Is Asian more Pejorative than Oriental?

I wrote this piece in response to the changes that happen with respect to language and terms that we use to describe who we are and what we do. In the Roman Empire, the term Asian was bloodied by the spread of empire. Today, the term Oriental is in decline, and the states of California, Washington and New York have purged the term Oriental from their legal documents. What was once a term designed to avoid national centrism and equitable representation of medical practices from the East has now been framed in the West as a term associated with hegemony. 


First published as an Op Ed in Acupuncture Today May, 2007, Vol. 08, Issue 05

There is currently much debate within the medical field about the proper naming of medical practices which have their roots in China. It has gone to such extremes that the California legislators officially changed the word Oriental to Asian However, in an effort to be politically correct, they may have missed the mark.

Asian
The words ‘Asian’ and ‘Oriental’ have similar roots. In ancient times, they referred to the direction of the rising sun. The term ‘Asian’ occurred in Greece as a descriptive for what is now Turkey some fourteen centuries before the Common Era. Further, ‘Asia’ may come from the Akkadian word (w)aṣû(m), which means "to go out" or "to ascend," referring to the direction of the sun at sunrise in the Middle East; it is also likely connected with the Phoenician word asa meaning east. For the Greeks and Romans, the term ‘Asian’ described those peoples whose power and territory were usurped in an imperialistic and hegemonic attempt to rule the world.
Oriental

The term ‘Oriental’ emerged during the post enlightenment era in connection with the European fascination with Eastern culture. The origins of the term ‘Orient’ c. 1300 originally referred to the East. By the time of the 19^th century ‘Oriental’ was connected to the colonization of the Near-East and the East by France and England and later the United States. It was during this time frame that ‘Oriental’ was used to express European imperialism at the material, aesthetic and sociological levels. According to Edward Said, “Orientalism, a way of coming to terms with the Orient that is based upon the Orient’s special place in European Western experience” (1978). Thus the post enlightenment and imperialistic world of England, France, and later the United States, used the term ‘Orientalism’ as a reference to character, style, trait, or idiom felt to be from the Orient.
1970’s Development

The histories of these two words pose an interesting quandary for the present day field of acupuncture and Oriental medicine (AOM). We now ‘fast forward’ to North America in the late 1970s. The Chinese, Korean and Japanese communities are developing a legal structure for their culturally distinct medical practices. The Japanese and Koreans adopted the term ‘Oriental Medicine’ in order to reflect their medical practices as distinct from the Chinese yet sharing a common foundation.

Under these circumstances, the term ‘Oriental Medicine’ developed into a brand identity. Regulatory agencies throughout the United States began using the term ‘Oriental’ as part of the language of legislature and incorporation. Several agencies adopted the term.  These included the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM), the Federation of Acupuncture and Oriental Medicine Regulatory Agencies (FAOMRA), the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM), and the American Association of Acupuncture and Oriental Medicine (AAAOM).

Currently, the term ‘Oriental Medicine’ is identified with the aggregate practices of acupuncture, herbal medicine, manual therapies, cupping, moxibustion bleeding, exercise therapies and dietary therapies. The field has matured in terms of its identity

We find some commonality for use of the terms ‘Oriental’ and ‘Asian,’ in post modern medical practices of North America.  Both terms are rooted in an desire to fairly represent cultural practices from the Far East .  The dominant cultures and countries that brought the practices of acupuncture and Oriental medicine to the West, notably, China, Japan and Korea seek to be identified fairly.

However, the identity of Asian medical practices tends to lack specificity due to the wide-ranging geographical, cultural and medical influences. Consider the following facts. The Thai, Vietnamese, as well as the sub-continental practices of the Unani Tibb, Ayurvedic and Buddhist medical disciplines have unique features of practice.  But they have no licensing status or official regulatory recognition at this time. Further, the full plurality of medical beliefs and disciplines practiced throughout Asia involve more than 60% of the global population. It is also the earth’s largest continent with 29.4% of the land mass. It is necessary to create clear practice and geographically based description of the profession.


