talking about how we connect with people, which in some ways helps them connect with themselves. And then there's what we do with acupuncture. And because you can work from the inside out as well. And because we can work with emotional aspects of people through a very physical medicine and through a very physical intervention, right? If someone, if someone is a constant ruminator, we can help their digestion. That's probably going to help. All right. If someone's got a really poor self-concept in there, and they're not good at drawing boundaries, we can work with their metal elements. These, these things have an impact. We don't necessarily know how it's going to impact people. Part partly the thing about practice that's interesting to me is to see what they do with, with what's been sort of reactivated. So we don't have to go at it necessarily directly in a conscious way. We can work with organ systems that have an influence on the emotions that in turn have an influence on the perception. And then the world becomes very, very different. One of the things that I've noticed in my practice is not always, but often enough people will come in for a first treatment. And they walk out and it's like, what the hell was that? Right. I mean, they walk they're in a totally different state of mind that, you know, something is really different. And so, you know, you ask them if they want to come back and they say, yes, yes, next week please. And you do your second treatment and then they come back for the third. They go, you know that second one related too much.

Yep. That's what I call the ho-hum treatment.

Well, yeah, you've seen this, I've seen this. I suspect those of you that are listening to our conversation right now. You've seen this and people go, oh, and it didn't work as well. I'm curious to get your thoughts about this,

about the, that second ho-hum treatment

about, about why they think it's a whole home treatment.

Yeah. Well that that's first experience. Being touched from low, you know, it could be from the outside in, if you have a co um, a masterful practitioner who can really on that first meeting, get in rapport and make that connection with you. And you start to realize things that you didn't realize before, and it's profound, or you feel inspired in a way that you've, haven't felt at all. And all the other things you've tried to address your health concern, or you feel empowered, or you feel hopeful. And these are big things for patients who have seen doctor after doctor with no results being frustrated and frightened about what they're experiencing. So that first touch can be so profound just to connect with someone in that way, just to be given a new perspective. A new possibility is huge. And then of course the treatment, if they're able to relax, um, even just for a minute, while they're on the table, they can have one good deep breath that they take all on their own spontaneously without thinking about it. That can be huge for us even. I mean, we, we live in a world where we travel a million miles an hour in our minds and we have a lot of external stimulation. So that moment of pause is profound and they go home with that and they might feel like kind of noodley after their treatment. They might be kind of spaced out. They go home, they sleep really well. Then they come back full of expectations that they didn't have. They didn't have those expectations the first time. They had no concept of what this medicine was going to offer them. So they come back in and they expect the same thing. So now I, now it, for me, it's just a standard when someone has completed their first treatment and they're sitting down and they're putting their shoes back on, or, uh, they're telling me what they experienced. I will say to them, this was, this was a profound experience you just had, you might not have that the second time. And I tell them, I call it the ho-hum treatment, not to put any thoughts into their heads, because of course we can do that when they're in that very receptive, relaxed state. Um, but I do say to them, the next time you come, it may not be as profound. And that's because the door has opened and you'll have acclimated to the new environment. So it might not be so. Um, in your face, so to speak. And then I say, but don't be discouraged because the path, every step you take on this path is just going to keep unfolding something pretty beautiful to you. So, and then of course they have the second treatment they come back and oftentimes they'll say you were right. It was ho-hum. And I'm glad you told me, because if you hadn't, I might not have come back. So it's, I think it's helpful to be overt about that. Uh, since it, like you say, it does happen and as your listeners might be nodding their heads going, yeah. What, what is that? That's what I think is going on the first time is just profoundly new and

fresh. And I like the way that you talk about it. The first time it opens a door and you walk through the door, you're in a new environment and we so easily acclimate. To our new environment. I often think about those first treatments where people really, you know, bang, something really happened as they get a glimpse of where they can be. They get a glimpse of what's possible. Now you got to live your way into it. Yes,

yes. Yeah. And that again is if you've established good rapport, they, the chances are really good that they'll keep walking with you on that path. Even though it's going to start to take work, it's not just Michael gave me an awesome treatment and now I'm a new person. You just opened the door and then they got to walk through and keep walking it. So, uh, I really think these skills are pretty important too, to help us walk together.

I really like what you have to say about this in terms of letting them know this time was like this the second time. Probably won't, you know, it's, it's so easy. I don't know what it is about us as human beings, but we have an experience and we think, oh yeah, if I do this again, I'm going to get the same experience. I mean, maybe this is the basis of what addiction is. Right. I had this experience. I do this thing again. I'm going to get this incredible state, but I remember hearing, yeah, we know how that ends up. I remember hearing someone once say the biggest impediment to the experience of God is your previous experience with God,

right? Absolutely. Oh yeah. Well it's the, the Dow can not be named the moment you name it. It's not the damn. Okay. I guess they can't hold on to this.

