Holistic Medicine and Holistic Education

Details

Created on Sunday, 23 March 2008 10:54

Written by Paul Hougham & Allen Parrott

Holistic Medicine and Holistic Education
Radical side effects of acupuncture accreditation.
Paul Hougham and Allen Parrott
Introduction – the challenge of holism
Since 1990 the British Acupuncture Accreditation Board (BAAB) has been
accrediting licentiate and degree level acupuncture professional courses in
Britain. Its success as a rigorous regulator has been celebrated by
government and even noted by other healthcare professions, but its
accreditation processes have also had beneficial educational effects.

For
many years nearly all professional education and training in Britain, including
the education of many teachers and health workers, has had to operate within
a narrow ‘skills’ and ‘competencies’ framework. This framework, based on a
technicalrational
version of practice in which everything of significance in the
world is assumed to be observable and measurable, is designed to ignore the
complexity of professional knowledge and to reject the ‘artistry’ of professional
practice. By contrast, the work of the Board has been helping the
acupuncture profession to move purposefully towards a sophisticated
framework of educational practice that is marked by the same holistic world
view as the practice of acupuncture itself.
The holism that is espoused by most acupuncture traditions, (although there
are modern forms of acupuncture that have made alliance with a less holistic
and a more conventional scientific model of medicine), is not a superficial
lifestyle choice or a feelgood
metaphor. In the main acupuncture traditions,
holism is the starting point for all theory and for all practice. It is traditional
acupuncture’s underlying ontology and its required epistemology. Deep
holism of this kind should not be labelled as either ‘alternative’ or
‘complementary’, but as bedrock and literal: a description of how the world is
and of how it should be viewed, known and inhabited. In medical contexts,
holism entails the integration and interpenetration of the life of the spirit with
that of the mind and body, requiring always that the whole person be treated
in sickness and in health. There is nothing irrational or antiempirical
about
this holism, even though it takes practitioners into areas of reality and
knowledge uncharted by mainstream medical science. This article tracks the
central rhythms of the holistic education vision developed by the British
acupuncture profession, explains the role of its Accreditation Board, and
suggests how the vision might speak to a wider audience.
Eighteen Years of Accreditation and Holism – 19902008
In November 2000 the House of Lords’ Science and Technology 1 committee
commended the acupuncture profession for the establishment of the British
Acupuncture Accreditation Board. It commented that “establishing an
independent accreditation board along the lines of the BAAB is a positive
move. Other therapies with fragmented professional representation may wish
2
to use this as a model.” This praise had little to do with holistic education.
Their lordships were applauding the Board’s constitution, its committee
structure and its independence, as well as its transparent, rigorous and
comprehensive accreditation processes. Accreditation of teaching institutions
is an important way in which any profession can demonstrate its maturity, its
capacity for effective selfregulation
and its public accountability. Many
features which impressed the Select Committee are still strongly in evidence
today. These include:
· Good relationships with other medical bodies in the mainstream and in
complementary medicine.
· The membership of the Board consists of 50% nonacupuncturists
and
a nonacupuncturist
Chair.
· The Board operates independently of the professional acupuncture
body – The British Acupuncture Council (BAcC) – which created it and
which continues to finance much of its work.
· The Board has clear enquiryled
processes for accrediting acupuncture
degree courses.
· The Board places as much emphasis on educational ‘development’ (i.e.
fostering institutional and course developments over time) as it does on
regular ‘inspections’ (i.e. checking up on the attainment of the
profession’s requirements).
· The Board’s accreditation process makes extensive use not only of
acupuncture practitioners, to ensure internal professional coherence
and credibility, but also of education and management experts to
provide external perspectives on quality.
· The Board sets out transparent standards for a degreelevel
core
curriculum and the clinical attainments expected of newly qualified
professional acupuncturists.
· The Board also has explicit standards for its own processes and
working, with a code of conduct based on the Nolan Principles.
