As part of the ongoing column on health, nutrition, and revolutionary transformation, I’m pleased to interview Holly Anderson, LAc, with the Service Workers Acupuncture Project. Holly has been practicing acupuncture and herbal medicine for going on five years, and has been studying for ten years. But as she says, “In the world of Chinese medicine that makes me an extreme novice.”
In this interview Holly discusses community acupuncture, efforts to make acupuncture and other forms of Traditional Chinese Medicine (TCM) accessible to working class people and people without insurance, the history of TCM in the US, and the compelling and provocative discussion in left organizing and activist circles about self-care and community care.
Michelle Foy: Can you briefly explain what Traditional Chinese Medicine (TCM) is?
Holly Anderson: TCM includes acupuncture; herbal medicine; Qi Gong, which is meditation/energy work; and Tui Na, which is manual therapy or massage. The way TCM is practiced in the United States, we’re mostly talking about acupuncture and herbal medicine.
Capitalized “TCM” comes out of Maoist China. Before the Revolution, the Chinese elite were not happy with traditional medicines and religions, and were looking towards Western Medicine more. More broadly, people in the cities saw Western medicine as superior. People outside of China, like those in San Francisco’s Chinatown, held onto traditional practices. Then, during the Revolution, when Mao Zedong was in the mountains, he met traditional practitioners of Chinese medicine who helped him quite a bit. This is part of the reason why there was a lot of interest in Chinese medicine within his government.
They also noted that traditional medicine was inexpensive, relatively easy to teach, and quite effective. Thus, it eventually became a model of medicine that the Chinese government wanted to export to the rest of the world. Before, it was largely based on family lineage, and there were as many ways of treating people as there were practitioners. That was when a set curricula was first developed.
MF: Can you explain how acupuncture works?
HA: The theory behind it is that there are more than 360 points on the body that can be manipulated in different ways: using acupressure; needling; or heating the points, which is called Moxibustion. By doing that, you’re giving information to the body to make some kind of physiological change.
The points are along Meridians, or channels, mapped out over the body. This is why, when you tell an acupuncturist that your back hurts, they put a needle in your ankle. It’s because that channel travels along the body where they are trying to make a shift.
This is the two-second answer to that question. It’s either this or a two-hour answer!
MF: What is community-style acupuncture? What do you attribute the upsurge in accessible acupuncture clinics in this country to?
HA: Community style acupuncture in the US was inspired by the folks at Working Class Acupuncture in Portland, a model that more easily allows people to get as much treatment as they need. This is more like what TCM looks like traditionally, as people commonly will receive daily treatments for a set period of time. The community acupuncture model is a sliding scale with four to six patients an hour, in chairs rather than tables. At the Service Workers Acupuncture Project I have low-cost acupuncture at a set price ($35/treatment) with tables, and I only treat two to three people in an hour. What I do is low-cost acupuncture in a community setting.
Acupuncture evolved in the United States as an “outsider” medicine, not in hospitals, established clinics, or HMOs, like Kaiser. It’s individual practitioners creating private clinics where, if a patient doesn’t have insurance, the cash price can be anywhere from $60-$120 a treatment. This is not due to acupuncturists being greedy; it’s what it takes to make private clinics succeed. Obviously the cost is prohibitive for a lot of people.
Given that, a lot of people were trying to figure out how to make it more accessible. One of the ways they did this was to push insurance companies to cover it, but as we know, a lot of people don’t have good insurance or insurance at all. Community style acupuncture was set up in order for people to get as much treatment as they needed without the finances being such a burden. It’s been really exciting to see it take off. When the price is $15-$30 a treatment, that’s possible for many people in a way that $80-$100 isn’t.
MF: Can you talk about the history of acupuncture and TCM in the US? What has been its relationship to allopathic/Western medicine since it arrived here?
HA: Chinese medicine has been in the US as long as there have been Chinese immigrants here, but until the 1970s, it was not something that outsiders were aware of.
The legend has it that the moment when non Chinese Americans became aware of acupuncture was when Nixon went to China. However, as we may figure, there’s much more to the story. Insight for Acupuncturists tells an interesting story and talks about people like Miriam Lee, who was arrested for practicing acupuncture and TCM in 1975 before acupuncture became a legal medical practice in California.
