Toxic Teachers: Are teachers the new mean girls? QL Investigates the bullies in front of your blackboard.

When you think about being bullied as a teenager, would you include your teachers as the culprits? I was recently quoted in an article exploring the negative impact of teacher bullying and how to cope. Publication: Girls' Life Author: Abbondanza, Katie Date published: August 1, 2013

"She said a 6-year-old could do better work."

"He criticized every little mistake I made."

"She called me stupid in front of the whole class."

As tough as it is to report, each of those statements came straight from GL readers discussing their very real experiences with bullies. But these bullies aren't fellow classmates - they're teachers.

We grow up thinking that teachers are kind, trustworthy and fair. And most are. But that's why the reports of educators singling out and berating students are troubling. This isn't girls being sensitive or overreacting to one-off comments. Teacher bullying is happening in classrooms across the nation. In fact, a 2012 study found that 45 percent of the 116 teachers surveyed copped to bullying a student. And the effects can be devastating to girls' self-esteem.

Bad Teacher

While it may seem harsh when your teacher doles out a detention after you flaked on the homework for the third time, if that's her rule for everyone, it's not bullying. Rather, teacher bullying is typically defined as using a position of authority to either manipulate or belittle a student past what's accepted as normal discipline, according to Dr. Stuart Twemlow, who has researched this topic.

It's important to remember that teachers are human, so they may lose their cool on a stressful day. But repeatedly lashing out or acting controlling is different. Name-calling, singling someone out, overreacting to the point that a student is afraid or physically intimidating or hitting a student all count as bullying or abusive behaviors.

Miranda H., 17, knows firsthand what it's like to be bullied by a person in power. During her sophomore year, she was harassed by her band instructor after a scheduling conflict didn't allow her to sign up for two periods of music.

Due to her other classes, Miranda, a talented saxophone player, had to take a seat in a less prestigious ensemble.

"I was one of his favorite students freshman year, but he made my sophomore year terrible," she says. "He would yell and be cruel, saying I was a 'disgrace to the band.'"

Just as scary, Miranda's teacher blamed her for his outbursts, a classic trait exhibited by abusers. He told her if she had just done what he wanted, he wouldn't have to call her out all the time.

"It was terrible," she says, adding that she'd go home in tears nearly every day. "I was constantly on edge, and I couldn't concentrate in my other classes."

Miranda's father talked with the band teacher at one point, but he denied any abusive behavior. And though she took all the right steps, his reaction made her feel like she was wrong, which is typical among bullying victims.

"If a teacher is calling you inappropriate names or repeatedly singling you out for minor mistakes [which are different from behavioral issues], know that you did nothing wrong," says Jennifer Musselman, a therapist who works with teens.

Speaking Up

It's easy for students to feel powerless in these situations, but all the experts we spoke with stressed the importance of talking to your teacher before things escalate. In some cases, he or she might simply have high standards for you and be inadvertently treating you differently than the rest of the class. Regardless of the reason, you have to say something.

Where to start? Be direct. You should bring up exactly what's bothering you, whether it's the way your teacher ignores your hand when you raise it or how it hurts your feelings when she teases you, even if she's joking.

Mention that you've noticed it more than once. Maybe your teacher isn't aware her behavior is bothering you, and all it will take is a quick after-class conversation to get her to back off.

Of course, confronting your teacher doesn't always guarantee success. Maggie L., 17, had an eighth-grade art teacher who constantly singled out her work. She loved to draw, but her teacher always criticized her. One day, Maggie spoke up and asked what she could do to improve her piece.

"Well, if I were you, I'd throw it out and start over," the teacher told her, even though she was almost done with the entire assignment.

"Sometimes, her comments hurt my feelings." Maggie confessed. "Teachers are in such a powerful position. No matter if you like them or not, their opinion of you really matters. It's very different from classmates being judgmental or not liking you."

Maggie's thoughts get to the heart of why teacher bullying is so troublingand why girls have to continue to defend themselves even after that initial chat with their teacher.

"[If a teacher's behavior is] starting to affect your self-esteem or your grade, it's time to take your concerns to a trusted adult like your mom, dad, school counselor or another teacher," says Jennifer. She recommends documenting the day, time and what the teacher said so you can have a record of what happened.

"Be very clear on what the teacher is saying or doing that is causing you to feel this way," she says. "If possible, list any classmates who can vouch for you."

Ask your parents to talk to the teacher with you, and give them your written list of concerns and incidents. They might decide it's time to talk with the principal or the vice principal, who will hopefully remedy the situation. In the meantime, focus on your work and, if necessary, ask for extra help from a friend or school counselor.

Damage Control

Truth is, just one semester with a toxic teacher can negatively influence your life for years to come, which is why it's extra important to deal with the damage before it's too late.

Miranda, the one-time band star who was bullied, ended up quitting her instrument altogether by the time junior year rolled around.

After having her teacher read her English paper out loud and then call her stupid, Nina J., 14, is now afraid to make her presence known in class. "I never raise my hand in class anymore, because I'm afraid she will make me feel dumb," she admits.

Nina's case may be extreme, but the psychological effects of dealing with a toxic teacher can linger long after class is dismissed. Dr. Nerina GarciaArcement, a clinical psychologist, says to put your feelings down on paper - either by journaling or writing a letter to your teacher that you don't send. Talking with a school counselor also can help sort through the issue.

A Fresh Start

If all else fails, know you can remove yourself from the situation if you and your parents talk with the school's administration. "If the teacher doesn't change, it may be time to transfer out of that class," says Jennifer.

Take Emily M., 15, who eventually decided to take it one step further. She switched schools after her former school's only drama teacher picked on her endlessly.

"He'd say I'm obnoxious and ugly and annoying and stupid. That there was no way I'd ever be an actress," Emily says.

In the end, Emily made the tough decision to transfer, opting for a fresh start. "As hard as it was to leave, it would have been even harder to continue to deal with that teacher," she says. "I'm finally back to my old cheerful self. I'm a lot happier as a person now."

But even if the cruel comments cease or you remove yourself from dealing with critical remarks by changing classes or schools, check yourself for any persistent habits you may have picked up during that time period - like not speaking up in class or thinking you're not good at a certain subject - just because a bully teacher told you so.

"Try to figure out, 'How did this impact me?'" says Dr. GarciaArcement. And then, if you realize you're scared or are avoiding something you used to love, figure out a plan to get involved again - away from the watchful eye of your toxic teacher.

Miranda, who quit playing saxophone because of her experience, could form a jazz band with some friends outside of school. Maggie, who stopped believing in her artsy abilities, could take a lowpressure drawing class at a ree center.

And remember, while it's unfair that you have to deal with a bullying teacher, know that most educators are supportive, professional people who want to see you go far. So for every toxic teacher in this world, there are hundreds of others out there ready to guide you in the right direction. Keep an eye out for the ones who will truly help you shine.

Read more: http://www.readperiodicals.com/201308/3030678731.html#b#ixzz2eQjJuSRa

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How to make stress your friend-Ted talk

Can how we think about stress make us healthier and stronger? Can seeking social support extend our lifespan despite our stress level?  Watch this insightful Ted talk and find out. http://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend.html

Can Meditation Make You a More Compassionate Person?

Meditating doesn't just reduce anxiety, it can make more aware of your surroundings and the needs of others.

Apr. 1, 2013 — Scientists have mostly focused on the benefits of meditation for the brain and the body, but a recent study by Northeastern University's David DeSteno, published in Psychological Science, takes a look at what impacts meditation has on interpersonal harmony and compassion.

Several religious traditions have suggested that mediation does just that, but there has been no scientific proof -- until now.

In this study, a team of researchers from Northeastern University and Harvard University examined the effects meditation would have on compassion and virtuous behavior, and the results were fascinating.

This study -- funded by the Mind and Life Institute -- invited participants to complete eight-week trainings in two types of meditation. After the sessions, they were put to the test.

Sitting in a staged waiting room with three chairs were two actors. With one empty chair left, the participant sat down and waited to be called. Another actor using crutches and appearing to be in great physical pain, would then enter the room. As she did, the actors in the chair would ignore her by fiddling with their phones or opening a book.

The question DeSteno and Paul Condon -- a graduate student in DeSteno's lab who led the study -- and their team wanted to answer was whether the subjects who took part in the meditation classes would be more likely to come to the aid of the person in pain, even in the face of everyone else ignoring her. "We know meditation improves a person's own physical and psychological wellbeing," said Condon. "We wanted to know whether it actually increases compassionate behavior."

Among the non-meditating participants, only about 15 percent of people acted to help. But among the participants who were in the meditation sessions "we were able to boost that up to 50 percent," said DeSteno. This result was true for both meditation groups thereby showing the effect to be consistent across different forms of meditation. "The truly surprising aspect of this finding is that meditation made people willing to act virtuous -- to help another who was suffering -- even in the face of a norm not to do so," DeSteno said, "The fact that the other actors were ignoring the pain creates as 'bystander-effect' that normally tends to reduce helping. People often wonder 'Why should I help someone if no one else is?'"

These results appear to prove what the Buddhist theologians have long believed -- that meditation is supposed to lead you to experience more compassion and love for all sentient beings. But even for non-Buddhists, the findings offer scientific proof for meditation techniques to alter the calculus of the moral mind.

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Anxious? Activate Your Anterior Cingulate Cortex With a Little Meditation

Practicing mindful meditation lights up the parts of the brain that control thinking emotions such as worry are activated. Anxiety levels are reduced.

