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One of my favorite sections of our Dreambook occupies only two-thirds of a page. It’s about discovering your core values. It’s easy to skip it. I know you could go through life only rarely, if ever, giving a thought to your core values. Or you could complete this part – choosing some appealing words from our list of suggestions, such as kindness, honesty, openness and love – and then quickly forget what you chose and why.
But what if we called them needs instead? What if I said, virtually everything you do is motivated by an attempt to get one or more of these values / needs met, and the same is true for everyone else? How might your communications be different if you could perceive the core values that are driving you and others?
A lot changes when we understand the underlying needs that move us, especially when we’re in conflict. For instance, the other day I was on the phone with a company that had really under-delivered on the large sum we paid for their services. I found myself getting angry and raising my voice even though I realized that the agent I was speaking with probably had nothing to do with it.
As I tuned in to figure out the underlying need that was pushing me, I realized it was fairness. Just to name it out loud felt better. “This isn’t fair,” I said. “It was reasonable to expect your company would do . . . but you didn’t, and then you still charged us the full amount.”
When we hit upon the value at the root of some conflict, we often feel more grounded in the situation – even if the circumstances don’t change. Here are five reasons why:
First, if we’re unaware of the core need behind our upset, we’re usually run instead by our feelings and the belief that things aren’t going our way. As soon as we see the need, there’s clarity: “Ah. This is what I value. This is what’s really driving me.”
Second, when we discover the underlying need and recognize that it’s a value, it’s easy to expand from “I want this for me” to “I want this for everyone.” This gives us perspective that lifts us out of the small feelings that are often engendered by the involvement of our inner child. With regard to fairness, the inner child of course understands “no fair!” from a self-centered point of view, but the mature inner adult grasps big picture fairness in a way that goes beyond one’s personal wants.
Third, it makes us more effective at getting another person to see our point of view when we know the core value that’s inspiring us.
Fourth, we can make rational, direct requests to achieve resolution because we know what we’re aiming for.
Fifth, when we know the need, we can almost always find more than one way to get it met.
I encourage you to consider this perspective when you’re working on the Core Values section of your Dreambook. If you’re having trouble, consider something you feel strongly about and ask yourself, “What would I get out of this?” Keep asking until you get to a refined, one word answer.
If you have about a situation like mine that you feel unsettled about, ask yourself, “What could have been done to resolve this or make it better?” And then ask yourself, “Why would that be better? What would I have?”
Also look at positive motivations. For example: Why do I like running? It keeps me healthy. What else? I release stress. I feel free. I feel strong. I feel connected to my higher self. These are great ways to home in on underlying values. Besides the list of sample core values in the Dreambook, consider these others: Peace. Security. Choice. Freedom. Creativity. Organization. Loyalty. Cleanliness. Clarity. Ease. Justice.
As you go through your day, check in a few times and see if you can discern what needs/values are currently moving you. Let’s try it right now. What motivated you to read this article? What do hope to get out of it? A feeling of peace? A feeling of achievement? Learning or greater self-awareness? Better communication and relationships? Clarity? Whatever you come up with, is that the value itself, or do you need to take it a step deeper to get to the value?
I believe that when we do the work to know ourselves deeply, this not only serves us personally, our clarity also benefits the community around us.
Be well,
Peter
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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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Previously I wrote about how community is like medicine. Our circle of fellow humans goes through this amazing journey with us . . . encouraging us, witnessing us, screaming with us on the roller coasters, and holding our hand when we take our last breath. My orientation in that article was toward what community can do for us, but it’s at least as important to look at what we can do for our community.
I was reading about a Native American grief ritual described by Black Elk, and while the ritual itself was interesting, what stuck with me was his assertion that long-held grief isn’t good for a person or the community to which that person belongs. That is, when someone is mired in suffering, this can have a negative impact on their community.
You can probably think of plenty of examples where a glaring state of imbalance, such as rage or terror, could result in behaviors that are detrimental to others. But the effects of less dramatic, often chronic negative states are subtler. What happens – besides their own discomfort – when a person is trapped in depression, anxiety, or grief for years? One repercussion is that they have a diminished capacity to fully show up in their community. We might think, “Well, the community doesn’t really need me to be at my best,” but imagine going to a place where almost everyone was depressed, afraid, or angry. Such places do exist, of course, and you can feel it as a palpable mass degradation of the human spirit.
These days we may feel that we don’t have any real obligation to our community, which is so different from how humans have operated for most of our history. Today community may be seen as an entirely optional part of life. We can live in near isolation while anonymous members of our community manage the utilities that provide us with power, water, and internet, take away our garbage, maintain our roads, even deliver our groceries. It feels like independence, but in truth we’re more dependent than ever on an infrastructure other humans maintain – we just don’t know who those humans are.
We’ve lost our sense of responsibility to our community. It’s due in part to the feeling that our government is huge, remote, and corrupt. But if our response is to disengage, the situation can only get worse. If anything, the sense of disconnection from our elected representatives and neighbors should magnify the need to do what we can to make a positive difference. It’s not just an obligation, it’s also an opportunity. If we can recognize and accept that our quality of presence affects others, this may inspire us to be our best selves. And it’s not just a matter of what we do but also who we are and how we are. Becoming fundamentally well inside helps heal the community. Imagine how healthily a community of fundamentally well people manages challenges.
