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Consciousness

What can Anesthesia tell us about Consciousness?

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In Brief

  • The Facts:

    Anesthesia is commonly used to put people to "sleep." This article is an interesting examination of why we do it, going deep into awareness, consciousness and fear.

  • Reflect On:

    Can awareness continually exists without interruption regardless of the fact that we are not always able to access our experiences, or remember them when given Anesthetic? What is awareness? Can we really be 'awake' when we are acting out of fear?

Before you begin...

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Take a moment and breathe. Place your hand over your chest area, near your heart. Breathe slowly into the area for about a minute, focusing on a sense of ease entering your mind and body. Click here to learn why we suggest this.

When patients ask anesthesiologists what we charge for putting them to sleep, we often say we do it for free. We only bill them for the waking up part.

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This isn’t just a way of deflecting a question, it also serves as a gentle reminder to both parties regarding the importance of “coming to.” If we couldn’t regain consciousness, what would be the point in having the surgery in the first place? Nobody wants to experience pain and fear if it can be avoided. If the only way to avoid the pain of an operation is to temporarily be rendered unconscious, most people will readily and willingly consent to that, as long as we can return to our natural state of being alert and interactive with the world around us. We are awake and aware and that–rather than any particular conception of health–is our most precious gift.

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How does Anesthesia work ?

From an Anesthesiologist’s point of view, we really shouldn’t charge for putting someone to sleep. It’s too easy. With today’s medications, putting someone to sleep, or in more correct terms, inducing general anesthesia, is straightforward. Two hundred milligrams of this and fifty milligrams of that and voilà: you have a completely unconscious patient who is incapable of even breathing independently. The medications we administer at induction are similar to the lethal injections executioners use. Unlike executioners, we then intervene to reestablish their breathing and compensate for any large changes in blood pressure and the patient thereby survives until consciousness miraculously returns sometime later.

In addition, those in my field have to contend with the reality that we really don’t know what we are doing. More precisely, we have very little if any understanding of how anesthetic gases render a person unconscious. After 17 years of practicing Anesthesiology, I still find the whole process nothing short of pure magic. You see, the exact mechanism of how these agents work is, at present, unknown. Once you understand how a trick works, the magic disappears. With regard to inhaled anesthetic agents, magic abounds. 

Take ether, for example. In 1846 a dentist named William T.G. Morton used ether to allow Dr. Henry J. Bigelow to partially remove a tumor from the neck of a 24-year-old patient safely with no outward signs of pain. The surgery took place at Massachusetts General Hospital in front of dozens of physicians. When the patient regained consciousness with no recollection of the event it is said that many of the surgeons in attendance, their careers spent hardening themselves to the agonizing screams of their patients while operating without modern anesthesia, wept openly after witnessing this feat. At the time, no one knew how ether worked. We still don’t. Over the last 173 years, dozens of different anesthetic gases have been developed and they all have three basic things in common: they are inhaled, they are all very, very tiny molecules by biological standards, and we don’t know how any of them work.

Why we still don’t know…

If you have never closely considered how our bodies do what they do (move, breathe, grow, pee, reproduce, etc.), the answers may be astounding. It is obvious that the energy required to power biological systems comes from food and air. But how do they use them to do everything? How does it all get coordinated?

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These are the fundamental questions that have been asked for millennia, by ancient shamans and modern pharmaceutical companies alike. It turns out that the answers are different depending on what sort of perspective and tools we begin with. In the West, our predecessors in medicine were anatomists. Armed with scalpels, the human form was first subdivided into organ systems. Our knives and eyes improved with the development of microtomes and microscopes giving rise to the field of Histology (the study of tissue). Our path of relentless deconstruction eventually gave rise to Molecular Biology and Biochemistry. This is where Western medicine stands today. We define “understanding” as a complete description of how the very molecules that comprise our bodies interact with one another. This method and model has served us well. We have designed powerful antibiotics, identified neurotransmitters, and mapped our own genome. Why then have we not been able to figure out how a gas like ether works? The answer is two-fold.

First, although we have been able to demonstrate some of the biological processes and structures that are altered by an inhaled anesthetic gas, we cannot pinpoint which ones are responsible for altering levels of awareness because inhaled anesthetic agents affect so many seemingly unrelated things at the same time. It is impossible to identify which are directly related to the “awake” state. It is also entirely possible that all of them are, and if that were the case consciousness would be the single most complex function attributed to a living organism by a very large margin.