June 4, 2013 — Scientists, like Buddhist monks and Zen masters, have known for years that meditation can reduce anxiety, but not how. Scientists at Wake Forest Baptist Medical Center, however, have succeeded in identifying the brain functions involved.

"Although we've known that meditation can reduce anxiety, we hadn't identified the specific brain mechanisms involved in relieving anxiety in healthy individuals," said Fadel Zeidan, Ph.D., postdoctoral research fellow in neurobiology and anatomy at Wake Forest Baptist and lead author of the study. "In this study, we were able to see which areas of the brain were activated and which were deactivated during meditation-related anxiety relief."

The study is published in the current edition of the journal Social Cognitive and Affective Neuroscience.

For the study, 15 healthy volunteers with normal levels of everyday anxiety were recruited for the study. These individuals had no previous meditation experience or anxiety disorders. All subjects participated in four 20-minute classes to learn a technique known as mindfulness meditation. In this form of meditation, people are taught to focus on breath and body sensations and to non-judgmentally evaluate distracting thoughts and emotions.

Both before and after meditation training, the study participants' brain activity was examined using a special type of imaging -- arterial spin labeling magnetic resonance imaging -- that is very effective at imaging brain processes, such as meditation. In addition, anxiety reports were measured before and after brain scanning.

The majority of study participants reported decreases in anxiety. Researchers found that meditation reduced anxiety ratings by as much as 39 percent.

"This showed that just a few minutes of mindfulness meditation can help reduce normal everyday anxiety," Zeidan said.

The study revealed that meditation-related anxiety relief is associated with activation of the anterior cingulate cortex and ventromedial prefrontal cortex, areas of the brain involved with executive-level function. During meditation, there was more activity in the ventromedial prefrontal cortex, the area of the brain that controls worrying. In addition, when activity increased in the anterior cingulate cortex -- the area that governs thinking and emotion -- anxiety decreased.

"Mindfulness is premised on sustaining attention in the present moment and controlling the way we react to daily thoughts and feelings," Zeidan said. "Interestingly, the present findings reveal that the brain regions associated with meditation-related anxiety relief are remarkably consistent with the principles of being mindful."

Research at other institutions has shown that meditation can significantly reduce anxiety in patients with generalized anxiety and depression disorders. The results of this neuroimaging experiment complement that body of knowledge by showing the brain mechanisms associated with meditation-related anxiety relief in healthy people, he said.

Support for the study was provided by the Mind and Life Institute's Francisco J. Varela Grant, the National Institutes of Health grant NS3926 and the Biomolecular Imaging Center at Wake Forest Baptist.

Co-authors are Katherine Martucci, Ph.D., Robert Kraft, Ph.D., John McHaffie, Ph.D., and Robert Coghill, Ph.D., of Wake Forest Baptist.

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Young Adults Are The Most Stressed Generation: Survey

Being young does not mean carefree.  Survey finds young Americans, aged 18-33, are among the most stressed. By Steven Reinberg

HealthDay Reporter

THURSDAY, Feb. 7 (HealthDay News) -- Young Americans between 18 and 33 years old -- the so-called millennials -- are more stressed than the rest of the population, according to a new report from the American Psychological Association.

What's stressing them out? Jobs and money mostly, said Norman Anderson, CEO of the American Psychological Association, during a Thursday morning press conference.

On a scale of 1 to 10, the millennial generation stands at 5.4 stress-wise, significantly higher than the national average of 4.9, the association found after surveying more than 2,000 Americans.

"Clearly there are a number of pressures facing young people that might account for this increase in stress," Anderson said. "These individuals are growing up in an era of unprecedented economic upheaval. This coincides with the time they are finishing school and trying to establish themselves in society."

Getting a job, starting a family and repaying student loans are all stressful, he added. "They have great difficulty finding jobs because of the higher unemployment and underemployment rates," Anderson said.

These young adults also don't feel they're getting support from the health system. Only 25 percent of millennials give the health care system an A grade, compared with 32 percent of the rest of the population, according to the report, Stress in America: Missing the Health Care Connection.

In addition, 49 percent said they aren't managing their stress well, and only 23 percent think their doctor helps them make healthy lifestyle and behavior changes "a lot or a great deal." Only 17 percent think their doctor helps them manage their stress.

"When people receive professional help to manage stress and make healthy behavior changes, they do better at achieving their health goals," Anderson said.

On that measure, the United States falls short, he said. To lower the rates of chronic illnesses and reduce the nation's health costs, "we need to improve how we view and treat stress and unhealthy behaviors that are contributing to the high incidence of disease in the United States."

Those who get support for stress from their doctor fare much better than those who don't, the researchers said.

People suffering from chronic illnesses report even less support for stress and lifestyle management than Americans without a chronic condition, according to the survey.

Despite seeing their doctor more often than most people, only 25 percent of those with a chronic illness say they get "a great deal or a lot" of stress management support from their doctor. And 41 percent of these chronically ill people said their stress level had increased in the past year, the researchers found.

The disconnect between what people need to manage stress and what the health care system delivers is evident at all ages, the survey found.

For example, 32 percent of respondents said it is extremely important to talk with their doctor about stress management, but only 17 percent said that happens often or always.

Fifty-three percent said they get little or no help with stress management from their doctor, and 39 percent said they have little or no support for other lifestyle issues. Those who felt unsupported were more likely than others to say their stress had increased during the previous year.

This problem is worse for the 20 percent of Americans who consider themselves extremely stressed, the researchers said. Among these people, 69 percent say their stress increased in the past year. Thirty-three percent, however, never discussed their increasing stress with their doctor, according to the report.

The report did find that many people know that controlling stress is important for good health. But for more than one-third of Americans, stress levels are on the rise, they noted.

More information

For more information on stress, visit the U.S. National Library of Medicine.

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How to Use Social Jujitsu To Snag New Business

How do you grow your client base? I was recently quoted in an article on expanding your business with confidence.

By: ANN BROWN

Monday, January 7, 2013

• Business Advice

Some executive leaders are born with it; other develop it. “Social Jujitsu” is the charisma that draws people and potential clients to you like a magnet. In the martial arts world, at its base the Japanese martial art of Jiujitsu is a method of defeating an opponent without a weapon. "Ju" is usually translated as "gentle, supple, flexible, pliable." And "Jitsu" is translated to mean "art" or "technique." Some experts say you can use the philosophy of jujitsu in the business world as the way to woo and win over colleagues and new business. But as with any art form, you have to develop and master the techniques.

Become more of who you are

The worse thing is to pretend to be someone you aren´t. So don´t fake it. “You don't develop a winning personality. You have one. Don't try to be someone you're not. The trick is letting it out,” says Mike Schultz, president and founder of RAIN, who is also a second degree black belt in Seirenkai Jujitsu. Adds Shari Goldsmith of Shari- Life Coach for Women, “Be you; true-to-you-authenticity is attractive. People can spot dishonesty a mile away.” The basics matter

Don´t throw common courtesy out of the window. Be polite and engaging. “Smile, offer a firm but not death grip handshake and open body language. Light touch is an HR no-no, but it's connecting,” Schultz points out. Do your homework

All clients appreciate knowing you have taken the time to study their company and their needs. They will be more attracted to you and what you are offering. “Know that you are offering your client something they need. Be aware of how you perceive your product or services. You are not simply asking for something from them but potentially solving a problem they have. Inquire about what they want to improve in their lives or business and explain how you can help them,” says Licensed Clinical Psychologist Dr. Nerina Garcia-Arcement, Clinical Assistant Professor at Dept. of Psychiatry, NYU School of Medicine and of the Williamsburg Therapy and Wellness.

Be all ears

Merely rattling off a sales pitch is an empty gesture. Listen to what is being said to you, what is being asked of you. “Listen more than you talk, but don't make it all listening,” says Schultz.

Apply the personal touch

You don´t need to tell a complete stranger or a potential client your life story, but sprinkle in personal bits into your conversation. “Don't be afraid to talk about personal things,” advises Schultz. “When you let your personality and personal life shine through, it can be very comforting to people who care about the same things. You have to find mutual areas of connection to build rapport.” Goldsmith agrees. “People want to do business with people that they like and trust. Focus on letting others see the real you and be consistently kind and honest,” she adds.

And, when you share, seek out information about your client. “Don't see people as just potential clients, see them as individuals you can get to know on a personal basis. Be friendly, look for potential connections and common interests.  This will help everyone feel more comfortable. For example, you both might have small children or enjoy the same sport,” stresses Dr. Garcia-Arcement. “Once you know your clients on a more personal level, this aids in breaking the ice at the next meeting. Inquire about their family, their favorite sport or recent trip. This will help everyone feel like they are doing business with a friend instead of a stranger.”

Throw out bias and discriminatory tendences

Never make assumptions. Not only is it a good rule in life but business as well. “Treat everyone the same, no matter what their station in life. You never know where your future business is going to come from. Don't judge,” says Goldsmith. Dare to be different

Being cookie cutter is boring. You want people to be excited about doing business with you, about having you around. “Be unique--know what makes you different and play it up,” says Goldsmith.

Do unto others..

The “me” generation has come and gone. When possible, help someone on a project. “Help others succeed. Focus on helping others succeed at their goals, and it will come back to you,” says Goldsmith. Confidence is dynamic

If you're timid about or unsure of yourself, your product/services, then how can you expect a customer to be eager to do business with you? “Feel confident in your product or service. Know why the product is worth selling. If you know the virtues of the product or services, it will show in your sales pitch,” advises Dr. Garcia-Arcement.

