Episode 189: The Evidence for Acupuncture
with Dr. Mel Hopper Koppelman
There’s a lot of fascinating research being done that continues to bridge the gap between Chinese Medicine and the conventional western medical approach. Dr. Mel Hopper Koppelman joins this conversation to discuss what she’s been seeing in the research of Chinese Medicine and acupuncture.
Using her expertise across multiple medical disciplines, Dr. Koppelman shares with us how drawing on a variety of approaches gives us the flexibility to meet people where they are in their health journey.
On Today’s Episode of A Healthy Curiosity:
- How we can try to chart a heathy, sustainable path forward through the COVID-19 pandemic
- What she’s excited about in the world of acupuncture research right now
- Why she finds the research around ATP and adenosine so interesting
- How different philosophies of science can affect the interpretation of data
- The importance of having more than one map or model for how things work
Dr. Mel Hopper Koppelman is passionate about helping people to optimize their health and improving access to safe and effective medical care through advocacy and education.
She came to integrative healthcare after overcoming several chronic illnesses using integrative approaches, which conventional medicine was unable to help her treat. She earned an MSc in Acupuncture in 2012 from the Northern College in the UK and a second MSc in Nutrition and Functional Medicine in 2015 from the University of Western States. She also has a diploma in hypnotherapy, which she enjoys weaving into her treatments.
She sees patients both online and at her practice in Rhode Island, Harbor Integrative Health, and is the Executive Director of Evidence Based Acupuncture.
Connect With Dr. Mel Hopper Koppelman:
Welcome to A Healthy Curiosity. The podcast that explores what it takes to be well in a busy world with self care strategies from Chinese medicine, functional medicine, Ayurveda, neuroscience, and beyond I’m your host, Brodie Welch, licensed acupuncturist and transformation catalyst here to support you on your journey of health, happiness, and personal evolution.
Hello, how you holding up? No doubt. You are riding some version of the Corona coaster, as I’ve heard it called those of you who are on my under utilized, but well-intentioned email list know that my clinic has been closed and I’ve been busy adapting my policies and procedures and getting new. Vinyl pillows for the clinic and treating with telemedicine and coaching and trying to assimilate all the new information about what COVID-19 is like in the body and what we can do about it with Chinese herbs and by paying attention to not only the germ itself, but the terrain, the, where it lands, because it really it’s the interplay that, that makes it so that some people have.
Really very few symptoms and other people have really problematic ones. So I have been busy, also been aware of my relative privilege, having a safe, warm place to live with access to nature, just keeping me sane and fresh. I’m also realizing that my job as an acupuncturist just got a lot harder. And again, for those of you on my email list, if you’re not, why not go to Brodiewelch.com and jump on my email list so that we can stay connected.
Anyway, those who have read my past missives know that I’m really grieving the loss of the way it used to be. Right? The ability to, in an attempt to engender a sense of trust and empathy with my clients to have to do this. Wearing facial coverings. And will this be harder? I don’t know. It’s clearly the right thing to do right now.
So I’ve spent these past few weeks in a flurry of activity, ordering the touchless soap, dispensers and lab coats and scrubs, and literally moving everything out of my clinic this week so that the carpets can be replaced with hardwood floors. And so generally like the movement towards more of a sterile place to be also hiring a new office manager who begins her training this week.
Because, you know, change. I haven’t had enough change. I clearly need more. And I don’t really know where I would be without my morning and evening routines. They have been the cornerstones that have been helping me through this whole period. And really also just connecting with people. I love, even though we’re physically distant, it’s a stressful time for everyone and stress and anxiety and depression are all on the rise.
As our substance abuse and people are drinking more and smoking more weed and joking about the quarantine 15 and reaching the end of Netflix because we’ve exhausted. Everything there is to watch. And whatever it is that you may be doing to get through this trauma, I have no judgment. And I’m also recalling to mind the episode that I did awhile back with Nancy Jane Smith, where she talks about how we all have this inner monger and an inner BFF.
And the monger is like the inner critic that might be belittling, whatever it is we’re doing like that old voice, that’s saying that you’re not doing enough or that it’s selfish to honor your body’s needs. And the inner BFF is like the opposite of that. And she’s the one that might be saying, like we’re in the middle of a freaking pandemic.
Yes. More chocolate is required, right. Finish that type of ice cream or whatever, and, and acting in ways that that might feel compassionate. But ultimately aren’t actually in our best interest. So there’s this, there’s this third voice that we have that when we listen to it, it can be super helpful in guiding our actions.
And that’s the voice of the wise one, right? The inner teacher, the inner mentor, or the inner one who knows how to walk that middle path of, of true self compassion. Because the more we do something, the more we’re carving that groove into our life, the more we literally are getting those neurons to fire together and wire together.
And that’s really about how habits are created. So. Given that if, if we do something over and over again, that neural pathway becomes more hardwired, it becomes more intractable and therefore harder to break out of. And so it’s really important. I think at this stage when maybe the shock has worn off for a lot of us of what it is that we’re dealing with and it’s, it may well be time to focus on the patterns that we may be creating.
Whether intentionally or unintentionally. So. I’ve been thinking a lot about how I’m dealing with stress. What gives me energy, what drains my energy so that I can start a path forward that feels sustainable. And that feels good. Part of what gives me energy is catalyzing deep transformation and healing for people.
