Too Many Cooks in the KitcheN
By Ken Andes, L.Ac.
Summary:
Patient Screening Process
Before a person becomes a patient at our office, we do a general screening process to determine if it’s worth it for them to come for an assessment. We want to know what their main issue is and if it’s something we have success with. If the issue is not something we have good success with then we’ll tell you that upfront and over the phone. We want to know what medications they are on because some medications make it unsafe or risky for the person to be treated with acupuncture and/or herbs.
We also want to know what other doctors and treatments the person is receiving for their main complaint. The reason why is because sometimes the patient is receiving a treatment that conflicts with the way we practice Chinese medicine and can thus nullify the treatments we provide.
Certain treatments mix well with what we do and certain ones don’t. It also depends on what the main complaint is. A treatment that doesn’t mix well for a specific complaint might work well for another complaint. It all depends. But this is something that we determine when the prospective patient calls and we collect their info.
Constrained Model of Energy Expenditure
There is a theory in evolutionary biology known as the “Constrained Model of Energy Expenditure”. What this theory states is that humans have a finite amount of energy that they can expend on any given day. The body will then spend these limited energy resources on the following three tasks:
One way to understand the constrained model of energy expenditure is to imagine that you wake up each morning with $100 worth of body energy. Once the $100 is spent you get no more money for the day. This $100 has to be used for vital functions, your daily job (and exercise routine if you have one), and tissue repair/recovery. The function of tissue repair needs to happen in both healthy and sick people but there’s a catch…sick people require higher amounts of daily energy expenditure towards recovery than healthy people do. The degree to which this happens depends on how sick you are.
In a perfect scenario, you would have an efficient body that was able to conduct vital functions without expending too much energy. You would have a job that is not too stressful (either physically or mentally) and doesn’t deplete your $100 of energy. You would also not be in the process of trying to overcome a chronic illness and thus needing to spend all of the $100 trying to conduct tissue repair. In this state your need for tissue repair would thus be minimal.
But let’s say the situation is not so perfect. Starting with a state of chronic illness, your body is already spending a large portion of that $100 towards tissue repair. The “money” being spent on tissue repair takes money away from vital functions like heartbeat, breathing, and hormone production. And then on top of it you have a stressful job (or home life) that sucks the life out of you and further depletes the $100 you woke up with.
This is how people get sick, stay sick, and get progressively sicker. The body can’t keep up with the energy demands and vital functions become compromised as the demands of life and chronic illness increase energy expenditure.
Healing process consumes energy
The process of tissue repair/recovery consumes limited energy reserves. It’s important to realize that treatments for chronic illness also consume limited energy reserves. This is something that patients fail to take into account and they end up getting in trouble because of it.
Acupuncture treatments, herbs, and supplements all require energy to be processed and utilized by the body. Sure the intent is for it to increase body energy, but before that happens energy reserves must be spent to process the treatment.
Think of the process of lifting weights to build big muscles. The process of weight lifting actually tears down and creates trauma to the muscles. Shortly after working out the person is tired. But during the time between workouts the body repairs the damaged muscle tissue and it becomes stronger than it was before.
If someone wanted to get big and strong in a hurry, they could spend 6 hours a day, every day, lifting weights. This would do nothing but make the person sick and injured because they are doing too much and not allowing the body to process the workouts.
The same thought process applies to getting acupuncture treatments. When the needles are placed in the pressure points, a neurological stimulus is sent to the brain which then carries out the healing process. Think of acupuncture as a set of instructions that are given to the body on how to heal itself. The body then carries out the healing instructions and this requires energy expenditure to do.
Just as muscles become stronger in the time between workouts, so does the body heal during the time between acupuncture treatments. As I say to my patients, the actual healing process happens after you leave the clinic, not while you’re on the treatment table.
Acupuncture requires that the body spend energy to produce energy. Because of this you have to be careful when treating people who are chronically ill and depleted of energy. Over aggressive treatment, including too many treatments, can actually make the person worse. It’s no different than the guy who lifts weights every day because he’s in a rush to get big muscles.
Herbs and supplements also require energy expenditure before they create healing results. When you take herbs/supplements they have to be digested and absorbed by the body. The process of digestion requires a large amount of energy which is one reason why you see appetite loss when people get sick; the body is trying to conserve energy so it tells you to stop eating.
