Our podcast schedule got a bit gnarled with the holiday season and the bustle of the New Year – but we're back! In this episode, I sat down with Amanda to talk about judgment, and non-judgment, in the holistic healthcare environment.
In particular, we examine some of the things that commonly hold people back from getting care due to worries about judgment around:
- Body image, such as body hair, body odor or weight gain
- Social factors, such as identification as gay or trans, or having low income and so being unable to wear “fancy” clothes
- Political and intellectual factors, such as having a very conservative viewpoint when you believe your practitioner to be quite liberal
It's just a quick 20 minutes, and we hope it will provoke questions – check out the form on the main podcast page to share your thoughts.
My Chinese herbal lineage focuses on deep understanding of the most venerated text of Chinese herbal medicine, the Shanghan za bing lun.
The first, and most well known, part of this text (often referred to simply as the Shanghan lun) contains information about treating diseases that are caused by factors outside the body. In particular, the vast majority of the formulas in the text treat the common cold, other viral respiratory infections & the secondary infections and complications that come from them. So, you could say that I spend a lot of time thinking about the topic of colds & flus!
Different types of colds?
Chinese medicine (CM) discusses various types of colds – which we call “external invasions,” to differentiate them from diseases caused by food, drink & strongly disordered emotional states. The symptoms of the external invasion, and the method for treating those symptoms, varies based on the character of each type of cold. In the simplest way of looking at it in CM, there are colds that are more “hot type” (with higher fever, yellower phlegm) versus those that are more “cold type” (with lower fever, runnier nose).
But further differentiations exist, based on the origin of the pathogen, the health status of the person invaded, and so on. The Shanghan lun differentiates the varieties of symptoms of exterior invasion into six stages, called Conformations. The conformations are a complex theoretical construct, so we can only sketch the outlines here. If you're interested in getting a bit more information, you might want to read about it on my website for students and practitioners of CM.
The conformations relate to the way a cold develops, and also helps us to see the difference between “regular colds” and more virulent & severe epidemic type invasions. The conformations themselves include physical structures, various bodily functions, acupuncture channels and other diverse parts of the human body. In other words, each conformation is not a single structure, but a mixture several structures and functions.
In a way, each conformation is like a landscape – and as a cold travels through each of the six landscapes, the way it manifests, and the way we treat it, changes.
I list and briefly describe the conformations below in order from the most superficial / exterior layer of the body all the way into the Jueyin which is the deepest level, the most interior to the body. As disease travels through the conformations, it changes character. The more exterior layers (yang layers) look more like typical cold & flu symptoms, and so it is from the chapters describing these disorders that most of my formulas come from when I treat this type of disorder.
- Taiyang – Taiyang contains the Bladder and Small Intestine channels & organ networks, as well as aspects of our immunity, our water metabolism and more. This is the most surface layer, and when struck, the typical symptoms of a mild cold are the result. Runny nose, mild congestion, an often lower grade fever, body aches, frontal headaches and low energy can all be the result. We treat this stage of cold by forcing the pathogen out & strengthening the surface to prevent reinvasion.
- Yangming – Yangming contains the Large Intestine and Stomach channels & organ networks, and thus has a lot to do with digestion, but dysfunction here can also impact mental state (anxiety, mania) and temperature regulation, among other things. We are proceeding more deeply into the body here, and if a cold or flu reaches here, the symptoms tend to be more severe. Very high fevers, even leading to bleeding, severe headaches, sinus trouble including congestion, and certain types of hot lung conditions can all be the result. We treat this stage by cooling down the body and allowing the body to release as much built up matter and energy as possible.
- Shaoyang – Shaoyang contains of the Gallbladder and mysterious Triple Burner channels & organ networks. The impacts of this conformation can be VERY diverse as befits the layer of the body that is getting so much closer to the interior (yin). As cold or flu symptoms, Shaoyang symptoms tend to be back and forth (fever AND chills), less acute and can also hang on for much longer. People who are repeatedly getting sick within one season, but never really having a fever or serious acute symptoms are often trapped in the Shaoyang stage. This can be harder to treat, and we do so by helping to “harmonize” the yin and yang aspects of this stage.
