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If you’ve ever done something reactionary, without thinking it through, there was a certain element that spurred you to act even though you might not have been aware of it. If you have an addiction, or simply find yourself repeating a behavior even while knowing it isn’t good for you, this element is there as well. It’s also there when you procrastinate. And when you avoid certain people. And when you dodge uncomfortable conversations. And it inevitably plays a central role in every case of anxiety or depression.
The element I’m speaking of is feelings. And although it might sound obvious to say, “Feelings play a central role in unhappiness,” I believe that most unhappy people rarely have an intentional meeting with those feelings. Whether recognized or not, their presence moves us to act – and to avoid acting. They dramatically alter our experience of life and our perspective of the ourselves and the world.
Rather than labeling them as good or bad, I think it’s more meaningful to look at how much freedom do you have in your relationship with a given feeling?
I often ask people about their feelings, especially when the feelings seem to be in control. Specifically, I inquire about the physical experience they’re having. Frequently they report that they can’t perceive anything. Despite the fact that there’s a feeling that’s strong enough to prompt them to, say, gobble up a bag of candy faster than they can stop themselves, the felt sense of that feeling can be hard to pin down. I guarantee it’s there though, and exploring it is likely to help unravel this behavior pattern.
We’re not apt to address our unpleasant feelings directly because, well, they’re unpleasant. Maybe we believe that willingly experiencing them would be more unpleasant than distracting ourselves from them or blocking them out. Furthermore, we learn early that other people disapprove of our anger and fear, and usually there’s no wise guidance for managing these feelings. So we develop the skill of stuffing them or becoming numb. When we look at trends in violence, it’s clear that boys, in particular, are expected to learn this skill and that it often fails miserably.
Actually it fails for everyone, eventually. Not acknowledging our feelings doesn’t neutralize them. It makes them toxic.
I know that an exploration of your negative emotions, many of them associated with traumatic events, doesn’t sound like a good time. It’s work. Perhaps even painful work. But it’s supremely worthwhile work. It’s like digging out a deep splinter. You know it’s not good to let it fester in there, and maybe it’s gotten so tender and swollen that you can’t get it all at once. However, there’s a certain strength that comes from knowing you’re finally doing what needs to be done. And it doesn’t have to be a grim process; you’re not going to be less effective by bringing humor, gentleness, and self-love to this work.
You will probably discover at times that your feelings are more complicated than you thought. Dr. Les Greenberg, the main developer of Emotion-Focused Therapy, explains that we have primary emotions and secondary emotions. Our primary emotions arise in the instant that an unpleasant thought or experience occurs, and they usually make us feel vulnerable or exposed. Thus, they’re often quickly and powerfully veiled by a secondary emotion (like anger, indignation, resentment, etc.) that feels less vulnerable. Greenberg describes primary emotions as “less rapid and less action-oriented” than secondary emotions. He says if we only address our secondary or surface emotions, the primary emotion remains and is likely to trigger new secondary emotions in future conflicts. With a spirit of curiosity and trust, you can go deep and get acquainted with these neglected parts of your shadow-self, bringing them into the light.
While reading the beginning of this article, perhaps you thought, “But these are all cases of being moved by negative feelings. What about positive feelings? Aren’t they one of the best parts of life? Can they run us, too?” Yes, they are one of the best parts of life. And no, they can’t run us in the same way. I have to choose my words carefully on this topic, because it’s easy to start thinking of certain emotions as good and others as bad, some as desirable and others as undesirable, and the truth is more nuanced than that. Again, what’s most important is how we relate to our emotions.
In most basic terms, negative emotions are a message that some form of conflict, resistance, or discord is occurring, and positive emotions indicate an experience of alignment, accord, or harmony. I know that sounds like good and bad, but how about we look at it this way: the Low Oil light on your dashboard indicates the potential for imminent friction and damage to your engine. Does that make the Low Oil light a bad thing? Would you prefer to put a piece of tape over it so you don’t have to see it? Auto makers would argue that this light, the equivalent of a negative emotion, is a very good thing as long as we respond to it appropriately.
