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[post_content] => Last week I saw a show by a troop of comedians at a tiny theater in Montana. Though they were talented, I didn’t find myself laughing much at the recurring “battle of the sexes” theme. The men accused the women of being frigid and overly emotional. The women complained that the men need to be mothered and only care about sex. And back and forth it went. Sure, there’s comic relief in sharing about our common issues, but as I sat there seeing men and women cast somewhat bitterly in these one-dimensional ways, I couldn’t help thinking, “Are we really still doing this?”
In my previous article, we looked at the role that attitude plays in the health and sustainability of a relationship. Of course, you can’t make your partner change their attitude, but it’s worth fully exploiting the potential of your own attitude before concluding that the relationship isn’t going to work. One way to be responsible for your attitude is by abstaining from relating your partner as a stereotype.
I believe almost everyone does this to an extent. It’s difficult to banish from our minds the ideas we have about men, women, and humans in general. Even if your partner isn’t a typical male or female, your conditioning can cause you to relate to them based on ideas and experiences from the past. And even when you relate to someone simply based on your ideas about that specific person – rather than whoever they are in this very moment – this may still serve as an impediment to authentic connection.
Practice presence with them. It’s good to start with a relatively casual conversation. Let both parties be innocent – try to enter the conversation without judgment, expectations, or lenses. Who knows what might happen and how you might see the other person if you were to enter the exchange with absolute freshness.
See if you can internally choose when to talk and when to listen. When it’s your turn to listen, don’t think about what you’re going to say next. Just listen. Listen with your ears and eyes and heart. Breathe slowly and fully.
What else is involved in “your work”? Here are some examples:
To the extent that you actively work to resolve past experiences (especially traumatic ones) that infringe on your current ability to show up “cleanly” with your partner, you will benefit.
To the extent that you work to deactivate your “buttons” which cause you to make you react disproportionately to relatively benign behaviors by your partner, you will benefit.
To the extent that you choose to show up in your relationship with as much presence and enthusiasm as you can muster, you will benefit.
To the extent that you take responsibility for your baggage, attitude, communication, and interpretations, you will benefit.
To the extent that you choose to remember and honor your commitment (assuming, of course, that neither party is getting hurt by remaining together), you will benefit.
All these benefits are yours whether or not the relationship survives, and the chances of its survival are so much greater when you’re an active and responsible participant in the above ways. Further, if you’re not in a relationship but want to be, doing your work will make for a healthier relationship when the time comes, and it will also support you to make better choices of who to invite into your life. If you’re not in a romantic relationship and don’t care to be, this work will serve you in all your other relationships, including the one with yourself.
Be well,
Peter
[post_title] => Relationship Repair Part Two: Do Your Own Work
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[post_content] => 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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[post_content] => Unbeknownst to most Americans, the world is full of animists. According to Professor Stephen Asma of Columbia College Chicago, “Pretty much everywhere except Western Europe, the Middle East, and North America” is dominated by animistic cultures. Animism is the belief that everything has a soul or spiritual essence; not just living things, but also mountains, fire, the sky, the sea, and sometimes even words and human-made objects.
In practice, though, it’s more than just a belief. It’s a sensibility, a way of experiencing and interacting with the world. Animists relate to their surroundings with a certain intentionality, as if constantly among old friends.
To people in the developed world, such beliefs might seem primitive and superstitious. After all, who needs a world full of spirits when we have science? Science has given us explanations and inventions that have alleviated many hardships and dispelled so much fear.
But it hasn’t made us invincible or immune to fear. We’re still afraid of death, suffering, being alone, poverty, public humiliation, paper cuts, and so on. There’s little solace in science from these bugaboos.
Its other major shortcoming is that science has sucked the spirituality out of life. By reducing everything to cells and atoms, electromagnetic waves and neurotransmitters, it puts the whole phenomenal world beneath us. This promotes a certain feeling of ownership over the world – rather than a sense of belonging to it. If we put all our eggs into the science basket, life can seem random, lacking meaning and soul.
Science and Spirit aren’t mutually exclusive. But ever since early anthropologists looked down their noses at animistic cultures – seeing them as too dumb to know the difference between living and nonliving things, and giving their leaders justification to colonize and oppress them – the developed world has favored science as the ultimate authority. As we seek to right such wrongs, perhaps it’s worth considering not just what indigenous cultures lost, but what the oppressors also lost.
To an animist, the scientist is missing out on an entire plane of reality that’s beneath the surface and accessible only through an expansion of consciousness. To a scientist, the subjective reality of the animist’s consciousness is unmeasurable, untestable, unprovable, and therefore unscientific and even unreal.
