Hunter College employees are protected against unfair practices in hiring and treatment by a policy of non-discrimination that includes sexual and gender identity. But unfortunately, many LGBT people still experience outright discrimination in other workplaces, in the housing market or legal affairs, especially outside of New York City where anti-discrimination laws are not nearly as inclusive. But what is far more common in the day-to-day lives of many LGBT people is heterosexism. Heterosexism is a very important concept for any discussion about LGBT issues in the workplace. Heterosexism is a more subtle term than the commonly used “homophobia.” Homophobia usually means active discrimination or hatred of gay men and lesbians. Heterosexism may be defined as denying, stigmatizing or de-legitimizing the experience and identity of gay, lesbian, bisexual or transgender people. Many times we make assumptions or remarks to coworkers without ever thinking what they might mean to an LGBT person.

Some of the most common examples of heterosexism that LGBT people encounter in the workplace are not acts of intentional harm, but acts of negligence that often involve language that can cause significant emotional distress and isolation. Asking a coworker “why aren’t you married yet?” happens often and seems innocent enough. But a statement like this carries a range of assumptions. First, that the person to whom you’re speaking is legally allowed to be married and second, is in a monogamous, traditional relationship with someone of the opposite sex. Jokes are another example of how language can cause pain. “Gay jokes” are unfortunately pervasive, but repeating them at work is never appropriate. Another example is holiday parties for “employees and their spouses.” Changing the language on invitations to “employees and their partners” sends a very different message.

Many LGBT workers report feeling tremendous pressure to “act straight.” This can mean changing patterns of speech, dress or physical manner while at work. That can be a huge source of stress that can lead to much more serious problems with job performance and social culture at work. Many gay and lesbians moms and dads have faced being asked, “who is the real parent” of their child (meaning who is the biological parent), or treated like they are not a legitimate family if their child is adopted. These are scenarios that heterosexual families and individuals usually never confront.

There are very real reasons why some LGBT workers choose to stay “in the closet.” While individual companies or organizations like CUNY colleges have specific protections for LGBT workers from being fired or discriminated against due to their sexual orientation or gender identity, in 34 states it is perfectly legal to discriminate against someone because of his or her sexual orientation. Indeed, according to a Harris Interactive poll cited by Lambda Legal, a legal defense organization for LGBT issues, 23% of gay employees have been harassed at work, 12% have been denied promotions, and 9% were fired because of sexual orientation or gender identity¹.

Even when a worker is protected by anti-discrimination policy, the choice an LGBT person faces about whether or not to share with coworkers his or her sexual orientation is a very complicated one. Studies show that LGBT people who work in a supportive environment wherein it is possible to share their sexual orientation with their coworkers experience much higher levels of “job satisfaction, productivity and loyalty.²” But every person does not get to have a job at a workplace that encourages and supports gay and lesbian people in sharing that aspects of their identity. Some researchers have observed a phenomenon called “minority stress ³” where a person experiences anxiety, depression or even health issues from the experience of having to constantly be in an environment where they are different from most of the other people there, especially when that difference must remain hidden.

By adulthood, many gay men and lesbians have already built a social network of friends and family members who accept who they are. In a social context, many of their friends may also be gay. At work, all bets are off. In most work environments LGBT people are the minority.
Unlike many other minority groups such as African-Americans, Latinos, gay men and lesbians probably did not grow up in a family of other gay, lesbian or transgender people, so the support networks of individuals who share their experience generally come from outside resources like LGBT community centers, advocacy groups and bars and clubs. With such a huge amount of time spent in the workplace by the average American employee, LGBT workers can often feel isolated and removed from the life experiences of their coworkers, especially when they are being given the covert message that they are not supposed to share who they really are. After all, we do still live in a “don’t ask, don’t tell” country.

Creating a social culture at work that is sensitive to the unique individual experiences of LGBT people benefits everyone. A workplace that is inclusive of all people regardless of their sexual orientation or gender expression is one that will be more ethical, productive and ultimately more creative as the personalities of each team member can shine through.
——————————
1 http://career-advice.monster.com/gay-lesbian-bisexual-transgender/diversity-inclusion/GLBT-workers/Fired-for Being-Gay/home.aspx
2 Rostosky, S. and Riggle, E.(2002) “Out at Work: The Relation of Actor and Partner Workplace Policy and Internalized Homophobia to Disclosure Status.”
3 Smith, N. and Ingram, K. (2004). “Workplace Heterosexism and Adjustment Among Lesbian, Gay and Bisexual Individuals: The Role of Unsupportive Social Interactions.”

This article will address some of the stresses associated with the images and experiences of war and strategies for coping. It will begin by looking at the stresses of deployment and their effects on the soldier, family, and community.
It will next look at the reunion of soldier and family and some of the issues associated with returning to civilian life. It will offer some ideas for coping, with a special focus on the family and the questions and concerns of children. It is the hope that anyone reading this article will find something to relate to and ideas to help cope with the images and experiences of war in our society and in our daily lives.

The Stress of Service:
When an individual is called to serve in war, the stresses and sacrifices are tremendous. That person is asked to leave their community (such as their friends and neighborhood), their family (such as children and partner/spouse), as well as their job and career. He or she enters the violence of war and faces the constant threat of physical harm and death. When this individual returns, he or she faces another adjustment as they resume civilian life, returning to their work and family roles. Often, this adjustment to “normal” life is complicated by symptoms of Post-Traumatic Stress Disorder (P.T.S.D.), such as nightmares, insomnia, irritability, a heightened “startle reaction” (i.e. to a car backfire), and the avoidance of situations that might remind one of the traumatic event. According to Richard Currey, there are many barriers to getting treatment for P.T.S.D., such as the stigma of the diagnosis (which can be a “career killer” in the military) and the complexities of veteran health care. In addition to these stressors, research by Currey and the American Psychiatric Association shows a strong relationship of P.T.S.D. with many other health problems and poor health overall. As a result, returning soldiers report feelings of frustration and isolation, which can sometimes lead to feelings of despair.

The stresses and sacrifices of service in war extend beyond the individual to the network of a whole community: the absence if felt by an employer, a friend, a partner/spouse, and especially by any children of the serving individual. The financial impact is often a taxing issue for families, such as a decrease in earned wages and an increase in child care needs. With these stresses in mind, Whealin and Pivar describe an emotional cycle that families often experience when a loved one is deployed. The cycle begins with anxiety based on uncertainty about the dangers this loved one will face and about when they will return. It shows itself as bursts of pride and anger (and often both at once) at being called to serve. This is followed by withdrawal as the separation nears, then sadness when the loved one departs. After that comes a time of adjustment, such as changes to daily family routines. As the term of service draws to a close, the family experiences tension about the reunion that can be expressed as excitement as well as fear of another period of adjustment. This cycle is challenging for partners/spouses and can be enormously challenging for a child.

Coping with Service:
If you or someone you know has experienced any of the situations or feelings described above, it is important to know that there are healthy and effective ways of coping with the stress of service, as an individual and as a family. If you are an individual who is serving or has served during war time and is having difficulty with the separation of deployment, the trauma of war experience, or the readjustment to civilian life, please know that you are not alone. Millions of veterans and men and women currently serving have reported these feelings and have found ways to cope with each step of this process. Below is a list of coping strategies suggested by Whealin and Pivar and Mental Health America that can be used by both individuals and their families to reduce stress and improve overall health.

Take time to talk and listen: Talking is one way we release stress. People need to express things, even you, throughout the process of deployment. Try to listen without judgment. The more a family communicates, the less they suffer from long-term stress

Limit exposure to news media: News programs emphasize the most frightening aspects of any story, and images of war and violence can produce a lot of anxiety. For those who will serve or have served, or for those who have a loved one serving, try to limit the hours you watch the news. This is especially true for children, who will have strong fears about the safe return of a parent that can be triggered by news and images of violence and war.

Join or develop support groups: Coping with stress is greatly helped by the company of others who may share your experiences and understand your concerns. These groups can be for those who have served and for their partners/spouses and families. They will help provide a sense of community and be a resource for sharing ideas and emotional support.

Keep up with daily routines: Familiar habits are comforting, so try to stick to (or create) a daily routine. To further reduce stress, this routine could include: time with family and friends, regular exercise, doing something fun, and doing something positive for someone else (such as volunteering, or making a “care package” for the loved one who is serving).

Remember to ask for help: Asking for help is not a sign of weakness. If you suffer from symptoms of P.T.S.D., seeking help from a mental health professional can greatly reduce the intensity and duration of your symptoms. Seeking help is important for any caretaker as well (such as a parent, grandparent, or partner/spouse). The stress of trying to
do it all can easily lead to exhaustion as well as more serious symptoms of anxiety or depression.

