Contemporary discipleship in Chinese medicine

on 11/25/2007 by Eric Grey in Study and Scholarship

One of the things I see as inherent in a Classical approach to Chinese medicine is the recovery of a sense of discipleship. The passing of knowledge from Master to Student has always been a part of the medicine, as far as I can tell. This is not a foreign concept in general, the use of apprenticeships and master-student relationship are present in most arts and sciences through time. But it is a pretty absent feature of contemporary American life, in my experience.

Chinese medicine education – for the most part – is done in the same ineffective way that most education is done. Lecturers lecture. Students listen, or at least try to listen. Lab time is neglected. Standardized tests are seen as a viable way to measure performance. People graduate who really don’t know what they’re doing or why.

Through every step of my education, I have sought real mentors. People with diverse life experience who can help me navigate not just the material, but life. The first is, perhaps, primary – but if the second isn’t present in some way I don’t really feel as though I am learning anything of value. I have been fairly successful finding people who I resonate with who have excellent information to share, a love for teaching and also many words of wisdom in life to pass along.

When I learned that the Classical Chinese Medicine program at NCNM had as an integral feature a restoration of true mentorship, I was very excited. I have to say that while there have been efforts to materialize this ideal, it has been no easier for me to find mentorship in this program than it has been anywhere else. I think the consciousness of the importance of mentor-mentee relationships is there, and various structures exist to help manifest those relationships. But, as everything, it’s a work in progress.

What does discipleship mean in contemporary society? Is it truly an integral feature of learning Chinese medicine? These are questions I consider heavily many times each day.

Recently I’ve been in conversation with a respected friend and colleague about this issue. We’ve gone back and forth about what constitutes discipleship and, perhaps most importantly, whether the exchange of money should be involved between mentor and mentee. What is gained or lost in this situation?

One argument I have made is that in the past, frequently trials were required from the mentee – involving considerable investments of time. Further, in the end we have to admit that if the mentor simply did not like the mentee, they would not come into relationship. At least not frequently. Many of us these days have money but not time. Or, rather, we trade most of our time for money. Does this make money a good substitute for time in this situation? It is sometimes a trial to come up with money. Also, does this somehow democratize the mentor-mentee relationship? Is this a good thing or a bad thing?

I’d be really interested to hear folks’ thoughts on this and related issues. Please add your voice in the comments. Also, if you would like to have more articles about topics like this brought to you directly be sure to subscribe to this blog via RSS feed or via email.

About Eric Grey

Hi - I'm the founder of Deepest Health. When I'm not writing here, you can find me reaching out to the Chinese Medicine community across the web and in my own backyard. I currently teach Chinese herbs at my alma mater, the National College of Natural Medicine. Additionally, I'm the founder of Watershed Community Wellness, a thriving local clinic in Southeast Portland in Oregon. No matter where I'm working, you'll find my focus on the Classical approach to Chinese medicine laced throughout everything I do.

View all posts by Eric Grey - Website: http://deepesthealth.com

Abdallah says:

11/25/2007

Gary Snyder, Axe Handles

One afternoon the last week in April
Showing Kai how to throw a hatchet
One-half turn and it sticks in a stump.
He recalls the hatchet-head
Without a handle, in the shop
And go gets it, and wants it for his own.
A broken-off axe handle behind the door
Is long enough for a hatchet,
We cut it to length and take it
With the hatchet head
And working hatchet, to the wood block.
There I begin to shape the old handle
With the hatchet, and the phrase
First learned from Ezra Pound
Rings in my ears!
“When making an axe handle
the pattem is not far off.”
And I say this to Kai
“Look: We’ll shape the handle
By checking the handle
Of the axe we cut with-”
And he sees. And I hear it again:
It’s in Lu Ji’s Wen Fu, fourth century
A.D. “Essay on Literature”-in the
Preface: “In making the handle Of an axe
By cutting wood with an axe
The model is indeed near at hand.-
My teacher Shih-hsiang Chen
Translated that and taught it years ago
And I see: Pound was an axe,
Chen was an axe, I am an axe
And my son a handle, soon
To be shaping again, model
And tool, craft of culture,
How we go on.

