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Reflexology – Some Lateral Thinking!

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This is the first time I have used this website blog to publish my thoughts on reflexology. I know that many who read this will disagree with my train of thought but at the very least I aim to spark debate, get the reflexology community thinking! Yes this is a long post, in excess of 5000 words, but if you manage to reach the end I would welcome your feedback and thoughts on the information presented here.

Elspeth

Uncovering the Missing Links in Reflexology?

I am passionate about reflexology – from the day I first encountered this amazing therapy I was intrigued, keen to learn, understand and explore its intricacies. Consequently I have spent many years attending training workshops & seminars, read many books and indeed have now developed my own approach to reflexology – Zu Qigong …….and yet there is still that elusive component that defies logic based explanation when applying current scientific theory.
Having a science background, for me, many aspects of current reflexology theory simply don’t quite work, there are still missing pieces in the puzzle. The current trend in reflexology is very much focused on neuroscience and the stimulation of the nervous system being the underlying effect / benefit of this therapy. There has been great excitement at the recent functional magnetic resonance imaging (fMRI) studies and consequently the hope that developments in neuroscience will eventually reveal the mechanisms involved in reflexology and prove to be the magic key that will unlock the mysteries. Whilst I have no doubt that neuroscience is, at last in part, a significant contributing factor in the mechanisms involved, I am not convinced that it is the whole story. I am concerned that we are “failing to see the wood because we are too focused on looking at the trees.”

In many ways reflexology should perhaps now be regarded as an “umbrella term” for a range of different techniques that have evolved around the anatomical reflection theory. There is such a variation in the techniques used; deep pressure, light touch, finger free, meridian based techniques, neurological based techniques, hands, feet, face, ears……… All produce beneficial effects and I find it difficult to attribute these benefits en mass to simply arising from direct stimulation of the nervous system. If it were that simple why doesn’t walking around in bare feet maintain our physiological equilibrium, what does the practice of such diverse reflexology techniques actually bring to the therapeutic equation? I am fully aware of the vast complexities of the nervous system, in my previous science career I worked for several years in brain research and co-authored scientific papers on neuro-endocrinology. The current explosion in research revolving around the powers of touch and the effects on the conscious and subconscious mind, I find truly fascinating. The vast complexities of brain function, psychology, neurology, endocrinology etc. stretch well beyond the boundaries of current knowledge and the potential for future research is exciting, however I firmly believe that there is an elusive component in the human to human contact of reflexology that defies current scientific explanation, a mechanism of communication that is fundamental to the efficacy of the reflexology approach to holistic health, are we perhaps failing to see the obvious, a system that in itself joins together all the communication networks in the body?

So does such a communication system exist in the human body, one that could convey the nuances of human touch as applied in reflexology? For this I am of the opinion that we need to do some lateral thinking, broaden our horizons. As a reflexologist who specialises in meridian based techniques my thinking is, as you would expect, focused on the transmission of “energy”, the movement of energy – whatever that is eventually identified as being. Qi or energy is, in itself, a scientific mystery; no scientist can actually define exactly what energy is! We can see what energy achieves, what it becomes but as to what it actually is currently lies beyond the realms of scientific knowledge. Hopefully in years to come the physicists and mathematicians working at the Hadron Collider near Geneva, looking for the Higgs-Boson particle will finally crack this mystery.

However, it is accepted that energy supports life i.e. all actions and reactions at the macroscopic and microscopic level require energy in order to occur. CAM practitioners widely utilise the concept of energy medicine, regarded by many as potentially being “the next big thing” in medicine. The whole idea of “working with energy” is not exclusive to “new age” practices. The idea of life-force energy has been expressed in many ancient cultures around the world, with some references dating back thousands of years. The Chinese concept of Qi dates back to the I Ching or Book of Changes, written in about 2200BC. The first references to Qi describe it as an all encompassing force that pervades and unifies the three energies in the universe – heaven, earth and human. Other ancient cultures also refer specifically to this elusive life force or vital energy;

Qi/chi – China

Ki – Japan

Prana – India

Mana – Polynesia

Ka – Egyptian mythology

Pneuma – Greek mythology

Ashe – African Yoruba mythology

Num – African people of the Kalahari Desert

Élan vital – French philosopher Henri Bergson

It is easy to see why, in current medical science, the whole concept of working with energy is generally dismissed as being complete nonsense, science cannot yet identify exactly what energy is and hence give us the irrefutable proof that the scientists require, they cannot devise experimental protocols for something that cannot be scientifically proved to exist. Sadly the Western mindset is such that if you cannot prove something categorically and repeatedly, using laboratory based science, then the theory will be dismissed, regarded as invalid or labelled pseudo-science. However we should always be aware that the scientists don’t always get things right, and indeed we regularly see controversial changes in advice emblazoned across the media, scientists are very definitely not infallible.

