michaelmax: December 4, 2020, 8:38pm
Clearly excess San Jiao female patient. Always polite, sparkly eyes, dresses neat as pin and has to have a towel
under calves “just so” to be comfortable on the table. She’s also all about perfection.
Responds well to Liver tonification.
Also rather high in KD, quite vain about her looks and keen on “keeping her youth.” Recently had a facelift which
helps to support the KD excess aspect of her.
Here’s the thing.
I saw her 1.5 months ago and I’d been making slow steady process with tonifying the liver, working the small
intestine (for an odd numbness she has along the UB channel on the right foot). Along with forays into the PC for
sleep and use of the ST because she’s also thin with good skin and well resourced.
In that last treatment I thought I’d “help her out” with that San Jiao excess by draining it. She’s done so well with
liver after all.
Result: she did not settle on the table, and today she reports that she did sleep at all that night and then she says
“Never do that to me again!!”
When you’re wrong with this stuff, you’re really wrong. And she was clearly angry about how that treatment went.
Here’s my musing on this…
While she is SJ excess, there is some part of her that is probably fine with that. So having the LV tonified helps her
to keep a sense of balance, but when I take away that San Jiao energy… well, there’s a part of her that loves her
San Jiao energy. Tonifying the LV helps her to keep leaning on and using her San Jiao, but when I actually take that
excess away… well, clearly that did not go well.
So I don’t think it is always a matter of making sure people are in balance. I suspect (just a hypothesis here) that
some people really love their imbalances, and they don’t want to get rid of them. And are looking for ways of
continuing life in the way that they like to live… but with something to support them in doing so.
That’s the sense I’m making of this. And I know for myself there are certain imbalances I have in my life, I don’t
want them to go away because in a way they are superpower. But I do want to do what I can so I can continue
along without burning myself to a crisp.
So when draining, it might be helpful to consider… “Does the patient enjoy the particular excess they are living?”
If so, support it with the counterbalance, but don’t drain it.
amyjenner: December 5, 2020, 12:32am
10/01/2024, 13:30Support people in being who they want to be – Qiological Community
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I wonder if it may also be that it was just a big step from status quo… I wonder if that might be a typical reaction
of a super controlling SJ type because it just feels to out of control not to have so much control… ;-)… If you
follow my meaning. And cause anxiety that kept her up all night. It seems like other channels, because control is
not a primary thing, might be easier to let go.
It would be curious to see if that happens more frequently with SJ than other channels. Hmmm
Daniel: December 5, 2020, 3:22pm
To be honest, I feel somewhere between a little leery and certainly quite cautious to advance such an interpretation
Michael. I’m certainly open to it, just not quite so ready to jump to it (of course, recognising I have not seen this
patient – just speaking generally) . . . . and will say I have most certainly seen cases over the years where a patient
was just not ready to handle what got mobilised / metabolised / liberated during treatment . . . . . I’d be much more
inclined first of all to consider two other possibilities . . .
1. While she has been responding well to Liver supplementation and she appears to you to clearly be a Sanjiao
excess . . . it is possible and must be considered that the Liver – SJ axis, while certainly part of her picture, is
not fully central and a revisitation of the basics to consider other axes may lead you somewhere important . .
. UB-HT? . . . ST-LU? . . . SP-LI? . . . GB-PC? ‘Responding’ to Liver reasonably well but adversely reacting
to SJ drainage may suggest the Liver-SJ axis is not as key here as you suspect – that really needs to be fully
considered (speaking from experience).
2. I wonder and am still very much in kindergarten level appreciation of the magnitude of difference between
supplementation and drainage. For a given oppositional pair, are
one sided supplementation
two sided supplementation
one sided drainage of the oppositional partner
stepwise increments from each other
OR
when we move from supplementation (even bilateral) to drainage (even unilateral) – are we jumping to an order of
magnitude or orders of magnitude difference in therapeutic signal / intervention??? I don’t know or have a strong
enough sense of this yet to tell – but if we are, it would make sense then, purely on ‘intensity’ of intervention that a
drainage action could be adverse where even a bilateral corresponding supplementation went well.