And I’m really fortunate to have two branches of what I do, that, that both do that for me. Like it happens in the acupuncture clinic all the time. It’s a wonderful thing to help catalyze, but there’s also some. Really deeply satisfying about helping people transform in a way that requires them to put their own sheet and blood into it.
Whether that’s teaching somebody how to breathe, how to do cheek gong, how to eat, right. How to change a habit. When people start living differently, like really doing the things that help them show up as their most present, most vital, most creative selves. It’s like they’re transforming on their own. And.
Also feels profoundly meaningful. And it’s what I teach in my wildly effective a level up your life course, which I’ve run nine times. Over the past few years, people feel less stressed. They feel more in touch with their bodies. They feel more calm and confident because they’re actually doing the things that they’ve been maybe intending to for years.
And, but maybe without knowing how to change a habit or falling prey to the black and white thinking that keeps them stuck. And. I’m not running a level of group right now, because in order to do that, like in the least in the past, I’ve had to get a pad to put out all this energy, to get a whole big group together, to start at the same time and focus on that.
And that really requires like doing things that I don’t frankly love, like showing up on social media and self promotional ways or sending daily emails, things that I find draining and in the maelstrom of questioning everything and really. Literally redo and replace everything in my clinic. I’ve been wondering if there’s still a way to offer level up without having to do that draining marketing blitz that I really don’t want to do.
So I got curious, like, is there a way I can still offer this powerful, personal evolution incubator without doing the stuff that drains. And I’m thinking that the answer is yes, there’s really no reason everyone has to be doing the same thing at the same time. So here’s the. I’m opening up level up your life as a go at your own pace course.
So when you register, you’ll get a six month membership, which is enough time to go through the whole thing twice, or to spend a couple of weeks on each module before moving on and you can breathe through the habits that you already have dialed in and spend more time on the things that are challenging.
You’ll get a structured framework for making small changes over time, 10 audio lessons for me, recipes, acupressure points, reflection, sheets, a deeper understanding of how your body works from a Chinese medicine and Ayurvedic perspective. As it intersects with modern research and habit change strategy, you also get three one-on-one laser coaching sessions with me and one group Q and a call with me every month.
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And now for today’s conversation on some very cool research on acupuncture with Dr. Mel hopper Koppelman. I hope you enjoy it as much as. Hello, and welcome to today’s show. I’m super excited for this episode because I get to talk to, uh, one of the people who is doing some amazing work within the field of Chinese medicine.
Get people to understand the research being done on acupuncture and how effective it can be from headaches to low back pain, to cancer, pain, to anxiety. Of course, acupuncturists have been researching the effects of acupuncture on their patients for literally thousands of years, in terms of observation based studying their patients and what worked and what didn’t.
And this knowledge has been passed down through oral tradition for thousands of years. And then through written tradition, our oldest texts being upwards of 2000 years old from the Shennong bond Sao one of our oldest herbal textbooks to the yellow emperor’s classic of internal medicine. Which is one of our oldest acupuncture texts.
But if we’re going to communicate with doctors, with insurance companies, with the people who are calling the shots today, it’s incredibly helpful to be able to speak the language that these people tend to understand and respond to. I E the language of science. And well-designed clinical research. And one of the people who has been working tirelessly to help move the ball up the field in this regard is my guest today.
Dr. Mel hopper Koppelman. She is a passionate advocate for people having access to safe and effective medical care through advocacy and education. She came to integrative health care after overcoming several chronic illnesses using integrative approaches, which conventional Western medicine was not able to help her treat.
She earned a master’s of science and acupuncture in 2012 from Northern college in the UK and a second master’s of science in nutrition and functional medicine in 2015 from the university of Western states. She also practices hypnotherapy and enjoys weaving that into her treatments. She sees patients both in-person and online from Bristol, Rhode Island at Harbor integrative health, and as the executive director of evidence-based acupuncture, fun fact, Bristol, Rhode Island, I have a personal connection to you and that this is the little town that my parents moved to after my sister and I graduated high school.
So kind of a fun coincidence that I should. With my guest today, Dr. Mel Hopper Koppelman, Mel. Welcome to A Healthy Curiosity. Thank you so much. I’m really excited to be here. I really just want to thank you for your work, because it’s so important to bridge the gap between the medicine that can truly help people.
And people’s mental blocks to it, right? Like that. We have these, if we think of Chinese medicine, is this fringy woo thing. It’s not necessarily real medicine. And like when people think of it, that way they’ve effectively closed a door that potentially holds the answer to very real healing on the other side.
Absolutely. I think what’s happened with our own relationship with research as practitioners and the public’s relationship with alternative medicine is really just a consequence of our culture and history and, and how we look at things. So I think a lot of. Turned to study Chinese medicine and acupuncture because it had an approach that was in some ways, preferable, maybe to a more conventional approach.
And so there’s like this union relationship there, but at the same time, Many of us. Most of us love science where we’re not anti-science at all. There’s just been a real challenge of almost a challenge of language and a challenge of translating worldviews so that we, the part of us, that’s looking at an individual person and getting a lot of information from them and using this almost systems biology approach, how we can.
Also on the other hand, respect and understand and utilize and appreciate all of the, the mechanistic and biochemistry research that’s out there. It’s really well put. I think that we all, a lot of us, yes, are initially attractive to like, we, we get that looking at well, it sort of. The, the flaws of the Western medical model.
