Chapter 116 of the book Self-Help Stuff That Works

by Adam Khan

THERE ARE BASICALLY TWO WAYS to talk to your loved ones.

The first is to hide some of your true wants and feelings, either by not expressing them at all or by being so indirect and "nice" that your loved ones don't know for sure how you really feel.

The other way is to be honest about what you want and feel.

The results of these two approaches are drastically different. When you hide what you really want and feel, guess what? You still want and feel those things. Remember that point; it is important. You're afraid to say what you really want and feel because you think you'll be rejected, disapproved of, or disliked. The love might be withdrawn. Saying what you want or feel might start a fight or hurt someone's feelings.

Even though you have all these perfectly good and valid reasons to refrain from speaking up, that doesn't alter the fact that you still feel what you really feel and want what you actually want.

And those wants and feelings will come out, one way or another. Consciously or unconsciously, you'll try to manipulate the other person into doing what you want and your feelings will be expressed, no matter how hard you try to hide them. There are many ways. You can hint, tease, argue about it indirectly, try to make the other person feel guilty for not doing something, "accidentally" make mistakes, and so on. Not to mention that your body language and the subtle expressions on your face give you away. Your wants and feelings come out, even against your will.

The problem with these indirect, nonverbal, and often unconscious ways of communicating your feelings and wants is that they are confusing. And the confusion causes problems in close relationships.

It is difficult to be honest, and it can sometimes cause an upset. But honesty is not confusing. When you are saying what you really want and feel, problems can be worked out and solved. You can't solve a problem when you don't know what it's about.

So that's the choice: Withhold the truth or say it.

 

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Of course, very few people are on either extreme. Every one of us hides our intentions and feelings from our loved-ones now and then, and at other times we're pretty frank. But any effort we make to move ourselves further toward the honest end of the spectrum will improve the quality of our close relationships over time.

If you want to be intimate, speak freely and honestly.

Here's how to create a spirit of willing cooperation in the people you work with and live with.
How to Get What You Want From Others

Being able to express your feelings is an important part of intimate communication. But there are times and places where the ability to mask your feelings is important too.
The Power of a Poker Face

Close friends are probably the most important contributor to your lifetime's happiness and your health.
How to Be Close to Your Friends

If you have hard feelings between you and another person, you ought to read this.
How to Melt Hard Feelings

Is it necessary to criticize people? Is there a way to avoid the pain involved?
Take the Sting Out

Would you like to improve your ability to connect with people? Would you like to be a more complete listener? Check this out.
To Zip or Not to Zip

next: Too Polite?

Learn about different massage techniques and whether massage is helpful for treating depression, anxiety, stress, ADHD in children and other mental health and health conditions.

Before engaging in any complementary medical technique, you should be aware that many of these techniques have not been evaluated in scientific studies. Often, only limited information is available about their safety and effectiveness. Each state and each discipline has its own rules about whether practitioners are required to be professionally licensed. If you plan to visit a practitioner, it is recommended that you choose one who is licensed by a recognized national organization and who abides by the organization's standards. It is always best to speak with your primary health care provider before starting any new therapeutic technique.

• Background
• Theory
• Evidence
• Unproven Uses
• Potential Dangers
• Summary
• Resources

Background

Massage techniques have been practiced for thousands of years in many cultures. There are references to massage in ancient records of Chinese, Japanese, Arabic, Egyptian, Indian, Greek and Roman nations.

Massage spread throughout Europe during the Renaissance. The basis of Swedish massage was developed in the 1800s by Per Henrik Ling (1776-1839) as a combination of massage and gymnastic exercises. George and Charles Taylor, two physicians who had studied in Sweden, introduced massage therapy to the United States in the 1850s. By the early 1930s, massage became a less prominent part of American medicine because of increased focus on the biological sciences. Interest increased in the 1970s, when massage became popular among athletes as a therapy to promote musculoskeletal injury healing and pain reduction, as well as well-being, relaxation, stress relief, sleep enhancement and quality-of-life.

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Many approaches can be classified as massage therapy. Most involve the use of fixed or moving pressure or manipulation of the muscles and connective tissues. Practitioners may use their hands, forearms, elbows or feet with or without lubricants to aid the smoothness of massage strokes. Touch is central to massage and is used by therapists to locate painful or tense areas, to determine how much pressure to apply and to establish a therapeutic relationship with clients.

Swedish massage involves several techniques:

• Effleurage — Superficial stroking in a direction away from the heart or deep stroking toward the heart
• Friction — Deep muscle stimulation using the palm, elbow and forearm
• Petrissage — Kneading in a circular pattern using fingers and thumbs, with the goals of enhancing circulation and stimulating muscle tissue
• Tapotement — Rhythmic movements such as slapping or tapping to stimulate muscles, often used for athletes before competitions
• Vibration — Delivered by the therapist's hands or by an electric vibrator

There are many other massage approaches used throughout the world. Examples include:

• Aromatherapy massage uses essential oils with the goal of enhancing healing and relaxation.
• Bindegewebsmassage focuses on connective tissues between the skin and muscles and is based on the theory that some ailments are caused by imbalances in these tissues.
• Classical massage aims to provide calmness and relaxation and to encourage self-healing and revitalization.
• Craniosacral therapists strive to locate and realign imbalances or blockages that are thought to exist in the soft tissues or fluids of the sacrum, head and spine.
• Deep tissue massage uses slow strokes, friction and direct pressure across the muscles with fingers, thumbs or elbows, often with the goal of improving chronic muscular tension.
• Esalen massage focuses on generating a deep state of relaxation and is often combined with other forms of massage.
• Ice massage has been studied for knee osteoarthritis, exercise-induced muscle damage and labor pain, with inconclusive results.
• Jin Shin Do involves finger pressure to acupoints of the body to release muscular tension or stress.
• Manual lymph drainage uses light, rhythmic strokes with the goals of improving lymphatic flow and reducing edema, inflammation or neuropathy.

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• Myofascial release may be used by physical therapists, chiropractors or massage therapists. This approach involves gentle traction, pressure and body positioning to relax and stretch soft tissues.
• Neuromuscular massage, triggerpoint massage and myotherapy are forms of deep massage administered to specific muscles or nerve points, used to release trigger points or entrapped nerves and to relieve pain.
• On-site or chair massage is administered to the upper body of fully clothed clients.
• Physiotherapy aims at stabilization of the lumbar spine in a flexed posture rather than in lumbar lordosis and at increased overall physical fitness.
• Polarity treatment is based on the concept that rebalancing the body's energy fields with gentle massage can improve health and well-being.
• Reflexology aims to return the body to its natural balance by targeting certain areas on the feet (or ears) believed to correspond with specific body parts or organs.
• Rolfing® structural integration involves deep tissue massage aimed at relieving stress as well as improving mobility, posture, balance, muscle function and efficiency, energy and overall well-being.
• Shiatsu emphasizes finger pressure not only at acupoints but also along the body's meridians. This type of massage can incorporate palm pressure, stretching and other manual techniques.
• Sports massage is similar to Swedish massage but is adapted specifically for athletes.
• St. John's neuromuscular technique may be used for chronic pain conditions that involve the musculoskeletal system.
• The Trager approach involves relearning patterns of movement to improve efficiency and well-being.
• Tibetan massage may be performed on any of several areas of the body, based on the practitioner's judgment of the patient's energy flow (for example, head, neck, vertebra, abdomen, legs).

Many other variations and styles of massage or touch exist, often developed in specific regions of the world.

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Most massage approaches involve the client lying face down on a platform or table with a sheet covering the lower body. Depending on the technique, sessions may last from 15 to 90 minutes. Many clients fall asleep during therapy. Environment is considered integral to massage therapy and often consists of a comfortable, warm, quiet location. Soothing repetitive low-volume music or sounds may be played in the background.

Massage therapy practices may be based in a therapist's home, a private practice office, a hospital, spa, athletic club, hair salon, hotel or airport or outdoors. Some practitioners will travel to a client's home or office. Sports massage may be administered in a gym or locker-room setting.

In the United States, licensure requirements for administering massage therapies vary from state to state. Some practitioners are licensed as nurses, physical therapists, massage therapists or other types of health care professionals. Some have attended extensive programs that grant professional degrees. However, many massage practitioners are not licensed, and national or international organizations have not agreed on standards. The International Therapy Examinations Council offers testing in this area.

