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[post_content] => Gratitude is the understanding that many millions of things come together and live together and mesh together and breathe together in order for us to take even one more breath of air, that the underlying gift of life and incarnation as a living, participating human being is a privilege; that we are miraculously, part of something, rather than nothing. – David Whyte
Coincidentally, I encountered this quote shortly after hearing a lecture on happiness in which the speaker asserted that when we truly recognize our privilege, we readily feel enthusiastic and grateful about whatever we’re engaged in, work included.
It’s easy to forget to be grateful though, just as it’s natural to expect life to continue in roughly the way it always has, with ample clean air, water, food, electricity, safety, and everything else that supports us. Sometimes it’s not until we experience contrast that we recognize our privilege.
Having a period of sickness makes us appreciate our health. Smoky air makes us appreciate fresh air – and firefighters and rain. Traveling in an area with mediocre food options makes us appreciate farmers’ markets and well-stocked grocery stores. All of our adversity, including even our day-to-day micro-adversities, can become prompts to recognize what’s still working and good in our life. You can even try making a rule for yourself that every time you complain about something – even just to yourself – you follow it with a statement of gratitude.
When traffic is bad, what’s good? When there’s pain in your back, what parts of your body still work well and feel okay?
Of course, we don’t need to wait for suffering in order to pay attention to our gifts. It’s just that suffering – especially when it’s really painful – has a way of capturing our attention. The key is the paying attention, and we’re in the habit of letting our attention go to whatever’s loudest or most dramatic, like media, interpersonal conflict, and worry.
Sometimes we need to grab our attention and put it on something else. And when I say “sometimes” I mean virtually all the time – choosing intentionally what we’re putting our attention on. Might I recommend a good place to put it: on the total experience that is happening right here, right now. Your breath and the air entering and exiting your lungs. What it feels like in your body. What you’re currently engaged in. The land you’re sitting on. The beating of your heart. The sun illuminating the world. The soft clothes on your skin. The feeling of the earth’s gravity acting on you.
We want to feel spontaneous gratitude, the exalted kind that comes to us with strong emotion, rather than needing to prompt ourselves to think of something to be grateful for. But the chosen form isn’t any less real. And it has the same benefits of promoting happiness, broadening our perspective, and focusing our energy on good things.
I am grateful for you.
Love,
Peter & Everyone at the Dragontree
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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] => I feel the more we celebrate, the better our quality of life. And there are two holidays worth taking time out for this week. Today, June 19th is Juneteenth, and Tuesday, June 21st is the summer solstice, the longest day of the year. I think it’s appropriate that Juneteenth falls so close to the summer solstice, because both symbolize a certain abundance of light.
Juneteenth is a celebration of the emancipation of African American slaves. Throughout the Civil War, many slaveholders moved to remote areas to escape the fighting and hold onto their slaves. When Lincoln’s Emancipation Proclamation went into effect on January 1, 1863, nothing changed where it wasn’t enforced. This was especially the case in Texas, where there were still a quarter million slaves in 1865, even after General Lee surrendered the Confederacy.
On June 19th, 1865, Union General Gordon Granger presented Texas with a proclamation that read, “The people of Texas are informed that, in accordance with a proclamation from the Executive of the United States, all slaves are free. This involves an absolute equality of personal rights and rights of property between former masters and slaves, and the connection heretofore existing between them becomes that between employer and hired labor.”
Although the enforcement of the law took years, and there’s still plenty of work ahead of us, June 19th became a day of celebration. Known as Juneteenth, it’s the longest standing African American holiday. The abolition of slavery was like clearing a dark cloud that had long hung over the country. It was the beginning of allowing African Americans to be their own people and freely shine their light.
There’s no way to undo the suffering caused by slavery and its aftermath of discrimination and systemic oppression, but one step in the right direction – especially for White people – is to recognize how much this country has benefited from the presence of African Americans. Just when the light of the sun is at its peak, we have the opportunity on Juneteenth (and always) to celebrate the light that’s symbolic of the African American soul, which has persevered through unimaginable violence and injustice, and evolved into an incredible cultural identity.
Despite comprising just 13% of our population, African Americans have had a disproportionately significant influence on the United States. From music to art to cuisine to literature to science to leadership to religion and more, it’s all around us.
So, let’s celebrate the light this week.
☀️ Bask in the sun. Try this simple “solar energy” meditation: Inhale for a count of 4 while imagining you’re absorbing the sun through your pores, deep into your body. Hold your breath for a count of 4 while imagining the solar energy working its way into all your cells and charging all your atoms. Exhale for a count of 4 while imagining you’re beaming the sunlight out of every pore. Hold (with empty lungs) for a count of 4 while basking in your own glow around you. Then repeat.
☀️ Open your heart and shine your light into every environment you find yourself in.
☀️ Make a conscious choice to see the light in everyone you encounter.
☀️ Enjoy the contributions of African American writers, musicians, chefs, comedians, and influencers.
☀️ Whatever your race, consider how you've benefited from the influence of courageous and visionary African Americans, then take some action to honor this light and support our work toward true equity.
Be well,
Peter
[post_title] => A Double Serving of Light
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[post_content] => Gratitude is the understanding that many millions of things come together and live together and mesh together and breathe together in order for us to take even one more breath of air, that the underlying gift of life and incarnation as a living, participating human being is a privilege; that we are miraculously, part of something, rather than nothing. – David Whyte
Coincidentally, I encountered this quote shortly after hearing a lecture on happiness in which the speaker asserted that when we truly recognize our privilege, we readily feel enthusiastic and grateful about whatever we’re engaged in, work included.
It’s easy to forget to be grateful though, just as it’s natural to expect life to continue in roughly the way it always has, with ample clean air, water, food, electricity, safety, and everything else that supports us. Sometimes it’s not until we experience contrast that we recognize our privilege.
Having a period of sickness makes us appreciate our health. Smoky air makes us appreciate fresh air – and firefighters and rain. Traveling in an area with mediocre food options makes us appreciate farmers’ markets and well-stocked grocery stores. All of our adversity, including even our day-to-day micro-adversities, can become prompts to recognize what’s still working and good in our life. You can even try making a rule for yourself that every time you complain about something – even just to yourself – you follow it with a statement of gratitude.
When traffic is bad, what’s good? When there’s pain in your back, what parts of your body still work well and feel okay?
Of course, we don’t need to wait for suffering in order to pay attention to our gifts. It’s just that suffering – especially when it’s really painful – has a way of capturing our attention. The key is the paying attention, and we’re in the habit of letting our attention go to whatever’s loudest or most dramatic, like media, interpersonal conflict, and worry.
Sometimes we need to grab our attention and put it on something else. And when I say “sometimes” I mean virtually all the time – choosing intentionally what we’re putting our attention on. Might I recommend a good place to put it: on the total experience that is happening right here, right now. Your breath and the air entering and exiting your lungs. What it feels like in your body. What you’re currently engaged in. The land you’re sitting on. The beating of your heart. The sun illuminating the world. The soft clothes on your skin. The feeling of the earth’s gravity acting on you.
We want to feel spontaneous gratitude, the exalted kind that comes to us with strong emotion, rather than needing to prompt ourselves to think of something to be grateful for. But the chosen form isn’t any less real. And it has the same benefits of promoting happiness, broadening our perspective, and focusing our energy on good things.
I am grateful for you.
Love,
Peter & Everyone at the Dragontree
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