A lot of times, like we see as like compartmentalizing people, right? This, the intense specialization to the extent that we’re not, no, we’re no longer looking at a whole person, but we’ve broken it up into parts can be, can be frustrating. And, and the idea of having Chinese medicine as this true mind, body spirit medicine, is this true systems biology system.
As, as you put it, the idea that we can think of. About the interconnection of different organ systems and different sort of pathogenic mechanisms and how they work through an entire system, as opposed to just looking at a tiny little slice, it opens up it’s this real. Holism that a lot of us really appreciate that that absolutely does not mean that we’re anti research, that we’re anti-science and certainly our conception of what science is, and even how research has done can be problematic.
Like the gold standard in Western scientific research is the randomized double blind study. Is of course very difficult to do in an, in a medicine. It’s very difficult to not know that you’re doing acupuncture on someone or that you’re receiving acupuncture. And so it’s challenging now that said there’s lots of different ways around that, but I’d love for you to kick us off with like giving us a sense of what is happening in the world of acupuncture research.
What are you excited about right now? Oh gosh. Um, there’s a lot to be excited about first. If you just look at studies that are measuring how much research has been done, and what’s the quality of that research? There’s a pretty large study that came out a couple of years ago. I think it was collaborative between IBM and MIT and a few other organizations.
They found that not only is growth into acupuncture, research, exponential. But that is actually growing at twice the rate of growth into research of biomedical research. So that’s extraordinary. So we’re seeing an exponential growth where folks are institutions who have access to research dollars. Think that looking at acupuncture is the better return on their investment.
So that’s super exciting. It’s really exciting. And it seems like we’re far beyond the question of does acupuncture work, right? Like we’re, we’re much more or getting much more sophisticated in the kinds of things, the kinds of specificity about what is being studied and how it all works. Absolutely. I mean, there’s a couple of ways to even look at that question.
So the first thing is, what do you mean by does it work? And so people would think. Worldviews have different understanding of what, what even that question means. And so if we’re looking at the body as a machine, and then we have to answer that question one way. If we’re looking at the body as blogging to a person who has life goals and aspirations and symptoms, that might be subjective, we might answer that question a different.
But even if we just are speaking with people who believe that the body is a machine and we need to find these mechanisms, acupuncture enjoys an impressive clarity into its various mechanisms, especially compared to many really commonly used pharmaceuticals. So this idea that, um, we don’t know how acupuncture works.
I think there’s definitely more. Left to explore and to understand and to go, but at the same time, uh, for looking at it compared to, to what we use very frequently with conventional medicine, we absolutely know a ton of how it works under the microscope. So let’s dive into that a little bit deeper. I love, I think that one of the main reasons that mainstream doctors don’t recommend acupuncture to their patients is because they don’t understand the mechanisms of action. Uh, part, part of that is that they’re largely ignorant of the amount, the growing body of research that is, that is out there. But I think that a lot of times it’s sort of like that, not to fault doctors for this foot coming from this.
If it’s not evidence-based quote unquote scientific, um, it’s not something. That they feel like they can responsibly recommend except anecdotally. So we know as far as like what I’ve delved into that acupuncture, moderates adenosine levels so that our perception of pain is altered, that it causes the release of endogenous feel-good chemicals in the body.
That specific points like stomach 36. It can be shown to raise or lower stomach acid depending on what the body needs. Like there’s, there’s all sorts of like little slices where we have a sense of what acupuncture does, but I’d love to hear what else is out there. What don’t I know about acupuncture does well, you’ve, you’ve really hit on some of my favorite ones.
So one place that I’ve done a lot of looking at is the literature on acupuncture’s effect on ATP and adenosine. I think what’s really cool about focusing there for a moment is that for most of the body, the biochemicals in our body are usually pretty specialized to where they are. So what organ they’re in or what system they’re a part of, but ATP and adenosine are found in every tissue of the body and are shown to regulate every function of.
So ATP could cause you recap for, for those who maybe haven’t, it’s been a while since they’ve had high school biology. Sure, absolutely. So ATP stands for adenosine triphosphate and so that’s adenosine with three phosphate groups attached to it. And if you did come across this in your high school biology class, then you would have heard of it referred to as the energy currency of the body.
So it’s really, you know, In, in all of our cells, we have what are called mitochondria that are really like, maybe like the end of the boiler. That’s converting fuel into energy and the energy is producing is ATP. But so we was, he was really thought of as the energy, but now what we know. Is that it’s really crucial to the communication and organization of the body.
So that is so wild, sorry. I mean, that’s really what acupuncture is all about, right? This, the idea that points on the surface of the body can communicate deep with, with the organs internally, that we can facilitate communication between the different organ systems in the body. And. Really, if we think about just the pun that you might’ve just unintentionally made energy currency, right?
Where are these bioelectrical organisms and plugging into our body’s natural energy, that currency, that current literally of energy is really wild. That bio electricity, that, that is really what acupuncture apparently. Affects. Absolutely. And you can, you know, you can look at any of these things, including ATP.
You can look at it as a chemical, or you can look at it as more of an electrophysiological component. So it’s a bit like light can be a particle or a wave. So it, you can focus on either of those attributes, but both of them are really important. And what I came to kind of discover or realize is that. In the conventional explanation of how a lot of the body works.
