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This means just that parenrs wean the child from the dependency without any intervening steps. This can be quite a shock to the child and the parents. When the child wakes during the night and calls out or cries, he is ignored. Ignore means ignore. Parents should not respond in any way, either by calling out, reassuring, ordering him to go back to sleep, threatening, feeding, cuddling, tucking may cry the rest of the night. This is obviously the difficult part for one or both parents; one or other is likely to weaken, not being able to bear their child being so upset.
The next night, if the scenario is repeated, the child will cry a little less, and the night after that even less until, in a short space of time, he stops altogether. The problem will be cured as soon as the child is convinced that his parents will not pay any attention in the middle of the night. The next morning the child should be praised for the fact that the parents did not have to attend to him during the night. Again, to allow the child to cry for a couple of nights and then give in just makes the problem more difficult to deal with the next time.
Taking the power back means changing the way we perceive the attacks and the anxiety. We see them as being life threatening, or a threat to our sanity, or as causing us severe embarrassment. There is no doubt the anxiety can cause extreme discomfort and the attacks can feel quite violent, but they are not life threatening, nor a sign of impending insanity. We may feel as though we will be significantly embarrassed, but what is embarrassment? It is a state of mind, produced by the way we think and a point I will return to shortly. We compound the disorder by continually thinking about ‘worst case scenarios’. We need to see the anxiety and the attacks for what they really are: anxiety and attacks. Nothing more.
Our thinking is so much a part of us, we don’t pay any attention to the process. Without realising it our thoughts create, dictate and control our life. All of us know the endless silent conversations, the chattering thoughts and the continual negative cycles of thinking. They roll along, carrying us with them. Yet it need not be like this. We can step in and take the power back by learning to control them. We don’t have to be dictated by them. We can dictate to them. The ‘what ifs’ and the self absorption are part of the control we all use. Although we need to let go of them, we can also learn from them. We are creating the fear by the way we think. The ‘what ifs’ and the continual monitoring of our symptoms don’t protect us or provide us with an ‘early warning system’, because they create the very symptoms we are trying to protect ourselves from.
We never take time to examine our thoughts. We don’t even realise we can. We never watch the internal world of our thoughts as it spins this way and that. We react to our thoughts without realising they are actually separate fleeting moments in time. We don’t see this separateness. Instead, we believe we have no power over the continual progression of these thoughts, and the feelings caused by them. We don’t see how our feelings can change within seconds of a change in our thought pattern. We can be calm one minute and anxious the next. Not seeing the progression from one thought to another and thus not seeing the progression from one feeling to another, makes it appear our anxiety and attacks are beyond our control. They aren’t.
Our thoughts create the fear, which creates its own symptoms. The symptoms create the ‘what ifs’, which creates further symptoms. It is not so much the original stress which perpetuates the disorder, as the stress of the disorder itself. We need to be able to see how we create this stress by the fear of what we are thinking.
We need to be in control of ourselves and our environment, yet the only thing we do not control is our thinking. We need to change this by letting go of the overall need to be in control, and control our thinking.
If you are wondering if your child’s sleep habits qualify as a “problem,” you might want to consider the following issues. Mark each statement A (agree) or D (disagree). If yours is a two-partner family, it is helpful if both partners mark the statements separately to see how each of you feels about the situation.
1.1 feel my child is not getting enough sleep. He is irritable during the day and shows subtle
signs of lack of sleep.
2. My child wakes too early or goes to sleep too late.
3. Sleep seems frightening to my child.
4. My child wakes during the middle of the night.
5. I wonder if my child is eating too much or too frequently.
6. Bedtime is unpleasant for my child. She goes to bed angry, sad, over-stimulated, or
7. I believe an undesirable pattern may be developing.
8. My child needs me at times that seem unreasonable to me. I fear he may be overly
9. Bedtime is unpleasant. I dread it.
10. I usually feel deprived of sleep. I crave a night of undisturbed sleep.
11. I need to go to bed sooner than I would like in order to accommodate an early riser or a non-sleeper.
12. My fatigue or anger is affecting my relationship with my child, his siblings, or my partner.
13. The current situation feels out of control.
14. I find myself asking, “Is my child the only one acting like this?”
15. My child continually disturbs the rest of the family.
Some of these statements reflect the child’s behavior. Others reflect the family’s response. If you agreed with three or more, there is definitely a problem within the family system. This checklist is only a guideline. A child may show only one area of difficulty that turns the family upside down. Go back to the definition of a sleep problem. If you experience it as a problem, then it is a problem worth working on.
If you need to pass urine often, but pass only small amounts each time, and especially if it also stings or burns to pass it, the lining of your bladder is probably inflamed (cystitis). Possible reasons include infection, radiation to the pelvic area and the chemotherapy drug cyclophosphamide (see pages 257-59).
If you need to pass urine often in large amounts, you are producing too much urine. Possible causes include kidney failure, sugar diabetes (perhaps due to corticosteroids), diabetes insipides and too much calcium in the blood. Diabetes insipides is a condition where you pass large amounts of very weak urine. It can follow attempts to destroy the pituitary gland — see page 295.
I’ll just explain a bit more here about one of the possible causes. Too much calcium in the blood is a complication of cancer which we have not discussed in detail so far. If this is the reason for you passing a lot of urine often, you are likely to have other symptoms as well— nausea, unusual thirst, a metallic taste in the mouth, constipation, muscle weakness, drowsiness and confusion.
“The common people call them piles, the aristocracy call them haemorrhoids, the French call them figs — what does it matter, so long as you can cure them?”