It’s kind of like the Hot/Cold game, where someone tells you you’re getting closer to some treat by saying “warmer” (i.e., a positive emotion) or further away from it by saying “colder” (i.e., a negative emotion). Hot and Cold stand to be equally useful. But imagine how the game would go if, upon hearing the other player say, “colder,” you just shut down. Or you said, “I can’t do anything right!” Or, “Why do you always have to attack everything I do?!” When we behave this way in the presence of negative emotions, the whole game ends. But when we remain open, the prize is our freedom – even if it takes years to find that treat.
Be well,
Dr. Peter Borten
P.S. I don’t mean to confuse the issue, but I feel it’s worthwhile to share a few words of non-dual perspective on the subject (garnered from several spiritual traditions). Within this dualistic world, it makes perfect sense to treat negative and positive emotions as two sides of the same coin. Or as two sides of the same mountain – the light side and the shadow side. Neither is more valid or real than the other.
But as we begin to have experiences of expanded consciousness – an awareness that transcends our everyday consciousness – positive and negative feelings may take on new meaning. If we define positive feelings as those that offer greater freedom, deeper peace, union with truth and love, these are (as I see it) an indication of alignment with our Highest Self (or God, or our Authentic Self, or Dao, or Buddha, or whatever other term you like).
The non-dual perspective is that there is no opposite to this state. That is, this (love/truth) is reality, and the negative feelings and suffering that so define the human experience emerge from our immersion in an illusion, a state of forgetfulness in which love is conditional, anything of value is bound to be lost, and we must out-compete each other for happiness. Therefore, as we expand beyond our ego-dominated awareness, negative emotions may be seen as indicators that we’ve become re-immersed in the illusion, or that our ego is attempting to regain control over our consciousness. And positive feelings (as defined above) show us that we’re in the flow, that we’re expanding, or that we’re choosing love.
While the perspective of Classical Chinese Medicine isn’t non-dual per se, it takes a similar view of classifying negative and positive emotions as fundamentally different things. The five basic “sentiments” – joy, contemplation, wonder, reflection, and vigor – are qualities we’re experience continually when we’re healthy. In contrast, the five primary negative emotions – anger, fear, joylessness (or mania), worry, and grief – are considered to be signs of imbalance. (However, if we’re able to accept and experience them readily, allowing them to move through us without resistance, this is not considered unhealthy. It’s only when they occur in an extreme or prolonged way that they become toxic.)
Finally, while we can be guided almost equally well by Hot and Cold (i.e., indicators that we’re becoming more aligned and less aligned with our truth), ultimately, we can’t be shown the whole way home through expressions of the Cold end of the spectrum (i.e., “you’re going the wrong way!”). Expect to encounter discomfort and difficulty – they don’t mean you’re on the wrong path – but if you make your choices from love rather than fear, you should also expect that increased freedom, peace, love, and joy will light the way for you.
[post_title] => Once More with Feeling
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Last year a disabled veteran came to see me for help with back pain. As we talked about his history, a familiar story arose. He got injured, experienced a lot of discomfort, was prescribed opioid painkillers, and became addicted to them. He described how his journey through his addiction treatment center and how, for several years, “I lost my personality and my life. I was barely a human.”
He lived in a numb haze, with no sense of humor or interest in anything, until a new doctor specializing in recovery treatment for all levels of addiction, finally recognized what was happening and began to wean him off these drugs. Much of the pain remained, but we were able to work on that. More importantly, he got his life back, and his friends and family got him back.
The familiar part of the story is the widespread long-term use of opioids and the unfortunate consequences. The uncommon part is that he got off of them. A 2017 study by the Centers for Disease Control called “Characteristics of Initial Prescription Episodes and Likelihood of Long-Term Opioid Use” looked at 1.3 million opioid users over 9 years.1 It found that the longer the initial prescription period, the higher the likelihood of long-term use. If someone used an opioid for 10 days, there was a 20% chance they’d still be using it a year later. At 35 days, the risk of yearlong use was about 45%. A 2014 study in the Clinical Journal of Pain came to a similar conclusion – the higher the initial dose and the longer the initial use of an opioid, the greater the chance of the patient developing a condition of abuse and dependence.2
It’s worth mentioning that both of these studies excluded patients with cancer pain (which is often expected to require ongoing medication, perhaps until death). That is, the great majority of those who were on opiates for several years were using it to manage back pain or joint pain (or to manage their dependency on opiates). Thus, we can assume that the prescribing doctors either didn’t know of an alternative method for pain relief or didn’t care. Do effective non-opioid alternatives exist? In the words of some ancient healer: Hell Yeah!