There’s a lot of details missing. So for example, we know that our heart is pumping blood around the body and that it’s really tightly regulated and that when it communicates with the brain, we can change our blood pressure and we can change a lot of parameters. But if we back up, it’s like, well, how does the brain know what the pressure is?
How does it know what’s going on? And it’s because ATP and adenosine are being released by blood going through the blood vessels. And so that’s sort of like the background thermostat, almost that when those change, then the brain knows, and that’s true for everything that’s true for, you know, how do you know when you need to do number two in the bathroom?
You get a signal that, that signal, that stretch signal is ATP. Really, really cool. So we know that that is one of the, one of the things that acupuncture can affect. Anything else that we should know in terms of what the research is showing? Well, I’d say from a biochemical perspective, the studies I’ve seen so far show that there are tons of different.
Chemicals that change, but they’re all downstream of ATP and adenosine. So if you block adenosine, none of those seem to happen nearly as much. So that was one thing that was quite interesting. There’s also a lot of emerging information coming from F MRI studies, that’s functional MRI study. So those are studies that are looking at changes in activity.
In the brain. So a lot of different studies are showing this improved regulation after acupuncture treatments. And even in one case that I’m aware of, which was a really interesting study that was looking at patients with carpal tunnel. Real acupuncture, both at the wrist and at the leg on the opposite side, but not sham acupuncture was actually able to change the, the modus motor sensory mapping in the brain to make it healthier.
So cool. And for those who might not be in the know about what you’re referencing there, that leg on the opposite side. Idea that has to do with this notion of imaging or like mirror images. And the idea that the body is you can use the opposite points on the opposite limb on opposite channels to affect a particular part of the body.
So if we were a four legged creature, And ankles would be the same joint, for example. And so you can use a place that’s that is far away from the site that is affected. Like, so for carpal tunnel, if you’re feeling it in your left wrist, you might use points on the right ankle to affect it. And it’s a, and you’re saying that the brain, in fact maps.
That’s correct. So the brain has quite a few maps of the body that it’s attached to inside of it. And so, um, this study was showing that both needling at the other affected wrist or the opposite side, Was it causing healthy changes, but in a slightly different way by slightly different mechanisms, which is really cool.
And it sounds, it might sound weird if someone hasn’t studied acupuncture, like why would you do the opposite angle? But now also studies looking at functional neurology. So how the brain and body developed together make that make more sense in terms of how the body is wired. There’s I remember. Uh, just this, this idea of the functional neurology is fascinating to me that we have in Chinese medicine, we had this notion that different tastes go with the different organs and that there’s actually tastes for receptors for the bitter taste in the whole.
Mm it’s like, what is that about? You know, like things like that, which is of course the taste that we associate with the fire element or the heart. Um, and so just things like that, that are, that are, um, go back to embryology, right. That go back to how things all fit together before, before the cells.
Absolutely. And I think there’s also sweet receptors, uh, further down in the digestive tract, near the stomach as well. And I think, you know, I like to switch hats back and forth between them looking through the Chinese medicine lens of the body as an interconnected system of systems. And then also looking at the biochemistry just cause it’s sort of interesting.
And just from that conventional biochemistry perspective, you can explain some of those things in terms of. Hormonal communication. You know, that what, what happens when a sweet receptor down closer to the stomach and pancreas perceived glucose or perceived sweet versus, uh, when it happens in the tongue.
And so, um, you know, It’s really cool how the body works. It’s so cool. Getting back to this notion of sham acupuncture. I just want to fill that out for people. Is that a lot of times, like sham acupuncture has been done with, like, I remember the toothpick study for low back pain where like literally it just to simulate that so that the person receiving the treatment would think that they were getting acupuncture.
It was, it was noninvasive. Toothpicks, just kind of like putting pressure on, on the points. And then remember the studies that came out of, uh, or the, the press that came out of that was like, the results of that study were like acupuncture works great for low back pain, actually better than the standard of care.
And that sham acupuncture. Like with the toothpicks did better than like, not quite as well as acupuncture, but still better than, and, and the, and the results were like acupuncture barely better than fake acupuncture, you know? And it was like so dismissive and instead of like, wow, like we could actually, it’s just really all in how you spin the results.
And I felt like the way that. Article or that that study was covered was, did not do acupuncture a service? No, absolutely. I mean, and what you’re really touching on is the philosophy of science and that’s gonna really affect how people interpret studies and also how guidelines people who are developing guidelines will interpret studies.
And what I have found in my participation in di guideline development, in different places in the world. Is that whether or not acupuncture gets recommended for a particular condition has almost everything to do with the philosophy of the guideline development developers and what type of study design their worldview accepts and not what the evidence is for acupuncture.
And especially, I’m very quick to point out how it compares to the other treatments that they recommend. I’m curious about this, this notion of the philosophy of the people designing the studies or the, or the, the implementation guidelines, what kind of a philosophy. Is going to result in someone being acupuncture friendly.
Yep. So that’s a really good question. Well, so let’s start with the other group of people. So the group of people who will see the acupuncture works better than usual care, but because it’s only a small amount better than this fake acupuncture in this study, they’re going to downplay it. So these. People who are more interested in theory that in practice and they are most certainly looking at the body as if it were a machine.
