Chinese Medicine in the West 2009 Journal of Chinese Medicine. Number 90. June 2009 it is really quite complicated. On the one hand good lifestyle advice, that style shou you have what Peter describes, then you have the become more dominant over time fact that some Westerners have been in China for a long time and come up with all these names like PD: When we say "lifestyle advice", that in itself is a very big subject isn'tit? I'm particularly interested in health medicine and so on, all competing with each other, preservation, which intersects with the practice of and then you have the development of acupuncture Chinese medicine. That is one of the great strengths for purely commercial reasons, so that it is not so of the tradition that i feel connected to, as much much about medicine any more, but more and more the actual practical delivery of the medicine. And the about"wellness"and"well-being", such as cosmetic tyle advice that is given by someone rooted in acupuncture, and IVE. These developments turn Chinese health preservation and Chinese medicine, away from medicine as being concerned with curing is going to be different from the advice given by a disease, and that could be seen as one aspect of doctor, or a physiotherapist for example. It also goes losing ones roots, or losing ones claims to being an a little bit beyond lifestyle advice, because it implies alternative. Though on theother hand, you could also a particular understanding of what human life is say that the entire notion of"alternative medicine For example regulation of the emotions, certainly was wrapped up from the beginning already in this within Confucianism, Taoism and Buddhism, is an white middle-class concern for well-being, and what absolutely fundamental part of being healthy. I'm some call the psychologisation of acupuncture has not sure necessarily that what people offer as lifestyle been well-documented, of course, by Linda barnes advice really connects with those traditions and others HM: I think it's very varied, people bring to their FM: That is something that concerns me, the inclusion relationship with their patient their experiences and of Chinese medicine into "Complementary and their background, and hopefully, if they are good, Alternative Medicine"-often called "therapie they find some way of connecting with the patient rather than medicine. I still think that it is not where that patient needs some help. That's the ideal, understood what Chinese medicine is, that it is a true and that's different for each patient, and different medical system in its own right, that can understand practitioners have different levels of skill. Maybe and treat serious disease. So the"acupuncture for lifestyle advice"is too broad a term, but if they are health and well-being"that is out there does worry thinking"how can I help that patient maintain any me, because there is this idea that we are not treating mprovements that might come from the treatment there are all sorts of things that could be in there, it's very difficult to map in any systematic way, HM: If you look at the membership of the British because it is so varied Acupuncture Council, and I think it is similar for the physiotherapists and the doctors in the UK VS: We talk about complex interventions very often and and I'm doing a big survey right now to track if you look at what the practitioner does in the clinic, down what is actually out there- if you look at there what practitioners treat, they are treating health medicine an many different parts to it, and Chinese conditions. We actually looked at"well-being all cross-fertilise each other and affect each other in we had a well-being question-and less than five different ways. One of the easiest ways to see it is per cent are what may be called"maintenance in terms of herbal medicine, so that you've got some treatments. Almost everyone who is coming to herbs that are also foods and spices, like yams root see us has problems, and we are on the front line which you might eat every day, and then you have of how to address them. And I'd like to pick up on got really very toxic herbs. You have a very wide the lifestyle advice that Peter was talking about, spectrum, so where is the boundary between eating that's always been something that is important to d taking herbs-it doesn't, on a certain level exist me. Actually we did a trial of acupuncture for back So what is the difference between regulating you pain in York, and we asked practitioners about what breath and meditating or just focusing on where you kind of lifestyle advice they gave and why, and all stick the needles in. So we have to talk in a way that of the practitioners thought that the lifestyle advice goes beyond just talking like when we do research was the key factor in terms of long-term sustained we have to frame the questions really carefully. One change. So I think hopefully, as Chinese medicine question would be, what is so specific about this thing becomes more integrated into the West, becomes that we call Chinese medicine that makes it different more part of Western culture, if we are getting goo And how is that different to, say, other forms of very8 Chinese Medicine in the West 2009 Journal of Chinese Medicine • Number 90 • June 2009 it is