The first modality that comes to my mind, as you might guess from the story above, is acupuncture. Acupuncture is no longer a fringe therapy. Its effectiveness is well supported by clinical research (comparable to opioids in effectiveness3), it’s routinely offered by many hospitals in the U.S., recommended as a standard option for pain management by health systems around the world, and even adopted by the U.S. military (in a form called “battlefield acupuncture”) for severe pain.
If acupuncture has been unsuccessful at managing your pain, I advise that it isn’t always an instant miracle. Sometimes it takes several treatments to produce significant, lasting results. Also, practitioners vary in their specialties and level of skill. If you don’t experience any relief after a couple sessions, try someone else – and ask if they specialize in pain. Further, a licensed acupuncturist is almost always going to be more skilled and certainly has more training than a medical doctor or physical therapist who also does acupuncture.
While it’s great to receive acupuncture from a professional, it’s also useful to know how to utilize this system to manage pain on your own. Many acupuncture points can provide effective pain relief simply by pressing on them. Especially when traveling, or when needles weren’t available or practical, I’ve often utilized acupressure to successfully eliminate my own pain or that of friends and family. There are specific points for pain in different locations, though one of the most utilized for pain anywhere in the body is called Large Intestine 4, and it’s located in the muscular web between the thumb and index finger. If you press around in this area on the back of the hand, especially directing your pressure toward the hand bone that leads to the index finger (second metacarpal), you will find a tender spot. Pushing firmly on this spot while moving the painful area may alleviate your pain.
Mindfulness-based pain management techniques can also be very effective, and they have the added benefits of helping you live more in the present and experience more gratitude. These strategies were pioneered mainly by Jon Kabat-Zinn, and are based loosely on Buddhist meditation. There are numerous books and courses available in his Mindfulness Based Stress Reduction (MBSR) practice. The basis of these techniques is non-avoidance of discomfort – learning not to resist or mentally depart from the experience at hand, but to instead “turn toward” it and explore it willingly, whereupon it ceases to feel like suffering, and may even open us to a whole new dimension of experience.
Breathing is another vital practice for self-management of pain. How we breathe can profoundly affect both our mental state and the feelings in our body. I have witnessed people doing breathing exercises which, within a half hour, turned off pain that had persisted for decades. In a way, breathing through pain is similar to mindfulness techniques, in that we’re willingly bringing our attention to the experience. I feel that the power of the breath to reduce pain makes so much sense – it seems like an intelligent plan that we should all be equipped with the means to facilitate our own healing. In the most basic way, you can imagine that, with each inhale and exhale, you’re moving the breath – and energy along with it – through the painful area.
After years of teaching these and many other pain relief techniques to my patients, I decided to gather all my knowledge into an online course. In it, I teach a philosophy for understanding pain that will make sense and will illuminate your perspective of what’s happening. And I explain and demonstrate a huge array of methods for eliminating your own pain. As I was creating the course, in fact, the others who were involved in the project kept asking me, “How much more are you planning to include in this?!” But there are so many useful approaches, so many opportunities not just to overcome the pain, but to grow and evolve as a person, and that’s my real goal for participants in the course.
My greatest hope is to see fewer and fewer cases like that of my veteran friend – fewer cases of opioid dependence, fewer cases of pain relief at the expense of the joy of life. And more cases of people overcoming pain in ways that are empowering and even help them heal and awaken. If you’re in pain or know someone who is, check out the course. It’s called Live Pain Free. It’s affordable, and you’ll learn things you’ll use for the rest of your life.
Be well,
Peter
Let Me Teach You How to Erase Your Own Pain Without Drugs
Sources:
1: Shah A., Hayes C. J., Martin B.C. Characteristics of Initial Prescription Episodes and Likelihood of Long-Term Opioid Use — United States, 2006–2015. MMWR Morb Mortal Wkly Rep 2017;66:265–269. DOI: http://dx.doi.org/10.15585/mmwr.mm6610a1
2: Edlund, M. J., Martin, B. C., Russo, J. E., DeVries, A., Braden, J. B., & Sullivan, M. D. (2014). The role of opioid prescription in incident opioid abuse and dependence among individuals with chronic noncancer pain: the role of opioid prescription. The Clinical journal of pain, 30(7), 557-64.