What John of Arderne, regarded as the first English surgeon, said in the 14th century is still applicable today.
Haemorrhoids are varicose veins in the anus. They are common, but rarely seen before the age of 30 except in pregnant women.
There are many factors associated with their cause. The condition is common in families, as are varicose veins of the legs. Some hereditary weakness of the veins is also believed to play a part.
Chronic constipation and the subsequent straining at stool may be the most important factor.
Developed nations’ highly processed diet, which is low in vegetable fibre, is believed to be associated with an increased risk, not only of developing piles, but also several other conditions, including cancer of the bowel, diverticulitis, appendicitis and varicose veins.
In the past 10 years, there has been controversy about whether or not childbirth should be induced or be allowed to progress naturally.
There has been an increasing tendency for doctors to induce labor.
Associated with this has been a progression in childbirth technology, so that the strength of the contractions of the womb can be controlled by drugs and the progress of the baby closely monitored.
Those parents who see induced labor as too technological, and a complication of what should be a natural and shared family experience, have been increasingly vocal in demanding that their viewpoints be heard and considered.
Medical proponents of the management of labor argue that the method allows the whole medical team to be available to deal with any problems which may arise, whereas spontaneous natural labor may occur at night, on weekends or holidays when the full medical team is not available.
In a British Medical Journal review of reports from several centres, it was found that there can be different interpretations and different results from various groups in matters of usage and observation of natural or induced labor. And so the debate continues.
In some competitive sports, athletes compete on consecutive days and glycogen stores need to be at their maximum each time. Here it is important to restock the glycogen store in the muscles as fast as possible after the event. High G.I. foods are best in this situation. Sports scientists at the Australian Institute of Sport in Canberra have shown that high G.I. foods resulted in faster replenishment of glycogen into the fatigued muscles. Muscles are more sensitive to glucose in the bloodstream in the first hour after exercise, so a concerted effort should be made to get as many high G.I. foods in as soon as possible.
Suggested foods include most of the sports drinks on the market (which replace water and electrolyte losses too), or low amylose rice (Calrose rice), breads and breakfast cereals with a high G.I. such as cornflakes and rice bubbles. Potatoes cooked without fat are a good choice too, but their high satiety means it is hard to eat lots of them. Soft drinks have an intermediate G.L, so they won’t be ideal but they won’t do any harm either.
Females weighing about 50 kilograms should aim to eat 50 grams of carbohydrate. Males weighing about 75 kilograms should aim to eat 75 grams of carbohydrate.
If you want to keep up the pace from one training session to another, day after day, you will benefit by learning to select high G.L foods. The trouble is that many people, even coaches and sports medicine practitioners, have got it all wrong when it comes to selecting sources of fast-release carbohydrate. The information in this chapter gives you the most up-to-date information and the key to better performance and faster recovery. Go for it!
Recovery formula. Aim to ingest about I gram of carbohydrate per kilogram of body weight each 2 hours after exercise. If you weigh between 50 and 75 kilograms, you need 50 to 75 grams of carbohydrate for each 2 hours after exercise.
Among the genetic factors thought to influence fat loss response, racial differences have probably been studied least. Yet simple observation shows that there are big differences in body shape between Negroids, Asians and Caucasians in particular. Negroid women store fat more readily around the hips and buttocks: amongst Negroids, the Hottentot women of South Africa, who have survived in a severe desert climate for millennia, are well-known for their exaggerated gynoid tat stores, which may have increased the survival potential of the race in the desert.
Asian women are known for their small hips, waist-to-hip ratios used as a measure of risk in Caucasians, therefore, are generally not relevant for these women because they give measures more characteristic of a man. Other fat measures such as skinfolds or machine measures may be more relevant here, and particularly when comparing between racial groups. Normative values for body rat, therefore, need to take account of racial differences, but to date this has not been done.
The deposition of fat may also differ amongst racial groups. Chinese and Indians, for example, appear to put additional fat on the waist first before then filling out all over. Island races like Sa moans and Tongans are big people and are prone to developing significant obesity, but that fat is stored more evenly over the body. Aboriginal Australians have naturally lean limbs and small hips but also a high tendency for fat gain from eating ‘Western-style’ foods. This appears to manifest more in the form of abdominal obesity rather than the overall obesity more common of Polynesians and Melanesians.
These measure energy intake or output by a variety of methods including food and physical activity diaries and questionnaires. All these methods are based on a number of assumptions and many are only very rough estimates of energy expenditure. Methods based on heart rate diaries are also not very accurate.
Body weight is the most important component of total energy expenditure, mainly because of the association between resting metabolic rate and fat free mass (FFM). Because bigger people have more total body mass and therefore also FFM, total energy expenditure will be greater. On the other hand, even the lightest female measured at rest in a metabolic chamber over a 24-hour period will expend at least 1200kcals, suggesting that a minimum dietary intake of 1200kcals is necessary for normal daily functioning.
Doubly labelled water. A more recent technique for energy expenditure measurement, which is likely to become more common in the future, is the doubly labelled mater technique. This was first used with humans in the early 1980s and involves loading a person with water which has been labelled with two stable isotopes, deuterium and a form of oxygen, and then measuring the differential elimination of these from the body through the urine. From this information, scientists can calculate the rate of use of oxygen and production of carbon dioxide over the period measured to a high degree of accuracy. The method is simple, safe and non-intrusive. At present its main limitation is the expense of the labelled water and the mass spectrometer needed to analyse the output.
