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When I first delved into cognitive behavioral therapy (CBT) as a psychology major, I remember thinking, “This is an evolution for humans.” CBT focuses on examining and challenging one’s thoughts and beliefs, changing related behaviors, and building coping skills and emotional regulation.
Of course, there is a long philosophical tradition of examining the nature of human thought and behavior, but the advent of cognitive and behavioral psychology in the past couple centuries infused these concepts into mainstream culture in a profound way. It’s now common for people to talk about their thoughts as something separate from themselves, and to routinely employ behavior modification techniques in all areas of life.
I had a mentor in my early 20s who was a big advocate of CBT, and at the time I told her I had been exploring methods for healing the memories of traumatic events. I felt both rebuffed and inspired when she said, “You’re wasting your time. We don’t need to go back and relive our childhood or spend the rest of our life lying on some shrink’s couch analyzing everything that ever happened to us! All that matters is, right now, are you going to be at the mercy of your thoughts and automatic behaviors, or are you going to manage whatever comes up in a conscious, intentional way?”
I’ve thought a lot about this in the decades since. My mentor was of the mind that we don’t need to figure out why these painful or dysfunctional patterns keep coming up, we just need to change our response to them, and eventually we’ll transform our psychological makeup in a permanent way. I believe there is real value to this approach, and also . . . sometimes I think we need to go back.
When it comes to our healing and growth, here are three good reasons to revisit your past:
(1) If you’re constantly managing your response to a recurrent pattern, it might be more efficient to get to the root of the pattern and dismantle it (or at least mitigate it) so that it doesn’t come up much, if at all. Of course, you can also use cognitive and behavioral strategies if it does arise.
(2) There is potential for deeper self-awareness, insight, and growth through visiting your past and coming to understand the factors that went into making you who you are. These are opportunities to forgive, correct misunderstandings, reframe our stories, and revise or erase beliefs. While it’s totally possible for many people to be happy without going there, it’s probably not possible to be self-actualized without making peace with your past.
There are some caveats. Analyzing your past can be taken to a self-indulgent degree. It can retrigger old trauma. And most common, it can make us feel worse as we work through it (and experience it without resistance, perhaps for the first time) – though this usually gives way to greater freedom. Thus, it’s important to do this work when you’re feeling relatively stable, with a clear sense of why (what you hope to accomplish), and with the tools and/or support to do it in a way that’s likely to turn out well.
(3) Finally, some people seek total liberation from our programming, i.e., the ego. Once this urge awakens in us, it often never goes fully back to sleep. If you’re in this boat, you may find value in recapitulation.
I read about recapitulation in a Carlos Castaneda book when I was 18 and it seemed unfathomable. Castaneda, a Peruvian anthropologist-turned-apprentice of shamanism, was instructed by his teacher to write down his entire life story, from his very earliest memories, including every person he had ever met. This process, he was told, was necessary to free him from his worldly attachments. It took him years. I remember thinking, “I could never do that.”
Since then, I’ve encountered various forms of recapitulation in my other studies of shamanism, and I now feel it’s more doable than I previously believed. Could it take years? Absolutely. But you’ve got time, and it’s not an all-or-nothing proposition. Every time we release some piece of baggage, it’s like dropping a sandbag from a hot air balloon. We’re that much lighter and freer – even if we’re not “done.”
As we go through our history, we find countless moments that have a certain weight or charge. They exist in a state of incomplete resolution. Taken together they have a powerful influence on how we show up in the present. They can make us dwell in the past and fear the future. They can cause us to live within a fraction of the spectrum of what’s possible. In short, they limit our freedom. As we loosen our history’s grip on us, we thus loosen the grip of our ego, and we more readily access our true essence and potential.
I stumbled upon my own recapitulation process while doing somatic releasing practices. In a nutshell, all our history with a charge – everything that doesn’t sit neutrally in us – can be experienced through the body. There is a physical expression and felt experience to all of it. And in willingly visiting it, experiencing it without resistance, and accepting it, we promote its resolution.
If this is unfamiliar territory for you, just try this: Bring up something about your current life or your past that you wish were different. While holding this in mind, expand your awareness to include what you feel in your body. You will perceive a certain unease. As you meet it and even invite it, the unease loosens. (Sometimes this takes a little practice, especially if you’re not accustomed to feeling your feelings. If you’re interested in diving deeper into this process, check out our workbook called Freedom.)