Just some other thoughts to consider
I’d love to hear Toby’s high level experience input on these matters!!!
having said all of this, I recently did something extreme in this regard!!!
and supplemented on one side (Liver supplementation on the right) and drained on the other side, the
corresponding partner (San Jiao drainage on the left) – it was very carefully considered in a case I’d seen 8 times –
and I stayed with the patient for ten minutes . . . . she felt very very good during the session and with that treatment
now two weeks ago, ALL of her symptoms vanished completely and have not returned!!! What could be more
‘extreme’ in Sa’Am than such a dual supplementation / drainage approach???10/01/2024, 13:30Support people in being who they want to be – Qiological Community
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sweiz: December 5, 2020, 11:30pm
Hi Michael,
I wonder if she met with the drainage criteria in that she was strong, the pattern was glaring and that you felt you
had reached an impasse. The last point seems to be super important – well all of them are I guess. But, as I recall,
and maybe I don’t recall correctly, Toby only uses drainage if the pattern is either super acute and dramatic or very
stuck…meaning you’ve worked a long time with little progress and things just move a little but not enough. You
wrote “responds well to liver” and “we were making slow steady progress.” This seems to me to contra-indicate
drainage. Do I have this wrong?
I did one pre-full moon drainage since the class and I was so trepidatious that I called Toby to talk it through with
him to make sure I was on the right track. It’s big deal!
empiricalpoint: December 7, 2020, 6:16pm
I am also wondering about taking this outside of the theoretical. Yes, we all manifest imbalances. Is there a point
where our imbalances are our constitution and temperament, rather than pathology? At what point are “imbalances”
we perceive, actually that person’s physiology that creates their individuation? Rather than hammering for the
perfection between those poles, should we move on to tackle another aspect?10/01/2024, 13:30Support people in being who they want to be – Qiological Community
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Daniel: December 8, 2020, 1:00am
This leads us into a very fascinating inquiry – as i understand it – one I have been grappling with for many years . . .
. when we start to speak of things like ‘personality’, ‘constitution’, ‘temperament’ – we have to dig deep and get
clear on what we are talking about. I am studying the enneagram right now – not as a personality typing parlour
game, but from the deeper spiritual perspective as a window into the personality ‘distortions’ that arise and
entrench in our internal structures very early in life with our first experiences of any trust betrayal or trauma. I have
heard ‘5 element’ practitioners speak of the 5 element constitution the same way – although I do not know if this is
rigorously rooted in the classics. What is ‘constitution’? What is ‘temperament’? What is healing? Almaas has a
very beautiful book that looks at the nine enneatypes as , also nine ‘holy ideas’ – nine authentic faces of God if you
will, revealed once one has truly healed the personality distortions in the same space . . . . in ‘our’ framework, one
could for example, see ‘Wood’ certainly as anger, frustration, rage, impatience when expressed at the level of
personality distortion – but at the level of ‘healed wood’ – it would be creativity, the authentic desire for growth.
That would be freely expressed Wood at the fully healed and holy level – I think its a long way to go to get to that
level – and in the ‘mean time’ – there is therapeutic value in addressing any imbalances. Richard Rohr quote . . . .
“without healing, all of use are dangerous people” – expressing some level of evil, albeit often very subtle
expressions.
michaelmax: December 8, 2020, 4:42am
empiricalpoint:
Yes, we all manifest imbalances. Is there a point where our imbalances are our constitution and temperament,
rather than pathology?
@empiricalpoint, wow. Yes, you have succinctly stated what I’ve been sculpting out of fog.
The lesson I took from this clinical encounter is that I had an agenda to “balance” this person out. I don’t think she
is looking for the kind of “balance” I had in mind for her. My agenda… not her’s. She likes her San Jiao +++.
It’s not mine to take that away from her. Support her so she can live her life in the way she wants to live it is what I
think she is asking for. And with that draining treatment I was in effect saying. I think I know what’s better for you
than you do.
I’ll be watching out for that tendency of mine in the future.
empiricalpoint:
At what point are “imbalances” we perceive, actually that person’s physiology that creates their individuation?
This is worth printing out and pasting to my clinic wall. Indeed our imbalances, our quirks, odd habits, the way we
create a sense of dynamism in our lives precisely because of our imbalances. Our ‘superpowers’ that are anything
but balanced. Indeed, our perfectly balanced off-center wobble is what makes us who we are. This is not something
to “fix.” Although is something to attended to and considered.10/01/2024, 13:30Support people in being who they want to be – Qiological Community
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On a bad day you could say that “this person just wants to get away with living the life that is causing them some
troubles.” And blame the patient for their ills. But yes… there just might be something here about individuation
and the unique way we put ourselves together that both allows us to move through life with our personality, and at
times is the source of our most profound troubles.
