Adina_Kletzel: January 13, 2020, 9:49pm
HI,
I am looking to improve my intake questions to help zero in on the excesses as seen in the Saam system. I would
love to hear from others what questions they ask their patients in order to bring out the information needed to
properly diagnose which channels are in excess.
Thanks!
KristinWisgirda: January 13, 2020, 10:53pm
Here is our discussion on the topic from last year.
Intake Questions
I was thinking that it would be very helpful if members of this wonderful forum could share some of the intake
questions that they have found useful in helping clarify which archetype is out of balance. For example, I have
heard Michael mention that he asks questions to clarify who is a LI entrepreneur type. Another example would
be myself. I am LI excess – very dry and always always very busy and I recently did tonify spleen for myself
and I felt myself able to focus so much better and my thou
Taking on Saam, I never changed my intake form. I definitely address any boxes that are checked off, but the
intake form is way less important than the interview and taking real interest n the person in front of me, in the
moment. I don t want to leave any subject worth talking about to whether or not a box is checked. While I do ask
direct Saam questions, such as are you light sensitive more often the interview is more conversational. Pursuing
off handed comments is often revelatory. Recently, I asked a sweet, teddy bear of a man about an off handed
comment about something he doesn t like at work. His face turned dark and I got a blast of defensive paranoia in
return. Hmm.
I really like our frequent contributor @Daniel s approach. He doesn t seem to be stopping at the checked-box
answers either. In his cases, he seems to be asking tell me more about that and getting responses that provide
insight. How could a seemingly SJ excess woman like New York City?
michaelmax: January 15, 2020, 2:10am
KristinWisgirda:15/01/2024, 17:23Saam intake quesions – Qiological Community
https://forum.qiological.com/t/saam-intake-quesions/832/print2/13
Taking on Saam, I never changed my intake form. I definitely address any boxes that are checked off, but the
intake form is way less important than the interview and taking real interest n the person in front of me, in the
moment.
Same here. My intake form has not changed as I am much like @KristinWisgirda in that I don t want my forms
to get in the way of having a genuine conversation and allowing what I need to know flow from that.
I love @Daniel s tell me more about that. Always helpful to keep a patient talking. As is (and this sound so
simple it s silly) just repeat the last few words a person says but as a question, and then shut up. It will invite them
to do deeper into what they are talking about.
Lately I ve been asking people this if I suspect they are +SJ so, when you walk into a room are you the kind of
person that notices the frame is hung a little off center before you notice the picture in the frame? SJ excess
people will widen their eyes and say Yes! How did you know.
Daniel: January 15, 2020, 2:15pm
I have to admit . . . I m a bad student, a bad beginner, just plain bad. I do study all the rules. I took Toby s intro
class live-streamed THREE times in short succession to just go over and over and over the basics. And I still
review the basics almost once a week. But in clinic, I am really bad . (and I always have been – with any
system ). I misbehave and break all the beginner rules almost from the get go – I seem to have no patience for
them – something deep inside me just rejects the forms, codes, formats, structures.
I think it cuts both ways for me. On the one hand, I do make mistakes with such an attitude. (of course, in Sa Am,
there are perhaps no mistakes as response to any treatment is a journey into knowing our patient better). On the
other hand, my tendency to riff with an exploratory mind with the patient often yields breathtaking and mind
blowing revelations and insights.
I know all the lists of signs and symptoms for each archetype, each counterbalance pair are just invitations to
connect with a much deeper, larger phenomenon. We have certain signs and symptoms we associate with each of
the patterns . . . . laziness . . . Spleen Excess, rudeness . . . Liver Excess, Cold . . . Bladder Excess, etc etc etc. But
in the end, anything can be anything (as a recent example I presented showed – loving a trip to crowded congested
New York City was in fact in service to a SJ Excess s love of anonymity – she found that shielding from everyone
knowing her business in a small town in the crowded anonymity of Manhattan) . . .
we are being invited into a deeper capacity to eventually see and ask a person and just recognise Liver Excess or
San Jiao Excess.