One area where the scientists appear to have made a significant error of judgement involves human anatomy. I am referring to the fascia – the connective tissue and “gloop” that anatomists and physiologists have consistently disregarded, scraped and washed away to allow them to study the “important aspects” of human anatomy. Until recently the fascia was totally overlooked, however research is slowly catching up to what turns out to be a remarkably communicative, sensory and proprioceptive tissue. Indeed fascia has suddenly become a hot topic particularly in the exercise and fitness world, even Hollywood celebrities are getting in on the act, Gwyneth Paltro referring to it last year as “the secret organ”.
Our massage colleagues are already familiar with the therapeutic possibilities of working on fascia to treat pain, muscular injuries, relieve tension etc. Techniques such as myofascial release, trigger point therapy, Rolfing, all utilise the fascia.
I would suggest that the reflexology world should now be taking note – the fascia may well hold the fundamental key to understanding how reflexology works.

The Fascia

First let’s define what the scientists now classify as being the fascia. Traditionally, the term fascia was used to describe specific sheets of dense fibrous material, and as reflexologists we are all familiar with the plantar fascia, that troublesome tissue that frequently becomes inflamed causing our clients pain on walking – plantar fasciitis.
However the new definition of the fascia being applied by the scientific community is: all the collagenous-based soft tissues in the body, including the extra-cellular matrix. The structures being included are therefore all of the tissue traditionally labelled fascia in anatomical classification plus tendons, ligaments, bursae, the fascia in and around the muscles – endomysium, perimysium, epimysium, surrounding the bones – periosteum, the fascia around the individual organs, the peritoneum and mysentery in the abdominal cavity, the mediastinum, pericardium and pleura that surround the organs in the thoracic cavity and the meninges; dura mater, arachnoid, pia mater and the perineuria that surround the brain, spinal cord and peripheral nerves and finally the entire network of the extra-cellular matrix (ECM), the “packaging” between cells.
The fascia is composed of collagen, elastin and a viscous fluid; containing mucopolysaccharides and 70% water. As can be seen from the vast array of tissues now classified as forming the fascia, this tissue comes in a wide range of densities from a light open matrix structure similar to candy floss, such as the ECM, through to dense fibrous sheets such as the plantar fascia. The fascia begins to develop within the first few days of embryonic development and is progressively folded by the process of gastrulation, gradually bringing about the complex layers present in the fascia – a continuous structure, forming layers and enclosed capsules.
As a single network or indeed organ, the fascia directly connects with every other organ, bone, muscle, the cardiovascular system, nervous system and the lymphatic system. The fascia is effectively a single structure, creating a 3 dimensional, continuous, fully integrated network, connecting the tip of the toe to the top of the head, the fabric that holds us together, regulating the biomechanics of the body and responding to forces going through the body. We can therefore conclude that the fascia responds to and transmits mechanical energy i.e. pulls, pushes, twists, turns – enabling movement and maintaining postural stability, giving the body what is now referred to as “tensegrity”; tension and integrity.
So if the fascia responds to and transmits force as mechanical energy what other forms of energy can be transmitted through this network? We know that chemical and electrical energy can be transmitted via the extra-cellar matrix as clearly shown in neural transmission and bio-chemical cell signalling. So this complex structure is undoubtedly involved in energetic communication and should therefore be recognised as the 4th energy communication system in the body; the nervous system providing electrical communication, the cardiovascular system providing chemical communication, lymphatic system involved in chemical communication and the fascia system providing mechanical, electrical and chemical communication. The laws of physics state that energy cannot be destroyed merely changed, therefore all energy in the body is in a constant state of flux, circulating between systems, organs etc, and it would appear that the fascia plays an important role in this process.