Many families seek supportive counseling. The Hunter College Employee Assistance Program is staffed by trained clinicians who can help individuals and families cope with the stages of deployment, service, and return. Call us at (212)772-4051 to set up an appointment and one of our trained counselors will meet with you as soon as possible.

Children and Coping:
Children are some of the most vulnerable members of our society and perhaps the most cherished members of our families. So it seems appropriate to include a special section addressing the concerns and needs of children who know someone (such as a parent or other loved one) who is in military service or in some way impacted by the stress of war. Here are some suggestions for helping children cope with images and experiences of war, offered by the National Association of Social Workers website and David Fassler, M.D.

Talk to your children: Create an open environment for discussion. Give honest answers (children usually know if someone is being truthful). Use words and concepts they can understand. Be prepared to repeat information and explanations. Avoid the stereotyping of groups of people by country or religion. Let them know what you are feeling (again, they probably already know and it can be very reassuring if their hunch is validated). Be reassuring but do not make unrealistic promises (let them know that they are safe, but do not tell them that no more planes will crash or no one else will get hurt).

Listen to your children: Acknowledge and validate their feelings. Pay special attention to remaining calm so you do not burden them with your distress. Help them express their feelings in ways besides words (such as drawing). Do not criticize or judge what they are saying. Do not confront their defenses (a fantasy that war is “far away” may be a way for them to feel safe). Listen and look for physical symptoms of stress (such as headaches or stomachaches). Encourage them to reach out to and communicate with, others (such as letters to loved ones who are serving or to politicians about their concerns). Let children be children (let them ignore news and talk about war and, instead, let them be playful).
Children naturally have questions about the world, and war is a part of this world. They learn about war from television, video games, and from listening to adult conversation. If a child has experienced war in any way (as the child of a soldier or refugee family), then these images and stories will cause more intense feelings of confusion and fear, and can therefore cause even greater stress for them. If we remember how a child sees and learns about the world, if we are mindful of their feelings and our own, and if we take the time to talk and to listen to their questions and concerns, then we will be showing them how to deal with the images and experiences of war and giving them tools to manage their stress. And remember, the Hunter College Employee Assistance Program is a resource for families looking for ways to communicate and cope with the stresses of war and military service.

Resources:
“How to talk to children about war.” Retrieved on
July 12, 2007, from the National Association of Social Workers, at
http://www.socialworkers.org/pressroom/events/peace/talk.asp.

“Talking to Children about War and Terrorism: 20 Tips for Parents,” by David Fassler, M.D. Retrieved on July,11, 2007, from American Psychiatric Association at
http://www.psych.org.

“How to Get Back to ‘Normal’” and “Understanding Your Mental Health in Times of War and Terrorism.”
Both retrieved on July 12, 2007, from the Mental Health America: Operation Healthy Reunions, at
http://www.mentalhealthamerica.net

“Coping When a Family Member Has Been Called to War,” by Julia Whealin, Ph.D. and Ilona Pivar, Ph.D. and “What is Posttraumatic Stress Disorder(?).” Both retrieved on January 03, 2008, from the United States Department of Veterans Affairs National Center forPosttraumatic Stress Disorder http://www.ncptsd.va.gov.

“Soldiers’ Mental Health Needs Increase Several Months After Returning From Iraq War.” Retrieved on December 19, 2007, from Social Work Today, at
http://www.socialworktoday.com

“U.S. Iraq War Veterans with P.T.S.D. Suffer Significant Physical Health Problems.” Retrieved on July 11, 2007, a news release from the American Psychiatric Association, at http://www.psych.org.

“Wounded Warriors: Lost in the Labyrinth of Care,” by Richard Currey, PA-C. In Social Work Today, September/October 2007, pp.32-36.

Although many individuals stay quite healthy well into their later years, it is issues around the deterioration of physical and mental health that usually come to mind when contemplating aging. Chief among these and certainly two of the more well-known are dementia and a specific form of dementia, Alzheimer’s disease.
Memory lapses are normal among older adults and can look like simple forgetfulness; misplacing glasses, forgetting conversation details, confusing children’s names with grandchildren names and occasionally forgetting appointments.

Symptoms of dementia include more significant memory impairments, but in addition can include diminution in learning, intelligence, language, problem solving, concentration, attention or behavior. What is important to notice in deciding if there is reason for concern are if the changes are persistent and stable and present a significant decline from a previous level of functioning. It is important to speak with your loved one and a doctor if this is the case.

It is necessary to know with what exactly you are dealing. While there are no cures in this case, there are potentially effective treatments in some instances, especially in the early stages. Also, there are other factors which can cause dementia-like symptoms including various combinations of prescription medication, exposure to environmental toxins, alcohol and drug abuse, thyroid problems and depression. Even though dementia or Alzheimer’s may not be in play, there may still be need for medical attention.

In either case, there are some actions that can be taken to lessen the ramifications of memory loss:

Encourage your loved one to:

• Keep track of dates, schedules and tasks by leaving notes, making checklists or writing down specific task steps.
• To remember where things are left, always leave them in the same place, or make written lists of exactly where things are kept.
• To remember times or appointments, set alarms or timers as reminders or enlist friends and relatives to call and remind them places they are to be or things that need to be done.
• In relaying new information, be sure to talk in quiet places, discussing one thing at a time, and even have them repeat things back to be sure it is understood.

Depression is not uncommon among the elderly and can result from any one of several reasons. Retirement for many can mean suddenly losing a daily purpose they once served and brings up questions of usefulness. So too can retirement bring around the loss of a social network. Volunteering can serve to fill both these voids and there are many organizations that work specifically with this population to meet this need (Senior Corps,www.seniorcorps.org is an excellent one). Monitoring physical health also plays a role here as depression can develop after serious medical episodes such as heart attacks and strokes that can seriously comprise an individual’s previous degree of functioning. Loneliness can also play a role in depression as older adults must deal with frequent bereaving. While not a substitute for a lost loved one, pets have been shown to reduce loneliness and many individuals respond with improved mental states and decreases in physical symptoms.

Even though the U.S. Center for Disease Control reports increasing HIV infection rates among individuals over age 50, sex is often an overlooked issue with older individuals. Many older adults were married or coupled in the pre-HIV era and therefore it was unnecessary to become educated about the disease once it appeared. Our culture is highly sexualized when it comes to advertising, but sex is still somewhat of a taboo topic in terms of practical conversation. This coupled with the recent advent of drugs like Viagra and Cialis create a vulnerable population in older adults. Although most individuals are somewhat uncomfortable with the idea of their parents as sexual beings, they are, and a conversation may be in order if your aging parent is entering the dating game after a several decade break.

It may be necessary to have other awkward conversations with an aging parent where it seems parent and child roles have become reversed. Now instead of the parent setting rules or boundaries it is the child that must bring up issues such as sex, when to stop driving, whether or not some type of assisted living is necessary or issues of money or insurance. While these are often difficult conversations, they should be well-thought out and delivered from a place of concern and caring, especially where decisions must be made that will result in a reduced level of autonomy. It is also best to keep a degree of patience and not expect immediate results. Even though the ultimate desired action may be the best for your loved one, it may take them longer to reach the same conclusion or even require more than one conversation.

Different kinds of financial issues can also crop up with older adults either because of forgetfulness, fear of losing control over their money, or fraud. While you may not be privy to financial specifics, you can look for warning signs or even take pre-emptive action.

• Be aware of whether or not mail is piling up in the home, especially bills or statements. This could be a sign of financial tasks becoming overwhelming or that money is much tighter than you know.
• Check to see if unusual numbers are showing up in the phone bills, or even check their caller ID. An increased number of calls from unknown numbers could represent bill collectors or credit card companies.
• An occasional trip to Atlantic City is certainly not a problem. However dramatically increased activity of this kind can indicate a problem that could spiral out of control very quickly, especially if living on a tight budget.
• Notice if money comes up in conversations more than usual or if social activities decrease significantly or needed home repairs go unchecked. Any of these could be signs of money problems.

Older adults are particularly vulnerable to fraud as they are usually home all day with possible loneliness leading to misplaced trust. Tips here include the following:

• Inform your loved one to give no personal information over the phone, including credit card numbers. Make sure they have caller ID so unknown numbers can be ignored, and be sure to register them on the national Do Not Call Registry(www.donotcall.gov).
• To protect against internet fraud, make sure they know not to give out personal information online or download unknown attachments. Also check to see that spam filters are set on high and anti-virus software is installed.
• Identity theft is an increasing occurrence and can cause considerable damage. Credit monitoring services such as Experian and Identity Guard can alert you or your loved one in cases of suspicious credit applications or unusually large spending.