- Taiyin, Shaoyin & Jueyin – The Shanghan lun text I have been discussing goes into detail about the treatment of deeper layers of the body as they are impacted by the consequences of external invasions. However, because these look less like what we call “cold” or “flu,” I'll not discuss them here. The same goes for the next two layers..
I hope to talk more about the conformations and how understanding them can help you respond better to cold-season illnesses. But, for now, with that general idea explained – a word on customization of cold treatment.
Different types of people, different treatments – right?
So, there are different types of colds to begin with, but there are also different types of people having those colds! One of the most important things about Chinese medicine as a distinct profession in healthcare is how we focus on the customization of treatment to the uniqueness of the individual patient. If a person is very weak, with a thin and deep pulse, not having much of a fever and the cold lingers for weeks, we will treat them much differently than a person who comes in with a big fever, big pulse and very rapidly moving illness. Doesn’t that just make sense?
You may have a different herbal formula than your partner with a similar cold!
That's the outcome of true customization of treatment. But, of course, sometimes I find myself prescribing very similar formulas to a large group of people. While customization is important, it’s also true that many people react similarly to particular colds traveling through their town. And there are some types of treatment or supplementation that help most people feel better. This is why we see standardized over-the-counter remedies on the shelves in the first place – they are a convenient way to help large groups of people. So, as a practitioner, or for you as a member of the public, we have to find the best way to balance customization and convenience.
Over-the-counter remedies and Chinese herbal medicine – the case of Yin Qiao (or Yin Chiao)
For many of my patients, the first Chinese herbal formula they ever took was in the form of several small tablets called Yin Qiao San – said to be great for the common cold. Many people swear by the remedy and keep it on hand just in case. In fact, there are some Chinese medicine practitioners who ask their patients to keep it on hand for just this reason. This formula was formally written down in a book published in 1798 devoted to exploring “Warm diseases,” so those types of illnesses that are either caused by warming factors, or expresses itself through heat type symptoms, or both.
It contains cooling, lightweight herbs like honeysuckle flower and forsythia seed pod.
This formula is appropriate for people who have hotter cold symptoms such as : fever, burning sore throat and a tendency to a more rapid pulse & yellowing tongue coat (especially as the cold progresses). In the basic CM way of looking at things, a warm or hot pathogen creates these symptoms. Warm and hot pathogens are traditionally more likely to be encountered in warm climates. If a cold came from a more cold type pathogen – such as those typical in my home in Oregon – then this formula would most likely NOT be appropriate. Further, when the cold goes into the interior, causing a phlegmy cough or profuse nasal discharge, this formula wouldn’t be appropriate regardless of the nature of the exterior invasion.
In other words, Yin Qiao San can indeed be effective – for certain types of colds and not others.
What are the potential consequences of using a formula that isn’t appropriate for the type of cold or other disorder you’re experiencing? Fortunately, Chinese herbal medicine is powerful – but also very gentle. Yin Qiao San is quite cooling, but it is also relatively easy on the body and the dose typically taken is too small to do much damage. So while there are Chinese herbs that can cause serious complications if you take them when they are not indicated for your condition, this particular example is not one of those.
That said, if you need warming treatment and take cooling herbs instead, there are undoubtedly consequences for the yang of the body. Long term, a person who inappropriately takes Yin Qiao San may find lowered surface immunity or mild digestive problems. That the consequences may not be severe in this case, though, doesn't mean we shouldn't attend to always taking the right herbal formula for our situation.
How do you avoid taking the “wrong Chinese herbal formula?”
Does the highly customized nature of Chinese herbal medicine mean that there can be no on-hand remedies a patient could self prescribe? Of course not. There are general treatment strategies that assist nearly anyone who is experiencing the symptoms of a cold or flu. For instance: increasing fruits and vegetables, decreasing sugar and strenuous physical activity and staying warm and hydrated will help virtually anyone have a better time with a cold or the flu.
But, if you would like to take a more active role to treat future colds and flus, or you have developed complications from one – like a chronic painful cough – seeking out treatment from a licensed Chinese medicine practitioner may well be part of an answer. If you come in for a visit, I will use CM diagnostic techniques, including a wide ranging discussion with you, to help determine the best treatment for an existing cold – or the prevention of one in the future. While I would be unlikely to prescribe Yin Qiao San, it being outside of my lineage and climate, I could certainly recommend a group of herbal formulas to have on hand for potential situations that would be appropriate for your constitution.