This is the danger of taking too many supplements and I see it all the time. A person is taking supplements from 3 different doctors as well as stuff they read about in a magazine or on the internet. After a certain point it becomes impossible for the digestive tract to fully absorb everything they are taking. And even during the process of absorption the body can end up expending more energy than the supplements end up giving to the body, thus creating a net deficit.
Another thing that happens is that a person is taking a dozen different supplements for a chronic illness, and perhaps one or two of those supplements is the right one to heal the illness. The problem is that the correct supplement then has to compete with a dozen other products for absorption in the digestive tract. If the patient was only taking the supplement that mattered, perhaps 80% of it would get absorbed (which is good). But in the presence of the other supplements only 20% or less of it would get absorbed.
Overtreatment is a real thing
The concept of overtreatment is discussed in Western medicine where you have a patient taking too many medications and going for too many unnecessary procedures. The danger of overtreatment is that you can create adverse reactions within the body and harm the patient.
The concept of overtreatment also applies to natural medicine but to a lesser extent. Whereas you don’t see life threatening reactions (unless something really negligent was done), what you see is a further exhaustion of an already debilitated state from too many supplements and too many treatments. Too many doctors working on the same person at the same time, each trying to make the body do something different.
The treatments we offer at Natural Chinese Medicine, whether it’s acupuncture or herbal medicine, require that the body spend a certain amount of energy in order to create healing energy. It’s like that old saying that you need to spend money to make money. It is for this reason that we want to know what else the patient is doing as part of their healing process. We want to make sure that we are not creating a state of exhaustion and energy deficit by overtreating.
Things take longer when you’re in a rush
Being in a rush and tackling a project with aggression and urgency can work with certain things like cleaning a messy house or finishing a project at work, but it can backfire when applied to chronic illness.
What I see happening is that a person becomes sick, or a long-term problem suddenly gets really bad, and that person wants it fixed now. And by “now”, what they want is for it to be fixed right now.
So they go on the internet and look up every supplement, every treatment, every procedure that could be effective for their illness and they try to throw everything at it at once. They feel that if they hit the problem from every possible angle that it will cover all bases and provide an immediate cure. They feel that going to several different doctors/healers at once will have an additive effect so they try to create a “team” of doctors similar to how a football team is created.
The worst cases of overtreatment are seen when a child becomes sick and the parents go into a panic and try to do everything at once out of desperation.
The problem with this approach is that the body is not a machine or piece of equipment that can be modified at will. Any modification to the body, and this includes therapeutic treatments/supplements, will require that the body expend limited energy reserves to process the treatment. If done without judgement and discretion this process can exhaust the body into a state of further harm and deterioration.
One problem of having too many cooks in the kitchen is that if the patient does indeed get better, you won’t know what it was that made the person better. Each doctor (cook) has a different theory as to why the patient is sick and is working off of that theory. If the theory of why that person is sick results in a successful outcome, then the patient not only has the cure, she now has the understanding of how she became sick in the first place. This understanding of what caused the problem is crucial if you want to prevent the illness from recurring. If you are applying multiple doctors and multiple theories to the illness then you will be unable to determine what it was that made you better, and thus how to prevent recurrence.
You may respond to this by saying “Well, I don’t care at this point what worked as long as I feel better right away. I also don’t care what the cause is.” And that’s a fair point. But another problem with having too many cooks in the kitchen is that the different cooks may be doing things that are conflicting with each other and thus cancelling out each other’s work.
A simple example of this is a patient who is coming to me for help with adrenal fatigue but is also seeing another natural doctor for the same problem. The other doctor is giving the patient ginseng and other stimulants to increase their energy. However, this patient also has insomnia as a secondary problem. What this patient needs is to fix their sleep first before working on energy levels, and in this situation the ginseng will actually make the insomnia worse. In this situation I will be trying to give relaxants to restore proper sleep (and thus increase energy in the long-term) while the other doctor is giving stimulants to increase energy. The two approaches end up cancelling each other out and further exhausting the patient’s limited energy reserves.