It is recommended that patients seeking a massage therapist for medical reasons discuss the choice of massage practitioner with their primary health care provider. References and training history should be checked before starting a therapeutic program.

Theory

There are many theories about how massage may work, although none has been scientifically proven. There is limited research in this area. It is suggested that massage may have local effects on muscles and soft tissues, reduce inflammation, soften or stretch scar tissue, reduce the buildup of lactic acid in muscles, stimulate oxygenation of tissues, break up adhesions, induce muscle fiber relaxation and stimulate healing of connective tissues or damaged muscles. Other proposed effects include immune system enhancement, reduction of blood pressure, central nervous system relaxation and sedation, parasympathetic stimulation, blockage of sensations from nerves that sense pain (the "gate theory"), stimulation of blood and lymphatic circulation, decreases in heart rate, increases in skin temperature, endorphin release, alteration of hormones such as cortisol, stimulation of substance P release, stimulation of somatostatin release, sleep enhancement or removal of blood toxins. Practitioners suggest that Swedish massage may assist the body in delivering nutrients and removing waste products from various tissues.

There is little high-quality research of massage. Scientifically based conclusions about the effectiveness of massage cannot be drawn at this time for any health condition.

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Evidence

Scientists have studied massage for the following health problems:

Anxiety
There are several trials of massage in individuals with anxiety. Studies have focused on patients with cancer, chronic illnesses, headache, dementia, multiple sclerosis, fibromyalgia, anxiety, stress, depression or premenstrual syndrome; before or during medical procedures; and agitation in elderly institutionalized patients. However, most research is not well designed. Better studies are necessary to make a scientifically based recommendation.

Asthma
There is promising initial evidence that massage may improve lung function in children with asthma. Better research is necessary to make a firm conclusion.

Back pain
Several studies in humans report temporary improvements in low back pain with various massage techniques. However, most studies are not well designed. Better-quality research is necessary to make a scientifically based recommendation.

Constipation
A small number of studies report that abdominal massage may be helpful in patients with constipation. Overall, these studies are not well designed or reported. Better-quality research is necessary to make a scientifically based recommendation.

Musculoskeletal conditions/chronic pain
Preliminary research reports that massage may help relieve chronic pain. Soft tissue massage may also improve range of motion and function. Further well-designed study is needed to confirm these results.

Dementia
Several studies have used massage (with or without essential oils) in patients with dementia living in chronic care facilities in order to assess effects on behavior. Early evidence suggests that aromatherapy with essential oils may reduce agitation in patients with dementia, although the effects of massage itself are not clear.

Depression
There is not enough scientific information to conclude if massage is helpful in patients with major depressive disorder, situational mood disorder, critical illness, pregnancy, or postpartum depression (including infant massage).

Fibromyalgia
A small number of studies report that massage may improve pain, depression and quality of life in patients with fibromyalgia. Additional research is necessary to form a scientifically based recommendation.

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Iliotibial band friction syndrome
There is not enough scientific information to conclude if massage is helpful in patients with iliotibial band friction syndrome, a painful tendonitis of the lower leg that occurs in joggers and other athletes.

Multiple sclerosis
Initial research reports that massage may improve anxiety, depression, self-esteem, body image and social functioning in patients with multiple sclerosis. Benefits on the disease process itself have not been well evaluated. Additional research is necessary to make a firm conclusion.

Infant development, neonatal care
Therapists or mothers sometimes use massage in pre-term infants with the goal of improving infant development and weight gain. Although several studies are reported, it remains unclear if this is a beneficial therapy.

Postoperative recovery
Several massage approaches have been used after surgery with the aim of improving recovery and decreasing pain. Better research is necessary to make a firm conclusion.

Pregnancy and labor
Massage approaches are sometimes used during pregnancy and labor, more commonly in Europe than in the United States. Reduction of pain or anxiety is often the goal. There is not enough research to determine if this is effective or safe. Pregnant women should speak with their health care provider before beginning massage therapy, particularly if massage to the abdominal area is involved.

Premenstrual syndrome
There is not enough scientific information to conclude if massage is helpful in women with premenstrual syndrome or with premenstrual dysphoric disorder.

Well-being in cancer patients
Massage techniques are frequently used in patients with cancer, with the goals of improving well-being and reducing anxiety. Although there are many anecdotal reports of benefits, there is not enough reliable scientific evidence to draw a firm conclusion.

Immune function
Preliminary evidence suggests massage therapy may preserve immune function. One randomized study reported that massage treatment maintained immunocompetence in HIV-1-infected children without antiretroviral medication. Another study stated an increase in lymphocytes in women with breast cancer. Further research is needed before a firm conclusion can be made.

Attention-deficit hyperactivity disorder (ADHD)
Preliminary research suggests massage therapy improves mood and behavior in children with ADHD. Additional evidence is needed before a recommendation can be made.

 

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Unproven Uses

Massage has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially life-threatening. Consult with a health care provider before using massage for any use.

Alzheimer's disease Athletic performance Atopic dermatitis Autism Bronchitis Bulimia Burns Cancer Chronic fatigue syndrome Chronic pain Coccygodynia Colitis Confidence building Crohn's disease Cystic fibrosis Diabetes Diabetic neuropathy Diarrhea Diverticulitis Eczema Endorphin release stimulation Enhanced breathing Enhanced circulation Enhanced digestion Enhanced immunity Enhanced lymph flow Exercise-induced muscle damage Exercise-related pain Gastritis Headache Heart rate reduction High blood pressure HIV/AIDS Hormonal imbalances Increased alertness Increased insulin activity at injection sites Increased parasympathetic nervous system activity Inflammation Inflammatory bowel disease

Insomnia Intensive care unit stress Irritable bowel syndrome Joint disorders Leukemia Mastectomy recovery Menstrual cramps Migraine Mother-infant bonding Muscle relaxation Muscle spasm Muscle wasting/weakness Nausea Neurocirculatory asthenia Osteoarthritis Pain Paralysis rehabilitation Postpartum hemorrhage Posture improvement Pressure ulcers Prostatitis Pruritis Recovery from surgery Repetitive strain injury Restless legs syndrome Rheumatoid arthritis Seizure disorder Self-image improvement Sinusitis Skin care Sleep disorders Smoking cessation Sports-related injuries Sprains Strains Temporomandibular joint disorder Tendonitis Ulcerative colitis Weight loss

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Potential Dangers

Reports of adverse effects of massage are rare, although this area is not well studied. Bone fractures, discomfort, skin bruising, swelling of massaged tissues, a case of liver hematoma (internal bruising), cerebrovascular accidents, displacement of a ureteral stent, embolization of a kidney, leg ulcers, nerve damage, posterior interosseous syndrome, pseudoaneurism, pulmonary embolism, ruptured uterus, strangulation of neck, thyrotoxicosis and various pain syndromes have been reported.

Areas of the body where there are fractures, weakened bones from osteoporosis or cancer, open or healing skin wounds, skin infections, recent surgery or blood clots should not be massaged. Individuals with bleeding disorders or low platelet counts or those taking blood-thinning medications (such as heparin or warfarin) should avoid vigorous massage. Allergies or skin irritation can occur with some essential oils used in massage.

Pregnant women should speak with their health care provider before beginning massage therapy, particularly if massage to the abdominal area is involved. In general, touch-based therapies should be used cautiously in people with a history of physical abuse. Massage should not cause pain to the client.

Massage should not be used as a substitute for more proven therapies. Massage has not been evaluated as a method to diagnose medical conditions.

Summary

Various types of massage are used throughout the world for many health conditions. Relief of pain, anxiety, muscle spasm or tension or depression and athletic event preparation are common uses. There is limited reliable scientific evidence in these areas, and it remains unclear if massage is effective for any specific health condition. Massage should not be used as a substitute for more proven therapies, and it is not a diagnostic technique. Massage should be used cautiously in pregnant women and in those at risk of fracture or bleeding.

The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.

back to: Alternative Medicine Home ~ Alternative Medicine Treatments

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Resources

1. Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
2. National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research

Selected Scientific Studies: Massage

Natural Standard reviewed more than 1,070 articles to prepare the professional monograph from which this version was created.

