#98 - Exploring the 5 Element Theory with Dr. Andria D’Amato, Part 2

Welcome back to The Factor Podcast, your go-to source for cutting-edge education in the world of sports medicine, rehab, and integrative healthcare. I'm your host, Jessica Riddle, and today we're continuing our deep dive into Five Element Acupuncture with Dr. Andrea D'Amato. If you tuned in for part 1, you'll remember we explored the core philosophy behind Five Element Acupuncture— how it's rooted in nature, emotion, and the interconnectedness of mind and body. Dr. D'Amato shared how each element— wood, fire, earth, metal, and water— correlates with specific organ systems and how emotional states and imbalances can manifest in our patients in ways we may not initially recognize. In today's episode, we're taking that knowledge a step further. We'll discuss how Five Element Acupuncture can be applied clinically to address chronic pain, stress-related disorders, and even athletic performance. Plus, we'll explore how understanding these elemental patterns can help you fine-tune treatment plans and improve patient outcomes in ways you may not have considered before. So whether you're interested in learning how to incorporate Eastern medicine into your treatment protocols, or if you're just someone fascinated by a more holistic view of patient care, this episode is packed with insights you won't want to miss. Let's get started.

So in order to get back to our physical wellness slide, we're going to want to consider maybe using stairs instead of an elevator or an escalator and then walk whenever possible. So airport travel, your work environment travel, you can park further away from the front door. I recommend this a lot to patients who just don't know how to start or are physically limited in what they can do or are too intimidated to go to a gym or do something like that. I'll just say, well, if you're out running your errands, just park further away from the door and increase your steps. And it's something that they're like, oh, I never thought about that. Like, we're kind of conveniently minded instead of also always wellness minded. So we can learn to recognize also those warning signs when our body begins to feel ill. So before we get to that burnout phase where our body shuts down, we can just say, you need an unstructured day where— You don't have a to-do list, if your life allows for that, where you can just stay in your pajamas for an extra hour in the morning and perhaps, or give yourself half an hour at the end of the day to get lost in a good book if you like to read or take a bath or turn your phone off or what, or heck, if it means that you want to zone out on some platform on your phone, because that's what is going to give your mind and body a little bit of a break, So you, you don't have those warning signs of becoming ill. Try that. Eating a variety of healthy foods and controlling your meal options and your portions. Excuse me. We can lean into traditional Chinese medicine foods as well. Each season is going to have a food. So that's a part where you can also tie in the Eastern and the Western side of things as well. There's a lot of information about that is not in here, but just in general that you could explore if that's curious for you. You want to try to maintain a regular sleep schedule. And get between 7 and 9 hours of sleep per night. Again, these are great suggestions towards that umbrella of wellness. Do the— as many, the best you can as possible. It doesn't have to be all or nothing. And then our spiritual side of wellness is gonna be what helps you to develop a set of values that helps you seek meaning and purpose. Spirituality can be represented in many ways, so either relaxation or religion. It's not necessarily only your religious aspect, so it's gonna help us cope with whatever's going on in our everyday life. So exploring your inner self, going into that introspective part. So even our, our quiz in this, learning your dominant element in this activity can help lean into that spiritual side. We can also experience, if we experience life-changing events, we wanna have to kind of take some, some time to integrate them in and what that means to us. Mm-hmm. Spend time meditating, practicing mindful relaxation, acceptance, as I mentioned earlier, to just be curious. So, and then look for a religious faith that you agree with if that's something that interests you and is important to you. So these are ways that you can sort of all like integrate in that wellness side. If you at all saw the, the like similarities between all the different slides overlapping into that wellness umbrella, and if you know that traditional Chinese medicine 5 element theory or just acupuncture, in general, you'll probably see where so much of that just overlaps anyway. As promised, I was mentioning that we're going to have that positive activity interventions. The research study is actually linked here below, but those positive activity interventions, PAIs, involve that simple self-administered cognitive or behavioral strategies to mirror the thoughts and behaviors of naturally happy people and in turn improve the happiness of the person performing them. So this is where that, when I said that fake it till you make it is evidence-based, here's where that is kind of coming from. So even though we might say that phrase tongue-in-cheek, we actually are then falling into that happiness or that whatever we're expressing emotion. And so by expressing gratitude, committing acts of kindness, savoring positive events in your life, and practicing optimistic thinking, Can lead to that increased positive emotions and overall your well-being. So I encourage anybody to try this and see if it doesn't improve something