A major task in late adulthood is coming to terms with one’s life and how it was lived. This can mean reflecting on all its’ aspects, good and bad, and such reflection can sometimes be difficulty to hear as it makes caregivers themselves face their loved ones mortality. However it is important to keep one’s own feelings from impeding this process as it can offer a degree of peace and comfort. Rather than attempt to change the subject or lighten the mood, it is better to think of ways in which this process can be creatively facilitated. For example, while your loved one is still in good health it may be helpful to assist in creating an oral history or photo journal (album) that documents their life. Not only does this allow a natural process, but it becomes something shared and lets the individual know their stories and life will be remembered.

If you find yourself in the role of caregiver for a loved one, it is easy to forget about self-care, yet it is essential if one is going to provide the best possible care. Stress is almost impossible to avoid yet can be reduced with proper attention.
Set Realistic Goals: Develop realistic expectations about what you can and can’t do. Think about how care giving will effect your life and other obligations and take this into account. If there are specific illnesses involved, take time to learn about them so you may understand your loved one’s behavior or interactions.
Establish Your Limits: You have a right to decide what you will (or are able) to do and what you won’t (or can’t). While you will sometimes have to go beyond these limits, not having any will only increase your stress and effect your care giving ability. It may be necessary at times to consider other ways in which your loved ones needs can be met.
Ask For Help: With our culture’s emphasis on independence it is unfortunately not easy to ask for help. However, being able to set limits and ask for assistance beyond those limits will ensure the best possibly quality care. Others are often eager to help, yet are unsure what exactly to do. If will be beneficial to you both to know exactly what needs to be done and
be specific with your request.
Take Care of Yourself: Caregiving can take an immense emotional toll, and it is important to be able to share your feelings with someone. Emotions can range from grief to resentment about the necessary time and energy provided. Whatever feelings you have, it is vital to your emotional and physical health to express and deal with them. Joining a support group may facilitate this process as you will be able to share with people experiencing the same situation. It is also important not to forget about your own needs. Whatever it is that allows you to relax and unwind must not be cast aside. Of course there will be less time to indulge yourself, but waiting until you are burned out may be too late.

Older adult developmental and care issues are enormous topics, and this article served to offer general bits of information about several main topics. Further information on all these issues can be ob-tained at www.helpguide.org and especially www.caring.com. Additional information for this article was obtained from Human Behavior in the Social Environment, by Esther Urdang. Also, for information on entitlement benefits for those retired individuals for whom you care and Social Security is their primary source of income, please attend the Lunchtime Seminar on Thursday, March 13th at 12:15PM.

Having all of these options can seem overwhelming–but it doesn’t have to be. Whether you or a family member are considering visiting Hunter College’s Employee Assistance Program or seeing someone outside of Hunter, it helps to have a better understanding of what’s involved. Following is an overview of the different kinds of therapy and providers, resources for locating services in New York, and some tips on choosing a therapist.

What is therapy?
In a nutshell, therapy is a process that helps people overcome or manage the mental or emotional problems they are experiencing by exploring them with the guidance of a mental health provider. The process goes by many names, is practiced by many kinds of practitioners, and takes many forms. Although “therapy” is the term most often used, it is also known as psychotherapy, counseling, and treatment. The names for persons who provide therapy tend to be used interchangeably, despite differences in training and approach (therapist, counselor, psychologist, social worker, doctor, “shrink”), as are the names for people seeking therapy (client, patient, consumer).

Therapy is provided to children, teenagers, and adults of all races, ethnicities, and lifestyles, and sessions may include individuals, couples, families, and groups. Treatment is offered in a variety of settings, including private offices, mental health clinics, hospitals, schools, and place of employment, and may last just a few, specified number of sessions or several months or years.

How does it work?
Many people wonder how “just talking” can solve their problems–and, if so, why they can’t get the same results from talking to their friends, family members, or co-workers. Although not all forms of therapy involve talk alone, talking or working with a therapist can be effective, and is different from interactions with other people, for a number of reasons.

Therapists are trained to understand and recognize ways in which people think about, feel, and act in social and other situations that may prevent them from living up to their full desires and potential. By being “outsiders” in their clients’ lives, they can make observations and ask questions that help people understand how their thoughts, feelings, and actions developed and may have led to certain results. They can also take an objective, nonjudgmental, and confidential stance, which enables clients to feel free to discuss and explore their most personal thoughts and feelings without fear of consequences or anyone else finding out. And if exploring such facets of oneself becomes difficult or painful, therapists can provide the encouragement, guidance, and sense of safety needed for clients to continue through the process and produce understanding and change.

An important component of therapy is the relationship between a client and therapist. Clients must feel comfortable with their therapist and believe that he or she is someone with whom they can work to resolve their problems. Research supports the fact that this bond–known as the “therapeutic alliance”–is one of the key factors in the treatment’s effectiveness, regardless of the method used.

Different approaches and methods
When we think of therapy, what often comes to mind is a client lying on a couch and talking freely, while the therapist sits out of sight, taking notes. While this method, psychoanalysis, is still used by many therapists, it is just one of a broad range of therapeutic approaches used today.

Therapists may use different approaches depending on their training, work setting, and views about what causes problems and what are the most effective ways to solve them. The three approaches you are most likely to encounter fall into the broad categories of psychodynamic,cognitive-behavioral, and experiential. To illustrate the differences among them, we will briefly explain of each one and then describe how a therapist trained in that method might use it to treat a person experiencing a particular problem.

Consider the case of John, a 32-year-old man who comes for therapy because he is frustrated about his performance at work. Although he does a good job on his projects and gets along well with his co-workers, he is uncomfortable speaking up in meetings, afraid that he won’t express his ideas well and his co-workers will find his comments “dumb.” While he would be contented to sit quietly and listen to others share their views, he is concerned that he will be seen as a “know-nothing” if he doesn’t talk. He also feels resentful of his co-workers who do speak up and receive recognition and praise for their ideas.

Psychodynamic therapy
This approach encompasses psychoanalysis and several other methods that share the belief that our past experiences influence our present experiences and feelings, and that by examining and understanding the ways in which our past experiences contribute to patterns in our present relationships and behavior, we can resolve our difficulties. Also known as “talk therapy,” these approaches all work on the assumption that talking about problems is therapeutic.

A therapist using a psychodynamic approach might ask John to talk generally about his life, describing perhaps his career, relationships, and family background. To help John feel comfortable sharing his thoughts and feelings about his experiences, the therapist would work to create an atmosphere of trust and acceptance; in addition, by listening closely to John’s descriptions, the therapist would notice patterns in his feelings and behaviors, and would share observations about them with him. Over time, the therapist would help John to see that while he is most aware of having this difficulty at work, he feels uncomfortable speaking up for himself in many areas of his life. John’s exploration might cause him to remember that when he was a child, his three older brothers often dismissed his comments as “babyish,” treating him as though he knew little and had nothing to add. John came to stay quiet much of the time to avoid his brothers’ teasing, and though he is an adult with expertise in many areas, he carries with him the belief that his contributions aren’t valuable. As he continued in therapy, he might come to recognize that his view of himself as the “unknowledgeable child” doesn’t apply to the person he is now, giving him the confidence to express himself more freely to others.

Cognitive-behavioral therapy
Rather than focus on past events, cognitive-behavioral therapists examine the ways in which we think about and experience events today. They believe that our early experiences teach us to think about the world in certain, often negative or distorted, ways, and that these thoughts directly influence the way we feel about and experience events. According to this approach, in order to change the negative feelings about ourselves that hold us back, we must become aware of our habitual negative thinking and work to change it.

Although there are many types of cognitive-behavioral therapy, this approach generally entails having clients identify specific issues that they would like to work on and then complete homework assignments and other exercises to help them understand the thoughts behind their feelings and actions. Thus, a cognitive-behavioral therapist working with John might engage him in an exercise aimed at identifying his thoughts and feelings about his participation in meetings. John might first list his thoughts during the meetings, the feelings they stir in him, and the reactions he anticipates his co-workers would have if he spoke up. Then, with his therapist’s coaching, he might list possible alternative reactions his co-workers could have, and come to see that just as they might react negatively, they might also find his comments useful. As a result of doing this exercise, John might remember a meeting in which he did share his views and received positive feedback–and realize that he tends to anticipate negative reactions rather than positive ones. As a homework assignment, the therapist might ask John to share one idea at each meeting for the next few weeks, and to jot down his co-workers’ reactions. In reviewing his co-workers’ reactions with the therapist, John might see that his contributions are valued–giving him the confidence to make them more often.

xperiential therapy
Many of our emotional patterns develop at a very early age, before we have learned to talk. Experiential therapy aims to help us access our emotions through nonverbal methods that bypass some of the thought processes that interfere with our having a full understanding of ourselves. In creative arts therapy, for example, the creative process of drawing, painting, dance, or music is used to help clients express their thoughts and feelings in symbolic, rather than verbal, ways. In psychodrama, clients usually work in groups to engage in dramatic re-enactments of their relationships, allowing them to examine their problems or issues and practice new, more effective roles and behaviors.

