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Acupuncture Skills

1st Year Acupuncture Skills flash cards

3 ways in which acupuncture skills are useful Patient rapport, better observation, assessing inappropriate emotion
Why rapport generates trust Patient feels you understand them
3 things determined by the depth of rapport Quality of information given by patient, quality & depth of change patient experiences, accurate assessment of emotion
What matching is Adjusting behaviour / expressions to be similar to your patient
What matching does Creates unconcious 'agreements' > builds trust > increases patient receptiveness & responsiveness
10 areas to match Posture, breath, tempo, representational system, phrase & word, gesture, voice, values, mental filters, language patterns & metaphors
4 areas of posture to match lower body, upper body, head, face
Stages of emotion testing 1-rapport, 2-opportunity, 3-emotion choice, 4-setting up, 5-delivery, 6-observation, 7-notation
The test of rapport Extent to which someone will allow you to lead / direct them
What the structure of an emotion refers to Factors that need to be present for the patient to naturally experience an emotion
2 things required for good 'delivery' in an emotion test Geniune & congruent expression of feeling from tester, be short & stop
3 types of responses to emotion tests Normal, inappropriate, hiding another emotion
2 things to notate in emotion testing Type of test, judgement of patient response
Emotion testing is done . . . Because you don't know, when you are in charge, in the patient's best interest
Angry brows & eyes Brows lowered & drawn together with vertical lines between, eyelids tense, lower lid may be raised, upper lid may be lowered, hard stare
Angry lips & jaw Lips pressed firmly together, jaw tense / jutting
Angry posture Erect, tight muscles, slight move forward
Angry gestures Emphasised, point / fist
Joyful eyes Crows feet at corners, eyes sparkle, lower lids wrinkled & raised (not tense)
Joyful cheeks, mouth & naso-labial fold Cheeks raised, naso-labial fold deepens, corners of mouth drawn back / up, lips may part
Joyful posture Upwards & expansive
Joyful gestures Tend to be upward movements
Lack-of-joy face Inner corners of brows drawn up & in, upper corner of eyelid raised, skin below brow triangulated from inner corner up, corner of lips down
Lack-of-joy posture Slumped, caved chest
Lack-of-joy gestures Withdrawal of movement
Sympathy eyes Eyes soft & wide open, brows raised, maybe small lines on forehead
Sympathy cheeks & mouth Loose cheeks, mouth maybe open soft & relaxed
Sympathy posture Middle of torso collapsed
Grief face Mouth corners turn down, mouth maybe slightly open, cheeks pulled down, lower lids loose, downward movement of face (expiration)
Grief posture Chest caved in
Respect face Open mouth, brows up, eyes open
Respect posture Body lifts (esp. upper body), may take breath in
Respect gestures Small, light, slow
Fear eyes Brows raised & drawn together, upper lid raised exposing sclera, lower lid tensed & drawn up, eyes fixed & pulled back / move from side-to-side
Fear forehead & mouth Wrinkles in centre of forehead, mouth open / lips slightly tensed / stretched & drawn back
Fear posture Slight backward movement, breath high / held, shaking
Fear gestures Tentative, shaking, still
Reassurance face Neutral
Reassurance posture Upright, straight spine, breathing low down
2 reasons why observing breathing is important Weak breathing indicates weak lungs, changes in breathing indicate changes of internal state
How breathing is matched directly Matcher breathes at same rate & depth as patient
How breathing is matched indirectly Matcher moves in sync with breathing (eg pressure of hand on patient's arm)
What a key gesture is Repetitive, comes at moments of excitement / stress, connected with significant recurring inner states
2 important things when matching a key gesture Be respectful: key gestures are powerful to match because they connect with significant internal states, match key gestures in their context
The intention of matching a key gesture Deepen rapport
We notice an emotion via . . . Gestures, posture, facial expression, voice tone, words
Metal CSEO White, weep, grief, rotten
Emotion can be experienced / expressed in . . . Feelings, thoughts, behaviour
2 things that are compared to assess Grief What was / might have been vs. what is now
Objects of grief (what was / might have been) Physical objects, status, a relationship, a function, an ability, a dream
Grief: what is now The current situation, from which something is experienced as missing
An alternative to assessing Grief Assess respect by articulating a Personal Inner Quality
PIQ Personal Inner Quality
What a PIQ is Attributable to a person, wothwhile (esp. with reference to a person's culture), Inner so they can plausibly take credit for it
When PIQs are often demonstrated Under difficult circumstances
How to find a PIQ Ask the patient to think of a difficult time / struggle
What Fire-Joy is associated with Interpersonal warmth, ability to share love, warmth & affection with other humans
Fire CSEO Red / lack-of-red, laughing, joy, scortched
What to give to assess Joy Congruent personal warmth, focus on a joyous activity (can they hold their joy?), natural lessening of joy
What to observe after giving congruent personal warmth Can the patient raise & maintain joy in themselves
The essence of congruent personal warmth "I like you. It's nice to be with you."
How to make focus on a joyous activity a good test Question the patient so they feel like they're engaged in the activity
How joy lessens naturally Once experiencing joy and stimulus is gone, joy recedes slowly in its own time
Inappropriate lessening of joy Joy disappears suddenly and drops into sadness
Earth CSEO Yellow, singing, sympathy, fragrant
Structure of sympathy 1-wound, 2-inner wound, 3-timing (recent/on-going), 4-can't be changed easily / not obviously the person's fault
What a 'wound' is A hurt presented for sympathy
What an 'inner wound' is Significant of the 'wound'
Sympathy timing 'Wound' is current / on-going / recent
Wood CSEO Green, shouting, anger, rancid
Structure of Anger 1-abuse, 2-timing (recent / on-going), 3-who, 4-wrongness
What an 'abuse' is What happened that made them angry + its significance
Anger timing 'Abuse' is current / on-going / recent
What an agent of 'abuse' is not Nature / God
What 'wrongness' is Appeal to social norms, agreements or fairness
Water CSEO Blue, groaning, fear, putrid
Structure of fear 1-threat, 2-future-fantasied violation, 3-reassurance via future-fantasied safety
What a 'threat' is Recurring / occuring now / recent & causing concern
What a 'future-fantasied violation' is Undesirable consequences we imagine are indicated by the 'threat'
What 'future-fantasied safety' is A safe situation imagined when the 'threat' no longer exists
What we need to give genuine reassurance Relevant information
3 distinctions with respect to Reassurance information What the patient knows, what you know, what other info may be available
How to assess if fear is appropriate Determine what info has influenced patient; determining what we know about the threat, future-fantasied violation & safety; reassuring the patient
How to assess if lack-of-fear is appropriate Determine what info has influenced patient; frighten the patient
Created by: Warthogontheweb