A New Model of Training for Community-Herbalists
by Ann Armbrecht (with help from Rebecca White)
In the summer of 2001, we created a free herbal clinic in Vermont which provided free herbs and health services to our community. The clinic was initially supported by Sage Mountain and the students of Rosemary’s Advanced Herbal Training program. The clinic provided a wonderful service in our community and grew over the years. A few years ago, the Vermont Center of Integrated Herbalism, a wonderful herb school started by Guido Mase’, Larken Bunce and Betzy Bancroft, took over management of the free clinic so they could provide hands on training skills for their 3rd year students. The clinic now operates out of two locations; Montepelier and Burlington, VT. It provides a wonderful model for other communities wishing to start free herbal clinics.
A healthy forest is composed of different species of trees at varying stages of growth, shrubs and low-lying forest cover. In its diversity the forest becomes a habitat in which plants and animals can live and grow and where humans want to linger. A white pine forest lacks the same appeal, ecologically and psychologically. In the same way, a system of sustainable health care should offer a variety of healing modalities made available in different settings, ranging from formal to informal, and by practitioners at different stages in their practice. A free clinic created by a group of nine community herbalists, many of whom are students of Rosemary Gladstar, in the working class town of Barre, Vt. fills a niche that until now has been empty in the herbal world and offers a model that the herbalists hope will be replicated around the country.
To me, the clinic is most inspiring because it offers an opportunity for aspiring community herbalists to acquire clinical experience in a way that reflects the vision and values of traditional western herbalism. Alternative medicine is often criticized by outsiders for reinforcing our cultural preoccupation with the self and thus, in many ways, for perpetuating the psychological causes of much of contemporary disease. Not only does the model of the free clinic transcend this criticism, as the herbalists give freely of their time to bring herbal medicine to a community that otherwise wouldn’t have that access. In building links between themselves and the larger social and ecological community, the free clinic offers a model of the healing that becomes possible by building connections rather than deepening isolation.
For many years Rosemary Gladstar had a dream of a clinic where students who had completed her two-year advanced program could acquire clinical experience in a cooperative and supportive environment. In the spring of 2001, Rebecca White offered to do the work needed to make that dream a reality. Rosemary and Rebecca contacted herbalists who, in addition to extensive knowledge about plant medicine, had a deep connection with the visible and invisible power of the plants, loved people, and wanted to contribute to this vision of creating a new model of health care. Most of the members of the clinic have completed three years of study with Rosemary Gladstar, including the apprentice program and the two-year advanced program, though some have acquired similar training in other ways. They all continue their education by taking on-going workshops at Sage Mountain and elsewhere, many of them teach classes, grow and prepare medicines, and have their own herb business.
In the summer of 2001, these herbalists began meeting with clients at Sage Mountain. After four months they moved to the People’s Health and Wellness Center in downtown Barre where they meet with clients twice a month. Four new herbalists joined the practice in the fall of 2002.
Before meeting with clients, the herbalists gather in a circle in a back room of the center, close their eyes and stand in silence. They invoke the spirit of the plants, the earth and sky and then each offer a prayer for their work that evening. Though this aspect of their work is never brought up in meeting with clients, this opening sets the tone for how the herbalists interact with each other and with clients, interactions that are marked most especially by listening: listening to the plants, listening to the messages of people’s bodies, listening to each other, and listening to the world of spirit. “How would the future be different,” the writer, Lousie Erdrich, once asked, “if we thought of listening as a political act?” This circle in the back room is the seed for the broader significance of the clinic.
The herbalists then break into two groups of three for meeting with clients while individual herbalists conduct follow up meetings with previous clients. The intakes are modeled on Rosemary’s advanced program, in which one herbalist conducts the interview, another takes notes, and a third offers support and is the timekeeper. They meet with the client for forty-five minutes to discuss the client’s primary health concerns. The herbalists then put their heads together for twenty minutes to create a protocol and then spend thirty minutes reviewing the treatment plans with the client. The client typically returns for a one-hour follow up session two weeks following the initial consultation and another half hour session one month later.
