Following the second article out of a series for Huang Ti ( a magazine for acupuncturist)
Vignette: How Headaches Became My Doorway to Presence
23-10-2022, recollected and revised on 20-07-2025
Until I started working as a therapist in complementary medicine, I was a stranger to headaches. First occasional, then more frequent, and eventually more debilitating. I became my own patient, and despite all the advice I offered to others, I was failing to help myself. If someone had asked me whether I liked my work or felt stressed, I probably would have answered yes to the first question and no to the second. Yet I often felt as if life was living me. I felt disconnected, hollow, and drifting, but I was not sure how to relate to it.
After some years as an acupuncturist, I started an MSc in Mindfulness Studies at the University of Aberdeen. We were encouraged to keep a meditation diary. Slowly, patterns I had not noticed before started to show themselves. Yet I felt unable to integrate meditation into my life; it remained mostly something I practised on a cushion.
After trying many fixes in relation to my headaches, I did not know what to do anymore. Then came an idea: What if I used the headache? What if, every time I felt pain, I treated it as a reminder to pause and ask: What am I thinking? What am I feeling? And where in the body? These questions might sound simple, but I would never think about them. Pain became a doorway to bring awareness into my life. I began collecting data: not pondering the whys or hows, just noticing what might unfold.
Many times, when I became aware of a headache, my mind had been preoccupied with a patient. I felt anxious, insecure, or afraid, but somehow I was unaware of it. I would drive to work replaying stressful consultations—rebuilding and reliving stress without realising it. Then the radio would play a nice song, and I would forget the thirty minutes of tension I had just lived through.
The pain helped me notice what was happening. It was a little like someone asking, “Hey, do you have an itch?” after seeing us scratch. Suddenly, both the itch and the scratching enter our awareness. What I found was often anxiety, insecurity, and a fear of not being enough. An inner critic whispering that I did not know what I was doing. A false voice of authority layered over doubt. These masks, meant to protect, only created more tension. And what a stress I was living—without even noticing.
The headaches helped me interrupt the unconscious cycle. Over time, I became attuned to subtler signs that grounded me in the present, even during consultations.
Waking Up from the Trance
Only later did I understand this experience as a kind of trance. Brach (2003) describes trance as living on autopilot, when fear, shame, irritation, or feelings of not being enough fill the space where presence might otherwise be. Becoming aware of the trance was helpful, but there was still a practical difficulty: how could I remember to become present while I was actually caught in it? My method—using headaches as reminders—was born from lived experience. Dobkin (2015) offers the more structured S-T-O-P technique: Stop, Take a breath, Observe, and Proceed. Although different in form, both approaches bring awareness into everyday life and interrupt unhelpful habitual patterns during clinical encounters.
“Presence” as an Ongoing Process
Collected from my journal and rewritten in August 2023
From the first encounter with a new patient, something felt uncomfortable. I perceived anxiety, embodied as a lump in my throat and an increased heart rate. I perceived the patient as frustrated and angry; her facial expression appeared unkind and tense. Before I realised it, a conditioned response captured me with thoughts I hadn’t experienced in a long time.
“Was she getting angry with me? What did she think of me? Like, what a weird little guy.”
Although, in retrospect, I could recognise these subtleties, during the consultation I lost presence and became angry, irritated, insecure, and overwhelmed. Our meeting was short, perhaps only five minutes, but the impact lasted for hours.
These dynamics increased my interest in presence. How could I grow as a therapist and become more aware of what was happening during a clinical encounter, while it was happening?
The Autoethnographic Approach
These experiences made me increasingly curious about the practitioner’s inner world. Research understandably asks whether acupuncture treatments and techniques are effective. Yet I found remarkably little exploring the lived experience of Chinese medicine practitioners.
For a long time, I believed there was only one real type of science: objective, measurable, and detached from the researcher. Even during my MSc, my embodied experiences felt like “soft science.” I felt like a nobody without a voice in the academic community. My perspective shifted when I encountered Ronai’s (1995) layered account of sexual abuse. What struck me was not simply her story, but the way she told it. She invited the reader into the complexity, vulnerability, and ambiguity of lived experience. It was rigorous, deeply moving, and profoundly human. Reading her work made me realise that research could honour experience without sacrificing critical reflection. This laid the groundwork for my choice of an autoethnographic study.