Working on this problem in a psychodrama group, John might choose someone to play the co-worker who intimidates him the most, and then start a dialogue with that person as if they were at work. The therapist might then ask John to stand behind his own chair and share with the group the feelings of anxiety and incompetence he experiences in this situation. John might then be asked to choose group members to play his brothers and to act out a situation from his childhood that stirred the same feelings. John could use this safe, therapeutic setting to tell his brothers how belittled he felt by them and to call on his own adult coping skills to nurture and advise “young John” in dealing with his brothers. Participating in the drama would allow John to start to heal his past hurts and to feel (not just understand intellectually) that, as an adult, he has power he did not have as a child.

Using medication to overcome problems
While psychotherapy has been the most prevalent method used to treat mental health problems since its inception in the early part of the last century, the use of medications in such treatment–often known as pharmacotherapy or psychotropic medications–has skyrocketed in the past few decades. This has been due both to the development of new drugs that are more effective and have less severe side effects than those of the past, as well as the tendency by insurance companies to view medication use as more cost-effective than psychotherapy and to provide fuller coverage for it.

As with psychotherapy, there are often many options about which medication to take, or whether to take medication at all. Such medications affect everyone differently; factors such as age, sex, body size, physical health, and diet can all influence how effective a medication will be, as well as the experience of side effects, which can include weight gain, dizziness, or a sense of emotional flatness. For some people, such medications provide a kind of “miracle cure,” while for others the side effects outweigh the benefits.

In addition, there has been some controversy regarding the effectiveness of medication in treating mental health problems. The success rate for many such medications is considered to be about 30%, and sometimes a person may try several medications, or several dosages of the same medication, before possibly achieving the “right” balance of symptom relief and side effects. Furthermore, some people question whether medications are as effective as psychotherapy in treating various kinds of problems.

As a result, depending on the nature, severity, and length of a person’s problems, as well as logistical and financial considerations, treatment may consist of therapy alone, medication alone, or a combination of the two. The decision to use medication is an individual one that often is made in consultation with a psychiatrist and based on a person’s particular goals and preferences.

Who provides therapy
Therapy is practiced by psychiatrists, psychologists, social workers, marriage and family therapists, and various kinds of counselors. Although the various types of providers may use the same or similar therapeutic approaches, what differs between them primarily is the training they received.

Psychiatrists are medical doctors who continue their studies to specialize in mental health. They are the only mental health professionals who can evaluate the need for and prescribe medication used to treat mental health issues, and while many psychiatrists provide therapy, many focus more on monitoring and evaluating the use of such medications. Psychologists have a doctorate in psychology and study the ways in which the workings of our brains affect our thoughts, feelings, and actions. They may also conduct psychological tests and research.

Social workers have a master’s or doctorate degree in social work or social service, and tend to focus not just on our “internal workings,” but also on the ways in which our external environment–our families, communities, and larger society–affects our outlook and success at achieving our goals. Marriage and family therapists may have a master’s or doctorate degree in marriage and family therapy or other credentials, and work with couples and families on issues that arise among them. Finally, counselors may be certified, licensed, or have advanced degrees in a variety of areas of expertise, and tend to focus on specific problems such as alcohol or drug abuse, learning difficulties in children, and career issues.

Resources for locating therapy services
The Hunter College Employee Assistance Program offers individual, couples, and family therapy to Hunter College staff and their family members. If you are interested in scheduling an appointment, call us at (212)772-4051. Alternatively, below are some of the many resources available in New York City that offer or refer to mental health services. Most accept various forms of insurance, and many offer low fees or accept payment on a sliding scale. (Note that these resources are provided for informational purposes only. Their inclusion does not imply endorsement of any kind.)

LifeNet (a 24-hour, 7-day-a-week hotline for counseling and referrals) English: (800)LifeNet (800-543-3638); Spanish: (877)Ayudese (877-298-3373);
Asian LifeNet: (877)990-8585; TTY: (212)982-5284;
www.mhaofnyc.org/2lifenet.html

DC-37’s Personal Service Unit (a confidential counseling service available to all union members of District Council 37) (212)815-1260

FEGS (Behavioral Health Division) (212)366-8187; www.fegs.org/products/index.cfm

Fifth Avenue Center for Counseling and Psychotherapy (212)989-2990; www.nyana.org/fifthavenue.asp or www.fifthavenuecenter.org

Jewish Board of Family & Children’s Services (serving people of all religions and backgrounds) (212)582-9100; www.jbfcs.org

Karen Horney Clinic (212)838-4333; www.karenhorneyclinic.org

Ackerman Institute for the Family (212)879-4900; www.ackerman.org/treatment.htm

Cognitive Therapy Center of New York (212)221-0700; www.schematherapy.com/cognitive/id342.htm

Institute for Human Identity (serving the LGBTQ communities) (212)243-2830 or www.ihi-therapycenter.org

Burnout is a physical, mental, and emotional response to constant levels of high stress. Burnout produces feelings of hopelessness, powerlessness, cynicism, resentment and failure–as well as stagnation and reduced productivity. These stress reactions can result in levels of depression or unhappiness that eventually threaten your job, your relationships and your health. Burnout is associated with situations in which a person feels:

• Overworked
• Underappreciated
• Confused about job security
• Over committed with responsibilities
• Resentful about duties that are not commensurate with pay

Burnout is not simply excessive stress. Rather, it is a complex human reaction to ongoing stress, and it relates to feeling that your inner resources are inadequate for managing the tasks and situations presented to you. The signs and symptoms of burnout are similar to those of stress, but burnout includes an emotional exhaustion and an increasingly negative attitude toward your work and, perhaps, your life.

What causes burnout?
Burnout can occur when you feel you are unable to meet constant demands, and you become increasingly overwhelmed and depleted of energy. Debilitating sadness, anger or indifference can set in. You begin to lose the interest or motivation that led you take on a certain role in the first place. Most people are stretched thin, concerned about keeping their jobs, and may feel uncertain about the future. The American Counseling Association notes that job insecurity and changes among and with corporations leave many employees feeling anxious to explore the possible causes of job-related burnout:

What? Have you faced changes in the organization, the demands of the job, your supervisor, or the industry?
When? Was there a pivotal occurrence that changed the way you viewed your job — a new boss, co-workers, or responsibilities?
Why? Have you changed? Are your interests or values pertaining to work now different than they were before? Has the company’s mission changed? Are your abilities and skills not being utilized?

Changes in your work environment and a feeling of lack of control over your work are major causes of the unrelieved stress that can easily become job burnout.

Burnout pervades every occupation. However, it is thought to be more prevalent among service professionals. Decades ago, researchers began exploring the rates of emotional and physical fatigue among those whose jobs required attending to the emotional needs of others. Research by and among those in the human-service professions led to a general understanding of burnout as a feeling of no longer being able to give of oneself. While all employees are subject to experiencing burnout, it is especially common among teachers, clergy members, health practitioners and caregivers.

People with tendencies to place too-high expectations on themselves also may be more prone to burnout. When carried too far, compulsiveness, perfectionism, and inflated self-confidence can have detrimental impacts on your professional and personal life. Setting unrealistic goals, thinking anything is possible with the right amount of work, and taking on more than you know you can handle will leave you striving to maintain an intensity that simply cannot be sustained over time. Burnout has been found to proceed in stages. These stages blend into one another so smoothly that you might not realize what is happening until you are in a state of despair and physical and emotional breakdown.