Evan Hadkins says:

11/26/2007

Eric, I think we are soul mates.

The big problem with the mentor-student idea is the exploitation of the student eg sweeping the masters floor for years to prove sincerity.

Another problem is the restriction of knowledge, there is every reason to suspect that many secrets have not been passed on before the master died.

Some things are best learned by modelling (Bandura spend his career writing about this). And the things best learned by modelling are complex behaviours – like dealing with people.

I think that as far as information goes the time for secrets is past (if there ever was one). As far as learning goes, observation, experimentation and feedback – as individual as possible – is indispensable for the practical skills.

I think money is likely to be a problem. It is far better for people to pass on their expertise without having to make a living from it (see what’s happened to the colleges).

My guess is that there is much expertise to be shared and people willing to share it. One way is to have worthwhile professional development instead of stuff people turn up to because they have to. Make it voluntary and see how many turn up – then start delivering what people want to know. People love to learn and will flock to those who can teach them what they want and need to know. Perhaps some kind of collective fund could be organised to give some kind of remuneration to those who share their expertise – but never too much or the system will become corrupted.

These are my thoughts. It’ll be interesting to see what others think.

Abdallah says:

11/26/2007

I would note, Evan, that if you see what the most popular and attended courses are, they are typically the most lucrative and easy to learn. The material is usually touted as “the one pattern that underlies X” or the “secret to Y.” You are right, the time for secrets is past. But those who are willing to go further and deeper will likely not do it via the lecture circuit and only through one-on-one engagement and modeling with teachers or mentors.

michael says:

11/29/2007

In this age of technology and endless free flowing information where secrets are a thing of the past and we all demand equal, democratic access to the mystery teachings, I think an image of Confucius may be in order.

“Kongfuzi said: Do I regard myself as a possessor of wisdom? Far from it. But if even a simple peasant comes in all sincerity and asks me a question, I am ready to thrash the matter out, with all its pros and cons, to the very end….[and in another passage]…”Kongfuzi said: My friends, I know you think that there is something I am keeping from you. There is nothing at all that I keep from you. I take no steps about which I do not consult you, my friends. Were it otherwise, I should not be Qiu (Confucius’s personal name)….[and finally in yet another passage]….”Zilu asked: When one hears a maxim, should one at once seek occasion to put it into practice? Konfuzi said: Your father and elder brother are alive. How can you whenever you hear a maxim at once put it into practice? Ranqiu asked: When one hears a maxim, should one at once seek occasion to put it into practice? Kongfuzi said: When one hears it, one should at once put it into practice…Kongxi Hua was perplexed and Kongfuzi said, Qiu is backward; so I urged him on. Yu[Zilu] is fanatical about Ren (Humanity);so I held him back.”

Though it may not be obvious from these passages, I hope with some careful examination a very helpful image of the master and student role emerges. A true master is ready to teach, but what is our role as students? Should we demand to receive all teachings, that they be available to us without any secrets? Are we so deserving? Are we so ready to take the mystery teachings in? [Or the practical teachings]. A great teacher, like Confucius, teaches the student by knowing where the student is and what the student needs. It is not just that there is the answer waiting for us and we just need to pay the right person or sign up for the right class and we can “get” the teaching….we must be ready for the right teaching at the right time, and the only way we can prepare for this is to be actively cultivating ourselves and to be humbly open to whatever teaching comes. The adage “The teacher appears when the student is ready” should probably say, “The teacher appears exactly as the student is ready.”

I offer this in hopes that our “get it now” society of technology and information remembers the sanctity and mystery of the teaching of the ancients.

Please let me know what you think.

Thanks,
michael givens
ccm3 ncnm

Evan Hadkins says:

11/29/2007

Michael,

I think you are dead wrong.

Each person is the expert on their own experience. And, even if we are sometimes wrong about ourselves – which I know I have been, we are certainly the one’s who should be in the place of decision. If a master is truly a master they should easily be able to show a learner their impatience, what their impatience is stopping them seeing and learning and finally, how to learn what they need to.

All knowledge should be tested by experience. While teachers, like anyone else deserve respect, if they care then they will welcome their knowledge being put to the test. In this way anything without truth will be eliminated.