Before there were schools, it was all passed down through family lineage, and the students would apprentice with practitioners. My school in San Francisco was one of the first continuous schools in the US, incorporated in 1985. Most of my textbooks in school were produced by the Chinese government, but now there are more and more textbooks that are not coming from China. Before the US government started licensing acupuncturists, much of the work of acupuncture was considered illegal.
I had teachers who were incredibly curious people who wanted to learn it, so they did, even though it was not easy to learn. Having any insurance cover TCM has been very recent.
MF: Behind TCM, there is both the science of thousands of years of observation, as well as more recent studies showing the impact through MRIs and other ways of measuring its impact. However, many people trained to believe in a certain interpretation of the scientific method still think that acupuncture is not based on science. How would you address these skeptics?
HA: There’s a lack of Western scientific understanding of how acupuncture works, but more and more it’s being proven to work. The World Health Organization recognizes acupuncture as a legitimate treatment for 50 or so different health concerns. Doctors are having patients come in saying, “This is what helps me.” More people are demanding it from their insurance companies or seeking it out on their own. And now it looks like acupuncture will be included under Obamacare. All insurance will have some kind of acupuncture coverage, which is definitely positive, although we don’t know exactly what that will look like.
There’s an interesting article that ran on Huffington Post called, “What acupuncture can teach us about science.” This piece talks about what gets studied and what is considered fundable for what’s studied. There is a bias towards only studying things that are already understood. Just because you don’t understand something does not mean that it’s not true. How unfortunate it would be if science understood everything already!
And then there’s the issue that so many things done in Western medicine have never been put to the same standards. For example, surgeons don’t have to prove that a particular way is the best way to perform surgery; they simply do what they were taught from their teacher.
All this said, I happen to love Western medicine. I think it’s a very young medicine that is going many exciting places. I’ve worked with and run into a lot of really open-minded doctors who are very open to seeing what works, and make referrals to acupuncturists.
When you go into a hospital in China the standard of care you get is both Western and Chinese medicine. They treated SARS in China with both Western and herbal medicine and they got fantastic results doing both. Fundamentally what I love about TCM is that it’s a very pragmatic medicine and is all about what works. Whenever they came across another medicine that was getting good results, they incorporated it into TCM. There are a lot of Indian herbs in Chinese medicine. If you’re getting acupuncture it’s not like you can’t do anything else; in fact, you’re encouraged to do everything you can.
MF: Some readers may be familiar with the program and history of the Barefoot Doctors, or the Rural Cooperative Medical Systems in China, started by Mao Zedong during the Cultural Revolution in the late 1960s. The program “strove to include community participation with the rural provision of health services.” Health activists around the world considered the program a model, while recognizing the contradictions of that program and that period in China’s history. How do you see TCM and the model developed during that period in China continuing today?
HA: National Acupuncture Detoxification Association (NADA) is one example that comes to mind. It’s ear acupuncture–five points in the ear. It’s used very successfully to help with different kinds of addictions. It’s considered so successful that in some places people in drug court get sentenced to get ear acupuncture. It’s also getting used for Post Traumatic Stress Disorder (PTSD) for returning soldiers. The US military is totally running with ear acupuncture.
NADA is somewhat controversial, as some acupuncturists don’t like non-acupuncturists doing it. I think it’s great, as lay people and people without masters degrees can very easily be trained to do the NADA points and can travel to places where there have been natural disasters or other situations, to help lower stress.
One part that I think is really interesting about the Barefoot Doctor program is that practitioners were expected to do farm work side by side with the people they were treating. What I get from that is the importance of being in the community where you provide services. Being connected to people in a way where we do not hold ourselves outside of that community.
MF: You have a history as an activist and organizer. How did you come to studying/working as an acupuncturist?
HA: My parents were anti-war activists and my dad was also in the Navy. He went to Vietnam and also protested against it, often in uniform.
During college, I became involved in a lot of anti-prison work, when the three strikes law was first implemented in California. After college, I worked in a lot of service jobs and worked with youth. I was drawn to community mental health work and health care. To me, social justice is about people being as fully human as they can be, to have the most full life as we can. Acupuncture really helped me, but I just didn’t think it was something I could go to school for. Then I met a young woman who was also gay who was an acupuncturist and realized this was something I could do. I worked my way through school working in cafes and taking out student loans.
