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Dr. Mike Smith presenting in Germany

As a doctor, part of my responsibility is not just to treat people but to set up a treatment system for a lot of people.  So you set up a treatment system that is very teachable and very reproducible.  We use ear acupuncture in ways that are convenient and then ways that are necessary in terms of treatment.  For instance, I run an AIDS clinic every week – I have an assistant to treat ear points before I do body points, because I want to settle people down and reduce fear and improve their focus.  Then the rest of the treatment will go better.

We used to think that we were using ear points just for convenience, and, if we only knew the right body points, it would work a lot better.  It took me several years to understand that this is not the case.  If I had to use body points for addiction, I would do less well than if I had used ear points.  I started out thinking just the opposite – I even wrote several articles about it, saying it was just the opposite.

I remember sitting in the clinic watching the clients.  A couple of hundred patients a day for 20 years gives you a lot of information.  Addicts are very convenient patients because they’ll honestly refuse to come back, they’ll honestly tell you you don’t know what you’re doing, and you can tell when something’s happening.  And I began watching to see which of the patients would show improvement.  We had staff that were very good at body-point treatment and would give extra points, more points, but we didn’t see any improvement.  You saw staff’s desire for improvement but you didn’t see any improvement.  We take urines every day and you could see who was doing well.

Second bit of evidence:  we used to have a protocol where we had Baihui [GV20] and He Gu [LI4], and we did that on everybody in addition to ear points.  And when you have a protocol, it’s hard to know what is necessary and what just makes you feel good.  And so one time I said we’re not going to do these points on the hand.  Make up a reason and we’re just not going to do them for a month and see what happens.  First of all, none of the patients asked for it – which tells you a lot – and there didn’t seem to be any change.  We did the same thing with He Gu.  These are very useful acupuncture points, but it doesn’t mean I have to give you two kind of noodles when I already gave you one kind of noodle.  That should be enough.  We eliminated the Baihui point and nobody asked for it.

We used to have general medicine and drug abuse treatment all in the same room.  And drug abuse patients are historically considered to be very needy, self-centered, demanding.  Drug abuse patients almost never asked for body points.  The only time they did was when they were high and they wanted attention.  But the people who wanted to get better – and, if you walked four miles to the clinic and your life depends on it, you want to get better – you don’t want to have a second-rate treatment. 

Based on all these things, it became increasingly clear that these ear points have a value that is quite different than other treatments.  It doesn’t mean I couldn’t do almost the same with other points – I don’t see any indication that I could do better.  That throws you into an angry thing of Why?  What is going on?  An irritating discovery.  Let me help you through some of that.

We have in the Bronx people coming from all parts of the world, and we have people coming from Puerto Rico.  Women who’ve worked on farms all her life.  Her toes spread out because she walked barefoot all her life.  Very grounded, very yin, earth energy.  Well in our program, we give everyone ear points while they’re waiting to get arthritis treatments and so on.  About a third of Americans who were not addicts would fall asleep and show very obvious reactions to the points.  Very often so much so that you didn’t even worry about their other problems until they got stable.  But these women from Puerto Rico never reacted to ear points at all.  They would often say, Well when does the treatment start?  Americans never say that because even though they may not be falling out, they knew something was happening.  It taught me, I think, that what we are doing with these people is that we are grounding the person.  We’re not just developing the yin energy but the whole energy that makes the body sort of stay in one place.  These women didn’t need that.  They lived all their life walking on the earth, and grounding was something they were good at.  People in China and Asia over the centuries didn’t need that.  So if you don’t need that, you’re not going to discover treatment for something that is not your problem.

We look at these machines that go back and forth, and drink plastic and so on like that all the time, after a while you do need these things.  And you especially need these things if you’ve been frightened or traumatized or chemically deranged so that you’re not in your own process anymore.

The ear is something that doesn’t change very much from birth.  It doesn’t do a lot, it doesn’t have a lot of jobs.  So this is a way of interacting with the baby in all of us so to speak.  This interacts with issues that are issues for a baby as well, and so these ear points are helping a person develop and grow and center again. 