On call As a small business owner, you´re always on call. You have to be ready to tell someone about your product at a moment´s notice—and with passion. People tend to respond to this approach just because of the sheer enthusiasm. “Prepare the proverbial elevator speech. This speech is best if you don't have a lot of time and want to get the client's attention. What would you say about the product you are selling if you only had a few moments with a client? If you have that prepared and memorized, it will reduce your anxiety the next time you approach a client,” says Dr.  Garcia-Arcement.

Martial arts mindset

Martial arts philosophies can easily be applied to business and business situations. “As far as jujitsu, the best conversation and connection application is a concept called kuzushi. Kuzushi literally means unbalancing, and it's applied as a redirecting of energy from one direction gently but specifically to another,” explains Schultz, author of the bestseller Rainmaking Conversations. “If you know where you want to go in a conversation, you can gently move it down to that path from wherever it's going. But do it subtly. For example, if you want to talk about an exciting project you're working on, don't just start talking..Just ask the other person, 'What's the most exciting thing you're working on.' They'll share, and then they'll ask you. At the same time, they're thinking 'what a great conversationalist,' and you got them to do what you wanted without forcing it.”

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Bounce Back from Setbacks - Help Kids Handle Disappointment

How do you handle disappointment and how are you teaching your child to manage setbacks? I was recently quoted on how to help kids learn to manage when they feel disappointed. Written by Heidi Smith Luedtke, Ph.D.; Photo: PhotoXpress.com

No one – including Supermom – can prevent kids from experiencing setbacks in life. Your daughter may miss the class field trip because she caught a nasty cold. Or she may come home crying when her science-fair project earns a lower-than-hoped-for grade.

Kids’ disappointments are no fun for parents to witness. But kids learn to lift themselves up when they get knocked down. Marriage and family therapist Christina Steinorth, M.A., author of Cue Cards for Life, says parents can help kids learn to bounce back from adversities by taking a teaching role. During tough times, aim to build your child’s coping skills and reinforce the value of persistence. Here’s how.

Acknowledge emotions – Family and art therapist Erica Curtis, MFT, says kids’ setbacks may feel intensely personal to parents. When our kids hurt, we hurt too. “Parents need to clarify their own feelings about the situation,” she says. “A parent may be more disappointed – or may assume the child is more disappointed – than the child actually is.”

Research shows we are biologically wired to catch others’ emotions through a process called emotional contagion. Mirroring others’ feelings promotes and preserves social connections by allowing us to feel empathy. But there is a downside: It’s easy to forget whose feelings you’re feeling. When that happens, you may overreact or respond with ways that amplify your child’s distress instead of helping them regroup.

It’s important to get an accurate read of your child’s feelings about what happened. Sometimes kids share intense bad feelings with parents then move on quickly. Other times, kids may feel truly and utterly devastated. Pay close attention to your child’s words, body language and behavior. All of these things provide insight into kids’ feelings and give clues about how effectively they are coping.

Accept your child’s emotional reaction, even if it seems overblown. “Parents need to be able to tolerate kids’ bad feelings,” says Curtis, even if they are uncomfortable. Take a deep breath and remind yourself parenting is hard. If needed, step back and tend to your own emotions first, so you can give generous comfort and support to your child.

Build coping skills – Start by giving your child a safe place to share their experiences. “The most important thing a parent can do is to listen actively. That means nodding, paraphrasing back what you’ve heard and asking questions instead of offering solutions,” says Curtis. If your child reports, “I wanted our team to be called the ‘Crushers’ but the other guys didn’t listen,” mirror his feelings by responding, “It sounds like you really wanted the team to choose the name you suggested.” This shows you are listening and validates your child’s point of view.

As your child describes the situation in greater detail, “encourage her to identify and label her feelings,” says clinical psychologist and mom Nerina Garcia-Arcement, Ph.D. Assigning specific emotion words to feelings helps kids address them more effectively. A child who says, “I feel angry because my best friend blabbed my secret to everyone else,” is ready to explore potential responses. One who just cries and moans, “It’s awful,” is not. Labeling emotions gives kids a sense of control and composure and decreases the chance they’ll act out in harmful ways to express their feelings.

As your child explains what happened, prompt them to identify potential reasons for the setback. For instance, you might ask, “What do you think got in the way of you running a faster race?” Instead of letting them focus on one or two obvious reasons, encourage your child to come up with more. There is usually a range of factors, both personal and situational, that may have affected an unhappy outcome.

Explore each reason with your child to identify ways they could do things differently next time. This helps your child move from feeling bad to doing better. For instance, noting they felt tired before the race started might lead your child to come up with ideas about eating a snack before the track meet or going to bed earlier. Specific action steps empower kids to bounce back on their own terms.

Encourage your child to write down their intended actions, so they’ll remember the plan. This also reinforces their commitment to change. Offer your support by asking what you can do to facilitate your child’s goals. “Parents have to commit to making changes along with the child,” says Garcia-Arcement. If your child says they need more practice to make first chair in the clarinet section, you may need to tweak the afterschool routine to find more practice time or designate a music-practice space in your home. Bottom line: Do what you can to create a supportive environment.

Pay it forward – After the pain has passed, talk with your child about what they learned. Focus on knowledge gained and skills developed. Perhaps your child learned how to speak up for themselves. Or maybe they built project-planning skills – such as goal-setting and task-scheduling – that they can apply to other endeavors. If your child can’t articulate what they learned, share your own observations. And don’t forget to tell them you’re proud of their improvement. Kids need to know parents notice.

When the next setback happens, remind your child how they handled previous situations and encourage them to apply past learning to present challenges. Be a confidant and a sounding board. Help your child find their own way forward. Then step back and watch them grow through adversity. Responding to disappointment with confidence, grit and good humor is the key to being a happy, successful person.

Heidi Smith Luedtke, Ph.D., is a personality psychologist, mom of two and author of Detachment Parenting. Learn more at heidiluedtke.com.

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Qi Gong Techniques Help Cancer Patients Cope

Practicing a combination of breathing, meditation and movement to achieve a state of relaxation and peace of mind improves quality of life, cancer-related symptoms and treatment side effects and promotes patient longevity. By: Lynette Summerill

Feeling anxious or stressed about a cancer diagnosis is a very normal response. After all, it’s a life changing experience. Patients and their loved ones often feel a whole range of emotions when learning to deal with the disease, treatments and its side effects. It’s not a road easily traveled. So naturally, finding positive coping mechanisms is essential to realizing the best possible outcome.

The mental stress that accompanies a cancer diagnoses not only negatively affects quality of life, it can actually contribute to suppression of the immune system, aggravating the side effects of chemotherapy and slowing the healing process, according to the National Cancer Institute.

Many cancer patients are finding stress-reducing health benefits by incorporating the ancient Chinese system into their treatment protocol. Qi Gong, sometimes called chi kung or vital energy exercises, involves breathing, meditation and movement to achieve a state of relaxation and peace of mind. Translated, qi gong means “breath work” or “energy work”.

While qi gong is typically not considered a “cure” for cancer, it is extremely helpful in coping with the disease. Practitioners say the exercises help manage pain, reduce anxiety, provide increased strength and enhance the quality of life.

The goal of qi gong is to help the flow of energy or “qi” (pronounced chee) through the body. The two forms of qi gong—external and internal— are exercises that people can do on their own or with a skilled master. It can also be used to target specific areas of the body. However, if this makes you feel a little too existential, there is also strong scientific evidence to suggest beneficial health outcomes associated with its practice.

Researchers from the Santa Barbara-based Institute of Integral Qigong and Tai Chi, Arizona State University and the University of North Carolina analyzed data from 66 randomized controlled qi gong trials involving 6,410 participants. The review was published in the American Journal of Health Promotion.

The researchers found the strongest and most consistent evidence of health benefits included bone health, cardiopulmonary fitness, balance, mental focus, improved quality of life and self-efficacy (the confidence in and perceived ability to perform a behavior.) The reviewers concluded sufficient evidence exists to suggest qi gong is a viable alternative to conventional forms of exercise.

More recently, a 2008 pilot study of medical qi gong (MQ) for cancer patients, conducted by University of Sydney researchers found MQ to be “an effective therapy for improving quality of life, cancer-related symptoms and treatment side effects and promote patient longevity” compared to non-practicing MQ cancer patients. Qi gong has also been found in medical studies to produce long-term physical benefits by reducing inflammation in some cancer patients.

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'Personality Genes' May Help Account for Longevity

Laughing, being optimistic, staying engaged in activities, and being outgoing can help you live longer? These personality traits appear to be common among those that live to be 100. May 24, 2012 — "It's in their genes" is a common refrain from scientists when asked about factors that allow centenarians to reach age 100 and beyond. Up until now, research has focused on genetic variations that offer a physiological advantage such as high levels of HDL ("good") cholesterol. But researchers at Albert Einstein College of Medicine and Ferkauf Graduate School of Psychology of Yeshiva University have found that personality traits like being outgoing, optimistic, easygoing, and enjoying laughter as well as staying engaged in activities may also be part of the longevity genes mix.

The findings, published online May 21 in the journal Aging, come from Einstein's Longevity Genes Project, which includes over 500 Ashkenazi Jews over the age of 95, and 700 of their offspring. Ashkenazi (Eastern European) Jews were selected because they are genetically homogeneous, making it easier to spot genetic differences within the study population.