This means that the narrow canal that leads from the stomach into the next part of the intestinal tract, the duodenum, is extremely narrow. For this reason it does not allow food to pass normally. It is more common in males, and more frequent with first babies.
The most important and earliest symptom is vomiting. This often commences about the 14th day of life, and becomes worse. It frequently occurs about half an hour after a feed. Because the food is not being absorbed by the system, baby is always hungry, but fails to thrive. As time progresses, vomiting may become projectile—it comes out with force and vigour—not merely dribbling down the side of the face, which is the common form of baby vomiting (as with burping). Later on, appetite is lost, as serious changes commence internally. The bowel actions tend to become loose and green in colour. As baby loses weight and fails to thrive, symptoms continue unabated. Between two and five per cent develop jaundice. The baby may become dehydrated, and the stomach may become distended.
Any symptoms like these need prompt investigation by the doctor. Often the cause is readily diagnosed, sometimes from an X-ray of the bowel.
Treatment is by surgery. The risks are low and the results are usually strikingly good. The baby soon starts to eat normally, can now digest food, starts to thrive, looks better, and rapidly becomes a normal infant. Long-term the results are also excellent. In short, the beneficial effects are usually dramatic.
In this book we will discuss many symptoms. Most of these will be related to a specific disease. For example, the child has abdominal pain, vomiting, loss of appetite and constipation. Tummy is tender to the touch, and probably the muscles are in a rigid spasm. Cause and effect. An inflamed diseased organ has produced symptoms which lead to a correct diagnosis and treatment. Acute appendicitis. Surgery. A satisfactory cure.
But take another case. The child has abdominal pains. Probably vomiting, a mild fever, feeling off-colour and looks pale and ill. Stops playing with friends, lies down, and looks and feels unhappy. This happened last month, and investigation revealed that there had been a mild altercation with a playmate over the bat and ball. This time, it was an argument about whose turn it was next. After an hour’s rest, the pains have vanished, the patient has miraculously recovered and is back playing with friends as well as enemies.
In this case, there is no organic cause for the child’s symptoms. But the symptoms are certainly there. The pain is just as real as it is for the little fellow with appendicitis. But the cause is different. Emotional stress and mental tension have somehow reverberated via the child’s mental system to produce very real, organic-type symptoms.
Enormous numbers of symptoms occurring during infancy and childhood are caused by emotional stress. Often the parents are unaware of this, and frequently it has the doctor puzzled also. The symptoms not only relate to abdominal pains (which are enormously common) but to aches and pains elsewhere, as well as many other common symptoms.
Investigators believe that with abdominal and limb pains, fewer than five cases in a hundred have an organic cause. Recurring headaches are similar. Doctors often refer to these as psychosomatic symptoms.
Everybody is born with a brain that has two parts. The smaller part (probably only 20 per cent of the brain) is the so-called conscious part which operates when the person is awake. This is the area that knowingly controls the person’s actions.
The larger part (probably encompassing 80 per cent, or maybe more) is the subconscious brain. This works tirelessly, morning, noon and night, whether the person is asleep or awake. It is often called the body’s in-built computer. Into this is channelled, right from birth, information picked up by all the body’s senses: hearing, seeing, feeling, tasting, smelling, warmth, sense of pressure, as well as emotional senses. All this is stored in the brain’s memory cells, and much of it will remain there indefinitely. Although much will not be consciously remembered, the storehouse of data builds up, and gradually this forms the bank of information that is often referred to as experience.
This form of resuscitation is also known as EAR (expired air resuscitation). It is used in first aid where the subject has stopped breathing. The technique is taught in practical first aid courses such as that which is offered by St John Ambulance Australia. The following description is a guide only. It is recommended that a first aid course be taken to learn techniques such as EAR and CPR (cardiopulmonary resuscitation).
After establishing that the subject is not breathing, turn onto the back and kneel beside the subject, keeping her or his head tilted back. With one hand pinch the nostrils between your fingers. Use the other hands to lift the jaw forward. Open your mouth wide and take a deep breath, then place your mouth firmly over that of the subject, making an airtight seal, and breathe into the subject’s mouth. Remove your mouth and turn your head towards the subjects chest. Listen for exhaled air and observe whether the chest falls. If there is no exhalation make sure the head is tilted back and check for foreign objects in the airway, removing any obstructions if necessary. Breathe into the subject’s mouth again, giving five full breaths in 10 seconds, then check the pulse in the neck for 5 seconds, placing the ends of your fingers (not thumbs or fingertips) in the groove behind the Adam’s apple on one side only. If pulse is present continue EAR at the rate of 15 breaths per minute. If there is no pulse CPR will be required.
Anxiety may have an effect on stuttering. The right side of the body is controlled by the left side of the brain and vice versa. In the right-handed person the left side of the brain is dominant over the right, and as a result the right hand is given preference over the left. In those who are left-handed the right side of the brain is dominant over the left. It is believed that stuttering often develops when the dominance of the leading side of the brain is incomplete, or when a potentially left-handed child is trained to function as a right-hander. We see then that stuttering results when the messages from the brain to the organ of speech are indecisive. This indecision may be further increased by the presence of anxiety. This is shown very clearly by the fact that many quite normal people show a hesitancy in their speaking or even a mild stutter when confronted with the task of speaking in some formal situation which produces anxiety.
On the other hand, some people stutter without showing or feeling much tension or anxiety at all. As a general rule these people who stutter in the absence of anxiety do not gain much help in their speech difficulty by practising relaxing mental exercises. However, the majority of stutterers experience considerable tension when they are speaking, and with them the reduction of the general level of anxiety by relaxing mental exercises is a great help toward establishing a pattern of easy normal speech.