Some of the more recent studies are listed below:

1. Aly H, Moustafa MF, Hassanein SM, et al. Physical activity combined with massage improves bone mineralization in premature infants: a randomized trial. J Perinatol 2004;24(5):305-309.
2. Blanc-Louvry I, Costaglioli B, Boulon C, et al. Does mechanical massage of the abdominal wall after colectomy reduce postoperative pain and shorten the duration of ileus? Results of a randomized study. J Gastrointest Surg 2002;6(1):43-49.
3. Bowles EJ, Griffiths DM, Quirk L, et al. Effects of essential oils and touch on resistance to nursing care procedures and other dementia-related behaviours in a resident care facility. Internat J Aromather 2002;12(1):22-29.
4. Brosseau L, Casimiro L, Milne S, et al. Deep transverse friction massage for treating tendonitis. Cochrane Database Syst Rev 2002;(2):CD003528.
5. Callaghan MJ. The role of massage in the management of the athlete: a review. Br J Sports Med 1993;27(1):28-33.
6. Diego MA, Field T, Sanders C, et al. Massage therapy of moderate and light pressure and vibrator effects on EEG and heart rate. Int J Neurosci 2003;114(1):31-44.
7. Ernst E. The safety of massage therapy. Rheumatology (Oxford) 2003;Sep, 42(9):1101-1106.
8. Epub 2003;May 30. Review. Ernst E. Does post-exercise massage treatment reduce delayed onset muscle soreness? A systematic review. Br J Sports Med 1998;32(3):212-214.

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1. Ernst E. Massage therapy for low back pain: a systematic review. J Pain Symptom Manage 1999;17(1):65-69.
2. Field T, Diego MA, Hernandez-Reif M, et al. Massage therapy effects on depressed pregnant women. J Psychosom Ostet Gynaecol 2004;25(2):115-122.
3. Field T, Henteleff T, Hernandez-Reif M, et al. Children with asthma have improved pulmonary functions after massage therapy. J Pediatr 1998;132(5):854-858.
4. Field T. Massage better than relaxation therapy for fibromyalgia. J Clin Rheumatol 2002;8(2):72-76.
5. Fogel GR, Cunningham PY 3rd, Esses SI. Coccygodynia: evaluation and management. J Am Acad Orthop Surg 2004;Jan-Feb, 12(1):49-54.
6. Forchuk C, Baruth P, Prendergast M, et al. Postoperative arm massage: a support for women with lymph node dissection. Cancer Nurs 2004;27(1):25-33.
7. Furlan AD, Brosseau L, Imamura M, et al. Massage for low-back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine 2002;27(17):1896-1910.
8. Gauthier DM. The healing potential of back massage. Online J Knowl Synth Nurs 1999;Jun 17, 6:5.
9. Goffaux-Dogniez C, Vanfraechem-Raway R, Verbanck P. Appraisal of treatment of the trigger points associated with relaxation to treat chronic headache in the adult: relationship with anxiety and stress adaptation strategies. Encephale 2003;Sep-Oct, 29(5):377-390.
10. French. Hasson D, Arnetz B, Jelveus L, Edelstam B. A randomized clinical trial of the treatment effects of massage compared to relaxation tape recordings on diffuse long-term pain. Psychother Psychosom 2004;Jan-Feb, 73(1):17-24.
11. Hernandez-Reif M, Ironson G, Field T, et al. Breast cancer patients have improved immune and neuroendocrine functions following massage therapy. J Psychosom Res 2004;57(1):45-52.
12. Hernandez-Reif M, Martinez A, Field T, et al. Premenstrual symptoms are relieved by massage therapy. J Psychosom Obstet Gynaecol 2000;21(1):9-15.
13. Howatson G, Van Someren KA. Ice massage: effects on exercise-induced muscle damage. J Sports Med Phys Fitness 2003;Dec, 43(4):500-505.
14. Khilnani S, Field T, Hernandez-Reif M, et al. Massage therapy improves mood and behavior of students with attention-deficit/hyperactivity disorder. Adolescence 2003;38(152):623-638.
15. Muller-Oelinghausen B, Berg C, Scherer P, et al. [Effects of slow-stroke massage as complementary treatment of depressed hospitalized patients]. Dtsch Med Wochenschr 2004;129(24):1363-1368.
16. Moyer CA, Rounds J, Hannum JW. A meta-analysis of massage therapy research. Psychol Bull 2004;130(1):3-18.
17. Piotrowski MM, Paterson C, Mitchinson A, et al. Massage as adjuvant therapy in the management of acute postoperative pain: a preliminary study in men. J Am Coll Surg 2003;197(6):1037-1046.
18. Remington R. Calming music and hand massage with agitated elderly. Nurs Res 2002;Sep-Oct, 51(5):317-323.
19. Shor-Posner G, Miguez MJ, Hernandez-Reif M, et al. Massage therapy in HIV-1 infected Dominican children: a preliminary report on the efficacy of massage therapy to preserve the immune system in children without antiretroviral medication. J Altern Complement Med 2004;10(6):1093-1095.
20. Trotter JF. Hepatic hematoma after deep tissue massage. N Engl J Med 1999;341(26):2019-2020.
21. van den Dolder PA, Roberts DL. A trial into the effectiveness of soft tissue massage in the treatment of shoulder pain. Aust J Physiother 2003;49(3):183-188.
22. Vickers A, Ohlsson A, Lacy JB, et al. Massage for promoting growth and development of preterm and/or low birth-weight infants (Cochrane Review). The Cochrane Library 2002;(2).
23. Walach H, Guthlin C, Konig M. Efficacy of massage therapy in chronic pain: a pragmatic randomized trial. J Altern Complement Med 2003;Dec, 9(6):837-846.
24. Waters BL, Raisler J. Ice massage for the reduction of labor pain. J Midwifery Womens Health 2003;Sep-Oct, 48(5):317-321.
25. Westcombe AM, Gambles MA, Wilkinson SM, et al. Learning the hard way! Setting up an RCT of aromatherapy massage for patients with advanced cancer. Palliat Med 2003;Jun, 17(4):300-307.
26. Wunschmann BW, Sigl T, Ewert T, et al. Physical therapy to treat spinal stenosis. Orthopade 2003;Oct, 32(10):865-868. Review. German.

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Good relationships are at the core of a happy life. If you are dissatisfied with your life, one of the tasks you and your therapist face is to explore the true nature of your relationships (parents, spouse/lover, friends, children, boss, etc.) past and present. The "true nature" is not necessarily what appears on the surface. We often "make" relationships work by adapting ourselves to them. For example, we may learn to ask for as little as possible from a depressed parent, or not to challenge an angry spouse. Over time, these responses become second nature, and we forget that we are being reactive. As a result, we may feel dissatisfied, but we don't know why.

Just as the "true nature" of relationships may not be what appears on the surface, so to, the "true nature" of communication may be disguised. Hidden messages are sent and received in all relationships. Hidden messages are those that are delivered "between the lines," verbally and non-verbally. They can be positive or negative, affirming or destructive. Often, these messages are more powerful than the ones directly spoken.

Let me give you a common example of what I mean by "hidden message." I'm sure you know people who, whenever you present a situation that has been troubling you, respond: "This is what you should do..." and proceed to describe how you should solve your problem. On the surface this advice appears to be a helpful response (and indeed sometimes it is). But there also may be an hidden message. What might the hidden message be from the advice giver? There are a number of possibilities:

1. Look at me---I am so smart!
2. Just do this and stop bothering me; I have troubles of my own.
3. Your situation makes me anxious; if I tell you what you should do, I'll feel less anxious.
4. I love you and I'm trying to be helpful.
5. All or some of the above.

As you can see, communication between two human beings is a complicated affair. While a message may appear to be straight-forward on the surface, underneath it may be constructive, destructive, or both. A skilled therapist is often needed to identify the hidden messages that fly back and forth between two people. This is especially true in couples therapy.

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The hidden messages received as children, both positive and negative, have far reaching and powerful effects. Our sense of self and sometimes even our life goals are strongly influenced by these messages. They are deeply woven into the fabric of who we are and what we want, and they impact the kinds of relationships we choose later in life. How does this happen? Let me give an example.

