I recently had an opportunity to sit down with Stephen Higgins, L.Ac. He spoke about the importance of maintaining inclusive awareness with patients, how herbs can be our teachers, and of his study and practice of the richly precise and complex Shen Hammer pulse diagnosis system. Here is what he had to say.
Sarah: How do you perceive your role as a healer?
Stephen: A big part of healing is offering the support that’s needed at each stage and for each person–really being there for whatever the person is going through when they’re going through it. Part of what we get to do as healers is to situate ourselves on whatever path our patients are on. We get to look and say, “Oh, you know, you take this side road a lot, and it doesn’t really get you going in the direction you actually want to go in.”
One thing I like to do is to provide resources for patients–to figure out what exactly is the work that you want to do with me, to make sure to work with the things that you find important in your own life. Not just, “Oh, you have this chronic issue, so let’s treat it.” Instead, it’s like, “Okay, well here’s where you are with this chronic issue, and here’s what it’s brought up for you, and here’s how you’re learning and growing through it. And, yes, you happen to have this pain and acupuncture’s great for that, so we can do that; but where does that pain find itself in your life?” I think it’s really important to–as a holistic healer–nest each of the parts of the person within the understanding that they are a whole person, and not forget for a moment that there’s a complete unperturbed human spirit there that’s available for healing. That’s really what I like to work with. To go in and tug at the heart strings of that. That’s the important work.
Sarah: It’s like a reminding, helping the patient remember their wholeness instead of just fixing the fragmented pieces.
Stephen: Definitely. Yes. But there’s a time and a place for that, too. When a fragmented part needs healing, we want to give it healing. We want to do it in the context of that part integrated within the person, so that it can be in service of their healing and growth and betterment and the diminishment of their suffering. We all have a body and they’re not getting any younger, and we have to acknowledge that that’s also true, and that, actually–in a life well lived–while there is a slow corrosion of the physical body, there’s also a polishing and refinement of that which is greater than the physical body. As a healer, the onus is on me to be available for all of those different parts of the person.
Sarah: So you bear witness.
Stephen: Yes, that’s a good way of putting it. In a treatment setting, whatever is important for the patient is important for me. And what’s also true is that there is a responsibility that I have to figure out what is going to be best for the patient. And that’s a conversation between me and the patient–the wounded parts of the patient, the parts of the patient that have the knee pain, the parts of the patient that have had chronic low back pain for two decades. But it’s also a conversation with the part of them that’s in the driver’s seat, something like: “what do you want out of this treatment and how can we get that for you in a way that resonates?” I’m happy to say that often I don’t have the ideas, that those are ready and waiting–sometimes in a nascent stage–in a patient. Often, though, it’s part of my job to be a teacher. That is, if the person had all the answers and knew how to implement them well then they wouldn’t have come in to see me in the first place.
At times, there’s not a lot of clarity around what they want in their life. There’s just a feeling of stuckness or of wishing for a different kind of life and not really having a clear trajectory on how to get it. So part of what I like to do is to go in there with them and unmuddy the waters: “Okay, let’s get some clarity here so that you can see what you want and then you can share that with me if that’s appropriate for you, and we can get it for you together.”
Sarah: So talk to me about how you use pulse diagnosis.
Stephen: I’ve studied for the past eight years or so in a pulse diagnosis lineage that’s usually referred to as Shen-Hammer Pulse Diagnosis, as Dragon Rises Pulse Diagnosis, or as Contemporary Chinese Pulse Diagnosis. It’s named Shen-Hammer pulse diagnosis after the two men that collated all the information that had been passed down since the early 1600’s and made it available to Chinese medicine practitioners in the States.