KristinWisgirda: January 15, 2020, 3:14pm
michaelmax:15/01/2024, 17:23Saam intake quesions – Qiological Community
https://forum.qiological.com/t/saam-intake-quesions/832/print3/13
Lately I ve been asking people this if I suspect they are +SJ so, when you walk into a room are you the kind
of person that notices the frame is hung a little off center before you notice the picture in the frame? SJ excess
people will widen their eyes and say Yes! How did you know.
Daniel:
we are being invited into a deeper capacity to eventually see and ask a person and just recognise Liver Excess
or San Jiao Excess.
In the beginning of practicing Saam, I was mislead by asking leading questions and believing the patient s words.
Now I know better. Sometimes the words say one thing but they way they are said give a completely contradictory
message. Ultimately, familiarity and fluency with the true felt sense qualities of the channel archetypes is the key to
Saam practice.
michaelmax: January 15, 2020, 3:16pm
Daniel:
something deep inside me just rejects the forms, codes, formats, structures.
Sing it Brother!
Yeah, we are cut from the same cloth. And I think this is one of the reasons I love practicing Chinese medicine.
There are principles and those principles hold, but the contexts within which we apply them ever-changing.
And so it can look contradictory and confusing to the untrained eye. It can look like we are making up a story to
suit our purposes, and in a way we are, but– and this is important. We have our eye on clinical results. So if the
results are good, we know we are on track with our observations and story of what is going on, and if the results
are bad then we have learned something and we can course correct.
The beginner s rules are helpful in orienting to the terrain. They can keep us from stepping off a cliff, they can help
us to gain a sense of understanding at a basic level. They are helpful, but if applied dogmatically then we only
grow so far.
Like you I m more inclined to look at rules out of the corner of my eye and think “yeah, maybe ” I m more
than a bit of a contrarian. Which often has not worked in my favor, but sometimes it has. At least it keeps life
interesting.
I think that tendency of mine does leave me open to being able to
Daniel:
riff with an exploratory mind with the patient often yields breathtaking and mind blowing revelations and15/01/2024, 17:23Saam intake quesions – Qiological Community
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insights.
But we are definitely out in the weeds when this happens. Off the usual map we all agree on.
And yet, it does leave open the possibility to find greater unity between apparent contradictions. You re having a
patient who is ++SJ finding a sense of shielding and relieve in the experience of being anonymous in a NYC crowd
is a great example of this.
The circumstances seem contradictory from the beginner s view, but from that wider field of applying the
principles so we can understand our patients from their own point of view it can be very helpful. And then our
understanding leaps a level it does however take a kind of flexibility on our part. And the ability to take a risk
without being reckless
It makes practicing medicine infuriating and a delight.
I think a key thing for me with Saam is that the system and way we apply the basics of our Chinese medicine
fundamentals yin/yang, five phase, six jing will teach us as we go. The system is coherent. It has a fundamental
?, a patterning, that is very helpful in allowing us to learn from our experience as we go.
And it s darned helpful too have all of you here on this journey. We have this method that teaches us if we are
paying attention and a group of thoughtful inquisitive practitioners who are generous with their experience and
insight.
michaelmax: January 15, 2020, 3:17pm
KristinWisgirda:
In the beginning of practicing Saam, I was mislead by asking leading questions and believing the patient s
words. Now I know better. Sometimes the words say one thing but they way they are said give a completely
contradictory message. Ultimately, familiarity and fluency with the true felt sense qualities of the channel
archetypes is the key to Saam practice.