3: Grissa, M. H., et al. Acupuncture vs intravenous morphine in the management of acute pain in the ED. The American Journal of Emergency Medicine, Volume 34 , Issue 11 , 2112 – 2116.
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This month’s theme is one of my specialties: pain management. There’s so much I could write about dealing with pain, but the fact is the approaches that are of greatest benefit to most people don’t need much explanation. As with most simple things, they’re easy to dismiss because we put so much value on complexity. Now that we have mapped out the human genome and can control the weather with our iPhones, who’s going to believe that the simple approach is the best?
Interestingly, many of the complex health-related developments don’t entail much involvement by the user. Just swallow this pill, which is the culmination of years of work by people much, much smarter than you. The simple interventions, on the other hand, often represent more work and/or lifestyle change by the user, but by the same token, they stand to heal you in a way that few pills could.
Now, let’s get down to business. I’d like to teach everyone to understand the meaning of pain from the perspective of Chinese Medicine. One of the most fundamental principles of this medical system is that all pain is due to some form of stagnation. When things move freely we feel good, and when they don’t we feel bad.
If we overeat and food is stagnant in our digestive tract, it feels bad. If blood stops moving through the vessels in our heart, it feels bad. If our muscles are irritated and taut (i.e., stagnant), they feel bad. If a joint is damaged and inflamed (stagnation again), it feels bad. If we broke up with someone but we keep fantasizing about them or replaying our conversations, this is mental and emotional stagnation, and it feels bad. If we’re attached to life being a certain way but it’s not that way, and we don’t accept it, it feels bad. Guess why. No matter what kind of pain you’re in, restoring healthy movement or flow will make you feel better.
Now for three important sub-principles. First, all parts of us are interconnected, so stagnation on one level can readily lead to stagnation on another level. For example, if we’re chronically angry, tense, or sad (emotional stagnation) this can eventually show up as, say, a tension headache or lower back pain (physical stagnation). Vice versa, living in a tight and inflexible body (physical stagnation) can contribute to a lack of mental flexibility – rigid thinking, frustration, depression, etc. Physical stagnation is easier to cure in this case, as emotional stagnation needs not just a treatment, but also your willing to get well. There is the natural product that can help to reduce stress and improve your emotional state.
Second, clearing stagnation on any level tends to promote healthy flow on all levels. For instance, physical exercise is beneficial for depression, because moving the body moves the mind. Likewise, using the mind to imagine energy and blood coursing freely through a painful area of the body can often be as effective as painkillers. For the same reason, if we’re in physical pain, it is always worthwhile to look inward and see if there’s some story or emotional pattern we need to let go of.
Third, you can’t argue with reality. Resistance produces stagnation. So, resisting pain doesn’t help. Acceptance does. Accept your pain (and everything else) and let it go.
Almost everything that benefits pain does do by mobilizing stagnation. We’ll explore a handful of the most beneficial interventions this month.
Let’s start by addressing conservative care for injuries. For several decades, the standard has been RICE: Rest, Ice, Compression, and Elevation. All of these tactics are aimed at inhibiting movement, based on the notion that the inflammatory process in injuries is somehow a mistake by the body. We’ve been taught that it’s vital to stop the influx of immune cells that causes swelling. As for Rest, it’s a good idea not to cause more damage, so avoiding activity that could be injurious is smart, but total immobility can slow the healing process. Contracting the muscles around an injured area gets the congested fluid (lymph) moving out of there. Controlled, low impact movement speeds healing.
The use of ice is the subject of fierce debate. In Chinese Medicine (and thermodynamics), cold is considered a contractive force. It inhibits movement. Therefore, if the goal is to get fresh blood into the area and clear out lymph and particles of damaged tissue, we need to keep the vessels in this area open. Cold constricts vessels, while heat opens them. Cold blocks pain signals, but inhibits healing. In fact, emerging research shows it may contribute to increased tissue death and slower healing. If you really love the refreshing feeling of brief cold application after minor strain (like working or exercise), I don’t think it’s a problem. But for healing pain, heat almost always works better.