Chinese Traditional Medicine
Some linguistic authorities such as Heiner Fruehauf and Paul Unschuld recommend using the term ‘Chinese Traditional Medicine.’ Ideally this captures the heterogeneous body of practices that compose the history of practice. However, the use of this description poses nationalistic concerns for the Vietnamese, Korean and Japanese communities, not to mention the French, English, Dutch and Americans.
While these ethnographic and cultural concerns are debated, the American public has a small but growing awareness of what ‘Oriental Medicine’ entails.  The western community is increasingly aware of acupuncture and that disciplined training is necessary for its successful practice. The phrase acupuncture and Oriental medicine captures this very well.


Oriental Medicine
The contemporary American use of the term ‘Oriental Medicine’ has a positive, specific and historical usage that emerged when the discipline was constructed into a professionally recognized in the US during the late 1970s. Generally speaking, the term is inclusive of the entire body of medical practices in which certified and licensed acupuncturists in the USA engage. It includes a plurality of national origins as well as methodologies. Therefore, my recommendation is to remain with the name ‘Oriental Medicine.’


[I no longer make this recommendation due to the changing legal and cultural climate involving the term Oriental.]

Said, E. (1978). Orientalism. New York: Random House.

Lorena Monda, DOM

Keynote Address AOMA Graduation September 12, 2009

I am delighted and honored to be here to celebrate your graduation with you. Last Sunday I was sitting in a meditation hall at Deer Park Monastery in Escondido, California listening to Zen Master Thich Nhat Hanh speak. His talk was about happiness. He talked about the capacity to stop and mindfully recognize a moment of happiness. To know a moment of happiness when it is present. To feel the energy of happiness in yourself. So let’s do that now—stop for a moment, and recognize this happy moment. Take a moment to acknowledge and feel your accomplishment, which has come to fruition after years of hard work.

Ceremony belongs to the realm of the fire phase, the realm of the shen and the heart. The heart allows us to joyfully connect with others, to feel and offer gratitude to all the people and things that have inspired us and gotten us to this potentially happy moment: our teachers, for example, our loved ones. Shen locates us in the here and now, and allows to act from our deepest intentions and aspirations in the here and now. It seems important to remember your aspirations—what drew you to this medicine those years ago—as you stand on the threshold of making this medicine your own.

Making Oriental Medicine your own—that is the key to your success as a practitioner. You have learned from many teachers, the stream practitioners before you who have kept this medicine alive for thousands of years. And now it is your turn to step into the stream. 

How do you make Oriental Medicine your own? You make time and space to listen for what inspires you. You allow yourself to be nourished. You find what makes you happy. You trust yourself. You cultivate your talents and gifts, the things that make you unique as a practitioner. You know and respect your limits. You cultivate internal and external resources to help you. You find what offers you encouragement when things get tough. You stay curious. You keep learning. You develop a relationship to the unknown. You let your patients and your challenges teach you, and let your experiences make you wise. If you do these things, people will be happy come to you for treatment.

 

25 years ago, I was in your seat, happily graduating in a graduating class of 8 people, in a country where it was legal to practice our medicine in only a handful of states (Texas was not one of them). 25 years ago when I told people that I practiced acupuncture, many of them said “what’s that?”

I was drawn to our medicine because of its beauty and power. Because it treated people as whole beings. Because it worked. I was drawn to this ancient medicine, because it was something “new.” I was excited because I knew that I could have a hand in shaping how Oriental Medicine was practiced here in my country, in my time.

25 years later, this is truer than ever. We are still pioneers. What many of us have known for so long is now at the forefront of the national debate: Our healthcare system is broken. We are fortunate that we practice a medicine that has the power to transform, not only individual lives, but communities, society, the planet. There has never been a time in the history of Oriental Medicine in America when we did not have to pay attention to our place in the larger society. Whether we are conscious of it our not, or whether we want it or not, this is part of our medicine.

Right now we have the opportunity, not only to influence the practice of Oriental Medicine, but to participate in the transformation of our whole healthcare system. If there was ever a time to get involved at this level it is now. There are great people in our profession doing great work in this regard. Some of those people did the hard work of making it so you can practice legally in all but a handful of states in the US today. We have helped millions of people. We have made inroads into hospitals, community clinics, medical schools, nationally funded research projects, regional accreditation boards, etc. My father-in-law used to send us clippings from the newspaper or magazines whenever acupuncture was mentioned (I think it was his way of saying, “so this is really legitimate.”) He has stopped doing that lately. I think he gets it now.