Uh, it was so tasty, please, please, please. Can I have another scoop?

Yeah, I have a patient who's been coming to see me, uh, since I started Michael, since I moved back to North Carolina and started practices, she's been with me 23 years, 24 years. And she'll come in and she'll say, I know I'm not supposed to ask you this because you're just going to say, I, I, it doesn't work like that, but she'll say, can you give me the exact same treatment you did last time? It doesn't work like that. Yeah. And of course, if I did, she wouldn't, she wouldn't necessarily feel the same thing because it's a new day. It's a new moment.

Yeah, this is, uh, this is one of the beauties and one of the frustrations of our, of what we do. All right. Cause I mean, in some ways it would be so easy if we could just go, oh yeah, well, here's that protocol and you just do that. And then you get this and conventional medicine is very much based on that. So people are, they're kind of attuned to that. They're expecting that. Well, but you, you know, you did this last time, how come you don't into it this time?

Or you did it, did it last time and you did it this time, but it didn't have the same effect. What's what's up with that.

Yeah. Well, you know, and I think to give people that glimpse of it's changing moment to moment, you're changing moment to moment. I think it can be very frustrating for folks in some ways. Cause we, we just want to know, but especially in situations where people are ill, they've got something going on, you know, enough so that they're coming to see an acupuncturist. There's often a lot of uncertainty anyway. And so being able to get a little bit cozy with uncertainty, I think it tends to be helpful.

Yes. And that too, you know, if you're in rapport with your patient, they will feel more secure with you so that when you were at what what's called pacing and then leading, when you're walking with them in familiar territory, and then you say, Hey, how about we go over there just for a moment and check it out. That's a frightening moment. Like really? You want me to, you want me to feel that? I don't know if I want to feel

that coming here to avoid feeling that, thank you very much.

Exactly. Uh, there they'll go with you. They'll come with you and you can sit there and investigate the experience in that moment. And then if it's too much, you can just walk right back to the same old path. And, but something's changed has changed forever and it may, they may want to go back to that place that. You know, you may have encouraged them to go a fresh new place. Yeah. I,

I really liked this sensibility that you're talking about here. That there's a place of security and, and that is vital and there's this place of unknown and uncertainty also helpful, useful, and to be able to have enough security so you can imbibe some uncertainty, right. And enough uncertainty. So you can break your idea, what you think is going on so you can try something new.

Yep, exactly. And if you're with someone who is listening and is genuinely wanting to live in your world without judging you, my God, that. Uh, to me, that's the most powerful medicine

I judge my patients all the time.

Yeah. I think, I think we do. That's I think that's part of the training that we get in school too, is to, we kind of know what's right and wrong or what's good and bad, but of course the medicine tells us, yeah,

I know we're supposed to know. Right. And wrong and good and bad. And, and in some ways people are looking for that. Tell me what to

do. Yeah. Yeah. Oh, they get frustrated in my practice because I don't do that. You don't

tell them,

I know I'll give them options and say what feels right to you. And of course, my minute, much of the time they can't, they don't know. They don't know what feels right to them. So, you know, then that's another part of the medicine is building that mindfulness to notice. How does that feel inside? Which, what, what is your intuition to. Anyway that deep listening without judging and just letting somebody be themselves, you get out of yourself, you meet them where they are, and you have this chunky, you have this, the three becomes the 10,000 things moment. It's great. I love practicing like that. It's really good.

I can hear that in your voice. Yeah.

Yeah. And that's, um, you know, when we start acupuncture school and after we've practiced it for your few years, those, those ego tendencies can really come to the forefront. Like I know what's best. I know the right path. If you do it like this, this is what's going to happen. And then of course, after you've practiced for a while you realize that doesn't work at all,

not so

much, not so much too many variables. There's something beyond the structure of the medicine that's happening. So that's the fun part is practicing for a long time and coming in and out of the mystery and the manifestation and back to the mystery. And so rich.