Consider a child who's parents rarely "heard" or valued what he/she was saying. While the parents were able to repeat their child's words back (and on the surface may have appeared to be empathic), they rarely paused to think about the meaning of those words from the child's perspective and savor his or her unique experience of the world. Perhaps the parent was more interested in sharing their thoughts and feelings because they desperately needed to be heard themselves, or, alternatively, they were too stressed or unhappy to listen. Either way, the hidden message to the child is: "Your 'voice' is not important. " Or, in the most severe circumstances: "You have no voice--you barely exist."

What happens when such a child grows up and looks for adult relationships? Here are two possible scenarios. The first is that the person will chronically be unable to hear what is at the heart of their spouse's/lover's communication--instead they will be chronically focused on being "heard' themselves. The person is "starved" for attention, and there is little to spare for anyone else. Interestingly, such a person may not realize that their needs supersede everyone else's. In fact, they may view everyone else as getting too much and themselves, too little. They may become just like the parent or parents who could not listen (see Voicelessness: Narcissism for more on this type of person.)

Alternatively, a person from this background might constantly seek out lovers who are similar to his/her parents, people who cannot "hear." As a result, the person receives the same message, "your voice is not important," over and over again. Why would a person want to put themselves back in a situation that was so unsatisfying? Two reasons: first, "not being heard" feels familiar. And second, there is a continued wish to make someone who doesn't "hear" hear, someone who doesn't value anyone, value them (see Little Voices and Why Do Some People Choose One Bad Relationship After Another? for more on this type of person.)

Unfortunately, many adults are ruled by hidden messages from childhood. A therapist, skilled in "between-the-lines" communication can expose them and loosen their hold. This is one of the values of psychotherapy.

About the author: Dr. Grossman is a clinical psychologist and author of the Voicelessness and Emotional Survival web site.

next: "Better Communication": The Great Myth of Couples Therapy

Books that offer support and insight into healing, wholeness, personal growth, psychotherapy and more.

"I suggest that the only books that influence us are those for which we are ready, and which have gone a little further down our particular path than we have gone ourselves."
-E. M. Forster

For as long as I can remember, I've always loved books -- they have taught, comforted, entertained, and helped to create me. Below is a list of books that I have found to be particularly valuable. By no means is this a complete list. I have loved many books, far too many to include on this page.

Many who have visited this page have recommended books to me and I thank you for sharing your discoveries.Several kind folks (including my wonderful webmaster at 1k.com) have also suggested that I place a link to Amazon in order to make ordering simple for those who'd like to purchase (as well as to recoup some of the expenses of maintaining this website.) Finally, I've heeded their advice (if you were one of those who made the suggestion -thanks for your patience with me.)

If you would like more information about any one of the books listed that has an "order now" link beside it, just click on the link and you'll be able to read reviews and even book samples in some cases. I present to you the following:

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INDEX:

• Aging
• The environment
• For Children and Young Adults
• Health and Healing
• Journaling and Creativity
• Life Styles and Values
• Loss
• For and about Men
• Parenting
• Psychotherapy
• Recovery
• Relationships
• Spirituality
• Transitions
• For and about Women
• Women's Fiction
• Work
• Thought Provoking Fiction

Aging

"Age Happens: The Best Quotes About Growing Older" edited by Bruce Lansky Order Today!

"Aging, Spirituality, and Religion: A Handbook" edited by Melvin Kimble Order Today!

"From Age-Ing to Sage-Ing" by Zalman Shalomi-Schachter Order Today!

"Listening To Midlife: Turning Your Crisis into a Quest" by Mark Gerzon Order Today!

"New Passages: Mapping Your Life Across Time" by Gail Sheehy Order Today!

"The Green Pharmacy : New Discoveries in Herbal Remedies for Common Diseases and Conditions from the World's Foremost Authority on Healing Herbs by James A. Duke

"Women as Elders: Images, Visions and Issues" edited by Marilyn Bell Order Today!

"The Measure of My Days" by Florida Scott-Maxwell Order Today!

"Why We Age : What Science Is Discovering About the Body's Journey Throughout Life" by Steven N. Austad Order Today!

"1003 Great Things About Getting Older" edited by Lisa Birnbach Order Today!

"The Girls with the Grandmmother Faces: A Celebration of Life's Potential for Those Over Fifty-five" by Frances Weaver Order Today!

"The Last Gift of Time: LIfe Beyond Sixty" by Carolyn G. Heilbrun Order Today!

"Be an Outrageous Older Woman" by Ruth Harriet Jacobs Order Today!

For Children and Young Adults

"Glory! To the Flowers by Maggie Steincrohn Davis Order Today!

"A Ring of Endless Light" by Madeleine L' Engle Order Today!

"Baby Alicia is Dying" by Lurlene McDaniel Order Today!

"Charlottes Web" by E.B. White Order Today!

"Chicken Soup for the Teenage Soul" by Jack Canfield Order Today!

"Emily of New Moon" by Lucy Maud Montgomery Order Today!

"Goodnight Moon" by Margaret Wise Brown Order Today!

"Hester in the Wild" by Sandra Boynton (currently out of print)

"Island of the Blue Dolphins" by Scott O'Dell Order Today!

"Miss Rumphius" by Barbara Cooney Order Today!

"The Black Stallion" by Walter Farley Order Today!

"The Giving Tree" by Shel Silverstein Order Today!

"The Secret Garden" by Frances Hodgson Burnett Order Today!

"A Little Princess" by Frances Hodgson Burnett and Tasha Tudor Order Today!

Environment

"The Lost Gospel of the Earth: A Call for Renewing Nature, Spirit, and Politics" by Tom Hayden Order Today!

"Earth in the Balance: Ecology and the Human Spirit" by Al Gore Order Today!

"Building the Green Movement" by Rudolph Bahro (out of print)

"Hope, Human and Wild: True Stories of Living Lightly on the Earth" by Bill McKibben Order Today!

"Heaven is Under Our Feet" edited by Don Henley and David Marsh Order Today!

"50 Simple Things You Can Do to Save the Earth" by the Earthworks Group (out of print)

"50 Simple Things Your Business Can Do to Save the Earth" by The Earthworks Group Order Today!

"Man and Nature" by George Perkins Marsh (out of print)

"Muddling Toward Frugality" by Warren Johnson (out of print)

"The Green Lifestyle Handbook: 1001 Ways You Can Heal the Earth" edited by Jeremy Rifkin (out of print)

"The Healing Earth: Nature's Medicine For the Troubled Soul" by Philip Sutton Chard (out of print)

"The Power of Place: How our Surroundings Shape our Thoughts, Emotions and Actions" by Winnifred Gallagher Order Today!

"The Wilderness Reader" edited by Frank Bergon

Health and Healing

"A Different Kind of Healing" by Oscar Janiger and Philip Goldberg (out of print)

"Healing into Life and Death" by Stephen Levine Order Today!

"Love, Medicine and Miracles" by Bernie Seigel Order Today!

"Living With Chronic Illness: Days of Patience and Passion" by Cheri Register Order Today!

"Mind as Healer, Mind as Slayer" by Kenneth Pelletier Order Today!

"The Insider's Guide to HMO's : How to Navigate the Managed-Care System and Get the Health Care You Deserve" by Alan J. Steinberg, Alan J. Steinberg M. D. Order Today!

"The Mozart Effect : Tapping the Power of Music to Heal the Body, Strengthen the Mind and Unlock the Creative Spirit" by Don Cambell Order Today!

"The Power of Prayer and the Practice of Medicine" by James Dossey Order Today!

"The Complete Medicinal Herbal" by Penelope Ody Order Today!

"You Are Not Your Illness: Seven Principles for Meeting the Challenge" by Linda Noble Topf and Hal Zina Bennett Order Today!

"One Degree Beyond: A Reiki Journey into Energy Medicine" by Janeanne Narrin ) Order Today!

"Sick and Tired of Feeling Sick and Tired: Living with Invisible Chronic Illness" by Paul J. Donoghue and Mary E. Siegel Order Today!

Journaling and Creativity

"Journal to the Self: Twenty-two Paths to Personal Growth" by Kathleen Adams Order Today!

"Pain and Possibility: Writing Your Way Through Personal Crisis" by Gabriele Rico Order Today!