Hey Kristin Do patients lie? 15/01/2024, 17:23Saam intake quesions – Qiological Community
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Daniel: January 15, 2020, 3:51pm
KristinWisgirda:
Ultimately, familiarity and fluency with the true felt sense qualities of the channel archetypes is the key to
Saam practice
Well said! (now I have to add text cause this template won t allow for brief texts)
Daniel: January 15, 2020, 3:57pm
All so very well said Michael! yes, I find the coherence of the system – Sa Am even more so than any other I have
studied / practiced – is intense! I see the basics as pedagogical tools to invite us into a deeper resonance with the
coherence! (where the apparent contradictions emerge as resonant. Its then that you know you are beginning to
tap into something deeper. For me – at that point, the ongoing challenge is to remain perpetually humble so that
tapping into something deeper can be given the space to continue to grow.
michaelmax: January 15, 2020, 4:22pm
Daniel:
the ongoing challenge is to remain perpetually humble so that tapping into something deeper can be given the
space to continue to grow.
Yes. And we get to immerse ourselves in this. Witness it and at the same time be a conduit for it.
Adina_Kletzel: January 15, 2020, 10:10pm
Daniel:
we are being invited into a deeper capacity to eventually see and ask a person and just recognise Liver Excess
or San Jiao Excess.
What, in your opinion, have you seen as the most helpful ways of achieving the goal of being able to just SEE the
archetypes?
I guess what I am asking is that I we would all love to be like Toby s teacher and just look at the face and know15/01/2024, 17:23Saam intake quesions – Qiological Community
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what is not in balance. That will take time and patience but you seem to have a sense of what would help lead us
there and I am wondering if you can share those insights.
Daniel: January 15, 2020, 11:17pm
Adina – well to be clear – I am certainly nowhere near there. And to give a pretty much not-surprising answer that is
not any more insightful than I am sure what you already know . . . . seeing 10,000 patients and humility! I guess
my ever so tiny attempt to contribute to the process is just to challenge us to – at the same time we are following the
rules and procedures, also submit / surrender to a degree of inquisitive spontaneity and creativity – in how we ask
questions and how we challenge ourselves to consider their answers – to always be open to the possibility that any
sign or symptom can be anything. What I LOVE about Sa Am is that it seems to be designed SO WELL to engage
us with that level of inquiry.
I have a patient now – a 50 year old woman – coming to me for stress . And for several months, I have seen her as
an overwhelmingly dominant GB Excess scenario . . . . she is angry at every one she works with – F—- them and
F—–this , she just seems so clearly angry and irritated by everyone she works with and loves to go home and just
be alone. Results of treatment have been moderate but nothing dramatic like I d expect. She s been to see me for
months. Last week, I really tried to surrender deeply to her presence – what am I missing. I SUDDENLY became
aware of an intense isolated lonely self-dislike she had – it was not in anything she said, but it was transmitting
strongly – it was a very profound awareness and then, WHAM – her lack of symmetry fell into plain view and now
I am just itching to Supplement Kidney on her next visit and see what happens. We will see. But I was fascinated
by the process of me locking in on a conclusion with such certainty and the deep surrender it took to allow an
entirely different take to enter my awareness. Sa Am is such an amazing opportunity for cultivating this process.
KristinWisgirda: January 15, 2020, 11:20pm
Daniel:
I have seen her as an overwhelmingly dominant GB Excess scenario . . . . she is angry at every one she works
with – F—- them and F—–this , she just seems so clearly angry and irritated by everyone she works with
and loves to go home and just be alone
Another option to consider is H+ to kindle love for other people. Toby mentioned this as an option in a case study
in St Louis.
GB excess can come to the defense of the system when other areas are weak, but it may not be the prime player. It
just knows how to yell loudly and be noticed.
Daniel: January 15, 2020, 11:48pm
15/01/2024, 17:23Saam intake quesions – Qiological Community
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KristinWisgirda:
Another option to consider is H+ to kindle love for other people
That s a GREAT idea – thanks! Now I have to decide between two compelling options.
KristinWisgirda: January 16, 2020, 12:07am
Daniel:
I was fascinated by the process of me locking in on a conclusion with such certainty and the deep surrender it
took to allow an entirely different take to enter my awareness. Sa Am is such an amazing opportunity for
cultivating this process.