Such a list is conventional enough and could no doubt be duplicated by other
professions and their accreditation bodies. In the functioning of this
Accreditation Board, however, there has been an emphasis on educational
ideas that might not be found so strongly elsewhere. The Board’s approach
over the last eighteen years has encouraged the profession to explore
educational issues and western educational requirements in a confident and
forwardlooking
manner. The core holistic philosophy that characterises the
profession’s acupuncture practice is now expected in its educational practices
as well. Some distinctive features of the Board’s way of working can be listed
as follows:
1. Levels of dialogue. The Board entrusts much of the detailed accreditation
business to a smaller ‘Accreditation Committee’ (AC), which, like the Board
itself, consists of 50% acupuncturists and 50% lay members. This committee
meets more often than the main Board in order to review and discuss all
documentation submitted by institutions, both before and after they are
officially visited, and to make recommendations to the full Board. By offering
an intermediate level of evidencebased
recommendations to the Board about
the stage of development that institutions and their courses have reached, the
3
work of the AC deepens the entire process. In addition, the AC provides a
regular opportunity for practitioners and educationalists to discuss current
practices in acupuncture education in detail. Its members therefore become a
vehicle for spreading uptodate
knowledge, both about the variety of
theoretical underpinnings within acupuncture education and about how these
lead to different practical approaches and emphases in the teaching
institutions.
2. Signatures of diversity. The Board’s educationalist members have helped
to ensure that there is an ongoing and wellinformed
debate about educational
standards within the profession. Board members and officers have been
instrumental in introducing the profession to such core curriculum
requirements of western higher and professional education as researchmindedness,
reflective practice and criticality. At the same time, the
educationalists and other lay members of the Board have had to learn about
the diversity to be found in acupuncture’s multiple traditions and the Board
has always sought not just to encourage this diversity but to honour and
celebrate it.
Each college, or each course team in the case of a university, is asked to
provide an explicit articulation of their programme’s uniqueness, i.e. a clear
account of which approach to acupuncture is being promoted in their course.
All institutions benefit from this exercise in clarification, while the profession as
a whole benefits from a transparency that enables professional differences to
be better understood and openly discussed. The best teaching institutions are
also keen to define how they would expect their graduates to operate as
acupuncture practitioners, and this exercise also enables them to articulate a
particular educational philosophy for their programme: to identify the kinds of
teaching and learning that they wish their students to experience, and the
kinds of professional conduct that they wish their teachers to model.
3. Clarifications of unity. The diversity of acupuncture has to coexist with,
and not detract from, the equally important theme of professional unity. As a
way to unify the profession, the Board promotes minimum standards that are
held in common across all its institutions. These detailed, transparent and
comprehensive standards are set out in the Board’s Accreditation Handbook.
As well as protecting the interests of patients, students and teachers, the
curriculum and accreditation requirements in the Handbook can function to
define and protect the title of ‘professional acupuncturist’ within the community
of practitioners itself. Unfortunately, it is increasingly apparent that this title
may need such protection. The notion of ‘professional acupuncturist’ is being
diluted, as aspects of acupuncture practice are filleted for repackaging
in a
healthcare
market which does not have holism as a core philosophy.
4. Expectations of professionalism in teaching. All teachers of
acupuncture, including clinic supervisors, are expected by the Board to regard
themselves as professional practitioners twice over. Teaching itself has to
become their second profession and it must be taken as seriously as their first.
Teaching is seldom as simple or straightforward as nonteachers
believe.
The Board therefore expects policies of staff development in its accredited
institutions to include courses and qualifications in teacher education,
4
alongside the continuing professional development that is directly related to
acupuncture knowledge and its specialist practices.
5. Cultures of development. The Board affirmed its strong educational role
from the start by insisting that its processes of accreditation be
‘developmental’ as well as ‘inspectorial’. Development, whether of the
individual practitioner, of the course programme or of the institution itself, is a
process that can never be regarded as finished. Excellence will always remain
an elusive goal to be worked towards, even by the most experienced
institutions or by the most admired practitioners. For new institutions, in the
early stages of thinking about an acupuncture degree course, ‘development’
means being helped by the Board’s paid accreditation officers to achieve the
profession’s required standards. Later in the process, fully accredited
institutions which have been through the Board’s demanding three stages of
accreditation and which have successfully demonstrated compliance with the
Board’s seventeen Essential Requirements, are nevertheless still required to
review their course selfcritically
each year and to build further ‘development’
into their culture and into their way of thinking.