Previous studies have indicated that personality arises from underlying genetic mechanisms that may directly affect health. The present study of 243 of the centenarians (average age 97.6 years, 75 percent women) was aimed at detecting genetically-based personality characteristics by developing a brief measure (the Personality Outlook Profile Scale, or POPS) of personality in centenarians.

"When I started working with centenarians, I thought we'd find that they survived so long in part because they were mean and ornery," said Nir Barzilai, M.D., the Ingeborg and Ira Leon Rennert Chair of Aging Research, director of Einstein's Institute for Aging Research and co-corresponding author of the study. "But when we assessed the personalities of these 243 centenarians, we found qualities that clearly reflect a positive attitude towards life. Most were outgoing, optimistic and easygoing. They considered laughter an important part of life and had a large social network. They expressed emotions openly rather than bottling them up." In addition, the centenarians had lower scores for displaying neurotic personality and higher scores for being conscientious compared with a representative sample of the U.S. population.

"Some evidence indicates that personality can change between the ages of 70 and 100, so we don't know whether our centenarians have maintained their personality traits across their entire lifespans," continued Dr. Barzilai. "Nevertheless, our findings suggest that centenarians share particular personality traits and that genetically-based aspects of personality may play an important role in achieving both good health and exceptional longevity."

The study is titled "Positive attitude towards life and emotional expression as personality phenotypes for centenarians." The POPS was developed by lead author Kaori Kato, Psy.D., now at Weill Cornell Medical College, who validated it through comparisons with two previously established measures of personality traits. Other authors of the study were Richard Zweig, Ph.D., assistant clinical professor of psychiatry and behavioral sciences at Einstein and director of the Older Adult Program at Ferkauf, and Gil Atzmon, Ph.D., assistant professor of medicine and of genetics at Einstein.

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Yoga Helps Ease Stress Related Medical and Psychological Conditions, Study Suggests

Yoga might increase GABA activity, low GABA (neurotransmitter) is linked to anxiety disorders, post-traumatic stress disorder, depression, epilepsy, and chronic pain. So practicing yoga might reduce distress from these disorders. Mar. 6, 2012 — An article by researchers from Boston University School of Medicine (BUSM), New York Medical College (NYMC), and the Columbia College of Physicians and Surgeons (CCPS) reviews evidence that yoga may be effective in treating patients with stress-related psychological and medical conditions such as depression, anxiety, high blood pressure and cardiac disease. Their theory, which currently appears online in Medical Hypotheses, could be used to develop specific mind-body practices for the prevention and treatment of these conditions in conjunction with standard treatments.

It is hypothesized that stress causes an imbalance in the autonomic nervous system (parasympathetic under-activity and sympathetic over-activity) as well as under-activity of the inhibitory neurotransmitter, gamma amino-butyric acid (GABA). Low GABA activity occurs in anxiety disorders, post-traumatic stress disorder, depression, epilepsy, and chronic pain. According to the researchers, the hypothesis advanced in this paper could explain why vagal nerve stimulation (VNS) works to decrease both seizure frequency and the symptoms of depression.

"Western and Eastern medicine complement one another. Yoga is known to improve stress-related nervous system imbalances," said Chris Streeter, MD, associate professor of psychiatry at BUSM and Boston Medical Center, who is the study's lead author. Streeter believes that "This paper provides a theory, based on neurophysiology and neuroanatomy, to understand how yoga helps patients feel better by relieving symptoms in many common disorders."

An earlier study by BUSM researchers comparing a walking group and a yoga group over a 12-week period found no increase in GABA levels in the walking group, whereas the yoga group showed increased GABA levels and decreased anxiety. In another 12-week BUSM study, patients with chronic low back pain responded to a yoga intervention with increased GABA levels and significant reduction in pain compared to a group receiving standard care alone.

In crafting this neurophysiological theory of how yoga affects the nervous system, Streeter collaborated with Patricia Gerbarg, MD, assistant clinical professor of psychiatry at NYMC, Domenic A. Ciraulo, MD, chairman of psychiatry at BUSM, Robert Saper, MD MPH, associate professor of family medicine at BUSM, and Richard P. Brown, MD, associate clinical professor of psychiatry at CCPS. They are beginning test these theories by incorporating mind-body therapies such as yoga in their clinical studies of a wide range of stress-related medical and psychological conditions.

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Awakening to sleep

New research describes the immense impact sleep deprivation has on our minds and bodies. Tempted to read just one more email before you sleep? Don't. New research finds that not getting enough sleep — whether because of our insatiable desire for digital media or more traditional sleep disturbances — has far-reaching effects on physical and psychological health.

By Dr. Siri Carpenter

January 2013, Vol 44, No. 1

Print version: page 40

Orfeu Buxton, PhD, has just pulled his first all-nighter in six years, and he is tired. Earlier in the week, he stayed up all night for the final push on a grant application to the National Institute on Aging, coordinating a small crew who worked past dawn. Two days later, he's still exhausted and says he feels "ghostlike." He may also be a little embarrassed. As a sleep researcher, he should know better. "Maybe next time the irony will be too powerful," says Buxton, a neuroscientist in the Harvard University School of Medicine and the Division of Sleep Medicine of Brigham and Women's Hospital in Boston.

Buxton has plenty of company in his sleeplessness. Technology keeps serving up ever more enticing ways to put off bedtime — whether for entertainment or work — and in this era of economic uncertainty, job and financial stress keeps millions of Americans from getting a good night's sleep. Data on just how much the nation sleeps are imprecise, but among scientists, the consensus is that it's not enough. According to the Centers for Disease Control and Prevention (CDC), a quarter of U.S. adults say they don't get enough sleep at least half of the time. Research indicates that a quarter of teens get no more than 6.5 hours, far short of the nine or so hours most need. And a 2012 study from the CDC's National Institute for Occupational Safety and Health found that 41 million workers get fewer than six hours of sleep a night — significantly less than the seven to nine hours that experts recommend.

Researchers are unlocking the unsettling and far-reaching health consequences of losing all of this sleep. Some are obvious: According to the National Highway Traffic Safety Administration, for example, driver fatigue results in 100,000 crashes annually, leading to 1,550 deaths and more than 70,000 injuries.

More subtly, a large body of research now shows that chronically getting too little sleep disrupts many aspects of physical health, including hormone regulation, glucose metabolism, insulin resistance, inflammation processes, pain perception and immune function, to name a few.

In a guest editorial for Sleep Medicine Reviews, clinical psychologist Michael Grandner, PhD, of the Center for Sleep and Respiratory Neurobiology at the University of Pennsylvania, argued that along with diet and exercise, "sleep should be considered a key domain of healthy behavior." The same sort of public health resources devoted to education and interventions promoting activity and healthy eating, he and others argue, should also be directed at promoting healthy sleep.

With the mounting evidence that normal variations in sleep can lead to poorer health, both the public health community and the media now seem to be waking up to the importance of sleep in our overall health. Fixing some sleep problems may seem as simple as following a few key "sleep hygiene" guidelines, but there is still a disconnect. The temptation to check one more message, read one more article or watch one more episode is powerful and insidious.

Every hour counts

In 1938, University of Chicago physiologist Nathaniel Kleitman, PhD, and a colleague sequestered themselves for 32 days in the bowels of Kentucky's Mammoth Cave to reset their bodies to a 28-hour clock and track the physical and psychological consequences of doing so. Kleitman, whose first paper on sleep deprivation was published in 1923, is considered the founder of sleep research in the United States. His research on circadian processes and his co-discovery of the rapid-eye movement, or REM, stage of sleep in the early 1950s were foundational developments. (Kleitman's willingness to tamper with his own sleep seems, paradoxically, not to have harmed his health — he lived to the age of 104.)

Throughout Kleitman's life and since, the University of Chicago (UC) remained a center of sleep research. In 1963, Kleitman's colleague Allan Rechtschaffen, PhD, described the first sleep disorder, narcolepsy. In another influential series of studies conducted during the 1980s, Rechtschaffen showed that sleep-deprived rats eventually died from the collapse of their thermoregulatory systems.

But despite such striking demonstrations of sleep's importance to basic physiological functioning, sleep science struggled for recognition. Sure, most people understood that you might not be your sharpest after a poor night's sleep. And for sleep researchers, it seemed obvious that anything we did for a third of our lives was probably important. But for the most part, popular culture and academia alike just yawned and declared: "It's only a quarter [of your life] if you're tough." And researchers didn't have much of a comeback.

But they were on the trail. In 1991, UC sleep medicine specialist Eve Van Cauter, PhD, reported in the Journal of Clinical Investigation that subjecting healthy people to total sleep deprivation threw off their glucose tolerance and insulin resistance and that these issues resolved after recovery sleep. Since then, dozens of studies have elaborated on that finding.

For years, laboratory sleep research focused on extreme kinds of sleep loss — the kind of total deprivation that Buxton experienced when he pulled his all-nighter. But outside the nation's sleep labs, far more common than total sleep deprivation is what researchers variously call partial sleep loss, sleep restriction or short sleep. Whatever they call it, they're referring to chronically cutting one's sleep short by just an hour or two a night. The first study to look closely at the health effects of partial sleep was published in The Lancet in 1999. In that study, Van Cauter's team found that levels of leptin, a hormone that regulates hunger and appetite, dropped 19 percent during a period of partial sleep deprivation.