Yes! Then the next step is really being present with the patient as you test the conclusion your different take has
opened up for you. Practicing Saam is a practice of loving presence.
Daniel: January 16, 2020, 3:31am
Do you find when you work with such presence, it takes a lot of energy?? I find when I work like that, when I
really strive in each treatment session to be deeply surrendered and present, by the time I have worked with 3 or 4
or maybe 5 patients in a day, I really feel I am done (at least at that capacity), or at least need a break.
michaelmax: January 16, 2020, 1:20pm
Daniel:
I guess my ever so tiny attempt to contribute to the process is just to challenge us to – at the same time we are
following the rules and procedures, also submit / surrender to a degree of inquisitive spontaneity and creativity
That sounds right to me @Daniel, and mirrors my process as well. It s a yin/yang mix of control and loose
spontaneity. Enough grounding with the rules/basics to bring some stability and focus, which in turn can leave
open the door to a loose sense of inquisitiveness and curiosity that allows stuff to come through that the rational
mind is busy trying to suppress because it does not fit the rules/pattern.
KristinWisgirda:15/01/2024, 17:23Saam intake quesions – Qiological Community
https://forum.qiological.com/t/saam-intake-quesions/832/print8/13
Practicing Saam is a practice of loving presence.
@KristinWisgirda, yes, yes, yes and being sure to include ourselves in that loving presence.
Daniel:
Do you find when you work with such presence, it takes a lot of energy?? I find when I work like that, when I
really strive in each treatment session to be deeply surrendered and present, by the time I have worked with 3
or 4 or maybe 5 patients in a day, I really feel I am done (at least at that capacity), or at least need a break.
@Daniel I find that working this way opens something in me. In some ways the work is easier because there is a
kind of coherence that arises in the room and in the interactions and treatment. I find that to be a kind of
sustenance. I m not working so hard with head, and so not drained by trying to think through things.
On the other hand, these kinds of insights and connections that we are talking about here tend land for me in a non-
verbal way. My feeling/perception opens, and I would not say that tires me, but I need to be attentive to that I m
more influenced by the non-verbal world, and that can be draining is not quite the right word but I find myself
wanting to be more gentle with the world in general.
Adina_Kletzel: January 19, 2020, 10:08am
Daniel:
I guess my ever so tiny attempt to contribute to the process is just to challenge us to – at the same time we are
following the rules and procedures, also submit / surrender to a degree of inquisitive spontaneity and creativity
– in how we ask questions and how we challenge ourselves to consider their answers – to always be open to the
possibility that any sign or symptom can be anything.
I agree with you. Sometimes I even find that when I make myself a chart of a person s excesses in each channel
that I am going to over emphasize the chart in my head and not really try to SEE/FEEL what this person really
needs. As with everything a balance between that sense and what the chart and rules say must be reached. That is
why Saam is amazing as you say and also so hard
Shanlarson: January 19, 2020, 6:21pm
What a great thread. I ve been thinking lately how easy it is to get hooked on something you know for sure but
miss what is NEEDED in that moment. I had a patient recently where I missed the mark because of it. She came
for insomnia and boy was she ever an angry at the world kind of gal. I first treated PC+. She fell asleep on the
table but at her next appointment said it had no impact on her insomnia so I thought I would try something else.
Here s where I went astray. She had some light sensitivity, weak nails, strong discomfort under her rib side, got
overheated easily and literally just came to the appointment after having a long walk in the woods alone. It seemed
on paper obvious SJ XS. I needled LIv +. She was hard to read but it seemed like she settled. At the end of the15/01/2024, 17:23Saam intake quesions – Qiological Community
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treatment though as she was paying I felt I had gone the wrong way. I missed the glaring thing in front of me. She
was exceedingly rude. I have a hard time seeing LIV xs but when she left I realized how obvious it had been. She
was physiotherapist and in the first 3 minutes of the intake she said she does acupuncture as well and what we do
(physiotherapy vs acupuncture) is basically the same. She blocked any of my questions in the intake. She said if
these points I gave her worked she would just do them on herself at home. When I said this style is a little more
complicated she said not really . And then asked if I could write her a herbal prescription so that she could give it
to her friend whose in school and she could get the herbs cheaper.