"The Artists' Way: A Spiritual Path To Higher Creativity" by Julia Cameron Order Today!

"The Creative Journal: The Art of Finding Yourself" by Lucia Capacchione Order Today!

"The New Diary" by Tristine Rainer Order Today!

"Giving Voice to Myself: A Memory Book for Women" by Peg Streep and Claudia Karabaic Sargent Order Today!

"The Healing Journey: Your Journal of Self-Discovery" by Phil Rich and Stuart Copans Order Today!

"Idea Catcher: An Inspiring Journal for Writers" by Editors of Story Press Order Today!

"A Trail Through Leaves: The Journal as a Path to Place" by Hannah Hinchman Order Today!

Lifestyles and Values

Awakening Earth: Exploring the Evolution of Human Culture and Consciousness by Duane Elgin Order Today!

Phoenix Soul: One Man's Search for Love & Inner Peace by David Essell Order Today!

New Age Directory of Planet Earth: The First International Directory of Body-Mind-Spirit Source Book" by Patti Normady Greenwood and Darrell Thomas Wilson. Order Today!

"A Country Year: Living the Questions" by Sue Hubble Order Today!

"A Return to Love" by Marianne Williamson Order Today!

"A Guide for the Perplexed" by E.F. Schumacher Order Today!

"A Better Place to Live: New Designs for Tomorrow's Communities" by Michael Corbett (out of print)

"Ecology, Community and Life Style" by Arne Naess Order Today!

"Flow: The Psychology of Optimal Experience" by Mihalyi Csikszentmihalyi Order Today!

"In Search of the Simple Life" by David E. Shi Order Today!

"Man's Search for Meaning" by Viktor Emil Frankl Order Today!

"People and Planet" edited by Tom Woodhouse Order Today!

"The Aquarian Conspiracy" by Marilyn Ferguson Order Today!

"To Have or to Be" by Eric Fromm Order Today!

"Voluntary Simplicity" by Duanne Elgin Order Today!

"What Really Matters: Searching for Wisdom in America" by Tony SchwartzOrder Today!

"Adventures in Simple Living: A Creation-Centered Spirituality" by Rich Hefren (out of print)

"Sustainable America: America's Environment in the 21st Century" edited by Daniel Sitarz Order Today!

"Your Money of Your LIfe" by Joe Domnguez and Vicki Robin Order Today!

"The Circle of Simplicity: Return to the Good Life" by Cecile Andrews Order Today!

"A Place Called Simplicity" by Claire Cloninger Order Today!

"The Good LIfe: Helen and Scott Nearings Sixty Years of Self-Sufficient Living" by Helen and Scott Nearing Order Today!

Loss

"Swallowed by a Snake: The Gift of the Masculine Side of Healing" by Thomas R. Golden Order Today!

"Chicken Soup for the Soul" by Jack Canfield and Mark Victor Hansen Order Today!

"Pathfinders" by Gail Sheehey (out of print)

"A Grief Observed" by C.S. Lewis Order Today!

"Beyond Endurance: When a Child Dies" by Ronald J Knapp (out of print)

"How to Survive the Loss of a Love" by Colgrove, Bloomfield, and McWilliams Order Today!

"In the Face of Death" by Peter Noll (out of print)

"Necessary Losses" by Judith Viorst Order Today!

"The Mourning Handbook" by Helen Fitzgerald Order Today!

How to Go On Living When Someone You Love Dies by Therese A. Rando Order Today!

For and about Men

"Flying Boy" by John Lee Order Today!

"Fire In the Belly: On Being a Man" by Sam Keen Order Today!

"Learning To Live Without Violence" by Daniel Jay Sonkin Order Today!

The Secret Love of Sons : How We Men Feel About Our Mothers, and Why We Never Tell by Nicholas Weinstock Order Today!

"To Be a Man" by Keith Thompson Order Today!

"Violent No More: Helping Men End Domestic Abuse" by Michael Paymar Order Today!

Parenting

"Discipline Without Shouting or Spanking" by Jerry Wychoff and Barbara Unell Order Today!

"Siblings Without Rivalry" by Adele Faber and Elaine Mazlish Order Today!

"How to Talk so Kids Cans Learn at Home and in School" by Lisa Nyberg and Rosalyn Anstin Templeton Order Today!

"Siblings Without Rivalry" by Adele Faber and Elaine Mazlish Order Today!

"All That She Can Be: Helping Your Daughter Maintain Her Self-Esteem" by Carol J. Earle and Carol Colman Order Today!

"Chicken Soup for the Mother's Soul" by Jack Canfield and Mark Victor Hanson Order Today!

"How to Talk So Kids Will Listen and Listen So Kids will Talk" by Adele Faber Order Today!

"Celebrating Girls : Nurturing and Empowering Our Daughters" by Virginia Beane Rutter and Virginia Beane Order Today!

"Caring for Your School-Age Child : Ages 5 to 12" by Edward L. Schor Order Today

"Parenting By Heart" by Ron Taffel (out of print)

"Reviving Ophelia: Saving the Selves of Adolescent Girls" by Mary Bray Pipher Order Today!

"The Centering Book: Awareness Activities for Children, Parents, and Teachers" by Gay Hendricks (out of print)

"The Optimistic Child" by Martin E. Seligman, et al Order Today!

Psychotherapy

"A Guide to Psychotherapy with Gay and Lesbian Clients" edited by John Gonsiorek Order Today!

"Bulimia: A System Approach" by Maria Root (out of print)

"In Search of Solutions: A New Direction in Psychotherapy" by William Hudson O'Hanlon and Michele Weiner-Davis Order Today!

"Healing the Incest Wound: Adult Survivors in Therapy" by Christine Courtois Order Today!

"Healing Voices: Feminist Approaches to Therapy with Women" by Toni Ann Laidlow, Cheryl Malmo, and associates Order Today!

"Homework in Counseling and Psychotherapy" by John L Shelton and Mark Ackermon (out of print)

"Love's Executioner and Other Tales of Psychotherapy" by Irvin D. Yalom Order Today!

"The Invisible Wound: A New Approach to Healing Childhood Sexual Abuse" by Wayne Kritsberg (out of print)

"Awakening the Heart: East/West Approaches to Psychotherapy and the Healing Relationship" edited by John Welwood Order Today!

"Beware the Talking Cure: Psychotherapy May be Hazardous to Your Mental Health" by Terrence W. Campbell Order Today!

"At the Speed of LIfe: A New Approach to Personal Change Through Body-Centered Therapy" by Gail Hendricks and Kathlyn Hendricks Order Today!

Recovery

"An Unquiet Mind" by Kay Redfield Jamison Order Today!

"A Hole in The World: An American Boyhood" by Richard Rhodes (out of print)

"After the Tears: Reclaiming the Personal Losses of Childhood" by Jane Middleton-Moz and Lorie Dwinell (out of stock)

"Broken Boys/ Mending Men: Recovery From Child Sexual Abuse" by Stephen Grubman-Black Order Today!

"Conspiracy of Silence: The Trauma of Incest" by Sandra Butler Order Today!

"Growing Through The Pain: The Incest Survivors Companion" by Catherine Bronson (out of print)

"It Will Never Happen to Me: Children of Alcoholics" by Claudia Black Order Today!

"Legacy of the Heart: The Spiritual Advantages of a Painful Childhood" by Wayne Muller Order Today!

"Making Peace With Your Adult Children" by Shauna Smith Order Today!

"Outgrowing the Pain: A Book for and About Adults Abused as Children" by Eliana Gil Order Today!

"Perfect Daughters" by Robert J. Ackerman Order Today!

"Recovering From Rape" by Linda Ledray Order Today!

"Sexual Exploitation Within Professional Relationships" edited by Glen Gabbard Order Today!

"Strong at the Broken Places" by Linda Sanford (out of print)

"The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse" by Ellen Bass and Laura Davis Order Today!

"The Obsession: Reflections on the Tyranny of Slenderness" by Kim Chernin Order Today!

"The Sexual Healing Journey" by Wendy Maltz Order Today!

"The Woman Inside: From Incest Victim to Survivor" by Patty Derosier Barnes Order Today!

"Trauma and Recovery" by Judith Lewis Herman Order Today!

