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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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A couple weeks ago, I wrote about the differences between acupuncture and “dry needling” to alleviate pain, and in that article I explained a bit about the phenomenon of myofascial trigger points. After I said I believe these are the cause of most of the physical pain humans experience, a number of readers asked me to explain more. For the science lovers out there, I’m going to dive deeper this week.
Besides the most common forms of pain, like lower back and headaches, I’ve had patients with digestive problems, sinus congestion, chest pain, ear ringing, numb hands, painful intercourse, acid reflux, vision changes, and other health issues that were eventually discovered to be due to myofascial trigger points. I believe everyone should know about them and how they work – it could save us a lot of time and worry.
Basically, a trigger point is a small, irritable region in a muscle (or the surrounding connective tissue – “fascia”) that stays stuck in a contracted state, making the muscle fibers taut. This can cause reduced muscle strength and range of motion, pain, numbness, itching, and other forms of dysfunction. Sometimes a trigger point feels like a palpable nodule or “knot,” but to untrained fingers they’re often tricky to find.
A unique property of trigger points is that they’re able to produce symptoms in other parts of the body – from a few inches to a couple feet away. For instance, there’s a trigger point that can form in the soleus muscle of the calf that’s capable of producing pain in the lower back. For this reason, the work of Janet Travell, MD and her colleague David Simons, MD, was groundbreaking. For each muscle in the body, they mapped where trigger points tend to form and what kinds of symptoms they cause.
If you were experiencing pain along the outside of your leg, you might assume that something was wrong with that part of your leg, perhaps with the often-tight iliotibial band (IT band). But this diagram might be helpful. The X’s show where trigger points can occur in a muscle called gluteus minimus above the hip socket. The red shading shows the potential areas of pain that can result. You might not suspect this muscle because, as you can see, there’s no pain at the site of the problem!
There are a handful of mechanisms that can promote trigger point formation, such as irritation of nerves, chronic organ problems, nutritional deficiencies, and autoimmune disorders. Most often, though, the cause is trauma to our connective tissue. When a muscle is strained by being worked too hard, too fast, or beyond its natural range, there is frequently a sort of “recoil” that occurs as segments of the muscle fibers bunch up and remain that way.
This is especially common when someone works out without warming up; when someone does a very ambitious workout after not having exercised for a long time; when someone makes a sudden movement (like reaching out to catch something or trying to stop oneself from falling); and especially when someone does any of the above when in a state of diminished resilience (e.g, when stressed, upset, sleep deprived, eating poorly, etc.).
Even more commonly, the trauma is a form of “postural stress” that’s demanding on muscles in a way that’s difficult to perceive at the time – such as doing the same relatively motionless activity (like sitting at a desk or driving) for hours, days, months, or years. One possible mechanism is known as the “Cinderella hypothesis.” During static muscle exertion – holding a position for a long time, as dentists, musicians, typists, and others engaged in precision handwork do – the body tends to engage a certain group of small muscle fibers, called Cinderella fibers because they’re put to work first and are the last to be disengaged. Even though they’re not doing heavy lifting, these muscle fibers (often in the neck, shoulders, back, and forearms) are continually activated and overworked, which makes them susceptible to trigger point formation.
Whatever the cause, the result is that eventually the muscle never completely relaxes. Muscles are composed of numerous parallel fibers that work together to shorten (contraction of the muscle) and lengthen (the return of the muscle to its relaxed state). Within each of these fibers are many end-to-end contractile units called sarcomeres, and in the case of a trigger point, a group of sarcomeres gets “stuck” in a shortened state. This makes the affected fibers taut and often “stringy” feeling.
To make matters worse, the contracted region clamps down on tiny blood vessels causing local ischemia (inadequate blood supply), reducing in-flow of fresh, oxygenated blood and out-flow of toxins. This leads to a localized hypoxic state (not enough oxygen). The tissue pH changes, local metabolism is impaired, and fluid and waste products tend to build up in the area. This combination of factors ultimately activates pain receptors – it starts to hurt – and when this happens you use the affected muscle less.
Instead, you overload “synergists” – nearby helper muscles. The body makes the surrounding musculature tense as a protective mechanism. Meanwhile, there’s a disruption of the balance between the affected muscles and their “antagonists” – those muscles that lengthen when the primary muscles shorten and vice-versa (for example, the triceps is an antagonist of the biceps). Altogether, this restricts natural movement of the original muscle, which just perpetuates the imbalance. Finally, with longstanding trigger points, the body may deposit gooey lubricant compounds called glycosaminoglycans (GAGs) between these triggered muscle fibers, resulting in a gummy lump called a “myogelosis.”
The good news is that there are now books, charts, online tools, and practitioners that can help track down likely trigger points that may be implicated in your discomfort. I have such a tool in my online pain relief course, Live Pain Free, and I teach many approaches for deactivating trigger points.