The second difficulty we have is even more unwieldy and requires some contemplation. As explained above, western medicine has not been able to isolate which molecular interaction is responsible for anesthetics’ effect on our awareness. It is therefore reasonable to approach the puzzle from the opposite side and ask instead, “Where is the source of our awareness in our bodies?” and go from there.

We do know that certain neurological pathways in the brain are active in awake patients, but if we attribute consciousness to those pathways then we are necessarily identifying them as the “things” that are awake. To find the source of their “awakeness” we must then examine them more closely. With the tools we have and the paradigm we have chosen we will inevitably find more molecules interacting with other molecules. When you go looking for molecules that is all you will find. Our paradigm has dictated what the answer would be like if we ever found one. Does it seem plausible to think we will find an “awareness molecule” and attribute our vivid, multisensorial experience to the presence of it? If such a molecule existed, how would our deconstructive approach ever explain why that molecule was the source of our awareness?  Can consciousness ever be represented materially?

A more sensible model would be to consider the activity of these structures in the brains of conscious individuals as evidence of consciousness, not the cause of it.  To me it is apparent that, unless we expand our search beyond the material plane, we are not going to find consciousness or be able to understand how anesthetic gases work. Until then I know I am nothing more than a wand-waver in the operating room. And that is being generous. The magician is the anesthetic gas itself, which has, up to this point, never let us in on the secret.

What happens when someone goes “under”?

The mechanistic nature of our model is well suited to most biological processes. However, with regard to consciousness, the model not only lends little understanding of what is happening, it also gives rise to a paradigm that is widely and tightly held, but in actuality cannot be applied to the full breadth of human experience. We commonly believe that a properly functioning physical body is required for us to be aware. Although this may seem initially incontrovertible, upon closer examination it becomes quite clear that this belief is actually an assumption that has massive implications. To be more precise, how do we know that consciousness does not continue uninterrupted and only animate our physical bodies intermittently rather than the other way around, where the body intermittently gives rise to the awake state? At first, this hypothesis may seem absurd, irrelevant and unprovable. I assure you that if you spent a day in an operating room, this idea is not only possible, it is far more likely to be true than the converse.

Let us first consider how we measure anesthetic depth in the operating room. We continually measure the amount of agent that is circulating in a patient’s system, but as described earlier, there is no measurable “conscious” molecule that can be found. We must assess the behavior of our patients to make that determination. Do they reply to verbal commands? Do they require a tap on the shoulder or a painful stimulus to respond? Do they respond verbally or do they merely shudder or fling an arm into the air? Perhaps they do not even move when the very fibers of their body are literally being dissected.

There are many situations when a person will interact normally for a period of time while under the influence of a sedative with amnestic properties, and then have absolutely no recollection of that period of time. As far as they know, that period of time never existed. They had no idea that they were lying on an operating room table for 45 minutes talking about their recent vacation while their surgeon performed a minor procedure on their wrist, for example. Sometime later, they found themselves in the recovery room when, to their profound disbelief, they noticed a neatly placed surgical dressing on their hand. More than once I have been told that a patient had asked that the dressing be removed so that they could see the stitches with their own eyes.

How should we characterize their level of consciousness during the operation? By our own standards they were completely awake. However, because they have no memory of being awake during the experience, they would recount it more or less the same way a patient who was rendered completely unresponsive would. This phenomenon is common and easily reproducible. Moreover, it invites us to consider the possibility that awareness continually exists without interruption, but we are not always able to access our experiences retrospectively

During some procedures where a surgeon is operating very close to the spinal cord, we often infuse a combination of anesthetic drugs that render the patient unconscious but allow all of the neural pathways between the brain and the body to continue to function normally so that they can be monitored for their integrity. In other words, the physiology required to feel or move remains intact, yet the patient apparently has no experience of any stimuli, surgical or otherwise during the operation. How are we to reconcile the fact that we have a patient with a functioning body and no ability to experience it? Who exactly is the patient in this situation?

What can Near Death Experiences (NDEs) tell us?