for you. Again, and the same thing, eat like you love yourself, move like you love yourself, speak like you love yourself, and act like you love yourself. Just a beautiful reminder. If you have children or are lucky enough to have children in your life who revere you and respect you and, and you know, they look up to you, I oftentimes think, how would the way I'm treating myself be perceived by them? Would it break my emotional heart if what I was doing for myself or thinking for myself was something that they were doing to themselves? Is there any way that I can like change my example to them and be a better person to myself based on how— I don't have any children. So a lot of these interactions are with my friends' kids who are my pseudo-nieces and nephews. And I'm oftentimes having that checks and balance with them of like, is this something that I would want them to, to see or experience or know? And if it's something that is, I need to change my perspective when I'm, I'm an example to them. It's that checks and balance. So this whole idea of like eating like you love yourself, moving like you love yourself, speak like you love yourself, act like you love yourself. It's that whole to me it's that idea of would I how how can I be an example to the the tiny humans or the young adults in my life that I would want not to have to go through some things that are not part of the wellness journey if that makes sense. So I don't know just something to consider. The water element is going to have each element we're going to discuss having strengths and weaknesses as mentioned. So our water element is going to have the following strengths. And then the following weaknesses. So it doesn't necessarily mean that things are, are not great. It's just something to be mindful of. So if you have like indecisiveness or anxious feelings or become self-indulgent that is out of character for you or more characteristic than normal, you might wanna think, okay, is this now possibly where an element system could be out of sorts? And is there anything food-wise that could support this? Is there anything treatment-wise that could support this? Can I identify one of those 8 aspects of my overall wellness that are not being fulfilled right now, that are now leading me into feeling anxious, indecisive, self-indulgent, any of those things? So that's where you can kind of tie in that Eastern and Western perspective. Same thing for that wood element here, those strengths and those weaknesses. Passive is going to be on both, so it, it's not necessarily— if that's the only quality and characteristic you have, maybe lean towards the other qualities of strength to see which one might be dominant, or just recognize that maybe at this point in time that's what's going on. You want to then think about maybe a fire element here: aggressive, susceptible to mood swings, impulsive, which is a different thing than indulgent. So again, Sitting with yourself. The strengths are listed out on all of them too. If the strengths are— those to me, I don't look at necessarily as much of a teachable thing in terms of the element being out of sorts or like imbalanced. But when there's the weaknesses, if I can recognize behavior patterns that are associated then to one of the elements, then I might look to see what lifestyle changes I could make, what food styles I could make, what what treatment interventions I might need, whether it's acupuncture, chiropractic, massage work, going to my primary care provider, anything like that. Maybe let me see what is actually going on, do a little introspective identification on that. For our metal element, we might see that somebody has this personality of being stubborn and sometimes unreasonable or feel that or unusually judgy. I oftentimes this, just a little side note. So the metal element is on— makes up the lung and the large intestine meridians or organ systems. And the emotion attached with metal is grief, longing, or despair. And so I might— in the setting that I work in, I have a lot of patients who have had a lot of trauma and are significantly— in significant states of despair, longing, or grief just through what they've gone through in their life. And so they can sometimes come across very jaded, like the woe is me. Okay, so with the earth element, we're looking at things like being overprotective, conservative, like meaning to the degree that it inhibits their life. So being conservative as a general rule is not necessarily a bad thing. When it impedes your ability to participate fully in your life, we might want to think, okay, what can we do to support that? disposition. So being reserved or overprotective. But then on the other side, you, you have the strong and enduring nurturing. So finding those things that have the balance is really helpful. And that is what we are looking at in integrating this information in. Our reference materials here, in addition to the ones that are already on the slides, here are some of the sources that we used. And then we will also be sharing in the future. We have quiz, a 5-element quiz to get to know your dominant element, as well as how to work with those in your, in your future and in yourself and in your practice.

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So as always, thank you for your attention. And then if you have any questions, please feel free to comment.

So I do have a few questions that have come in. A lot of those are related to how you utilize this information in your practice. So we'll start with the first one here. Someone was asking how having a better understanding of your own relationship with the 5 Elements has impacted you as a practitioner and how you interact on a daily basis in your practice?