What are the signs and symptoms of burnout?
Since burnout is not an overnight occurrence, it is important to recognize its early signs and to act before the problem becomes severe. In a chronic state of stress, your body will begin to show the following physical signs of stress overload:

• Psychosomatic illness (psychological/ emotional problems which manifest themselves physically)
• Digestive problems
• Headaches
• Teeth grinding
• Fatigue

When you are on the verge of burnout, you may feel:

• Powerless
• Hopeless
• Like you are burning a candle at both ends
• Detached from people and things around you
• Little satisfaction from your work
• Resentment for having too much to do
• Like a failure
• Withdrawn, isolated from co-workers and friends
• Cynical, irritable and anxious

Under prolonged conditions of chronic stress, the body begins the downward progression to burnout. When specific psychological responses interact with the body’s natural physical responses to stress, burnout occurs. It is the end result of a tired body and mind. You may be unable to sleep or unable to stay awake. You might even turn to escapist behaviors such as “risky sex”, drinking, drugs, partying, or shopping binges to try to escape from your negative feelings. Your relationships both at and outside of work may begin to fall apart. Burnout can impair your job performance as well as your health.

Can burnout be prevented or treated?
To prevent or treat burnout, you must become familiar with the symptoms and try to identify possible causes. Since burnout is a physical and psychological response that is connected to feelings you begin to have about a work or a life situation, it is important to attend to the mind as well as the body when treating burnout. Once you have recognized causes of work dissatisfaction, consider whether any of the causes can be addressed. For instance, you might be able to speak to your supervisor about possibilities such as transferring to another department or obtaining an updated description of your job duties and responsibilities. It is not always within your control to address problems at work, but it is worth identifying the causes and trying to see if you can change them. To prevent and reduce burnout, you can make the following changes to improved your physical, mental and social well-being.

Physical changes

• See a doctor —Schedule a complete physical check-up with your doctor.
• Sleep — Make sure you are getting the sleep your body desperately needs
• Eat right — Develop healthy eating habits, including having breakfast and high protein snacks to help sustain your energy throughout the work day.
• Exercise —Stretch in your office, take walks during breaks etc.

Mental changes

• Put yourself first — Regularly set aside time to be alone and to do something you enjoy. Ask yourself: “what recharges my batteries?”
• Set realistic goals — This will add direction, clarity and focus to your life. Establish personally meaningful goals, divide them into short-term and long-term, and establish a plan for attaining them and setting new ones. Striving, learning and reaching for new accomplishments will give you a real sense of purpose.
• Hone your coping skills — Develop coping skills for dealing with stress including using muscle relaxation techniques, mental imagery and positive self talk. You might consider finding a professional such as a therapist or life coach to help you hone these skills.
• Arm yourself with self-knowledge — Understanding your strengths and weaknesses can help you learn better ways to deal with day-to day stress.
• Monitor your depression — If you have a history of depression, burnout can reactivate it.
• Learn effective time management skills — To help you develop control over your work and home life, you might consider taking more time off, scheduling more frequent breaks while at work, or delegating tasks.

Social changes
Although time alone is important, maintaining a balanced life also means spending time cultivating your relationships with others. Poor relationships can contribute to burnout, but positive relationships can help prevent or reduce it. Steps you can take to improve your work and home relationships include:

• Nurturing your closest relationships such as those with your partner, children or friends — These relationships can help restore energy and alleviate some of the psychological effects of burnout, such as feelings of being underappreciated.
• Address your dissatisfaction at work. Talk to a supervisor to explore options that may alleviate your stress — Perhaps your job responsibilities can be reviewed or your hours changed to better suit your needs.
• Consider a job or career change — You might choose to consult a Career Counselor. Check the National Career Development Association’s Web site for helpful guidelines in selecting a career counselor.
• Practice healthy communication &mdash Express your feelings to others who will listen, understand and not judge. Burnout involves feelings that fester and grow so be sure to let your emotions out in healthy, productive ways.

References and resources for burnout:
Burnout Inventory — A quick test to help you measure your level of burnout

www.lessons4living.com

Preventing Burnout — Includes further assessment tools as well as exercises to help you overcome stress-causing frustrations www.coping.org

The Road to Burnout — Describes how the stages of burnout could occur in the workplace www.healthyplace.com

Antidotes for Workplace Burnout — Describes 10 ways to combat stress and replenish energy www.vibrantlife.com

Catching Up With Our Bodies: Reflections on Teacher Burnout (National Education Association)

Modern-day dilemmas
Some relationship challenges are linked to recent changes in cultural norms. For example, our culture reinforces unrealistic expectations that relationships should always “feel good”, so that when inevitable difficult periods occur, couples may not believe that conflict in relationships is normal and needs to be worked out. Combined with increasing social acceptance of separation and divorce, people may be choosing to end their relationship in search of something that “feels better,” only to find that the same issues follow them to their next relationship.

Other modern developments have increased certain types of external stressors for couples. For example, in the last 40 years in America, changing male and female roles within a marriage have offered some freedom of choice to both partners, but can create tension between competing priorities at certain stages of life. We need to negotiate responsibilities within the partnership for everything from day-to-day chores to child care to financial planning. Each of these decisions offers an opportunity for you and your partner to bond, or can breed resentments which build up over time if unresolved.

Also contributing to stress in relationships is the post-war phenomenon of living far from one’s family of origin, where you may have less financial and emotional support and relatively loose ties to the community. You may feel further isolated if your extended families have trouble accepting your relationship, as may happen in the case of gay and lesbian or interfaith unions. Increasingly common, intercultural relationships leave couples with additional challenges of unmatched cultural norms and expectations.

Technological developments may also contribute to a couple’s distress in a society which increasingly devalues patience and cooperation, leaving us confused about what to reasonably expect from a long-term partner. As yet unknown are the cumulative effects on relationship skills of such modern developments as e-mail (supplanting voice-contact with another human being), text-messaging (creating the expectation of instant response), and cyber-communities in which people adopt alter-egos to interact with each other in pseudo-relationships they can abandon with the click of a button as soon as an uncomfortable feeling arises.

Other relationship challenges are age-old
Financial difficulties, as well as differences in attitudes towards money, have long been a marital stressor across socio-economic levels. Money problems raise practical dilemmas, as well as strong emotions like fear for survival, anger about failed expectations, and shame about loss of status. Other external stressors such as job loss, illness and death in the family may leave a couple in an acute crisis from which they eventually reach a new, stronger status quo, but also may derail a relationship. Such crises can test the couple for the same reasons they test the individual: they challenge us to cope with severe practical challenges at a time when we are feeling most vulnerable.

Besides external factors, sometimes personal factors threaten a relationship, such as an individual’s limited capacity for intimacy. Avoidance of growth in oneself and in the relationship may be subtle, such as an individual whose unconscious desire to avoid his or her spouse results in long hours at the office; or it may be more obvious, such as when alcohol or drug abuse makes it impossible to engage in the emotional give-and-take of a mature relationship. In these situations, the other partner may start to feel abandoned or that he or she is “outgrowing” the relationship, and without an intervention that offers an opportunity for reconciliation, the relationship may continue to deteriorate.

Can we predict if a partner will be compatible over a lifetime?
There are many articles in the popular press with common-sense advice about how to determine if you and your loved-one are compatible. They aim to reveal whether you share basic values and spiritual beliefs, as well as expectations about such fundamentals as: Where will we live? Do we want children, and if so, who will care for them? How will we manage our finances? Do we have similar expectations of our sexual relationship? Sometimes overlooked is the importance of sharing a interest, so that during times of stress you can come together around an activity or lifestyle you both find enjoyable. Although your answers to any of these questions may reasonably change over time, it makes sense to wait to make a commitment until you feel confident of your own and your partner’s desires in at least some of these core areas.

Even assuming a basic level of compatibility, though, many couples report that maintaining a satisfying relationship is their hardest job in life! This is because we choose partners not only for their compatibility as defined above, but also because they fulfill unconscious emotional needs at the time–to be needed or to be taken care of, to escape loneliness, or to establish status in the community, to name a few. A relationship may feel right to both partners because of the complementarity of their emotional needs at the time. But healthy human beings continue to mature throughout life, and their emotional needs–conscious and unconscious–change as well. When our emotional development is not in tune with our partner’s, which is inevitable at some point during a life-long relationship, the result can be conflict, feelings of anger or sadness, feelings of betrayal, and other stressful emotions for one or both parties. A satisfying life-long relationship needs to accommodate these stressful periods for both partners and indeed is one of our greatest challenges as human beings.

Principles of long-term stability and satisfaction in relationships
Given the diversity of faiths, values, and cultural norms in our society, it is no easy task to develop a list of universal principles that apply to all long-term relationships. Indeed, the principles developed below are culture-bound, as they reflect a particular set of values and norms. First and foremost, they reflect the assumption that there is no proper place for physical, sexual or emotional abuse of any kind in human relationships. They also reflect a deep respect for the dignity of each individual, regardless of race, gender, level of education, and other aspects of our identities which can result in power differentials within a relationship. Finally, these principles confer on both partners mutual, responsibility for trying to make a relationship work. While these principles would be most effective if practiced by both partners, they can sometimes improve a relationship even if initially followed by only one partner.