The cardiometabolic trap

Subsequent studies have confirmed the effects of partial sleep loss on hormone regulation and have led to a burgeoning of research on the role of sleep in obesity, diabetes and cardiovascular disease — a tangled triumvirate of sickness and mortality that are key elements of what researchers sometimes refer to as cardiometabolic disease. In a 2012 article published in the American Journal of Human Biology, UC biomedical anthropologist Kristen Knutson, PhD, reviewed research on sleep and cardiometabolic health and concluded that sleep restriction leads to "substantial and clinically significant changes in appetite regulation, hunger, food intake, glucose metabolism and blood pressure control." Knutson also found a significant association between short sleep duration (less than six hours per night, in most studies) and either more obesity or a higher body mass index. Adolescents and children showed a stronger association, suggesting they may be especially vulnerable to the effects of lost sleep.

One way in which lack of sleep may thwart cardiometabolic health is by skewing people's dietary choices. In a 2011 study published in the American Journal of Clinical Nutrition by a large multicenter team, healthy men and women who were restricted to just four hours of sleep per night over six nights took in significantly more calories, particularly from fat, than their well-rested counterparts — and they didn't make up for it by burning more energy.

Another study, conducted by Arlet Nedeltcheva, MD, and colleagues at UC and published in the American Journal of Clinical Nutrition in 2009, found that adults who were allowed to sleep only 5.5 hours per night for two weeks indulged in more snacks than their counterparts who enjoyed 8.5 hours of sleep each night. Likewise, in a 2012 yet-to-be-published study that drew on data from the CDC's 2007–08 National Health and Nutrition Examination Survey, Knutson, Grandner and colleagues mapped dietary patterns to sleep complaints including difficulty falling asleep, difficulty staying asleep, non-restorative sleep and daytime sleepiness. Every complaint, they found, was significantly associated with greater total caloric intake.

In a 2012 study published in the Annals of Internal Medicine, a team of UC researchers uncovered a molecular clue to how lack of sleep might promote diabetes: Fat cells in people who don't get enough sleep have a 30 percent reduced ability to respond to insulin. Fortunately, the biochemical processes that sleep loss sets in motion may reversible, at least if skipping sleep doesn't become a lifelong habit. In September, psychologist Karen Matthews, PhD, of the University of Pittsburgh, reported in SLEEP that if teens who normally got six hours of sleep per night were allowed just one extra hour of sleep, their insulin resistance improved by 9 percent.

Now, Till Roenneberg, PhD, of the University of Munich's Institute of Medical Psychology, has introduced a new wrinkle to the sleep literature: The physiological chaos that ensues when the body's internal clock, which is set by our exposure to sunlight and night-time darkness, is out of sync with our "social clocks," which are set by the demands and temptations of modern life, from early-morning alarms to the late lure of "The Daily Show." Roenneberg calls this familiar brand of circadian disruption "social jet lag," noting that staying up later and sleeping later on weekends, then wrenching one's schedule back in time at the beginning of each workweek, is akin to traveling from New York to Denver every Friday night, then returning every Monday morning.

In a study in Current Biology in 2012, Roenneberg and colleagues in Germany and the Netherlands surveyed 65,000 European adults to understand their sleep habits, health behavior and physical health. They found that 69 percent of respondents suffered from at least an hour of social jet lag each week, and a third of participants regularly suffered at least two hours of social jet lag. Like short sleep, social jet lag appears to be a significant health hazard. Even after the researchers accounted for sleep duration and other characteristics that affect health, people who suffered social jet lag were more likely to be overweight than those whose social and biological clocks were more in sync. And among people who were overweight, more extreme social jet lag was associated with much greater risk of obesity.

The importance of considering both the duration and the timing of sleep is further bolstered by a study by Buxton and colleagues, which showed that disrupting people's internal clocks as well as partially restricting their sleep could increase risk of both diabetes and obesity. In the research, reported in Science Translational Medicine in 2012, Buxton's group controlled the sleep and diet of 21 participants for six weeks, cutting their sleep by about two hours per night and subjecting them to an artificial 28-hour circadian day for three weeks. The participants' pancreatic function went "haywire," Buxton says, causing hyperglycemia after a breakfast meal, which over time leads to increased risk of diabetes. The circadian and sleep disruption also caused a metabolic slowdown that, if not counteracted, would cause a weight gain of about 10 pounds a year.

Far-reaching effects

The ill effects of too little sleep go well beyond metabolism and cardiovascular risk. For example, research indicates that sleep loss also messes with people's moods and leads to exaggerated pain perception. In a 2005 study published in Pain, Harvard University neurologists Monika Haack, PhD, and Janet Mullington, PhD, brought research participants into the laboratory and randomly assigned them to sleep for either four or eight hours per night for 12 consecutive nights. Even when participants did not report fatigue, the shorter sleepers reported lower levels of optimism and sociability, an effect that grew stronger the longer the experiment continued.

Haack and Mullington also found that sleep-deprived research participants reported increasing "bodily discomfort" — known to most of us as pain — starting after the second sleep-deprived night and lasting until after their recovery sleep. In a follow-up study published in SLEEP in 2007, they found that sleep deprivation caused increases in blood plasma levels of interleukin-6 (IL-6), a signaling molecule that contributes to pain sensitivity. The more bodily discomfort that participants reported in Haack and Mullington's study, the more their IL-6 levels were elevated. Even though the increases in IL-6 were typically small, the researchers argued that they may play an important role in exacerbating pain.

Sleep's importance is now felt across more areas of medicine. In a 2012 study in the American Journal of Geriatric Psychiatry, psychologist Kathi Heffner, PhD, of the University of Rochester Medical Center, and colleagues reported that when healthy men and women age 50 and older were given stressful cognitive tasks, those who were poor sleepers showed a larger IL-6 response — a marker of inflammation — than did good sleepers.

Other research shows that sleep apnea and other sleep-disordered breathing (SDB) conditions are associated with higher cancer incidence as well as more deaths from cancer. In a study published in the American Journal of Respiratory and Critical Care Medicine in 2012, the University of Wisconsin's F. Javier Nieto, MPH, MD, PhD, and colleagues found that the incidence of cancer deaths in patients with severe SDB was five times higher than in those without the disorder.

Even the body's immune response to vaccines is weaker if the recipient is short on sleep, according to a recent study in SLEEP led by University of California, San Francisco, health psychologist Aric Prather, PhD. The researchers gave 125 healthy adults a three-dose series of hepatitis B shots, monitoring their sleep duration and quality for a week before and after each shot. Results showed that people who slept less during the study had lower antibody response to the vaccine, potentially increasing their susceptibility to hepatitis infection.

Who lacks sleep?

Just as important as understanding the effects of insufficient sleep is understanding who is most at risk, so that efforts to fix the problem can be concentrated most effectively. In recent years, sleep researchers have found that insufficient sleep is related to a constellation of social factors, including socioeconomic status, race and ethnicity, and workplace and neighborhood conditions.

In a 2010 survey of 9,714 randomly selected Pennsylvania adults, published in BMC Public Health, Grandner and colleagues found a significant "sleep disparity" within the sample. Overall, minority respondents had poorer sleep quality than white respondents. However, among those who were impoverished, whites unexpectedly fared worse.

In the most refined look at sleep and race to date, Northwestern University's Mercedes Carnethon, PhD, used wrist monitors to study sleep patterns in a random sample of 500 healthy U.S. adults. Results showed that after accounting for potentially confounding cardiovascular disease risk factors and education levels, black adults slept an average of only 6.8 hours per night, compared with 7.4 hours, on average, for whites. Asians and Hispanics didn't fare much better — they slept an average of 6.9 hours per night.

Workplace conditions also appear to exert power over one's sleep — or lack thereof. In a 2010 study in the Journal of Occupational Health Psychology that looked at sleep duration and cardiovascular disease risk in 393 health-care workers, Buxton and colleagues found that workers with less-supportive managers — as defined by their "openness and creativity in dealing with employee work-family needs" — got 29 minutes less sleep daily and were twice as likely as those with more supportive bosses to have two or more risk factors for cardiovascular disease. "That's a powerful effect of a supervisor on their low-wage employees," Buxton says.

Where one lays one's head is another important risk factor, says Lauren Hale, PhD, of Stony Brook University School of Medicine. She suspects that people in low-income neighborhoods can't sleep as well due to a constellation of physical and psychological hazards — from high-traffic streets and inadequate heating and cooling to food insecurity and landlord hassles. In a study published in Social Science & Medicine in 2012, Hale and colleagues examined the associations among neighborhood conditions, sleep quality and health in using data from the Survey of the Health of Wisconsin. People who reported they lived in neighborhoods with more physical and social disorder tended also to report poorer sleep quality, perceive their health as poorer and experience more symptoms of depression.

By statistically controlling for numerous demographic and health factors, Hale's team found that people's sleep quality accounted for about 20 percent of the association between neighborhood quality and both self-rated health and depression. "The determinants of poor sleep fall along lines of social disadvantage," Hale concludes. "My hunch is that it's bigger than just A/C and noise. It's more about autonomy. If people have choices and control over their lives, they have more ability to shut down at night and sleep when they need to sleep and wake up when they need to wake up."