If we broadened our examination of the human experience to consider more extreme situations, another wrinkle appears in the paradigm. There are numerous accounts of people who have experienced periods of awareness whilst their bodies have been rendered insentient by anesthetics and/or severe trauma. Near Death Experiences (NDEs) are all characterized by lucid awareness that remains continuous during a period of time while outside observers assume the person is unconscious or dead. Very often patients who have experienced an NDE in the operating room can accurately recount what was said and done by people attending to them during their period of lifelessness. They are also able to describe the event from the perspective as an observer to their own body, often viewing it from above.

Interestingly, people describe their NDEs in a universally positive way. “Survival” was an option that they were free to choose. Death of their body could be clearly seen as a transcending event in their continuing awareness and not as the termination of their existence. Very often the rest of their lives are profoundly transformed by the experience. No longer living with the fear of mortality, life subsequently opens up into a more vibrant and meaningful experience that can be cherished far more deeply than was possible prior to their brush with death. Those who have had an NDE would have no problem adopting the idea that their awareness exists independently of their body, functioning or not. Fear and anxiety would still probably arise in their life from time to time, but it is the rest of us who carry the seemingly inescapable load of a belief system that ties our existence to a body that will perish.

What happens when we wake up from Anesthesia?

The waking up part is no less magical. When the anesthetic gas is eliminated from the body, consciousness returns on its own. Waking someone up simply requires enough space and time for it to occur spontaneously. There is no reversal agent available to speed the return of consciousness. I can only wait. In fact, the waiting period is directly related to the amount of time the patient has been exposed to the anesthetic. At some point the patient will open their eyes when a threshold has been crossed. Depending on how long the patient has been “asleep,” complete elimination of the agent from the body may not happen until a long while after the patient has “woke.” 

By the time I leave a patient in the care of our recovery room nurses, I am confident that they are safely on a path to their baseline state of awareness. Getting back to a normal state of awareness may take hours or even days. In some cases, patients may never get their wits back completely. Neurocognitive testing has demonstrated that repeated exposure to general anesthesia can sometimes have long-lasting or even irreversible effects on the awake state. It may occur for everyone. Perhaps it is a matter of how closely we look.

Interestingly, it is well known that the longterm effects of anesthetic exposure are more profound in individuals who have already demonstrated elements of cognitive decline in their daily life. Indeed, this population of patients requires significantly less anesthetic to reach the same depth of unconsciousness during an operation. This poses an intriguing question: Is our understanding of being awake also too simplistic? Is there a continuum of “awakeness” in everyday life just as there is one of unconsciousness when anesthetized? If so, how would we measure it?

Does our limited understanding of awareness keep us “asleep”?

Modern psychiatry has been rigorous in defining and categorizing dysfunction. Although there has been recent interest in pushing our understanding of what may be interpreted as a “super-functioning” psyche, western systems are still in their infancy with regard to this idea. In eastern schools of thought, however, this concept has been central for centuries.

In some schools of Eastern philosophy, the idea of attaining a super-functioning awake state is seen as something that also occurs spontaneously when intention and practice are oriented correctly. Ancient yogic teachings specifically describe super abilities, or Siddhis, that are attained through dedicated practice. These Siddhis include fantastical abilities like levitation, telekinesis, dematerialization, remote-viewing and others. The most advanced abilities, interestingly, are those that allow an individual to remain continuously in a state of joy and fearlessness. If such a state were attainable it would clearly be incompatible with the kind of absolute psychological identification most of us have with our mortal bodies. It may be of no surprise that Eastern medicine also subscribes to an entirely different perspective of the body and uses different tools to examine it.

Certainly fear has served our ancestors well, helping us to avoid snakes and lions, but how much fear is necessary these days? Could fear be the barrier that separates us from our highest potential in the awake state just as an anesthetic gas prevents us from waking in the operating room? It is not possible to remain fearless while continuing to identify with a body that is prone to disease and death. Even if one were to drop the assumption that the source of our existence is a finite body, how long would it take to be free from the effects of a lifetime of fearful thinking before any changes that reflect a shift in this paradigm manifest? As long as we leave this model unchallenged we may be missing what it means to be truly awake.