And so there’s very specific rules that they will accept in terms of demonstrating that a treatment works, but they’re sort of ignoring where these rules came from, right. That these are, you know, developed by people in vulnerable and, and that sort of thing. The. We’re more likely to look at the same body of literature and look at acupuncture and see it in a favorable way, tend to be more people-based than theory based.
And so they’re more pragmatic and they’re more interested in how acupuncture helps people. In the real world and how it compares to their available options. So, one thing I’m fairly quick to say is if a so-called acupuncture, skeptic, um, looks at studies where acupuncture, outperforms, pharmaceuticals, and usual care and still insists despite the evidence that it’s a placebo.
Then my question to them is, well, why doesn’t your treatment, your real treatment work, as well as the placebo. Really good point. Yeah. I also love the pet analogy. Like why does my dog feel better after acupuncture where presumably there is no bias. Yeah, no, I, I agree with that. Um, I had spent a lot of time in discussion with the self-styled skeptics and they will argue that there is a placebo effect with lab rats and cells and all sorts of things.
But then I feel like they’re getting a little bit desperate at that point. Yeah. I, I. Commends the strength that it takes to argue with skeptics. Um, I feel like as a clinician, trying to help people feel better. I’m certainly pragmatist. If someone decides they need to take a pharmaceutical drug, I don’t, I don’t disagree with them on philosophical grounds.
I support their decision to do what’s right for their body. And it’s the kind of thing where I’d love to see. I’d love to see really all clinicians. Give patients the freedom to make choices that are right for them. And that feel good. And you know, like that, that seems to work for them or even to the end to admit their own biases and areas where they are simply, or they simply haven’t delved into the research.
Oh, I can that, I completely agree. I think that what I’ve discovered, cause I’m always, you know, I’m really fascinated about why people think, what they think in. How, how people’s minds work and where authority comes from and this sort of thing. And I think at the end of the day, it’s really helpful to have more than one map or model of how something works so that you can use the appropriate map to help best help you get the result that you want.
Um, so if you’re gonna, I don’t know if you’re going to go visit New York city. You might want a tourist map. You could also have a map of like their sewer system or something like that. That might not be as helpful to you. It’s not wrong. Um, but we also recognize that the maps going to include certain things.
It’s not going to include other things and it’s going to have a certain zoom level. And I think what happened was that what, you know, what we think of as conventional biomedicine had a lot of really big wins, you know, in the early. 20th century, maybe even the late 19th century, they discovered some things about human disease and human health and some in developed really wonderful tools to address those things and really save millions of lives in the process.
The problem was that then they developed a map about how humans work based on those successes. Not realizing that that map is really useful. In certain cases and is not only not useful in other cases, but I would go as far as to say, is really dangerous when applied as the only map. And so I think that in that worldview, there is a myth that they’re not even using a map.
There are just looking at reality and for anybody who’s, um, I don’t know, exploring. Things enough to have the benefit of using different models, conceit, see the problem with that logic. And so, um, really comes down just for using the right map for the job and switching to a different map. If you have a different question.
And I think this is a way that people can be empowered to make better healthcare decisions, and practitioners can also do a really great job of knowing when this tool or that tool is going to be most helpful. I couldn’t agree more. I really there’s so many. Uh, there are so many ways in that people can utilize to help themselves feel better.
And it’s the kind of thing where like, just being able to knowing who to refer to and knowing, knowing kind of what lens to look through that might be useful, I think is, is something that. Really important for all health care providers to, uh, like to recognize like that no one has a monopoly on truth and being able to like swap out the lens you’re looking through to, to see how you can best help someone, um, can be, can be really important.
I just got back from a workshop on treating auto-immunity and fibromyalgia with Chinese herbs and Xi gong. And it was so empowering because the whole workshop, like. I had gotten so used to looking at those conditions through a functional medicine lens that I’d really forgotten the power of looking at it from a Chinese medicine perspective.
And so just it’s like, it can be even just within my own practice, I find that just. It’s, it can be really rewarding to, to deepen into one way of looking at something and to shift gears and to, and to look through it another way, looking at all my patients with new eyes after this workshop. And it’s really, it’s really endless.
Absolutely. You can always zoom out further. You can always come in further. You can step across. Yeah, absolutely. That sounds wonderful. I’d love for you to give us a sense from what you know of the research, what kinds of conditions is there really rock solid razors for people out there who are, who are maybe still acupuncture, skeptics, or acupuncture, agnostic, who might be curious, how can this medicine really help for, for what conditions might we think of it best for?
That’s a really good question. I think. One observation I made fairly early on in looking at the literature was that hockey puncture seems to shine most and to have the highest effectiveness and efficacy rates for conditions for which conventional medicine is. Performance. And I now realize that that’s not a coincidence because it’s going back to that map that the map they’re using is an unhelpful map for this condition.
And then not that we have that kind of fills in some of those gaps is a more helpful map. So that, that definitely applies to most pain conditions. Um, it certainly applies to migraines and tension-type. It’s really quite wonderful at balancing and regulating the hormone system. And then as I’m stepping out, you know, you asked about conditions and these conditions really are defined according to the Western biomedicine map, which is interesting.
So we’re looking at the conditions of the diseases based on where they are geographically in the body. But what we find is that. Acupuncture is really excellent at improving people’s self-regulation and that’s always. It’s also not just acupuncture, right? I mean, acupuncture is the sexiest branch of Chinese medicine, but Chinese medicine also encompasses herbal medicine and lifestyle and diet and exercise or cheek gong or meditation and all of these.