6. Practices of reflection. The Board’s requirement that teaching institutions
should themselves become selfaware
and explicitly selfcritical
runs parallel
with the related expectation that institutions will encourage a reflective
mentality and lifelong
habits of reflective practice and critical thinking in all
their acupuncture students. Becoming an effective practitioner is never just a
matter of ticking off lists of skills acquired, knowledge attained or competence
demonstrated. In addition, it requires each newcomer to the profession to
engage in a uniquely personal process of reflection about the tradition of
conduct into which they are being inducted. In these formative years when
they are learning to become competent, students are likely to be learning as
much from the experiences, relationships and lived values that they see
around them every day – the hidden curriculum as
they are learning from the
course syllabuses of the formal curriculum. A set of professional values is
being conveyed to them every day, consciously or unconsciously, through the
ethos of the teaching institution and the conduct of its teachers. Students
need structured opportunities to reflect on their experiences of this hidden
curriculum, while the best of their teachers will also be modelling a reflective
approach to the subjectivities and complexities of both their teaching and their
acupuncture practices.
7. Ethics of Conduct The idea that students learn about acupuncture from
seeing good professional practice modelled by their teachers is familiar
enough, but the Board also expects similarly ethical role modelling from its
own officers and its teams of accreditation visitors. The injunction from the
Board to its visiting teams can be expressed as a categorical imperative: “do
not do unto teachers what you would not have teachers do unto students”.
The Board’s accreditation teams are therefore required to conduct themselves
and their enquiries with the same professionalism that they expect to find
when observing teaching in classrooms and clinics. This is the same respect
that the institution’s senior management is expected to display in all its
dealings with students and with staff. It is also the same level of sensitivity
5
that every member of the institution is expected to display towards patients. In
this way professional values and ethics are placed at the heart of the
accreditation process, and at its longer accreditation visits the Board employs
its own observer to report back on the conduct of its visiting team.
8. Tensions of critical friendship. Because of its unusually rigorous
expectations, the Board can be regarded as a particularly demanding ‘critical
friend’. The tension between criticism and friendship has frequently tested
relationships between the Board and those teaching institutions which have
chosen to submit courses to its scrutiny for accreditation. One or two have
fallen by the wayside. But the demanding nature of the accreditation process
has also empowered teaching institutions, as they strive to go beyond merely
achieving minimum acceptable standards and as each of them strives to
make its own distinctive contribution to the emerging acupuncture profession
in Britain. The Board itself has spent eighteen years coping with the tension
of being, simultaneously, a westernstyle
inspection, quality assurance and
public watchdog agency on the one hand, and a forum, sounding board and
advocate for a nonwestern
form of health care on the other.
Acupuncture Education and Holism – Into the Future?
The struggle to reconcile, or synthesise, eastern and western versions of
knowledge, professional practice and professional education will continue to
face western acupuncture for many years yet. There are certainly some key
western liberal educational values that will play a role in the Board’s thinking
and in its accreditation practices for the foreseeable future. It remains an
article of faith, for instance, that teachers and students should share equal
status as autonomous human beings, even if they are at times operating
within an undemocratic master/apprentice model of teaching and learning that
has been imported from the east. The Board also encourages its accredited
institutions to adopt such western notions as:
· studentcentred
approaches and strong pastoral care systems
· activitybased
and experiential learning
· overtly democratic forms of participation by staff and by students
· critical thinking and deep questioning of orthodoxy, (including the
institution’s own deeply held beliefs about acupuncture)
· a variety of assessment modes, including selfassessment
and peer
assessment
· the use of reflective practice portfolios throughout a degree
· research mindedness and some direct student experience of formal
research
However, nonwestern
streams of educational theory have also entered
acupuncture courses, introducing different cultural themes. One of the
Board’s strengths has been a willingness to combine its unflinching demand
for accredited courses to foster a researchminded
and very western
scepticism towards all knowledge and all authority, on the one hand, with a
deep respect for the knowledge contained in eastern traditions and in the
authoritative texts of the past, on the other. This is a multidimensional
and
sophisticated approach, as befits two complex professional practices like
6
acupuncture and education. The simpleminded
opposition between
‘traditionalists’ and ‘progressives’, which has bedevilled the education debate
in Britain for over a century, has fortunately been avoided in discussions of
acupuncture education.
Education in practice can never be anything but multidimensional.