Meridians and the Fascia

As stated above many members of the CAM community already recognise the significance of the fascia, in particular the massage profession where specific therapeutic approaches have been developed to work with the fascia – Rolfing, Myofascial release and trigger point therapy being specific examples. When looking at the practice of trigger point therapy for example, it becomes clear that this involves pressure on specific areas of “tension” which often appear to correlate to the acupoints of TCM, this then raises the question as to the potential relevance of the fascia to the meridian network?
Some practitioners, familiar with the meridian system, have suggested that the fascia may be significant in the function of these energy pathways and generally this has been dismissed as a less than viable theory. I can understand why this theory would initially appear to be inconclusive as the Western perspective of meridian theory is unfortunately very limited, focusing on the 12 regular meridians (plus Governing & Conception Vessels) i.e. those meridians generally used in the practice of acupuncture, acupressure massage etc. Although these are important meridians they are only a part of the story!

You may be surprised to learn that there are a total of 71 interconnecting pathways in the meridian network. The channels termed meridians provide the main energetic routes running longitudinally through the body and the collaterals run transversely and superficially from the meridians. The network actually comprises of:

12 regular / organ meridians

8 Extraordinary meridians (Vessels)

15 Collaterals

12 Divergent meridians

12 Muscle regions

12 Cutaneous regions

When we take note that there are 12 channels described as being connected to specific muscle areas and 12 channels connecting to specific skin areas then it becomes much more plausible that the meridians are indeed an integral part of the fascia, added to which 67 of these pathways are bi-lateral i.e. present on both the right and left sides of the body. This I would suggest represents a comprehensive network running from head to toe as does the fascia.

As a practitioner specialising in meridian based reflexology techniques, it wasn’t until I began studying Taiji and Qigong, the exercise disciplines of TCM, that I realised the limitations of my meridian knowledge. After considerable research and reading around the subject I began to explore the possibility of integrating this wider meridian network into my approach to reflexology. By applying the underlying theories of Qigong and the anatomical reflection theory I found that it was indeed possible to incorporate the 8 extraordinary meridians into a reflexology based therapeutic sequence hence the development of Zu Qigong. The technique focuses entirely on the meridian system, working with the 20 main meridians; 8 extraordinary meridians and 12 regular meridians. Aimed at supporting the natural flow of Qi around the body, encouraging the body to restore and maintain its own unique equilibrium, Zu Qigong uses a very light touch and involves no diagnosing, sedation or stimulation techniques and yet like all other reflexology techniques it appears to be highly effective. Clients find it deeply relaxing and on this particular aspect more so than any other reflexology technique I have used in the past. Inevitably my science training makes me question why, how does this technique interact with human physiology that differs from other reflexology techniques? The answer to this has to lie in how Zu Qigong interacts with / affects the extraordinary & regular meridians.

The eight extraordinary meridians are described in TCM theory as representing the body’s deepest level of energetic structuring. These meridians are believed to be the first to form in utero, and are carriers of Yuan Qi, the ancestral energy which corresponds to our genetic inheritance. They function as deep reservoirs from which the 12 regular meridians can be replenished, and into which the latter can drain their excesses.

The 8 extraordinary meridians / vessels are:

The 4 Primary or Main Extraordinary Vessels – single, unpaired. Contained within the trunk of the body.

Du Mai – Governing Vessel

Ren Mai – Conception Vessel

Chong Mai – Thrusting Vessel

Dai Mai – Girdle Vessel

The 4 Secondary Extraordinary Vessels – Paired / Bilateral. Located in the trunk and the legs

Yang Qiao Mai – Yang Heel / Motility Vessel

Yin Qiao Mai – Yin Heel / Motility Vessel

Yang Wei Mai – Yang Linking Vessel

Yin Wei Mai – Yin Heel Vessel

Interestingly the eight vessels are all described as having quite broad areas of influence within the meridian network. For example the Du Mai is described as the confluence of all the Yang channels, over which it is said to “govern.” Because it controls all the Yang channels, it is called the “Sea of Yang Meridians.” The Ren Mai plays a major role in directing all of the Yin meridians (plus the stomach meridian). It is known as the “sea of Yin channels”. The Chong Mai regulates the circulation of Qi and blood within the twelve regular meridians, so it is known as the “sea of the twelve regular channels” and the “sea of blood”. Similarly the Yin and Yang Qiao Mai are said to regulate all of the Yin and Yang channels respectively.
One of the most important functions of the eight extraordinary vessels is to deliver Jing Qi (essence Qi, which has been converted from original Qi and sexual Qi) to the entire body, including the skin and hair. They also deliver Jing Qi to the five ancestral organs, these are also known as the Extraordinary Fu:

the brain and spinal cord;

the gall bladder;

the bone marrow;

the uterus; and

the blood vessels.

