Five element acupuncture – an overview

In every style of acupuncture the practitioner aims to treat the root of the problem. Rather than treating symptoms as separate issues everything is taken into account and we look at the person as a whole rather than the individual symptoms that they present with. Five Element acupuncture can be particularly effective when it comes to treating the spirit or the vitality of a person. Therefore, it is often used to treat anxiety, depression, insomnia, etc. or in the case of chronic illness where there is no apparent cause.


One of the biggest pioneers of Five Element acupuncture was a British acupuncturist named J R Worsley. He looked at humans as a microcosm reflecting nature so he looked to nature to help him treat people with acupuncture.  J R Worsley believed that every person contained the Elements (Fire, Earth, Metal, Water, Wood) and their qualities but he also believed that every person had one Element that was weaker or more out of balance than the rest. He called this the primary imbalance or ‘Causative Factor’ (CF). Like a weak link in the chain he thought that the primary imbalance would lead the other Elements to become weak or imbalanced leading to disease.


Five Element really focuses on treating that weak link so that the other Elements can harmonise and our Qi can flow smoothly. This makes it quite an elegant style of acupuncture as, during a treatment, only 4 needles may be used to treat the primary imbalance.


While someone’s ‘Causative Factor’ can be their weakest link, when all of the Elements are balanced and in harmony the qualities of that Element can also be their greatest attribute. I’ll discuss this further when we look at each of the Elements in turn.


The Five Element cycles


The Five Elements are often depicted in this manner. First you have the Sheng cycle otherwise known as the ‘Generating’ cycle. What this means is that each Element basically creates the next one.

  • Wood creates Fire by burning.
  • Fire creates Earth from the ashes.
  • Earth creates Metal by hardening.
  • Metal creates Water by containment (minerals not allowing the Water to soak into the Earth).
  • Water creates Wood by nourishment.


The next cycle is the Ke cycle otherwise known as the ‘Controlling’ cycle and what this means is that each Element basically keeps the next Element in check so it doesn’t grow out of control.

  • Fire controls Metal by melting.
  • Metal controls Wood by cutting.
  • Wood controls Earth by covering (Wood binds the Earth so it doesn’t scatter or erode).
  • Earth controls Water by damming.
  • Water controls Fire by extinguishing.


Diagnosing the primary imbalance

As practitioners we use our observational skills to diagnose a person using four things: Colour, Sound, Emotion, Odour.

– What is the main colour around the eyes?

– Is the tone of voice congruent with the behaviour and what the person is saying? When we’re listening to the tone of the voice we’re trying to determine whether the tone matches what they’re saying. Are they talking about a frustrating experience with a laughing tone in the voice?

– Is the emotion smooth?  Does it fade away naturally? What we’re looking for is the most inappropriate emotion. Do facial expressions match the tone of the voice match what they’re trying to convey with their words?

– Are they constantly laughing and joking? (Fire)

– Do they find it difficult to move through and out of anger? (Wood)

– Are they frightened of everything and need constant reassuring? (Water)

– Do they struggle to take in sympathy or are they constantly asking for it with their words or their facial expression? (Earth)

– Do they get stuck in grief? (Metal)


The next post will feature the Fire Element and what a Fire CF might look and act like.

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