This is just a brief overview of the issues involved in treating colds and flus with Chinese herbal medicine. Questions? Get in touch – maybe I’ll write a future article about your question!
Today was such a beautiful spring day, after such a relentless winter, that I couldn't help but walk around our new place in amazement. One thing I can say about Amanda and I – the owners of Watershed Wellness – is that we tend to find beautiful spaces to live and work in. Our space nestled into the elm avenues of Ladd's Addition in Portland is resplendent – and this newest space equals it in beauty, energy and enjoyment.
Instead of describe all the great spaces in our clinic, I thought I'd shoot you a quick video with a mildly silly voiceover. I'm no videographer, and our spaces probably deserve a more professional presentation – but I hope you will feel the enthusiasm and wonder in my voice as I show you around.
I hope we'll be shooting more videos around our new home – Astoria, Oregon – to show you all the myriad ways your own local environment, and the nature you see all around, can be a free source of healing and relaxation. In the meantime, check out the page we're building to introduce you to our favorite spots in and around this remarkable town.
Check it out, share it, and by all means – come in for a yoga class, an acupuncture appointment or an ultra stress busting massage. We're ready to help you on your next steps to wellness.
Watershed Wellness has been a center for high quality natural medicine in Oregon since 2009. For many years, we had no overt movement practices integrated into our clinic – it wasn't our focus or expertise. However, Amanda Barp has been a practitioner of yoga for many years. To deepen this practice, she decided to undergo rigorous yoga teacher training in Portland – which opened her eyes to the fun & power of teaching yoga. So, it was natural to include a yoga studio in Astoria when we opened our second clinic.
But it's not simply interest and opportunity that led us to open a yoga studio in Astoria
In our clinical practice, we so often see that massage and acupuncture patients need to gain strength, flexibility and relearn patterns of movement so they can heal more quickly and avoid future injury. This preventative focus is very important to us at Watershed Wellness. Yes, we can help you once you’ve already been injured – but what’s even better is to avoid the problem in the first place. Yoga can be a tremendous boon in this regard.
While there are excellent options for yoga in Astoria, we felt that we could offer something new to complement what people are already doing well here.
Our focus is to help all kinds of people ease their way into a healthy, long lived yoga practice. Yoga is individual – there's no one way to be a person doing yoga. The most important thing is that you practice in a way that honors your anatomy, your history, and your goals for your body in the future.
Too often eager new yoga students charge into positions that aren't right for them – get injured – and end up abandoning yoga altogether to avoid future injury. This is a shame, since careful, intentful and physiologically customized yoga can relieve pain and prevent injury – the opposite shouldn't be the case.
Some people don't get there at all – instead they avoid yoga altogether thinking it is too difficult, embarrassing or woo-woo for them. Nothing could be further from the truth! This is a time tested, physiologically helpful way of maintaining healthy flexibility and strength through your entire lifespan. There are levels of yoga, and approaches to yoga, for everyone.
At Watershed Wellness, Amanda combines many years of experience studying anatomy and physiology as a massage therapist, with her excellent yoga teacher training from the Bhaktishop in Portland, OR, to create yoga classes that are just the right combination of challenge, relaxation, quiet & fun. She adapts to what each class needs, and includes information about yoga philosophy & her own lessons in practice as appropriate.
You'll find a complete class that is just right for you at Watershed Wellness' yoga studio in Astoria. And you really cannot beat the view looking out over the mighty Columbia River.
To encourage you to come try out our yoga classes we're offering an ongoing intro special
Try all our classes with the intro special – 2 weeks of unlimited classes for only $20. This will allow you to experience all the teachers' unique styles as well as experimenting with different days and times to ensure that your yoga practice gets off on the right foot.
Acupuncture treatment is one of the foundations of the clinical work we do at Watershed Wellness
This form of medicine treats a huge variety of conditions, is safe and effective, and also is great combined with massage and yoga. This makes it a natural choice to be one of our primary modalities. I am excited to share this medicine with you, including the special way we approach acupuncture treatment at Watershed Wellness.