Some researchers indicate that there are six Extraordinary Fu and include the bones.

It is interesting to note that the brain & spinal cord are included here which gives us a potential link to the meninges (dura, arachnoid, pia) and perineuria of the fascia which surrounds the brain, spinal cord and peripheral nerves. Some texts refer to the eight extraordinary vessels/meridians as the psychic channels with significant influence over the psychological and emotional aspects of health. Could this be due to a direct link with the meninges covering the brain; delivery of energy directly to brain tissue?
The apparent overlap between the meridian network and the fascia becomes clearer when represented in a diagram showing the relationship between the main energetic structures – the layering is clearly demonstrated, and we know that the fascia is progressively folded, forming layers during embryonic development by the process of gastrulation.
The embryonic development of the fascia also closely resembles my own theoretical model of the initial development of the 4 primary extraordinary vessels. (Outlined in; Zu Qigong Foot Energy Work, p33)

A Diagrammatic Representation of the Relationship between the Main Energetic Pathways. (Sagittal Cross-Section)

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When taking into consideration the regular meridians, each of which is associated with an organ, a consistent pattern relating to the fascia emerges. The fascia encapsulates each individual organ making it feasible that this is indeed the network channelling energy to and from individual organs thereby connecting the organs into a communication pathway.
If we are looking at the probability that the meridian network is linked to the fascia then one further aspect of the meridian network that we should look at is the Dan Tian. The Dan Tian is described in TCM as storing Qi, providing an energy reservoir which effectively propels Qi through the body like a pump, connecting into the meridian network; Dan Tian literally translates as the Elixir (Dan) Field (Tian).
There are in fact three energy centres in the body according to TCM, these energy centres contain the 3 treasures; Jing, Qi and Shen.

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Looking at the location of the 3 centres it is apparent that they each corresponds to significant areas of human anatomy and the fascia. The lower Dan Tian which is regarded as the main Dan Tian corresponds to the area where the pelvic cavity meets the abdominal cavity. Perhaps the most interesting aspect of this is that in embryonic development the human foetus develops from the base of the spine upwards, the lower Dan Tian therefore corresponds to the “point of origin” in embryonic development as well as being located over the reproductive organs, which ties in with the TCM theory that this area contains our inherited Qi, Jing. The middle Dan Tian is situated over the area where the abdominal cavity meets the thoracic cavity, corresponding to the TCM theory that this area stores acquired Qi, i.e. the energy from air and food – digestion and respiration. The upper Dan Tian is located in the front of the cranial cavity therefore associated with the brain; in TCM theory this energy centre stores Shen the energy of consciousness.

It is apparent that there are many similarities between the fascia and the wider meridian network, and I would suggest that there are too many to simply be coincidence. Undoubtedly a vast amount of research would be required to prove the correlation categorically, but as a practitioner for me this theoretical link makes so much sense.

For those reflexologists who prefer to use the Ayurvedic approach to energy work i.e. Chakras, Marma points and channels, and are of the opinion that they are using a different system, then hopefully the following diagram will demonstrate that they are in effect accessing the same system using very similar theories to those used in TCM. The difference lies only in the terminology and philosophy.

Ayurvedic Terminology-The Chakras | TCM – The Extraordinary Vessels

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If the fascia and the energy networks, as described in detail in TCM and Ayurveda, are one and the same thing, then the truly remarkable fact is that the ancient physicians of China and the Indian sub-continent appear to have had a far better understanding of human anatomy and physiology than we currently have in the 21st century!