Compression is meant to keep an area from swelling, but again, the influx of fresh blood to nourish damaged tissue and the immune macrophages, cells that clean up debris, are beneficial. We don’t want to restrict this response; we just need to keep things moving. Although there are some cases in which compression is useful, I generally advise against it for acute traumatic injuries.
Of the four RICE interventions, I find Elevation the least objectionable. It’s meant to reduce gravity’s contribution to swelling and to improve the return of blood to the heart through veins. The thing is, most of the fluid swelling in trauma is lymph, not blood, and lymph moves through lymphatic vessels, not veins. Gravity alone isn’t going to help much in moving that lymph. Instead, the muscles around these lymphatic vessels need to contract to squeeze the fluid along. Again, this is why controlled, low impact movement is vital.
So, next time you get injured, try slow, low impact movement and heat application. Next week I’ll discuss more strategies for alleviating this and other forms of pain. Stay tuned and keep moving.
Be well,
Dr. Peter Borten
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If you’ve ever done something reactionary, without thinking it through, there was a certain element that spurred you to act even though you might not have been aware of it. If you have an addiction, or simply find yourself repeating a behavior even while knowing it isn’t good for you, this element is there as well. It’s also there when you procrastinate. And when you avoid certain people. And when you dodge uncomfortable conversations. And it inevitably plays a central role in every case of anxiety or depression.
The element I’m speaking of is feelings. And although it might sound obvious to say, “Feelings play a central role in unhappiness,” I believe that most unhappy people rarely have an intentional meeting with those feelings. Whether recognized or not, their presence moves us to act – and to avoid acting. They dramatically alter our experience of life and our perspective of the ourselves and the world.
Rather than labeling them as good or bad, I think it’s more meaningful to look at how much freedom do you have in your relationship with a given feeling?
I often ask people about their feelings, especially when the feelings seem to be in control. Specifically, I inquire about the physical experience they’re having. Frequently they report that they can’t perceive anything. Despite the fact that there’s a feeling that’s strong enough to prompt them to, say, gobble up a bag of candy faster than they can stop themselves, the felt sense of that feeling can be hard to pin down. I guarantee it’s there though, and exploring it is likely to help unravel this behavior pattern.
We’re not apt to address our unpleasant feelings directly because, well, they’re unpleasant. Maybe we believe that willingly experiencing them would be more unpleasant than distracting ourselves from them or blocking them out. Furthermore, we learn early that other people disapprove of our anger and fear, and usually there’s no wise guidance for managing these feelings. So we develop the skill of stuffing them or becoming numb. When we look at trends in violence, it’s clear that boys, in particular, are expected to learn this skill and that it often fails miserably.
Actually it fails for everyone, eventually. Not acknowledging our feelings doesn’t neutralize them. It makes them toxic.
I know that an exploration of your negative emotions, many of them associated with traumatic events, doesn’t sound like a good time. It’s work. Perhaps even painful work. But it’s supremely worthwhile work. It’s like digging out a deep splinter. You know it’s not good to let it fester in there, and maybe it’s gotten so tender and swollen that you can’t get it all at once. However, there’s a certain strength that comes from knowing you’re finally doing what needs to be done. And it doesn’t have to be a grim process; you’re not going to be less effective by bringing humor, gentleness, and self-love to this work.
You will probably discover at times that your feelings are more complicated than you thought. Dr. Les Greenberg, the main developer of Emotion-Focused Therapy, explains that we have primary emotions and secondary emotions. Our primary emotions arise in the instant that an unpleasant thought or experience occurs, and they usually make us feel vulnerable or exposed. Thus, they’re often quickly and powerfully veiled by a secondary emotion (like anger, indignation, resentment, etc.) that feels less vulnerable. Greenberg describes primary emotions as “less rapid and less action-oriented” than secondary emotions. He says if we only address our secondary or surface emotions, the primary emotion remains and is likely to trigger new secondary emotions in future conflicts. With a spirit of curiosity and trust, you can go deep and get acquainted with these neglected parts of your shadow-self, bringing them into the light.