Last weekend, in New Mexico—a state where oriental medicine practitioners worked for and achieved primary care physician status—New Mexico acupuncturists in conjunction with the AAAOM, our national professional organization gave about 100 treatments to legislators from all over the country at the National Foundation for Women Legislators conference. (They loved it by the way. The first brave few, told their friends, and then there was a deluge…) We did this because we wanted the work we do, the medicine we practice, to be in the awareness and felt experience of lawmakers at a time when the healthcare system is on everyone’s mind.

I encourage you to include as part of your professional life, the active participation in your state and national acupuncture associations. I encourage you to include the healing of communities, society, and the planet in your vision of how you practice Oriental Medicine.

Now, just a couple fun facts to launch your careers:

In 2006—the first of the 76 million baby boomers, the generation born between 1946 and 1964, turned 60.  As a member of this generation, the generation that brought alternative medicine to the edge of the mainstream, I can say that we have never been content with the status quo, even as we are creating it. 76 million baby boomers getting old…I am sure we don’t want to do getting old the way it has been done before… I recommend knowing something about geriatrics…

In 2007—more babies born in the US than in 1957 the height of the baby boom, so some pediatrics wouldn’t hurt either….

Lastly, I want to remind you that you if you plan to make this profession your livelihood, you have made a lifelong commitment to cultivating a relationship with qi, healing, and transformation, and that includes your own. I wish you many moments of happiness in the practice of this beautiful medicine. I am happy to have you as my colleagues.

Congratulations!

Acupuncture and Oriental Medicine Education, Critical Thought and Complexity

First published in Acupuncture Today November, 2008, Vol. 09, Issue 11
Knowledge is not an object or a tool that can be used without studying its nature. It is a question of preparing minds to reach for clarity. Part of this comes with the awareness that what we know is subject to error. There are several bases for these errors of knowledge, which might include rational thought, emotions, blinding by paradigms, face saving, resistance to change, conformity, stereotyping and self-deception, the unexpected and uncertainty (Morin, 2001; Ruggiero, 2006). Understanding how knowledge is built should figure as a primary requirement to prepare the mind to confront the constant threat of error and lack of critical thought that can and has affected the progress of the profession of acupuncture and Oriental medicine.

The purpose of education is to transmit knowledge. However, education is “blind to the realities of human knowledge, its systems, infirmities, difficulties, and its propensity to error” (Morin, 2001, pp 11-12). Historically, certainty has posed a level of vulnerability that has been repeatedly proven over time by the likes of Galileo, Keppler and Prigogine. Yet, education in general still does not bother to teach what knowledge is.

Our way of knowing and acting in our world, continually reinforced by our cultural conditioning, has established a complex interlocking system. Everything, including language, educational systems, economies, commerce, politics, and social institutions: is dependent upon everything else. Underlying this great superstructure are our concepts, beliefs, assumptions, values, and attitudes, which are linked together like an underground network of pipelines connecting across a vast continent (Tulku, 1984). Universities teach emergent science and technology, however the premises of thought upon which all our teaching is based are ancient and…obsolete (Bateson, 2002).

It is time for an educational process that is based on inquiry into uncertainty, the global crisis and complexity. Education has an ‘anthropo-ethical’ mandate vis-à-vis individual-society-species (Montuori, 2005). It takes place through a human awareness of individuality concurrent with a conscious participation and awareness as a member of the species and a member of society. Taken as a mode of transformation and preparing members of society, we might consider four primary areas of scholarly inquiry for the professional, they include: personal transformation, improvement of professional practice, generation of knowledge, and the appreciation of the complexity, intricacy, structure and beauty of reality (Bentz & Shapiro, 1998).

It seems important to discuss the difference between “informative’ and “transformative” learning at this point. Informative learning is the acquisition of knowledge, skills and attitudes. Transformative learning brings about a transformation in self-identification, the role the individual maintains within the culture and in the ways of thinking, communication and defining knowledge. Therefore – all learning is transformational in some dimension. What becomes important is where the transformation takes place, for what purpose and whether it is designed as part of the educational outcomes.