Daniel:
What is ‘constitution’? What is ‘temperament’? What is healing?
Oh boy. Those are some powerful questions worth consideration. And as I begin to inquire into these, I can see that
yet again… I have an agenda as a practitioner to “do something” and to have the patient “be different.”
There is a place for that. But there is perhaps also a place to simply give people the support they need to keep being
who they are, until the moment they are ready to blossom into something else. But that blossoming is not in our
hands.
sweiz:
I wonder if she met with the drainage criteria in that she was strong, the pattern was glaring and that you felt
you had reached an impasse.
She was not at an impasse. I was thinking I would be more helpful by turning down her intense critical SJ focus.
Hubris and frustration on my part. She was not asking for her critical nature to go away. This treatment taught me,
once again, the value of listening to understand.
KristinWisgirda: December 9, 2020, 6:16pm
My biggest clinical mistakes have come fixating on certain ideas about patients to the exclusion of being able to be
really present to other aspects of their presentation. The scenarios that make my head hang are those when my
ideas about what should work have lead me to rationalize why the patients are not settling on the table.
Evaluating settling is a super critical skill for us. It wasn’t always easy before masks which make it that much
harder. Definitely something that I suspect all of us need to keep cultivating and orient to.
amyjenner:
I wonder if it may also be that it was just a big step from status quo… I wonder if that might be a typical
reaction of a super controlling SJ type because it just feels to out of control not to have so much control… ;-)…
If you follow my meaning. And cause anxiety that kept her up all night. It seems like other channels, because
control is not a primary thing, might be easier to let go.
It would be curious to see if that happens more frequently with SJ than other channels. Hmmm
I don’t think our curiosity should go in this direction. When asked about SJ patients “resisting” Liv+ treatment,
Toby said that yes it was possible and more likely to be a slower settling on the table. Yes, there can be an
adjustment period to new states of being. But to know that that the “side effects” of treatment are part of a positive
treatment response, we want to see that they patient did settle on the table and that the side effects make sense for10/01/2024, 13:30Support people in being who they want to be – Qiological Community
https://forum.qiological.com/t/support-people-in-being-who-they-want-to-be/1424/print6/6
the quality that we are adding. After draining SJ or supplementing Liver we would expect the patient to report
feeling duller or foggy or slower, not having insomnia and being pissed off as with this patient.
A much better explanation for the patient’s response is inappropriate treatment with the added fact that she was
drained inappropriately.
The nature of draining is that it weakens the patient, whether used appropriately or inappropriately. Sucking out the
life force a patient needs to function will make anybody with enough GB energy pissed off.
Daniel:
when we move from supplementation (even bilateral) to drainage (even unilateral) – are we jumping to an order
of magnitude or orders of magnitude difference in therapeutic signal / intervention??? I don’t know or have a
strong enough sense of this yet to tell – but if we are, it would make sense then, purely on ‘intensity’ of
intervention that a drainage action could be adverse where even a bilateral corresponding supplementation
went well.
My notes say “Bilateral is synergistic and so much more powerful than 2 single treatments.” This suggests that we
are jumping an order of magnitude when we go from 1 sided to 2 sided.
As for jumping from bilateral to draining, everything Toby has said strongly suggests that it is not an only jumping
an order of magnitude for the intensity of the intervention, but that it is a different therapeutic method. If we use
image of righting the wheel, with supplementing we are righting it by making the wheel bigger in places. In the
process, the wheel gets bigger and if done correctly will be sturdier overtime. Draining tries to balance the wheel
by making it smaller. Maybe the draining helps the wheel spin better, but it does so by giving the patient less to
work with.
A patient experience gives me evidence that the above is true. Partially draining GB gave the patient complete
relief from decades of body stiffness except an unusual neck pain developed soon after the treatment. At the next
treatment, I used gua sha and the neck pain went away. A month or 2 later, fully draining the GB eliminated her
recalcitrant light sensitivity but caused a return of the unusual neck pain. Gua sha and other treatments didn’t help
her neck pain. GB+ eliminated her neck pain. What is interesting is that her body stiffness and her light sensitivity
never returned, even months later. This tells me that 1 supplementing treatment is not the same level of input as 1
draining treatment. If it was then we would have seen a return of one of the symptoms that draining GB helped
with. (excuse the imperfect math).
I know we are all well intentioned here and want the best for our patients. My hope is that students will understand
that draining is a big deal and should be treated as a last resort.
PS don’t ask about partial draining. You will have to wait for Toby to share that info.