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Consciousness

How To Ground Yourself: A Simple Yet Powerful Technique

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Take a moment and breathe. Place your hand over your chest area, near your heart. Breathe slowly into the area for about a minute, focusing on a sense of ease entering your mind and body. Click here to learn why we suggest this.

Mental health challenges, depression and even physical illness, are all on the rise. All three are believed by emerging research to be linked to trauma.

Thankfully, nervous system health and trauma are becoming a big part of what people talk about as it seems people are looking to get to the root of these issues more now than ever before.

After coming to my own realization that I was traumatized from experiences I had, I began studying trauma to not only help myself but to see how I could further improve my own media work – which has been, in essence, trauma-informed, since 2009.

What I’ve come to feel is that trauma affects almost all of us in some way, while there is not much data to back that up, I truly believe this to be the case. Learning useful skills to work through that trauma is becoming important in order to take our health into our own hands.

In the video below, I talk a bit about how events going on in the world can make us feel anxious and worried, and how that affects our bodies, minds, and health. I also share a simple yet powerful technique for sensory grounding.

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Consciousness

Why Hugging Is Powerful: Especially When We’re So Isolated

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CE Staff Writer 6 minute read

Before you begin...

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Take a moment and breathe. Place your hand over your chest area, near your heart. Breathe slowly into the area for about a minute, focusing on a sense of ease entering your mind and body. Click here to learn why we suggest this.

When’s the last time you had a good hug? Can you even recall a time when one lasted longer than 10 or 15 seconds? Hugging releases oxytocin, a bonding hormone, as well as serotonin and endorphins. These hormones are a big part of what makes us feel good and build a sense of community and connection with others.

When we hug our friends or family, or even spend a good few hours with them, we often don’t know what exactly the mechanism is that makes us feel good, but often times it’s touch, eye contact and reading facial expressions.

Throughout COVID, once we got a sense of what it feels like to not have as much touch, see smiles, see our friends or family, we might have gained a greater awareness of how important this really is. Intense isolation, like we’ve all experienced, leads to touch deprivation, and one could argue, has led to collective traumatization throughout the course of this pandemic.

Humans biologically need touch, it’s built right into our physiology. When we are babies, touch is a crucial part of our ability to regulate our nervous systems and feel safe. When we’re very young, our bodies have not yet built the ability to self-regulate (feel safety and comfort), and thus our caregivers play the important role of not only touching to bring regulation and safety, but also using facial expressions to send the message that ‘all is OK.’

Further, humans thrive in a sense of community and connection. When we are too isolated, without a deep and dedicated practice like monk’s might do in a cave in Tibet, we begin to lose the benefits of co-regulation, and in turn our psychology can begin to suffer over time. Humans have built incredible things – together – when in community, and touch plays an important role in that.

It most cultures around the world, hugging is part of daily life. Other cultures might decide to greet one another with cheek kissing instead, but touch is often a common denominator. But it’s true, there are places that may be ‘less touch-y’ and will certainly find other ways to connect.

One thing I can say though, especially during this unprecedented time of isolation, make it a point to hug those close to you when you can. Make it a good one, 15 or 20 seconds! Pay attention to how you feel after.

As mentioned, hugging is not the only way we get a sense of co-regulation and connection. Looking into one another’s eyes, sensing facial movements and reactions are also important. We have millions of mirror neurons in our brains that are constantly reading what is happening in another person, and sending information to areas of our brain, subconsciously, that tell us how a person might be feeling, for example. When we witness someone taking an action, neurons in our brains respond to that action in the same way as if we were taking that action ourselves – hence ‘mirror neurons.’

This might mean that when we watch a nervous moment in sports for example, although we are not playing, we might take actions like covering our mouths or holding our chest, feeling the nerves the players are likely feeling. As you can imagine, this is not a perfect science. Sometimes we are nervous but the player is cool as a cucumber, but generally, mirror neurons tend to help us connect to what others are feeling or doing, giving us a sense of empathy.

It goes even deeper. Research from Institute of HeartMath has shown that the human heart emits a measurable electromagnetic field that contains information other people can pick up on and decode in their brains. Regardless of how ‘new-agey’ this might sound to some minds, it’s a reality of our physical bodies.

