Intuitive Aspects of Acupuncture and Dry Needling

It is commonly discussed amongst acupuncturists that “an acupuncture point does not appear until you need it.” What does this mean? The most common explanation offered is that you only treat points that are necessary; they present with tightness or blockage of some sort. This is valid, but there is a more subtle and nuanced aspect.

While we call it as such, in actuality, there is no such thing as an “acupuncture point.” I have written previously on the subject of how to choose an acupuncture point.  Acupuncture points do not exist in space, but they do exist in time. Their manifestation and their necessity are one and the same; they are there when we “need” them and gone when we don’t.

The philosophy that underlies Chinese medicine considers that all phenomena arise and dissolve spontaneously. Applied specifically to acupuncture, the notion is that acupuncture points come in and out of existence; they are not fixed. While this may seem esoteric and clinically irrelevant, it is in fact extremely important. If an acupuncture point manifests only when needed, who makes that determination and decides if, how, and when it gets treated?

You may have had the experience during acupuncture treatment of “wanting” or “needing” a point to be needled. This article gets into that idea a bit, exploring the choosing of acupuncture points from the point of view of the patient, as well as a deeper exploration of the existence of “acupuncture points.”

What Is the Point?

The term for an acupuncture point in Chinese is “xue”. The character is   While we commonly translate this into English as “point,” it is incorrect. Xue translates as cavity, cave, or hole. I discuss this briefly on the Acupuncture page of my website. For the rest of this article I will use the correct term “hole” rather than “point”.

To refer to something as a point implies that it is a) existent and b) static and localized. (We make the same error in referring to the menstrual cycle as a ‘period’.) An acupuncture hole is neither. An acupuncture hole does not per se exist in space. It is defined by the surrounding terrain, and its qualities may shift in relation to this. While it is common in the West to conceptualize acupuncture holes as points that exhibit electromagnetic and conductive properties, this is simply an attempt to force the concept onto a Western scientific paradigm. That is not to say that this model is not of value, only that it does not comprehensively describe an acupuncture hole as understood from the framework of acupuncture itself.

Here is a brief presentation of an important and complex subject in Chinese medicine: the three levels. Three is the number of “phenomenal manifestation” in Chinese philosophy. The Dao De Jing says “The One begets the Two. The Two beget the Three. The Three beget the ten thousand things.” I will write more about this. The three levels in Chinese medicine are translated simply as upper, middle and lower; or as heaven, human and earth; superior, medium and inferior.

With regard to acupuncture treatment; the lowest level of choosing a hole means choosing according to symptoms or disease. In common vernacular for example, “GB 20 treats headache”.

The middle level corresponds with energetic functions of a hole. GB 20 eliminates wind and subdues rising yang qi. It relates to the entirety of function of the Gall Bladder channel, which includes outward manifestation of Liver function. So in Chinese medicine, the Gall Bladder relates to storage and dissipation of blocked energy in the body and in life. In health and balance it allows for movement and vision. This is also part of the middle level of understanding.

The upper level is not related to specific function. In this perspective, any organ, channel or hole can be chosen as, ultimately, they all address the same thing – contacting a person where and when they are out of balance with the Dao, or original nature.

Here is the appropriate metaphor. White light fragments into the primary colors, but they are all simply aspects of white light. The Chinese conceive that Dao presents as the five phases – wood, fire, earth, metal and water. They progressively present as the organs, tissues, channels and acupuncture holes of the body. At the right moment, treating any hole makes contact with the entire chain. That is to say, any acupuncture hole can restore balance and original nature, separate from its conceived physical or energetic function. The conceived functions are tools for perception at the lower and middle levels. They are necessary tools, but as such this perspective does not explain the depth to which Chinese medicine posits health, disease, balance and acupuncture holes.

Returning to the original premise of this essay, people intuitively know where they are stuck, both metaphorically and literally. For both the patient and the practitioner, using this intuitive guidance that is informed by the diagnostic model of Chinese medicine allows for flexible, dynamic treatment. All the levels of understanding are valid here, and all are addressed when a needle is inserted. By identifying and touching where we are stuck, we get unstuck. This is the fundamental premise of acupuncture, that disease happens when qi (energy) does not flow properly and health is restored when it does. It is that simple.

This principle applies to any sort of treatment; in this case, needles. While it is possible to have and to cultivate an intuitive sense of energetic blockage, for most people it is more tangible to connect with this physically. People know where they hurt, and where they need to be treated. When I touch a patient to insert a needle and they tell me to move over a little, this is valid and an expression of this knowing. To say that a point is fixed is incorrect. If a person feels the point here and not there, the here spot is the one that needs treatment.

I encourage patients to pay attention and tune in to their own intuition. I do the same when I am treating them. It is this state of being that defines the higher level of treatment; not the choice of hole, but the state of being aware and present. The deep state of relaxation that people typically feel with acupuncture arises from this state. Acupuncture can help someone to get there and to become familiar with it, but it is achievable with practice. This is why it is important to take time after an acupuncture treatment and relax and pay attention. Trust your intuition. The more you use it, the greater the potential for healing.