The
distinguished American educator, J.J.Schwab, expressed the complexity of
practice in a simple fashion, when he pointed out that underlying any
educational setting or issue or practical debate there are always four basic
dimensions or ‘commonplaces’ which had to be taken into account: the
subject matter; the teacher; the learner; the milieu (context). To ignore any
one or more of them, or to be overly concerned with only one of them, is
always to oversimplify
the educational situation or problem. Educational
progressives since the 1960s can perhaps be accused in general of being too
focussed on learners, while educational traditionalists in every generation
have tended to be overconcerned
with subject matter. Each group may feel
they have a plausible body of research evidence or a convincing ‘theory’ to
call on, but Schwab pointed out that any theoretical position that does not
include all four of the commonplaces will always be partial, in one or both
senses of the word: incomplete and/or biased. Simple theories or apparently
authoritative accounts of ‘what works’ should therefore be distrusted by
education practitioners, because there is never going to be a single ‘evidence
base’ giving simple theoretical solutions to complex practical problems.
(Shulman 2004, p.427) 2 .
The acupuncture profession’s willingness to cope with complexity became
apparent during the debates that took place about the BAcC Standards for the
Practice of Acupuncture (SPA), first published in 2006 and revised in 2008.
This documentation has set a new benchmark for any healthcare
profession
that might be seeking to describe the distinctive nature of its professional
JJ Schwab’s four ‘commonplaces’ of education
Subject matter
Milieu
Teacher Learner
7
practice or to define the more subtle aspects of its specialist professional
knowledge.
Acupuncture’s SPA document can be contrasted with the uninspiring National
Occupational Standards (NOS) that the Department for Health in recent years
has required all the nonconventional
branches of statutorily regulated
medicine and healthcare
to provide. In 2004 when the government’s request
for NOS for acupuncture came through, acupuncturists were quick to
recognise that the extreme technicalrational
view of the world underlying the
NOS initiative sat uneasily not just with their clinical and professional values
but also with the deeplyheld
educational values that underpinned the work of
their profession’s accredited teaching institutions. Between 2004 and 2006 a
working group comprising members of the Board, the BAcC and the
acupuncture teaching profession took up the challenge of drafting a document
that would more fully bear witness to the realities of professional acupuncture
practice, while still paying full justice to the ‘bottom lines’ of practitioner
competence and patient safety.
The NOS framework represents the opposite of holism, because it focuses
only on the technical, the measurable and the observable aspects of any skill
or job. Checklists
of generalised and measurable skills are relatively easy
and straightforward to produce, but educationally they are valueless
(in both
senses). As an educational tool, the entire NOS initiative provides a textbook
example of a theory that fails to meet Schwab’s basic criteria, because it
focuses entirely on ‘subject matter’ and ignores ‘milieu’, ‘learner’ and ‘teacher’.
The SPA document, by contrast, explicitly engages with the contextual
complexity of all practice and also focuses strongly on the practitioner as
learner, while suggesting possibilities for teaching and being taught as well.
However, unlike NOS, the primary texture of the SPA document is that of a
qualitative, practitionerled
inquiry. Instead of static tickboxes,
the SPA
questions generate a momentum which invites practitioners to undertake an
openended
and creative developmental path of personal enquiry. These
openended
questions about a practitioner’s experience seek to expand their
understanding of practice as well as to provide assurance about its safety.
The combination of acupuncture’s intrinsic holism and a reflective practice
philosophy familiar in higher and professional education has produced a
sophisticated professional selfhelp
document that practitioners in all health
modalities could find relevant and useful.
Despite recent political rhetoric about moving towards pluralistic or integrative
medicine, it is clear that the benefits of holistic medicine in general and the
potential of acupuncture in particular are not properly understood by the
medical and political establishment. Some practitioners are more equal than
others. That the NOS documentation has not been required of mainstream
physicians, surgeons and GPs is very revealing, for example; such a
differential approach to medical education suggests that medical traditions like
acupuncture are still being seen as subordinate and ‘supplementary’, rather
than genuinely ‘complementary’. If the acupuncture profession had to limit its
working practices to those which are capable of being expressed in the NOS
framework, its contribution to Britain’s future healthcare
provision would be
8
stillborn. It may not be the intention, but the practical effect of working strictly
to NOS guidelines would be the destruction of holistic acupuncture.