Reflexology and the Fascia

Having established a reasonable theoretical case to view the meridian network as being integral to the fascia network let’s return to the therapeutic benefits of reflexology and the potential involvement of the fascia.
Reflexology, in its classical approach, is believed to work through applying pressure to specific points on the feet, hands etc. The individual points corresponding to all of the glands, organs and parts of the body – the anatomical reflection theory. This reflected anatomy by deduction must therefore also include a reflected fascia. Having already established that the fascia transmits force in the form of mechanical energy then it becomes clear that the firm pressure of classical reflexology would theoretically be transmitted via the reflected fascia and the physical fascia of the foot. The transmitted mechanical energy thereby altering fascial tension and alignment not just locally at the point of contact but travelling through the connected system. No part of the system operates in isolation – everything is connected. In a normal healthy state the fascial system maintains the body in equilibrium using a delicate balance of tension and elasticity. When injury occurs resulting in physical trauma, or if there is habitually poor posture, or localised inflammation then there is a change in this balance, energy fails to move smoothly through the system. This in turn results in abnormal pressure, force being exerted on bones, joints, nerves, blood vessels and organs, creating pain both locally and in other areas of the system, giving us the phenomenon of referred pain. Again it is important to stress that if the fascia connects to every other organ, structure and communication system in the body, then the delivery of energy in its various forms via the fascia would be contributing to the homeostatic balance throughout the body, helping to maintain function in all systems including the nervous system.
Firm reflexology pressure, applied to the feet or hands etc, may therefore be providing sufficient mechanical energy to the fascial system to encourage a rebalance within the network, correcting areas of excess or deficient tension. We know that under sustained, low intensity pressure fascia slowly lengthens and eventually remains that way. In myofascial massage for example, therapists stay with a stretch and follow a restriction 3 dimensionally for up to 2 minutes as the collagen in fascia is extremely tough and resistant to quick stretching. Interestingly this may give us an insight into why techniques such as VRT are so successful at treating specific muscular- skeletal problems such as frozen shoulder. Alteration in the fascia alignment and tension may also help to partially explain the benefits of lymphatic drainage techniques. These shifts in fascial tension would also explain the twitching that many clients exhibit during reflexology treatment. I have always attributed the twitching to energy flow overcoming blockages and effectively that is what I would suggest is happening when there is an alteration in fascia tension thereby allowing energy to move more freely through the collagen network.

If firm reflexology techniques are providing efficacy via pressure on the fascial network then how do the very light touch and meridian based techniques produce their beneficial effects? The answer must also lie within the energy transmission properties of the fascial network, however functioning at a much more subtle level. Is the transferred energy; vibrational, electromagnetic, thermal, perhaps a combination of all three, or a completely different form as yet unknown? This is an area open to debate and requires considerable research; however it may well remain shrouded in mystery until the scientists are able to understand exactly what energy is. Regardless of the form energy takes, any practitioner who practices an energy based therapy will tell you that they can “feel” the energy, some will feel it as pressure or a buzzing sensation, some feel heat while others will feel pulsing, regardless of how we experience energy, “something” definitely transfers through human touch. Yes I know this will be labelled as pseudo-science by the scientists but if as a practitioner you experience this phenomenon on a daily basis then, like me, you will have formed your own unique opinions and theories. I perceive energy as being subtle vibration, and view the meridian system as being a network of pathways that transmits this vibration throughout the body, each meridian having its own unique vibrational frequency.

