The Patient-Practitioner Relationship in Acupuncture
Leon I. Hammer MD Published by Thieme Publishing Group, Stuttgart, 2009 Paperback. Price £24.24
(Reviewed by Jasmine Uddin, EJOM Vol. 6 No. 3)
As practitioners of Chinese Medicine we are fortunate enough to have a therapeutic tool that explicitly honours a relatively sophisticated understanding of mind-body relationships as part of its diagnostic repertoire, but as this book so aptly reminds us, without an equally developed understanding of what the therapeutic relationship itself can offer or entails, we may fall short of the healing potential that our encounters with patients could bring.
Leon Hammer sets out to write a book for acupuncturists which covers the ‘basic tenets of a therapeutic relationship independent of context’. It is an easy book to dip in and out of, largely because of the way it is organised under bite size headings. This suggests that the book is primarily written for students, although practitioners may also find it useful. The contents are made readily accessible through avoiding the use of psychological jargon and the prose is clear, elegant and succinct. Although there is the inevitable repetition that comes from the overlap of concepts such as empathy and intuition, this is not unlike having to learn the concepts of Chinese medicine where saying slightly similar things in different ways adds to the overall interpretation of meaning. It is, in fact, at times beautifully written, with humility and compassion.
The book is divided into two sections. The first covers the ‘basic tenets’ referred to above and which are grouped together under four headings, ‘Basic Conditions and Tenets – an overview’, ‘Conditions for Healing, Growth and Change’, ‘The Practitioner’s Role’ and ‘Issues Relevant to Any Therapeutic Relationship’. Under these headings various topics are discussed and illuminated by cases from the author’s own practice. We are constantly reminded of the emotional baggage that patients can bring and how we need to develop the qualities of respect, integrity, authenticity and caring not to retaliate with our own. It gives a preview of how managing the therapeutic relationship is often no walk in the park, without creating too much apprehension for the would-be practitioner. The case study examples are insightful but require the practitioner to be self reflective if the advice is not to be a series of truisms.
The second section ‘Questions and Answers’ relates to questions from practitioners and students that Hammer has encountered over the years. The answers are mainly given by the author, although observations are included from other correspondents. All the questions are listed in the contents table, so that a practitioner can quickly refer to a few words of wisdom should the need arise. Some questions are ‘straightforward’, such as those relating to contractual issues, but the majority refer to more complex situations often encountered in daily practice.
The value of this book for me is two fold. Firstly it is written by a practitioner with enormous clinical experience whose dual training as a psychiatrist-psychoanalyst and Chinese medicine practitioner reveals his respect for both traditions. Most patients coming to see an acupuncturist will not benefit from this level of expertise and we are fortunate that Hammer is willing to share his experience.
Secondly, this book reminds us of the importance of good healing encounters. The demands of increasing professionalisation may lead practitioners to undervalue the significance of the therapeutic relationship, especially when evidence based medicine is the clarion call of the day and you sense that acknowledging the time and attention we give patients as valuable is used to somehow deny the power of the medicine itself.
The Patient-Practitioner Relationship in Acupuncture is a very good introduction to the psychological and interpersonal processes that are part of all therapeutic encounters. Jasmine Uddin Jasmine Uddin used to teach on the Practitioner Development module of the acupuncture degree course at Westminster University. She is President Emeritus of the BAcC, editor of EJOM and has a practice in Brighton.