Yeah, that's a great question. So for me, it has helped me in, in the sense of recognizing what is my own emotional state or wellness state and committing differently in that interaction. So For some things, it's just being able to be fully present. It's recognizing and having compassion when I am either burnt out emotionally, physically, and then it's holding me accountable to not forcing myself consistently to stay in that state because I can't help others heal if I'm not feeling healed myself. So it's that personal accountability. Exercise of what is truly going on in my life. Am I keeping myself in a good checks and balance, which is to me what the 5 Element Theory demonstrates emotionally, food-wise, physically? If I have something physically that ails me, that is, is not something that goes away with, with an intervention, treatment, ice, rest, anything like that, I might introspectively be like, okay, Organ system-wise, what meridians are going here? Is this emotional perhaps? Am I seeing something? Is my subconscious participating in an alert moment that my conscious mind is ignoring so far? So it had— again, that health and personal accountability is where this has helped me the most. And it allows me to recognize with my patients what is my stuff, and then secondarily, what is their stuff? And so occasionally I'll have days where I have complete compassion fatigue and I recognize that and I call a timeout because if I can't do my best job fully, I'm not helping anybody achieve their wellness goals either. So that the— this whole umbrella of Eastern medicine practice with traditional Chinese medicine and acupuncture has made me— I keep saying like that personal accountability. But it has really made me be a better individual healing self so that then when others have questions, I can help them navigate that with humility and grace instead of force or like part of a treatment plan regimen, if that makes sense. Like I'm an active participant in their journey for that self-discovery because I'm also going through that in a different way. Continuously, which is, I hope, what we can all be kind of taking home from this or in our daily interactions. So that was a great question. Thank you.

Well, and that's huge. I think you touched something there that's really important, especially for healthcare providers. And I know we have a lot of students listening. So this is something definitely to, to keep in mind. And I would love your insight on this decision fatigue. Decision fatigue, I'd imagine, runs rampant in healthcare providers just because you're constantly in a space where you're dealing with people who are in pain. who are having sometimes some of the hardest experiences of their life, and then they come to you looking for answers. That's a lot of— that takes an emotional toll on you, I'm sure, as well. And I think you're right, having a little better insights into yourself are helpful in this regard. Likewise, how do you, when you're in that space where you're, you know, having a great deal of decision fatigue, I know During 2020 and beyond, there were a lot of patients that were coming in with stress and psychological things that were manifesting as physical pain. How did understanding some of this stuff help you navigate through that time and by really helping the biopsychosocial aspect of how you treat your patients?

That was a huge part of my initial interest in acupuncture was To, as I call it, cut through that BS a little bit of the blinders that we have with our emotional health affecting our physical well-being. And so I loved acupuncture very quickly for for that capacity to identify where our emotional health is affecting our physical well-being, and also having that understanding of how stress physiologically affects. affects us neurologically and, and that domino effect of it. And so what, what I am constantly reminding patients of and myself is what I perceive as stress is not the same thing that physiologically you might perceive as stress, or students here might perceive as stress, or colleagues in the same field, or somebody who doesn't have all of those 8 measures of wellness needs being met. And so having that awareness that what is stressful for me is no more important than what is stressful for somebody else, because physically that neurological aspect is, is the same. And so then having that dialogue and that permission for somebody to be in that, that heightened state of stress and say, you're, it's totally fine. You're allowed to feel that way. This is why. So physically, neurologically.

That's absolutely huge. And I know that when it comes to kind of Extending your ability to practice, extending your ability and your craft. There's a lot of discussion about physically and how to make sure, especially hands-on providers, still have the ability to physically deal with the demands of seeing patients day in and day out. But I think you touched upon some really important aspects of looking into more of the emotional and the kind of holistic wellness aspect. When it comes to your patient care, do you incorporate any of this 5-element analysis into your initial intake or into your assessments? What does it look like when a new patient comes to see you in terms of what all do you try to find out about them to make sure that you're really providing a holistic element to your care?

