Soft or tough needling?: A personal story
Dr. Jiří Bílek, M.D. (CZ)
My acupuncture story has begun in 1990’s in Beijing. At that time and space disposable needles have been scarce, so needles not very sharp after multiple use and sterilization was the daily reality. In order to penetrate the skin with rather blunt tip, needles had to be quite thick and insertion intense. 0.30-0.35mm was the standard, deep needling common and strong “deqi” a must. Pricking through a dense cardboard was a popular way of needling technique training.
When I started to practice and learned about the acupuncture reality outside of China, I was astonished about the variety of needling techniques and power of a shallow or even contact needling. Needles I used were getting gradually thinner up to the current 0.14-0.16mm and I thought that I’d never go back to the intense painful needling styles. But only up until last year…
Going back to Beijing, I came across the classical “yuanqi” acupuncture technique, which was more painful than anything of my previous experience. Never-less the clinical results convinced me that it is worth to master it and now the whole spectrum from a light contact to deep and strong manipulation is on the menu.
Competitive theories: myofascial muscle chains, meridians, segmental structures, triggerpoints? How to find our way out?
Jan Willem de Bruijn (NL)
For centuries defining and explaining acupuncture has been a major challenge. It is not easy to “squeeze the enormous array of concepts and schools of thought in traditional Chinese medicine (which are sometimes mutually contradictory, antagonistic, or exclusive) into the kind of homogeneous, logically coherent system of ideas and practices that is so attractive to the Western mind”, Unschuld 1986 Nan Ching-Translation/Annotation. How do we avoid getting lost in the web of acupuncture theories? And how to build a bridge over the explanatory gap between acupuncture and western medicine? In this lecture parameters are presented to take into account when analyzing concepts, hypothesis, theories and techniques. Amongst which are; different styles in scientific reasoning, a coherent view on the physiology, pathology, diagnostics and treatment of the acupuncturestyle at hand and subsequently its rooting in the basic concepts of Chinese medicine and sometimes even Western health- and lifesciences. TCM-, fascia- and channelstyle acupuncture will serve as examples to be analyzed as mentioned above.
The Essence of Needling
Intention and Related Ideas in Classical Practice
Dr. Charles Buck (GB)
When investigating the ideas behind this medicine we should first ask what its originators actually meant by the words used. With this in mind we will reflect on the meaning of Yi – intention both from the linguistic and cognitive standpoints. As part of this quest to know Yi we will then need to examine ancient conceptions of resonant causalities – the means by which intention was considered to operate. We will look, too, at the question of what precedes the skilled practitioners’ intentionality – the intention is to do what exactly? Knowing the classical approach to “diagnosis” requires that we understand the particular cognitive skills that were valued by those early scholars. Intention is beneficial only when it is specific and is properly aligned with what is most appropriate in one situation at one moment in time. Finally, in an attempt to keep things real, I will outline some ideas about ‘intent alignment’ in clinical practice.
The acupuncture needle as a diagnostic tool
Dr. Mike Cummings (GB)
The filiform acupuncture needle has some physical similarity to a digit of the examiners palpating hand. There is no cutting edge as there is with hypodermic needles, and the needle tip appears to exert consistent degrees of resistance in different soft tissues. So with a light grasp of the needle handle it is possible for the examiner to determine the nature of the tissue on which the tip exerts its pressure and hence mechanical stimulus.
Unlike an examiner’s fingertip, the needle can exert pressure on individual tissue layers with minimal pressure or distortion of other layers, either below the point, or through which the needle shaft passes. Thus with a needle the examiner can create a very localised tissue-specific mechanical loading that is not possible with a finger, or indeed, any form of external physical examination.
Using a needle in this way requires some practice to ‘tune in’ to the tissue resistance, and also requires a good working knowledge of somatic anatomy, but an equally essential skill involves the interaction with the patient. The patient must decode the sensory perception and interpret it, and they can only do this with the skilful guidance of the examiner.
Typical questions on needling a target tissue might be: “Is this the pain (or sensation) you are complaining of, or am I creating another pain in the same place?” “Does it feel as if it is in the same place (and/or depth) as your pain?”
If you can reproduce a patient’s pain on the end of a needle, and not with a needle 1cm away in the same tissue (i.e. within the receptive field of a single nerve), this implies that there is peripheral sensitisation of nerve endings relevant to the presenting condition.
