Healing with Five Element Acupuncture
An Interview with Robert J. Abramson, D.D.S., M.D., M.Ac.
Russ Mason: Tell me about the Five Elements.
Robert J. Abramson: It is a system developed in China centuries ago. It dates back to Lao Tzu
(see box entitled About Lao Tzu) and the Tao Te Ching (see box entitled About the Tao Te
Ching), where the Five Elements are discussed. It is not an artificial or human-made system. It is
looking and perceiving the way that nature is.
The Five Elements form a circle, in the way that the seasons form a circle. Each season
leads into the next, and each has unique qualities. So it is with the Five Elements. The only
difference is that there are five, not four, Elements. If we were to mirror this in our seasonal
reference we would add a late Summer season that would be after early Summer and before
autumn, or harvest time.
RM: Please take us through the Five Elements and explain about how they make an
impact on an individual’s health.
RJA: The Five Elements are Water (Winter), Wood (Spring), Fire (Summer), Earth (Late
Summer), and Metal (Autumn). Corresponding to each of the Five Elements is a specific color,
odor, sound, and emotion. The color category may be perceived in the patient‘s face. Voice, odor
and emotional state are all indicators of the person‘s state of health. So, for example, if the
person‘s face has a blue cast, then an imbalance in the water element is considered.
While the Five Elements are based on the seasons, there is no direct correlation between
the seasons and the patient‘s state of health. Each person carries with him or her all of the
properties for all of the Five Elements. So, throughout the course of a day or an hour,
―elemental‖ differences will arise and fall. If a person becomes momentarily angry, then the face
color will change, as will the voice, and so forth. A practitioner of the Five Elements assesses
patients as to their states of elemental balance or imbalance.
At the moment I am speaking to you from my porch. It has been raining for several days,
and water has been very prevalent, so let us begin with the Water element. Water is about flow,
allowing life its natural course. (I am referring to water in its liquid state, since frozen water has
no flow). The color is blue, the odor putrid; the voice has a deep groaning quality; the
predominant emotion is fear.
A Five Element practitioner also looks for a lack of water, dryness, in the skin, (for
someone who is) emotionally dry, mentally dry…the absence of water. So there are balanced and
imbalanced aspects to each of the Five Elements. The Water Element is about Winter; other
qualities are a sense of stillness and quiet. Nature is resting and building up its reserve. Then,
Winter yields to Spring.
The Spring, or Wood, element is about movement, growth, beginnings. The voice quality,
interestingly, is shouting and the emotion is anger. This may seem odd, but anger in this context
really means intensity, forcefulness, It‘s the sprout coming up through the earth, regardless of the
obstacles. How many times have we seen little sprouts emerge through concrete? The Wood
Element derives its flexibility from the Water, the previous element. Without the Water, there
would be no source of power. The odor is rancid and the color is green. This also means
forcefulness in one‘s behavior—sometimes a project needs to get pushed through; think of the
intensity of the birth experience.
RM: I can follow all of the transitions—Wood to Fire, for example—but not Metal into
RJA: I know. It seems less comfortable than the others, but one must remember that Metal, in
the form of rock, provides a home and channel for Water. Without the hard rock streambed, the
Water would drain away; on a smooth, cool Metal surface, Water condenses. The invisible
Through the Five Element System, through the Tao, we can feel an integral part of the
natural world; we are part of it, as much as the raindrops and the trees. And yet we are separate
and individual, the way there are individual trees and raindrops.
RM: Not all practitioners of acupuncture use The Five Element model. Please comment
RJA: Very true. But that is the case with most healing disciplines—there are many schools.
Take psychoanalysis, for example. A person could be a Freudian, A Jungian, or a behaviorist, but
each one works for the appropriate patients in the appropriate situations at the right times.
With Five Elemental Acupuncture, there is an integration of body, mind, and spirit. It‘s
all one. So when you go to a Five Element Acupuncturist, he or she will ask you about your
family life, your childhood… right up to what you had for breakfast this morning. Because the
more a practitioner knows about a patient, the more comprehensive the diagnosis and subsequent
treatments will be. This means knowing where to look for inappropriateness or imbalances.
Sometimes when people leave me messages on my answering machine, I can pick up
information about their state of health by their voices. There are vast differences just as there are
differences between a lavender (Lavendula angustifolia) plant and a redwood tree.