"Victims No Longer: Men Recovering From Incest" by Mike Lew Order Today!

"When Helping You Is Hurting Me: Escaping The Messiah Trap" by Carmen Renee Berry (out of stock)

Relationships

"Allies In Healing: When the Person You Love Was Sexually Abused as a Child" by Laura Davis Order Today!

"Love and Addiction" by Stanton Peele (out of print)

"Love is a Verb: How to Stop Analyzing Your Relationship and Start Making it Great" by Bill O'Hanlon and Pat Hudson Order Today!

"On Caring" by Milton Mayeroff Order Today!

"The Art of Loving" by Erich Fromm Order Today!

"Women Who Love Too Much" by Robin Norwood Order Today!

"I Love You, Let's Work it Out" by David M. Viscott Order Today!

"10 Steps to a Great Relationship" by Howard J. Rankin Order Today!

Spirituality

"A Worldly Spirituality: The Call to Redeem Life on Earth" by Wesley Granberg-Michaelson (out of print)

"As Above, So Below: Path's to Spiritual Renewal in Daily Life" edited by Ronald S. Miller Order Today!

"Death of a Hero: Birth of a Soul" by John C. Robinson Order Today!

"Fire in the Soul: A New Psychology of Spiritual Optimism" by Joan Borysenko Order Today!

"Hymns to an Unknown God" by Sam Keen Order Today!

"Nourishing The Soul" edited by Anne Simpkinson Order Today!

"Minyan : Ten Principles for Living a Life of Integrity Rabbi Rami M. Shapiro Order Today!

"Soul Food : Stories to Nourish the Spirit and the Heart" edited by Jack Kornfield and Christina Feldman Order Today!

"The Feminine Face of God : The Unfolding of the Sacred in Women" by Patricia Hopkins and Sherry Ruth Anderson Order Today!

"The Four-Fold Way : Walking the Paths of the Warrior, Teacher, Healer, and Visionary" by Angeles Arrien Order Today!

"Wrestling with the Prophets: Essays on Creation Spirituality and Everyday Life" by Matthew Fox Order Today!

Transitions

"Pathfinders" by Gail Sheehy (out of print)

"Necessary Losses" by Judith Viorst Order Today!

"Light From Many Lamps" edited by Lillian Eichler Watson Order Today!

"Managing Transitions: Making the most of Change" by William Bridges Order Today!

"The Art of Ritual: A Guide to Creating and Performing Your Rituals for Growth and Change" by Renee Beck Order Today!

For and about Women

"Battered Wives" by Del Martin Order Today!

"Chicken Soup for the Woman's Soul" by Jack Canfield Order Today!

"Circle of Stones: Woman's Journey to Herself" by Judith Duerk Order Today!

"Everyday Sacred: A woman's Journey Home" by Sue Bender Order Today!

"Fat is a Feminist Issue" by Susie Orbach Order Today!

"I Dream a World: Portraits of Black Women Who Changed America" by Brian Lanker Order Today!

"Storming Heaven's Gate : An Anthology of Spiritual Writings by Women" edited by Amber Coverdale Sumrall and, Patrice Vecchione Order Today!

"The Beauty Myth: How Images of Beauty Are Used Against Women" by Naomi Wolf Order Today!

"Transforming Body Image" by Maria Germaine Hutchinson Order Today!

"Getting Free: A Handbook for Women in Abusive Relationships" by Ginny NiCarthy Order Today!

"Women and Madness" by Phyllis Chesler Order Today!

"Women Who Love Too Much" by Robin Norwood Order Today!

Women's Fiction

"Divine Secrets of the Ya-Ya Sisterhood" by Rebecca Wells Order Today!

"Fried Green Tomatoes at the Whistle Stop Café" by Fannie Flag Order Today!

"Reckoning" by May Sarton Order Today!

"She's Come Undone" by Wally Lamb Order Today!

"The Bean Trees" by Barbara Kingsolver Order Today!

"The Woman's Room" by Marilyn French Order Today!

"The Women of Brewster Place" by Gloria Naylor Order Today!

"The Book of Ruth" by Jane Hamilton Order Today!

"The Boys of My Youth" by Joann Beard Order Today!

Work

"Artful Work: Awakening Joy, Meaning, and Commitment in the Work Place" by Dick Richards Order Today!

"Confessions of an Accidental Businessman" by James A Autry Order Today!

"301 Ways to Have Fun at Work" by Dave Hemsath and Leslie Yerkes Order Today!

"The Soul of a Business: Managing by Profit and Common Good" by Tom Chappell Order Today!

"The Reinvention of Work: A New Vision of Livelihood for our Time " by Matthew Fox Order Today!

"Love and Profit: The Art of Caring Leadership" by James A Autry Order Today!

"Awakening Corporate Soul: Four Paths to Unleash the Power of People at Work" by Eric Klein and John B. Izzo Order Today!

Thought Provoking Fiction

"A Prayer for Owen Meany" by John Irving Order Today!

"Ishmael" by Daniel Quinn Order Today!

"Johnny Got His Gun" by Dalton Trumbo Order Today!

"One" by Richard Bach Order Today!

"The Celistine Prophesy" by John Redfield Order Today!

"The Color Purple" by Alice Walker Order Today!

"The House of the Spirits" by Isabel Alende Order Today!

"The Kin of Ata are Waiting for You" by Dorothy Bryant Order Today!

"The Truth Machine" by James L Halperin Order Today!

"Talk Before Sleeping" by Elizabeth Berg Order Today!

"My Ishmael: A Sequel" by Daniel Quinn Order Today!

"All is Quiet on the Western Front" by Erich Maria Remarque Order Today!

"Jonathan Livingston Seagull" by Richard Bach Order Today!

"The Bridge Across Forever" by Richard Bach Order Today!

"The Golden Notebook" by Doris Lessing Order Today!

Audiobooks by Tammie Fowles

"BirthQuake: Journey to Wholeness" Order Today!

"Discovering Meaning" Order Today!

"Embracing the Spirit" Order Today!

"The Mind/Body Dance" Order Today!

A friend asked me why I hadn't listed the BirthQuake series on this page. "Don't you value them?" she queried. I shared with her that I very much valued them because as I wrote BirthQuake, it began to write me. "But it seems somehow wrong to list them here." I explained to my friend. A very special look she gives me from time to time was her only response. So I decided to add them. She has a way of saying so much without a single word.

next: Welcome to SagePlace! Homepage

Thoughtful quotes about ambivalence and authenticity, body and courage, death and happiness, life and opportunity, parenting and work.

Select a Topic:

Ambivalence and Authenticity:	Body and Courage:
Ambivalence Anxiety Attitude Authenticity	Body/Health/Healing Change Children Choice Community Courage
Death and Happiness:	Life and Opportunity:
Death/Endings Dreams and Visions Education/Learning Enlightenment Faith Giving Gratitude and Wonder Growth and Aging Happiness	Life and Living Searching Loneliness and Solitude Marriage Meaning Miracles Nature Opportunity
Parenting and Work:
Motherhood The Past Pleasure Priorities Progress Risk Spirituality Success/Failure Suffering and Pain War & Peace Wealth and Poverty Wholeness Wisdom Women Work

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next:A Message From Chief Seattle

There are many natural treatments - herbs, supplements and alternative remedies claiming to prevent Alzheimer's Disease. But do they work?

The Alzheimer's Association carries this warning on its website:

"A growing number of herbal remedies, vitamins and other dietary supplements are promoted as memory enhancers or treatments for Alzheimer's disease and related diseases. Claims about the safety and effectiveness of these products, however, are based largely on testimonials, tradition and a rather small body of scientific research. The rigorous scientific research required by the U.S. Food and Drug Administration (FDA) for the approval of a prescription drug is not required by law for the marketing of dietary supplements."

Concerns about alternative therapies for Alzheimer's disease

Although many of these remedies may be valid candidates for treatments, there are legitimate concerns about using these drugs as an alternative or in addition to physician-prescribed therapy:

Effectiveness and safety are unknown. The maker of a dietary supplement is not required to provide the FDA with the evidence on which it bases its claims for safety and effectiveness.

Purity is unknown. The FDA has no authority over supplement production. It is a manufacturer's responsibility to develop and enforce its own guidelines for ensuring that its products are safe and contain the ingredients listed on the label in the specified amounts.