Dr. Hammer is now 91 years old. For the past five-or-so years I’ve gone to Florida every year to study with him and hone my skills. But what is pulse diagnosis? Traditionally one of the four diagnostic methods of Chinese medicine is palpation, and that includes palpating, or touching, sensing the radial artery at the wrist. This particular form of pulse diagnosis has been refined over the past four centuries or so in order to hone in on the different organs of the body, the different functions of the body. We can assess things like hemorrhages or aortic aneurysms. Or we can find evidence for past surgeries that haven’t quite healed all the way. With some training it’s really easy to access things like pain or anxiety, depression, resignation, perfectionism; these states of being are common these days. We can find evidence for all of those things on the pulse.
One of the things I like to say is that “the pulse doesn’t lie”. It’s a way to cut through all of the stories the patient might have, or ideas they might have about their case, to get right to the root of something and say, “This is happening. We have objective evidence to support the fact that this is a pathology that’s happening for you and that it’s important in your case.” We actually rate the importance of things that we feel on the pulse based on how readily available they are to feel at the fingertips. Essentially, the louder the body is screaming out a message the easier it is for us to hear and then to actually do something about it.
I have taught this pulse system now for about three years. I have worked under different mentors in the lineage in order to hone my skills, and I’m now able to get a huge download of information in a relatively short period of time based on pulse findings. It’s the most reliable method I know of for getting a clear snapshot of where a person is in terms of anything they’ve experienced in their body, in their spirit, in their mind up to now, the interventions we can take at present and in the near future, and the outcomes we can expect with or without that treatment.
Sometimes in the experience of taking the pulse of relatively young people I find evidence of disease processes in their earliest stages. Say I’m taking the pulse of a man in his early 30’s in whom, when I go to feel the pulses that correspond to his heart organ, I find evidence for the beginnings of pathology there that could, further down the line, become things like heart attacks or strokes or all sorts of cardiovascular diseases. Things that–found when a man is 30–we can actually prevent or postpone. In many cases we can change the course of the disease process.
Sarah: Such a far cry from allopathic medicine’s way of responding.
Stephen: Yes! It’s preventive medicine in the truest sense, and the pulse is amazing for it’s preventive capabilities–to be able to find a potential pathology instead of finding a full blown stage four pathology. In allopathic medicine they talk about regular screenings for certain things: “Any person over 50 should have a yearly colonoscopy” or “women over 30 should have an annual.” They’re talking about screening so that the practitioner can find something once it’s becoming manifest. One of the beautiful things about Chinese medicine is that we conceive of the body as essentially existing on a spectrum from the most rarified energetic aspects to the most physical aspects. So if we can, say, find a liver pathology before it’s crystallized into cirrhosis, if we can say, for example, “Hey, maybe this weekend drinking that you’re doing isn’t leading to headaches or skin rashes in your friends, but there’s clear evidence to show that your liver is pretty unhappy and that this habit is directly related to your presenting symptoms,” then we can step in and affect change on the level of behavior that then affects the physical body and prevents serious disease from taking place.
Sarah: And then you’re able to treat from more than one perspective. You’re not just going to treat someone’s liver. You’re not just going to treat someone’s digestion. You’re going to treat their whole being.
Stephen: Exactly. Because we exist on a full spectrum, there are interventions we can take on multiple levels. For instance, a patient might have a really solid yoga practice, and we can utilize that yoga practice for what it gives them on a physical level and for what it gives them on a spiritual level–or a level of quieting their mind–and make that an asset in their treatment.
We can see with the pulse how a person tends to use their activities. We can see the behavioral patterns the person has, the cognitive style they have, their tendencies, their genetic predispositions. In short, we can see how their behavioral patterns end up manifesting as a benefit or a detriment to them in real time, and we can help them change the way they really approach life.
Sarah: Say more about how your practice is informed by psychology.
Stephen: I feel so much gratitude for the teachings that I’ve received from Dr. Hammer and from Brandt Stickley. The transmission of that information happens on such a deep level. Dr. Hammer was an MD, a psychiatrist, so the way that he approaches Chinese medicine is through a lens that includes the psyche and the soma, the mind, the body, and the spirit of a person. Whenever I’m taking a person’s pulse, I’m explicitly looking for information on all of those levels so that I can figure out, essentially, what is going to be the “lynch pin” for this person’s case; I’m curious as to what’s going to be the key that unlocks their patterns and can have a ripple effect down into them.