Findings that link sleep deficiencies to social factors signal a need for a more sophisticated public health approach to promoting healthy sleep, sleep researchers believe. "We have to understand the social and environmental context of health behaviors before we can intervene on them," Grandner says. For some people, simple changes to "sleep hygiene" can go a long way toward ensuring a good night's sleep. But it would be naïve to believe that across the board, simply educating people about the importance of healthy sleep habits — avoiding caffeine late at night, having a consistent bedtime routine, eschewing the seductive blue light of the laptop late at night — will be sufficient to correct endemic problems that lead to insufficient sleep.

Strength in sleep

"I'll sleep when I'm dead."

You've no doubt heard it said, and possibly even said it yourself. You were joking, and projecting a certain brio, the notion that sleep is a luxury.

Buxton doesn't see the humor, and he has a quick retort. "If you want [death] to come sooner," he responds. Sleep, he argues, can be an incredibly strong indication "of things going well or things going wrong."

Even as the causes and consequences of insufficient sleep become better understood, developing and implementing behavioral interventions to improve sleep are likely to be major challenges. Grandner speculates that doing so will require a community-based behavioral strategy, similar to campaigns used to improve diets and promote regular exercise.

Can we change health at a societal level by changing sleep patterns?

"I think it's possible," Hale says. "Do I think it's easy? No." But she does think it's important to try to tackle the deteriorating length and quality of sleep wrought by new devices, new media and new societal pressures. Recently, she came across a disturbing video in which a motivational speaker tells teens, "If you're going to be successful, you've got to be willing to give up sleep. … You've got to be willing to work off of three hours of sleep, two hours … because if you go to sleep, you might miss the opportunity to be successful."

"I hate the ethos that sleep is for the weak," she says. "That's very shortsighted, and the wrong message to be sending adolescents. In the long run, everybody is better off if they go to bed at a reasonable hour."

---

Siri Carpenter, PhD, is a writer in Madison, Wis.

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New Year, New Tips To Handle Work Stress

By Nerina Garcia-Arcement, Ph.D. Stress is on the rise in the United States. In a recent APA survey, Americans reported a 44% increase in their stress over the past five years. What are people worried about?  Money, relationships, work and the economy are at the top of the list.  Work is a popular concern. Not only are individuals worried about losing their jobs in this down economy but also about increased job responsibilities and difficult interpersonal relationships.  All this worry impacts your sleep, physical and mental health, and productivity. It also erodes your ability to be patient when dealing with others—all things that can make working more difficult and put your job at risk.

If this sounds familiar, you are not alone. The good news is you can change this. There are simple steps you can take that will help you manage your stress and improve your quality of life. Below are proven stress reduction suggestions you can use at work and at home.

While at work build into your day these three tips.

1. Walk away from what is stressing you and take regular breaks. Time-outs are not just for toddlers. They are an effective coping strategy that will allow you to clear your mind and refocus, as well as be more productive and creative.

2. Take deep breaths. Shallow breathing increases anxiety, while deep, slow breathing helps calm your mind and body.

3. Stretch your tense muscles. For example, progressive muscle relaxation sends your brain a message that you are safe and relaxed which helps reduce stress and anxiety.

While at home, try these habits regularly to decrease your stress.

1. Practice yoga. Even a few minutes will help calm your mind and relax your body.

2. Use imagery. Imagine yourself in a safe place, such as the beach or a cabin in the mountains. If imagining a peaceful place is difficult, you can use memories from a favorite vacation spot or familiar personal sanctuary (even if it’s just your favorite bench in Central Park).  Your memories will trigger positive feelings and distract you from your stress at the same time.

3. Speak to a trusted friend or family member. Share what is upsetting you, whether in person or over the phone. Social support is a great stress reducer and mood enhancer.

Preventing stress before you feel it is even better. Follow these suggestions to stop the stress before it hits.

1. Have open communication with your supervisors/bosses about what projects you are working on and their status.

2. Ask for help when you need it. We all require assistance at some point. Don't be afraid to ask for what you need.

3. Create a detailed list of work requirements and deadlines. This way you don't waste mental energy keeping track of what needs to get done and instead focus on how to accomplish those tasks.

If these tips are not enough, consider talking to a mental health provider that specializes in stress management.

Visit http://www.apapracticecentral.org for more information about stress.

Mental Illness and Marriage

I was interviewed on how mental illness affects marriage and how to cope. Listen to the podcast.

What kind of impact does mental illness have on a marriage?

In today’s society, it’s becoming more and more common for individuals to be living with some sort of mental health condition or illness like anxiety or depression. And while there are many issues and conditions that present themselves in different, unique ways, oftentimes the effects on a marriage are very similar.

In addition to anxiety and depression, some people suffer from more extreme conditions like post-traumatic stress disorder and substance abuse problems. When these issues creep in without the proper treatment, their impact on a marriage and the individual can be fundamentally problematic. In some situations, the partner without the condition will have to pick up the slack for the other. And in many cases, couples will begin to suffer from tension and exhaustion within their marriage.

Our guest today is Dr. Nerina Garcia, a clinical psychologist with Williamsburg Therapy and Wellness in Brooklyn, NY. Nerina is here to give us some advice about how couples and individuals can learn to cope with mental illnesses within marriages while building a network of support.

To find out more about Nerina and her practice, visit her website or call (917) 816-4449.

Podcast: Play in new window | Download

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To Drink or Not To Drink At Holiday Work Parties: Easy Steps to Managing The Stress

By Nerina Garcia-Arcement, Ph.D.

Work place holiday parties can be a time to connect with co-workers in a different friendlier setting. Yet for many it can also be stressful and awkward. Stressful because individuals are familiar with their workplace expectations, they have scripts or rules they follow on a regular basis, yet holiday parties create the opportunity for a different social interactions that does not follow familiar rules.  It is a blending of expectations that can create stress and uncertainty about how to behave. One common way to cope with stress or anxiety is drinking alcohol, sometimes to excess.  Some drink as a way to numb or avoid feeling uncomfortable emotions, yet it can lead to problems if done at work. Over drinking at the holiday party can create problems in the workplace if you behaved inappropriately while drunk. Although this is a "party" it is still work related and those rules of conduct still apply. Sober and drunk behavior reflects upon who you are as an employee.

If you tend to over drink at holiday work parties, here are a few steps you can take to protect yourself from overindulging.

1. Explore what triggers you to drink. Such as: Do you feel anxious when you walk into the party alone? Do you worry about having to speak to certain co-workers? Do you find it difficult to say “no” when encouraged to have another drink by coworkers?

2. Prepare yourself before the event by engaging in stress reduction activities. If you know that interacting socially with co-workers is stressful or anxiety provoking try activities such as deep breathing, imagining yourself in a peaceful place, reading a chapter of a favorite book, and/or progressive muscle relaxation.

3. Create a plan to managing your feelings and triggers before and during the party. Recognize your triggers and walk away from them or surround yourself with positive supportive coworkers that don't encourage excessive drinking.

4. Stick to your specific plan regarding drinking. If you are not going to drink at all then remove yourself from that temptation by holding a cup with soda throughout the party or staying away from the beverage area. Take steps to succeed with the plan, such as letting your coworker friends know you are not drinking at the party. If you decide to set a limit to your drinking, remember that once you start drinking inhibitions lower and you might be tempted to alter your original plan and it becomes more difficult to keep track of how many drinks you had.

5. Invite a friend to attend with you or shorten the length of time you stay at the party if you know the party is a trigger and difficult to manage by yourself. You are not expected to stay for the entire time.

If you are concerned about how stressed and anxious you feel when faced with an invitation to a social gathering or that you over drink when at parties, then you ought to consider speaking to your primary care physician or a mental health provider to evaluate if these actions are a sign of a more serious problem such as depression, an anxiety disorder, or substance abuse disorder.

Childhood Trauma Leaves Mark On DNA of Some Victims: Gene-Environment Interaction Causes Lifelong Dysregulation of Stress Hormones

How we live and what happens to us changes our genes. Trauma in early childhood can change DNA and lead to PTSD, anxiety and depression.

Dec. 2, 2012 from Sciencedaily.com— Abused children are at high risk of anxiety and mood disorders, as traumatic experience induces lasting changes to their gene regulation. Scientists from the Max Planck Institute of Psychiatry in Munich have now documented for the first time that genetic variants of the FKBP5 gene can influence epigenetic alterations in this gene induced by early trauma.

In individuals with a genetic predisposition, trauma causes long-term changes in DNA methylation leading to a lasting dysregulation of the stress hormone system. As a result, those affected find themselves less able to cope with stressful situations throughout their lives, frequently leading to depression, post-traumatic stress disorder or anxiety disorders in adulthood. Doctors and scientists hope these discoveries will yield new treatment strategies tailored to individual patients, as well as increased public awareness of the importance of protecting children from trauma and its consequences.

Many human illnesses arise from the interaction of individual genes and environmental influences. Traumatic events, especially in childhood, constitute high risk factors for the emergence of psychiatric illnesses in later life. However, whether early stress actually leads to a psychiatric disorder depends largely on his or her genetic predisposition.

Research Group Leader Elisabeth Binder of the Max Planck Institute of Psychiatry examined the DNA of almost 2000 Afro-Americans who had been repeatedly and severely traumatised as adults or in childhood. One-third of trauma victims had become ill and was now suffering from post-traumatic stress disorder. The risk of developing post-traumatic stress disorder rose with increasing severity of abuse only in the carriers of a specific genetic variant in the FKBP5 gene. FKPB5 determines how effectively the organism can react to stress, and by this regulates the entire stress hormone system. The scientists hoped to cast light on the mechanisms of this gene-environment interaction by comparing modifications of the DNA sequence of victims who had not become ill with that of those who had.