And the fact that most of us are set up in a place of being able to. To look through the lens of Chinese medicine, give someone a diagnosis that we then employ as many of the branches of the medicine as the person is willing to work with in order to recreate balance and health and the system as a whole.
And it’s like a lot of times I think that’s, what’s really missing is that it’s not just slinging needles. Like we’re, you know, we’re giving people a sense about how to make choices in their lives that are in fact medicine that go along with their diagnosis.
Absolutely. And you’ve actually highlighted something that’s a little bit kind of unspoken or hidden in the research literature.
And also when we’re talking about it is that acupuncture can be referring to a treatment that’s given by an acupuncturist. And so it’s referring to this worldview, this worldview that understands that people live in relationship to their inbox. And that they are multifactorial and that we’re really going to use all of those things that you mentioned in order to help the person heal.
Acupuncture can also refer to, um, what we would say is as a device, a medical device, and when we’re studying it that way, we have different goals and different questions. Um, and then that can lead to some faulty conclusions and faulty reasoning, but it’s also done that way. Partly to build up the evidence base.
So it’s a little bit of a tricky line to cross, but you’re absolutely right for people who are listening, who either have acupuncture treatment or would like to go see a Chinese medical practitioner or an acupuncturist, you’re going to be seen in context with your environment. And it’s really, you know, a wonderful and dynamic, uh, approach to healthcare there.
A difference between, as you were talking about it, like the idea of. Treating a condition like for example, knee pain, someone comes in with knee pain, we might identify what kind of pain it is, where it is. We might identify what channel it’s on. We’re going to pick some points and not only pain is created equal, right?
Because your knee pain might be coming actually from the fact that your hip is. Continually and outward rotation because you’ve got a tight muscle up there and that that’s affecting the way that your knee impacts the ground. And so for you, it’s like, it might not be that we’re treating your knee at all.
It might be that we’re treating your hip in order to talk to your knee. And that’s, that’s a question that I always have when we’re thinking about these studies where it seems like limiting to, to have. Point prescription where you apply, like kind of some of the studies that don’t show that acupuncture is particularly impressive.
And it’s because they’re using the same 12 points on all of the people in the study, you know, it’s it’s, it goes against our whole notion of bio-individuality and, and diagnosis of the individual. Like seeing, we treat, treating the person with a condition as opposed to treating the conditions. Absolutely.
Absolutely. And I think that also it’s reflective again, of these different ways of looking at people. So one distinction is that conventional biomedicine is looking at, is looking at particles under the microscope. It’s looking at meat. Um, it’s looking at body parts. It’s a lot of its understanding came from studying dead people.
So it was really looking at much material. On the other hand, Chinese medicine is really focusing on the relationships between things and the spaces between things, even the meeting of acupuncture points, really denotes something hollow, um, something that’s not there. So, if you have a Western trained practitioner, they might be aiming for tissue.
And if you have a traditionally chained practitioner, they might be aiming for space. How, you know, how interesting is that? Well, and, and that’s a beautiful example of the different ways that we can practice with the different ways of practicing acupuncture, right? There’s this idea of, oh yeah. You find a trigger points in a muscle.
You find, you know, you’re, you’re actually, you’re going for you’re palpating. and type things versus, uh, versus yeah, the space that, that is there. And you’re going to get cheap in both places. You’re going to, you know, that, that sense of the energy arriving at the point, which can feel a little bit like a light, gold, light bulb going on, or a little bit like a zing, a little something electrical happening at those points.
And sometimes there may be a, um, you know, a structure associated with it and sometimes. Absolutely. And that’s, um, that hard to explain, right. When people are saying, oh, I think you hit a nerve. It’s like, well, maybe not exactly. Yeah, no, absolutely. And, and also. Going back as well to these different worldviews and how we’re approaching it.
Right. It’s that, it’s the idea of also looking at, you know, how do we, what do we think is causing some things? So if you take your example of knee pain, then the, of the simplistic conventional, you know, under the microscope explanations, like, well, there are nerves in the knee that are transmitting a pain signal to the brain, and that’s true of all, all of these people who have this knee pain and that’s kind of like.
Pedantic, almost autistic sort of answer, but that’s sort of the answer, but if we step back a little and go, well, what’s causing that, um, that’s where if we have 10 people in front of us with knee pain, we might start to see 10 different causes and it really starts to become common. So. So, you know, th th that person has an externally rotated hip.
That person fell on their need, that this other person, you know, has bilateral knee pain and rheumatoid arthritis. And, and you can start to see very, you know, very quickly that it doesn’t really, you don’t need to be rocket scientist to see that these people have different types of knee pain that might benefit from being addressed in slightly different way.
Exactly. Are you familiar with thinking about the different kinds of like in Chinese medicine? We’ll think about liver chewy or kidney cheek, and there’s this movement to start thinking about it as nitric oxide or as gases, like translating Xi as gas. Uh, yes, I’m, I’m familiar with that. Um, Andrew Miles, um, has been doing a lot of research in that area and he makes some really compelling arguments.
I agree. I had him on the show recently and I really appreciate his podcast and yeah. And, and just that, that notion that like, it’s, it’s fascinating that Western medicine is starting to talk about. The gases associated with different organs in the body and how they function as neurotransmitters. And that, that in fact can be a proxy for what we think of as cheap.