I would say that I tend to practice in a way that is psychologically informed. Through all the training that I’ve had in this pulse diagnosis system from teachers who are, if not psychiatrists per se then well trained and well informed as to how the mind and body interact, I tend to use the therapeutic relationship as a treatment modality. This is to say that the way that I interact with patients is “on purpose”. It is not to say that it’s contrived or, say, that I’m coming at it with preconceived notions of how you approach “a female in her mid 30’s”, or how I need to approach a “blue collar man”, or how I need to approach any person. In short, I intend to give each patient a deep compassion and empathy derived in part from an understanding of how they themselves experience the world.
Something else that informs my practice that seems relevant in this context is that I’ve had a fairly long term relationship with taichi and with qigong, with meditative practices, and I’m very cognizant of the fact that there is such a thing as the “teachable moment”: that every moment presents an opportunity for going deeper, or for respecting the fact that perhaps a patient doesn’t want to go deeper right now. There’s always an opportunity to grasp and to actually do that together with the patient is part of the work that I do.
Sarah: To come to greater awareness.
Stephen: Exactly, to come to inclusive awareness of what’s happening. One of the ways in which I work is to foster an inclusive awareness in the patient. In simple terms that is just pointing out what’s actually happening for a patient in a given moment. It might be as simple as saying something like, “I’m noticing that when you talked about your knee pain, you looked really sad. Did you notice that?” Or “You know, I noticed that when you brought up your son, you looked so joyful.” Or “Do you notice how every time you talk about your shoulder pain you tend to hold your breath?” Something like that, to get the different pieces of a person to connect. Without an inclusive awareness of all the pieces, without being able to explicitly pick them up, turn them around in your hand and feel all their edges, you don’t really know what those pieces feel like. So, in order to go toward a person’s wholeness, we pick up all the different parts and figure out where they fit into this beautifully kaleidoscopic, complex person that happens to be there. I like to honor that much of the healing potential is innate within the person. I like to follow the axiom that every person who comes into the clinic is already whole, and we just need to figure out where all the cracks are that we need to fill in.
There’s a concept from Buckminster Fuller’s work, which he calls “tensegrity”. I think the Rolfers use this term. It describes how, just in order to stand up, for instance, there has to be a dynamic tension that’s happening between the bones and the muscles. Even thinking of standing up will cause certain muscles to start firing. In order to create a standing body we have to go through all these motions that for us, as adults, are intrinsic and often taken for granted. But in order for a child to stand up, it takes a whole lot of efforting, to move this part, and tense this part, and relax this other part, and allow the body to come into an erect posture. To hold that position, there might be some wobbling, there might be some shaking.
This burgeoning walker is going to go over and find some bolstering from the chair or make it two steps to the coffee table, and then realize (or not), “Oh, I’m a little too heavy on the backside and then fall down onto their diaper-padded bottom.” And I actually like to think of moving through any disease process as having a similar trajectory–that, at certain points, we might need bolstering from a “chair”; we might need herbs in order to calm down the inflammation that’s happening in this part of the body in order for another process to come in and allow for deeper soothing, for instance.
Because I practice in a psychologically-oriented way, I will often approach a person’s case with questions like, “Sure, they’re anxious, but what is the part of their system that’s the most agitated?” And for the modern human being often times that is the nervous system: we’re in traffic for 30 minutes sitting between two other cars that are too loud, the semi goes right by us, there’s honking, there are flashing lights. Our nervous systems aren’t really evolved to handle that kind of stimulus, so most of our nervous systems are a little bit rattled. For a person who is vulnerable in that system already, it’s going to be a weak link that causes other systems to break down. So coming in and soothing the nervous system in a person like this is a way to allow for the healing of, say, the musculoskeletal system to take place.