Communication — Couples often rate open communication as an important way to prevent underlying resentments from building into crises. Sometimes, one partner must learn a basic life-skill, like feeling entitled to ask for what he or she wants. Other times, the challenge is to express anger in an acceptable way, which may involve learning first to recognize that one is angry or, conversely, learning to calm down before attempting to have a conversation. The basic rules of thumb when discussing hot topics are to keep accusations and insults (”You’re lazy”) to a minimum; make as many “I” statements as possible (”I feel like I do more than my share of the housework”); ask questions (”Do you think the way we split up responsibilities is fair?”); and listen to the other person’s point of view, even if you disagree (”I hear you saying that since you work late sometimes, you shouldn’t have to do laundry…do I have that right?”).

Empathy — Understanding one another’s point of view, not only intellectually, but on a “feelings” level, is central to building an intimate relationship. Unless you and your partner can empathize with each other’s feelings much of the time, it will be very difficult to build a bridge of mutual respect, trust, and support. One key challenge to true empathy arises when our partners’ emotions feel threatening to us, causing us or deny their validity as a way of protecting ourselves. In this case, getting whatever support you each need to resolve the fear or grief you trigger in each other can in turn relieve pressure on the relationship.

Acceptance — This principle is equally important to adopt toward oneself as it is towards one’s partner. Acknowledging that no human being can fulfill all of our needs all of the time helps us to tolerate the least perfect stages of our relationship, when we are just becoming aware of and learning to navigate our core differences. An accepting posture acknowledges that each individual in a relationship, as well as the relationship itself, is a “work in progress”. Allowing and respecting the differences we discover without feeling overly threatened by them is part of the process of building trust and stability with a partner over a long period of time, and can help provide an environment in which both individuals can mature at their own pace, without needing to grow permanently apart.

Kindness — With intimacy can come knowing our partner’s core vulnerabilities, and revealing our own, to our partners and ourselves. Perhaps the ultimate kindness is choosing, as often as we can, not to take advantage of that knowledge to hurt our partner, and giving credit to our partner when he or she makes that same choice for us. One motivation to stay committed through the low points in a relationship is that, over many years, these accumulated kindnesses breed mutual trust, gratitude and forgiveness.

What to do if your relationship is in trouble
Talk-As difficult as it might be to speak frankly with your partner about the hot points in your relationship, opening the lines of communication is essential to breaking through an impasse. If resentments have built up over a long time, you both may be feeling deeply hurt or angry, so these early conversations may not be easy. If communication has been lacking in the relationship, the goal of early talks may be to make your point of view understood, and to understand that of your partner, before trying to either forgive each other or reach a solution which works for both of you. Setting ground rules, such as prohibitions on abusive language or threats, may be a way of making early conversations emotionally safe for both parties.

Listen — Sometime when we are very hurt or angry, it is hard to listen fully to another person’s point of view. We may not feel our partner has the right to his or her own “grievances” because we feel so aggrieved ourselves. Or we may misinterpret what our partner is saying or doing because of our own biases or frame of mind. Making a safe space for your partner to tell you what he or she is hurt or angry about is equally important to being honest about your own point of view. If your only goal is to express your anger or make your partner “pay” for past hurts, try to vent some of that energy elsewhere so that you are better able to sit down to a truly two-way conversation.

Be open to change — Often, the underlying source of conflict is not one person’s “wrong” behavior, but a mismatch between two partners’ needs or expectations. Sometimes the “change” needed in oneself might be as subtle as noticing and learning to love what one’s partner has to give rather than dwelling on what he or she does not. If each partner is willing to examine his or own contribution to a conflict and tries to compromise, many conflicts can be resolved.

Make time for each other — Intimate relationships require a certain amount of nurturance, all the more if you are experiencing a rough patch. Try to make a time commitment to each other that cannot be interrupted by work, children or other distractions. Some couples carve out such “relationship time” every day, whether it is at a meal or after the kids have gone to sleep. Others plan a weekly or “date night.” Even just 15 minutes lying awake together every night before falling asleep might be enough. There is no formula for the “right” frequency or length of this time together, but ideally it should be time for relating to each other rather than, for example, watching the same television show in the same room at the same time.

Focus on the physical — Physical estrangement can be a sign of emotional estrangement. Sometimes one partner unconsciously withholds sex out of anger, or is afraid to tell the partner that their sexual relationship is unsatisfactory. At the same time, frequent sex can mask a lack of emotional intimacy that both partners are loath to discuss. Try to come to a mutual decision about whether making changes (either temporary or permanent) to your physical relationship might better serve you both emotionally.

Ask someone you trust for help — Sometimes input from people who care about us and who have a fresh perspective can help relieve the pressure, calm us down, and offer sound advice. If you have friends or family members whose relationship skills you admire, talk to them, either individually (while respecting your partner’s confidentiality) or as a couple. You may be surprised, and relieved, to find that a couple you respect has dealt with, and survived, similar issues to your own. Clergy or other spiritual mentors may also provide useful guidance and recommendations of books or films which can help.

When to seek professional help
Sometimes our relationship problems are greater than we feel able to resolve on our own or with the help of friends and family. The Hunter College Employee Assistance Program (212-772-4051) is a free, confidential source of crisis intervention and longer-term therapy, as well as a source of outside referrals, available to all Hunter employees and their significant others. As described above, much of the “work” to be done in resolving relationship conflicts is internal, so professional support can be extremely effective even if your partner refuses to participate. Therapy can also support you through the emotional upheaval of separation or divorce.

Fortunately, recent scientific breakthroughs have made large gains in slowing the aging process at the cellular level. Scientists have discovered that as organic antioxidants are introduced into the body, they have a dramatic effect on free radicals. Specifically, antioxidants dramatically reduce the amount of free radicals that are found in the body. Although scientists are cautious to say that they are able to stop the aging process, they definitely have said that they have made significant advances in “slowing” the aging process.

Studies have shown that increasing the antioxidant level in the body does several things. First, it assists in increasing energy levels. This is done by reducing the amounts of free radicals that attack the cells involved in energy production. Second, antioxidants dramatically improve the immune system. This is done by providing the body with the necessary nutrients to maintain a healthy immune system. Lastly, antioxidants provide the body with nutrients that are not consumed in a regular diet. This contributes to improved general health. Although scientists are not willing to say that they have developed a modern day fountain of youth, many are touting their findings as “miraculous” Although we could potentially get all of the antioxidants that we need from our diet, doing so would require a strict diet that includes many fruits and vegetables….although possible, perhaps we should embrace scientific advances and supplement our diet with an all natural option.

Efficacy of Antioxidants

Antioxidants protect normal cells and other tissues by fighting free radicals and the oxidative reaction that free radicals cause. Antioxidant nutrients include beta-carotene, vitamins C and E, selenium, copper, zinc and bioflavonoids. There are now more than 200 studies that show antioxidants can help decrease the risk of developing cancer. Antioxidants have been shown to boost immunity, promote longevity, guard against heart disease and cancer, and produce positive effects on cholesterol.

One recent investigation took place in Linxian, China. Researchers from the Cancer Institute of the Chinese Academy of Medical Sciences teamed up with researchers at the United States National Cancer Institute. They studied nearly 30,000 adults, randomized over a five-year period in four groups receiving different nutrients during that period. Here are the results of the studies:

• It was the first large-scale intervention trial in a prospective randomized fashion to demonstrate that three antioxidant nutrients together–beta-carotene, vitamin E, and selenium–significantly reduced total mortality, especially mortality from all cancers and particularly stomach cancer.
• Antioxidant nutrients decreased the risk of cancer in humans.
• Antioxidant nutrients substantially reduced the prevalence of cataracts in the older patients (aged 65 to 74 years).
• Antioxidant nutrients reduced mortality from stroke.

One antioxidant that can help to better your health is Green Tea. For centuries green tea has been credited with restorative and healing properties. Recent scientific studies have confirmed the truth of these claims. Despite the fact that green, black and oolong tea are derived from the same plant, Camellia sinensis/Camellia assamica, the different preparation processes used to produce each tea result in variations in the content of active ingredients.

Green tea is loaded with polyphenols–naturally occurring chemical compounds packed with antioxidant power. These polyphenols give green tea its unique flavor and color.

By weight, polyphenols comprise 30 percent of the green tea leaf. Although it can vary, one cup of green tea typically contains 252 mg of four separate polyphenols. The antioxidant potential of green tea polyphenols has amazed even the scientists studying green tea. One study compared green tea extract with the “gold standard” of antioxidants: vitamin E. The extract was shown to pack two hundred times the antioxidant punch of vitamin E.