The Munich-based Max Planck scientists were then able to demonstrate that the genetic FKBP5 variant does make a physiological difference to those affected, also in nerve cells. Extreme stress and the associated high concentrations of stress hormones bring about what is called an epigenetic change. A methyl group is broken off the DNA at this point, causing a marked increase in FKBP5 activity. This lasting epigenetic change is generated primarily through childhood traumatisation. Consequently, no disease-related demethylation of the FKBP5 gene was detected in participants who were traumatised in adulthood only.

Torsten Klengel, a scientist at the Max Planck Institute of Psychiatry, explains the findings of the study as follows: "Depending on genetic predisposition, childhood trauma can leave permanent epigenetic marks on the DNA, further de-repressing FKBP5 transcription. The consequence is a permanent dysregulation of the victim's stress hormone system, which can ultimately lead to psychiatric illness. Decisive for victims of childhood abuse, however, is that the stress-induced epigenetic changes can only occur if their DNA has a specific sequence."

This recent study improves our understanding of psychiatric illnesses which arise from the interaction of environmental and genetic factors. The results will help tailor treatment particularly for patients who were exposed to trauma in early childhood, thereby greatly increasing their risk of illness.

Story Source:

The above story is reprinted from materials provided by Max-Planck-Gesellschaft (2012, December 2). Childhood trauma leaves mark on DNA of some victims: Gene-environment interaction causes lifelong dysregulation of stress hormones. ScienceDaily. Retrieved December 10, 2012, from http://www.sciencedaily.com­ /releases/2012/12/121202164057.htm

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Holiday Stress, Parties and Hangovers: Drinking Responsibly This Holiday Season

I was quoted on the negative impact of over drinking at holiday parties. By Rheyanne Weaver HERWriterDecember 4, 2012 - 7:10am

Holiday parties are among the highlights of the winter season, and these parties tend to involve drinking alcohol.

If you’re not careful, you might overindulge in festivities, leading to a hangover the next day. This can become a problem, especially if the next day is a work day.

Caron Treatment Centers recently released survey results from 2,005 adults age 21 and above, suggesting that it is quite common to drink excessively, suffer from a hangover and miss work after a holiday party.

In fact, 64 percent of Americans have either called in sick or know someone who did because of a holiday party hangover.

 74 percent of holiday party attendees drank more than three alcoholic drinks or know someone who has at a holiday party, which is considered above a moderate alcohol limit.

Drinking out of moderation could be a sign of substance abuse or depression, which are major mental health issues.

The workplace can already be filled with stress and competition, so missing work or having impaired functioning in the workplace just adds to a negative workplace atmosphere.

Sometimes alcohol can lead to destructive behavior, which is even worse if the holiday party involves co-workers.

Survey results showed that most people who have attended holiday parties noticed behaviors such as arguing and aggression, excessive use of profanity, drunk driving and inappropriate disclosure of private details.

Dr. Harris B. Stratyner, the vice president of Caron Treatment Centers and New York regional clinical director, said in an email that hangovers can be terrible for mental health because dehydration leads to an “alcoholic migraine.” Serotonin levels also decrease, which leads to depression.

“Drinking too much alcohol can affect your mental health and harm your status in the workplace, because you can come off looking immature and having poor judgment,” Stratyner said.

“Employers and colleagues will start to question your judgment, therefore leading them to question your reliability to meet deadlines and do your job well.”

He suggested only drinking a maximum of two alcoholic drinks at work-related events.

And if you can’t drink in moderation, that is a major red flag.

“I would say that having a hangover and missing work after a holiday party is a sign that you have a problem with alcohol,” Stratyner said. “Anytime alcohol interferes in your life, you have a problem with alcohol. You have now interrupted the way you earn your living.”

Many employers have to make cuts as it is, so looking irresponsible and foolish by over-drinking at a holiday party is not a wise choice. Unfortunately, he said it is quite common for people to overindulge in alcohol during the holidays due to holiday stress.

“People tend to self medicate because they want to relax, escape or manage difficult emotions that may come up,” Stratyner said.

However, alcohol tends to cause more problems than it solves. He suggested engaging in healthier ways to relieve holiday stress, such as shopping early and online, planning a potluck holiday dinner so everyone contributes, and avoiding alcohol and drugs (especially while driving). He recommended exercising consistently, and focusing only on positive past holiday memories.

Rosalie Moscoe, a registered nutritional consultant practitioner and author of “Frazzled Hurried Woman! Your Stress Relief Guide to Thriving ... Not Merely Surviving,” said in an email that hangovers can lead to lower self esteem, especially if people are perceived poorly in the workplace because of their lack of control.

Besides a hangover, an excess of sweets and alcohol can also lead to hypoglycemia, which is associated with mood swings.

She said that for people who are already struggling with substance abuse, holiday parties can be a trigger because of the acceptability of profuse amounts of alcohol.

It can be tempting to drink more at holiday parties because of all the additional holiday stress that piles up, including financial stress and dealing potentially with unpleasant family members.

Nerina Garcia-Arcement, a licensed clinical psychologist, said in an email that if holiday parties involve co-workers, sometimes it can be an awkward situation.

People are anxious about how they should be acting.

They might think that drinking alcohol will relieve any tension, stress and anxiety about the situation.

People who do decide to overindulge in alcohol can suffer side effects of hangovers like low energy level, concentration and attention problems and changes in mood.

Garcia-Arcement said that overdrinking one time and suffering the consequences at work might not be a dealbreaker for employers. However, if it’s on a consistent basis, this could be a sign of serious mental health issues and you could lose your credibility at work (or your job).

Sources: Caron Treatment Centers. Hungover at Work During the Holiday Season? Web. Dec. 3, 2012.

http://www.caron.org/hungover-at-work-during-the-holiday-season.html

Stratyner, Harris. Email interview. Dec. 3, 2012.

Moscoe, Rosalie. Email interview. Dec. 3, 2012.

Garcia-Arcement, Nerina. Email interview. Dec. 3, 2012.

Reviewed December 4, 2012 by Michele Blacksberg RN Edited by Jody Smith

Link to article

El Huracán Sandy: Como Lidiar con las Secuelas Emocionales

Por Nerina Garcia,-Arcement Ph.D. Traducción por Carla Saad, B.A.

Los desastres naturales, como el Huracán Sandy, nos recuerdan que tan vulnerables somos.  Entre más cercano haya sido la experiencia de uno con el huracán, la reacción que uno sentirá después podrá ser más intensa.  Al sobrevivir un desastre natural como el Huracán Sandy, uno puede sentir estrés, ansiedad, depresión y síntomas del trastorno de estrés postraumático.  Si usted ha sufrido de problemas emocionales en el pasado, el enfrentarse con un evento estresante, como el Huracán Sandy, puede exacerbar éstas condiciones pre-existentes.

Algunas de las reacciones emocionales típicas que uno puede sentir tras vivir un desastre natural incluyen sentimientos de incredulidad, sentirse confundido o indefenso, irritabilidad, tristeza, miedo, dificultad para concentrarse y para tomar decisiones, sentirse preocupado y pensar constantemente acerca de lo que paso durante/después de la tormenta, sentir preocupación por consecuencias negativas que puedan llegar a ocurrir, y sentir que uno está volviendo a vivir los eventos del desastre.  Algunas de las reacciones físicas comunes que uno puede tener incluyen: dificultad para dormir, tener pesadillas, sentirse nervioso y sobresaltarse con facilidad, latidos rápidos del corazón, problemas para respirar, dolor de cabeza y sentirse tembloroso.

Hay varias cosas que usted puede hacer para sentirse mejor si ha notado que está teniendo éstos problemas:

1. No se aísle: Busque apoyo de gente querida, amigos y vecinos que entiendan lo que usted está viviendo. Esto le ayudará a darse cuenta que no está solo, y no es el único que siente éste dolor.
2. Hable con amigos y gente querida acerca de como se siente: El expresar sus preocupaciones, miedos, ansiedades, tristeza, sentimientos de incredulidad y confusión puede ser un proceso curativo y catártico.
3. Limite ver noticieros: Ver las imágenes de destrucción únicamente recuerdan la experiencia traumática y reafirman los sentimientos de miedo y vulnerabilidad.
4. Participe en actividades de recursos de socorro: El ser voluntario y donar su tiempo en esfuerzos de ayuda humanitaria le ayudará a sentir mayor control y sentir que puede causar un impacto positivo. Ayudar a otras personas a sentir menos dolor, le puede ayudar a aliviar su propio dolor.
5. Participe en pasatiempos o en actividades positivas: El participar en actividades que uno disfruta le ayuda a distraerse y en no pensar en su aflicción, y le recordará que aún existe belleza y creatividad en el mundo, y no solamente destrucción.
6. 6.      Manténgase activo: Haga ejercicio, o salga a dar caminatas. Estas actividades le ayudarán a no pensar en sus problemas. El mantener el cuerpo activo le ayuda a liberar hormonas que reducen el estrés.

Si después de intentar éstos consejos usted todavía se siento afligido, considere hablar con un experto en problemas de salud mental o con un consejero espiritual.  El sobrevivir un desastre natural puede tener impactos negativos y duraderos en la manera en que nos sentimos y en la que vemos el mundo.  El enfrentar el dolor emocional lo antes posible reduce las probabilidades de que los síntomas de estrés, ansiedad, depresión y del trastorno de estrés postraumático sean duraderos, y persistan en los años por venir.