RM: You are both an M.D. and a master of Five Element Acupuncture. Please talk a little
about your practice and if you are able to integrate these healing systems.
RJA: Most of the time, when people come to see me, they come because something is wrong.
Lao Tzu talked about preventive medicine—stopping things before they start. His view was: If
you go to the doctor when you are sick, it is like starting to dig a well when you‘re thirsty. So the
real basis of all medicine should be prevention. But, alas, most people go to practitioners when
something is wrong.
My approach is always to talk with the person. Now it often happens that, even before the
patient sits in the chair, he or she starts with: ―Oh my left toe, doc! I have so much pain, it‘s
incredible!‖ And then, for some patients, their pain is the last thing they mention. So, while we
are all fundamentally the same, we are all totally different. That is one reason why Five Element
Acupuncture is so powerful. As Carl Jung (M.M.; 1875-1961) said, you need to create a new
treatment plan every time a patient comes to your office.
For the first visit, I allow an hour-and-a-half in which the patient tells his or her story.
There is no desk between us; we are face-to-face, getting to know each other. Very often, people
come to me or go to other acupuncturists, because these patients weren‘t helped by other
You asked about Western medicine. It is wonderful when used appropriately. The
principal options are surgery, medication, and radiation, and there are times when these
treatments are appropriate. Five Element Acupuncture says: ―You know what? We will work
with what you have. We will not inject anything or cut anything out. We are going to open up
There is a great quote: "There is no illness, only stagnation. And there is no cure, only the
re-establishment of flow". This refers to qi, or the life-force, within each of us.
RM: Who said it? Lao Tzu?
RJA: I wish I could say I made it up! But I found it in an obscure book in a library long ago.
But it says it all.
RM: Is there any part of your allopathic training that comes into your practice now? Or
are you pretty much in the Five Element model?
RJA: It‘s hard to separate out all of the things I do, because I see my activities as being part of
a larger, integrative whole. But yes, I talk about blood pressure, lab values, and the patient‘s
entire medical history. But I practice Five Element Acupuncture.
Also, Five Element Acupuncture is not symptom-based. That is, if a patient comes in
with a sore back, he or she may expect me to take a look. I will examine the back but Five
Element Acupuncture is about bringing the whole person into an appropriate balance, from an
energetic point of view, so I will also examine the entire person.
I will begin with a treatment called tapping or draining Aggressive Energy. So I am
assessing the status of the Five Elements within the patient and finding the Element that has the
most, or earliest, damage. That will be the primary imbalance, and this is what Dr. Worsley
referred to as, "the Causative Factor".
For example, if you look at the wheel of the seasons and we have a dry Winter, or lack
the Water element, this will affect every other season. The crops won‘t be that good so,
therefore, the harvest won‘t be that plentiful. So the Causative Factor is a lack of Water.
Each element has the ability to influence the others- this is what I look for. I determine
the Causative Factor by assessing a person‘s color, sound, emotion, and odor to find which
Element is primarily out of balance.
Each of the Five Elements has corresponding organ systems. For example, the Fire
Element is the Heart, Small Intestines, Triple Heater, and the Heart Protector. Wood is the
Gallbladder and Liver. Water is the Bladder and Kidneys. Metal is the Large Intestine and
Lungs, and Earth is the Stomach and Spleen.]
The acupuncture treatment I do is based on what the Causative Factor is. The actual
needling takes a fairly short period. The person is not going to be lying there with needles in her
or him for 20 minutes. The technique is in and out. The goal is to remove the blocks and open the
channels. What helps the process is that people innately want to get better, and nature strives for
RM: Let’s get back to the patients and arriving at a diagnosis. If I were to come to you
with a problem, you would be evaluating a spectrum of variables. So I might have too
much Wood in one aspect of my health, or not enough Water in another? Is that right?
RJA: [laughs] Yes, that‘s right. You‘re a practitioner! I‘ll give you a degree!
RM: Do you use other adjunctive therapies in addition to acupuncture such as herbs, for
RJA: I do prescribe some Chinese herbs and use moxa when appropriate. I also recommend
some homeopathic remedies, which are gentle. I discuss diet with the patient, and whatever
substances and medications they are taking—and why they are taking them. We always come
back to what is appropriate for this patient.