Less is more
When working with chronic illness you are dealing with someone who has limited energy for the healing process. To use the prior example of $100 in “body energy” that gets divided into three parts (vital functions, workday, healing), let’s assume that the money is equally divided among the three functions and each gets $33.
In chronic illness the person’s vital functions are often compromised and thus require more energy to perform. This function is non-negotiable because without it you die, so let’s say the body then allocates $50 to vital functions. This only leaves $50 for workday and healing.
In chronic illness things that were once easy to do now become more difficult and this includes your job and dealing with stress. The stress can be from either work or personal life and it also includes just sitting around and being in a state of anxiety. Let’s say that this then ends up consuming another $40 of body energy.
$100 body energy – ($50 for vital functions + $40 daily stress) = $10 of body energy left for the healing process.
So in this analogy, whereas a healthy person may have $33 of body energy for the healing process someone with chronic illness now only has $10 and needs to spend it very carefully. It is for this reason that an efficient, almost minimalist approach to healing can provide the fastest results with the least amount of healing aggravations (also known as “herxheimer reactions”).
Our approach towards limited healing reserves
The approach we use is targeted towards addressing the most foundational cause of the patient’s illness, yet in a manner that affects their entire body as a whole. This process is detailed in our (long) article on the 4 patterns and 8 steps.
We begin by identifying the first step that needs to be done to restore proper physiology. Then we analyze this step through the 4 tissue patterns and apply the appropriate treatment. This results in a treatment that is targeted towards a specific body function, yet the treatment is designed to affect the entire body in a system-wide manner. This allows us to create a therapeutic response with the least amount of energy expenditure and healing aggravations.
- For some of the patients we see, especially those with chronic and severe illness, they are forcing their body to process too many treatments at the same time.
- Too many supplements at once, too many different treatments/therapies, and too many doctors who are often using conflicting methods.
- Any treatment or supplement, even if therapeutic, requires energy expenditure on the part of the body to process the treatment. This has to be kept in mind when the patient already has poor energy reserves.
- At best, too many cooks in the kitchen creates poor results and confusion as to what is working vs. not working. At worst, it creates further exhaustion of the body’s energy reserves and accelerated deterioration.
Patient Screening Process
Before a person becomes a patient at our office, we do a general screening process to determine if it’s worth it for them to come for an assessment. We want to know what their main issue is and if it’s something we have success with. If the issue is not something we have good success with then we’ll tell you that upfront and over the phone. We want to know what medications they are on because some medications make it unsafe or risky for the person to be treated with acupuncture and/or herbs.
We also want to know what other doctors and treatments the person is receiving for their main complaint. The reason why is because sometimes the patient is receiving a treatment that conflicts with the way we practice Chinese medicine and can thus nullify the treatments we provide.
Certain treatments mix well with what we do and certain ones don’t. It also depends on what the main complaint is. A treatment that doesn’t mix well for a specific complaint might work well for another complaint. It all depends. But this is something that we determine when the prospective patient calls and we collect their info.
Constrained Model of Energy Expenditure
There is a theory in evolutionary biology known as the “Constrained Model of Energy Expenditure”. What this theory states is that humans have a finite amount of energy that they can expend on any given day. The body will then spend these limited energy resources on the following three tasks:
- Vital functions: Things like heartbeat, lung function, liver function, etc. These processes are non-negotiable and the most important of all. Without these functions you would die.
- Work load: This includes daily tasks that you do which consume both mental and physical energy. Remember that mental tasks can consume just as much energy as physical tasks if not more depending on the stress level. So this would include your job and running errands. It also includes any exercise programs that you are doing.
- Recovery and repair: This is the process of healing and rebuilding the body. It doesn’t matter if you are sick or healthy, the body is in a constant state of repairing itself because cells are constantly dying. The important thing to note is that this recovery process requires energy and it competes with the prior two functions for energy reserves.
One way to understand the constrained model of energy expenditure is to imagine that you wake up each morning with $100 worth of body energy. Once the $100 is spent you get no more money for the day. This $100 has to be used for vital functions, your daily job (and exercise routine if you have one), and tissue repair/recovery. The function of tissue repair needs to happen in both healthy and sick people but there’s a catch…sick people require higher amounts of daily energy expenditure towards recovery than healthy people do. The degree to which this happens depends on how sick you are.