What would be possible if we stopped using science to dominate or invalidate what we don’t understand? Can we concede – scientists included – that not everything is a scientific matter? This applies foremost to consciousness itself, which is entirely beyond the grasp of science, and arguably the only thing we know for certain to be real. We also know that humans yearn for a connection that’s beyond the ability of science to explain or provide.
You don’t need to be anti-science to be open to a spiritual reality. I say this as a scientist and animist.
If you’re open to it, I have a simple assignment for you to try this week. Consider this: how might your life be different if you treated your surroundings as if you were in relationship with them? Make it a lighthearted game.
What happens when you express gratitude to your bed, sheets, and pillow upon waking? What happens when you allow yourself to be in awe of the shimmering water that flows, as if by magic, from your showerhead? How does it feel to thank it for invigorating and purifying you? Does it feel any different to bless your food before eating it and thank it for giving itself to nourish you?
What is it like to thank your home for keeping you safe and comfortable? When you step outside, what happens when you experience the earth as the ever-present stability beneath your feet, supporting you and nurturing everything that grows upon it? What do you notice when you give names to the familiar trees or rocks in your neighborhood? How does it feel different to think of the sky as a beautiful, conscious dome over you versus your usual way? What changes when you think of all the animals you encounter as non-human people, each with an equally valid reason to be here as the human people you see?
And what happens when you listen and feel as if all these aspects of the world have something to communicate back to you?
When I say, “What happens?” I’m not (necessarily) asking, “Does your pillow respond, ‘Thanks for finally saying something! It was a pleasure to cradle your head all night!’?” More importantly, I’m asking, how does it make you feel to relate to the world in this way in comparison to your usual way? And if the answer is, “good” or “better” or “playful,” then keep going with it.
Be well,
Dr. Peter Borten
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[post_content] => Last week I saw a show by a troop of comedians at a tiny theater in Montana. Though they were talented, I didn’t find myself laughing much at the recurring “battle of the sexes” theme. The men accused the women of being frigid and overly emotional. The women complained that the men need to be mothered and only care about sex. And back and forth it went. Sure, there’s comic relief in sharing about our common issues, but as I sat there seeing men and women cast somewhat bitterly in these one-dimensional ways, I couldn’t help thinking, “Are we really still doing this?”
In my previous article, we looked at the role that attitude plays in the health and sustainability of a relationship. Of course, you can’t make your partner change their attitude, but it’s worth fully exploiting the potential of your own attitude before concluding that the relationship isn’t going to work. One way to be responsible for your attitude is by abstaining from relating your partner as a stereotype.
I believe almost everyone does this to an extent. It’s difficult to banish from our minds the ideas we have about men, women, and humans in general. Even if your partner isn’t a typical male or female, your conditioning can cause you to relate to them based on ideas and experiences from the past. And even when you relate to someone simply based on your ideas about that specific person – rather than whoever they are in this very moment – this may still serve as an impediment to authentic connection.
Practice presence with them. It’s good to start with a relatively casual conversation. Let both parties be innocent – try to enter the conversation without judgment, expectations, or lenses. Who knows what might happen and how you might see the other person if you were to enter the exchange with absolute freshness.
See if you can internally choose when to talk and when to listen. When it’s your turn to listen, don’t think about what you’re going to say next. Just listen. Listen with your ears and eyes and heart. Breathe slowly and fully.
What else is involved in “your work”? Here are some examples:
To the extent that you actively work to resolve past experiences (especially traumatic ones) that infringe on your current ability to show up “cleanly” with your partner, you will benefit.
To the extent that you work to deactivate your “buttons” which cause you to make you react disproportionately to relatively benign behaviors by your partner, you will benefit.
To the extent that you choose to show up in your relationship with as much presence and enthusiasm as you can muster, you will benefit.
To the extent that you take responsibility for your baggage, attitude, communication, and interpretations, you will benefit.
To the extent that you choose to remember and honor your commitment (assuming, of course, that neither party is getting hurt by remaining together), you will benefit.
All these benefits are yours whether or not the relationship survives, and the chances of its survival are so much greater when you’re an active and responsible participant in the above ways. Further, if you’re not in a relationship but want to be, doing your work will make for a healthier relationship when the time comes, and it will also support you to make better choices of who to invite into your life. If you’re not in a romantic relationship and don’t care to be, this work will serve you in all your other relationships, including the one with yourself.
Be well,
Peter
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