The SPA document with its holistic medical education synthesis may,
however, be only the start of the acupuncture profession’s distinctive
contribution to 21st century debates on health care and education in the
west.The following propositions from acupuncture’s holistic tradition suggest
some interesting possibilities for the future of healthcare
and healthrelated
education. Although they might be contested or dismissed out of hand by
many ‘scientific’ educators and medical practitioners, it would be foolish and
irrational not to explore these propositions fully and without preconceptions.
· Direct transmission from teacher to learner. Apprenticeship remains
of fundamental importance in the learning of acupuncture practice, with
on occasions the aetheric transfer of knowledge from master to student
in the proximity of the treatment room. Particularly within the root
Daoist traditions of acupuncture, such ‘direct transmission’, which can
also be experienced in group meditation, remains integral to the
learning and the teaching of acupuncture.
· The patient’s body of knowledge. The body contains its own wisdom
and knowledge. The meridians and acupoints
of acupuncture’s
sciences hold not only potential treatment protocols for the practitioner,
but also caches of energy and knowledge for student and master alike.
· The acupuncturist practitioner’s inner orientation. The legacy from
acupuncture’s root culture requires acupuncture educators to honour
the body, mind and spirit of every student engaged in the learning
process. The best teaching and the most meaningful learning both
derive from such holistic awareness. Therefore the ‘inner orientation’
of both student and teacher also finds itself being articulated in the
‘criteria for professional development’ of modern acupuncture courses.
The deeply holistic nature of human experience which lies at the centre
of clinical practice must also be found at the centre of acupuncture
education.
Two of the most prominent scholars of Chinese medical classics, Father
Claude Larre and Elisabeth Rochat de la Vallee, have affirmed that:
The most important thing for healing is the relationship between the practitioner, the
spirits and the patient. The relationship begins with the personal attitude and inner
behaviour of the practitioner. Your own spirits and forces must be in a good
concentration in order to be able to evaluate the patient and to be able to rectify what
is wrong in the movement of his or her vitality. It is your spirit which enables you to
make the diagnosis, choose the points, and give a feeling of rightness to the patient
at a high level – without interfering in the patient’s freedom. The treatment always
takes place inside of this practitionerpatient
relationship. 3
Because many aspects of eastern wisdom have been appropriated as soundbites
and buzzwords, the same vocabulary of holism might today be used by
a member of one of the allied health professions such as podiatry, or by a
9
practitioner of another complementary therapy such as aromatherapy, or even
by a western trained physician. What makes the language and the holistic
message uniquely significant in the acupuncture context is the notion that the
personal relationship between practitioner and patient is part of the very
infrastructure of healing; also, that the sophistication and complexity of an
unseen and unmeasurable but nevertheless real ‘spirit’ can itself be part of
the active agent of acupuncture’s efficacy. For acupuncturists, the holism of
bodymindspirit
is deeply rooted; it does not reside in the possession of a
good bedside manner or in the psychological dexterity of advising patients on
their lifestyle choices. Such superficial attributes or skills can indeed be
applied to any healing discipline and are easily acquired by many practitioners,
including charlatans. Holism, properly understood, is something deeper and
different: it goes beyond words, (which is why “defining holism” is an
oxymoron), into the very landscape of the human experience.
The profound characteristics of the holistic acupuncture tradition have
inevitably permeated aspects of the Board’s work with teaching institutions,
even though the Board itself is primarily concerned with the attainment of high
educational and professional standards. Holistic themes, initially quite alien to
the contemporary mainstream western culture, have been discussed with due
seriousness and within a multicultural
framework. Attention has been given to
the way in which such themes might have a universal relevance beyond their
eastern cultural context. For example, one debate has questioned the extent
to which the homoeopathy of 19 th century Europe created the “body/mind/
spirit” approach of 20 th century holistic western thought and how far this
western formulation dovetails, historically and clinically, with the ancient
acupuncture distinctions of shen, qi and jing (spirits, breaths and essences).
Where areas of scientific and cultural tension have arisen as a result of such
discussion, the Board has remained neutral, choosing merely to encourage
the criticality, debate and self reflection that are features of a mature
profession and of good higher educational practice. The Board itself has
never pushed one view or version of healthcare over any other. Yet by
providing a platform, the Board has also wanted to encourage the profession’s
continuing engagement with the thorny creativity that such tensions can
engender.