If you’ve been struggling, I don’t mean to make you feel guilty as well; that won’t help you or your community. Rather than focusing on the negative impact your unwellness might have on your community, consider that getting well is good for you and it’s good for your community. Sometimes it’s easier to do it for others than for yourself.
Years ago, I read A Course in Miracles with friends. If you’re unfamiliar with it, it’s a book on spiritual awakening with a section of scripture and a year-long workbook of daily lessons. It’s not for everyone, but I gained some valuable insights from going through it. One of those insights occurred when I encountered this passage: “Lesson 66: My happiness and my function are one.”
Whereas I had tended to think of my happiness as a personal thing – sometimes even a selfish thing – this spiritual book was telling me that being happy (true, causeless happiness) is one of the greatest things I can do for the world. As I meditated on it, I saw clearly that the happy people I’ve known were like lights in every setting they entered. Without even intending it, they had a therapeutic effect on everyone they encountered. Not only did they tend to uplift those around them, in an unspoken way they communicated that this is a possibility for you, too. Happiness is a perspective, a choice. If I can choose it, you can choose it.
Being happy makes us more peaceful, compassionate, and creative. It gives us the freedom to see a bigger picture, rather than focusing on what’s wrong or bad. Even just one happy person in a room full of scared people can change the whole atmosphere – and the choices that community makes.
So I encourage you to consider this week:
- Who am I and what role do I play in my various communities?
- How have I been affected by the genuinely happy people I’ve known?
- What do I believe stands between me and being one of those happy people?
- What happens when I make a conscious choice of how I’m going to show up in a given setting?
- When I give, what do I receive?
- How do I feel when I put myself in service to others?
- Where could I dedicate myself to more actively resolve any unhealthy patterns of thought, communication, or behavior?
- How will I be different as I heal, and how will I affect my community differently as I release my baggage?
- When will I choose happiness?
Be well,
Peter
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One of my favorite sections of our Dreambook occupies only two-thirds of a page. It’s about discovering your core values. It’s easy to skip it. I know you could go through life only rarely, if ever, giving a thought to your core values. Or you could complete this part – choosing some appealing words from our list of suggestions, such as kindness, honesty, openness and love – and then quickly forget what you chose and why.
But what if we called them needs instead? What if I said, virtually everything you do is motivated by an attempt to get one or more of these values / needs met, and the same is true for everyone else? How might your communications be different if you could perceive the core values that are driving you and others?
A lot changes when we understand the underlying needs that move us, especially when we’re in conflict. For instance, the other day I was on the phone with a company that had really under-delivered on the large sum we paid for their services. I found myself getting angry and raising my voice even though I realized that the agent I was speaking with probably had nothing to do with it.
As I tuned in to figure out the underlying need that was pushing me, I realized it was fairness. Just to name it out loud felt better. “This isn’t fair,” I said. “It was reasonable to expect your company would do . . . but you didn’t, and then you still charged us the full amount.”
When we hit upon the value at the root of some conflict, we often feel more grounded in the situation – even if the circumstances don’t change. Here are five reasons why:
First, if we’re unaware of the core need behind our upset, we’re usually run instead by our feelings and the belief that things aren’t going our way. As soon as we see the need, there’s clarity: “Ah. This is what I value. This is what’s really driving me.”
Second, when we discover the underlying need and recognize that it’s a value, it’s easy to expand from “I want this for me” to “I want this for everyone.” This gives us perspective that lifts us out of the small feelings that are often engendered by the involvement of our inner child. With regard to fairness, the inner child of course understands “no fair!” from a self-centered point of view, but the mature inner adult grasps big picture fairness in a way that goes beyond one’s personal wants.
Third, it makes us more effective at getting another person to see our point of view when we know the core value that’s inspiring us.
Fourth, we can make rational, direct requests to achieve resolution because we know what we’re aiming for.
Fifth, when we know the need, we can almost always find more than one way to get it met.
I encourage you to consider this perspective when you’re working on the Core Values section of your Dreambook. If you’re having trouble, consider something you feel strongly about and ask yourself, “What would I get out of this?” Keep asking until you get to a refined, one word answer.
If you have about a situation like mine that you feel unsettled about, ask yourself, “What could have been done to resolve this or make it better?” And then ask yourself, “Why would that be better? What would I have?”
Also look at positive motivations. For example: Why do I like running? It keeps me healthy. What else? I release stress. I feel free. I feel strong. I feel connected to my higher self. These are great ways to home in on underlying values. Besides the list of sample core values in the Dreambook, consider these others: Peace. Security. Choice. Freedom. Creativity. Organization. Loyalty. Cleanliness. Clarity. Ease. Justice.
As you go through your day, check in a few times and see if you can discern what needs/values are currently moving you. Let’s try it right now. What motivated you to read this article? What do hope to get out of it? A feeling of peace? A feeling of achievement? Learning or greater self-awareness? Better communication and relationships? Clarity? Whatever you come up with, is that the value itself, or do you need to take it a step deeper to get to the value?
I believe that when we do the work to know ourselves deeply, this not only serves us personally, our clarity also benefits the community around us.
Be well,
Peter
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[is_preview] =>
[is_page] =>
[is_archive] => 1
[is_date] =>
[is_year] =>
[is_month] =>
[is_day] =>
[is_time] =>
[is_author] =>
[is_category] => 1
[is_tag] =>
[is_tax] =>
[is_search] =>
[is_feed] =>
[is_comment_feed] =>
[is_trackback] =>
[is_home] =>
[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] => 67105066d2f44444bb2951d494c182dc
[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
)
)
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