Relax the muscles of your chest first. Push your breasts as high into the air as you can. You will find that you tend to arch your back when you do this and you will feel tension along both your sides too. Breathe out and fall back, letting your breasts flop and remembering to drop those shoulders at the same time.
Now imagine that you have an extremely tight, old-fashioned corset on and it’s pulling in your belly even further than you thought possible. As you breathe in, wearing your corset, the tension will spread upwards into your chest and you’ll probably clench your buttocks too. As you breathe out, loosen the corset and let your belly flop and sag. This is a very difficult thing to do, because a lot of clothes are designed to show off a flat stomach- so a full, rounded belly is something most of us try to avoid. In other times and other places it was, and still is, considered to be a mark of great beauty. It may take quite a time to achieve entire relaxation of this part of the body. But it’s the most important bit, because these are the muscles which will clash with the muscles in your womb that are squeezing out the period, and they will squeeze no matter what you do. Don’t give them any opposition and the whole business immediately gets a lot easier. After all, they’re extremely powerful muscles; ten times stronger than any other muscle anywhere in your body.
At this point it’s a good idea to pay some attention to the position of your spine. If you started off supported by a lot of cushions and pillows and now your spine doesn’t feel comfortable, remove them all and start all over again. Many women find that if they imagine they are lying on their backs floating in pleasantly warm water they can curve their spines into a very comfortable position; others need to arch their spines up from the bed and then let them relax; others find that if they relax their necks and shoulders, their spines relax too. It takes time and experience to find the best method and position.
We have spoken of the problems of food allergy and chemical susceptibility as the two main components of environmental disease. This is technically correct, but in actuality these two problems are usually found together, tightly interlinked in the history of each chronically ill individual. One of the major ways in which these two elements interlock is in the chemical pollution of our food supply.
It is no secret that our food is now treated with synthetic chemicals of every sort. Some of these chemicals have been deliberately added, to impart color, flavor, or longer shelf life. These deliberately added substances are called additives. In addition, numerous chemicals accidentally enter the food supply as residues of pesticides, fertilizers, or environmental pollutants. These are called food contaminants.
Together, food additives and food contaminants have become a major source of the problem of chemical susceptibility in most Western countries, since everyone must eat, and most food now comes from the giant agribusiness conglomerates. These giant corporations are mainly concerned with maximizing profit, even if the health consequences for the population are negative. What is more, these companies are often closely linked to chemical companies and thus have a built-in bias in favor of synthetic pesticides and fertilizers.1
For any person who wants to avoid environmentally induced illness, it is necessary to understand the sources of such chemical contamination of the food supply. These chemicals can either cause, or help perpetuate, chronic illnesses of all sorts. However, their presence can be detected, and they themselves can be avoided, by methods which are explained later in this book.
I have already described how the role of chemical pesticides was discovered in the case of William Petersen, the man who found that he could eat unsprayed apples from an abandoned orchard, while commercial apples from a store gave him a headache. The principles discovered in this case were soon extended to many other food-allergy patients. It was determined that in some cases they were actually reacting only to chemical contaminants. Usually, however, patients with the chemical susceptibility problem also had the food allergy problem, and vice versa. Some patients appeared to react to commercial food in the winter, but to a much lesser degree in the warmer months. This was because in the cold months they were often cooped up in their houses and exposed to the cumulative effects of indoor air pollution (Chap. 6). The combination of food allergies, contaminated food, and such indoor pollutants greatly heightened their symptoms and made their winters miserable. Not infrequently their winter maladies, environmental in origin, masqueraded as colds or flus. In other cases, they did have genuine infections, but these were accentuated by allergic problems.
The variety of problems is endless, since environmental disease is above all things an individual problem. There is no single cause for all people, nor a single solution. Usually the disease is a result of the interaction between an individual, with his particular bodily makeup, and his environment. Certain exposures, however, stand out as most troublesome for the greatest number of patients. Of the food additives and contaminants, some of the most troublesome are residues of pesticide sprays which find their way into almost everything the average person eats.
Constipation is a condition in which the bowel movements are too hard. The frequency of bowel movements is not a factor of constipation. Passage of six too-firm bowel movements a day is considered constipation. Passage of one normal or soft bowel movement every third or fourth day is not constipation. Many normal, healthy children have a bowel movement only every few days and are not constipated. The hardness of a stool is judged by appearance and by diameter. A stool greater than twice the usual diameter is probably too hard.
Over 95 percent of constipation cases involve no physical abnormality. This form of constipation can always be cured by changes in the diet or by using medications that soften the stools.
Constipation occurs in the large bowel (colon). The function of the colon is to store unabsorbed food waste and to absorb and hold water from the liquid material received from the small intestine. If the colon absorbs too much water, the stools become hard.
In children, there are two common reasons for constipation. The first reason is that the diet does not include enough roughage, which holds water in the stools. Foods that prevent constipation are all fruit juices and all fruits – particularly those eaten with their skin on – except bananas and apples; all vegetables, especially if eaten raw, except peeled potatoes; unrefined grains (whole-grain cereals and breads); and unrefined sugars (brown sugar, molasses, honey). All other foods, including milk and milk products, promote constipation.
A second common reason for constipation in children is that the child resists the normal impulse to move the bowels. This allows the colon to continue absorbing water out of the retained stools; it results in stools that are too hard. A common reason why children resist the normal impulse to move the bowels is that the parents are putting too much pressure on the child during toilet training. Once the stools become too hard, bowel movements become painful. Fear of such pain makes the child even more determined to postpone bowel movements. Constipation enlarges the colon, causing a loss of muscle tone, and the physical impulse to empty the bowel becomes weaker. This cycle can lead to chronic constipation.
