Five Element Acupuncture

Working the Withins

When I was in school learning Five Element acupuncture, there was occasional talk about this mysterious thing called the “Withins.” Each person has one element that is his or her Constitutional Factor (CF), which is the basis for Five Element treatments. And then there is a secondary one called the Within.

Some people describe the Within as the second car of our train. Our CF is the first car. Alternately our elemental makeup can be seen as layers, like transparencies where the second color shines through almost as clearly as the first.

I have understood that J.R. Worsley variously said a lot and very little about the Withins, although I do recall from somewhere that he said a practitioner must ultimately address the patient’s Within for full healing to occur.

This is my take currently on what the Withins are, how they show up, and how they should be treated.

First of all, I find that the Within shows up almost as prominently as the patient’s CF. We may hear it in the sound of their voice (Earth’s sing with an underlying groan of Water), an overlay of color on the face (Earth’s yellow simultaneously with Fire’s red), or as a prominent emotional dynamic.

These can be tricky to distinguish at first, but in my experience the CF will respond positively to treatment ending on that element’s command points, while the Within will not. The proof is in the pudding.

As an example, L.P. is a patient in my clinic. She appears as a quintessential Metal CF and had received maybe a year of monthly treatment with a positive response to Metal points. But over time I noticed a consistent need to be heard that I would characterize as the sympathy request that is a cardinal sign of Earth. You could say Earth was “talking” — shouting really. It came forward so strongly that I thought I should test her to see if Earth was actually her CF.

So, approaching this new element slowly, I first delivered Earth with needles retained in Stomach and Spleen command points. I find that retaining needles allows most patients to get the benefit of any element, even if it is not their CF, and it’s a way that I sometimes do a soft test of an element. In this case I also used Metal points retained, so there was a kind of dialogue there between Earth and Metal. Note that these two elements are physiologically connected via Tai Yin and Yang Ming.

The patient got a lot of satisfaction out of that dual Earth and Metal treatment, something she had not really fully gotten from her Metal-focused treatments so far. And satisfaction is such a great gift to the Earth element! So for the next treatment I decided to go further and give her a simple Earth CF treatment, ending with tonification of the Earth source points.

The patient happens to be very sensitive, so her negative response was quick. She was able to identify almost immediately that this was not a good fit for her.

My conclusion is that what this patient needs is not Earth as primary, but Earth, delivered in a container of Metal. The CF element is Metal, and the Within is Earth.

The photo above is an illustration of what that means, showing Earth (the yellow) in a container of Wood (L) or a container of Metal (R). This way the treatment is still delivered to the patient’s CF.

This is my interpretation of what a Within is and how we might treat it. In sum, the Within is something that shows up strongly in all aspects of the person as a second layer, but does not feel good as the final message of the treatment via the command points. This is the approach I have since taken with my patient L.P. She has confirmed that this feels good to her.