Andrew Flower considers the time needed
to become a competent herbalist
I have been contacted several times in the past week by people expressing a strong interest in signing up for our 3 year diploma course in Chinese Herbal Medicine, but they have all asked if we can make it a) cheaper and b) shorter. The first request is entirely understandable, although we do not run the course at a profit, and all the White Crane team worked for nothing for the first 2 years of setting up the Academy, so, despite offering bursaries and scholarships, there’s not a lot of slack in this particular financial rope. The second request is an interesting one and it has prompted me to write this article. I suspect it originates from a review of the various herb courses on offer at the moment. In the current unregulated climate there is no statutory criteria that a herb course has to fulfil. This means that you could do a 9 month course that offers to teach you Chinese herbal medicine or our own 3 year course that offers to teach you Chinese herbal medicine. What’s the difference, and exactly how long does it take to grow a herbalist?
The rationale for a 3 year training has emerged from several sources. First of all in the past 20 years I have supervised many graduates from a number of different colleges. These graduates are usually smart, passionate about herbs, and seriously lacking in confidence about their ability to use these herbs to achieve the desired therapeutic outcome. They are often inexperienced in modifying formulae to suit the needs of the presenting patient, extremely conservative in the dosages they prescribe, and petrified of causing any adverse effects. Whilst these concerns are reasonable they seem to be magnified to the point at which the practitioner feels disabled and unable to develop their herbal practice. This is a great shame and it’s one of the reasons that prompted me to set up a herbal academy where we could engender both clinical competence and confidence so that our graduates could enter the profession without these crippling insecurities.
“…herbal medicine is learned via a system of spiral learning…”
Our view is that herbal medicine is learned via a system of spiral learning. You encounter the weird and wonderful world of herbs in year one and try to make sense of their unique nature and how they are similar to and different from other herbs in the same category. You learn to characterise a herb through its temperature, taste, actions and indications, directionality, channels, botany and the way it has been empirically used and in recent times researched and trialled. You start to learn how herbs are combined into formulae and how these formulae can be reconfigured by changing key components, adjusting dosages, and modifying with additional herbs. You sit in on clinic and gradually, out of the bewildering mist of multiple herbs you start to see shapes emerging that you recognise and remember.
In Year 2 you meet the same herbs but you are looking at them from a different angle, a higher perspective. This time you are seeing them as part of a formula used to treat the various syndromes responsible for causing common symptoms such as headaches, nausea, urinary tract infections. The formulae are like libraries, records of the thought patterns and expertise of previous practitioners; some recent, some almost 2,000 years old. In clinic you start to treat the first of the 30 patients you need to see before you can graduate. You learn how to take a good herbal case record and to report this back to your fellow students in your weekly supervision groups. You swallow your pride as your supervisor tries to get you to make a consistent thread between your diagnosis, treatment principles and the formula you have spent hours trying to put together that falls apart under more rigorous scrutiny. You see the same happening to your colleagues and you go away and try again, get the formula right, and then you have to learn how to adjust the formula and manage the patient during the ebbs and flows of their chronic illness. You finish one patient, and have 29 to go; you will have the pleasure of seeing over 100 such cases discussed and dissected by your peers and supervisors. It feels like a very large hill to climb – maybe a 2 year course would have been a good idea – but after you get a good pass in the end of second year exam you still feel under-confident and you welcome the support and guidance you are now getting from your fellow students and teachers. You feel your herbal understanding is starting to mature. Maybe a third year was not such a bad idea after all.
The formulae are like libraries, records of the thought patterns and expertise of previous practitioners; some recent, some almost 2,000 years old
Now you are in your final year. You are receiving lectures from herbal experts in the field of oncology, gynaecology, research and digestive diseases. Next weekend you will explore the shamanic aspect of herbal medicine and in your final summer on the course you will be able to spend 5 days on a field trip where you will collect herbs, make creams and tinctures, and meditate on plants so that you can touch with your mind their wild energy and distinctive spirits. In clinic you are approaching the end of your 30 patients and you feel competent to select an appropriate formula, modify it, crank up the dose of the key active herbs to heroic proportions, and use a small dose of a herb that quietly modifies the formula the rudder in the boat that subtly changes the therapeutic direction of travel. You can deal with the highs of success and the lows of failure and you know how you can expand your knowledge through practice and reflection, talking to your peers and tutors, exploring modern and classical text books, and searching online for the most recent research, even though half of it is written in a language that is indecipherable.
You are also about to hand in your end of year dissertation. You may have decided to develop your own range of skin creams or massage oils, or done a systematic review on Chinese herbs for Parkinson’s disease, or conducted a small case series on 10 patients with ulcerative colitis. You have been supported by teachers with experience of clinical trials who tend to curb your ambitions but make sure what you do is focused, rigorous and properly recorded.
Now the end is in sight. You complete your 30 cases and you have been signed off by the third experienced supervisor you have had in the past 2 years. You have your hard earned knowledge and the clinical experience gained from your own patients and those of your peers and you’re ready to start the long process of building your own herbal ‘house’. Your foundations are solid. You have an idea of how you want to practice, what herbs you want to use and which conditions you would like to treat. This will change as your house develops its second floor and you put an extension on the back where you can develop your knowledge and skill as you age, and in time where you will start to tutor the next generation of students who come to your door and ask to share your hard earned herbal treasures.
That is why we do a three year course.
There is value in any training but, as with everything, you get out what you put in. A nine month course might equip you to deploy patent herbs or ready-made formulae but it will be like driving a sports car in first gear. You will not be able to utilise the full potential of the medicine you practice. After 2 years you should have a solid understanding of the basics but your clinical experience will be limited and your confidence fragile. After 3 years we feel your herbal knowledge will have matured. You will have covered the same material at different levels and basic memory will gradually give way to a deeper understanding of the application of herbs in formulae and finally how these formulae can be deployed to treat serious disease. It’s like learning a new language and it takes time to move from rote learning, to basic sentences and finally to a sense of fluency. We believe this takes 3 years…a reasonable amount of time to grow a herbalist.
PS I showed this account to some of our current students who have just completed their second year and are about to enter their third year of training. These are their thoughts:
That’s an epic account of what is going on for students undertaking that course, while being very accurate up to year two from my experience as well. And like LG, I am really grateful for the third year to be available to us: there is no way – even with all the supervised cases and weekly supervision meetings we were lucky to get so far – that we’d be ready to treat people safely and successfully on our own yet. Proof is we still all regularly “fail” and need to “get back to the drawing board” at the supervision meetings. We need the 3 years, and the continued support as well as tight network of peers we’ll be getting afterward, thanks to spending all these years struggling and growing into herbalists together. LS
Wonderfully put together! Totally my experience! AB
So well said without making people feel like they will just be utterly overwhelmed. We won’t tell them that if they ask! Or the fact that somewhere in the middle of year two, whilst studying for your final exam, and managing 9-15 case studies, you decide you will never know what you are doing, and have to have a peer talk you off of the quitting cliff. But then, all of a sudden, you take the final exam, and the gap of self doubt and knowledge align and you say, man, maybe I can do this thing. You take a nap for two straight weeks, and then give gratitude for that 3rd year to lock all of that s**t in! LG