Health and safety offers a practical and a current example of this creativity. In
recent years acupuncture teaching institutions have fully embraced the health
and safety culture of contemporary medical practice, and the Board itself
enforces the rigorous codes that are designed to ensure safe practice. The
distinctive holistic perspective of acupuncture, however, encourages a deeper
debate on health and safety arising from a more esoteric interpretation of
‘safe practice’. When needling an acupuncture point ‘safely’, does the
practitioner not only need to wash their hands to ensure that they are clean,
but also to attend to the state of their own qi (breaths, energies), to their own
inner orientation and to their healing intention, all of which together, for some
acupuncture traditions, provide a great part of the potency and active agent of
the medical intervention itself? This approach to safe practice, and by
extension to good medical practice, has the potential to throw light on what
10
western scientific medicine chooses to call, often disparagingly, the ‘placebo
effect’.
As a common and wellattested
human phenomenon, the placebo effect
would seem to deserve openminded
investigation rather than scientific
disparagement. This vast, and currently slightly taboo, area of medicine may
one day become the arena for much of medicine’s future efficacy. But it is
already a sphere for which acupuncture can provide an infrastructure of
understanding and a route towards a sophisticated model of application. The
solid empirical foundations of traditional acupuncture and, in particular, the
mapping of over 300 acupuncture points on the human body, offer today’s
clinicians not only an avenue of remedial healing for the patient but also a
repository of knowledge and wisdom for the practitioners themselves and for
the wider society. Such embodied forms of knowledge constitute an example
of Aristotelean ‘praxis’, whereby active, practical knowledge is intertwined with
theoretical and poetic knowledge and knowledge experienced through
practice takes priority over knowledge conceived through theory. But eastern
wisdom about embodied knowledge sometimes goes further than classical
western praxis. For the acupuncturist of a Taoist persuasion, the body is the
primary gateway and is in itself a cache of wisdom and information, holding
the knowledge unmediated by intellect. As we hear from the Tao Te Ching,
the kinaesthetic mode of knowledge takes precedence over the visual:
The sage is for the belly, not for the eye.
Dao De Jing ch12 (transl. DC Lau)
In a similar vein, much of acupuncture’s knowledge of the body comes not
from dissection but from meditation.
Acupuncture’s use of ‘fuzzy logic’ 4 may mean that its practical wisdom will go
on being largely rejected or discarded by modern scientific medicine, which
remains dominated by positivist materialism. That the actions of placebo and
intention are to be found in human consciousness and in explorations of
wisdom and humility – rather than in laboratories where they can be easily
observed and measured does
not make them obvious candidates for
research funding in the current political climate. Alternatively, acupuncture
may one day be able to offer society a detailed map of how human beings can
understand the action of placebo and intention in medical practice, and also
how these aspects can be consciously brought into the patientpractitioner
relationship and scientifically worked with. There has been a steady growth in
popular awareness of mindbody
connectedness and of the inescapable
human interconnections
with nature, so perhaps there is an evolutionary
momentum behind the silent and nonaggressive
entry of such things into the
social and global consciousness. Terms like ‘holistic’ and ‘mindbodyspirit’,
currently employed as superficial metaphors in the west, may one day claim,
or reclaim, centre stage as part of everyone’s lived reality.
Conclusion A
listening silence
11
The Board’s accreditation processes have helped the acupuncture profession
to hold in creative tension its own varied lineages, while meeting the demands
of a contemporary healthcare
context. The beneficial educational sideeffects
from its accreditation work include a true scientific neutrality towards
medical models and traditions and a nurturing, as well as a safeguarding, of
professional creativity and independence. The hope is that acupuncture’s
professional creativity and educational synthesis will continue into the future
and evolve into even higher forms. While acupuncture’s fortunes have in
some respects developed encouragingly over the forty years since it began to
have a substantial presence in the western world, the dominant cultural
scientific and political context at the beginning of the 21st century still does
not allow complementary and alternative medicine to share a level playing
field with mainstream healthcare.
Yet perhaps complementary healthcare
professionals should not be seeking
too ardently to emulate or to climb on board the leaky vessel that is the
current national healthcare
system within Britain. Despite the undoubted
wonders of some aspects of scientific medicine and the huge commitment of
most of the people who work in the NHS, there seems to be a widespread
longing among many conventional health professionals for a return to more
human and less technological methodologies. A surprising number of these
practitioners, as well as a majority of the general public, might support the
introduction of genuinely holistic values into mainstream healthcare
culture.
