We are presenting here the opening speech given by Nils von Below (originally in German) at the 2013 Rothenburg Congress in Germany. Nils’ rallying call to TCM practitioners across Europe is heartfelt and shared by many and we will be exploring differing experiences within the European context in the coming year.
In recent years I have frequently talked here [in Rothenburg] about the amazing achievement of our profession, that we have reached and established ourselves in the health market. The resulting new orientation and strategic direction for our profession are still in the making. Most of us, however, seem to be unaware that we have to deal with a new political situation and that we have to work on our strategic outlook.
To inspire this discussion I would like to give you my assessment and evaluation of the situation now and develop an action plan. I hope and expect you to take up this discussion. It needs to be clear to us that our present political situation is much more complicated and difficult than that of the last 30 years. Those years were easy: it could only go up. Now we have to stand up for our positions and defend them.
I do this because I have the deepest conviction that TCM is the future of medicine. We are part of the answer for healthcare. We are the modern answer with old roots. We give answers to people that they want and need to hear. We are the medicine that takes the patient seriously, and that does not hide behind data sheets and machines, which have their legitimate place, but they have no conscience, they are not humane. Patients want to be taken seriously, they want and need to take responsibility for themselves and they want guidance that responds to their needs. We do this.
But there is no help for us if we don’t succeed on a political level. And to do this we have to post our convictions to the outside world, we have to go against the trend of dehumanizing medicine, against the pharmaceutical industry, against the quick fix of no depth, no responsibility.
So what is the situation in the world of TCM at the moment?
Firstly, in those countries where TCM is not statutorily regulated 80% of acupuncture is given by therapists: meaning ‘Heilpraktikers’ (1) or non MDs, MDs, midwives or physiotherapists, who have less than 150 hours of training in TCM. Please don’t quote me here in any research or data: this is an estimate, based on the numbers of Heilpraktiker and MD-TCM organisations and therefore I think it’s a very conservative estimate. I believe the numbers are higher.
So what does this treatment look like? Needles are used like aspirin, standardised treatment protocols, and patients need to accept that it is the receptionist who takes out the needles. That’s the reality out there.
The questions one has to ask are: What do these practitioners know about qi? How can they evaluate the movement of qi, the distribution of qi and Blood in the zang fu, the status of the 8 extras? How can these therapists assess the pulse and tongue diagnoses so that they can do a holistic treatment?
If Chinese medicine is reduced to patent remedies, we take away its soul and our approach towards the individual human being.
The potential of TCM is its possibility to diagnose and treat a human individually, on all levels.
If we reduce ourselves to the level of patent remedy treatment we not only give away our soul but we will also be assimilated into inhumane Western medicine. We have to fight against this development.
This leads us to the second theme: science and research. In Western medicine research is used to enhance knowledge. In theory practitioners should base their therapy on the results of the most modern scientific research. They should use their insights for their therapy.
Chinese medicine is totally different. The basis of our therapy is our individual anamnesis. We derive our therapy from the testimonies and the awareness of our patients and based on the knowledge of the therapist of Chinese medicine and their own experience they develop their therapy for each individual patient.
Research results normally very rarely influence these decisions, and this is a fundamental difference and conflict between Western and Eastern medicine.
Western medicine is supposed to be based on a general, scientifically derived knowledge store, Eastern medicine works with both the knowledge of the individual practitioner and the revelations our patients offer us.
Research carried out in the field of TCM in recent years has above all been aimed at giving TCM a scientific value and proving its effectiveness. If you look at the data this actually has been proven.
Politically we have to concede that we have not reached the goal of acceptance. It does not matter how many positive results we present, we will not be accepted as being of equal value. This is not a question of science, it is a political question.
And therefore not to be won!
Our medicine questions the Western medical system, it questions the pharmaceutical industries!
Yes my friends, for them we are the enemy.
By now they have understood that they just can’t wipe us away like a fly: we are here to stay! But they are trying to undermine us.