Signs and symptoms
The major sign of constipation is stools that are too hard, too dry, and larger in diameter than usual. Constipation can cause pain in the anus during bowel movements. Red blood may appear on and around the stools. Other symptoms are cramps in the abdomen and an eventual loss of appetite.
If constipation continues for days and weeks, paradoxical diarrhea may develop. In this condition, loose, watery stools seep around the hard stool in the colon and are passed as diarrhea. When this happens, it can be difficult to tell whether the child has constipation or diarrhea.
For immediate temporary relief, use a glycerin suppository or disposable commercial enema. For a long-term cure, increase the amount of roughage and decrease the amount of constipating foods in your child’s diet. If constipation occurs during toilet training, stop training efforts.
• Check with your doctor before using laxatives in children. Laxatives may force passage of a hard stool and cause pain that leads to further holding back by the child.
• Enemas, suppositories, and laxatives are habit-forming. They should never be used on a regular basis.
• Do not assume that a child is constipated simply because bowel movements do not occur every day.
Your doctor will perform a rectal examination and a careful examination of the child’s abdomen. X ray studies of the bowel may be taken to look for possible physical abnormalities. Directions and follow-up by your doctor may be needed.
Troublesome symptoms of varying severity that affect most women at least to some extent around the time of the menopause (about the age of 50 in most women today). Throughout a woman’s reproductive life she produces female sex hormones, but from the menopause onwards these are produced in reduced amounts. The first sign of the onset of the menopause is usually irregular periods. Although a woman’s female sex-hormone levels may fall to below those found in most men, her male sex-hormone level can remain high and could account for the facial hairiness seen in some women at this time.
The most common symptoms around the menopause are hot flushes, vaginal dryness, pain on intercourse, headaches, night sweats, weight gain, light-headedness, muscle and joint aches and pains, dry skin, depression, excitability and a loss of confidence. There are, of course, many others too. The vast majority of these signs and symptoms can be reversed by giving female sex hormones, so clearly they are hormone-linked. However, such replacement therapy has fallen under a cloud since research has found an increased level of breast cancers in women taking oestrogens in this way. It also increases the risk of gall-stones and high blood pressure.
Once over the age of 50 or so ischemic heart disease (which leads to heart attacks) becomes more common in women than before and a few women lose their pubic hair and armpit hair and have degeneration of their vulva and vagina. Women also start to lose calcium from their bones and are more liable to fractures when they fall than are men. Some women welcome the onset of the menopause because it means they can now enjoy sex without worrying about contraception, but others mourn the passing of their fertile years and are miserable.
The menopause also often coincides with the departure of children from the home and the woman’s husband may be at the stage of life in which he is becoming interested in younger women, perhaps to sow the oats he never did when he was young. This is now the second peak time for divorces (the first is during the first five years of marriage).
Having said this, the menopause is used somewhat as a catch-all and any problems a woman encounters at around this time of life tend to be attributed to it-often erroneously. About 10-20 per cent of women suffer no symptoms at all at the menopause.
The concepts of “health” and “Grateful Dead concerts” don’t often appear in the same sentence. But those enthusiastic souls who used to shake their whatevers nonstop while the Dead played 1 1/2 hours straight (without tuning up once) were faithfully, if unwittingly, engaged in a noble health pursuit-aerobic exercise.
Jane Fonda-style aerobic dance classes may have publicly appropriated the word, but the truth is that any activity that jacks your heart rate up for an extended period of time is aerobic exercise. That means running, cycling, swimming, rowing, skiing, inline skating, or anything else that gets you huffing and puffing enough to feel it but not so much that you can’t keep it up.
All those good things that exercise does to help you avoid heart disease come mostly from aerobic work. That’s eminently logical when you bear in mind that what aerobic exercise essentially does is strengthen your heart (hey, it’s a muscle, too) and improve your lung capacity, thus helping the flow of oxygen through your bloodstream.
Aerobic exercise is also the principal player in diabetes prevention. “Regular aerobic-type exercise will allow you to metabolize your blood sugar without requiring as much insulin,” says Ben Hurley, Ph.D., director of the Exercise Science Laboratory at the University of Maryland’s College of Health and Human Performance in College Park. “That’s important for both heart disease and diabetes prevention. And the research is very consistent.” If you want to take advantage of aerobic exercise’s health benefits, here’s all you need to do.
Do as you please. The kind of aerobic exercise that works best is whatever kind you’ll do. So your wisest choice, according to physical therapist Mark Taranta, director of the Physical Therapy Practice in Philadelphia, is to go with what you like. “Do something you’re familiar with or enjoyed doing in the past,” he advises. “Don’t go out and buy a big piece of equipment like a treadmill if you’ve never tried it before. You might hate it.”
Get that heart rate up. Any exercise expert will tell you that to reap the full benefits of aerobic exercise, you have to do it hard enough. Sorry, golf won’t cut it. (No, not even if you carry your clubs and take 130 strokes to finish.) The aerobic effect doesn’t kick in until your heart’s beating at 70 percent of its maximum rate.
Your maximum rate per minute, by the way, is 220 minus your age. So if you’re 40, you want to have your heart beating at 70 percent of 180 beats per minute while you’re exercising. (We’ll do the math for you, this time only-it’s 126 beats per minute.) Check your pulse by putting two fingers to the side of your neck and counting the beats for 10 seconds; multiply that by six, Taranta says.