RM: In Five Element acupuncture, is the needling technique different from other forms
RJA: Yes, there are differences. The point location is quite similar but the needle technique is
different. For example, we almost always start on the left side of the patient, which is the
tonifying side. The patient‘s right side is the sedating side. We begin on the left side. We find the
point, put the needle in the direction of the flow of the meridian, reach the depth, engage the qi,
and then tonify, by turning the needle a half-turn clockwise. Then we pull the needle out and seal
up the hole with pressure. By tonifying, we are opening up the channels.
RM: So you don’t leave the needle in for a long length of time?
RJA: Rarely, but sometimes I will if it is appropriate. To leave the needle in, starting on the
right side, has a calming or sedating effect. Sometimes a patient will come in and he or she is
ready to explode (the pulse is plus, or excess, from a Five Element prospective) on a physical or
emotional level. The patient needs sedation, so that is what I treat.
But, whether the person is being tonified or sedated, the practitioner must check the
pulse, which is part of the evaluation process. Even if the patient has an acute physical problem,
like a sore knee for example, there will also be an emotional component to the pain and mental
and spiritual components to the pain. Similarly, if a person comes in with an emotional
problem—angry or depressed or can‘t sleep—this may manifest on a physical level at times or
on a spiritual level.
That is why the discussions are so important—because the emotional problem may be
one from childhood or anxiety about the future. There are people who will carry around scars
from childhood for more than 40 or 50 years, and that might be inappropriate for them. The
emotional scars will prevent them from stretching fully, like a rubber band that can only go so far
and then snaps back.
Five Element Acupuncture can cut right through a lot of stagnation… it‘s experiential.
The first thing Lao Tzu says is: "The real Tao can‘t be talked about in words."
RM: How did you find out about Five Elements Acupuncture?
RJA: I started as a dentist in 1971. Right around that time I started doing acupuncture with a
professor of mine, Martin Rubin [D.D.S.], at New York University Dental College, New York
City. Back then, acupuncture was not well-known, but President Nixon had reestablished
diplomatic relations with China and James Reston* had come back from China and Chinese
medicine was beginning to attract interest in the West.
Dentists were especially interested in acupuncture as a treatment for pain. As I recall,
WNET, a PBS television station, showed people undergoing surgery with acupuncture as an
anesthetic and this was fascinating to us. We were excited because acupuncture suggested there
would be fewer risks or hazards, or expense, than with local or general anesthesia. But it never
really took hold in the West. Western anesthesia is quite profound and safe.
But we did use acupuncture for head and neck pain, sinus pain, TMJ [temporomandibular
joint] pain, and other musculoskeletal problems. In time, I came to realize that the kind of
acupuncture I was doing was not completely satisfactory. It was symptomatic acupuncture (a
"cookbook" approach). In fact, there were—and probably still are—books that you can look up a
problem and the book will tell you where to place the needles.
This didn‘t resonate with me but, when I read about The Five Elements, that was
something that made sense intuitively. Then I went to hear Dr. Worsley speak, in Philadelphia,
and I thought: "This guy is saying what I need to hear." It was like water to a thirsty soul.
That was 1975, and I soon became his student and went to Royal Leamington Spa,
[Leamington, Warwickshire, England], four or five times a year to study Five Element
Acupuncture with Dr. Worsley. He talked about the Tao and the Universe and how love and
compassion are essential to the healing process. He was able to diagnose a patient from across
the room correctly! He set the bar very high and I thought: ―This is the way I am going.‖
I began to practice Five Element Acupuncture a few days a week and dentistry a few days
a week. But then an idea popped into my mind, and that was to go to medical school. I was
recently married at that time and wasn‘t sure if my wife would be supportive of this idea but she
embraced it fully. Because I was already a dentist, I received some advanced standing and went
to Downstate Medical College [New York City], and did my internship at King‘s County
Hospital, in Brooklyn, New York. In retrospect, it was the right thing to do.
After I received my M.D., I continued to go to England and Florida to study with Dr.
Worsley. I learned a great deal from him and we remained the best of friends until he passed
away in 2003. I learned much from Dr. Worsley; and my patients benefit from this remarkable
RM: Bob, thanks very much for an informative interview.
RJA: Thank you.
[Alternative & Complimentary Therapies, August 2006, VOL. 12, NO. 4]