This is where the circle closes itself, if we allow ourselves to be convinced that in acupuncture and TCM it is sufficient to use patent remedies, one only needs 150 hours of education and it does not matter where you stick the needles.
On this topic I want to mention a discussion from the last ETCMA [European Traditional Chinese Medicine Association] symposium. In the presentation by James Cuffe, who is a cultural anthropologist, he demonstrated that what a society considers to be the ‘truth’, and with it the ‘right and legitimate’ science theory, are always part of the dominant power system. The ‘truth’ is defined by the rulers – in our case the pharma – and research industries and medical establishment.
Research and science are therefore not as independent as we would like them to be or as they want to sell themselves to us.
Our experience equals the experience of a heretic with the medieval church, everything that is nonconformist to the prevailing orthodoxy, for example TCM, will be disclaimed and therefore inhibited.
It is therefore clear that it is only partially useful to comply with modern science. Maybe it is much more interesting to think and create a different awareness of the modern science industry.
The best place to see that is in the field of placebos, placebo treatment and the scientific research carried out in this field.
Scientists who believe there is a placebo acupuncture stray from the way, and don’t understand acupuncture and natural therapies. These medicines work on the whole human being. So they will use all possibilities and the power of human beings to heal themselves, and therefore most of all will incorporate everything that is nowadays called placebo.
I specifically look at the research into Navajo Indians carried out by Harvard professor and an old TCM companion Ted Kaptchuk. Ted proved in his research that healing rituals are not an unspecific effect that we need to eliminate, but a specific effect that we can use additionally, well actually that we must use. Modern Western medicine has lost its knowledge of how to access this side of the human being.
We represent this innate ability to access through healing rituals. We in TCM use this possibility, we can modulate it because it’s a natural and self-evident part of our medicine. We take human beings as they are and try to use their potential. We are the servants of the people and not the other way around. This does not mean that TCM works because it is a placebo: we have proven this is not the case, but we use it for the benefit of the patient because healing can only work through it.
What kind of consequences arise out of this?:
1. Modern science is a political instrument yes, but we need science that serves us, like that of Hugh MacPherson, Arya Nielson, Velia Wortman, Heiner Frühauf or Yair Mammon which hopefully will find their way into our practice.
2. Whoever wants to use TCM should have proper training. The idea that you can learn Chinese medicine in 150 hours is a mistake, and this goes for whatever kind of training you had beforehand. Whoever wants to use the specific effects, that are called placebos, needs to know what they are talking about and how to act. They need to be acquainted with the Eastern way of seeing a human being: based on the ideas of yin and yang, qi. This can’t be learned in 150 hours: because you have to learn, try out and assimilate the knowledge to use it.
3. To use this kind of medicine you have to pay for it. Whoever thinks you can get decent medicinal treatment for 20 euros an hour is fooling themselves. Yes for 20 euros you can get a pragmatic acupuncture treatment that is probably healthier for your stomach lining than an aspirin, but you will not get any holistic treatment. This is not possible or intended.
All modern health systems are aiming to save money: So politically we have to work on the issue of decent payment.
The payment for acupuncture by MDs, for knee and back pain, by our public health insurance in Germany shows us that this way will lead to underpayment and loss of holistic treatment.
Dear Colleagues: I´m a child of the ‘68 revolution and was raised by what we call (in Germany) Sponti (2) talk. One of my favourite sayings is still: “Whoever does not fight has already lost.”
We, dear friends, we have to fight: We need to stop thinking everything will regulate itself: No it won’t and especially not in our way.
We have to convince others that our way of seeing a human being and our way of medicine are the right way for people.
Therefore our message must be:
• Traditional Chinese Medicine (or Traditional East Asian Medicine) uses all healing powers and resources that a human being is capable of
• To use them the therapist needs time and a good education. This can not come for free
• We represent these well-educated therapists!
Notes (1) Heilpraktiker – Licensed health care professional who has completed one year of Western medicine followed by two years study in any CAM therapy of their choice. (2) Sponti – anti-establishment