Just think, have you ever walked into a room with multiple people in it and noticed the energy of it? Perhaps you noticed right away it was very tense or very jovial. This sense likely comes from having an awareness of how our electro magnetic field is interacting with the collective field of the room.

What you’re feeling is how someone’s general emotional state is affecting the field they emit. The more we feel tension, anxiety, or depression for example, the more we also put that signal out into our communities. Now, this isn’t a call to get stressed out about how we’re affecting others, this is simply a realization of what’s going on.

In our current chaotic world, it’s quite common to feel anxious or uncertain about what’s happening, and acknowledging that is OK is perfectly fine. The next question becomes: how can I manage my emotional state and create a a felt sense of calm? (Which of course will change the field you emit as well.)

Managing Our Emotions & Energy

One very simple option is written at the top of the article we post here on The Pulse. It’s a simple technique I adapted from my training at HeartMath, but I added in my own flair learned from my trauma specialist training as I felt a greater focus on interception, our awareness of sensations in our body, was important to be in the mix.

As go move through your day, stop, take a breath and release the tension in your body starting from your head all the way down to your feet. Take a few moments on each muscle group if you like. Place attention on your physical heart and breathe slowly into the area for 60 seconds, focusing on feeling a sense of ease.

I wrote a much more in-depth article here, where I share more detailed steps and how this helps improve our overall energy levels as well.

Our bodies are filled with tools that sense anything from obvious to ‘unseen’ signals coming from others and our environment. These tools suggest we are beings of connection, and we thrive when we get enough of it. They also suggest it’s important to pay attention to more than just the material aspect of our world, as there is much that needs to be ‘taken care of’ in the ‘unseen.’ By that, I mean, as we manage our emotions and regulate our nervous system’s, our felt electro magnetic field communicates a different message to others out there.

What message are you sending?

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Consciousness

Full Moon In Aquarius: Rationality & Seriousness

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Take a moment and breathe. Place your hand over your chest area, near your heart. Breathe slowly into the area for about a minute, focusing on a sense of ease entering your mind and body. Click here to learn why we suggest this.

We are having a Full Moon in Aquarius on July 23rd/24th. It will appear the brightest on the night of the 23rd throughout most of the world and on the night of the 24th in the time zones East of Japan. This is the peak of the Lunar cycle that began with a New Moon in Cancer on July 9th/10th.

The energies of a Full Moon are strongest in the days surrounding it yet its astrological configurations also play a part over the following two weeks. You may start to see its themes slowly build up after the New Moon prior.

This is a period in which we feel a push-pull between two opposing signs, in this case being the Moon in Aquarius and the Sun in Leo. It can play out as either a conflict, an integration, or some sort of dynamic between the energies of both signs. The Moon reflects the expression of feeling and emotion while the Sun reflects the expression of ego and conscious self.

We may feel this opposition happening individually within us and/or we can also experience it play out around us; with some people (or circumstances) expressing the Aquarius side and others expressing the Leo side. In some cases, Full Moons can also reflect/trigger some sort of change or release.

Full Moon In Aquarius Opposite Sun In Leo

Leo season began 36 hours before the Full Moon and will continue until August 22nd/23rd. This is the sign of self-expression, creativity, love, affection, children, courage, vitality, passion, leadership, generosity, and playfulness. Ruled by the Sun, it is also about shining in our power and being in alignment with what really lights us up and gets us excited.

The negative expressions of Leo can be egotistical, self-absorbed, authoritarian, dramatic, stubborn, jealous, and hot-tempered.  As it is associated with seeking praise and attention, it can be demanding of respect and be boisterous without considering or caring about how others respond to that.

The Full Moon highlights and brings the energies of the opposing sign of Aquarius into this Leo backdrop. This is the sign of friends, networks, social dynamics, social issues, groups, teams, humanity, and being in the best interest of the collective. This energy is unconventional, idealistic, innovative, progressive, scientific, original, inventive, technological, reforming, and even revolutionary.

Negatively, Aquarius can be overly detached, aloof, unemotional, and very invested in the mind at the expense of the heart. Traditionally ruled by Saturn, it can also be unyielding when it comes to the ideas and perspectives that it has already decided on.

Both Leo and Aquarius have some similarities. They are ‘Fixed’ signs and therefore can both be determined yet stubborn. They are also both associated with originality and authenticity. In Aquarius, this comes from its unconventional and innovative attributes while in Leo it comes from being inspired by its heart centred self-expression.