Anyway my point is I got caught in the list that helps guide us but didn t in that moment step back and see what
that person needed. She was extremely shielded. It was the glaring thing in the room. I suspect what she really
needed was SJ+. The details of each of the archetypes are helpful but it s really learning how to listen and see what
this person needs. I m still working on it.
KristinWisgirda: January 20, 2020, 3:28pm
Adina_Kletzel:
Sometimes I even find that when I make myself a chart of a person s excesses in each channel that I am going
to over emphasize the chart in my head and not really try to SEE/FEEL what this person really needs.
Shanlarson:
I ve been thinking lately how easy it is to get hooked on something you know for sure but miss what is
NEEDED in that moment. I
Listing all possible excess is a great tool to open yourself to all possibilities for the patient.
Asking “does the patient need X quality in this moment or for this problem? helps bridge your understanding of
the patient as a collection of qualities to an experience of the patient in the room at a moment in time.
@Shanlarson To me, your patient sounds more aggressively rude than shielded rude.
Daniel: January 20, 2020, 3:51pm
KristinWisgirda:
Asking “does the patient need X quality in this moment or for this problem? helps bridge your understanding
of the patient as a collection of qualities to an experience of the patient in the room at a moment in time.
Perfectly said. This mirrors my understanding fully.15/01/2024, 17:23Saam intake quesions – Qiological Community
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michaelmax: January 20, 2020, 9:11pm
Shanlarson:
At the end of the treatment though as she was paying I felt I had gone the wrong way. I missed the glaring
thing in front of me.
Yes @Shanlarson this does happen. Great that you were able to catch it. And when you do the whole gestalt
snaps to grid and there it is!
One of the things I think I m starting to see is that very excessive TB types can look like the rudeness of LV excess,
but that it because they are overwhelmed. Very Liver excess can seem polite, but I think they are trying to read
the other person or situation because they really don t know how to genuinely connect with others.
We that when we go to extremes of yin and yang they tend to transform into each other. We know that both sides of
the political spectrum right and left out at the edges are intolerant and murderous if given the chance.
Again, great that you did catch it. This is what I mean when I say that this system will teach you if you give the
chance.
Thanks for sharing this case
Daniel: January 21, 2020, 1:38am
this is interesting . . . it is my ongoing experience that a significant number of patients have somewhere between a
50-50 to 40-60 split between signs and symptoms of excess for BOTH channels in a counterbalanced pair which
speaks (as I understand it) to the dynamic and compensatory relationships between two channels in a pair.
Daniel: January 21, 2020, 7:00pm
michaelmax:
I find that working this way opens something in me. In some ways the work is easier because there is a kind of
coherence that arises in the room and in the interactions and treatment. I find that to be a kind of sustenance
Hi Michael. I agree with this – I also find it actually quite energising – surrendering and aligning with this
coherence. Very much so. I know that seems contradictory to my question above!! So that got me thinking – what
am I talking about. I had to really think about it. I came to realise in my own clinical case – I have noone else here .
. . I am doing everything, answering calls, writing receipts, doing reception, keeping things clean and organised, etc
etc . . . so I think its the contrast perhaps of having to alternate between the management side of clinic and this
deeply contemplative coherence with patients in treatment that after 4 or 5 patients into the day, I find myself kind
of in an ok, thats enough state. I don t think its the actual contemplation on patients and treatment of patients -15/01/2024, 17:23Saam intake quesions – Qiological Community
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which like you, I find in this style, is as you said, energising – its the toggling back and forth between that and
day-to-day clinic management. Maybe I need to work on my shielding!!!