On a really simple level, if a person has a lot of tension held in their musculo-skeletal system as a result of their nervous system being racked–as a result of them being in this fight or flight state all or most of the time–then healing of the musculoskeletal system isn’t going to be able to take place. Dr. Shen–who was Dr. Leon Hammer’s teacher, and who brought the pulse system from China to the states–was primarily an herbalist. He didn’t do much acupuncture, and the pulse system is informed by that. So often times I’ll have diagnostic findings that indicate specific herbs. I know, for example, that these herbs treat this sort of syndrome well and they’ve treated this thing well for the past thousand years, so there’s no reason why they can’t treat it well in you.
Sarah: Say more about how you use herbs.
Stephen: In terms of on-the-ground training, I went to NCNM and worked with Heiner Fruehauf; I took herbal formulas classes from him and then went on to become his teaching assistant for, let’s see, at least two school years. So I had three-or-so academic years of being steeped in his methods of herbal prescribing. My understanding of his system is that half of it comes from classical Chinese medicine formulas and half of it comes from learning empirically–from his teachers or from his own extensive practice–that, say, certain sorts of herbs treat certain diseases or symptoms really well. The formulas that end up being prescribed may or may not be from the classical lexicon of Chinese herbal medicine but they happen to be really effective, so we’re going to use them. The way that I prescribe is informed by Heiner’s way of prescribing.
Another way that I prescribe is based on my training in the pulse lineage, through Brandt Stickley and ultimately Dr. Shen. Often, I give a patient two formulas because it’s rare to find a patient in whom there’s only one system that’s been problematized: It’s rare to find a patient that doesn’t need support on multiple levels, and I want to give that support on those multiple levels so that they actually get better. Going back to the newly-able-to-walk toddler analogy, they need firm ground below their feet and they need the coffee table for support; they need something to lean on but they need something to hold them up in the first place, too; And they need the energy and strength of their body to move them through getting that support.
I’ve treated a few patients that have had M.S. and energetically-similar conditions, and often a patient in that sort of situation–let’s say a patient with M.S., Chronic Fatigue, or Fibromyalgia… often this sort of patient’s body has become so weakened that it can’t accept a whole lot of support. Support is actually crushing to them. So, on some level, a patient who is that weak needs to be strengthened in addition to having their nervous system calmed or things cleaned out of the brain or their digestion overhauled.
In practical terms, I would say that anxiety, depression, insomnia, digestive issues, headaches, and migraines are things that I’ve had good results with so far–and herbal medicine is indispensable in treating these cases.
Sarah: So with the herbs you can work on really subtle levels.
Stephen: Definitely! Yes. For example, herbs can work on really subtle levels in terms of bringing a foundation of calm into a person’s experience of anxiety or worry over time. I have patients who come back two weeks after I’ve first prescribed the herbs and I’ll ask about their anxiety and, while they can’t exactly describe how it’s different, they’ll say something like, “I feel calmer”. And then maybe two more weeks down the road we’ll talk more about this symptom and they’ll actually be able to say specific things like, “Oh, you know, I noticed how someone cut me off when I was driving to work and I just kind of let it happen. I didn’t get angry. I didn’t get agitated. I got to my desk and I realized, oh, wait! I’m arriving here at work and I’m not already stressed out!” It’s going from the more subtle understanding of how their body is working differently to more concrete realizations of how it’s actually affecting their life.
When it comes down to it, we work on the person’s relationship to their own energy and how they want to use it. “Behavior modification” is a relatively clinical way to say that, but in more down to earth terms I’m talking about helping patients to get to a level at which they’re asking things of themselves like, “How much energy do I have?”, “What are its limits?” and “How do I want to use it?” Then getting really clear on that stuff… And getting the person to have more energy and more clarity so they’re actually getting to do what they want to do.
Sarah: Would you say that the herbs can be our teachers? That they can teach us how to deepen our awareness?