Yep. So I begin asking them the normal questions: location, onset, better, what makes it worse. Rate your pain, time of day, the normal things that we would ask. And then I might say, does ice make your pain better? Does heat make your pain better? Does pressure change your symptoms? If we're strictly dealing with pain, then I might say, is there a certain time of the year that this happens? Somebody may come in though and say, you know what, I get this summer cough every year, or I always get a sinus infection in the fall. And you're like, hmm, the fall, that could be Five Element because I know that there's a dominant element in the fall time. So that's sometimes where I'm also actively listening and practicing that exercise of how I am with the one in front of me, being very fully present in the room, listening to what they're saying, also being a great observationalist in terms of if somebody is saying, oh, I'm just heavy-hearted right now, and they touch an area where they don't think that they have a symptom, they might say, or I just, I I don't know, or they'll have their hand on their hip, or they'll kind of like hug themselves, and they'll cradle an area that I know from traditional Chinese medicine or acupuncture has an emotional component, or is directly on an emotional, like on a point on an on a meridian that is emotionally derived. And so it's that decision-making process from fatigue. It's constantly going on. Like I'm reading between the lines of what somebody is saying. So it's more that of the nonverbal cues of being a great— doing your best to observe things, read between the lines, not being afraid to ask difficult questions that sometimes are intuitively guided, not always on a piece of paper. Listening to what the patients say about their history, letting them talk. With acupuncture, it's a hug. It is a listening ear. It is a reminder to journal. It is a half an hour for them to just sit there and cry. It is not always about a treatment plan with needles. Needles or an adjustment. Sometimes for somebody to just have the space to be heard, to have a physician listen to their needs, to hear the symptoms that they have that have been undermined or gaslit in medicine for, for months or years where they're not getting answers, acupuncture gives you this beautiful umbrella to connect dots that don't seem linear. You get to be the one curious enough to try. And sometimes just that, that interest in somebody's well-being is enough for them to give you information to succeed for them. And so a lot of it is this applying that random information on, on one of the slides of emotions, of times of year, of symptoms, and just seeing where that conversation leads, seeing where somebody might touch to be like, oh, I'm sorry, does Sometimes somebody will just touch their head, but they have headaches, but they don't have one right now, but they'll touch their head as they're talking about their family stress, their work stress, something that whatever context, if somebody is doing this, I will sometimes interrupt and be like, do you see where you put that? Like visibly and physically, do you see where you put that context of the emotion or that subject matter? No wonder you have headaches. No wonder you have a lot on your mind or Listening to the, the verbal cues, that, that whole positive affirmations topic, our brains and our body are hearing it. So if we're constantly saying, I just have a lot on my mind, or the weight of the world is on my shoulders, or pick, pick us something like, I don't have the support, or I'm not healthy right now, or whatever that verbiage of dialogue that our patients are communicating to themselves, I'm oftentimes interrupting that for them and saying, listen to how you're talking to yourself. Can we please consider changing that dialogue? What is the goal of your treatment plan? And how do we communicate that for your mind, body, spirit, to where you're then participating fully in that healing between our visits? I don't want codependency on my treatment plan being the reason you're better. I want you actively engaged in how you're participating in our plan, and it's X, Y, and Z in terms of 5-element wellness or anything like that. So— It's an evolved examination and evaluation based on the individual. Some of them are very clear-cut. They've had treatment before, they know pressure here makes those symptoms feel better. And I'm like, okay, I don't need to overthink it. And so it varies a little bit that way. But a lot of times it's just truly listening to the nonverbal cues and kind of asking questions based on what has been curious to me clinically from trainings and my own interests, I guess, and a curiosity to try something.

Oh yeah, absolutely. And something that you said was very interesting there is they have to be an active participant in their care. And I know this is something that I've heard time and time again, especially from chiropractors and physical therapists. Sometimes just getting the patient to understand that they have responsibility in this, they have to do the things you tell them to do at home. They have to modify their behaviors, how do you incorporate or do you have conversations to educate them a little bit about some of these 5 Elements, some of the things that you're looking at? Because clearly, you mentioned that you might look at parts of the body that they touch.

Mm-hmm.

And especially if they're a new patient, if they're very unfamiliar with acupuncture or how any of this is intertwined, how much do you kind of explain to them and educate them on? And how much of it is just kind of things that you as the clinician say, okay, Like, I'm gonna file these pieces away and use this when it comes to putting together my plan of care for them.

That's sometimes patient dependent on where they are on their journey. So if somebody is acutely aware of their emotions and their physical wellbeing, they're already doing meditation, they're doing journaling, they're actively participating in some sort of Social wellness or mental healthcare plan, then they might be the ones that I lean more into explaining the 5 element theory, the emotions, the foods, the time of the year side of things where I can fully say like, okay, here's how all of that is integrating into your overall well-being. If somebody is very, very newly on their healing journey, they're not likely ready for that. It's going to be overwhelming them just coming into the door. to try acupuncture or chiropractic even might be where they draw the line. And they're there, they're showing up, they're curious. The beautiful thing with acupuncture is it doesn't have to be something that you believe is going to work for you for you to get the benefit. So if you don't want to explain anything from a 5-element theory, if that's too out in left field for you and your patient population, don't say it. You don't have to. You can have the understanding and be a really good clinician and diagnostician with that in mind. But you don't have to share that with your patients at all. You can say, well, neurologically, acupuncture is going to affect the way our brain and our body perceive and integrate pain and interrupt that process. So you get some relief if it's strictly a pain or stress, whatever stresses somebody is experiencing in their life. So I guess it's, again, it's that discernment of where somebody is on their healing journey and what you're reading as that clinician. And what your comfort level is to explain it to them in that experience. So they might not be ready for it, or you might think that they're ready for it and you explain it to them and you just see like the deer-in-the-headlight look, or they come back the next day and they're like— or call you and they're like, we don't know what just happened, or we were really emotional, like, we— you didn't prepare me for that, what's going on? And so then it's like, oh, I'm sorry, I didn't know that that's where you were. So you kind of Are growing with your patients that way, but also, yeah, making sure you're listening and having discernment to see where they are in their journey. And you clinically, you, you can kind of figure out the body language. Sometimes they're closed off, they might not be, or you might mention it like, oh, I see that you're touching that area that relates to grief. Are you— is there anything that you're struggling with that way? No, I'm fine. Okay, you move on. Like, if they're not there, they're not there.

