“You can’t be tied down to one theory without knowing that other theories certainly exist.” — Wang Zhong, Classics that enrich your life with acupuncture
One of the strengths of traditional Asian medicine is that it does not deny or discredit new information in the face of it; instead, it absorbs it and assimilates it into its rich tapestry of knowledge and tradition. Many examples of this are evident in our pharmacology; frankincense, myrrh, and American ginseng were the first in a long history of borrowed herbs.
This openness to new concepts and practices also applies to incorporating modern technologies into my practice: electroacupuncture, acupoint injection therapy, lasers, and even microneedling devices are good examples.
It’s no secret that Traditional Chinese Medicine (TCM) is not a single form of treatment, but rather an attempt to encompass a variety of styles, systems, frameworks, and ideologies. This medical “stew” does not dilute the effectiveness of medicines, but rather gives practitioners the flexibility to adapt to the needs of their patients with a nearly limitless array of techniques.
The challenge is to appropriately employ the right techniques that will be in the greatest interest of the patient. With millennia of theory, methods, and ideology combined with modern research, new technologies, and an ever-expanding knowledge base, how do we know which strategy or theory is “best” at any given moment for a patient with a particular sign or symptom? Most of us, myself included, answer this question with our cognitive biases fully exposed.
Over the past 20+ years of clinical experience, I have heard many times my colleagues condescendingly speak about systems they do not practice, as if their system, training, or lineage is superior. How many times have you said or heard statements like, “TCM only treats symptoms,” “The Japanese stuff is good for emotional problems but it can’t treat pain,” or “Our system treats the mind”?
Upon reflection and deeper study of multiple systems, we find that none of these descriptions reflect the actual practice of the system, but rather reveal more about the practitioners they describe.
I remember attending a seminar by Denmei Shuto and hearing a student ask a question about another system. His answer, beautifully translated by Stephen Brown, was one of the most enlightening I have ever heard. He said, “I’ve tried it for three years and I think it’s worth a lot.” This was followed by the Japanese expression “sannen ishi no ue mo,” which is similar to “put yourself in someone else’s shoes.”
Dr. Shuto has been studying and experimenting with this system for three years prior to his sentencing. He has reached a level of curiosity and interest in expanding his clinical knowledge and skills that I hope to reach someday.
So which system is best?
Given the scope and breadth of East Asian medicine, this question is inherently flawed, but we may be able to borrow some answers from other sources, just as physicians of old learned new herbs and medical procedures.
First, consider martial arts. Many martial arts have literally come to blows to determine which system is best. Today, many martial artists would answer that question with, “What I train in.” While different individuals have different innate abilities and strengths, training in a formal system allows practitioners to build a solid foundation. Each system has its weaknesses and strengths, but by digging deep into a particular style, you can better understand when to use other techniques and when to borrow from different systems.
Enter the Dodo
A year ago, I had the pleasure of networking with a licensed clinical social worker whose profession is perhaps less specific than ours, and filled with enthusiasts of particular styles of practice, a philosophy that is also at issue in the field of mental health care. The social worker described this phenomenon in their field as ” The Dodo Verdict About 100 years ago. I was immediately intrigued by the word and wanted a more detailed explanation.
The Dodo Verdict by Lewis Carroll Through the mirrorThe dodo was a large flightless bird that was hunted to extinction. Its docile and slow movements made it easy to kill. Hunters personified the poor bird’s lack of intelligence because it often did not flee from humans, even when it saw other birds being killed.
In Carroll’s book, the Dodo is hosting a race, but cannot see the finish line and therefore cannot tell who has won. As judge, the Dodo determines that all participants in the race are winners.
In 1936, a psychotherapist named Rosenzweig proposed the Dodo Verdict Theory. Based on his observations about psychotherapy as a whole, as long as patients received mental health treatment, regardless of the style, they got good results. This observation was very controversial and has been both supported and rejected, but empirical data gained over time has shown its validity.
Are we running the dodo race?
In East Asian medicine, debate exists about the superiority of one system over another. Many systems, even the neoclassical system (which began around 1950 on a classical basis), have a rich history and many clinicians and patients support these techniques. Systematic reviews in mental health have created further debate and confusion in attempts to define a superior system.
There are many high-quality studies on East Asian medical practices, but few that compare techniques and systems side-by-side. The scope of these studies would be nearly impossible given the diversity of methods and theories used for even the simplest medical conditions.
The dodo will set you free
If we accept the Dodo ruling as valid for our field, we won’t have to spend hours arguing with colleagues on social media. We can spend more time digging deeper into specific system frameworks and, when necessary, drawing on knowledge of other systems to expand our knowledge base. Cultivating curiosity about other systems deepens our understanding as individual practitioners and helps strengthen and unify the field as a whole.