In a perfect scenario, you would have an efficient body that was able to conduct vital functions without expending too much energy. You would have a job that is not too stressful (either physically or mentally) and doesn’t deplete your $100 of energy. You would also not be in the process of trying to overcome a chronic illness and thus needing to spend all of the $100 trying to conduct tissue repair. In this state your need for tissue repair would thus be minimal.
But let’s say the situation is not so perfect. Starting with a state of chronic illness, your body is already spending a large portion of that $100 towards tissue repair. The “money” being spent on tissue repair takes money away from vital functions like heartbeat, breathing, and hormone production. And then on top of it you have a stressful job (or home life) that sucks the life out of you and further depletes the $100 you woke up with.
This is how people get sick, stay sick, and get progressively sicker. The body can’t keep up with the energy demands and vital functions become compromised as the demands of life and chronic illness increase energy expenditure.
Healing process consumes energy
The process of tissue repair/recovery consumes limited energy reserves. It’s important to realize that treatments for chronic illness also consume limited energy reserves. This is something that patients fail to take into account and they end up getting in trouble because of it.
Acupuncture treatments, herbs, and supplements all require energy to be processed and utilized by the body. Sure the intent is for it to increase body energy, but before that happens energy reserves must be spent to process the treatment.
Think of the process of lifting weights to build big muscles. The process of weight lifting actually tears down and creates trauma to the muscles. Shortly after working out the person is tired. But during the time between workouts the body repairs the damaged muscle tissue and it becomes stronger than it was before.
If someone wanted to get big and strong in a hurry, they could spend 6 hours a day, every day, lifting weights. This would do nothing but make the person sick and injured because they are doing too much and not allowing the body to process the workouts.
The same thought process applies to getting acupuncture treatments. When the needles are placed in the pressure points, a neurological stimulus is sent to the brain which then carries out the healing process. Think of acupuncture as a set of instructions that are given to the body on how to heal itself. The body then carries out the healing instructions and this requires energy expenditure to do.
Just as muscles become stronger in the time between workouts, so does the body heal during the time between acupuncture treatments. As I say to my patients, the actual healing process happens after you leave the clinic, not while you’re on the treatment table.
Acupuncture requires that the body spend energy to produce energy. Because of this you have to be careful when treating people who are chronically ill and depleted of energy. Over aggressive treatment, including too many treatments, can actually make the person worse. It’s no different than the guy who lifts weights every day because he’s in a rush to get big muscles.
Herbs and supplements also require energy expenditure before they create healing results. When you take herbs/supplements they have to be digested and absorbed by the body. The process of digestion requires a large amount of energy which is one reason why you see appetite loss when people get sick; the body is trying to conserve energy so it tells you to stop eating.
This is the danger of taking too many supplements and I see it all the time. A person is taking supplements from 3 different doctors as well as stuff they read about in a magazine or on the internet. After a certain point it becomes impossible for the digestive tract to fully absorb everything they are taking. And even during the process of absorption the body can end up expending more energy than the supplements end up giving to the body, thus creating a net deficit.
Another thing that happens is that a person is taking a dozen different supplements for a chronic illness, and perhaps one or two of those supplements is the right one to heal the illness. The problem is that the correct supplement then has to compete with a dozen other products for absorption in the digestive tract. If the patient was only taking the supplement that mattered, perhaps 80% of it would get absorbed (which is good). But in the presence of the other supplements only 20% or less of it would get absorbed.
Overtreatment is a real thing
The concept of overtreatment is discussed in Western medicine where you have a patient taking too many medications and going for too many unnecessary procedures. The danger of overtreatment is that you can create adverse reactions within the body and harm the patient.
The concept of overtreatment also applies to natural medicine but to a lesser extent. Whereas you don’t see life threatening reactions (unless something really negligent was done), what you see is a further exhaustion of an already debilitated state from too many supplements and too many treatments. Too many doctors working on the same person at the same time, each trying to make the body do something different.
The treatments we offer at Natural Chinese Medicine, whether it’s acupuncture or herbal medicine, require that the body spend a certain amount of energy in order to create healing energy. It’s like that old saying that you need to spend money to make money. It is for this reason that we want to know what else the patient is doing as part of their healing process. We want to make sure that we are not creating a state of exhaustion and energy deficit by overtreating.