No, I love it. And I think it goes really far to explaining a lot of the gaps in what we observe versus, uh, the explanatory power of these models that we had. And I think it’s very useful. I think personally, Ultimately, I don’t believe that we’re going to find a molecular analog of cheap, because I think that she is really describing something that’s more relational and relative, and maybe bioelectricity can better explain what we see in and that those molecular changes may be happen downstream.
The more and more things that we can measure and observe and see that go along with those changes the better. And ultimately, I, what I love and I try to teach is that if we can have more than one way of explaining things, then we can have flexibility. In how we explain things. And ultimately the purpose of explaining something is to increase or change understanding of your audience and said, you really need to meet them where they’re at.
So true. I, that, that I’m sure a lot of people are familiar with the notion of confirmation bias, that how we encounter information. And we will immediately reject it if it goes against what we already think, we know, and we’re more likely to accept it if we can fit it into what we already know. And so it can be really like a service to introduce another model, another way of looking at something so that you can kind of like, uh, increase your carrying capacity for information.
Absolutely. And almost, you know, when you talk about someone coming across new information and trying to fit it into what they know, it’s almost like they have the map in front of them. And now they’re figuring out where to put this thing on their map. And I think that’s really valuable. And then if we can go, maybe even a level beyond that, we can become aware of how different types of maps are structured.
And now we can have like a filing cabinet full of different maps and we can jump between them. And that can be really. Super fun. And, and so really just to outline this for people like in, in the Chinese medicine that we we’ve already made some of these distinctions, right. That Chinese medicine we’re focusing on the relationships are focusing on space or focusing on what happens in a living being as opposed to the meat, the, the physicality and, and that which can be seen when you cut open a dead person.
Right. That that’s, that those are, those are different ways of looking at the body. We’ve talked about how thinking about. As an ecosystem is different than thinking about the body as the machine and thinking about the body as a bunch of interconnected systems, as opposed to a bunch of parts that we can swap out, um, are, are kind of like, just are, are, are, are part of these different models of looking at conventional medicine versus Chinese medicine.
And in, in that way, we see a lot of parallels with functional medicine, right? Like, like functional medicine is actually. Pretty much, I would say closer to the Chinese medical model than it is to Western medicine as traditionally conventionally practiced. Uh, absolutely. Um, my understanding is that functional medicine, modern functional medicine was actually founded by a few.
Traditional Western MD docs who were dissatisfied with the model of healthcare that they were part of and how the limitations of how they can help people. And I think they all traveled to, um, some travel to China and say Chinese medicine and other ones to Indians study Ayurveda. And then what they brought back, uh, I usually refer to is like the conventional biomedicine and Chinese medicine had a love child.
Oh wow. I had no idea that that was part of the, how functional medicine was born. Yeah. I think Jeffrey bland went over there and I think a few others. And if you get the kind of, it’s maybe getting a little dated now, but if you get that giant dark Navy blue functional medicine textbook out in the early pages, you’ll see.
Tree. Um, and you’ll see the roots and you’ll see the branches. And, you know, I started studying this just after I finished a Chinese medicine. I’m like, oh, well, this looks awfully familiar. And, but what I discovered fairly quickly is when I would discuss Chinese medicine. Doctors and other medical professionals and against some self-styled skeptics, they’re like, ah, Chinese medicine.
She woo. You know, this is silly. And then I studied functional medicine and I went fairly in depth into biochemistry and organic chemistry and neuroscience. And I was like, okay, great. Now I can communicate with this population. And so I would to talk about these pathways and I would, they would give me the same look.
That they’ve given me, women talked about Chinese medicine, I thought, okay, so I’ve got the right language. But what I realized later is that it is a different paradigm and that is where we were all in different pages. Talk to me about proximate versus ultimate causes of disease. Uh, yeah, cool. This is, um, I came across this way of explaining an understanding, um, these different causes and it was really, I thought it was really, really helpful because it really clarifies things.
So if you imagine that a disease or a diagnosis or a symptom is. The last domino falling over and you’ve got these, all these dominoes lined up, then the proximate cause of that domino falling over is the domino right before it, that knocked it over. Um, and that tends to be what conventional biomedicine is focused on.
And it’s usually going to fix it using a chemical or intervention. The ultimate cause is the first domino. Right? So, uh, it’s the, the original domino that knocked it over. This makes sense, because when we talk about what causes disease, the way someone answers again is going to depend on whether they’re focused on the D the reaction right before it, or going back further into people’s real, real lives.
And this is sort of like a working theory, but I’d say, you know, the more. That’s uh, something resembles an emergency. The more, it’s helpful to look at the proximate cause. So if someone’s like arm’s been blown off, then we don’t necessarily need to have a long chat with them about their childhood and their bonding with their mom and how they feel about things and make their diet.
They should probably just get their arm back on. But if we’re talking about, you know, the, all of the top causes of death and disease in the United States, And other places, these are lifestyle diseases and the ultimate causes or things that new, and there’s nothing new under the sun. It is, um, connection with others.
It is stress levels, life satisfaction, diet, sleep, exercise, and movement toxicity. It’s all of these things. And the medications that are being given, given to address those things are not bringing the person back to equilibrium. They’re only really addressing that. Proximate cause and sometimes making the person overall less.