Yeah.

You can't force it. So I sort of just let them direct their interest and curiosity in it and go from there.

Absolutely. So what advice would you give to a student or a provider who maybe has been considering incorporating some type of needling into practice, but they're a little intimidated at all the options and the hours that might be involved? If you could give a little bit of advice to the next generation, but then also if you could talk a little bit to how that has really transformed your practice, especially from a diagnostic standpoint, it sounds like it's been a huge benefit.

Oh, absolutely. It has been for me. As I mentioned, I took the coursework strictly out of curiosity. I don't like needles. I don't like blood. I couldn't go into allopathic medicine. I would have never made it through a surgical rotation. I know that. So the irony of my life that this is what I do is is, I, is laughable. So the, the basic 100 hours is gonna get you prepared to like take your boards, learn enough to not be dangerous, but maybe not learn enough to feel like you're an expert, and that's okay. So I always just encourage the, the participation in the academic experience. So find places and people that you align with. I've had a lot of great instructors who are my colleagues and mentors, and I've had ones that I'm like, that's not going to be the way I practice, and that's okay. So having again that discernment to acknowledge like, this fits me, this doesn't, but it doesn't make one right or wrong.

Right.

So utilizing the resources that are available, finding what your state allows you to do, seeing what interests you, seeing what patients bring in problems for you— that helped me evolve significantly in my clinical practice in my early days because I somehow became the expert in my community on things that I, studying-wise, had very little interest in. But it was because the patient population came in requesting things, and I, I felt a professional obligation and personal curiosity to achieve that goal for them if I could. And so I would say constantly Reminding yourself that it's okay to be a beginner in this field is really also important, and having patience with yourself while you are learning something completely familiar. This is a practice that has been passed down lineages for, for centuries, for thousands of years. We are like babies learning it in the West. And since the '60s, it's been in the States. So having patience to like lean into that, I think, is really awesome. And just accepting— where your journey is from an educational standpoint. So yeah, I mean, I would welcome anyone to ask any questions if there's anything I can help with further for that, because out of strictly curiosity, and here I am years later. So it's been a great, a great journey, that's for sure.

That's amazing. And I know that so many in our network globally are lifelong learners. And thank you so much for today. It's been a pleasure. It's been great information. And I know this has been Highly insightful and something great to share with our network.

Thank you.

That wraps up part 2 of our deep dive into Five Element Acupuncture with Dr. Andrea D'Amato. This conversation has been a powerful reminder that while Five Element Acupuncture is rooted in ancient wisdom, Its applications in modern healthcare are more relevant than ever. I think this was a fascinating discussion on how to blend traditional healing practices with evidence-based medicine. What we've explored in this series is that these 2 worlds don't have to be at odds; rather, they can work together to provide a more comprehensive approach to patient care. 5-Element Acupuncture offers us a lens to look beyond just physical symptoms, Addressing the deeper emotional and energetic imbalances that contribute to pain and dysfunction. If this series has sparked your curiosity, I encourage you to continue exploring how integrative approaches like this can complement your current practice. And if you haven't already, be sure to check out the online courses Dr. Ideamato recently launched in our online learning platform. I'll be sure to leave a link in the show notes for you. Be sure to tune in next time where we kick off a new 2-part training with Keith Cronin, DPT, on electrophysiological neuromodulation.

Say that 5 times fast.

Episode 98 drops in 2 weeks. You won't wanna miss it. As always, if you found today's episode valuable, be sure to subscribe, leave us a review, and share it with your colleagues. And check out the show notes for links to more resources, upcoming courses, and more. We'll see you next time.

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