“Fuck being an herbalist, help people!” ~7Song

Edit: it is now 2024 and it’s been 7 years since I was an apprentice! The following is some writing that I initially made into a zine in 2018 following my apprenticeship in 2017 at the Northeast School of Botanical Medicine. Please keep in mind that these are just observations of a newbie herbalist and I post this in its original form as sort of a historical record of my own growth. Many points have room to grow and expand upon (now 7 years out), which I may do so in a later post.

The Ithaca Free Clinic (Ithaca, NY) was established 11 years ago to provide free and lo-cost healthcare to folks that do not have insurance. It’s an integrative clinic, with doctors, massage therapists, chiropractors, energy workers, nurses and an herbalist. In 2017, I had the incredible opportunity  to spend 11 months here observing the herbalist 7Song in clinical practice as part of my role as an apprentice. 

Two of us apprentices sat in on his consultations each week, gaining valuable clinical skills that are often hard to obtain as a burgeoning herbalist. Now, nearly a year later, I wanted to share some gems of wisdom I’ve combed from the pages of my clinic notebook to share the process with any beginning health practitioners out there.

❤There is SO MUCH MORE to learn. I feel inspired to learn more about the medical system (perhaps though nursing), pathophysiology, medications, symptoms and disease, as well as acupuncture, tongue and pulse diagnosis and a deeper understanding of herbal energetics. My ideas about herbalism have undergone a massive shift since October of 2016, when I originally made the decision to become an apprentice. Although I acknowledge there are many different ways to be an herbalist (and all are valid and needed), based on the experiences I’ve had this year, I would personally consider it a disservice to those I see to NOT have a well rounded understanding of allopathic medicine. Understanding what different lab tests mean, knowing the most common pharmaceutical medications people take, learning about common diseases and their symptoms and underlying causes and having a grasp of herb-drug contraindications are all areas I would feel amiss not knowing when consulting with folks.

****Start where you are. The world of health and medicine is huge. Learn first what you’re drawn to, then expand out slowly. Be easy on yourself. As alternative healthcare providers, we are often expected to know as much as those who have been through medical school! Research is your friend, and when you say ‘I don’t know’ (as I will expand on later), know that every question mark is an opportunity to learn.

❤People need simple, basic care a lot of the time. Though I have just indicated my intense excitement about going deeper in all the areas I listed above, it’s obvious that many people that come into the clinic, rather than needing herbs, need someone to listen to them and support them with their feelings and goals. Whether it’s the patient who has COPD, diabetes and wants to lose weight, or the person who wants to make changes in their life, but feels stuck because they don’t have encouraging friends or family, both need a foundation on which to build on. They need someone to listen to them, to support them, to tell them that change is possible and that they have the resources to make those changes. If no one cares about what they’re going through, or encourages them to move forward with a change, why would they feel motivated to make that hard change on their own?

❤The ability to direct and guide a conversation is of paramount importance. I’ve learned that there is a difference between cutting someone off in their story and needing to guide them back to the original question, so you, as the practitioner, can uncover information that is helpful for their situation. Some folks are only too happy to segue way into talking about their dog, kids or health articles they’ve read on Facebook, and while it’s easy to listen to them rattle off this information, it’s your responsibility as the practitioner to rein them in and gently redirect. Though this may be of less importance for those herbalists that have 2-3 hour consultations, in the Free Clinic we only have thirty or sixty minute long slots, so it’s crucial to keep the conversation on track to get all the information you need for an effective formulation.

❤Some useful questions to ask:

-How would you describe your anxiety/muscle pain/fatigue/?

-If you were to take herbs, in what ways would you feel different?

-Does anything help or has anything helped in the past?

-What would you like to focus on/What is your most troubling symptom? (typically nearing the end of the consult, especially if we have talked about a lot of issues)

-What makes it feel better? What makes it feel worse?

-Is alcohol OK for you to take? (Since the majority of the medicine is in alcoholic tinctures, it is crucial to ask if people are alright ingesting alcohol. Some people cannot take alcohol because of pregnancy, religious reasons, past or current addiction issues or current medications.

-Do you have a support group/Do you have a fulfilling social life? 

This can be a telling question, as it can indicate how probable it is that someone will feel motivated to move forward with the changes we recommend. The importance of a support network cannot be downplayed; it makes a massive difference in the potential of someone making positive changes in their life or continuing to feel stuck. As I will mention below, sometimes people need not herbs but counseling or a form of socializing where they can feel part of and supported by a community. 

❤Burden of responsibility. As a health care provider, what we say, and what we do, carries a lot of weight. We have a responsibility to give accurate information, hold space for that person, and to be be compassionate listeners, being aware that most people who have been through the medical system have often been treated poorly and are used to being dismissed and ignored.