Trauma and Disaster: Helping Teens Manage the Impact of Hurricane Sandy

Listen to my interview on The Mary Waldon Show on the emotional impact and how to cope with Hurricane Sandy. Hurricane Sandy has had a tremendous impact on countless families up and down the east coast of the United States. Such an event can leave even the most well-informed parent with questions and concerns.What is the potential impact of natural disasters and other traumas on teenagers? What can parents do to help mitigate the impact of Hurricane Sandy? What is an expected reaction to such extreme events, and what kinds of reactions indicate a need for professional intervention? For answers to these and other related questions, please tune in to The Mary Waldon Show to hear the insight and expertise of Dr. Nerina Garcia-Arcement, an expert in the treatment of Post Traumatic Stress Disorder.

Link to radio show

Bite, chew, savor

Mindfulness can help reduce anxiety and new research shows it can help with overeating. This article discusses the importance of mindfulness to gaining awareness of our eating habits and the role food plays in our emotions. 

Jean Kristeller reconnects people with their hunger and other inner experiences to curb overeating.

By Amy Novotney

November 2012, Vol 43, No. 10

Print version: page 42

Eat when you're hungry, stop when you're full. It sounds simple, yet for many Americans, it's anything but, says clinical psychologist Jean Kristeller, PhD. Barraged by advertisements for high-fat, high-salt and high-sugar foods, and confronted with restaurant portions fit for two or three people, it's all too easy these days to forget what the experiences of hunger and satiety feel like, she says.

"We eat when it's time to eat, when food is put in front of us or because we need to handle feelings of anger, anxiety, depression or simple boredom," says Kristeller, a psychology professor at Indiana State University and president and co-founder of The Center for Mindful Eating.

Kristeller has developed an intervention called Mindfulness-Based Eating Awareness Training (MB-EAT) that blends "mindful eating" exercises, such as being aware of hunger, chewing food slowly, tuning in to taste and noticing fullness, with mindfulness meditation practice to cultivate more general moment-to-moment awareness of self. Psychologists around the country are using it to help binge and compulsive eaters, diabetics, and people who are mildly and moderately obese to regulate their eating and avoid weight gain.

"Traditional techniques for tackling the obesity epidemic often don't take into account the strong drivers of eating: negative emotions, cravings and impulsivity, particularly in the face of highly palatable food," says University of California, San Francisco, psychology professor Elissa Epel, PhD, who has collaborated with Kristeller on several research studies using MB-EAT. "Mindfulness training gives us more control over these strong drives and makes us more aware of the triggers of overeating that come from outside of us."

Kristeller advocates no particular diet — and no foods are off-limits. She teaches students to savor their food while eating, rather than mindlessly eating while watching television, surfing the Internet or reading the paper.

It's this everyday applicability that makes Kristeller's approach so valuable, says social psychologist Ronna Kabatznick, PhD, a former consultant to Weight Watchers International. "It's one thing to have these strategies in textbooks, but she's embodied them by teaching people very specific skills such as how to enjoy a buffet or restaurant meal," Kabatznick says. "She's simplified mindful eating for everyday living."

Saying goodbye to super-size

Kristeller's MB-EAT 10-week course teaches people that, once they pay attention to their body's signals, brownies and chocolate cake are best experienced and savored in just a few bites.

"Our taste buds are chemical sensors that tire quickly," she says. "The first few bites of a food taste better than the next few bites, and after a large amount, we may have very little taste experience left at all."

Participants in her training programs — those who struggle with food and weight issues and health-care professionals interested in helping them — focus on three mindfulness practices: awareness of hunger and what it feels like in the body, awareness of what it feels like to be full, and the practice of savoring — slowing down to truly taste food and be mindful of the various flavors and sensory experiences associated with each bite. A variety of foods — including chocolate — are used in the program, and Kristeller even assigns participants increasingly challenging homework assignments, such as going to a buffet. She teaches them that by attending to how much they are enjoying the food and recognizing the point at which it stops being as enjoyable, they can eat much smaller amounts, leave food on their plates and return for seconds if they still want more.

"It's about finding satisfaction in quality, not quantity," Kristeller says. She also teaches people not to beat themselves up if they overeat, but to see this as a learning experience.

With funding from the National Center for Complementary and Alternative Medicine at the National Institutes of Health, Kristeller has proven the program's effectiveness. She's completed two studies — one at Indiana State University, another with Ruth Wolever, PhD, at Duke University — with more than 100 binge eaters and obese non-bingers. She's found that binge eaters who take her MB-EAT program reduce their bingeing from four times per week, on average, to about once a week. When they do binge, she says, they report that the binges are much smaller and feel less out of control. Participants also report that their depression decreased (Journal of Health Psychology, 1999; Eating Disorders: The Journal of Treatment & Prevention, 2011). Both bingers and non-bingers also improve significantly on other indicators of more balanced eating and emotional regulation. Furthermore, these effects are proportional to the amount of mindfulness meditation practice that is reported.

Other researchers are testing her program as a treatment for obesity. Gayle Timmerman, PhD, RN, at the University of Texas at Austin, has successfully adapted it for use with eating restaurant meals, showing a significant impact on weight and dietary intake. Epel and her associate, Jennifer Daubenmier, PhD, recently paired MB-EAT with stress reduction exercises in an intervention with obese women. They found that the more mindfulness the women practiced, the more their anxiety, chronic stress and deep belly fat decreased. Obese participants in the mindfulness program also maintained their body weight while those in the control group increased their weight over the same period of time (Journal of Obesity, 2011). And in an ongoing study with overweight pregnant women, Kristeller, Epel, Daubenmier and Cassandra Vieten, PhD, director of research at the Institute of Noetic Sciences, are teaching participants similar mindful-eating techniques in an effort to help these mothers-to-be avoid excessive weight gain.

"One lesson we've learned is that with the effort and attention to eating taught in the MB-EAT program, people can change their relationship with food very quickly, and within a few sessions, they're often starting to eat differently," Epel says.

The three-minute raisin

Kristeller's interest in meditation began as an undergraduate at Swarthmore College, where she read about research on how meditation can help lower blood pressure and heart rate and reduce ruminative thinking. Kristeller began meditating to reduce the stress of college and immediately found that it calmed her "chattering mind," she says. Later, as a doctoral student at Yale studying food intake regulation with Judith Rodin, PhD, and self-regulation theory with Gary Schwartz, PhD, Kristeller began using meditation to treat eating disorders.

"Judy was identifying how a lot of the disregulation in eating behavior was from people's lack of tuning in to their hunger signals," Kristeller says. "I thought you could help people tune back into those experiences."

After graduating from Yale in 1983, she joined the faculty at the University of Massachusetts Medical School, where she met Jon Kabat-Zinn, PhD, and took part in his eight-week Mindfulness-Based Stress Reduction (MBSR) program. Kabat-Zinn introduced her to an exercise where participants slowly eat three raisins as a way to begin to cultivate mindful awareness.

"A light bulb, so to speak, went off for me during this exercise," Kristeller says. "I saw it as another way to help ground people in their experience of eating, and began thinking about how to do this more systematically, particularly around the kinds of foods that people eat that get them in trouble — the high-sweet, high-fat foods. I wondered what would happen if people started engaging with those foods this way." Now, thanks to her research and her clients' enthusiastic feedback, she knows.

Link to article

Hurricane Sandy: Coping with the Emotional Aftermath

By Nerina Garcia-Arcement, Ph.D. Natural disasters, such as Hurricane Sandy, remind us of our vulnerability. The closer the impact of the hurricane to you the more intense your reaction can be. Surviving a natural disaster such as Hurricane Sandy can bring about stress, anxiety, depression and post traumatic stress symptoms. If you have experienced emotional distress in the past, then a major stressor such as Hurricane Sandy is likely to exacerbate a pre-existing condition.

Typical emotional reactions include disbelief, feeling confused or helpless, irritability, sadness, fear, difficulty focusing and making decisions, feeling preoccupied and ruminating about what happened during/after the storm, worrying about what future negative things could occur, and re-experiencing events from the disaster. Common physical reactions are sleep problems, nightmares, feeling jumpy and being easily startled, racing heart, trouble breathing, headaches and trembling.

If you notice you are experiencing these problems there are actions you can take to feel better:

1. Do not isolate yourself: Seek out support from loved ones, friends and neighbors that know what you are going through.  This will help you realize you are not alone in your pain.
2. Talk to friends and loved ones about how you are feeling: Expressing your worries, fears, anxieties, sadness, disbelief and confusion can be healing and cathartic.
3. Limit your news watching: Seeing the images of destruction simply reminds you of your traumatic experience and reinforces your feelings of fear and vulnerability.
4. Donate or volunteer your time through relief efforts: This will help you feel more in control and that you can make a difference. Aiding others through their pain helps reduce your own.
5. Engage in hobbies or life affirming activities: Doing things you enjoy will help distract you from your distress and remind you that there is beauty and creativity in the world, not just destruction.
6. Stay Active: Exercise or go outside for walks. These activities will get your mind off of your problems.  Getting your body moving will help release hormones that relieve stress.

If you find you are still distressed after trying these suggestions, consider talking to a mental health professional or a faith based adviser. Surviving a natural disaster can have a lasting negative impact on how you see the world and how you feel. Addressing your emotional pain now can reduce the chances of your stress, anxiety, depression or PTSD symptoms lasting for years into the future.