Adina_Kletzel: January 21, 2020, 9:48pm
Daniel:
after 4 or 5 patients into the day, I find myself kind of in an ok, thats enough state.
Could it also possibly be that since Saam is relatively new to us and we often cannot predict what the results of the
treatment will be that the strain of the uncertainty of working with a new system is actually tiring? I love the Saam
method but every so often I revert back to other acupuncture styles when I feel like I dont have the strength to let
go and let Saam take me wherever it may go.
I do think that some time in the future seeing many patients a day will be very energizing but until some of that
uncertainty with the system passes, it can at times be tiring
michaelmax: January 22, 2020, 1:56am
Adina_Kletzel:
I love the Saam method but every so often I revert back to other acupuncture styles when I feel like I dont have
the strength to let go and let Saam take me wherever it may go.
@Adina_Kletzel we all have days when we are on it and other days where it s hard to find our stride. Not just
with Saam but with life. And of course with practice.
There are times my patients seem pretty in balance and I ll not use Saam as it tends to be so moving. There are
times I want something balance and quieting.
Mostly if I see the Saam present shine through, I use Saam. But there are days and there are patients were I don t
quite have it dialed in. Fine, I ll do something else.
But mostly I do find a way to see through the lens of Saam. And especially when I write up my case notes while
the patient is on the table, I ll often see things that i missed in clinic. And so have more options for the next time
I see them.
The Chinese say ????? yi bu yi bu lai step by step, arrive.
I suspect that being on the path is enough.
Daniel: January 22, 2020, 2:56am
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michaelmax:
I love the Saam method but every so often I revert back to other acupuncture styles
Ha. Even after 20 years of doing Matsumoto-Nagano style acupuncture primarily, I would still have a patient every
so often who would get a Stomach 36 – Liver 3 – Large Intestine 4 – Spleen 6 treatment!!
michaelmax: January 22, 2020, 4:44am
Daniel:
Even after 20 years of doing Matsumoto-Nagano style acupuncture primarily, I would still have a patient every
so often who would get a Stomach 36 – Liver 3 – Large Intestine 4 – Spleen 6 treatment!!
Hey if it is the right thing to do, then you gotta do it.
I actually did LI4, LV3, GB38 and a few ear points for someone the other day. Totally gave them the quiet and ease
they needed this was after doing +PC and having their throat tighten up and start to get a headache in the back of
the head.
live and learn
George_Mandler: February 1, 2020, 12:48am
Shanlarson:
She blocked any of my questions in the intake. She said if these points I gave her worked she would just do
them on herself at home
Whoa! That is one extremely difficult person to treat. I find these mixed cases can be quite confusing and dropping
into the Sa am zone of feeling helpful. I still sometimes get lost in the archetype checklist details and miss feeling
the essence of the presentation.
Too bad we didn t get to see the result of a SJ+ treatment, that would have been enlightening if it helped her
insomnia. We ve seen GB+ help with insomnia but not the bright SJ+, I wonder if Toby has a case.
KristinWisgirda: February 1, 2020, 12:49pm
Recently, SJ+ helped my insomnia but I only got there because Liv+ went south. I wasn t feeling dark at the time-
it felt more like being caught up with micromanaging – but it was November and darkness is not foreign to me as15/01/2024, 17:23Saam intake quesions – Qiological Community
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well as a tendency to dwell too long in my own little world.
George_Mandler: February 1, 2020, 5:26pm
KristinWisgirda:
it felt more like being caught up with micromanaging
This is where I sometimes stumble as I would equate that micromanaging with SJ excess – but coupled with the
other factors of winter and inwards tendency the SJ+ helped. Am I interpreting that correctly?
KristinWisgirda: February 1, 2020, 10:02pm
George_Mandler:
I would equate that micromanaging with SJ excess
I interpreted the micromanaging as SJ excess too but maybe it was more inward oriented. Since SJ+ worked
wonderfully, Liver excess must of been dulling me out, so I probably am not a good reporter on this situation.