The most basic methods involve simple mechanical disruption of this holding pattern. First, drink some water if you’re not well hydrated. Second, you or a friend can methodically feel around (ideally guided by a trigger point chart) for points that are sore, and ideally that reproduce the very sensation you’ve been experiencing. Third, maintain firm pressure on the epicenter of the point (with a finger, elbow, ball, or other tool) for about half a minute, consciously breathing into the area and intending to let it go, until there’s a palpable release. Then move on to all the other nearby points that are tight and tender and do the same.
This approach is called ischemic compression. By compressing the tissue enough to block blood flow, the body responds with reflex vasodilation, meaning it opens these vessels and flushes the tissue with a dramatic increase of blood. This will usually produce a significant improvement in the pain or dysfunction, though it will typically return sooner or later. These points tend to go from being active trigger points to “latent” trigger points, which have a certain “memory” (not the good kind of muscle memory) and are capable of getting reactivated. For this reason, persistence is important. The best results come from working on a trigger point consistently – usually from one to several short sessions per day (or less frequent if the sessions are intense) – and continuing for a while even after everything seems better.
As I said, this is a most basic approach, and while it’s often effective, sometimes a more nuanced intervention is required. There are many techniques that build on compression. We can replace fixed pressure with slow, deep strokes in the direction of the muscle fiber, as if re-lengthening this segment. We can work the trigger point back and forth across the direction of the muscle fibers. We can combine pressure on the trigger point with engagement of the affected muscle or antagonistic muscles. We can combine manual work on trigger points with topical herbs and/or internal herbs and nutrients that improve circulation and reduce inflammation. We can utilize release points on the same acupuncture meridian as where the trigger point occurs - or complementary points on other parts of the body. And more.
If all of this sounds interesting and relevant to you, I encourage you to do a little research. It might well be the end of a problem you thought had no solution. And if you need more guidance, check out my online course, Live Pain Free, where I go deeper into trigger points and much, much more to help people get out of pain of all kinds.
While I said I believe trigger points are the cause of most of our physical pain, I think it’s worth mentioning there are usually even deeper causes, such as stress and withheld emotions, poor body mechanics, dehydration, and an inflammatory diet. Holistically addressing these issues will lead to a more complete resolution of the condition. Always look at the big picture.
Be well,
Dr. Peter Borten
[post_title] => The Science Behind Our Pain: Inquiring Minds Want to Know
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If you were birthed by Earth, then every pebble and plant is your sibling.
Last week I wrote about animism, the belief that all things possess a spirit. Animistic cultures are incredibly widespread – chances are, if you didn’t grow up in one, you’re descended from one. But these sensibilities have been largely supplanted by science. Science and spirituality are often at odds, and the science-oriented developed world generally disbelieves in spirituality – especially in a form so different from our monotheistic religions. This might not be a problem if a reductive, nonspiritual orientation met all our needs, but I believe we’ve lost something along the way.
Scientists and animists alike can agree that a rock isn’t biologically alive in quite the same way that, say, a bird is. But the scientist wouldn’t be scientific if they assumed that this means we can’t be in relationship with both. A person who believes a rock doesn’t possess a spirit has no understanding of what life would be like if they did.
The animistic perspective transforms a thing we use into someone we relate to. Our surroundings turn from scenery into family members. Just as it’s relatively easy to perceive the personality of a pet and recognize it as a member of the family, an animist would extend such personhood to all aspects of their world.
Could you be open to experiencing the personality of your favorite tree or stream or mountain? Have you ever felt inexplicably drawn to a certain place in your yard, your home, or the park? It’s where you feel naturally most comfortable, maybe also safer, more focused, even more powerful. What is it that your inner compass is tuning in to?
Beyond the ways in which such an orientation might enrich your subjective experience of your surroundings, there are potentially global repercussions to remembering and being reverent of the spirit of the world – even if we don’t fully embrace the animistic view.
Dr. John Reid of the Ngai Tahu Research Centre in New Zealand explains that when we mistreat the world through disregard for the spirit within, it becomes a vicious circle. Lacking a conscious relationship with nature, we take from pristine resources with no restraint, then we dump our waste back into them. This diminishes what the Maori call its mauri (lifeforce), and the reduction in its vitality makes it less supportive to humans. This willfully ignorant behavior and the hardship that results from it diminishes the mana (dignity / power / authority) of the humans involved.1 The weakened mana of the humans causes them to act in increasingly desperate and irreverent ways, and the cycle continues.
It's possible to transform this situation into a virtuous cycle, but it requires coming into right relationship with our planet. This means humbling ourselves and perhaps taking a cue from animistic cultures. If that sounds good to you, I encourage you to take another week to relate to your surroundings differently than usual.
What happens when you ask before taking? What happens when you give thanks to everything you encounter? What happens when you open yourself to the existence of a spiritual world? What happens when you feel into the dynamic between your body and the elements around you? What happens when you bring greater awareness to the act of consuming something? What happens if you do the same when throwing something away? What happens when you listen?
I believe that bringing consciousness to these relationships yields great benefits. Perhaps we stand to make our planet habitable by humans for longer, but for certain we enrich our mana as we re-weave ourselves into the living tapestry of this exceptional, gorgeous planet.
Be well,
Dr. Peter Borten
1. Informative Maori dictionary here: https://maoridictionary.co.nz/
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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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