When we do this work we inevitably find layers of holding. We release one layer and discover another layer, and so on. In my case, I began to recognize the layers faster than I could process them, so I started writing them down. Hundreds of cords, linking me to my past, pulling on me, distorting my present self. The list grew at the same rate that I crossed things off it. I’m not nearly done, but I feel much lighter.
I’m not saying a person can’t show up in a clean and authentic way until they release every conflict or resentment they’ve ever had. What I mean is that a thorough recapitulation facilitates ego liberation – something that’s beyond the scope of CBT and, frankly, not of interest to most people.
In my own process, I found that I was sometimes inspired to move my body in certain ways to assist the release of a sticky pattern, which is an integral part of some somatic therapies. Interestingly, it’s also a technique used in shamanic recapitulation. As Sandra Ingerman and Hank Wesselman explain in their book, Awakening to the Spirit World, we can facilitate the “unraveling” of a memory (or the emotional charge attached to it) by spinning. This can also be accomplished by turning the head or twisting the body from side to side, and the authors say they believe this is also why EMDR (Eye Movement Desensitization and Reprocessing) works. They recommend spinning or turning while breathing deep into the memory and its associated emotions, accepting it, and intending to release it.
I believe recapitulation also occurs to some extent automatically, especially when we’re ready for it: in dreaming; in meditation, when we are sometimes spontaneously presented with something from the past that needs to be “cleared”; in yoga and exercise; and very often under the influence of entheogenic (psychedelic) substances, especially when used intentionally as medicine. This is why psilocybin mushrooms are rapidly gaining a reputation as one of the most effective therapies for attaining peace at the end of life.
I’m curious to hear from readers about your experience with the different approaches I discussed. Have you used CBT, and did it help? Have you dug into your past to heal yourself? What methods did you use, and how did it go? Have you done a large scale recapitulation? What was the outcome? Please share.
Be well,
Peter
[post_title] => Are You Willing to Go All the Way Back?
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I am often asked, “What’s the difference between acupuncture and dry needling?” So, I thought I’d answer the question for everyone in our community who might be interested, and offer some history and science along the way.
“Dry needling” is a term that has grown tremendously in usage over the past decade because it’s a newly adopted practice by many physical therapists. It essentially consists of inserting acupuncture needles into tight muscles. In many states, acupuncturists have fought physical therapists’ attempts to expand their scope of practice to include this procedure. However, physical therapists outnumber acupuncturists by about seven to one, which means stronger state organizations and greater legal power.
Acupuncturists argue that physical therapists are essentially stealing their medicine and calling it something different. In some states physical therapists can practice dry needling with no training in it; in others they typically complete a 55-hour course. By comparison, a licensed acupuncturist generally receives about 500 hours of instruction in the acupuncture-specific portion of their training.
For a few centuries in the West and a couple millennia in China, observers of the human body have known about nodules that occur in tight muscles and are associated with chronic, complex pain patterns. You might just call them “knots.” In the mid-1900s a doctor named Janet Travell coined the term myofascial trigger point to describe this phenomenon. About 90% of them are found at the locations of acupuncture points, which were mapped out on bronze statues at least 1,000 years B.C.E.
Travell explained that myofascial trigger points are irritable regions in our connective tissue (muscle and fascia) that get stuck in a contracted state. They make muscle fibers taut, reducing muscle strength and range of motion, and causing pain, numbness, and other symptoms that often spread to areas far from where they originate. In many cases, what we perceive to be a visceral problem (heart attack, ulcer, migraine, irritable bowel, urinary tract infection, etc.) is actually the symptom of one or more trigger points. I believe trigger points are responsible for most of the physical pain humans experience.
Travell and her colleague David Simons went on to chart the locations and symptoms of trigger points in every major muscle. Travell became John F. Kennedy’s doctor (the first female presidential physician) and his family credited her with saving Kennedy’s political career by curing his back pain through the release of myofascial trigger points.
Travell (and researchers before her) discovered that it’s possible to release a trigger point through a simple procedure she called “ischemic compression.” It basically entails pressing firmly on the center of a trigger point for about half a minute until it softens. Travell’s maps and manual techniques for releasing trigger points were adopted by physical therapists over the following decades. (For what it’s worth, body workers have probably been doing ischemic compression for ages, without calling it ischemic compression.)
Travell also found that she was able to release trigger points by injecting them with numbing agents or saline. However, it emerged that the most effective aspect of this practice wasn’t the injection of fluid, but the mechanical act of probing at the trigger point with a needle. That is, a release could be accomplished even with a “dry” needle, without injecting anything.
