This is not a topic that an acupuncture practitioner likes to explore because it is not very constructive for those who daily have to fight for the cause of this very special technique. It is nevertheless a realistic and useful approach to restrain and curb the attitudes of those who show exaggerated satisfaction and who believe that they know perfectmu hpw to do acupuncture.
Failures and successes (as well as their numerous intermediary stages) give sometimes rise to astonishment because of their unexpected results. In this patient, for whom the practitioner was nearly sure to obtain good results no improvement is observed, even if the patient was mentally cooperative. On the other hand the acupuncturists are sometimes consulted by patients who suffer from a disorder which is far from the group of good acupuncture indications. He doesn’t always dare to send the patient away but proposes a treatment trial limited in time and the number of sessions, nearly convinced that he will face a complete failure. Yet the contrary happens: the patient is delighted, so is the practitioner (as well as puzzled). When teaching acupuncture to my students I always make a point to stress these unpredictable results.
It is not proper to make blown up promises or to guarantee a cure. On the other hand it is counterproductive to be pessimistic and discourage the patients who consult. One must show simultaneously a skilful balance of interest, determination, a will to try and possibilities of successes (that is the positive aspect), but also a wise cautiousness so that those who come asking for a solution to their health problems are not too disappointed if the rsults are not up to their expectations.. This navigation in the formulation of the prognosis is delicate and requires many nuances in the discourse. The patient will be grateful for the honesty expressed by the practitioner.

There is a risk that the patient gets put off and demoralized in spite of the precautions and the self-restraint shown by the practitioner, which he interpreted wrongly as the announcement of a failure. So it is necessary to support the patient’s moral at each session, to be attentive to any manifestation of doubt, to reaffirm the chances of good results and underline that the improvements don’t always show along a linear aspect but often with ups and downs. Explain, relate, clarify, reassure. There is no ideal formula because it depends on the pathology, the psychological profile, the history, the age and the ancientness of the disease, the drugs taken, the constitution, as well as the personality of the practitioner himself.

The failures show in multiple forms : giving up after the first treatment, a strong sensitivity (mentally or physically) to the needles, the lack of understanding of what the practitioner will try to achieve or the too high demands of the patient, his absence of perseverance or the diversion towards another kind of treatment under the influence of his environment. The absence of attention from the practitioner (sometimes for valid and understandable reasons) felt by the patient in a negative way. A deficiency in communication, whether in quality or in quantity, which makes the relation cold and rigid instead of supple and warm. One must also take in account the incompatibilities, the personality clashes, and the mutual impatience.

At the beginning of a practice the acupuncturist hasn’t got the faintest idea of all these shades and nuances which can make the success or the failure of a treatment. He was never really informed of how to behave, what to say using which words, how to balance his sentences and statements so that the patient knows more or less where he stands in the range of possibilities. Time and experience will improve his efficiency so that he will less and less miss the opportunity of a cure, but also detect more accurately inescapable negative results. The borderline between failures and successes, as far as prognosis is concerned, will become thinner and thinner with time, improving the quality of the practitioner.