Stephen: Definitely. So one herb that comes to mind right now for me is Evodia. That herb is superbly effective for treating migraines. From a biomedical perspective Evodia has compounds that are able to cross the blood-brain barrier and decrease inflammation in the brain. From a Chinese medicine perspective, it’s going all the way up to the crown of the head in order to bring this energy that’s kind of frenetic back down into the body so that that energy is available to the rest of the body for normal functioning. So, on a subtle level, that experience goes from feeling throbbing and pounding and sharp shooting pains and auras going on in my head to that energy coming down into the body so that my body can function normally. On a less subtle level, that’s taking energy–energy that in fact belongs to you but happens to all be in your head–back down into your body so that you can utilize it.
Evodia is really good at tonifying liver yang in Chinese medicine terms, and that is essentially a person’s ability to step into asserting. Sometimes I’ll actually tell a person: From the pulse I can see the trajectory your migraines have taken thus far and we’re going to have to walk backward through that trajectory in order to get to a place where we’ve reversed the pathology and you’re in a healthier state. As we walk that trajectory here’s what’s likely going to happen: First you’re going to feel a little more tired because all that energy in your head isn’t as available. Then you’re going to feel like you have more energy but you’re going to notice how you have a habit of putting that energy back into your head because that’s where you felt like it belonged. And then it’s going to come back down into your body, and then you won’t feel quite as tired but you might feel agitated, and you might feel angry, and you might realize, “hey, you know those boundaries people have been overstepping? That doesn’t work for me anymore. So you actually start to assert yourself in the world with that energy that had been yours the whole time. You just had a habit of using it in a way that didn’t serve you.”
In a nutshell, I would say that, by having an inclusive awareness of all the different parts of a person–the way that a person feels in their body, the emotions that a person has, the aspirations that a person has, the way that a person problem-solves and finds strategies for things, the fears that a person has, whatever shows up for a person–that by being aware of all of them, all of them can get some healing and become more and more integrated such that the person can move as a whole person, so that the person can be aware as a whole person. “You know this wrist pain that I have from playing the guitar too much? Maybe if I play for 30 minutes three times per day instead of an hour-and-a-half all at once, maybe then I would feel better in my body. Maybe I would be a better guitarist, too. I wouldn’t be playing from a place of such tension and stress and obsessiveness.” Yes, we can stick needles in the wrist and get the wrist pain to go away, but if we don’t effect the reason why the wrist pain happened in the first place, then not only is it going to come back and potentially get worse, but we haven’t really treated the person. We’ve only treated the wrist, and I’m interested in treating people.
Sarah: What brought you to Chinese medicine?
Stephen: When I first received acupuncture, I was an undergraduate. I was studying piano pedagogy, and I was one of those people who was over-practicing in a really obsessive way. I got acupuncture and even at my first session I realized how profound it was. It offered me relief the way that nothing else had. But then I went back to practicing the way I had previously in order to finish my Bachelor’s and eventually got tendonitis and pretty severe pain. That lead me to realize how just sticking needles in people doesn’t really treat the person and that we have to treat the person as a whole. I think it’s been my own process of walking through something that on a surface level was tendonitis and body pain and then, on a deeper level, was the way that I used my energy–the way that I approached something like practicing the piano. In retrospect, I can see how my underlying desire for mastery manifested as overwork. I’m essentially describing my own healing in coming to clarity that “oh! Actually, it’s just important for me to master things, and I’m okay with that taking a little longer than I maybe expected it to.” That ongoing healing process makes me a better healer.
Sarah: Do you still play piano?
Stephen: I do still play piano. But I don’t play an hour and a half straight anymore! <laughter> But, yes, I do still play. And I love it. In fact, I plan on putting together a concert for maybe this winter. It really opens my heart to be able to express through music and share these things that are beyond words with others.
Sarah: And your ability to go there undoubtedly enhances your healership.
Stephen: Certainly. Piano brought me my healing, and what the piano has taught me is inevitably a part of the way that I help others to heal themselves, too.