really quite complicated. On the one hand you have what Peter describes, then you have the fact that some Westerners have been in China for a long time and come up with all these names like “Classical” Chinese medicine, “Canonical” Chinese medicine and so on, all competing with each other, and then you have the development of acupuncture for purely commercial reasons, so that it is not so much about medicine any more, but more and more about “wellness” and “well‑being”, such as cosmetic acupuncture, and IVF. These developments turn away from medicine as being concerned with curing disease, and that could be seen as one aspect of losing one’s roots, or losing one’s claims to being an alternative. Though on the other hand, you could also say that the entire notion of “alternative medicine” was wrapped up from the beginning already in this white middle‑class concern for well‑being, and what some call the psychologisation of acupuncture has been well‑documented, of course, by Linda Barnes1 and others. FM: That is something that concerns me, the inclusion of Chinese medicine into “Complementary and Alternative Medicine” ‑ often called “therapies” rather than medicine. I still think that it is not understood what Chinese medicine is, that it is a true medical system in its own right, that can understand and treat serious disease. So the “acupuncture for health and well‑being” that is out there does worry me, because there is this idea that we are not treating serious illness. HM: If you look at the membership of the British Acupuncture Council, and I think it is similar for the physiotherapists and the doctors in the UK – and I’m doing a big survey right now to track down what is actually out there – if you look at what practitioners treat, they are treating health conditions. We actually looked at “well‑being” – we had a well‑being question ‑ and less than five per cent are what may be called “maintenance” treatments. Almost everyone who is coming to see us has problems, and we are on the front line of how to address them. And I’d like to pick up on the lifestyle advice that Peter was talking about, that’s always been something that is important to me. Actually we did a trial of acupuncture for back pain in York, and we asked practitioners about what kind of lifestyle advice they gave and why, and all of the practitioners thought that the lifestyle advice was the key factor in terms of long‑term sustained change. So I think hopefully, as Chinese medicine becomes more integrated into the West, becomes more part of Western culture, if we are getting good results with good lifestyle advice, that style should become more dominant over time. PD: When we say “lifestyle advice”, that in itself is a very big subject isn’t it? I’m particularly interested in health preservation, which intersects with the practice of Chinese medicine. That is one of the great strengths of the tradition that I feel connected to, as much as the actual practical delivery of the medicine. And the lifestyle advice that is given by someone rooted in Chinese health preservation and Chinese medicine, is going to be different from the advice given by a doctor, or a physiotherapist for example. It also goes a little bit beyond lifestyle advice, because it implies a particular understanding of what human life is. For example regulation of the emotions, certainly within Confucianism, Taoism and Buddhism, is an absolutely fundamental part of being healthy. I’m not sure necessarily that what people offer as lifestyle advice really connects with those traditions. HM: I think it’s very varied, people bring to their relationship with their patient their experiences and their background, and hopefully, if they are good, they find some way of connecting with the patient where that patient needs some help. That’s the ideal, and that’s different for each patient, and different practitioners have different levels of skill. Maybe “lifestyle advice” is too broad a term, but if they are thinking “how can I help that patient maintain any improvements that might come from the treatment”, there are all sorts of things that could be in there, and it’s very difficult to map in any systematic way, because it is so varied. VS: We talk about complex interventions very often and if you look at what the practitioner does in the clinic, there are so many different parts to it, and Chinese medicine and acupuncture is only one part, and they all cross‑fertilise each other and affect each other in different ways. One of the easiest ways to see it is in terms of herbal medicine, so that you’ve got some herbs that are also foods and spices, like yam’s root which you might eat every day, and then you have got really very toxic herbs. You have a very wide spectrum, so where is the boundary between eating and taking herbs – it doesn’t, on a certain level exist. So what is the difference between regulating your breath and meditating or just focusing on where you stick the needles in. So we have to talk in a way that goes beyond just talking; like when we do research we have to frame the questions really carefully. One question would be, what is so specific about this thing that we call Chinese medicine that makes it different. And how is that different to, say, other forms of very