❤The importance of having a resource list. As herbalists, we are only one part of the healthcare plan for someone. Sometimes, people will come in with problems that may be more effectively treated by another practitioner. Maybe they are suffering from chronic back pain that feels better when pressure is applied. Though we can give herbs for pain, it’s going to be much more helpful for that person to see a massage therapist or a chiropractor to work on the physical issue. Some folks, like I mentioned above, would really benefit from counselling or psychotherapy, others need to see a doctor to get a drug prescription. When you’re realizing this in the middle of a consult, instead of scrambling and stretching for herbs that may or may not work for their condition, you can reach for your resource list, offering that while at the same time creating something nourishing and tonifying for them in the meantime.

❤Let people choose. Although some people may be feel overwhelmed by the option of more choice, often allowing people to be active agents in their health contributes to both a sense of empowerment as well as better patient compliance. Many people have been given the runaround in the medical system and are rarely, if ever, given options. If it seems appropriate, give someone the option to make a decision for themselves. What medicine will work best for them? Although I might think that the convenience of a tincture might be best for someone, they may not be able to stomach the taste and fail to take it altogether. Perhaps they enjoy the ritual of a tea, or maybe capsules are a better option. Asking before administering can be the difference between someone taking their medicine and coming back, or losing out on the opportunity to assist someone into the future.

❤ It’s OK to say I don’t know. There is something to be said about humility and admitting when you don’t know something. Herbalist Paul Bergner calls humility ‘attunement to reality’, and advocates showing up as yourself, not making false claims about what you know and allowing ‘I don’t know’ to roll off you easily. When you must say this to someone, affirm to them that you will do your best to find out, and provide an answer for them the next time you see them or over email (if appropriate).

❤ Grounding. Every person that walks through the door is bringing their own histories, baggage, and current problems from the day. Know that the energies that every person brings in is going to vary and affect you in different ways. In order to be fully present and engaged with each person you see, I recommend that you find a way for yourself to center and reorient, to be ready for the person that may come in with an especially heavy burden on their shoulders. This can be a simple as spraying a cleansing mist before and after someone leaves or as involved as a visualization meditation before seeing someone and a grounding practice after. Lets also make room for daily grounding and meditation practices! Get outside, gain perspective!

❤Don’t take it personally. I can’t stress this one enough. This may be more of a teachable moment for myself that I’ve identified from a year of living in a different country, working very closely with folks and being around large groups of people on a regular basis. To extrapolate from the personal to the public, don’t take on a patients views, bad attitude or a mistake you might have made as failure as a practitioner. Remember that everyone moves through the world differently and mistakes WILL happen. To fortify yourself against being sucked into a negativity spiral, one of the very best things you can do is to practice letting things slide. Not in any sort of lackadaisical manner, but learning to move on when small upsets happen, or when someone rolls in and attempts to spoil your mood. The cultural tendency to dwell on shitty situations and to allow someone else to dictate how you feel is very strong. I strongly encourage moving away from this socially accepted victim centered mentality to an empowered view, in which you learn how to take responsibility for your feelings and emotions, and realize that mistakes and conflict are not the end of the world, but an opportunity to learn and grow. **

❤Keep learning. Not just about the herbs and pathophysiology and trending medications, though that is important, but about yourself and your way of practicing. If possible, have someone sit in on an appointment (with your patients consent) and get feedback on who you are as a practitioner. How you function in the world and how you navigate your personal relationships can bleed out into your practice. Be aware of this. Constantly strive to learn from the people around you (especially those that you admire and look up to), receive constructive criticism and before responding defensively, ask yourself, Could I be wrong? This is a sister thread of humility. Allow for the possibility that the way you move in the world could afford some minor (or major) improvement.

❤Self care. Being in a therapeutic role can be incredibly inspiring, lifting you up to superhero heights! But sometimes it can draining and demotivating, and as such, it is critically important that you take care of yourself to work through mental obstructions, physical ailments and spiritual questions that you might have about your place in the world. As practitioners, we have the responsibility to be there fully for people, and we can’t be there fully if we allow our personal problems to boil at a slow simmer on the back burner. As I mentioned above, personal problems (whether it’s proper boundaries, unresolved grief or anger, unconscious cognitive biases or physical pain felt chronically in your body) can bleed into our practice. Go to therapy, go for acupuncture, go for long walks in the woods, remember to eat well and talk to an honest friend that will support you towards self-realization. Do things that help to replenish your well. Above all, be gentle with yourself. ***

❤Power objects and routine (thanks to Ced for this inspiration during their Free Clinic presentation on grief). There is something to be said for the reassurance a physical object brings to people. Simply the act of placing a ‘power object’ into someones hands (in my case, a tincture bottle, tea, or powder mix), imbued with healing potential has the possibility of making someone feel better (especially one they may have helped create). Building a routine into someones wellness plan is often crucial to both helping them change as well as increasing patient compliance. The ritual of making tea or the act of carrying a tincture bottle around and taking it regularly, is a constant daily reminder that they are taking charge of their health.

Xo. Many thanks to 7Song, the Ithaca Free Clinic and fellow apprenti, Aviva and Drea for the richness of this experience.

** & ***The topic of authenticity, empowerment and taking personal responsibility is one I am fascinated with, so I plan to do a post in the future on this topic, as well as doing a follow-up post on self care for those who feel they can’t afford it.

****Seriously though, be gentle with yourself.