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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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CLICK HERE TO CHECK OUT OUR NEW 'LEARN HOW TO MASSAGE' COURSE ***
From the beginning, Briana and I agreed that if The Dragontree could be well known for anything, we wanted it to be that our therapists are absolutely top notch. We’ve felt especially qualified in guiding The Dragontree’s massage program, since we have both worked professionally at performing and teaching massage.
Our friends often tease us when one of us has a massage interview planned. “Oh, it must be so hard,” they chide, “having to get massages all the time.” But I assure them, when I’m receiving a massage as a means of evaluating whether to hire someone to represent my business, it’s not usually a relaxing experience. I am constantly evaluating their technique, and I am pretty picky.
We try to check out other spas and get treatments whenever we travel, and, for better or worse, it can be hard to turn off my inner critic (especially when they only give me 50 minutes for my “one hour” massage). When you know how good a massage can be, you’re always hoping that every massage will be that. One year, on my birthday, I was receiving the worst massage of my life, and I actually ended it after fifteen minutes – something I had never done before. The therapist was clearly taken aback when I sat up and said it wasn’t working for me. When he defensively responded that he had plenty of clients who love his work, I realized, most people don’t know what to look for in a good massage. And that’s what I’m going to teach you.
It’s always worth remembering when you have an unsatisfying massage – or any other kind of service – that not every two people are compatible. It could be that the professional – whether a graphic designer, massage therapist, or hair stylist – is skilled at what they do but they just don’t do it to your liking. So, I hope to provide you with some criteria that will make the evaluation process a bit more objective.
I realize that by writing this, I am setting up The Dragontree to meet some very high standards, but I believe I’m also setting up our practitioners for some very big tips. And, I hope that I’m arming you with ways to be constructive about a massage that falls short of your expectations.
Ideally, you can communicate to your therapist during the massage if it isn’t to your liking, and it can be improved on the spot.
If you just like receiving massage, these criteria may help you identify if a particular therapist is right for you or not. If you are an amateur or professional massage therapist, you might find something here to improve your skills. These are, in my opinion, the six most important factors in a good massage.
1. Confident Touch - The first moment a massage therapist lays their hands on a client’s body, something is communicated. When the touch is not confident, the communication is something like, “Hmmm... let’s see... err... maybe this way... no, wait. Oh, I have an idea... uh, maybe not.” As the client, it is difficult to relax and trust the therapist’s skills. When touch is confident (and I don’t mean firm, but something less tangible), the communication is, “I know what I am doing, and I’m here for you.” Confident touch makes us feel like the therapist has a plan. Every touch feels purposeful. This encourages us to relax and open ourselves to the therapist’s therapeutic intention.
2. Continuity of Touch - Every time the therapist removes their hands from the body, there is a disruption in the continuity of sensation and connection. Occasional disengagement from the body is sometimes necessary. But when it happens very frequently, and especially if the therapist’s hands are more off the body than on the body, there is a choppy or jumpy, discontinuous feeling to the massage. It impedes our ability to relax. Conversely, therapists who maintain nearly continuous contact with the body help us stay in a relaxed state.
3. Complete Strokes - When a therapist is working along a natural line on the body, it generally feels best to a client if this line is followed to its completion. There are some techniques that are exceptions to this rule, but when doing long strokes, if a therapist stops short of the natural end point of a stroke, it feels incomplete to the recipient. For instance, if a therapist is performing a stroke down the spine, and they stop a few inches above the base of the spine, or if they working along a limb and they stop before reaching the joint or the end of the limb, it usually doesn’t feel as satisfying as when a therapist continues the stroke to its natural end.
4. Entering the Tissue at the Right Speed and Depth - Some therapists are enthusiastic about getting hard and deep into people’s muscles, but they fail to perceive the body’s unwillingness to let them in. When a therapist tries to go too deep too fast, we tense up and the whole thing becomes counterproductive. When a therapist “listens” well to the body, they enter the tissue at a rate whereby it is able to accept increasing amounts of pressure and depth without tightening up and pushing back. If the body does tighten up, the therapist feels this, backs off, and re-enters more slowly or in another way. If the area continues to be excessively reactive, the good therapist may leave it alone entirely, and work complementary areas instead. This doesn’t mean that good massage must be painless, but at no point should it feel like the therapist is fighting with the client’s body.
5. Sensitivity and Responsiveness – As I alluded to in the previous section, a sensitive therapist is able to perceive how their touch is being received by the client. They also check in verbally from time to time to be sure the client is getting what they want out of the massage. Then, a responsive therapist adjusts their technique to suit the client’s needs. Some therapists with good sensitivity do minimal verbal checking in and still succeed at making appropriate adjustments throughout the massage, but even a seasoned therapist should know that they can fail to read a client’s feelings, so they should always be humble enough to ask.