Not only is the time for secrets past, so is the time past when knowledge is accepted without testing. All the good teachers say this.

It is not disrespectful to enquire carefully into what the teacher says. This is what a good student should do. Any teacher who has a problem with this has an ego problem ie. they are not worthy of the name.

Eric Grey says:

11/30/2007

Interesting. Evan, it is not clear by your reply why you disagree with what Michael has said. I think I agree with both of you.

I guess I tend more on the side of Michael’s words as I understand them. The privileged attitude of many contemporary learners is reprehensible. Just because someone knows something, just because you signed up for a class does not mean the teacher is obligated to tell you everything they know right up front. The mark of a true teacher, in my estimation, is the ability to judge carefully the level of the student and offer them information as they are ready. They may misjudge, they may frustrate students – but as you say Evan, a true Master can carefully show the student when they are mistakenly charging ahead.

I seek out Masters because I know they have learned this information thoroughly and have tested it against the world. It’s pre-filtered and comes with the wisdom of knowing how best to assimilate it. This doesn’t mean that the master can’t be wrong sometimes – they are human after all. But I expect that the Master knows something about the right sequence of learning and what constitutes too much information. If I demonstrate by my quick and able mastery of what they have already given me that I am capable of taking more (even more than they expected) then I expect they will give me more.

I value highly the pursuit of wisdom, and I do believe that Masters should be open to the questioning of their students. But I place a higher priority on humility and my own willingness as a beginner on this particular path to be dead wrong much of the time. I don’t bring a Master into my life until I’m sure that he or she is a person likely to help me become LESS dead wrong.

Eric

Evan Hadkins says:

11/30/2007

I think the basic disagreement is about hierarchy (politics if you like). I prefer convivial democracy to (however benign) hierarchy. Though in both learning can be done well or badly.

Evan

michael says:

11/30/2007

Evan, Eric,
Thank you for the replies. I am relishing in being dead wrong; it is so clear cut and definitive as if one can finally believe that there is a dead right (or would it be a living truth?) Either way, it is a nice concept; however, I believe our difference of opinion lies in a difference of subject matter. I think, if I am reading correctly, that you are speaking of education in the western democratic sense, one which involves scientific examination of truth and knowlege, tested with experience, but more so with the achievements of the mind. In the educational systems this is helpful and so I agree with you. Yet, when the truths have all been tested and taught, no secrets left behind (just as all of the Zen Koans were published with all the answers), will we still be searching for something? Will we be able to say, “Now we are not seekers of truth, but those who hold it in our own hands, who share amongst it equally.”?
What I am speaking of is the role of the discipleship (in particular within Chinese medicine), for I believe that, as opposed to the western concept of “Truth” and “Knowledge”, to be on the path of wisdom, we must be seeking what our teachers seek, we must be traveling with our teachers, following their guidance, humbly and with discipline, so as to continue seeking. When one has the truth, is that enough; when one hears a Zen Koan, and then is told the answer, is that enough? When one is told exactly how a teacher treats a pattern, is that enough? Is there not something deeper, something larger,something dynamic or even something mysterious to work with within the teaching? I think this depends on one’s teacher; a college professor who knows the material and has strong experience may offer one kind of teaching (which I think Evan is speaking of); a mentor, someone worthy of a disciple, who lives a certain kind of wisdom and seems to radiate or transmit this to his or her disciples, may offer a different kind of teaching that may not be available to all.
I think that we are simply talking about two different kinds of discipleships, and I greatly appreciate the discussion. It is a pleasure to find teachers in unexpected ways.
michael

Evan Hadkins says:

11/30/2007

Hi Michael,

Thankyou for your response. I am enjoying our discussion a lot.

Yes, I am writing from my experience with the (benighted) western education system.

A koan for you: this is structure.

I don’t think the west is superior to the east (or vice versa).

Where the west falls down is seeing that abstraction isn’t learning. When learning acupuncture the education should be in doing – a friend and I have done a critique of the usual western nonsense that passes for education, we call our alternative ‘artificer learning’. Abstract knowledge is of no value for a healing modality – it is results of action that count.

