IM4US Conference Recap (and Intro to the Blob)

Last week one of POCA Tech’s Advisory Board members, Tyler Phan, and I presented at Integrative Medicine for the Underserved’s annual conference. Tyler talked about the professionalization of acupuncture and I talked about re-imagining acupuncture safety (including why our AERD is a form of prefigurative intervention, more about that in a minute). This post is a re-cap, as well as an introduction to a series of posts about the acupuncture profession.

One of Tyler’s main points, the truth and the value of which can’t be overstated, is that acupuncture as medicine and acupuncture as a profession are not the same thing. The acupuncture profession has been making a concerted effort for about fifty years to argue that they are, but if you look closely enough at their respective histories, you’ll see that they aren’t. And the difference between them is particularly important for community acupuncturists -- as well as anybody else who is interested in acupuncture safety -- to grasp.

According to Tyler, the best metaphor for the medicine of acupuncture is the kids’ toy Slime. Remember Slime?

Slime is a non-Newtonian fluid, which means it behaves like a solid and a liquid at the same time. It oozes, it’s viscous. It’s hard to wrap your mind around its contours because they’re always changing. If you put it on a flat surface, it spreads out; if you put it into a container, it takes the shape of the container. Otherwise it doesn’t really have a shape. One of its most significant characteristics is how it sticks to things and how things stick to it, how it adheres and is adhered to. Its nature is to be shapeless, sticky, malleable -- and fun to play with. Acupuncture is a blob.

Acupuncture as a medicine adheres to cultures. It sticks to some (Chinese, Japanese) better than others (Western European), but it doesn’t belong to any of them. Nobody can own it or even control it without changing its essentially blobby, squishy, sticky nature. Sometimes things get stuck inside it --like a Lego block or a piece of hair or a theory about how acupuncture works -- but they’re not actually part of the Slime itself.

Professionalizing acupuncture is like taking Slime and putting it in the oven (which is a thing you can do with it). But then it hardens into a fixed shape; it loses its unique texture and essential nature. It becomes brittle instead of flexible and malleable. Whatever got stuck inside it is now VERY stuck and you can’t pry it out without making the whole thing crumble. Once it’s set, you can’t easily add things or take them away anymore. You can’t play with it.

I’ve been thinking so much about how people resist uncertainty, even though for safety purposes we need to embrace it -- but it hasn’t occurred to me until now that the squishy contours of acupuncture as a medicine versus the hard edges of acupuncture as a profession are probably related to our anxious impulse to nail down everything we possibly can. Blobs make us nervous. According to Tyler, professionalization is something that modern people like to do, period, regardless of the field being professionalized. However, professionalization isn’t working out well for acupuncture, and I wonder how much of that has to do with how averse we are to its natural form (or lack thereof).

Here’s the slideshow from my conference presentation about re-imagining acupuncture safety.

And here’s what I hope POCA Tech students and others will take from this presentation: the process of regulating and professionalizing acupuncture, although it leaned on public safety as a justification, had little or nothing to do with actual safety, particularly as we understand it now in light of concepts like harm reduction and trauma informed care. As a result, the acupuncture profession doesn’t have a culture of safety. The acupuncture profession’s approach to safety is a lot like hygiene theater for COVID, except instead of obsessing about surfaces we obsess about degrees and credentials.

Our AERD is a way to create a healthier culture around acupuncture safety, even though the acupuncture profession as a whole couldn’t be less interested in it. Prefigurative intervention (check out this image) is an action that models “the world that is possible”. Changing our relationship to acupuncture safety is something we can do for ourselves, right now, even if no other changes are currently accessible to us. It’s one way to be open to a hopeful future.

It would be good if POCA Tech students could contemplate Tyler’s Slime metaphor for the medicine, particularly what it means for community acupuncturists. For me this metaphor is a big relief, because it fits so well with my experience of practicing acupuncture. The community acupuncture model is one container you can put the medicine (the blob, the Slime) into. And it fits there. It holds a useful shape, one that creates access to treatment for many many people.

Ever since community acupuncture became a thing, there’s been consternation about what it might mean for the acupuncture profession as a whole. I think the Slime metaphor really clears that up. We’re not “devaluing” the medicine or “degrading” the traditions or anything else we’ve been accused of. Community acupuncture is one shape that the blob-like medicine of acupuncture can take, one expression of its inherently flexible nature. Community acupuncture just doesn’t have much in common with the hardened form of the profession. (More on this in a future post.) At POCA Tech, we’re following the laws that the acupuncture profession created so that our graduates can practice legally, but that’s all; we’re not part of the aspirations or the plans or the visions that the acupuncture profession has for itself. We’re something looser, weirder and more connected to other divergent shapes that the medicine has assumed over its long history. We’re stuck to the blob and the blob is stuck to us.