Based on this new expression, one could say that all acupuncture is “dry needling.” This is precisely what acupuncturists have always done, although the insertion of needles into these local epicenters of pain is generally just one aspect of an effective acupuncture treatment. What makes an acupuncture treatment holistic (i.e., addressing the whole person) is that the treatment also addresses the underlying mechanisms that led to the surface issue (e.g., stress, diet, digestive problems, more global structural or energetic imbalances, etc.).
In the 1980s, an osteopath and acupuncturist named Mark Seem, founder of Tri-State Acupuncture College in New York City, began integrating Travell’s trigger point maps into traditional acupuncture. He met with Travell and demonstrated his approach. Travell immediately recognized the value of using a much thinner, solid, and springy acupuncture needle (which has a cone-shaped tip), as compared to the hypodermic needles she had been using (which have a scalpel-like hollow beveled tip).
Over the following decades, physical therapists gradually discovered that “dry needling” with acupuncture needles is often a faster and more effective trigger point release method as compared to the various forms of pressure, friction, stretching, exercise, and structural education that have been part of the physical therapists’ palette for their hundred-ish year history. In court cases between acupuncturists and physical therapists, PTs often argue that the insertion of needles into trigger points is a simply an extension of these “manual therapies” described in their scope of practice, and the decision comes down to whether or not the judge agrees.
The other common argument by PTs is that there are many differences between dry needling and acupuncture. In my opinion, having observed PTs doing dry needling and having studied many styles of acupuncture, there’s clear evidence that acupuncturists have been doing everything encompassed in dry needling for a very long time. PTs have insisted that because they know nothing of the acupuncture meridians (energy circuits along which acupuncture points are located), dry needling therefore isn’t acupuncture. But this is like saying that because you haven’t studied anatomy, when you cut into someone with a scalpel you’re not actually doing surgery. Further, there are many systems of acupuncture, several of which don’t utilize meridians.
Enough about the arguments. My purpose isn’t to determine whether or not it’s right for physical therapists to do dry needling, but to clarify the differences in the consumer’s experience.
While acupuncture is great for pain, not all acupuncturists are pain specialists, and most acupuncturists don’t specifically target the trigger points mapped by Travell. If that’s what you’re looking for, it may be worth seeking out an acupuncturist who specializes in pain. Or you might be happy with a skilled physical therapist who does dry needling.
Both acupuncturists and physical therapists run the spectrum from mediocre to brilliantly talented. I have no doubt that there are some masterful PTs out there who get great results doing acupuncture (dry needling) – perhaps better for structural issues than an average-level acupuncturist. I have had patients ask me to “fix” them after a painful dry needling session from a PT that worsened their condition, and I’ve had other patients report good results from dry needling.
If you are skittish about needles, you may not enjoy dry needling from a physical therapist, since it tends to be more intense than the average acupuncture treatment. That said, any form of acupuncture that specifically focuses on releasing trigger points is unlikely to be painless. Regardless of the style of acupuncture I’m performing, I always tell my patients I’m not the person to see if they don’t want to feel anything; I believe a certain degree of sensation is productive.
If you’re someone who cares about how much training your practitioner has received, perhaps it’s meaningful to you that an acupuncturist typically spends ten times as many hours learning their craft than a physical therapist spends learning dry needling. (And virtually all of the acupuncturist’s continuing education will be in acupuncture as well.)
If your primary concern is having your treatments covered by insurance, you’re more likely to get this from a physical therapist. There are some acupuncturists who bill insurance, but more often it will be up to you to submit your receipts and hope for reimbursement.
If it’s important to you that your treatment gets to the root and addresses the whole you, including non-structural issues, you’ll probably be more satisfied with treatment from an acupuncturist. The common experience of “going to acu-land” as some of my patients call it – i.e., becoming deeply relaxed or even having a transcendent experience – isn’t part of the dry needling session. Some would consider the peaceful effect of acupuncture merely a pleasant bonus, but I believe it’s often much more instrumental in the overall outcome than people realize. How often do we stop, rest, and drop all of our concerns? It can be akin to the benefit of a session of deep meditation. The alleviation of stress and a nervous system “reset” is no small thing, especially when stress is the root cause of so much pain.
That said, I find that many patients honestly aren’t concerned with a holistic treatment, and that’s fine. They want a practitioner who will get right into the painful area and work the hell out of it. It might be intense and they might feel beat up afterwards, but there’s a time and place for this kind of work if it’s effective. Personally, I don’t mind receiving aggressive treatments. Occasionally they’ve been miraculous (other times they’ve left me temporarily crippled with no relief). And of course, if the pain itself is one’s primary stressor, one could argue that getting rid of the pain should be a higher priority than alleviating stress (though we don’t have to choose one or the other). In my experience it’s a slight minority of acupuncturists who work this way, while it’s quite common for a physical therapist.