Well, I love the way you put that. The domino explanation I think is, is a really easy to grasp for metaphor because even things like, um, people getting sick frequently, you know, like people, um, that we can think about like. Um, oh yeah, I caught a cold and so therefore I have a sore throat and congestion or whatever, but we can, we can think about like, well, why is this the third cold you’ve gotten this year?
You know, like what’s going on such that you’re a susceptible host for whatever virus or bacteria is coming into your system. And this is where we can in Chinese medicine, we have this notion of terrain. We have the notion of like, what kind of imbalanced. Are we kind of chronically cultivating such that we are going to be the right kind of host for a particular kind of pathogen or what kind of, what are we believing?
What are we buying into on a regular basis about life, um, such that we aren’t necessarily taking care of ourselves. You know, like that, that’s a huge focus of my work with my coaching. Clients is helping people do the things that, you know, that you just mentioned, right. Exercise and sleep and nurse themselves properly.
And that all of these things really create resilience. These are the ways that we stay healthy and it’s so totally not sexy. Right. It’s just basic. Exactly. I know it does not make a compelling headline. And so, you know, there’s like, Yeah. Like, yeah, well, yeah, you need to get some more sleep and people are like, yeah, I know.
I know. And it’s like, okay. So if we all know like basically how to stay healthy, which you know, that we’ve yes. Social connections, sleep exercise opting out of the industrial food system and actually cooking whole foods and eating them in a, in a slow, relaxed way. All of that, managing our emotions, et cetera, what’s wrong.
That people can’t seem to do it. It’s like, I don’t think it’s the fault of the individual here. I think this is a cultural problem. What do you think? Yeah, absolutely. So it is definitely a cultural problem. What passes for normal around here is not good. So, um, there was a study that came out last year that showed that.
12% of American adults are metabolically optimal. So to be, for, to be metabolically optimal is to be counter-culture. Um, it has to be a total weirdos. So yeah, there’s definitely a problem with culture. Um, but that said as well, you know, be. Interesting as well to understand the mechanics, the neurology, the spirituality, all these things of how do we change?
How do we change habits? How do we understand? Because, um, yes, you know, culturally foods not healthy and we get, you know, too little vacation and, uh, we get celebrated for working ourselves into the ground, but at the same time, you know, I. Talking to loads of people who really, really want to do something differently.
They’re like, no, I’m, I’m sold. Ah, something’s got to change. And it’s like, how do we work with how humans work in order to make that sustainable and lasting? And that can be really. How do you work with that in your practice? Um, that’s a good question. So I, what I tend to do, I think at this point in time, because I’m kind of doing a little bit of a hybrid, you know, style, my own kind of style is let’s say for example, really common ones.
One that I saw today is someone who’s addicted to or eating too much sugar. Then I’m kind of curious. And maybe to oversimplify it, is this like mainly biological or is this mainly. Emotional, like, is it that their sugar crashing and then they’re craving it? Cause that’s what, that would be a normal physiological response or, um, was, you know, being given, um, you know, cake cakes and cupcakes and candy, the primary way that a distant primary caregiver showed this person that they loved them and an art scene, you know, both in combinations and, and then.
That will dictate how I go about guarding this person to changing the habit. So in the case of the kind of childhood attachment, I use hypnosis and healing trauma techniques, and this worked really well because if it’s based on a visceral unconscious program, then it doesn’t matter how much they understand logically that the sugar isn’t good for them or how much they don’t want to do it in a, in a way that decisions a little bit out of their control.
Um, and so we can update the pro. But, uh, for someone else, if it’s more physiological than, you know, we can give certain things to that person in different instructions about how to prevent it. And then, then they’re cool. Then they’re fun. Then their body’s no longer giving them signals that what they need right now.
Oh, awesome. I love it. And I love that you also work with habit change and with, with helping people really do the deep healing work of getting, getting past old traumas, graduating from old stories and really evolving that’s really, I think, and that’s really. I think the beauty of Chinese medicine is so much people, people come in, we have an opportunity to go deep with people because maybe they’re here for, for something on the surface, but we have the opportunity to probe a little deeper, and we have the opportunity to, if people are willing, uh, to, to open some of these doors to.
Go down many, many layers to the root, as opposed to just treating the branch of like, oh yeah, I, you know, I, I eat too much sugar, you know, or like, or even the branches, like I’m overweight or I’m, I just have issues or whatever that, um, and it’s just a it’s I think it’s a really beautiful example. I know you have lots to do in your day.
And so I don’t want to keep you too much longer. I, if people are interested in connecting with you, uh, where would you suggest they go. Uh, sure. So if people are interested in learning more about the evidence behind acupuncture, there is a nonprofit organization called evidence-based acupuncture.org that I’m a part of and work with a stellar team of international volunteers.
And so that’s a free. And you can find us on Facebook as well. Um, and in my private practice, I’m at Harbor integrative health.com and I also spend a bit of time on Facebook as well. So those would be a couple of good places to connect. Fabulous. And those will all be at the show notes at brodiewelch.com.
Dr. Mel Hopper Koppelman, thank you so much for joining me for this really fascinating conversation. Thank you so much for having me and for all the incredible work you’re doing. Thanks for listening today. To check out the show notes, get on my email list or drop me a line heads of Brodiewelch.com. That’s Brodie with an “IE” and Welch to the “CH” I’d love to hear from you.
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