Yeah. So you've been at this 25 issue years. You sound as excited about it is when I knew you as a student, I love it. What's kept what's, what's kept you. What's kept your interest alive. You know, there's, there's a lot of talk in our profession these days, about how people five years out from school, they're not practicing. There's a whole industry. That's grown up around getting people kind of up and going with their practice. My sense of it is if you can manage to keep it going for five years, you've got enough stability that you've got a shot at, you know, a longer. Unfoldment in being a medical practitioner, being a Chinese medicine practitioner. So I've become increasingly curious about not just what it takes to start a practice. I mean, again, there's lots of people that have good advice for that. What does it take to sustain a practice? What does it take to have a practice go decades?

I think the key, Michael, and I'd love to hear your response to this too. I think the key for me was to keep digging deeper into myself. And of course the Sioux one tells us that the Ling Shu tells us that you have to know yourself. I pulled something from Julia measures. Did you ever know who the, who Julia measures is? Was she was part of the, um, Tai school and Maryland. She was a student of chair Worsley's in England. She was one of his top students. She came to the states and started teaching at Tai and they started this Sophia program. She had this to say that her preconditions for treatment. I, before I went to school, when I was hunting for a school, I went to a presentation that she and Diane Connolly and the TA high school was, um, was giving at Nisa in Boston. So I got to visit Nisa. And then I also had to got to take this class from the five element tradition. And she said, you know, you have to know your medicine. This is a precondition for treatment. You've got to know the, the, the system of medicine that you're in. And then the second condition was insight into yourself. So I think that's, what's kept me going, is that when I first started and I, again, I'd like to know this, if this was true for you, I had studied five element acupuncture, uh, while I was in school because I had already done all of my biomedicine in undergraduate. So I didn't have to take those classes at acupuncture school. And that freed me up to study outside of school. You know, I'd studied with Kiko and Dr. Tan and, um, Michael Adams and Stephen Birch and Stephen Brown. And, you know, the list just goes on with, uh, the school environment in Seattle was so rich and so many people were coming through. So I had all these techniques and tools. My basket was overflowing with. Knowledge and what I could do. And then I moved to Hawaii and then I moved back to North Carolina and I got into practice and it was slow. And I just kept remembering my teacher saying, give it five years before you make any judgment about practicing. I didn't advertise because I was in the rural south and I had been warned that to talk about Chinese medicine sounded like satanic practice. You know, that we have the five star. And anyway, I kept very, very much under the radar and patients trickled in, but I was very doubtful of myself. I felt like I didn't get it. And I didn't know what I was doing. And I shouldn't be doing this. I should be working at a bank. Seriously. I thought I had that thought for many years and I went and studied in China because I felt so deficient that I took three months and David learner and I went and D made our own internship and herbal medicine there at the hospital in Chandu. I came back and I still felt so insecure. It didn't know what was happening. And, um, it wasn't really, till I started studying with Jeffrey UN that I really need to look at myself. It's not about, it's not about my technique or my understanding is there's a lot of, there's a big mess inside of me and that's, what's blocking me. So in that environment of someone saying to me, don't judge yourself, just let yourself unfold and look at yourself and don't be afraid. My gosh, it just, it opened me up. I kept on wanting to drink from that fountain. It was just profound. And so as I practiced the medicine and as I worked with people and saw, I'm just like them, they're just like me. How can we help each other here that just kept feeding me and growing. And it's still the case today. I, I love my practice. I love my patients. I'm grateful to each and every one of them they've taught me so much and we've really grown together. So that's what keeps me going. I just fall more and more in love with, with us, I guess I could say it like that.

Yeah. I too was schooled in the Seattle area. So lots of rich influence rich. Oh my God. So much. Yeah. I mean, fabulous. And in the techniques are helpful and the knowledge is helpful and yeah. You know, I went to a school that was very long on internship. Right. They had us in clinic the first, first you were in there for 300 hours. Wow. So yeah, I

didn't realize that.