And so if you have a person come in for instance who has lupus, and the person is very frightened and very disturbed and very panicked and very embarrassed, you might try the ear points for a week or two to settle that person down, to prepare them for your general treatment.  Many people are too frightened to lay down on the bed, they’re confused, not sure if you’re important or they’re important, basic things.  And ear acupuncture is a preparation for basic things.  A lot of times that’s all a person needs.

But just because I know how to do a technique doesn’t mean the person is in the right position to receive that treatment.  You have to prepare for these things and this is a simple system.  You don’t want to take pulses when people are afraid of you, when people are nervous.  And very often when you talk to a person in a private office the main thing you get is that they’re afraid and nervous about being there with you.  Nervous with themselves in all sorts of situations.


[Now he’s giving people a treatment.]

Observe and help us all listen to what the results are that the people might have.

I try to tell the Americans that the Germans are more relaxed about these precautions than they are and they have trouble imagining that, but it’s true.  That’s not to say that people here are not careful and compulsive and all that, but that’s to say the American reaction in these things have to do with fear and panic and projection, not logic.  And that’s my job – to treat fear and panic and projection.

People come in who are very upset and distracted, and you’ll see the difference this treatment makes.  Because if you don’t have these kinds of information, it doesn’t necessarily make sense what we’re doing.  This is a treatment that is valuable because it’s practical.

Let me talk a little bit about how this treatment helps the treatment system in general, the counseling system in general.  First of all, I have to say that drug treatment in Europe is not very good, not very extensive, not very successful.  It’s not successful primarily because the expectation of how well people can do is very low.  And the people expect that this person who is a junkie and an addict really isn’t going to change very much, isn’t going to do very much.  So we have to provide minimum treatment, minimum methadone, and not really a lot of other services and just be cautious and so on.  I think a lot of that has to do with the image of what treatment is all about.  And when you learn about acupuncture, hopefully we can sort of adjust that image.

When I got into the field as a medical doctor, treatment was about treating withdrawal symptoms and crisis of detox, and if I did that well, then you sort of made a referral somewhere and you did what you were supposed to do.  In the beginning we made treating withdrawal symptoms very complicated, and we used short-acting barbiturates with alcoholics – it was just ridiculous – but after a while we learned you could use benzodiazepines for alcohol and methadone for narcotics, and you can treat withdrawal symptoms very easily.  Acupuncture will also do that treatment about as easily, but all these treatments are convenient. 

And the doctor will say, Well this person has behavioral disorders going on for 10 years – we treat withdrawal symptoms in a week – it’s okay.  Well that doesn’t make any sense the more you think about it, and it doesn’t work very well.

So what happens if I’m a doctor and I treat withdrawal symptoms.  I’m doing the best I can.  I’m doing a protocol I know.  I’m using medications I know about.  Yet the patients start out good and they keep turning bad again all the time.  So I get discouraged.  I say what is it that can help?

Now some programs, if you have a lot of money, the programs provide all sorts of social services.  There’s a program I remember visiting where they find you an apartment, they get you lunch.  They help with this, they help with that, they help with something else.  Well as soon as I heard all this, I knew that they weren’t having any success either.

Because the definition of addiction – one of the best definitions of addiction – is “You cannot give an addict anything in a useful way.”  I give them something – Oh, I’ll sell it for more drugs.  I give them something else – Oh, I’ll hustle it for more drugs.  I give them something else – Oh, we can trade that for something else.  Oh, I need this letter that says I have cancer – then I can get more methadone because I have cancer.  Oh, I’d like to have this, I’d like to have that. 

And somebody says this person sells drugs that they are dangerous, all their customers start to die.  Well what happens is that dealer gets more customers.  People come and buy drugs because they want to buy something that is harmful.  That is the whole point – they are trying to harm themselves.  The pretense is, Oh, I’m just doing it to feel good, I want to feel better.  That just isn’t the case and isn’t the case almost any time. 