Things take longer when you’re in a rush
Being in a rush and tackling a project with aggression and urgency can work with certain things like cleaning a messy house or finishing a project at work, but it can backfire when applied to chronic illness.
What I see happening is that a person becomes sick, or a long-term problem suddenly gets really bad, and that person wants it fixed now. And by “now”, what they want is for it to be fixed right now.
So they go on the internet and look up every supplement, every treatment, every procedure that could be effective for their illness and they try to throw everything at it at once. They feel that if they hit the problem from every possible angle that it will cover all bases and provide an immediate cure. They feel that going to several different doctors/healers at once will have an additive effect so they try to create a “team” of doctors similar to how a football team is created.
The worst cases of overtreatment are seen when a child becomes sick and the parents go into a panic and try to do everything at once out of desperation.
The problem with this approach is that the body is not a machine or piece of equipment that can be modified at will. Any modification to the body, and this includes therapeutic treatments/supplements, will require that the body expend limited energy reserves to process the treatment. If done without judgement and discretion this process can exhaust the body into a state of further harm and deterioration.
One problem of having too many cooks in the kitchen is that if the patient does indeed get better, you won’t know what it was that made the person better. Each doctor (cook) has a different theory as to why the patient is sick and is working off of that theory. If the theory of why that person is sick results in a successful outcome, then the patient not only has the cure, she now has the understanding of how she became sick in the first place. This understanding of what caused the problem is crucial if you want to prevent the illness from recurring. If you are applying multiple doctors and multiple theories to the illness then you will be unable to determine what it was that made you better, and thus how to prevent recurrence.
You may respond to this by saying “Well, I don’t care at this point what worked as long as I feel better right away. I also don’t care what the cause is.” And that’s a fair point. But another problem with having too many cooks in the kitchen is that the different cooks may be doing things that are conflicting with each other and thus cancelling out each other’s work.
A simple example of this is a patient who is coming to me for help with adrenal fatigue but is also seeing another natural doctor for the same problem. The other doctor is giving the patient ginseng and other stimulants to increase their energy. However, this patient also has insomnia as a secondary problem. What this patient needs is to fix their sleep first before working on energy levels, and in this situation the ginseng will actually make the insomnia worse. In this situation I will be trying to give relaxants to restore proper sleep (and thus increase energy in the long-term) while the other doctor is giving stimulants to increase energy. The two approaches end up cancelling each other out and further exhausting the patient’s limited energy reserves.
Less is more
When working with chronic illness you are dealing with someone who has limited energy for the healing process. To use the prior example of $100 in “body energy” that gets divided into three parts (vital functions, workday, healing), let’s assume that the money is equally divided among the three functions and each gets $33.
In chronic illness the person’s vital functions are often compromised and thus require more energy to perform. This function is non-negotiable because without it you die, so let’s say the body then allocates $50 to vital functions. This only leaves $50 for workday and healing.
In chronic illness things that were once easy to do now become more difficult and this includes your job and dealing with stress. The stress can be from either work or personal life and it also includes just sitting around and being in a state of anxiety. Let’s say that this then ends up consuming another $40 of body energy.
$100 body energy – ($50 for vital functions + $40 daily stress) = $10 of body energy left for the healing process.
So in this analogy, whereas a healthy person may have $33 of body energy for the healing process someone with chronic illness now only has $10 and needs to spend it very carefully. It is for this reason that an efficient, almost minimalist approach to healing can provide the fastest results with the least amount of healing aggravations (also known as “herxheimer reactions”).
Our approach towards limited healing reserves
The approach we use is targeted towards addressing the most foundational cause of the patient’s illness, yet in a manner that affects their entire body as a whole. This process is detailed in our (long) article on the 4 patterns and 8 steps.
We begin by identifying the first step that needs to be done to restore proper physiology. Then we analyze this step through the 4 tissue patterns and apply the appropriate treatment. This results in a treatment that is targeted towards a specific body function, yet the treatment is designed to affect the entire body in a system-wide manner. This allows us to create a therapeutic response with the least amount of energy expenditure and healing aggravations.