Art & Fear
& the Cult of Done
Mindset is everything in community acupuncture: how we think about what we’re doing shapes what we do. Just like placebo is a litmus test for mindset for community acupuncturists, so is perfectionism.
I love the book Art & Fear (see above, my battered copy). Written by two photographers who are also teachers, I draw on it when I’m teaching classes on both community acupuncture and entrepreneurship. On page 29 there’s a parable (or maybe a true story?) about perfectionism:
The ceramics teacher announced on opening day that he was dividing the class into two groups. All those on the left side of the studio, he said, would be graded solely on the quantity of work they produced, all those on the right side solely on its quality. His procedure was simple: on the final day of class he would bring in his bathroom scales and weigh the work of the “quantity group”: fifty pounds of pots rated an “A”, forty pounds rated a “B”, and so on. Those being graded on “quality”, however, needed to produce only one pot -- albeit a perfect one -- to get an “A”. Well, came grading time and a curious fact emerged: the works of highest quality were all produced by the group being graded for quantity. It seems that while the “quantity” group was busily churning out piles of work -- and learning from their mistakes -- the quality group had sat theorizing about perfection, and in the end had little to show for their efforts than grandiose theories and a pile of dead clay.
That’s WCA for you: acupuncture treatments by the pound.
In a recent Faculty meeting, Whitsitt (who’s both a classroom teacher and a clinical supervisor at POCA Tech) shared the Cult of Done Manifesto, which he’s been talking about with students, especially interns in clinic. Here’s a visual representation (that you can actually buy as a poster:
Nobody at POCA Tech or WCA will be surprised to hear that I love this manifesto, especially “Failure counts as done. So do mistakes” and “Done is the engine of more”. Those two statements, taken together, are why WCA has four clinics and an acupuncture school. Without that mindset — especially on this side of the pandemic — we’d have nothing.
In a week or so I’m going to be teaching a class on intakes to first year students. You can’t teach intakes without getting into treatment planning, and this is where the concepts of acupuncture by the pound, and “done is the engine of more” really come into play. When you welcome someone into the clinic, you’re almost always inviting them to a series of treatments, because acupuncture almost always works incrementally.
As I mentioned in the last post, now that we’re pursuing a 5NP law for Oregon, I’m getting a stream of writing prompts in the form of acupuncturists’ objections. I get the feeling that some of them reflect acupuncturists’ worries that people don’t take acupuncture seriously. (There’s a lot of history behind that — more details in a future post.) In trying to legitimize acupuncture, worried acupuncturists are positioning it as similar to other healthcare interventions — in ways that it really isn’t similar. It’s important for POCA Tech students to be able to think about what acupuncture’s really like before they can confidently welcome patients into the clinic, so let’s dig into that.
Acupuncture isn’t like a surgical procedure, and it isn’t like a pharmaceutical prescription. An acupuncture treatment isn’t even equivalent to a Chinese herbal prescription, though some TCM practitioners frame it that way (the topic of “the herbalization of acupuncture” probably deserves its own post at some point).
Of course you want a surgical procedure, or a pharmaceutical prescription, to be as close to perfect as possible. In general, you don’t want your surgeon or the provider writing you a prescription to be improvising, riffing, and following their inspirations in the moment, because the stakes are too high. You want them to get it right the first time.
With acupuncture, the stakes are much much lower, there is no right and the first time is almost always just a first pass. A patient’s first treatment in the clinic is the place that you set out from, together; it’s the beginning of your way-finding, which will probably include improvising, riffing, and following your inspirations. That’s what I learned by spending several decades doing acupuncture, mostly in high volume settings: that it’s more like art than anything else.
I know that my take on acupuncture, even though it’s based on experience, gives some acupuncturists hives. I know some acupuncturists are appalled by POCA Tech’s existence (because they’ve told me so, lol) and part of their aversion is that they’re afraid I’m giving ammunition to all the people who don’t take acupuncture seriously. The red fist, the second hand recliners, WCA acupuncturists wearing t-shirts and jeans to work and calling themselves punks — it’s just not the look that the acupuncture profession was going for. And now saying loudly, in public, that placebo is a good thing and acupuncture treatments don’t have to be perfect? (If anybody’s hate-reading this newsletter, you might want to stop because it’s only going to get worse.)
Making it seem like acupuncture is equivalent to a surgical procedure or a pharmaceutical prescription may feed the narrative about why acupuncturists should be well-compensated as healthcare professionals, but it also feeds fear, unnecessary fear in acupuncturists and acupuncture students about getting their treatments wrong and also, about sharing acupuncture with other professionals and non-professionals via things like 5NP laws. That kind of fear leads to scarcity and in my experience, a scarcity mindset is no good for business. Acupuncture by the pound, “done is the engine of more”, and 5NP itself come from an abundance mindset, and they make it easier to stay in an abundance mindset.
Sometime around the end of February or the beginning of March, 22 years ago, I first saw the big empty space that would become WCA. It was much larger than I was expecting and represented much more square footage than I thought I needed at the time; it was the beginning of a kind of expansiveness that was unfamiliar to me but that I intuitively knew I could trust. Ever since then, I’ve been “busily churning out piles of work” (to quote Art & Fear), both clinical and non-clinical, and I’ve learned so much about acupuncture and myself and other humans that I couldn’t have learned any other way. There were plenty of times I felt scared and there will be plenty more. But I recommend this kind of expansiveness, I recommend it wholeheartedly — because the best way to take acupuncture seriously is by doing it.