Bad reactions are not routinely monitored. Manufacturers are not required to report to the FDA any problems that consumers experience after taking their products. The agency does provide voluntary reporting channels for manufacturers, health care professionals, and consumers, and will issue warnings about product when there is cause for concern.

Dietary supplements can have serious interactions with prescribed medications. No supplement should be taken without first consulting a physician.

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Coenzyme Q10

Coenzyme Q10, or ubiquinone, is an antioxidant that occurs naturally in the body and is needed for normal cell reactions. This compound has not been studied for its effectiveness in treating Alzheimer's.

A synthetic version of this compound, called idebenone, was tested for Alzheimer's disease but did not show favorable results. Little is known about what dosage of coenzyme Q10 is considered safe, and there could be harmful effects if too much is taken.

Coral calcium

"Coral" calcium supplements have been heavily marketed as a cure for Alzheimer's disease, cancer and other serious illnesses. Coral calcium is a form of calcium carbonate claimed to be derived from the shells of formerly living organisms that once made up coral reefs.

In June 2003, the Federal Trade Commission (FTC) and the Food and Drug Administration (FDA) filed a formal complaint against the promoters and distributors of coral calcium. The agencies state that they are aware of no competent and reliable scientific evidence supporting the exaggerated health claims and that such unsupported claims are unlawful.

Coral calcium differs from ordinary calcium supplements only in that it contains traces of some additional minerals incorporated into the shells by the metabolic processes of the animals that formed them. It offers no extraordinary health benefits. Most experts recommend that individuals who need to take a calcium supplement for bone health take a purified preparation marketed by a reputable manufacturer.

See also the FDA/FTC press release on the coral calcium complaint.

Ginkgo biloba

Ginkgo biloba is a plant extract containing several compounds that may have positive effects on cells within the brain and the body. Ginkgo biloba is thought to have both antioxidant and anti-inflammatory properties, to protect cell membranes and to regulate neurotransmitter function. Ginkgo has been used for centuries in traditional Chinese medicine and currently is being used in Europe to alleviate cognitive symptoms associated with a number of neurological conditions.

In a study published in the Journal of the American Medical Association (October 22/29, 1997), Pierre L. Le Bars, M.D., Ph.D., of the New York Institute for Medical Research, and his colleagues observed in some participants a modest improvement in cognition, activities of daily living (such as eating and dressing) and social behavior. The researchers found no measurable difference in overall impairment.

Results from this study show that ginkgo may help some individuals with Alzheimer's disease, but further research is needed to determine the exact mechanisms by which Ginkgo works in the body. Also, results from this study are considered preliminary because of the low number of participants, about 200 people.

Few side effects are associated with the use of Ginkgo, but it is known to reduce the ability of blood to clot, potentially leading to more serious conditions, such as internal bleeding. This risk may increase if Ginkgo biloba is taken in combination with other blood-thinning drugs, such as aspirin and warfarin.

Currently, a large federally funded multicenter trial with about 3,000 participants is investigating whether Ginkgo may help prevent or delay the onset of Alzheimer's disease or vascular dementia.

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Huperzine A

Huperzine A (pronounced HOOP-ur-zeen) is a moss extract that has been used in traditional Chinese medicine for centuries. It has properties similar to those of cholinesterase inhibitors, one class of FDA-approved Alzheimer medications. As a result, it is promoted as a treatment for Alzheimer's disease.

Evidence from small studies shows that the effectiveness of huperzine A may be comparable to that of the approved drugs. In Spring 2004, the National Institute on Aging (NIA) launched the first large U.S. clinical trial of huperzine A as a treatment for mild to moderate Alzheimer's disease.

Because currently available formulations of huperzine A are dietary supplements, they are unregulated and manufactured with no uniform standards. If used in combination with FDA-approved Alzheimer drugs, an individual could increase the risks of serious side effects.

Omega-3 fatty acids

Omega-3s are a type of polyunsaturated fatty acid (PUFA). Research has linked certain types of omega-3s to a reduced risk of heart disease and stroke.

The U.S. Food and Drug Administration (FDA) permits supplements and foods to display labels with "a qualified health claim" for two omega-3s called docosahexaneoic acid (DHA) and eicosapentaenoic acid (EPA). The labels may state, "Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease," and then list the amount of DHA or EPA in the product. The FDA recommends taking no more than a combined total of 3 grams of DHA or EPA a day, with no more than 2 grams from supplements.

Research has also linked high intake of omega-3s to a possible reduction in risk of dementia or cognitive decline. The chief omega-3 in the brain is DHA, which is found in the fatty membranes that surround nerve cells, especially at the microscopic junctions where cells connect to one another.

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A Jan. 25, 2006, literature review by the Cochrane Collaboration found that published research does not currently include any clinical trials large enough to recommend omega-3 supplements to prevent cognitive decline or dementia. But the reviewers found enough laboratory and epidemiological studies to conclude this should be a priority area for further research.

According to the review, results of at least two larger clinical trials are expected in 2008. The Cochrane Collaboration is an independent, nonprofit organization that makes objective assessments of available evidence on a variety of issues in treatment and health care.

Theories about why omega-3s might influence dementia risk include their benefit for the heart and blood vessels; anti-inflammatory effects; and support and protection of nerve cell membranes. There is also preliminary evidence that omega-3s may also be of some benefit in depression and bipolar disorder (manic depression).

A report in the April 2006 Nature described the first direct evidence for how omega-3s might have a helpful effect on nerve cells (neurons). Working with laboratory cell cultures, the researchers found that omega-3s stimulate growth of the branches that connect one cell to another. Rich branching creates a dense "neuron forest," which provides the basis of the brain's capacity to process, store and retrieve information.

See also the 2004 FDA press release announcing extension of the qualified health claim for omega-3s and coronary heart disease from supplements to foods.

Phosphatidylserine

Phosphatidylserine (pronounced FOS-fuh-TIE-dil-sair-een) is a kind of lipid, or fat, that is the primary component the membranes that surround nerve cells. In Alzheimer's disease and similar disorders, nerve cells degenerate for reasons that are not yet understood. The theory behind treatment with phosphatidylserine is its use may shore up the cell membrane and possibly protect cells from degenerating.

The first clinical trials with phosphatidylserine were conducted with a form derived from the brain cells of cows. Some of these trials had promising results. However, most trials were with small samples of participants.

This line of investigation came to an end in the 1990s over concerns about mad cow disease. There have been some animal studies since then to see whether phosphatidylserine derived from soy may be a potential treatment. A report was published in 2000 about a clinical trial with 18 participants with age-associated memory impairment who were treated with phosphatidylserine. The authors concluded that the results were encouraging but that there would need to be large carefully controlled trials to determine if this could be a viable treatment.

Source: Alzheimer's Association

next: Alternative Treatment Strategy for Alzheimer's Disease

Chapter 49 of the book Self-Help Stuff That Works

by Adam Khan

I WAS AT A PUBLICITY SEMINAR recently and the speaker said something very useful. She suggested that when you do a TV interview, you decide beforehand what message you want to communicate to the viewers, and then, no matter what the interviewer asks you, make sure you answer with your message.

Of course you have to acknowledge the question somehow and make the transition to your answer smooth, but, she said, no matter what, you must stay on what you want to say and not get sidetracked by the interviewer.

She was an expert in her field and said this was good advice. Some interviewers are downright hostile. Even if they aren't, they often have a different purpose than you do for being there. So the question becomes: "Whose goal will be achieved? Yours or theirs?" Of course, if your two intentions are not wholly antagonistic, it is possible that both of you can be satisfied.

The same principle operates not only on TV interviews, but in regular life too. The first and most important principle is to know what you want. Know what you want. It doesn't mean you have to step all over everyone to get it. But your wishes are at least as valid as anyone else's, and from your perspective they are more valid than anyone else's. That's the way it ought to be.

So take whatever you get from the world - your circumstances, the people in your life and what they're trying to accomplish - and use it to accomplish your goals.

To do this you have to focus on what you intend to accomplish, and go after it like a hungry lion stalking her prey. No matter what happens, keep trying to accomplish your purpose. It takes some concentration and a little practice. But you'll be able to achieve your goals with more certainty. And you won't be drained as much by things unrelated to your purpose.