Filiform Fire Needling (introduction and demo)
Dr. Ioannis Dimitriou (GR)
“Disease that is not successfully treated by acupuncture may be treated by heat application methods (jiu fa)” Yellow Emperor’s Inner Classic
Even though fire needling uses acupuncture needles, it is considered as an internal heat application method (nèi jiǔ fǎ, 内灸法) and not acupuncture. The first recordings about fire needling can be found at the Yellow Emperor’s Inner Classic. Spiritual Pivot mentions nine needles, one of which is a special needle for fire needling.
Professor Liu En Ming invented filiform fire needling because of the need to apply painless fire needling. Liu En Ming is dedicated to spread this knowledge in China and Dr. Ioannis Dimitriou outside China.
During the lecture in Maastricht, attendants will get introduced to filiform fire needling, the tools that are used for it and could experience themselves, painless fire needling with instant results, even in most difficult cases.
Needling the face to dissolve hidden emotions revealed in facial expressions.
Nicholas Van Bergen Garner and Lisa Wright (DK)
At this demonstration seminar Nicholas will guide you through a range of the most common stress related emotional issues that we see in clinical practice: anxiety, depression, loss of happiness, grief and anger.
Nicholas will give examples of how emotional distress can be diagnosed through facial expressions, and how combinations of certain body and facial points using specific needling techniques, can return the face to its natural beauty.
Intentional needling with knowledge of both CCM (Classical Chinese Medicine) and more modern Western approaches of how facial muscles and skin tissue reacts, provides transforming results on a physical, mental and spiritual level.
These techniques will be performed and, depending on the number of participants, a workshop will be set up with Nicholas and Lisa as supervisors assisting participants in trying these techniques themselves.
Acupuncture needles and the path of self-cultivation
René Goris (NL)
In this lecture René describes the practice of acupuncture as part of Daoist means of self-preservation through moral action. It also shows combined acupuncture practice and theory in the context of Chinese history as a science of life. It roots the practice in essential concepts and essential classical texts that transcend a purist biological view on health.
There are major factors playing a variety of roles affecting change in understanding of the science of Chinese medicine in general and acupuncture in particular. This incomplete understanding does lead to a simplification in understanding and reduced options for application, most notably noted in the way how we perceive acupuncture and the application of needles in therapy.
Major in this article we see that education plays a strong role in this, education often being influenced by historical trends, commerce, need for innovation and so on.
Crafting the ultimate acupuncture needle
Dirkjan Heijne (NL)
The aim of this interactive talk in to provide an insider’s look into the manufacturing process of acupuncture needles. An overview will be given into the mechanics of making the very same needles every practitioner uses on a daily basis, from raw materials to quality control. We will revise the common practices and uncover unexpected facts in the needle industry. We will determine what the limits of the current available technology are and what developments could be expected in the future, thereby debunking paradigms and bridging common wisdom with the hard facts. In group context we will be looking into the difficulties of establishing a common reference for “good quality” and try to elaborate on the characteristics for a perfect needle.
The Journey of the Practitioner I
What does it take to become a living, breathing and compassionate acupuncturist?
Koos van Kooten (NL)
It is said that ‘medicine is intention’ – a quality of being present in the moment, taking one’s position as a human being between heaven and earth, meeting the person and the situation at hand, doing exactly what is needed. What does it take to become such a practitioner? The classics only describe the desired outcome of that journey, not the journey itself. As practitioners we often define ourselves by the methods we have learned to apply, not by our own development as a human being. Some ‘basic questions’ may help us to discover the journey that led us to being the practitioner we are here and now. In this lecture, I will ask myself these questions and formulate answers that are necessarily incomplete, but may offer a glimpse of what it takes to be a living, breathing and compassionate acupuncturist.
Journey of the Practioner II
Inner Freedom in the treatment room
Maximising the amount of inner freedom is an important part of becoming a living, breathing and compassionate practioner. We will ask ourselves which factors limit our freedom in the treatment room and which factors enhance our freedom. The core of the workshop will be dedicated to exchange in small groups, circling around these two questions. In this way we can learn from ourselves and each other.
Max. number of participants: 15
This workshop is open to participants that attended the workshop/lecture Journey of the Practioner I.
PTNS/acupuncture treatment of the overactive bladder
Gerrit van de Maat (NL)
An overactive bladder is a common complaint and may be found among over 10% of the population. With 1 out of 10 people, the complaint is so disruptive that treatment is required. This adds up to a lot of patients.