Full Moon Quincunx Venus, Conjunct Saturn, & Square Uranus

This Full Moon is in a quincunx with Venus which has recently entered Virgo. Our feelings, emotions, needs, or domestic lives may be at odds with friendships, values, finances, pleasure, or matters of love. It can be hard to integrate these areas but being flexible and making adjustments can be the solution.

The Full Moon is moving towards Saturn in the same sign. This can reflect a serious energy and we may be faced with limitations, restrictions, delays, or obstacles. We or others may be emotionally distant, pessimistic, or reserved. However, this can be good for some sort of effort that requires discipline, structure, and orderliness. After the Full Moon period, some of these energies will be strong again on August 1st/2nd.

Following the conjunction with Saturn, the Moon forms a square aspect with the disruptive Uranus in Taurus. This is activating the square between Saturn and Uranus that is happening throughout the year which I’ve covered in previous articles. Themes around ‘old versus new’, ‘restrictions versus freedom’, ‘the status quo versus revolution’, ‘commitments/responsibilities versus liberation’, ‘elder versus youth’, ‘progressiveness versus tradition’ and so forth.

Jupiter Going Back Into Aquarius

Jupiter entered its home sign of Pisces in mid-May for a short stint as it is returning back into Aquarius on July 28th/29th. The planet of expansion, freedom, beliefs, perspective, education, is unrestrained in Pisces and gets to express itself more ideally in this sign. We have seen examples of this as many jurisdictions loosened up covid related restrictions during this period.

With it going back into Aquarius, a traditionally Saturn ruled sign with Saturn currently present there, Jupiter will be more inhibited until late December when it re-enters Pisces again. It’s possible that during this 5 month period we will likely experience more restrictive measures return or new ones implemented. We may also experience this in different ways in our personal lives such as not being able to expand the way we’d like to. However, this might not be noticeable immediately.

The combination of Saturn and Jupiter in Aquarius (which began last December) can be good for building towards something or planting seeds pertaining to some sort of technological integration, social networking, collective or social pursuits, activism, new scientific approaches to things, and innovation.

Venus Square Lunar Nodes, Mars Opposite Jupiter

Venus will be in a square with the Lunar Nodes which will be strong from July 28th-30th. We may be reflecting on the past and future, or perhaps at a crossroads, when it comes to friendships, love, values, or financial matters. We may need to complete something and address what is holding us back  to help us move on and take a step forward in an evolutionary way when it comes to these areas of life. Venus is in Virgo so therefore discernment, details, practicality, health, organization, or efficiency may be key.

At this time Mars will be switching from Leo to Virgo while in an opposition to Jupiter. We may begin to feel the need to apply ourselves in a way that is more productive, sustainable, healthy, and clean. However, we can overextend ourselves and take on more than we can handle. This can also play out as conflicts around beliefs, perspectives, opinions, or judgements.

Mercury’s Superior Conjunction

Mercury will be in its Superior Conjunction on August 1st/2nd which is in an important phase of Mercury’s cycle with the Sun. From this point onward we may have a better perception around certain things that were seeded or occurred in the previous two months which may also help our momentum forward. .

Circumstances and developments that happen at this time can help us gain more clarity or facilitate necessary realizations to help us make the right decisions and appropriate mental focus. During this conjunction, the Sun and Mercury will be opposing Saturn which can play out as hindrances or the need to be pragmatic as part of this process.

Things To Consider

How can you balance or integrate your personal passions with the needs of the collective? How can you resolve any conflicts between leadership and a team or group? Are you experiencing any challenges or conflict between your heart and intellect? What areas of your life do you need to be more orderly, structured, disciplined, or take more seriously? Is there anything that you need to separate from? How can you apply yourself in a more noble way?

These are just some examples of themes that could come up or ways to approach this period; however, there may be other variations of this energy playing out as well.  If you wish to do any sort of intentional release, it is best to do so after it begins to wane following the peak or during the two weeks afterwards when it is waning before the next New Moon. The exact peak of this Full Moon is at 2:37am Universal Time on July 24th, night of the 23rd. You can click here to see what that is in your time zone.

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