So a person will turn every nice thing you do into something harmful.  So what can I do?  I treat this person nicely – I listen to them, I talk with them, and then they go out and seek a boyfriend or girlfriend who treats them really terribly.  And I say you deserve more – then they go out and seek someone else that treats them badly. 

To give you a New York example.  You have a person standing in a window getting ready to jump, and you say you’re a good person, don’t jump – they jump.  You say you’re a bad person, they turn around because now we have something to talk about.  This is not only true for addicts, it’s true for depressive people, it’s true for paranoid people.  They cannot tolerate anybody who gives them good news, and they don’t respect anybody who gives them good news.

Suicide rates go up in the springtime and go up when the sun rises.  Because that is good news, and good news is so different than their own world.  If the springtime bothers you, what kind of doctor can I be?  I’m trying to give you something that gives you more light and more relaxation, and yet springtime frightens you.  Everything frightens you.  And so it’s a situation where people say, Well, what can I do?  There’s nothing I can do on the outside.  That’s totally correct, there is nothing you can do on the outside.  Threats won’t work, promises won’t work.  All this stuff won’t work.  And then you say, Well, what is this?  What is going on?  And they have a saying in Alcoholics Anonymous, and the term is an inside job, and what it says is that the primary way this person will get better is through their own process and growth and change – internally through their spirit, through their self.

And first you say well that’s an alright theory but this person is terribly destructive, this person doesn’t do anything right, this person has no promise of anything like that.  How can they possibly have this inside job?  Only good people should be able to grow like this.  And that’s where the mistake comes in.  Number one, we can all grow like this, but growing like this is difficult, and so you grow like this when you’re desperate. 

And you talk about spiritual change.  Well spiritual change isn’t what I pay $100 to go to the ashram because it would be good to have spiritual change.  Spiritual change is when you’re walking on the desert and you don’t know what’s going on and you’re lost.  And then something comes in.  Spiritual change comes best to people who are desperate, people who hit bottom.

And we’re using acupuncture in a context to support this process. And how does acupuncture even relate to this process?  Remember I said before that you couldn’t give anything to an addict?  Most of the time we can’t even touch them.  They’re not interested in being touched.  They’re frightened.

And so acupuncture first of all gives you a way of touching people that is okay.  “Oh I’m not sure – I don’t like that.”  Then you touch the right spot, and you touch it in a way so the person responds.  And if you’re in the field, this is a very striking thing that now you have a way to touch the person and be in a natural nurturing process rather than not have that.

The second thing that acupuncture does – remember I said you couldn’t give anything to the person because they wouldn’t want it, they would be bothered by it?  This allows you to give a person quietness, to give them privacy, to give them solitude – and they take it.

I went to a drop-in needle-exchange place, and they had what was called junkie art.  All these pictures on the wall that were very jagged and wild and strange and so on.  And they said this is done by all the junkies, all the addicts.  I said no it wasn’t, it was done by the people before they got the drugs, that’s people who need drugs. 

If you want a picture that was done by a person on drugs, they don’t draw these jagged lines.  They sort of schmush up some yellow and white and lay back.  Drug addicts do not want to be noisy and nasty and wild and all that.  They are paying money to shut up and be quiet, to be polite, to be silent.  That’s what they’re paying for – peace at any price. 

And so I’m going to give you peace at a good price, peace at a constructive price.  And I’m going to give it to you in a way that you can tolerate it.  If I sit there and say, Oh I’m going to give you this treatment and it’s going to help your body improve and all that, the person doesn’t like that.  So – we’re just going to put these pins in.  Now the person’s going to observe that their body is improving, they’ll observe that there’s calmness and settled behavior. 

So acupuncture is not only doing a treatment, it’s teaching the person what is possible in their own system.  That is very important for a drug addict who feels that nothing good is possible and that their whole system is broken.  And it is good for the whole society who certainly agrees that nothing is possible, that the whole system is broken.  Everyone needs to see that in 15 minutes I can take someone that yesterday put a screwdriver in her eye and missed, and today they’re going to be calm and be able to work in this program.  And I expect that happens, I don’t know many times that doesn’t happen. 