Each time I’ve observed the herbalists meeting with a client, I’ve been struck by the different kinds of stories that are shared and the power that telling those stories and having them listened to has for the clients. On one level, there is the story of physical symptoms, the story of the body that brings the client to the clinic in the first place. Then there are the messages, often more broken, that are communicated through gestures and pauses, in how a client holds their body, in what they choose not to say as much as what they do say.
Telling these stories is healing in two ways. First as the client speaks, patterns and connections emerge, narrative order is brought to what had previously felt chaotic. The steps needed to restore order in an individual’s often become clear simply by talking about that life. One young woman came to the clinic for help coping with panic attacks. By responding to the herbalists’ questions, she discovered parallels in her job, her living situation and her relationship that she previously hadn’t seen. When she returned for her follow-up, she had moved, quit her job, and ended her relationship. Simply seeing the patterns and understanding their connection to her panic attacks helped her see what was needed to remove the pressures that caused the attacks in the first place.
Secondly, like all holistic health care, the questions asked in the intake elicit a story of the client that is big enough to incorporate their whole experience. Clients who come to the clinic are often looking for something they haven’t found in the medical world. Many have had a negative experience, for others it is subtler, they come looking for an alternative explanation for their illness, one that speaks to all of who they are.
Every illness has layers. The questions asked guide the client from the physical symptoms into the underlying emotional and often spiritual sources of the disease. For example, a middle-aged woman kept saying that everything in her life was fine, except, she said, she had these problems with her thyroid. In response to questions about her emotions, it became clear that everything wasn’t as fine as she wanted to believe. Her body was calling for the attention she was devoting to her children, her husband and her job. Physical symptoms offered a window into a deeper exploration of her spiritual and emotional health. Instead of just fixing the symptoms so she could go back to how things were, the herbalists helped the woman see her illness as part of a larger journey of coming into her self and speaking that self to the world.
Sylvia, one of the herbalists who works as a dietician at the nearby hospital, talked about the role of story telling from a different perspective. At the hospital, patients become known among medical staff by their symptoms and what sort of patient they are. A patient Sylvia knew from the hospital as difficult and non-compliant came to the clinic. By conducting the intake with other herbalists who had no preconceptions, she was immediately struck by the difference in what she saw and in how he acted. In the clinic, where the herbalists saw this man as a person, he showed up as a person.
After the intake, the client waits in another room while the herbalists put together a protocol for the client. The herbalists draw on traditional western herbalism and their own eclectic experience to interpret what they have heard and observed. Patterns emerge that aren’t necessarily visible to the client. For example, one man came in with chronic chest problems. As the man spoke, it became clear that he carried a lot of sadness, what he said and didn’t say expressed a deep sorrow and a sense of lingering loss. In traditional Chinese medicine, this herbalist explained, the man had the characteristics of metal, which meant that the constitutional emphasis of his body was the lungs. This was supported by what the herbalists observed in the pulse and the tongue, diagnostics they take with each client.
The protocol addressed these different layers. The herbalists recommended ways for him to help release his sadness and so relieve the burden on the lungs. They recommended tonics, in this case, astragalus, to strengthen the overall health of the lungs. They worked to support the underlying emotional and physical causes of the symptoms, trusting that if they freed up the energy in the lungs, the body itself could heal the more specific complaints expressed by the client.
Protocols include teas and tinctures, dietary recommendations, external treatments, lifestyle and exercise considerations, and vitamin and mineral supplements analysis/recommendations. In explaining why certain herbs are recommended, the herbalists share as much of their interpretations of the client’s story as seems appropriate and useful. These interpretations draw on all of what the client has shared and thus reinforce the clients’ experience of being more than their symptoms.
A certain plant often appears to the herbalists during the intakes. As they listen to the client’s story, it becomes clear how that plant might help. Sometimes a plant doesn’t appear, and one herbalist suggested that in that case the person wasn’t meant to get an herbal formula. One man who had spent years on disability from an injury at his work place came to the clinic disillusioned with any system of authority. When he returned for his follow up, he said he had only taken one dose of the herbal tea they had recommended. Yet, he told the herbalists that coming to the clinic had changed his life. The experience of being seen and heard, of being loved the way clients are when they meet with these herbalists, was what he needed to take charge of his life again, seeing what he could control in his life, instead of simply being angry at all he couldn’t.