Yeah. Seattle Institute. Yeah. You're in clinic 300 hours. Dan and Paul. Yeah. You're in clinic 300 hours watching people that have been doing it for 10 years or more. Yeah. So from the get go I've, I've had this infusion of medicine, the medicine unfolds in relationship, you know, in folds in the clinic and unfolds in relationship, um, and unfolds through doing it. And, and, and yes, you got to know your stuff. You've got to know your medicine and you also have to be attentive to what's unfolding in front of you at this particular moment, at this particular moment, at this particular moment. You know, I came from that kind of a background, but I'm the kind of person who likes to know stuff. I mean, I used to be in high tech and work with computers and stuff. So, you know, I mean, there's something to know and there's something to do. And with medicine, there's also something to know and something to do, but there's also a space for someone uncertainty and being able to sit with, well, what's actually here, how can I get a grasp of what's here before I actually start trying to do anything? Yeah. We can have our ideas about what's going on with someone, but that's more about us than about them. And it might be helpful to them in some ways. But then you end up in a situation where now they're dependent on you and you're the person who's doing the fixing. Exactly. I get really uncomfortable these days. When people come in and go, you fixed my XYZ. I mean, it's nice, right? I mean, there's a part of me that goes, oh yeah. You know? Oh yeah, right. I got to shut down. I fixed your XYZ, but it, but that doesn't help them in an especially. Doesn't help me if I'm thinking I fixed her XYZ because there is something that unfolded that changed. I got to have a hand in it. They're the ones who do the work. And so part of what keeps me going. Yeah. Somehow getting through those years of, I got to fix things. I gotta be the smart guy who fixes things. Exactly. And, and, and there's enough. And having had enough experience with that, working to stay in the game and enough experience of that failing to go. There's gotta be more here than just that. Yeah. So that's, that's kinda my thought on it at this moment in time. We should, we could maybe sit down again together in five years and see where we're

at with it. True, true. So, is that what keeps you going, Michael?

That, well, what keeps me going? That's a good question. I, well, first of all, I see it work and be helpful to people often enough that I feel like it's a worthwhile reason to get out of bed and do something in a day. Yes. Number one, it's helped. I see it being helpful enough that. You know, I mean, if I didn't see being helpful, I go up on a coffee shop or something. Right. Cause that, that would be more helpful, but I see it be helpful enough. I'm continually surprised and amazed at the resources people actually have with inside themselves that they didn't know that they had that. I didn't know they had that they didn't know they had and through the relationship and connecting with them through the acupuncture, through whatever it is through whatever dance it is we do together that we call Chinese medicine. They find stuff in themselves. That's been laying there. Latents that has an avenue of expression and how that's going to express. We don't know. And being able to sit in a place with somebody and watching. And getting to be a part of something coming out in a way that no one could know it was going to come out. That's delightful and it's not because I did something. I mean, I get to help cultivate the relationship, you know, and I, and it's my job to put needles in certain places where I think it's going to be helpful, but that something else comes through in a way that there's a bit less suffering. There's more integration, something shifts. People don't need to come see me as much. It's a good way to spend the day. It's a w you know, I can go to bed at the end of the day and go, that was a day well lift. Well, so that's kind of

what keeps me in that. Yeah. That's beautiful. Thanks for saying that.

So I've got, I think I've just got one or two more questions here. I could go on with you for hours like this. Maybe we'll do a part two at some point. But I'm, I'm here in Taiwan and I got some stuff I got, I got to go attend to here in a little bit. So, so I've got a little bit of a time limit. You were talking about being able to listen without judgment. And I think I made a wisecrack about, oh yeah, good luck with that. Or I judge my patients all the time or something like that because, well, I do, we do, you know, as human beings, we do it all the time. It's hard not to, you know, and, and we're taught to, and as medical practitioners with got to have good judgment and discernment, so, you know, judgment is going to creep in how to have that, but not let it get in the way how to, how to be discerning. How can we work with our judgment? So we, not that we get rid of it, but that it doesn't get in the way so much of. I was working with our patients.

Well, uh, I have a two-pronged approach to that because I am a very judgmental, critical person. That seems to be one of the, um, one of your

enduring quality.

Yeah. Talk to my family about that. Yeah. So one of the ways that I respond to that when I notice it coming up in clinic is that I will check in with myself, like I'll say, so I'm going to give you my thought bubble here. I'll notice that I'm feeling judgmental, which is I can feel that sh my cheek rising. So there's a sense of superiority coming up. I can. I might have a thought, like, you gotta be kidding me. Are you not hearing yourself here? You know, so when I noticed that, when I noticed that thought and I noticed that feeling, I stopped right there and what happens here, I might not be listening to the patient as they're talking anymore because I've gone internal to check out something inside myself. And I'll just say to myself, you're judging, aren't you? Oh yeah. You're critiquing something. And I don't, I don't give myself a guilt trip or anything like that. It's just, oh, oh, here I am judging again. Interesting. Okay. Of course, the minute you notice it, it's gone and then I can listen again. So that's one way that I respond to my. The other way I respond to my judgment is I might hear myself say to myself, oh really, really? You think you've done this better? Really? Is that really true? Margot, have you really done life better than this person? Nope. Nope. We're all in the same boat. So I say that a lot. We're all in the same boat. Sometimes I say it out loud. It's something that I once heard the Dalai Lama say we're all in the same boat. And of course, when he said it, I was like, you're not in my boat, dude. You're definitely in a different boat, but of course the way he, his transmission, his, uh, uh, his nod, I got. Like, oh, we are, we're all in the same boat. So those are two ways that I deal with judgment that comes up in practices, bringing some mindfulness to it, or just really asking myself really, really? You want to get superior here? I think you live in a glass house. My dear.