6. Devoted Presence - A devoted therapist conveys throughout the treatment that the client has their undivided attention. The client never feels that the therapist’s needs are “in the room.” Thus, a devoted therapist rarely starts conversation during a treatment. Some clients like to talk a lot. While there is nothing wrong with this, the therapist who is really devoted to their art recognizes that this may diminish the benefit of the treatment, and they will often gently guide the client back to relaxing and feeling what is going on in their body. Another mark of a devoted therapist is that they are open to receiving criticism, because they want the client to have the best possible experience. That said, when we’re clients, if we really want the best outcome, we’re likely to get it by offering any criticism in a kind way.
In the end, everyone likes something a little different, and there is no single massage therapist who is perfect for everyone. If you ever have a massage experience here at the Dragontree that doesn’t quite meet your expectations, please feel free to talk to us about it. We’d love to hear your input and are eager to find ways for you to have the blissful experience you deserve.
Be well,
Dr. Peter Borten
All rights reserved © 2015 Peter Borten
[post_title] => The Six Keys to a Good Massage
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In this month’s series on pain, I’ve detailed the interventions that I feel make the biggest difference in sustainable pain management without medication. I haven’t mentioned drugs because I feel their side effects make most of them inferior for chronic pain management. For short term use, I have no problem with aspirin or ibuprofen. Many of my our clients are as naturally-oriented as I am, and want to avoid pharmaceuticals at any cost, but if you get a headache once a year, don’t feel guilty about taking an aspirin for it! For longer term use, I encourage you to try the measures I’ve discussed and also to consider some natural analgesic and anti-inflammatory supplements, many of which are profiled in an article on joint pain I wrote a few years ago.
Now I will introduce a few final practices to help you avoid pain:
1. Pay attention to your posture. I’ve written a lot about posture, so here’s the deep and brief. The majority of our pain results from muscular strain, and a great deal of our muscular strain is postural strain. We may think about posture when we sit at a dinner table and perhaps when we lift a heavy box, but all day long we have opportunities to improve our posture and lessen the total strain our activities exert on our bodies.
Some of the key situations to pay attention to posture are: (A) Sitting on a chair or couch. (B) Holding a phone up to the ear. (C) Typing on a phone, tablet, or computer. (D) Driving. (E) Exercising (F) Sleeping.
In exercise, we call good posture “good form,” and without it, our workout isn’t as comprehensive, plus there’s a much higher risk of injury. When talking on the phone, we should be careful not to tilt the head to one side. When typing, keep the shoulders back, the chest open, and the spine straight. When driving, be aware that keeping your elbows up in order to grip the steering wheel means a prolonged strain of the back – take breaks, stretch, drink water, relax.
2. Get your sleep situation optimized. By bedtime, most people – even those with chronic pain – crawl into bed without having given a thought to the fact that they always wake up sore. This could simply be the result of 8 hours of immobility, but since we spend a third of our life in this place, it’s worthwhile to make it thoroughly rejuvenating to the body. Or at least, to ensure that it isn’t a detriment.
Unfortunately, many of the positions we put ourselves in create postural stress or put excessive pressure on sore spots. I’ve had patients make tremendous recoveries from severe pain just by changing their sleep configuration. Investigate mattresses and pillows of varying firmness. Get a body pillow, and/or multiple smaller pillows and experiment with positioning them so that all parts of you feel supported. Avoid positions that crimp muscles or joints (such as sleeping with an arm above your head or under your pillow). Almost everyone does best sleeping on their back, possibly with a small support under the arch of the neck and another under the arch of the lower back.
3. Treat your life like an all day workout. This is another subject I’ve covered extensively in the past, so I’ll bottom line it. All day long, we work certain muscles for longer than we ever dream of working them at the gym. And we habitually (though unintentionally) work the same muscles day after day and neglect the same muscles day after day. If we were approaching our day’s activities as a workout, we’d stretch before and after, we’d drink lots of water, we’d take breaks, we’d be well-rounded, etc. Try to bring the same level of consciousness to your everyday activities. Switch it up, take breaks, stretch, move around, engage your core, have good form, drink water and electrolytes, etc.
Holistic practices of conditioning, such as taijuquan (tai chi) and yoga are excellent in part because they help us to use the body and breath in a balanced way throughout our day. Of course, it’s up to you to not think of these as compartmentalized practices, but to endeavor to do yoga/tai chi all day long. Your life will change in ways that far exceed the alleviation of pain.
I hope you earnestly apply these recommendations and overcome your pain.
Be well,
Dr. Peter Borten
[post_title] => Unlocking Pain, Part Four – Body Mechanics
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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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[is_privacy_policy] =>
[is_404] =>
[is_embed] =>
[is_paged] =>
[is_admin] =>
[is_attachment] =>
[is_singular] =>
[is_robots] =>
[is_favicon] =>
[is_posts_page] =>
[is_post_type_archive] =>
[query_vars_hash:WP_Query:private] => c2cd81ed83b60d31e20ffc4fe2d74a1b
[query_vars_changed:WP_Query:private] =>
[thumbnails_cached] =>
[allow_query_attachment_by_filename:protected] =>
[stopwords:WP_Query:private] =>
[compat_fields:WP_Query:private] => Array
(
[0] => query_vars_hash
[1] => query_vars_changed
)
[compat_methods:WP_Query:private] => Array
(
[0] => init_query_flags
[1] => parse_tax_query
)
)