Our acupuncture department is united by a set of principles that make our treatments safe, enjoyable and most importantly, profoundly effective for an astonishing variety of conditions
At Watershed Wellness, we’re not just an assembly of unrelated healthcare practitioners. We work hard to function as an interconnected whole as much as we can – particularly when it comes to the energy and intention we bring to the work we do. While each practitioner brings important and unique attributes to the table, where we are most united is in the vision and values behind how we practice.
Over the next months, we will discuss more about this vision and these values and how they improve your experience as a Watershed client
I think this will help you get a good feeling of what you can expect when you come in for an appointment – this one is a special bonus because it allows me to discuss one of my favorite Chinese medicine topics, the five phase elements. That's right – we're going to dive into a little bit of Chinese medicine theory – the intricate and fascinating body of information that guides every acupuncture treatment I do.
The five phase elements (also just called the five elements) are one of the more recognizable theories within Chinese medical science.
The ancient scholars who developed Chinese medicine initially had a habit of categorizing many things according to number. There are five phase elements, six conformations, twelve organ systems, and so on. This makes things easier to learn and understand and, according to the scholars of these theories, help our work as human beings to resonate with what they understood to be the fundamental laws of the universe.
The five phase elements we use so frequently in Chinese medicine are 水 water, 木wood, 土 earth, 火 fire and 金 metal (other traditions typically would add air or void instead of metal). These are connected through a generation or creation cycle (in the order written above, with metal feeding into the water) as well as cycles of control or regulation. Nearly anything can be categorized according to the five phase elements and their interrelationships, from acupuncture points to grains to stars to organ systems.
Side note : I'm going to be doing a lot more education on the basics of Chinese medicine and how this information can help you to get and maintain vibrant health – if you want to get all the latest information please do sign up for our newsletter if you haven't already.
I've articulated five basic principles that lie at the heart of Watershed Wellness acupuncture as resonating with each of the five phase elements
I think doing it this way makes it easier to understand. But, even if you don't fully grasp how the five phase elements fit into this thing, I believe you'll recognize the importance of the principles we use to guide our acupuncture practice.
Water – Deep knowledge
Water is about the depths. It is about the storage of all that is valuable, keeping it still with winter’s cold. It is about connection to ancestors and others that have come before. When it comes to Watershed acupuncture treatment, water reminds us of our commitment to constantly refresh and expand our knowledge of the world and the human body so that we practitioners can be of maximum service to our patients.
The education that American acupuncturists receive is extensive. At NUNM, where I went to school there is a strong emphasis on scholarship, independent research and adherence to the ancient, basic principles of the medicine. We are taught, early on, that lifetime study is part of our commitment as practitioners. I take this very seriously and regularly engage in all kinds of continuing education, both formally and on my own.
I utilize this knowledge every day in work with my patients, and I believe it makes the work we will do together much more effective.
Wood – Responsiveness
Wood is the springtime element. It is all change and youth and movement, like new blackberry canes emerging from disturbed soil, or like a 8 week old puppy’s constant exploration, mouthing and noise making. Wood gives us the ability to start new things, but also to respond appropriately when a situation is in progress.
Above all, at Watershed, we want to be responsive to your needs – and wood reminds us to do this. Your acupuncture treatment will be 100% created just for you – we don’t use the same treatment for everybody, and we don’t impose our will on you as the patient when something about the treatment is clearly not working.
Every time you come into the treatment room, I will reevaluate your situation, discuss your experience during the last treatment, and do careful diagnostic work to ensure that your treatment is exactly what you need in that moment.
Fire – Connection
Fire, the phase element of the Heart, is the ruler of intimacy, of connection between people, and of building community. Fire is warmth, brightness, life giving. It’s also associated with the summer solstice – that high time of joy, experiencing and flourishing.
Watershed acupuncturists pay special attention to the fire element when we engage in our work. We believe that the swiftest and most long lasting healing comes when patient and practitioner work together to address whatever needs to be addressed.
We connect with you, get to know you as a person, and hope to become trusted advisors. We make sure that you understand the treatment, and are OK with what’s to come and respect your boundaries at every step. That connection and Heart is part of what makes treatment at Watershed special.