Whew! That was a long-winded exploration of this topic. I thought about removing parts of this article to shorten it, but having had this conversation so many times, I’ve found that many people are curious about all the facets of this subject. I hope I offered some clarity.
Be well,
Dr. Peter Borten
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This Wednesday is the winter solstice, the day when the northern hemisphere is at its maximum tilt away from the sun, giving us the shortest day of the year. As you know, even though this is technically just the first day of winter, the days start getting longer again on Thursday.
In our family, it’s a day for making peace with the darkness and remembering that the light is always here, even when we can’t see it. Before bed, Briana and I hide dozens of electric tea lights throughout the house and it’s the kids’ job to find them all.
I have some winter solstice questions for you.
What are some expressions of light in dark times? There are people like Nelson Mandela and Mahatma Gandhi who stand for freedom in the midst of oppression. There is the light of human innovation and the love of our planet in the midst of the climate crisis. There are songs of hope that arise from the hearts of the enslaved. Can you think of some other examples, both in the world at large and your own life?
What is the source of this light? Where does it come from? Rather than searching for the answer with your analytical mind, I encourage you to look inside, quiet the mind, and simply ask into the space: “What are you, Light? Where do you come from?” What do you see, hear, or feel in response?
If you have friends or family members who like to share and “go deep,” try bringing up these questions in a group setting.
It’s my belief that we are all carriers of the One Light that unifies us all. Every one of us has the power to illuminate our perspective and to shine it into the world. Every one of us has the potential to be a beacon in our community. The biggest impediment is simply forgetting. Sometimes we know the Light is within us and ours to call upon, but we get wrapped up in busyness. Other times we buy into disempowering stories about life that make us feel the Light is gone, or it’s outside us somewhere. Remember.
Here's a solar meditation I encourage you to try from Damien Echols, author of High Magick:
- Sit in the daylight.
- Inhale for a count of four while imagining that you’re drawing the sun’s light into your body through your skin.
- Hold your breath for a count of four while you imagine this light is seeping into all your tissues, penetrating every cell.
- Exhale for a count of four while imagining that you’re powerfully projecting the light out of every pore, shining it out into the world.
- Hold your breath for a count of four while imagining that you’re immersed in and basking in the field of light you just projected outward.
- Repeat.
We really are rather like those creepy bottom-dwelling fish with a lantern thingy sticking out from their foreheads. We generate the light and then that very light illuminates the path ahead for us. Try it.
Happy holidays from all of us at The Dragontree.
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When I first delved into cognitive behavioral therapy (CBT) as a psychology major, I remember thinking, “This is an evolution for humans.” CBT focuses on examining and challenging one’s thoughts and beliefs, changing related behaviors, and building coping skills and emotional regulation.
Of course, there is a long philosophical tradition of examining the nature of human thought and behavior, but the advent of cognitive and behavioral psychology in the past couple centuries infused these concepts into mainstream culture in a profound way. It’s now common for people to talk about their thoughts as something separate from themselves, and to routinely employ behavior modification techniques in all areas of life.
I had a mentor in my early 20s who was a big advocate of CBT, and at the time I told her I had been exploring methods for healing the memories of traumatic events. I felt both rebuffed and inspired when she said, “You’re wasting your time. We don’t need to go back and relive our childhood or spend the rest of our life lying on some shrink’s couch analyzing everything that ever happened to us! All that matters is, right now, are you going to be at the mercy of your thoughts and automatic behaviors, or are you going to manage whatever comes up in a conscious, intentional way?”
I’ve thought a lot about this in the decades since. My mentor was of the mind that we don’t need to figure out why these painful or dysfunctional patterns keep coming up, we just need to change our response to them, and eventually we’ll transform our psychological makeup in a permanent way. I believe there is real value to this approach, and also . . . sometimes I think we need to go back.
When it comes to our healing and growth, here are three good reasons to revisit your past:
(1) If you’re constantly managing your response to a recurrent pattern, it might be more efficient to get to the root of the pattern and dismantle it (or at least mitigate it) so that it doesn’t come up much, if at all. Of course, you can also use cognitive and behavioral strategies if it does arise.