Scientific research confirms that green tea reduces the incidence of dental cavities, although researchers believe that the polyphenols are primarily responsible for the anti-cavity effects.

Green tea supports good health in a dozen diverse ways. The following summary shows that almost every system of the body is beneficially affected by green tea:

• Lowers total cholesterol and LDL (”bad”) cholesterol levels
• Increases HDL (”good”) cholesterol levels
• Reduces blood pressure and acts a “blood thinner” thus decreasing risk of stroke
• Reduces the risk of and likelihood of death from heart attack by supporting good circulatory and cholesterol health
• Aids in the proper function of the liver thus helping to detoxify the body
• Promotes normal blood sugar and insulin regulation thus aiding the control of diabetic conditions
• Reduces the risk of cancer by preventing it from starting and spreading
• Boosts longevity
• Enhances immune function and aids in fighting bacterial infections
• Aids digestion and prevents ulcers of the stomach, esophagus and small intestine
• Prevents dental cavities and gingivitis
• Promotes weight loss by reducing the rate and amount of dietary carbohydrates absorbed by the body

So how many cups of green tea does one need to drink to obtain these wonderful health benefits? The average green tea intake in Asian countries is about three cups daily, or 240 to 320 milligrams of polyphenols. Scientific studies indicate that 300 to 400 mg of polyphenols, taken in the form of green tea extract, are needed for effective health protection. This dosage is equivalent to four to ten cups of green tea daily.

For a comprehensive look at how green tea performs its healthful magic, read The Green Tea Book, China’s Fountain of Youth, by Lester A. Mitscher, Ph.D. and Victoria Dolby. It explores the scientific research, discusses green tea’s long and rich history, and examines the individual benefits green tea offers.

Source: Portions of this article are excerpted from the The Green Tea Book by Mitscher & Dolby, 1998 Avery Publishing Group, page 13
http://www.antioxidants.com/health
http://mayoclinic.com/health/antioxidants

Health Benefits

A good source of protein, fish is generally low in calories, saturated fat, and cholesterol and provides several important vitamins and minerals. Limiting the amount of saturated fat and cholesterol in your diet helps keep down your blood cholesterol, reducing your risk of developing heart disease and heart failure. Even shrimp and crayfish, which are higher in cholesterol than most types of fish, are lower in saturated fat and total fat than most types of meat and poultry.

Some types of fish contain omega-3 fatty acids, which provide cardiovascular and other health benefits. For this reason, the American Heart Association recommends eating fish at least twice a week.

Omega-3: It’s Good for Your Health (and Other Things, Too)

Omega-3 fatty acids are polyunsaturated essential fatty acids that are found in oil from oily, fatty fishes and in many plant and nut oils. They are considered “essential” because they cannot be produced by the body, and must be obtained from outside sources.

Omega-3 acids have many health benefits, and are most well known for their ability to lower the risk of cardiovascular disease. They have been found to reduce the risk of heart attacks and strokes, slow the buildup of atherosclerotic plaques (”hardening of the arteries”), protect against irregular heartbeats, and lower blood pressure slightly. Some studies also suggest that these acids can reduce the risk of prostate cancer, asthma, and mental decline in old age, and can help in managing diabetes, rheumatoid arthritis, and a host of other medical conditions.

Fishes containing omega-3 include anchovies, bluefish, carp, catfish, halibut, herring, lake trout, mackerel, pompano, salmon, sardines, striped sea bass, tuna (albacore), and whitefish.

Health Risks: Watching Your Mercury Intake

Despite the many benefits of eating fish, some fish may contain contaminants, such as pesticides and polychlorinated biphenyls (PCBs), that derive from pollutants in lakes, rivers, and oceans. The major contaminant found in fish is mercury. For most people, the risk from mercury by eating fish is not a health concern. Some fish, however, contains higher levels of mercury that may harm an unborn baby’s or a young child’s developing nervous system.

For this reason, women who might become pregnant, women who are pregnant, nursing mothers, and children under age 5 are considered to be at greater risk from mercury intake, and they are advised to limit the amount of fish they eat. According to the U.S. Food and Drug Administration (FDA) and the U.S. Environmental Protection Agency (EPA), these individuals are advised to:

• Avoid eating shark, swordfish, king mackerel, and tilefish, since they contain high levels of mercury.
• Eat no more than 12 ounces (or two average meals) a week of fish that is lower in mercury, such as shrimp, canned light tuna, salmon, pollock, and catfish. Note that albacore (”white”) tuna is higher in mercury than canned light tuna, so these individuals should limit the amount of albacore tuna to 6 ounces (one average meal) a week.

Go Fish!

Do your enjoy fishing? Catching your own fish can be a great way to spend time outdoors and put a fresh meal on the table. Keep in mind, though, that sport fish can contain pollutants that may pose health risks when these fish are eaten in large amounts, so it’s important to reduce your health risks when eating freshly caught fish.

One way to reduce your risk is to call your local or state environmental health department before you go fishing, to see if there are any advisories in the area where you want to fish. Sometimes warning signs are posted near the water, but if they aren’t it’s a good idea to call ahead. In addition, you can choose fish that are less likely to contain pollutants. For example, with gamefish–such as lake trout, salmon, walleye, and bass–the smaller, younger fish are less likely to contain chemicals than the larger, older fish. Fish that feed on insects and other aquatic life–such as bluegill, perch, stream trout, and smelt–can be eaten more regularly because they are less likely to contain high levels of pollutants, while fatty fish (such as lake trout) and fish that feed on the bottoms of lakes and streams (such as catfish and carp) should be eaten less often, since they are more likely to contain high levels of pollutants. You can also clean and cook your fish in ways that will reduce your health risk (see box). Note that because mercury is contained throughout the fish, these cleaning and cooking techniques will not reduce the amount of mercury in the fish.

Cleaning Fish
Can I clean my fish to reduce the amount of chemical pollutants that might be present? Yes. It’s always a good idea to remove the skin, fat, and internal organs (where harmful pollutants are most likely to accumulate) before you cook the fish. As an added precaution:

• Remove and throw away the head, guts, kidneys, and the liver.
• Fillet fish and cut away the fat and skin before you cook it.
• Clean and dress fish as soon as possible.

Remember that with any fresh meat, always follow proper food handling and storage techniques. To prevent the growth of bacteria or viruses, keep freshly caught fish on ice and out of direct sunlight.

Cooking Fish

Can I cook my fish to reduce my health risk from eating fish containing chemical pollutants? Yes. The way you cook fish can make a difference in the kinds and amounts of chemical pollutants remaining in the fish. Fish should be properly prepared and grilled, baked, or broiled. By letting the fat drain away, you can remove pollutants stored in the fatty parts of the fish. Added precautions include:

• Avoid or reduce the amount of fish drippings or broth that you use to flavor the meal. These drippings may contain higher levels of pollutants.
• Eat less fried or deep fat-fried fish because frying seals any chemical pollutants that might be in the fish’s fat into the portion that you will eat.
• If you liked smoked fish, it is best to fillet the fish and remove the skin before the fish is smoked.

Reprinted from: U.S. Environmental Protection Agency, Office of Water (2002). A Guide to Healthy Eating of the Fish You Catch. Retrieved July 6, 2006, from http://www.epa.gov/waterscience/fish/30cwafish.pdf

References:

American Heart Association, 2006; Harvard Health Publications, 2006; Mayo Foundation for Medical Education Research, 2006; National Institutes of Health, Office of Dietary Supplements, 2005; U.S. Department of Health and Human Services and U.S. Environmental Protection Agency, 2004; and U.S. Environmental Protection Agency, Office of Water, 2002. Complete references are available on request.

What does the medical establishment say about drinking water?

We turned first to the Mayo Clinic website and several other sources to learn about the effects of drinking water on our physical health. We found that, indeed, since water makes up 50-70% of our body’s weight, drinking water over and above the amount we absorb from the foods we eat can have a positive impact on almost every system in the human body. Water serves such important functions as transporting oxygen to cells, washing toxins out of our vital organs and regulating our body temperature.

The most important (and obvious!) benefit of drinking water is ameliorating the risk of dehydration: losing as little as 1% of your body’s weight in water can leave you feeling lethargic. More serious affects of greater dehydration include headache, muscle weakness, and dizziness; and extreme dehydration can require administering intravenous fluids and electrolytes to avoid death. Other ways that drinking water can help us feel good and stay healthy include preventing constipation, keeping our skin moist, lubricating joints and dissolving nutrients we eat to aid our body’s absorption ability.