Earth – Comfort
Earth is about nurturance, solidity, safety and comfort. Earth is at the center of our digestion, and is injured whenever we have to worry about ourselves or other people. When we pay attention to Earth in our acupuncture treatment at Watershed Wellness, we are putting your comfort at the forefront of what we do. You can see this in our waiting room, in the softness and warmth of our treatment tables, and more. This comfort allows you to feel more relaxed and safe, which in turn seems to make treatment more effective.
A note about comfort, here. Sometimes, you will have sensations during needling that can be uncomfortable. While I always seek to make sure we don’t push you beyond a tolerable level, some discomfort is usually necessary in order to treat disease. The principle of Earth doesn’t guide me to avoid that. It simply means that we will always be checking in, always making sure that you’re still OK with what’s happening, and doing everything in our power to make your total experience comfortable and relaxing.
Metal – Safety
Metal, of course, has the most direct resonance with acupuncture given the material of acupuncture needles. Metal otherwise is about letting go, about autumn, about balance and justice. Metal calls us to be precise, to make clean breaks, to keep everything in its place – and as such becomes a primary arbiter of safety. At Watershed, we take acupuncture safety very seriously.
We abide by all state regulations and professional commitments, of course, but go above and beyond that to ensure that you never have to worry that acupuncture treatment will create problems that weren’t there in the first place.
Another way that metal comes into our clinical work is in the simplicity and precision that lies at the heart of classical acupuncture treatment. While some traditions use large numbers of needles, the acupuncture we practice uses only as many needles as absolutely necessary to ensure a positive outcome. This minimalism means that we have to diagnose very carefully and be extremely precise with our creation of the point prescription. This care increases the safety of your treatment while also making it far more powerful.
We look forward to discussing these principles with you more in person – you can get on the schedule any time.
As we've discussed on our Portland website, on our Facebook account and via our new Watershed Astoria newsletter, we're opening a new clinic here in Astoria! We will be inviting the first appointments and classes in starting January 17 – assuming everything goes more or less according to plan.
But how did we end up opening a second clinic focused on health and wellness in Astoria?
Good question! We'll hope to tell more of the story of how the clinic opening has been here on the blog and on the newsletter in the coming months. But the shortest possible story is simple. In March of 2016, we (Eric and Amanda) manifested our vision of moving our home base to Astoria, OR from Portland. But, instead of closing up shop in Portland – a place we still dearly love – we decided to expand! Thus you have Watershed Astoria.
The two locations will have different modalities, different foci, and yet maintain the same commitment to customer service, quality work done by intentful experts and a spirit of joy and fun in everything we do.
One of the most notable differences between the two clinics is in what we're offering. In Portland, of course, we offer Chinese medicine, Naturopathic medicine, skin therapy and massage therapy. In Astoria, we will be focusing on Acupuncture, Chinese herbs and massage therapy as far as medical modalities are concerned. While we may expand from those initial healthcare offerings, we are hoping to first focus on providing the best possible acupuncture, Chinese herbs and massage as we can.
One of the most exciting things about the new location is that we will be offering Watershed Yoga to the Astoria community
Amanda Barp, co-founder and chief massage therapist at Watershed, completed yoga training at the Bhaktishop in Portand. While she started school at her favorite studio mostly to enhance her own practice, as she went, she discovered how what she was learning about yoga meshed with what she already knew about the human body through her 10+ year long massage career.
This sparked further study and a deep immersion in her studies which resulted in her being asked to teach a class at her alma mater studio! This honor has allowed her to learn so much about yoga in a short period of time – particularly how she can help new practitioners to do yoga safely, no matter their age or mobility impairments. This passion drives her today.
We will be writing a lot about Watershed Yoga on the blog and through expanding the main Yoga page on this site. To give us a chance to make sure the studio is perfect for you, we'll be delaying the start of classes until February 1. Those first classes are already available for you to register if you're excited to get started.
To help jumpstart a vibrant yoga community at Watershed, we're offering 50% single classes and 5 class packs through the entire month of February 2017.
To take advantage, just use the code ASTORIAOPEN if you pay for your class online, or mention the discount if you pay in person.
We'll be sharing more about what's new at Watershed over the next several days. Stay tuned – and if you would like to have the latest articles sent direct to your email – sign up here.