(2) There is potential for deeper self-awareness, insight, and growth through visiting your past and coming to understand the factors that went into making you who you are. These are opportunities to forgive, correct misunderstandings, reframe our stories, and revise or erase beliefs. While it’s totally possible for many people to be happy without going there, it’s probably not possible to be self-actualized without making peace with your past.
There are some caveats. Analyzing your past can be taken to a self-indulgent degree. It can retrigger old trauma. And most common, it can make us feel worse as we work through it (and experience it without resistance, perhaps for the first time) – though this usually gives way to greater freedom. Thus, it’s important to do this work when you’re feeling relatively stable, with a clear sense of why (what you hope to accomplish), and with the tools and/or support to do it in a way that’s likely to turn out well.
(3) Finally, some people seek total liberation from our programming, i.e., the ego. Once this urge awakens in us, it often never goes fully back to sleep. If you’re in this boat, you may find value in recapitulation.
I read about recapitulation in a Carlos Castaneda book when I was 18 and it seemed unfathomable. Castaneda, a Peruvian anthropologist-turned-apprentice of shamanism, was instructed by his teacher to write down his entire life story, from his very earliest memories, including every person he had ever met. This process, he was told, was necessary to free him from his worldly attachments. It took him years. I remember thinking, “I could never do that.”
Since then, I’ve encountered various forms of recapitulation in my other studies of shamanism, and I now feel it’s more doable than I previously believed. Could it take years? Absolutely. But you’ve got time, and it’s not an all-or-nothing proposition. Every time we release some piece of baggage, it’s like dropping a sandbag from a hot air balloon. We’re that much lighter and freer – even if we’re not “done.”
As we go through our history, we find countless moments that have a certain weight or charge. They exist in a state of incomplete resolution. Taken together they have a powerful influence on how we show up in the present. They can make us dwell in the past and fear the future. They can cause us to live within a fraction of the spectrum of what’s possible. In short, they limit our freedom. As we loosen our history’s grip on us, we thus loosen the grip of our ego, and we more readily access our true essence and potential.
I stumbled upon my own recapitulation process while doing somatic releasing practices. In a nutshell, all our history with a charge – everything that doesn’t sit neutrally in us – can be experienced through the body. There is a physical expression and felt experience to all of it. And in willingly visiting it, experiencing it without resistance, and accepting it, we promote its resolution.
If this is unfamiliar territory for you, just try this: Bring up something about your current life or your past that you wish were different. While holding this in mind, expand your awareness to include what you feel in your body. You will perceive a certain unease. As you meet it and even invite it, the unease loosens. (Sometimes this takes a little practice, especially if you’re not accustomed to feeling your feelings. If you’re interested in diving deeper into this process, check out our workbook called Freedom.)
When we do this work we inevitably find layers of holding. We release one layer and discover another layer, and so on. In my case, I began to recognize the layers faster than I could process them, so I started writing them down. Hundreds of cords, linking me to my past, pulling on me, distorting my present self. The list grew at the same rate that I crossed things off it. I’m not nearly done, but I feel much lighter.
I’m not saying a person can’t show up in a clean and authentic way until they release every conflict or resentment they’ve ever had. What I mean is that a thorough recapitulation facilitates ego liberation – something that’s beyond the scope of CBT and, frankly, not of interest to most people.
In my own process, I found that I was sometimes inspired to move my body in certain ways to assist the release of a sticky pattern, which is an integral part of some somatic therapies. Interestingly, it’s also a technique used in shamanic recapitulation. As Sandra Ingerman and Hank Wesselman explain in their book, Awakening to the Spirit World, we can facilitate the “unraveling” of a memory (or the emotional charge attached to it) by spinning. This can also be accomplished by turning the head or twisting the body from side to side, and the authors say they believe this is also why EMDR (Eye Movement Desensitization and Reprocessing) works. They recommend spinning or turning while breathing deep into the memory and its associated emotions, accepting it, and intending to release it.
I believe recapitulation also occurs to some extent automatically, especially when we’re ready for it: in dreaming; in meditation, when we are sometimes spontaneously presented with something from the past that needs to be “cleared”; in yoga and exercise; and very often under the influence of entheogenic (psychedelic) substances, especially when used intentionally as medicine. This is why psilocybin mushrooms are rapidly gaining a reputation as one of the most effective therapies for attaining peace at the end of life.
I’m curious to hear from readers about your experience with the different approaches I discussed. Have you used CBT, and did it help? Have you dug into your past to heal yourself? What methods did you use, and how did it go? Have you done a large scale recapitulation? What was the outcome? Please share.
Be well,
Peter
[post_title] => Are You Willing to Go All the Way Back?
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