How much water should I be drinking?

Many of us have heard the advice to drink 8 to 10 cups of water each day on top of water absorbed in our food, although 2004 standards issued by the Institute of Medicine recommend 11 8-oz cups for women (almost three quarts) and 16 8-oz cups for men (a gallon). Using our common sense, we know that the actual amount of water we need to stay hydrated varies depending on how much water we consume in our food (the rule of thumb is that our food represents 20-30% of our required water intake), and how much water we excrete due to urination, sweat, and the temperature and humidity in our environment. Other factors affecting water requirements include our age, our level of physical activity, any medications we may be taking, and certain medical conditions. Generally speaking, if you are urinating frequently, and if your urine is clear or pale yellow, you are well-hydrated. Populations at risk of dehydration who should take care to drink frequently are the elderly, athletes, children in summer sports programs, people whose bodies are fighting off infection, and pregnant women.

While you may be managing your calories by limiting sugary drinks, for purposes of staying hydrated you can include most liquids in your calculations, such as herbal teas, decaffeinated soft drinks, fruit juices, and sport drinks. Even caffeinated drinks add water to your system, although less so due to caffeine’s diuretic affects. While you may want to limit caffeine intake for other health reasons, you can generally count ½ of your coffee or tea intake, perhaps more, towards your daily water quotient. The only beverages that nearly everyone agrees should not be counted are wine, beer and liquor, as alcohol is a potent diuretic. Combined with the lack of humidity in a pressurized airplane cabin, it’s not hard to see that drinking alcohol on a flight can badly sap your energy by the time you disembark at your destination.

Finally, when determining how much water to drink, even water is subject to the adage, “Too much of a good thing….” The water in your body carries electrolytes such as sodium, potassium, calcium, magnesium, and chloride, which carry positive and negative charges whose function is to ensure water is properly distributed throughout the body. Excessive water consumption can cause a condition called hyponatremia: sodium dilution from over-drinking “plain” (low-electrolyte) water. Symptoms include diarrhea, vomiting, muscle tremors and brain swelling. There have been occasional deaths due to deliberate ingestion of many gallons of water in a short time during fraternity hazings, although the more typical situation is endurance athletes who rehydrate with too much plain water. Contrary to popular perceptions, many sports drinks, although delivering water and complex carbohydrates, do not deliver electrolytes (check the label). If you perform cardiovascular exercise for periods longer than 60-90 minutes at a time, you should familiarize yourself with how certain foods and dietary supplements can help you maintain and restore your electrolyte balance. And as always, talk to a nutritionist and your doctor before making any major changes in your eating and or drinking habits.

Are bottled and filtered water better for me than New York City tap water?

Many people report that the lower risk of contaminants justifies the price of bottled and filtered water. Although the Natural Resources Defense Council (NRDC), an advocacy group, has found contaminants in both tap water and bottled water across the country, New York tap water is often heralded as among the most pure, healthiest and best tasting in the country, thanks to a farsighted water supply system installed between 1842 and 1927. This system delivers 1.4 billion gallons of water each day to 9 million people in NYC and the surrounding counties, consistently earning high health marks in the NYC Department of Environmental Protection’s annual public report on its comprehensive testing of the city’s tap water. (For the official report, visit the NYCDEP’s water quality page, www.nyc.gov/htm1/dep/htm1/watersup.html.) The NRDC does supply on its website comprehensive information on holding governments and bottled water companies accountable for adhering to water safety standards, and a discussion of when those standards might not be applied. If you have any doubts about the quality of tap water in your neighborhood, visit the U.S. Environmental Protection Agency’s site: www.epa.gov/Region2/water/nycshed/ or call the EPA’s Safe Drinking Water Hotline at 800-426-4791.

Three of the key contaminants of concern to public health officials are lead, harmful bacteria and viruses, and disinfectants or disinfectant byproducts. Although NYC water supplies are nearly free of lead, if you are concerned about lead leeching from pipes into your home’s water, you can call 311 for a free testing kit. Another small concern is that NYC tap water is treated with chlorine to keep bacteria and viruses at their current low levels; chlorine and its byproducts may slightly increase the risk of certain types of cancers. Others have raised concerns that bottled water may carry a carcinogenic risk of storing water in plastic bottles for long periods of time. If these risks, though small, concern you, there are many resources available for further research at government and non-profit advocacy group websites.

Finally, the Columbia University’s Health Q&A internet service, “Go Ask Alice,” offers a useful summary of the different types of home water filtration systems, as well as some definitions of various types of bottled water, such as “spring water,” “mineral water,” and the chic-sounding “artesian water” (http://www.goaskalice.columbia.edu/2007.html). “Alice” concludes that the primary difference in health benefits between these waters may be the healthy choices you make on how to spend the money you save by drinking tap water.

What is the latest news on fluoride additives in our drinking water?

Fluoridation of tap water began in this country in Grand Rapids, Michigan, in 1945 and has been highly controversial ever since. In NYC, we have access to both fluoridated tap and bottled water. Proponents, such as the American Dental Association and fluoride toothpaste manufacturers, attribute a 15-40% drop in cavities to fluoridation of public water systems, which now reach over 60% of American households. These benefits may be lower today than in 1945, however, as most Americans now brush their teeth with fluoride toothpaste at least once per day. Opponents object to the government forcing us to consume fluoride which could just as easily be ingested voluntarily; and since at least the 1960s, concerns have been raised about the health risks of consuming fluoride for certain subpopulations. Re: the cavity-prevention qualities of fluoride, the more moderate opponents of water fluoridation argue that fluoride is more effective anyway as a topical application than a dietary supplement.

One risk of excess fluoride on young children’s teeth is a cosmetic condition called enamel fluorosis, which is the occurrence of bright white spots on teeth prior to their enamel being formed (about age nine). The condition is not generally believed to carry any health risks. As U.S. fluoridation levels for cavity prevention are generally maintained at only 3-6% of the levels believed to cause fluorosis, the cause is more typically a child’s fluoride ingestion from other sources, such as unsupervised toothpaste use. If you suspect enamel fluorosis in a child you know, contact the child’s dentist for advice about reducing fluoride intake and the risk of fluorosis in the child’s permanent teeth.

Another risk receiving much more than passing interest is that of osteosarcoma, a form of bone cancer, in boys under 20 years old. Since the 1970s various studies have found higher levels of this cancer in communities with water fluoridation and many public health advocates have urged more studies to rule out linkage between the two. Other studies have concluded no relationship could be found, and the Centers for Disease Control and Prevention has lauded water fluoridation as one of the top 10 public health successes of the 20th century. To find out if a boy you know should be ingesting less fluoride, speak to your doctor and dentist.

A few words on “water ionization” and “water oxygenation” systems

“Water ionization” and “water oxygenation” system manufacturers speak of changing the chemical properties of water in ways which can prevent disease, but many nutrition and sports-medicine websites challenge the physical possibility of changing the chemical properties of water in any meaningful way, much less the validity of evidence supporting the manufacturers’ health benefit claims. One website pointed out that increasing oxygen in our cells by breathing more deeply is cheaper (free, in fact) and much more efficient (since we are not fish)! As some of these water systems cost more than $1000, we recommend researching the evidence thoroughly and drawing your own informed conclusions before taking the plunge, so to speak.

Additional sources of information

Besides the sources cited above, we found the following websites provide useful information on the health effects of drinking water and access to recent scientific studies on related topics. So if this article has whetted your appetite, dive into “drinking water” in your web search engine, and you will find yourself awash in information, every pun intended.

Resources:

National Sanitation Foundation for a veritable sea of information on both bottled and tap water: http://www.nsf.org/consumer/

U.S. Environmental Protection Agency (EPA) for information on safe water standards and national water policy: http://epa.gov/safewater/

Natural Resources Defense Council (NRDC) on the environmental and public health aspects of clean water supplies: http://www.nrdc.org/water/drinking/default.

Mayo Clinic for links to articles on how much water to drink, dehydration and hyponatremia: http://www.mayoclinic.com/health/water/NU00283

Centers for Disease Control and Prevention on water fluoridation: http://www.cdc.gov/oralhealth/waterfluoridation/safety.htm#1

National Academies Press on the health risks of excessive fluoride intake, in “Fluoride in Drinking Water: A Scientific Review of EPA’s Standards, 2006″: (http://fermat.nap.edu/catalog/11571.html#toc)

For information about water fluoridation in your state: http://apps.nccd.cdc.gov/MWF/Index.asp

American Dental Association on enamel fluorosis http://www.ada.org