When we talk about tonifying and draining, one of the main ideas in Meridian Therapy, beyond all the various techniques, is that the more one feels pain or other strong sensations from the needling, the more draining the needling is. This is quite distinct from the more standard Chinese practice of deqi, which is considered necessary in TCM acupuncture whether the technique calls for tonifying or draining. The Japanese view is similar to the Arndt Schultz law which states that weak stimulation promotes life processes while strong stimulation inhibits them.
Part of the characteristic nature of most of the Japanese classical styles is this idea that weak stim is therapeutically useful, even desirable. Where TCM acupuncture relies on the patients’ report of the needling sensation, or the eliciting of the muscle twitch which grabs the shaft of the manipulated needle, Meridian Therapy and its related styles rely on their systems of subtle feedback (pulse, hara, etc) to inform the clinician that the needling is having the desired effect.
Needle Techniques
There are many techniques taught by the various acupuncture organizations in Japan, though they break down to only a few basics. On the one hand, there is inserted vs non-inserted needling, and on the other, there is retention vs non-retention of needles.
Inserted Needles
There are two basic types of inserted needles: retained needles and non-retained needles. Retained needles are inserted, either with a tube or manually, and the needle is left in the point for some time after the insertion. There may be manipulation of the needle before leaving it retained, or it may just be inserted to the desired depth and left without manipulation. For Meridian Therapy, the depth of insertion is usually less than 10mm, often between 1-5mm. Depending on the brand of needle, just tapping the needle through the tube gives an insertion depth of 3-5mm. Some sources say that the optimum depth of insertion for tonification is 1-2mm, so that the needle tends to flop over unless it is very short and thin.
Non-retained inserted needling is sometimes called “simple insertion”. In simple insertion, the needle is inserted, sunk to the desired depth, and removed. There may be brief manipulation, or it just may go in and come out at once. I use simple insertion often, mostly on points where it would be either difficult to retain the needle or possibly hazardous to retain it. An example would be GB21; I would rather not retain the needle there since there is a risk of hitting an important structure such as the lung. Many patients move around quite a bit in a recliner and even on a table and retained needles can go in deeper or at a different angle than one intended.
Simple insertion is a common technique in Japan, but in my experience it is virtually unheard of in America. Sometimes when I mention it to other acupuncturists, they think I am joking. But I find it quite effective and it solves some problems with retaining needles in awkward places.
Non-inserted needles
Non-inserted needling is sometimes called “contact needling” (sesshokushin). In contact needling, the tip of the needle just makes contact with the surface of the skin. This is the foundation technique of the blind acupuncturists I studied with for many years. To accomplish this technique, the needle shaft needs to be supported by the non-dominant hand, usually with the thumb and index finger. This is called “oshide” or “pressing hand”. In truth, the oshide is used in Japan even when inserting needles, as the light pressure from the fingers helps to reduce the sensation of needling and keeps the thin needles (my preferred needle is 0.12x30 mm) from bending. In America, however, Clean Needle Technique discourages this technique, so it is best to use it only when doing contact needling or very superficial insertion.
As subtle as it is, contact needling can be surprisingly effective, especially on the sensitive areas of the hands and feet. A variant of this method is the use of a teishin, or rounded needle, which is a needle-shaped probe with a rounded tip, often made from various precious metals (gold, silver, copper, etc) to enhance their effects.
Contact needling is most often done on acupuncture points, but there is a technique of contact needling called sanshin, “scatter needling”, which is performed over a larger area such as the upper back or abdomen. In this technique, a single needle is touched to the skin repeatedly in a somewhat random fashion, quickly stimulating the desired area. It requires a great deal of practice, the early stages of which usually results in the acupuncturist sticking their own fingers a few times.
I use these techniques in virtually every treatment, and frequently combine them depending on which points I am treating. For example, I may use contact needling or teishin on yin channel five-phase points for the root treatment, followed by retaining needles in yang channel points, with some simple insertion or sanshin to areas of tension. I don’t aim to get deqi; rather I watch for autonomic cues like the patient’s breathing rate and depth, abdominal sounds, color and temperature changes on the skin, and so forth. Interestingly enough, sometimes deqi comes anyway, patients may comment on it even when I am using contact needling or a teishin.
I have frequently heard the complaint from colleagues that they attempted to treat with these methods, but they didn’t achieve the desired effect. I think part of the answer is practice, but I also believe that the process of locating points needs to be adjusted as well. I will write more about this in an upcoming post.
Note: this newsletter is for information purposes only and is not intended as medical advice. Please seek the opinion of a health care professional for any specific medical issues you may have.