If inquiry, learning and knowledge are to be pertinent, education must elucidate these factors: I must penetrate my reactions to and affinities towards the matters of question. I must unhinge myself from the biases of patterned belief to consider the great potential of error in thought, perception, recall and conclusions. This may create a space for learning, knowledge and inquiry to occur authentically and with a modicum of validity. To this end I will discuss six thought habits that can distort critical thinking including these concepts: mine-is-better, face saving, resistance to change, conformity, stereotyping and self-deception (Ruggiero, 2006).

Mine-is-Better

The idea that ‘mine-is-better’ is a basic human trait that can be observed in child-hood as well as various stages of civilization and culture. It is present in academia on the basis of conferred degrees and often supersedes the values of ‘meritocracy.’ The real contributions of an individual are as important as the past accomplishments or degrees achieved.

‘Mine-is-better’ thinking leads to thoughts that consider others are lesser or even subhuman. Historical examples of atrocities stemming from this form of thought abound in the prisons, insane asylums and leper colonies. A weak sense of self often drives this need to bolster the ego by somehow thinking of others as the lesser. We can move away from self-flattering errors and gain more objectivity about what may be a more unpleasant reality. And, if we can recognize the piece in ourselves it is possible to make contributions to unbinding the white male Euro-American dominator system that impairs partnership values in organizational development.

One example of this is the type of thinking that goes on between schools of thought in Asian medicine. We see the mine-is-better thinking in the way that TCM and Worsley practitioners have positioned themselves with each other in the market place. However they seem to both serve their patient populations well.

Face Saving

One of the strongest influences for upset and anger in interpersonal relations is ‘face saving.’ It triggers deep emotional conflicts from past traumas. Looking good is what it is about. People will attempt to take credit for work performed by subordinates and peers in order to look good. This poses an ethical quandary that impairs leadership because people do find out. In addition, they will blame peers, people in the position before and subordinates in order to save face. This disempowers leadership whereas owning the responsibility gains respect and honor. It is bizarre. The very attempt to save face actually causes a loss of face.

Here is an example in the story of the three letters. A president takes office and he finds three envelopes in her desk left by her predecessor. The instructions state: when you get into trouble, open the first envelope. If trouble comes again, open the second envelope. And if it comes again, open the third envelope. So, the new president hits a problem with an external regulatory agency and opens the first envelope and it says, “blame the previous president.” So she does. This gets her through the problem. However, the agency returns and there is another problem and she opens the second envelope. It says “blame your workers.” She gets through this one and a new problem arises so she opens the third envelope. The letter says “get three envelopes.”

Resistance to Change

This is the tendency to resist change and new ways of thinking without a fair analysis. Sometimes this tendency can be very unconscious. A child asked her mother, “why do you cut the end off of the ham when you cook it?” The mother replied, “I don’t know, my mother always did and that is how I do it.” So, the child approaches her grandmother to find out only to hear the same statement, “I don’t know, my mother always did and that is how I do it.” So, the child goes to her great grandmother as asks her “why do you cut the end off of the ham when you cook it?” The great grandmother replies, “we had a very small oven and I had to cut the ends of the ham off in order to get it into the oven.”

Culture is, the way we do things around here. Often this is tied not only to social convention or unquestioned behaviors but also to survival. The psychological drivers against the forces of change can be powerful, evoking survival responses and deep reactions that confound the ability to see what is real. Openness to change is not an abandonment of critical thinking. It is the suspension of judgment long enough to give new ideas a chance.

We saw this when the field went to the master degree in the late 1980s. There was tremendous fear that schools would be put out of business and that there would be unfair competition between practitioners in the market. These fears were never realized. Similar fears drive the current resistance to the development of specialties and first professional doctorates.

Conformity

Conformity can result in peer pressure and group values affecting decisions in place of critical thinking. Rooted in face saving, the desire to not stand out or be different from the group can be powerful. This has political and cultural value when large populations seek to maintain order and is seen as a virtue in Confucian ideologies where a peg must not stand above others on the board. To stand out like this has posed threat to life during various periods of Chinese history such as the Cultural Revolution and the Gang of Four, or the Khmer Rouge, a communist party in Cambodia.