While reading the beginning of this article, perhaps you thought, “But these are all cases of being moved by negative feelings. What about positive feelings? Aren’t they one of the best parts of life? Can they run us, too?” Yes, they are one of the best parts of life. And no, they can’t run us in the same way. I have to choose my words carefully on this topic, because it’s easy to start thinking of certain emotions as good and others as bad, some as desirable and others as undesirable, and the truth is more nuanced than that. Again, what’s most important is how we relate to our emotions.
In most basic terms, negative emotions are a message that some form of conflict, resistance, or discord is occurring, and positive emotions indicate an experience of alignment, accord, or harmony. I know that sounds like good and bad, but how about we look at it this way: the Low Oil light on your dashboard indicates the potential for imminent friction and damage to your engine. Does that make the Low Oil light a bad thing? Would you prefer to put a piece of tape over it so you don’t have to see it? Auto makers would argue that this light, the equivalent of a negative emotion, is a very good thing as long as we respond to it appropriately.
It’s kind of like the Hot/Cold game, where someone tells you you’re getting closer to some treat by saying “warmer” (i.e., a positive emotion) or further away from it by saying “colder” (i.e., a negative emotion). Hot and Cold stand to be equally useful. But imagine how the game would go if, upon hearing the other player say, “colder,” you just shut down. Or you said, “I can’t do anything right!” Or, “Why do you always have to attack everything I do?!” When we behave this way in the presence of negative emotions, the whole game ends. But when we remain open, the prize is our freedom – even if it takes years to find that treat.
Be well,
Dr. Peter Borten
P.S. I don’t mean to confuse the issue, but I feel it’s worthwhile to share a few words of non-dual perspective on the subject (garnered from several spiritual traditions). Within this dualistic world, it makes perfect sense to treat negative and positive emotions as two sides of the same coin. Or as two sides of the same mountain – the light side and the shadow side. Neither is more valid or real than the other.
But as we begin to have experiences of expanded consciousness – an awareness that transcends our everyday consciousness – positive and negative feelings may take on new meaning. If we define positive feelings as those that offer greater freedom, deeper peace, union with truth and love, these are (as I see it) an indication of alignment with our Highest Self (or God, or our Authentic Self, or Dao, or Buddha, or whatever other term you like).
The non-dual perspective is that there is no opposite to this state. That is, this (love/truth) is reality, and the negative feelings and suffering that so define the human experience emerge from our immersion in an illusion, a state of forgetfulness in which love is conditional, anything of value is bound to be lost, and we must out-compete each other for happiness. Therefore, as we expand beyond our ego-dominated awareness, negative emotions may be seen as indicators that we’ve become re-immersed in the illusion, or that our ego is attempting to regain control over our consciousness. And positive feelings (as defined above) show us that we’re in the flow, that we’re expanding, or that we’re choosing love.
While the perspective of Classical Chinese Medicine isn’t non-dual per se, it takes a similar view of classifying negative and positive emotions as fundamentally different things. The five basic “sentiments” – joy, contemplation, wonder, reflection, and vigor – are qualities we’re experience continually when we’re healthy. In contrast, the five primary negative emotions – anger, fear, joylessness (or mania), worry, and grief – are considered to be signs of imbalance. (However, if we’re able to accept and experience them readily, allowing them to move through us without resistance, this is not considered unhealthy. It’s only when they occur in an extreme or prolonged way that they become toxic.)
Finally, while we can be guided almost equally well by Hot and Cold (i.e., indicators that we’re becoming more aligned and less aligned with our truth), ultimately, we can’t be shown the whole way home through expressions of the Cold end of the spectrum (i.e., “you’re going the wrong way!”). Expect to encounter discomfort and difficulty – they don’t mean you’re on the wrong path – but if you make your choices from love rather than fear, you should also expect that increased freedom, peace, love, and joy will light the way for you.
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Thank you that was very helpful. It seems like everything comes back to the breath!! Not resisting what is and breathing into where stagnation seems to be present. ☀️ Your examples of stagnation and the simple way you spoke are the perfect start to my day today.
Thank you, Dr. Borden, for this message. It rings so very true. I will endeavor to pass this on to others.
I enjoyed being a student in your Dragontree “Live Pain Free Course”. This video is a timely reminder. I also appreciate that I can go back and review your video lessons at will. I have retold some of the stories from your Course many times. The snake bite comes to mind. Teaching via parables makes depths of lessons stick. (Snake/stick…* smile)