If that seems too ambitious, perhaps at least all modern healthcare
modalities might start to explore, with the tools of their own traditions, the
dynamics and the detailed practical implications of the holism metaphors
which are in widespread use already. Also there are two ‘folk’ wisdoms that
must be restored to a central position in every health modality before there
can be a genuinely pluralistic infrastructure for health care in Britain: the
notion of selfhealing
and the practice of traditional nursing care. However far
along the ocean of technorationalism
and scientific medicine western society
may choose to travel, many acupuncture practitioners will want to go on
proclaiming the validity of these two wise traditions and of all the other
wisdom to be found in an authentically holistic approach to health.
It seems appropriate to end with a quote from Lao Zi, in 600 BCE, which was
cited in the BAcC’s Standards of Professional Acupuncture document. These
words point to, but do not define, the values of listening and witness that are
shared by both holistic education and holistic medicine.
It is as though s/he listened
And such listening as this enfolds us in a silence
In which at last we begin to hear
What we are meant to be.
Allen Parrott and Paul Hougham have both been members of the British
Acupuncture Accreditation Board, but the views expressed here are their own.
Allen Parrott is an educational consultant currently employed by the British Acupuncture
Accreditation Board and by the Kent, Surrey and Sussex NHS Deanery. He found his
12
vocation in adult education and worked as a teacher, senior manager and teachereducator
in
Local Education Authorities, Further Education Colleges and Universities between 1973 and
2001. He has extensive firsthand
experience of the whole English educational system, as
pupil, teacher, lecturer, manager and, most recently, Chair of Governors at his children’s
Secondary School. He was an early campaigner for lifelong learning and continues to write
about and
hope for educational
arrangements and curricula that will promote both social
justice and health in its broadest sense. He wrote ‘Education and the Challenge of Change’
with Ray Flude in 1979, and ‘Educational Research and Educational Practice’ with Michael
Golby in 1999. His 1991 PhD thesis explored the implications for adult learning of the
ecological imperatives which are now being widely recognised as determinants of all our
future health and wellbeing.
Paul Hougham is a teacher, writer, and traditional acupuncturist practising in the Malvern Hills.
His research interests concern the impact of the elements on health and the scope of all
branches of medicine to facilitate not just the alleviation of pain and disease but the promotion
of good health and the development of personal potential. Paul combines his practice with
teaching, writing and serving on committees of the British Acupuncture Council and the British
Acupuncture Accreditation Board. He has taught at the School of Five Element Acupuncture
in London since its inception in 1995 and is currently VicePrincipal,
focusing upon clinical
supervision and the development of practitioners’ diagnostic skills of rapport and odour. He
has trained with teachers from different spiritual traditions, including having completed a nineyear
apprenticeship with the Metis Medicine Woman, Arwyn Dream Walker, lineage carrier of
Navajo Holy Many Grandfather Tom Wilson. He also holds teachings from the Daoist lineages
of QiGong and Evelyn Carter’s vision of the Great Work. He is the author of The Atlas of Mind,
Body and Spirit published by GAIA Press in 2006.
1 House of Lords Science and Technology Committee Sixth Report, 21 November 2000,
Complementary and Alternative Medicine.
2 Shulman, Lee S, 2004. The Wisdom of Practice: Essays on Teaching, Learning and Learning to
Teach. JosseyBass,
San Francisco.
3 Larre C SJ & Rochat de la Vallee E (1990). The PractitionerPatient
Relationship, Wisdom from the
Chinese Classics. Journal of Traditional Acupuncture, Winter 19901991,
1450.
4 ‘Fuzzy logic’ is the theoretical understanding employed by mathematicians and computer
programmers to straddle the geometric certainty that limits our capacity for thinking. Fuzzy logic (of
which there are many versions and applications) will, for instance, allow an object within an equation
to be both ‘A’ and ‘notA’
in order to map the probability and possibility in between. Acupuncture’s
central dynamics of intention, and her embrace of contradiction and subjectivity, bear similar features
to the burgeoning use of fuzzy logic. Some aspect of both may, at some point, converge.

• Next >