The workshop provides a practical opening towards treatment which, although applied within the boundaries of regular health service, has its origins in TCM: electric stimulation of (among others) MP6, with 20 Hz, 200 µs, for 30 minutes, once a week, twelve sessions in total and with a decreasing schedule if so required.
It will be obvious to the reader that the basis of this therapy is a good starting point for other complaints within the small pelvic area, such as urogenital and anorectal pain syndrome, interstitial cystitis and pain with prostatitis.
Dry needling: de nieuwe ontdekking voor pijnbehandeling (translation soon)
Hans van Male (NL)
Dry needling is de Westerse techniek voor het behandelen van triggerpoints. Er is nog veel ontwikkeling binnen deze nieuwe behandel methode en er zijn interessante veranderingen. Tijdens de presentatie wordt gekeken naar de naaldtechnieken en de diverse naalden die gebruikt worden met het dry needlen. Het is een echte spiertechniek, maar ook kan periostaal ingezet worden. Ook kijken we terug op de geschiedenis van het dry needlen.
Naast het needlen is de lokalisatie en anatomische kennis wel een pré omdat diverse locaties vrij diep liggen en sommige locaties dicht tegen de ribbenkast liggen. In de workshop zal vooral aandacht gegeven worden aan de manier van naalden en de diverse naalden die er zijn om diepe locaties te behandelen.
I-Needle: Detecting the biological mechanisms of acupuncture
Dr. Christine Nardini (I)
In order to be well exploited by the largest possible number of people, in particular in the western world, acupuncture is often requested to go through a modernization process allowing this practice to enter the realm of evidence based medicine.
To contribute to this quest we propose to synergistically integrate the ancient empirical wisdom carried on by acupuncture with state of the art technologies including next generation sequencing -to explore over time and space the molecular effects of the needle stimulation-, and nanobiochips to develop a nanosensor in the shape of a needle able to report in real time the molecular events occurring upon stimulation
Preliminary results and perspective applications will be discussed in this presentation.
The Dao of the Needle
‘An inquiry into uncertainty, science, Toyohari and the pursuit of confidence’
Willem Pinksterboer (NL)
This adventurous lecture integrates scientific, philosophical and practical aspects of the journey of the needle, investigating an essential yet often discarded characteristic of all medicine: uncertainty. You will understand why both Zhuang Zi, the Daoist from ancient China, and Karl Popper, the 20th century philosopher, urge us to acknowledge this fundamental aspect of reality. The inability to accept uncertainty leads to either a lack of critical faculties and a false sense of sureness, or to unproductive doubt and insecurity. The only way to develop compassion and true confidence is to embrace uncertainty. But how?
An answer may be found in Toyohari, a Japanese meridian therapy. Toyohari turns acupuncture practice into a continuous learning process, one that resembles Karl Popper’s critical method of falsification. At the same time, the actual treatment methods keep us rooted in the state of ‘not knowing’ praised by the Daoist masters. Insight into the principles that underlie this treatment system can be of great value to anyone who handles the needle to heal.
Acupuncture and Scientific Research
Dr. Yannick Tobbackx (B)
Acupuncture has been the subject of many scientific studies. But because of heterogeneity and, quite often, a less methodological structure, these studies tend to be below par when it comes to quality.
In this lecture we will explore how to tackle this issue and how to implement improvements in the professional use of acupuncture.
Only relatively recently (in 2008), guidelines were issued that every scientific acupuncture research should adhere to (the STRICTA guidelines). In this lecture we will mirror these guidelines to our scientific research that was carried out in 2011 in a cooperation between the Vrije Universiteit Brussel and the Belgische Acupunctuur Federatie. In 2013 and in 2015 our papers were published in the ‘European Journal of Pain’ and in ‘Pain Physician’, respectively.
In addition, this lecture will discuss an important study published in 2010 by the KCE (the federal knowledge centre for health care) in Belgium. This study was mentioned by the government. It critically discusses the application of acupuncture and also provides recommendations.
Blood Letting – A forgotten but powerful method acupuncture technique
Philip Weeks (GB)
A major part of traditional acupuncture is the use of specialized needles to elicit a few drops of blood, which can have a profound effect on the way the body functions. It is arguably the most powerful treatment method that can be applied in Chinese Medicine. However, in the west, bloodletting has not been widely taught or applied. Bleeding is also a major component of Master Tung Acupuncture, known for bringing about a rapid and often permanent therapeutic result. It can be very effecting for treating many conditions including back pain, high blood pressure, and infection. Some of the theory of blood letting and its application will be discussed as well as a live demonstration.