That doesn’t mean their whole life is better.  That means I can show them the possibility that they can be calm and easy and the possibility that something like an inside job – that is, their own development – might actually occur instead of just being a cruel joke. 

To treat drug abuse, the first thing you have to do is make the person feel safe.  The second thing you have to do is indicate that the whole thing still works, that improvement is possible.  That’s very different from most health care. 

The third thing you have to do is give the person possession of something, because what you’re doing is taking away something from them.  Most times when I do health care, the first thing that happens is I give you something.  With addiction, what’s the first thing?  You’re going to lose a love object, you’re going to lose this heroin that’s been your life.  You rented your kids out to have a little more heroin.  And suddenly right in the beginning: Oh yeh, you can’t have anymore, you can’t do that anymore.  Well that’s very shocking.

And so the first thing that happens in health care with addiction is that you take something away that’s very valuable.  Why would I want to do that?  If I have something that I like, that’s valuable, and all of a sudden you’re going to say you can’t have it.  What day would I want to volunteer not to have this?  It may be harmful but it has a value, and they’re too weak and frightened to go for anything else.

I’m in the ocean and somebody threw over a little string – I hold on to the string.  It may not hold me up but, what, I should hold on to nothing?  I’m going to hold on to the string.  And somebody else throws a little bigger rope over there, but you gotta let go of this one to go over there and get that one.  Well I’m not sure I can get there.  How many of us want to throw away something that we’re holding on to out of desperation? – not very many. 

So the drug abuse treatment right from the first day has to be safe.  It has to provide some relief so that the person sees that improvement’s possible.  And it also has to replace the loss that took place – replace the loss right away, not a week later or a month later.

Well psychotherapy and group therapy has none of these three characteristics at all.  It may be very valuable in the future.  It may help you change your behavior.  That’s what I learned in school, but it has none of these characteristics.  I see this stranger and Oh good, you can trust them and admit all your weaknesses and they’ll help you.  Well I’m an addict because I don’t trust other people, I don’t even trust myself.  Now I’m supposed to do all these other things.  I’m just going to be more of a victim, there’s going to be more of a problem.  I don’t want to do that.

And so acupuncture puts the treatment program in a point of interaction that is possible.  And that’s why clients come back.  Because it’s safe, it’s possible.  And I’m not just believing something.  You’re not just putting something over on me.  We’re working with this whole thing.  This is very important with trauma survivors, this is very important with refugees. 

Refugees – what happened?  They lost all their love objects.  They don’t know what they have.  They don’t know what’s going on.  They don’t know what’s happening tomorrow.  And we say, Oh yeh, you should go and try for that.  Well I just lost everything I got yesterday – I don’t feel very adventurous today.  I don’t want to try a lot of stuff.  Well you could try school.  Yeh I could fail from that school – I don’t want to do that.  I failed yesterday, I lost my home.  I’m going to lose everything else now?  I don’t want to lose. 

So you have to have a treatment that helps a person that’s in that state of affairs.  Because all of us, if we were made refugees, and if we were damaged when we were young, we’d all be in that state of affairs.  And it’s a question of how can I come out of that and the only tool I have is me.  That can seem the weakest tool, the most useless tool.  How dare you say the only thing that can help me is me when I’m already beaten and I’m already ruined and stuff like that.  How could you say that?  And frankly none of the other tools are working.  You can see that as well. 

Acupuncture is a gateway to the spirit and the growing process – the living process within.  And short of me teaching you yoga for six months and tai chi for six months, I can do this in two minutes and we’re in a better space. 

Treatment needs to work as fast as cocaine to retain anybody who uses cocaine.  That doesn’t mean it does everything.  It means it opens the door.  It means it sets the table.  It means it’s part of a cooperative thing.  And these are very difficult things to do in a private office.  They are very useful things to do in the public sector.