MF: How do you see your work in health connected to the broader work of revolutionary transformation? How is it challenging to keep it connected and grounded in that framework?
HA: When I was working in a café full time during school, it came to me. Here I am, standing in room full of people in the same situation, doing service work and without insurance. Starting a clinic like SWAP was a way that I could work with people that I really want to work with, working class people, people who work with their bodies, who don’t have access to health care. I also started to reach out to people in community groups about whether they would be interested in having an acupuncturist come in to work with members. An organization that was organizing restaurant workers had a restaurant workers day and I did acupuncture there.
I grew up being very clear about my politics. As a practitioner, I hold the space for the patient and I am opaque. My agenda, my thoughts, my needs, are not as important as theirs. I don’t talk about anything political unless someone brings it up first. And what I think about it really doesn’t matter. The good thing about this is that I listen to people a lot more than I used to. I am a lot more curious about people than I used to be. I feel way less like I know what’s right and wrong, and I think that’s appropriate.
MF: B Loewe, on the movement website/resource Organizing Upgrade, recently wrote a piece on Self-Care that’s created a lot of discussion in left/movement circles. B writes, “Talking about how we sustain ourselves, honor our personal needs, and prioritize our well-being in this brusque and brutal world is a huge advance from movement culture generations before. However, centering that conversation on ‘self-care’ devoid of our place in the collective misses the central point of why we need to care for ourselves.” What do you think of this and how do you see your work as part of creating a more collective approach to care, resiliency and health?
HA: I worked for the organization Breast Cancer Action. They are very clear about their politics, and it was started by people with breast cancer. They don’t take pharmaceutical money or money from anyone that might be profiting off of breast cancer. One of the things we came across in the work at Breast Cancer Action was the issue of individual answers to systemic problems. For example, environmental causes of breast cancer have people trying to stay away from toxins in every single guise.
How much can individual answers really do? Of course I encourage people to take care of their health. Acupuncture is a great way for anyone that’s working hard to do that–to lower stress, to feel more clear.
It is tempting to get pulled into a world of just taking care of your body. Chinese medicine is all about balance. You can’t work yourself into the ground. At the same time, there’s a way that only eating certain foods, and having to be so careful, can be problematic. Yes, some health situations do call for that, and there are people who have to spend a lot of time to manage their health. Someone who’s relatively healthy, however, can end up treating themselves like a delicate flower, and that can be isolating and alienating.
I think another key thing is the role of trauma in our communities and the need to address it, while also addressing systemic causes of oppression.
MF: What do you think about the state of healthcare and the healthcare system today?
HA: It’s a disaster, a total disaster, with amazing people working within it. I see a lot of people struggling to get any kind of health care and a lot of people with insurance, but not good insurance, like high-deductible plans. This is the situation I’m in and all I can do is hope that I will never have to use it.
MF: Do you have stories of how acupuncture and TCM has impacted some of the service workers that have come into your clinic?
Being the kind of medical provider that I am, I will see people that haven’t seen a doctor in a really long time. I once had a patient that I had to send to the emergency room, as it was clear to me that he had had a stroke. I was the first provider that he had seen since having the stroke.
Another story is a patient who was in his 60s and had worked for many years in a unionized job. He had been injured at work and was on disability. He was on so many pain-killers that he couldn’t function, but he was still in pain. He was a very well respected guy, and his whole family was involved politically. Not only was he a union leader, but also a community leader.
After his family brought him in for the first treatment, his pain was reduced by 90%. 95% of people have a response to acupuncture, but then there’s the small percentage of people who respond incredibly well to acupuncture, as he did. I only treated him three times. He was able to go off all of the pain-killers. Although he was still injured, he got his life back. He was able to do the things that were really important to him, which in his case was community organizing. Then his daughter came in, as she had a lot of stress from taking care of him. It’s one thing that I love about the SWAP clinic: I can treat families together. It was really an amazing thing for me to have this experience. As I’m a corny acupuncturist, one of my jokes is, “It’s not magic but it seems like it is!”
I’ve seen a lot of people who, for one reason or another, were having a hard time living their lives, but the treatment gave them what they needed to live their lives. That is what makes it that much more important to make TCM accessible.
To find a community acupuncture clinic near you, check out the People’s Organization of Community Acupuncture.