And keep it up. Once you get your pulse up to 70 percent of your maximum, keep it there for at least 20 minutes. While you’re working your way up to that magic 20-minute mark, remember that accumulating the time over a 24-hour period (say, three seven-minute sessions on the stationary bike) will provide almost the same benefits.
Stick with it. If you get your aerobic workout three to five times a week, you’ll be amazed at how quickly the positive changes kick in. But you’ll be just as amazed at how fast they fade if you start backsliding. “If you don’t keep at it, you lose it,” Dr. Bortz warns. “The gains and losses are very transient. If you want to translate them into genuine health benefits, you have to do it regularly.”
Be reasonable. Assuming that your fitness goal is achieving overall health rather than medaling in the Olympics, it makes more sense to enjoy your exercise sessions than to turn them into torture tests. Yes, there are the minimum requirements we’ve mentioned, but you don’t have to go much beyond them. “It doesn’t take a whole lot to maintain your cardiovascular fitness,” says Tom Baechle, Ed. D., chairman of the exercise science department at Creighton University in Omaha, Nebraska. “We’ve gotten away from the killing-yourself mode. You can get it done in 20 minutes a day, three times a week, at a reasonable intensity.”
A variation of lumpectomy, this operation is done for a larger tumour and involves the removal of a larger wedge of normal tissue. Auxiliary lymph nodes may also be removed.
The advantage of this operation for women with larger breasts is that most of the breast tissue is preserved. There is also unlikely to be much swelling of the arm as most of the auxiliary lymph nodes remain intact. However, the breast may be left flattened or distorted, particularly the nipple.
Radiotherapy is likely to be necessary after a partial mastectomy in case any cancer remains in the breast tissue left behind. Again, radiotherapy must be avoided if all the auxiliary lymph nodes have been removed.
In simple or total mastectomy, the entire breast is removed, usually together with some or all of the auxiliary lymph nodes. Breast reconstruction should be possible following this operation. Its advantages include the retention of the muscles of the chest wall, which are removed in a radical mastectomy. The risk of arm swelling is increased if the auxiliary lymph nodes are completely excised, or if some of them are removed for staging and then radiotherapy is given.
There is controversy about how many of the auxiliary lymph nodes should be removed. Some surgeons claim that complete removal leads to a very low recurrence rate and makes radiotherapy unnecessary. Others prefer to perform a wide lump excision (removing the lump itself as well as a wedge of the normal tissue surrounding it), with sampling of the auxiliary nodes for prognostication, and follow it up with radiotherapy to a large area around the breast and armpit. This is a quicker operation, involving less risk of damage to the nerves responsible for sensation in the arms.
This operation is now uncommon. It involves the removal of the entire breast, the auxiliary lymph nodes, fat, and the pectoral muscles of the chest wall. If metastasis has not already occurred, radical mastectomy can completely remove the malignant cells. However, it does leave a long scar, a hollow chest, restricted movement of the shoulder, and loss of arm strength due to the removal of the muscles which normally allow arm movement.
Modified radical mastectomy (Patey)
In this operation the entire breast, all the lymph nodes in the armpit and the smaller of the two chest muscles are removed.
As all the auxiliary lymph nodes are removed, swelling may occur in the arm, but muscle strength is retained.
Another uncommon operation, this involves radical mastectomy as well as removal of further lymph nodes known as the internal mammary and supraclavicular nodes. However, there is no evidence to prove that this operation is more effective than radical mastectomy alone.
These include things such as stopping smoking, wearing seat-belts reducing alcohol consumption and so on. They are often extremely cheap to implement. A cost-benefit analysis on smoking and alcohol produces dramatic results. The cost of alcohol abuse and smoking accounts for one fifth of all health expenditure. When indirect costs are added the cost of smoking and alcohol abuse accounts for one quart of all the economic costs of illness. These figures would increase even more if the costs of fire losses, ca accidents and crime due to smoking and alcohol were added.
According to Dr John H. Knowles, President of the Rockefeller Foundation:
Over 99 per cent of us are born healthy am suffer premature death and disability only ñ result of personal misbehaviour and environmental conditions. . . . the individual has the ðîã indeed the moral responsibility to maintain own health by observance of simple prudent rules of behaviour. . . life is meant to be enjoyed . . . but the cost of individual responsibility health care now becomes prohibitive. The choice is individual responsibility or social failure. Responsibility and duty must gain some degree of parity with right and freedom.
So much for the costs of alcohol and smoking. The benefits are harder to quantify. The benefit could be the amount people are prepared to pay to indulge in these activities but this is probably an underestimate because presumably people prevented from smoking and drinking would need to do other things to answer the need; they have in the first place. Perhaps the cost of the drug bill would rise proportionately. A prevention plan to reduce smoking and alcohol use would, of course, cost money and there would be transitional costs as the two industries lost profits and put people out of work. Governments could, of course, compensate these industries temporarily in the interests of the nation’s health.
Even allowing for all these costs economists still think the financial advantages could be considerable. To see just how cost-effective a reduction in tobacco and alcohol use would be one need look no further than the Mormons and Seventh Day Adventists in the US who live without these drugs and have provably lower death rates and longer lives. Their healthy eating habits also give them a cancer mortality of between 50 and 65 per cent that of other Americans.
It wasn’t until Susan Ledford discovered the power of a fresh, sweet orange that she was able to pass up her biggest indulgence and lose 43 pounds.