Where the eastern approach falls down is the need to accept that the master has in some sense ‘attained’. Especially in shame-based rather than guilt-based cultures this can lead to problems. Mistakes can be left unchallenged and so passed down the generations. Eg in food soy beans are sometimes said to be neutral. I think they are cold, my body’s (and others’ body’s) reaction says they are cold. If I was teaching food my duty to my students would be to pass on what I know, not just what I have had passed on to me.

From the western tradition two pieces of wisdom:
St Paul: test the spirits
Karl Popper: science’s difference is falsifiability.

My vision of teaching is that the teachers sets up sufficiently challenging experiences so that the student gradually masters the complexity of the area they are studying. Thus there are exercises to learn an instrument, a sport or martial arts gradings. This is my picture of good teaching.

Hope this makes sense. As you can see this is something I care passionately about and think is very important. I’m really enjoying your comments and how they are causing me to think.

Heartfelt thanks.
Evan

michael says:

12/01/2007

Evan,
Great! Thank you.
Structure is, when?

I’ve noticed through the latest Carnival of Health (amidst so many thought provoking articles) that you have been working with these thoughts on education for a while, so I’ll pose the question: Is Chinese medicine a trade or an art? If it is both, then is it the art and trade of the scholar/ philosopher, or the art and trade of the artisan?
I’m curious, because I see many problems with the TCM model of understanding of Chinese medicine, as well as the TCM model of teaching. A classical study of Chinese medicine is very difficult and not an easy model from which one can simply learn the tools and begin practicing; yet, it makes me nervous that so many practitioners graduate from numerous TCM (non-classical) schools and, due to having a zang-fu model of cut and paste diagnosis and treatment, feel that it is quite an easy medicine to practice.
Thank you,
michael

Evan Hadkins says:

12/01/2007

Hi Michael,

What are the problems you see with the TCM model of Chinese medicine?

Evan

Evan Hadkins says:

12/04/2007

Where’s Michael got to.

I was really enjoying our discussion. I thought we had got to a really significant point – his problems with TCM – and now he’s disappeared. I hope he returns.

Eric says:

12/04/2007

Hey Evan,

It looks like Michael accidentally replied to you in a way that actually just sent me the comment in email form. I will cut and paste his comment here:

—-

Hi Evan,

I should say that, since I am still a student I am quite inexperienced and perhaps naive in my understanding of the reality of chinese medicine; however, I have be fortunate in my education in that I have had the opportunity to study at both a very TCM school (OCOM) and a “CCM” school (NCNM). So, I feel that I have an understanding of both. While my current school (NCNM) claims itself to be Classical, this is actually very difficult to achieve. What we are getting in the realm of classical though is extremely amazing and I am very thankful for the education we are receiving. Nonetheless the problems that I see with the TCM model are:

1. TCM is purely eclectic — I have a pretty strong understanding of the history of Chinese medicine and so it is clear to me that TCM pulls theory and practice from any dynasty, any school of thought, where it is convenient. Our school is also like this, except that our core teachers are trying to show us how to not be eclectic, how to chose one or two systems and get to the bottom of them. Many of our teachers were trained in the TCM model, so we also get eclectic medicine. The problem with it is that it is folk medicine, not classically systematic and therefore scientific medicine. Eclectic medicine picks up what ever works. Classical and therefore scientific medicine bases its medicine on the foundational principles which were established during the scientific systematization which occured during the Han dynasty.

2. TCM works to prove itself with Western medical methods and incorporates Western principles into its medicine. There actually is nothing wrong with gaining validity from Western medicine, and should be relevant; however, Classical chinese medicine has its own science and therefore can stand on its own. I don’t believe it is possible to prove with western methods why Chinese medicine works on its own terms. I also see how Western concepts, such as “toxicity” and “germs” have changed the way our medicine is practiced, which brings me to my third point

3.Classical Chinese medicine is a science of Medical Climatology. It is based on Qi and Weather and our relationship to space, time and direction. TCM does not adhere to these principles.

Eric has so many great articles on the differences between TCM and CCM and I think he explains quite well what the draw backs are of TCM. I respect anyone who is practicing Chinese medicine and would never want to ge antagonistical; but I am very interested in raising the standard of our medicine to one of a scholarly, highly skilled and refined science of medicine.