These environments cause one to conform as a means of survival. The cultural developments then extend into work environments in the US and other ‘free’ countries. This problem extends to the personal and behavioral level. An individual can develop a response to a set of circumstances that are overwhelming such as a violent parent. Later in life, the person continues the behavior as a habit, even if it kills them. This is a learned pattern of behavior (habit) that once ensured survival but now impairs life. The conformity is to the learned patterns of behavior.

We find conformity in the national processes of Chinese medicine. For instance, sometimes California acupuncture politics are dismissed because it is “California.” This allows stakeholders in the profession from other areas of the country to write off the opinions of an influential state that has in the past led on legal and educational requirements in the field. In this instance, California politics in AOM are dismissed because they do not conform.

As a point of clarification, there are very good reasons for conformity. However, the need to conform is so powerful that to recognize it and suspend it while giving due consideration to new ideas and concepts will enhance the ability to think creatively and critically.

Stereotyping

Does functional stereotyping have a place? While stereotypes are a convenient way of organizing reality and may provide insight, they must be exposed: they distort our view of reality. “Blinded by stereotype” is a risk if it becomes an irrational and unbending generalization. The most common stereotypes are sexist, racist, religious and nationalistic. This type of thinking dazes and muddles the mind and impairs the ability to sort, analyze and contemplate the nuances of reality. Ruggiero quotes Walter Lippman, “Stereotypes are loaded with preference, suffused with affection or dislike, attached to fears, lusts, strong wishes, pride, hope. Whatever invokes the stereotype is judged with appropriate sentiment…Neither justice, nor mercy, nor truth enters into such a judgment, for the judgment has preceded the evidence” (2006, pp 56).

This is a difficult area. We are a field that is engaged in the transmission of knowledges across language and cultural chasms. Further, one can never underestimate the powers of assumption in multicultural environments to confuse and add fuel to the fire which supports stereotyping as a means of coping. One example is the statement that Asians must learn the rules and regulations of the American environment. While this is true, it becomes a way of dismissing a need for a critical examination of what we are doing in AOM education and the building of legal systems for practice.

Self-Deception

Katherine Anne Porter observes that, “One of the most disturbing habits of the human mind is its willful and destructive forgetting of whatever in its past does not flatter or confirm its present point of view” (Ruggiero, 2006, pp 55). Take blame and resentment for instance, when these are held from the past, they are hardly seen as ones own set of behaviors such as “I was angry.” But the finger of blame is readily pointed. As a teacher in AOM said to me once “it is good to have someone to blame.” This was said in jest, however, when I quoted him, he corrected me stating, “No, that is not what I said; this is what I said, ‘tis human to err, ‘tis more human to blame.” This was a rather humorous interaction and benign, and I recall it endearingly. However, recreating history according to the needs of self worth is powerfully motivating. Looking good and maintaining ‘face’ compel people to recreate history. However, in a group process, when there are discrepancies between the stories and the recollections, this process of self-deception can erode trust.

In Summary

Complex thought is contextual and connecting. An example is the perspective that comes from considering the recursive loop between the individual and society or a social system and global concerns. That idea that individuals make society, and society makes the individual becomes a powerful component of the socialization of the physician. To entertain ‘complex thought’, it may be useful to consider that while the whole is greater than the sum of the parts, the whole is also less than the sum of the parts, and the whole is greater than the whole (Morin, 2001).

References

Bateson, G. (2002). Mind and nature, a necessary unity (6 ed.). Cresskill, NJ: Hampton Press.

Bentz, V., & Shapiro, J. (1998). Mindful inquiry in social research. Thousand Oaks: Sage.

Montuori, A. (2005). Gregory bateson and the promise of transdisciplinarity. Cybernetics and Human Knowing, 12(1-2), 147-158.

Morin, E. (2001). Seven lessons in complex education for the future. Paris: UNESCO.

Nicolescu, B. (2002). Manifesto of transdisciplinarity. Albany: SUNY Press.

Ruggiero, V. R. (2006). The art of thinking. A guide to critical and creative thought. New York: Pearson Longman.

Tulku, T. (1984). Love of knowledge. Berkeley: Dharma Press.