A member of a big Southern family that loves food, Susan is no stranger to temptation. When special occasions call for family celebrations, “it’s like a race to see who can make the most disgustingly rich casserole,” says the 36-year-old newspaper designer from Tallahassee, Florida.
Such decadent dishes were standard fare while Susan was growing up. But they weren’t kind to her waistline. She gained weight throughout her teenage years, and by her twenties, she was trying all sorts of diets in an effort to slim down. “I’d go on one diet and lose a few pounds only to watch them return when I went back to my normal eating habits,” she recalls. By age 34, she topped out at 168 pounds.
Knowing that Susan was unhappy with her figure, a friend suggested that she join Weight Watchers. The program taught Susan how to make healthy food choices and control her portion sizes. Within a year, she took off 43 pounds.
Thrilled to have finally reached her goal weight of 125 pounds, Susan was determined to stay there. But she had one dietary hurdle to overcome. Susan loved to bake cookies for her family and friends, especially around the Christmas holidays. She especially enjoyed licking the bowl and sampling each batch fresh from the oven.
Realizing that her taste-testing ways would do nothing for her hard-earned figure, Susan decided to have a healthy snack before baking. Her food of choice: a fresh, juicy orange. She found that the intense flavor of the fruit quashed her cravings for cookies. She was i able to bake to her heart’s content without eating a thing.
Thanks to her ingenious strategy, Susan had an easier time sticking with her healthy eating habits. Her weight has held steady at 125 pounds since 1998.
Feed your sweet tooth an orange. Susan’s strategy has real scientific merit. According to Marilyn C. Majchrzak, R.D., food-development manager at the Canyon Ranch Spa/Health Resort in Tucson, Arizona, intensely flavored foods such as oranges tend to be more satisfying than bland foods. So snacking on something sweet and juicy will help reduce temptation. Keep lots of oranges, fresh pineapple, strawberries, or your favorite tastebud-shocking fruit in your fridge.
The main drug in this group is ipratropium (Atrovent) which is taken by inhalation. Side-effects are rare except at high doses. They include dry mouth, difficulty in passing urine and constipation. Other anti-cholinergics include butethamate and atropine. Anti-cholinergics help to reduce the amount of mucus present in the airways as well as relaxing the muscles,
and may be useful where asthma and bronchitis occur together.
Sympathomimetics, such as adrenaline and ephedrine, are sometimes combined with anticholinergics in inhalers. Atropine is combined with adrenaline and a muscle relaxant in Brovon and Rybarvin. Butethamate is combined with ephedrine in CAM, which is taken by mouth. Ipratropium is combined with the bronchodilator fenoterol in Duovent.
Sympathomimetics were once the main drugs used for bronchodilation, but they are much less specific for the bronchial muscles than the drugs described above. They produce side-effects more easily than modern bronchodilators and are much less used now. They include adrenaline, ephedrine and phenylephrine. Typical side-effects include nervousness, anxiety, tremor, irregular heartbeat and dry mouth.
For anyone with multiple food sensitivities, avoiding all their culprit foods can be very difficult. And it may mean that they eat too much of other foods, with die attendant risk of developing new sensitivities. Even those who are intolerant of just one or two foods may find it difficult to avoid them, especially if they eat away from home a lot. So there have been many attempts to develop alternative methods of treatment.
Given the lack of knowledge about how food intolerance arises, these attempts are largely a ‘suck-it-and-see’ exercise: trying out treatments and seeing if they work. No treatment has yet been devised which is 100 per cent effective for all patients, and there are some on offer from ‘alternative’ practitioners that are quite ineffective and even potentially dangerous (eg urine therapy). However, there are two methods currently being tried out by some doctors, known as neutralization or desensitization treatments, that are worthy of further investigation.
In some studies, these treatments have performed quite well, but in others they have been less successful. Consequently such techniques are controversial and many doctors feel that they should not be used until there is more evidence that they work. But given the complex nature of food intolerance, and the evidence suggesting that it is caused in several different ways (see Chapter Twelve), perhaps it is not surprising if a treatment gives varying results – it might be expected to work for some patients and not for others. Our own experience suggests that such methods are effective for a proportion of people with food intolerance. But they are probably not worth trying unless there is no reasonable dietary alternative.
These methods have also had some success in treating classical allergies, and in this context they may be very useful. The traditional method of desensitization, once widely used for hay fever and other allergies, cannot now be given by family doctors in Britain. This method involved injecting minute, but gradually increasing, doses of the allergen over a period of many months. There is a risk of collapse, due to anaphylactic shock, with this method, and a few patients have died as a result. Such desensitization treatment can now only be given in hospital, where resuscitation equipment is available.
Other uses claimed for these techniques include desensitization to environmental chemicals, such as exhaust fumes, and desensitization to Candida, where there is a sensitivity to the yeast’s products as a consequence of candidiasis.
Most of the cross-reactions that are seen (or suspected) in patients do not match so well with the biological classification. For many foods, the use of the family group to predict cross-reactions is more a matter of faith than science, but it is still the most useful guide we have. There are also some unexpected cross-reactions, which do not tally with classification schemes.
If you have reason to suspect any food before starting on your elimination diet (because you eat it in large amounts, for example) you should check the food-family list to discover which family it belongs to. All its relatives should be excluded during the first phase of the diet, along with the food itself. The food families may also be useful later, in interpreting your reactions to tested foods, and in planning your diet afterwards – just as you should not eat too much of any one food, you should not eat too much from any one food family either.