Take care,

Michael

Evan Hadkins says:

12/04/2007

Hi Michael,

Thanks for your reply.

I think the place that both western and eastern meet is in concern for the client. That is, both sides want to know what works.

I don’t think any school (western or eastern) claims to understand why everything works (none I’ve come across anyway). There are always points that are used just because they work. Especially the ‘extra points’ – which to me means: we don’t know why we just use them because they work.

Any living tradition, any medicine, adapts and changes. The tradition of chinese medicine is the tradition of innovation from one point of view.

Like you, I think, I am profoundly doubtful of TCM ‘proving’ itself in western terms. I think this is a mistake for all sorts of reasons. Likewise I want to keep traditional ways of diagnosing and not replace them with modern machines. I think the attempt to ‘prove’ acupuncture with ‘western science’ is based on all sorts of confusion about what evidence is and leads to confused results.

Like you my desire is to have better pracitioners (and as many of them as quickly as possible). This must be based on the understanding of what is going on (this is based on my experience of myself and others). Deep understanding is of our experience in my view. On this base our medicine can advance. I don’t see any other way.

I hope this makes sense.

Grace and peace,
Evan

michael says:

12/05/2007

Evan,
I am so amazed by the wonders of Chinese medicine! We are so fortunate to be able to study and practice such a powerful and effective medicine. I couldn’t agree with you more that what matters is that it works, and why?, well that’s just the interesting and fun stuff to delve into; but knowing what works and how, that’s the art of practicing medicine and I can’t wait to finally start.
One of our most influential teachers in our program would constantly tell us “classical Chinese medicine is medicine of the future.” What he meant was that with a deep understanding of what Chinese medicine stands upon, which is essentially nature and physiology (the way of rivers and movement of fire…), one can practice a dynamic medicine, a medicine which is flexible, adaptable and living, as you say.
If you are familiar with the preface of the Shanghan Lun, you may recall what Zhong Zhangjing says about the doctors of his time. He complains that they are essentially stuck in the past, that they practice only what their fathers or uncles told them to do, but do not understand the big picture which would allow them to be dynamic and adaptive. His clinical manual (including the Jingui Yaolue), as we have been taught, can be applied to potentially every disease that could ever arise, if one understands his system well enough. This is because he always based his patterns and prescriptions on a sound understanding of nature and physiology. The doctors of his time treated symptoms (like for instance a sore throat) without treating the cause (the sore throat goes away, but the disease is pushed more deeply within or the body’s response is suppressed; this can be seen today with the incessant use of Yinqiao San); they treated diseases but at the wrong time (usually too late, for the failed to understand the progression of disease); they harmed the body in an effort to save the body (which goes against the rule in holistic medicine to “First do no harm”).
Another thing we are taught is that matter follows qi and qi follows shen; therefore, the more we deepen our understanding of consciousness and spirit, the more we are aware of the implicit underlying causes and imbalances, which reside in the unmanifest realm, the more we can treat disease before it becomes manifest, rather than chasing after the symptoms as they appear. The medicine we are taught is founded in symbols and archetypes, images of underlying patterns, microcosmic links to the macrocosm. This model is found in the Neijing, but in the obscure chapters that have been disregarded by TCM. Nonetheless, the principle of holism, upon which TCM bases itself, comes from this model in the Neijing which states that the movement of the stars, the movement of the planets, the movement of the qi in the atmosphere, the movement of the five processes, (as well as the stillness) have a direct relation with our lives and health.
So, for us to be practitioners of the future, I believe we need to be able to fluidly move with the changes while staying rooted in the wisdom of the ancients. So, I hope that through sharing what works, exploring new possibilities and applications of what we know, and new means of bringing health and healing to our times, we are able to keep our medicine alive; but, I hope to at the same time revive the roots and preserve the wisdom intact and whole. Ancient medicine is so incredibly rich and precious; it is a gem I’d like to not lose or shatter.
Sorry for rambling… I should get back to studying for finals.
Take care,
michael

Evan Hadkins says:

12/05/2007

I am in wholehearted agreement with you Michael.