In order to maintain systematic energy flow around the body, energy delivery cannot be a random process. As a communication network the fascia must therefore be directing energy flow in a structured fashion, TCM gives us a very precise energy flow pattern in its description of the meridians, a system that has been successfully used for over 2,500 years. The meridian network is said to have its own checks and balances – the generating and regulating cycles of the 5 elements/phases, working in a rhythmical pattern; the horary cycle. The TCM system uses analogies from nature to describe how energy flows and transforms as it journeys through the body. The use of poetic language and descriptions leads to the misconception that TCM is a range of strange and mystical modalities. In reality TCM is describing natural science processes, following very similar principles to those used in modern Western science. Then, as now, energy was an elusive component however for the ancient Eastern philosophers and practitioners it was not necessary to define energy – it simply “is”, a vital component in maintaining our health and wellbeing, the meridian network being responsible for the movement of energy around the body.
Although science is still very sceptical about the existence of meridians, experiments as far back as the 1960’s demonstrated that there is evidence of a unique circulatory system that could be attributed as being the meridian system.
In the 1960’s, Professor Kim Bong Han and researchers in Korea attempted to prove the existence of meridians in the human body using micro-dissection techniques. They found evidence of an independent series of fine, duct-like tubes corresponding to the paths of acupuncture meridians. Fluids in this system sometimes flowed in the same direction as blood and lymph, but also travelled in the opposite direction at other times. They realised that these ducts were different from the vascular and lymphatic systems; were they actually looking at the collagen structures and fibres of the extra-cellular matrix?
This meridian system structure was further validated by a French researcher, Pierre de Vernejoul, who injected radioactive isotopes into acupoints and tracked their movement with a gamma imaging camera. These isotopes travelled 12 inches along the meridian pathway within 4 to 6 minutes. He then challenged his work by injecting isotopes into blood vessels in random areas of the body rather than acupoints, and found that the isotopes did not travel in the same way at all.

If we are going to use meridian based reflexology techniques then it stands to reason that we should respect the natural flow patterns of the meridian system in order to encourage holistic balance. This is where Zu Qigong differs from other meridian based techniques, designed to work with the natural flow patterns/rhythms of the 20 main meridians, there is no diagnosing, stimulating or sedating of Qi, merely encouraging flow and, where detected overcoming stagnation of circulating Qi. This means that the therapist is working with what they actually find rather than what they expect to find. Control of change is ultimately with the recipient, the therapist is not imposing their will on the client. It is a simple, gentle approach that is highly effective.
The energy or Qi flowing through the system is subtle and I would argue that if we are aiming at encouraging natural flow and balance then our work should be similarly subtle. Overworking, forcing the will of the therapist onto the client may result in a rapid and unbalanced change within the energy system, undoubtedly the recipient’s body will work to re-establish a natural balance, and some may interpret this as giving the energy system a “kick-start” towards a balanced state, but this period of extreme in-balance may result in some very unpleasant side-effects for the client; could this be interpreted as the “healing crisis”?

Conclusion

Based purely on conjecture I know, but I am inclined to believe that reflexology does, at least in part, operate via the fascia, and the meridian network appears to be a probable component of the fascia system. This therefore implies that reflexology, working on the principle of anatomical reflection, has several mechanisms of action, something I have always maintained to be the case;

The ability to influence both the physical and reflected anatomy including the communication systems.

Direct stimulation of nerve endings using applied pressure / touch.

Deep pressure resulting in force thereby imparting mechanical energy sufficient to alter fascia tension and alignment.

Human to human touch resulting in subtle energy exchange/movement, directed via the fascia throughout the body, aiding balance and function of all systems and organs – homeostasis.

One final piece of the puzzle that needs to be explored is how or if we can control energy transfer from one person to another through touch. As reflexologists we are aware that intent is important in our practice, in other words our intention to assist the client does impact on how effectively we work with individual clients, as too is the willingness of the client to be helped. This implies that we have conscious and subconscious control over energy movement.
The philosophy and practice of Qigong is aimed at developing the ability to gently move energy through the meridian network using breathing, physical movement and via conscious control – mental focus, so the concept of using the mind to control energy flow has existed for thousands of years.
Perhaps the neuro-psychologists will eventually unravel this particular conundrum, but what is apparent is that we need to view all the communication systems as being interlinked, the nervous, lymphatic and circulatory systems are all connected with the fascia, nothing works in isolation – it is a holistic system. In reflexology we appear to be working with different aspects of the communication network dependent on the techniques we use, this may help us to identify which technique is best suited to the client’s requirements but it does highlight the fact that no technique is wrong and we should therefore be much more tolerant and open minded about different approaches.

My biggest concern is that by focusing so intently on Western science in the hope we will find all the answers to explain reflexology, thereby making reflexology acceptable to mainstream medicine, we are in danger of losing the beautiful simplicity of human to human interaction that I find so enthralling in our modality. We may end up over complicating things, over thinking and hence destroying the subconscious connection between therapist and client – the elusive human component of reflexology.

“Any intelligent fool can make things bigger, more complex…….. It takes a touch of genius — and a lot of courage — to move in the opposite direction.”

Albert Einstein

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