The clinic is stocked with dried herbs and tinctures grown, prepared, and donated by local herbalists. This is a central part of the herbalists’ vision of bioregional health care. The medicine itself embodies an important connection with the natural world that is part of the healing process, particularly in a culture where much of our dis-ease arises from a lack of connection to place.
The herbalists give the clients two days worth of tea, one or two tinctures, and often a flower essence. The herbalists explain what the plants in the teas and tinctures are and why they are included. Sometimes they recommend that the clients grow the plants as part of their healing. Most of the herbalists also offer classes on medicine making either independently or at the local hospital. They believe that teaching people to make their own medicine is one of the most revolutionary aspects of their work, an act that is as revolutionary as growing your own food. It engages the client in a way that alternative systems like massage and acupuncture cannot. This engagement in itself is healing.
Much of what I have described thus far is typical of other herbal practices. What distinguishes the free clinic is that the herbalists work in a group and that they offer their services for free. The vision was Rosemary’s, yet she trusts the wisdom of these herbalists working together as a group and she only offers input as and when she is asked. That same trust permeates the group. Though Rebecca is paid by Rosemary to spend one hour a week on logistical organization, there is no hierarchy in the clinic. The herbalists listen to each other with the same understanding and openness that they listen to their clients. They express a quality of trust and respect that makes this model so powerful – it truly is community based, not just in the community of plants, but in the community they have created. They trust each other because they know each other, they explained, not because an outside institution has given them a license that says they should be trusted.
Because no one at the clinic is the ultimately in charge, the herbalists discover that they know more than they thought they did, more than they may have discovered had there been an expert to turn to. The structure of the clinic thus models their belief that the client knows best what their body needs, not the doctor or some other expert. This recognition is an important layer in the healing process.
Alternative health care is rarely covered by insurance and so tends to attract a largely white, middle to upper-middle class clientele. Workshops and courses in herbal medicine extends beyond this group to those devoted to plants and plant medicine. The free clinic goes further by reaching out to those also frustrated with biomedicine but without the resources to pay for alternative care. Like community healers in the past, this care isn’t off limits to anyone. People can make donations, but there is no charge. In addition to providing access to herbal medicine, the fact that the herbalists volunteer their time – and thank the clients for the opportunity to do this work — makes real what they tell clients about their lives being important.
The free clinic offers an intermediate step between the lay practitioner working alone in a community and a more medical model where credentials make a healer credible. In addition to getting clinical experience, the herbalists gain confidence, make connections with their larger community, and have support for addressing concerns like liability, creating protocols etc. The herbalists benefit from the different experience and training they each bring, and they deepen relationships with other practitioners so that if and when they do move out on own, they have this support to draw on. Rosemary’s vision was that the clinic would provide herbalists with the confidence and capacity to ultimately set up a practice on their own, one that was supported by and rooted in the community and so was a training ground for community healers in the fullest sense of the word. In reality, the herbalists at the free clinic get so much from working together — each of them talks about how enriching the experience is and how energized they feel after each night together — that none have yet decided to move off on their own.
- The anthropologist Jean Comaroff describes how the Tswana in southern Africa believe illness rises from an imbalance in the relationship between an individual and the larger social and cultural environment, rather than from germs. Successful healing must address that imbalance (Comaroff 52).
- While most alternative systems of health care consider this broader context in their assessment of illness, the path of healing focuses almost exclusively on the individual, not on working to transform that context and the imbalances it perpetuates. In creating a free, bioregional, community-based health care clinic, these herbalists are working to address the underlying disconnections that create and perpetuate many of the illnesses they treat. In addition to what it offers the community, this activism is an invaluable aspect of the herbalists’ own healing, the healing that comes from engaging in the world and doing what one can to make that world a better place. The herbalists hope to see a string of free herbal clinics across the country. I like to imagine that, with the support these clinics would offer each other, the herbalists can create ways to bring this dimension of healing into the client’s experience as well. In that way, the clinics could be the seeds of a grassroots movement to create both a more sustainable system of health care and a healthier cultural, social, and physical environment in which to live.
- Comaroff, Jean. get