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80 Acupuncture Treatment Staging
AN EMBODIED LIFE
outer actions and behavior and the invisible realm of inner sensa-
tions and feelings. "Our shape," he adds, "is a multilayered real-
ity, each layer a structure of inner and outer reality."2 Keleman
divides these levels into three zones: genetic (prepersonal), socie-
tal (postpersonal), and personal. Together, these layers form our
self as somatic image. "A somatic image is an anatomical or
behavioral form. Skeletal muscles are responsible for posture,
learned social roles, and instinctual gestures. They make a motif
of sensations that give a body image, an external, somatic image.
The pattern of visceral motility gives rise to sensations that estab-
lish an internal somatic image."3 In this crucial reformulation of
Freud's concept of body-image, Keleman emphasizes this dual
nature of somatic awareness of self, with an inner aspect know-
able only by oneself from the inside, and an external aspect fac-
ing toward the outside world and observable in one's body
structure and behavior. "A somatic image, then, contains inner
organ sensations and emotional configurations as well as body
stances and action poses. A somatic image not only tells the world
who you are, it also tells you who you are."4
As a phenomenologist, and like phenomenological psycholo-
gists,S Keleman emphasizes that we create our own space, our
interior, our insides as bodily forms not given at birth, which
some traditions might call soul or spirit. In this sense, then, we all
create stories that shape our body-image. "A story is an experi-
ence of organized bodily responses. It involves muscular patterns
of too much or too little form, too much or too little excitation."6
Memory includes these muscular and excitatory patterns as our
past history embodied in the present, according to Keleman. To
change old behavioral patterns, then, it is not enough to remem-
ber intellectually or recollect emotionally. One must also revive
the body's memory of a particular story, changing its muscular
Clearing the Suiface, Supporting the Core 83
A MULTILAYERED APPROACH
TO ACUPUNCTURE THERAPY
In the following pages, the treatment strategies I most com-
monly use are listed in the order of preference I give them. I
select these strategies in a way reminiscent of my early training
in Van Nghi's three levels (Wei, Ying, Jing): in terms of treating
on the level of suiface energetics, functional energetic reaction pat-
terns, or core or constitutional energetics, and adopt this three-part
division to discuss those strategies I have come to rely on over
ten years of acupuncture practice leading to a bodymind inte-
grative perspective.
Clearing the Suiface, Supporting the Core 85
Surface Energetics
Conceiving of the energetics of the surface not only as the realm
where Wei energy travels, according to tendino-muscular merid-
ian theory, as the zone controlled by the Greater Yang Meridian
Unit (Small Intestine and Bladder) in the Six Levels theory, and
as the site of exogenous invasions of the atmospheric elements
causing Bi (obstruction) patterns, but also as the bodymind's
armor (or the external somatic image, to use Keleman's concept),
we see that the simple act of needling into this surface is loaded
with meanings and effects that go far beyond the skin and fleshY
The late Dr. Jean Schatz, past president of the International
Society of Acupuncture and the European School of Acupuncture,
emphasized the relationship between the surface-energetic realm
of the tendino-muscular meridians and Wei energy, and Reich's
character armor as described in his teachings.
Conceived in this fashion, intervention at the surface, to free
up local obstructions by dispersing blockages, also puts therapist
and client in touch with the core of the bodymind. It is therefore
impossible, from this perspective, to free up the surface without
touching larger issues of one's reactions to the outside world
(except perhaps in some trauma cases). The reaction patterns car-
ried out in the realm of surface energetics (entailing tendino-
muscular meridian systems, trigger points, and Bi disorders) must
be evaluated initially to determine whether the muscular-energetic
zone is reacting in a specific way to an external stressor (for
example, developing wandering spasms, twitches, and pains in the
case of a "wind" disorder) as a unique, acute event, or whether
this reaction is part of a series of responses by the bodymind
always bringing into play the same meridian pathways or zones.
Disorders in this realm involve the skin, muscles, and ten-
dons (primarily in Yang, acute reaction patterns) or the joints (as
86 Acupuncture Treatment Staging