Your goals are honorable and valuable. Don't let them get shunted aside by pushy people or less-than-ideal circumstances. Take whatever the world presents to you and use it to accomplish your purpose. No matter what.

Whatever happens, use it to accomplish your purpose.

Scientists have found out some interesting facts about happiness. And much of your happiness is under your influence.
Science of Happiness

 

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Find peace of mind, tranquility in body, and clarity of purpose with this simple method.
Constitutional Right

The questions you ask direct your mind. Asking the right kind of questions makes a big difference.
Why Ask Why?

A simple change in perspective can make you feel better and can also make you more effective at dealing with the situation. Here's one way to change your perspective.
Adventure

What if maximizing your full potential was bad for you?
Be All You Can Be

This is a simple technique for reducing a little of the stress you feel day to day. Its biggest advantage is you can use it while you work.
Rx to Relax

next: Do You Want to Give Up?

Chapter 18 of the book Self-Help Stuff That Works

by Adam Khan

NEGATIVE FEELINGS PLAGUE all of us from time to time. Worry creeps into the mind like an unwelcome in-law, and if something isn't done about it, the worry will stay and eat you out of house and home. Anger strikes, pumping your body full of adrenaline, making it hard to concentrate on your work or speak with a civil tongue. Depression brings feelings of hopelessness and helplessness, darkening and saddening your world like a cold, bleak day in winter.

These are the three faces of negative feelings: Worry, anger, depression. Most negative feelings you ever feel are a shade of anxiety, anger, or sadness. You know these feelings are unpleasant. You know they aren't good for your health. But what can you do to minimize the amount of time you feel them?

First, of course, is to look at the situation causing the negative feelings. If there is a concrete circumstance, a real problem causing the feeling, give it some good hard thought and then do something about it, if you can.

But if there's nothing you can do about it, get involved in something that engages your mind and forget about it. Don't try to stop thinking negatively. Simply try to get absorbed in doing something constructive.

Purposeful activities occupy mind-space, and the more the task engages or takes up your attention, the more mind-space it occupies. Get involved enough in something or do something absorbing enough, and there's no more mind-space left to think about anything else.

What continues a negative emotion is thinking about it. Just as you can distract a crying child and he will forget his skinned knee, you can distract yourself with something so interesting or challenging or important, your mind will stop thinking about the problem, and your negative feelings - now that you're no longer producing them with your thoughts - will dissipate.

Seek escape from unnecessary negative feelings by fleeing into a purpose. It will take your mind off the negative thing, giving you a healthful break from those negative feelings. The side effect is that something purposeful and productive gets done in the meantime. And that will give you something to feel good about.

Relieve negative feelings by turning your attention to purposeful activities.

Find out a useful way to look at the cause of anger, and how much control over your own life this insight can give you:
Argue With Yourself and Win

 

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If worry is a problem for you, or even if you would like to simply worry less even though you don't worry that much, you might like to read this:
The Ocelot Blues

We've been fooled into believing that more material goods
will make us happier than we are now:
We've Been Duped

next: The How of Tao

This page was developed to address issues related to psychotherapy. We hope you find them of interest.

Index:

• To Participants of a Workshop on the Treatment of Bulimia
• The Incorporation of Holistic Principles into a Brief Treatment Framework
• Guiding Principles
• The Contributions of Feminist Therapy
• Old Assumptions and the New Assumptions of O'Hanlon and Davis
• Working with the Body as a Pathway to the Mind
• On Providing Support to Parents who are Also Survivors
• Until We Meet Again

 

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next: To Participants of a Workshop on the Treatment of Bulimia

The potential to communicate on-line opens up whole new possibilities for emotional healing. While some decry the use of technology as an intermediary and claim that the artificial, dehumanizing medium is the "message," there is no doubt that the internet will take on a greater and greater role in the therapy/counseling universe. Why is this? For two reasons. First, in people's busy lives, productivity and efficiency are at a premium. Simply stated, it takes too much time to drive (or worse, take public transportation) to the therapist's office. It will not not be long before people say "Do you remember when we spent an hour in the therapy office and an hour in the car?" Second, the internet gives clients extraordinary choice. Rather than being restricted to their own community, clients can pick therapists from anywhere in the world--language replaces locale as the only barrier.

The availability of internet therapies in different modalities, however, is no guarantee of their effectiveness. Do internet therapies (e-mail, icq/chat, and video) work? How do they compare to traditional face-to-face therapy? Because the use of the internet for this purpose is so new, there is little empirical research on this matter, but we can make an educated guess based upon our understanding of the therapy process.

In Psychotherapy: The Restoration of Voice I identified three parts of the therapy process: discovery, broadening and deepening understanding, and developing a strong therapeutic relationship.

If we use these three processes, discovery, broadening and deepening understanding, and developing a strong therapeutic relationship, as criteria, how do internet therapies stack up against traditional face-to-face therapy.

	Face-to- Face	E-Mail	ICQ/Chat	Internet Video
Discovery	Yes	Yes	Yes	Yes
Broadening and Deepening Understanding	Yes	Yes, but difficult and very inefficient	Yes, but inefficient	Yes
Developing a Strong Therapeutic Relationship	Ideal	Difficult and very inefficient	Difficult and very inefficient	Probably yes

From this table, you can see that both e-mail and ICQ/Chat are adequate for the discovery part of therapy, but they they are less than ideal beyond this function. E-mail suffers because the therapist is unable to interrupt and ask a question in order to better understand what the client is thinking/feeling at the moment. The therapist can send an e-mail, but he or she has to wait for a reply--a thirty second clarification turns into a day's wait. ICQ/Chat solves the immediacy problem, but the mechanics of typing slows the therapy process to a standstill, and keeps the therapist from attending fully to the client. Internet video shows promise. One question remains to be answered: Will the video technology somehow interfere with the human relationship building process? My guess is that it won't. If it did, people would not laugh and cry at movies; rather they would stare, like my dog Watson, blankly at the screen.

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Face-to-face therapy remains the ideal mode of treatment, because it offers the fewest obstacles to a genuine therapeutic relationship. But internet video, with its advantages of time efficiency, and almost unlimited choice of therapists will likely grow in popularity as broadband and fast computers become widely available. It remains to be seen whether this technology will somehow dehumanize the therapy process.

Searching On-Line for a Therapist?

It can be a frustrating experience. But, if you are able to get a sense of who the therapist is through his/her web site, it's a good first step.

Every therapist brings their own philosophy of therapy to their work. But just as importantly, they bring their own "self" through which this philosophy is filtered. That "self" is critical to a good therapy match. Unfortunately, that "self" is rarely revealed in a web site. Yes, credentials and experience are important. But as a therapy consumer, I would also want to know what my therapist is like. What issues is s/he sensitive to? Is s/he bright? How "deep" is s/he? How much world experience does s/he bring to the therapy office as opposed to book knowledge? How realistic is s/he? Is s/he pompous or self important? Will s/he be able to sit with me through my blackest moods? Will s/he be honest with me or hide behind a therapist persona? Does s/he have children? (Perhaps the best way of evaluating a new therapist would be to spend an hour with their children!) Does s/he know what it's really like to raise adolescents? How about stepchildren (if this is relevant)? Does s/he have experience with the death of a loved one? Has s/he had enough pain and loss in their life to really know what I'm talking about?

If a therapist is willing to be revealing, a web site offers people an excellent opportunity to "pre-screen" potential candidates. I think all therapists should put them up. Of course, constructing a site that reveals yourself is risky business. If my therapist had revealed himself in this way, I never would have chosen him (see Dreams, Imagined Dreams: Failed Therapy) Indeed, at most therapist sites, the person is hidden behind a sea of credentials, slick graphics, etc. These sites cry out: "I am professional." But being "professional" does not, by itself, make a good therapist. Good therapy is an endeavor that involves two human beings, and the client will and should over time discover who the therapist is. A good web site can help begin this process.

Certainly, perusing a site is no substitute for a face to face meeting, but it can be an excellent first step in determining whether a good match can be made.

Good luck in your search.

About the author: Dr. Grossman is a clinical psychologist and author of the Voicelessness and Emotional Survival web site.

next: So, You Want to Be a Therapist?