Yeah. We kind of know how that's probably going to go.

Yeah. So what do you do?

Oh man. Oh God, you always do this. It's like, okay, now, Michael max, I'm asking you.

Well, yeah, you're the celebrity on the show?

No, you're the celebrity. I just have the show, you know?

Yeah. You wrote a book. I haven't done that yet, but it's coming.

I did not write a book. No, I did not write a book. I translated a book. I did not write a book. Writing a book is a whole different kettle of fish while you are

writing a book. So

I'm working on it, but it's a whole kettle of fish, different kettle of fish. Holy crap. How do I do it? Do it. Wow. Let me think here. You were saying something about really, you don't see that. And, and I see this with my patients all the time. They'll say something and it floors me. It's like, wait a minute. If they could just hear what I heard promise solved. Right. But often the problem is that they can't hear it. Sometimes I will try to get them to hear it. That's usually not so helpful. I've tried that. It's like. It's like here, it is so clear. If you could just hear what you just said and I'll try reflecting it back to them and sometimes they'll get it, but, but usually not. Yeah. Um, so I just have to sit there frustrated. I hadn't thought about looking at that and going, oh, can't you hear that in taking that as an invitation for myself just to go, oh, okay. There's something here. It's not yet able to be inhabited. Maybe I should just get a little curious about it, or how does this fit in? How does this fit in with how I think about how emotions work in organ systems and where can I go? You know, is there like a Zong Fu I can have a little conversation with, because if I can have a little conversation with the song Fu does on food, we'll have a conversation with the patients. So I'll, I'll, I'll think about it like that.

Well, that's really using. This immense, incredible medicine. Like you just, you just keep turning to it and putting it into practice. Just like what you just described. There's you can hang your hat on so many things in this medicine and feel like, yep, that's a good place to put my hat.

And I think there is this a central part of who the practitioner is not in an egoic way, but I mean who we are in our own tender edge. And if I can somehow be there at my tender edge without making the patient, the therapist, so to speak, but just there at my own tender edge, being able to hold my own tender edge, it sometimes shifts the feeling in the room and sometimes it shifts something in the patient, but at least I know that I'm at, at, at a tender points. Yeah. I need to tread cautiously with myself. It reminds me to tread cautiously and with care with my patient. And then again, bring it back to, and, and how do I use all this information to translate into where a needle is going to go that I think will be a benefit. Yeah.

And that tenderness that you speak of, you know, when you, when we, as the practitioner allow ourselves to enter that tenderness, that space of vulnerability, then we give, we give permission for them to, to, and again, if we're in good rapport, they will. And that then the shame, the self-loathing, the guilt, whatever it is that has kind of been operating under the scene under the cover for so long. And that's, that's led them to this point. Now they can start to look at that and, and share that vulnerability shared. Whatever it is self hatred or

blood, whatever that, whatever that blockages, whatever that block. And then she is. Yeah. And then the

knot is already unraveling and you didn't do anything. It's just through your presence. You were the needle, you know, through your presence, you, you provided an opportunity for change.

Well, in this, this brings us back full circle to what you were talking about earlier with some of the classics, linking it to Sue in doubt, aging, these things where it talks about how we are with ourselves in the process of being with a needle, being with a patient. Yup.

Oh my gosh. That is repeated over and over in those texts. It is really, I th it's there, those texts, those classics are shouting at us. Who are you? Who are you? That's the key. Who am I? And if I can, if I can show up authentically, then maybe this person that I'm in rapport with, maybe they can't too.

Um, well, my friend,

I'm sorry. We have such boring conversations.

Well, let the listeners be the judge of that or, you know, I think that's pro I think this is just a good place to put a bookmark in it for today. And we can, we can maybe pick up, uh, another time and noodle on some of this

stuff. Yeah. Or something else we could talk about. Um, my really good meat sauce for pasta.

Okay, well, since you brought it up, I think you're just going to have to send me like, you know, a PDF and I'll put it on the show notes page for people.

Okay. And I'm also going to circle back on the death and perishing and a walk on the veranda and you need my Sugo dichotomy because Carnegie recipe. Yeah.

Okay. All right. All right, my friend, thank you, Michaels for listening to, it's always a delight.