Hope you do excellently in you finals.

Evan

michael givens says:

12/19/2007

Hi Eric and friends,
You probably thought that this conversation was long over, but I have a question for you. I have been pondering this question for some time and so I thought it would be nice to hear some differing perspectives. I hope that even though this is the 17th comment on an old conversation that it reaches a few people at least. My question is: Does the moral character of our teachers matter? I know various aspects of this has already been discussed on this site, but what I am wondering is, should we hold a high standard for our teachers to be models of not only excellent clinicians and scholars of the medicine, but practitioners who cultivate their presence in the world, who are able to hold a safe healing space, who have a healthy emotional life and who can maintain safe and respectable boundaries with others (especially students and patients)? I have witnessed on numerous occasions teachers who do not have clear and safe boundaries, or who are severely lacking in personal cultivation and maturity, or who are lacking in integrity, honesty, kindness, etc…. Does this matter? Should we just take the good and leave the bad, as so many have suggested to me, or to follow what our teachers seek and not our teachers? I can accept all of this, but it really skirts what I am asking. Yes, our teachers are human, but while we take what we like and leave the rest, what standard should we uphold, if any? What effect does it have on us if our mentors are in someway acting in the world in such a way that counters the healing energy we are trying to promote in the world?
Please let me know what your thoughts are on this.
Thanks!
michael givens

Eric says:

12/21/2007

Hey Michael,

It’s an interesting question, no doubt. I can only offer a few thoughts, mostly because of a splitting headache and the fact that it’s 3:30am. Ha!

As a philosopher, I was always taught to look at idealized situations to understand the principles behind things. Imagine a mentor of great medical prowess who, we came to find out, was a murderer. Would we take the medical information that person could impart unto us and leave the rest? Well, probably not. Most of our mentors are not monsters, just human. As such, they have human flaws. Some more egregious than others. Some less palatable to us than others. A few things come to mind here:

1. I will take the enemy I know before the enemy I do not. Though certain folks may have “louder” flaws (ie: being obnoxious publicly, being openly sexist, etc) this doesn’t by any means suggest that others do not have flaws that are simply “quieter.” In other words, we shouldn’t imagine that we know people as well as we think we do. The loud, sexist person may be nearly sage-like in most other respects, and the quiet mouse may be secretly hateful and vindictive.

2. Most of us work on the premise that greatness within the realm of Chinese medicine comes only through a combination of many factors. The person must be a great scholar, yes, but also must be calm, committed, open, aware, spiritually/physically/emotionally cultivated, etc… Because of this, I tend to privilege the possession of great medical achievement on the part of our docs above little character flaws. Why? Because the possession of great knowledge and the ability to heal patients indicates that they are surely doing something right and perhaps the weight of those things they are doing right are greater than those difficulties that I see because of my own perception scheme. Again, this doesn’t mean we excuse things that are clearly morally excluded like: murder, rape, systematic discrimination, open hatred, great dishonesty, etc…

3. Because the discovery of a great mentor is so important in our medicine, I am reluctant to leave it up to my conscious mind to figure out. We need to go deeper in order to understand who is coming to us and why. I, of course, use the Yijing in these times of cloudy understanding and it is how I have chosen all of my mentors. Not alone, but combined with plenty of meditation, prayer and listening deeply to my inner awareness. Some would laugh at this method, but it has served me well. There may be things that we are failing to consciously understand, we may be blinded by our particular predjudices – many things could be causing us to fail to see the truth of the situation. Consulting change brings clarity.

4. Ultimately this is a very personal decision. Character flaws you find to be absolutely impossible I may find easy to deal with. Because I am a bad person? No, perhaps it is a type of immunity. I have the antibodies to particular kinds of moral failing. Who knows why this is? Some things that I cannot abide you may navigate with aplomb. Maybe each of us carries personal strength that is able to act as a counter to particular difficult personality traits, and that is why we are drawn to people who have them. It’s a process, anyway, and we can only make our best guesses and keep an eye on the results.

Does any of this make sense?

Eric

Evan Hadkins says:

12/21/2007

Makes great sense to me.

Hope the headache is better and that you have a great Christmas if we don’t speak before then.

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