I began to trust that lived experience, when explored reflexively and honestly, could become a meaningful source of understanding. Knowledge can be situated, contextual, and still meaningful (Adams, Jones, & Ellis, 2022; Creswell & Creswell, 2018). I therefore decided not to undertake another project on effectiveness, but to focus on the practitioner’s inner world.
Journal Entries as Part of the Data
Who else has direct access to everything I experience as an acupuncturist? It is me. I know what is hidden, what I think, and what possible agendas I might carry.
Data collected on 06-05-2025 — Doubt and Questions
Sometimes I worry about how it is with my patients and how it will go. What will I do? What should I be doing? Will it be okay? If it is not okay, can I still make a new appointment? Will they still trust me, or do they even trust the process? Do I know what I am doing, and do I still believe I can help them? Damn, I want to suppress those doubts. With some patients, the dynamic is so hard. They hardly speak, and then what should I be doing? I do not want to fill the gaps simply because they do not speak, but then I feel so awkward. Actually, is it even about me?
In another journal entry from the data collection period, I noted:
Data collected on 13-05-2025 — Self-Talk, Doubt, and Mindfulness
After the session, I feel doubtful. Did I do the right thing? And what about the payment—is that correct? I do not want to feel this. The self-talk is easily activated as a way of defending myself. Presence helps me notice my automatic engagement with the emotions and thoughts that arise. Letting it be. No need to suppress, solve, change, or understand anything. Just staying vulnerable and allowing these feelings.
These reflections revealed how easily genuine care for a patient could become entangled with fear about my competence. Silence, a disappointing outcome, or a question about treatment could activate worries about trust, payment, and self-image. The important discovery was that these reactions often operated outside conscious awareness. Suppressing these reactions did not make them disappear. Presence helped me recognise what was happening and created some space around it.
By writing about these experiences, I hope to make hidden processes within therapeutic practice more visible and discussable.
A change of perspective
My own pain became a doorway into my inner world and helped me move from practising meditation on a cushion towards integrating presence into my work. Instead of becoming habituated to the stress, my work became an inspiration to learn and reflect. I experienced renewed curiosity. Through presence, I learned to create more space for what was happening within me. And that same space became available for the patient: I could remain more centred and recognise when something of my own was getting in the way.
In relation to healing, presence helped me recognise that not everything needs to be changed, solved immediately, or fixed forever. Some experiences need to be held in awareness with kindness so that we can learn to relate to them differently.
In my earlier years, I asked:
How can I treat, cure, or change the person in front of me?
Now, I would rephrase it:
How can I create a relationship that inspires the person to become involved in their own healing?(inspired by Rogers, 1967/2020)
The way my headache practice emerged also taught me something about learning. Nobody gave me the answer; through awareness and curiosity, I discovered something that worked for me. This helped me trust more deeply in patients’ capacity to recognise patterns and develop their own understanding, while respecting their intelligence and uniqueness. My role is not always to provide every answer, but to help create the conditions in which their capacity for learning and healing can come forward.
Knowledge and technical skill remain essential. But treatments are carried out by people and received by people. The practitioner does not disappear behind the method; our presence, fears, expectations, and ways of relating may all shape the therapeutic encounter and treatment outcome. The more aware we become of what lives within us, the less unconsciously it governs that encounter—and the more fully we can meet the person in front of us.
Bibliography
ADAMS, T.E., JONES, S.H. and ELLIS, C. (2022) ‘Introduction; Coming to know Autoethnography as More than a Method’, in Adams, T.E., Jones, S.H. and Ellis, C. (eds.) Handbook of autoethnography. 2nd ed. New York and London: Routledge, Taylor & Francis Group, pp. 17-48.
BRACH, T., 2003. Radical acceptance. London, Sidney, Auckland, Johannesburg: Rider.
CRESWELL & CRESWELL (2018) Research design; qualitative, quantitative, and mixed methods approaches. SAGE publications, London, United Kingdom.
DOBKIN, P. (2015) ‘Lost Heart (Beat)/Broken (Body)’. In: DOBKIN, P. and HASSED, C. (eds.) Mindful Medical Practitioners: A Guide for Clinicians and Educators. 1st ed. Cham: Springer International Publishing, pp. 13–18.
Rogers, C. R. (1961/2020). On becoming a person: A therapist’s view of psychotherapy. Robinson.
RONAI, C.R., 1995. MULTIPLE REFLECTIONS OF CHILD SEX ABUSE. Journal of contemporary ethnography, 23(4), pp. 395–426.
