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Tonify or sedate a point


I read an article on the internet that concluded with the statement that it doesn’t matter if you tonify or sedate an acupuncture point as it is the metaphysical intentionality of the practitioner who is stimulating a point that matters. Some articles I’ve read say to twirl the needle clockwise or counter-clockwise to tonify or sedate, and other articles saying to do it the reverse way. It seems there is no real understanding or agreement about how this is supposed to work. No wonder so many people are sceptical about the use of acupuncture and refuse to try it because it all sounds like magic. What do you think about this? Thankyou.


The practice of acupuncture is an art. Just like some artists prefer watercolor to oil, natural to synthetic brushes, etc there are also a variety of stylistic differences in the field of acupuncture. There is no one ‘right’ way to needle. I personally prefer using a neutral technique. Most patients prefer a minimal amount of pain and frankly most needle manipulation techniques result in pain unless you have a lot of practice doing it. And since I’ve gotten excellent clinical results using neutral needling technique, I don’t see any reason to incorporate manipulation techniques into my practice. Hope that helps.


How I understand it (just being a student of TCM) the Qi system of the body always is trying to be in balance, as this is it’s natural state. As acupuncturists we try to correct the imbalances by stimulating acupuncture points. The Qi system reacts in the way which is needed to restore balance, either by sedation or tonification. Some points are more bound to react with a sedative reaction, others with a tonifying one.


In my opinion what it comes down to is what you really think is happening with acupuncture. So if you think acupuncture is like steering a river of qi around the body - then it would be easy to think you need the needles to guide it in a directional way. If you feel the needles are a large part of what does the work so to speak, then you feel that needle manipulation makes it more effective.

If, however, based on what we know from most clinical research you see that acupuncture largely stimulates the brain and then the body to perform certain functions - then it comes down to whether you see a clinical difference in simply asking the body to do this (i.e. even needling, no manipulation) or whether you want to yell at it so to speak (i.e. more aggressive needling/techniques). Personally, I’ve never been convinced that any of the more aggressive techniques lead to anything positive - but I read the clinical studies closely that look at these issues.

After studying and using Japanese acupuncture which generally uses very light techniques and from own personal masters who get impressive results with even needling, I am a hard sell on the need for strong techniques.

What I’ve found, and this comes from the thought processes instilled in me from years of clinical practice - but even more so from the practice and teaching of tai chi, is that even if you could argue that stronger techniques create stronger stimulation you have to balance that with the tension it can create in the patient. So stronger stimulation of a point with a patient that is tense or in pain is generally going to disperse their energy and the areas of the brain that their reactions are lighting up are very likely going to stop what you are trying to have happen. For those reasons, in the vast majority of cases, even needling with no or limited manipulation seems the most effective.


Thankyou Chad, it’s a very interesting subject and thought provoking.

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