For the older baby, early weaning may be the answer, although it involves the risk of sensitizing the child to even more foods or – if all the high-risk foods are avoided – failing to give the child an adequate diet. Early weaning is only recommended if the baby is suffering quite badly and you have exhausted all other possibilities. It would not be appropriate, for example, in the case of a colicky baby who was otherwise well and growing normally. If you decide to try early weaning, remember the following points:
1. Certain foods seem to contain more potent allergens than others. Do not give the child eggs, fish, chocolate, wheat, oranges, peanuts or other nuts for at least the first six months, and preferably for the first year of life. If you introduce them before a year old, do not give them every day. Test out beef and chicken cautiously, as these can cross-react with milk and eggs respectively. If they seem to cause no problems, you can include them in the child’s diet.
2. Formula feeds commonly contain maize (corn) and tapioca, as well as cow’s milk, so your child may have become sensitive to these. Avoid these foods for at least six months and then try them out carefully. Maize comes in many guises, including cornflour, cornflakes, corn oil, corn syrup, sweetcorn, corn-on-the-cob and popcorn. Some medicines contain corn syrup: ask your pharmacist for advice if you are concerned about avoiding all corn products.
3. No food should be eaten in very large quantities, and it is best not to give any one food every day. This means using your imagination and buying some fairly unusual items. Foods such as millet and sweet potatoes make a good basis for baby foods, and if the baby does become sensitive to them, at least they are no trouble to avoid in later years.
4. Do not force the child to eat any food that is obviously disliked. Most children reject new foods the first time they are offered, but if your child clearly finds the food disagreeable, even after trying it three or four times, then don’t serve it up again. A dislike of the taste is sometimes an early sign of sensitivity.
5. If a child is not eating eggs, milk or fish, there is a risk of protein being in short supply. Make sure that you include other protein-rich foods, such as lamb, pork and other meats. Beans are a good source of protein, but they are also rather indigestible and cause wind; chickpeas (p303) are less of a problem, and have a milder taste.
6. Your child will probably need a calcium supplement, and the overall diet should be checked by a paediatric nutritionist to see if it contains enough of other minerals, as well as vitamins. Ask your doctor to arrange this for you.
Anyone who lives in a town or city will have been kept awake, at some time or another, by the sound of a burglar alarm ringing endlessly in an empty shop or house. The alarm is only meant to ring if someone breaks in, but it is triggered off by some other quite innocent event, such as a strong wind or the vibrations of a passing lorry. This is more or less what happens in the case of allergies. The mast cells, which are meant to respond to invasion by parasites, are triggered off by an innocuous substance such as eggs or cow’s milk. But why should this happen?
The answer is that the body misguidedly makes IgE antibodies that fit the antigens in these substances. A very complex and intricate set of controls normally prevent the body from making IgE in response to such harmless materials, but in the allergic individual something goes awry and the control mechanisms break down.
In the case of Jane, her body had mistakenly made IgE antibodies to an antigen in peanuts, probably a protein. The strange symptoms that she experienced on eating peanuts were all produced by mediators released from her mast cells. Mast cells in the tissues of the mouth were triggered as soon as the food came into contact with them, producing symptoms almost immediately. Her lips and tongue swelled up because tiny blood vessels inside them became leaky, allowing fluid to seep out into the surrounding tissues.
The cause of Jane’s collapse (anaphylactic shock) when she ate peanuts again was a sudden drop in blood pressure, likewise produced by the mediators. This time, it seems, more IgE was present and far more mediators released. By making the blood vessels all over her body expand, and at the same time become more leaky, the mediators left her without enough blood pressure to keep the vital organs functioning.
Petasites is one of the best, if not the best, natural remedies, often giving better results than one hopes and expects in cases of tumours, especially those of suspected cancer or actual cancer. If it is taken together with Viscum album, the reliable fresh plant extract from mistletoe, or in the form of a combination remedy made up of these two remedies, it is possible to experience satisfactory results even in cases where chemotherapy has no more to offer.
So when the doctor says that he has done everything possible, and that there is no hope left for an improvement in a patient’s condition, remember Petasites and Viscum album. These two remedies, together with an appropriate diet containing plenty of fruit juices and vegetable juices, can often achieve an improvement in the patient’s general well-being. At any rate, this treatment can definitely reduce sensitivity to pain and make life easier.
The importance to our health and well-being of caring for the feet will be clear from the preceding sections. Other interesting points will also be explored in the following pages. However, this section sets out to provide some useful guidelines on caring for the feet in general, as discussed above, as well as dealing with specific problems that may be experienced.
1. To start with, go and buy yourself shoes that are sensible and fit the foot rather than the fashion.
2. In the second place, take note of the following three points:
If you suffer from rheumatism, arthritis or an ailment that causes water to accumulate in the feet, it is useful to add a tablespoon of herbal sea salt to a foot bath. This bath should last 15—30 minutes, at a constant temperature of 37°C (98.6°F).
Sore feet should be bathed in an infusion of mallow or sanicle.
The reaction in this case may be a mild form of heart trouble. Remove the gold and the problem goes too. If such a sensitivity to metals exists, the dentist cannot use them for your fillings, particularly silver, since its effect is worse than that of gold. However, the degree of sensitivity will vary from one person to another, depending on the individual’s constitution, especially the lymphatic system.
When fitting a crown, a good dentist will take great care to see that it fits well. It must come well up into the neck of the tooth, leaving no space, as this would become a breeding ground for micro-organisms. Neither should a crown be too long, as this might cause irritation and inflammation. The solution to these problems depends upon the dentist’s skill. A loose crown can lead to suppurative conditions and an abscess formation which, when prematurely closed in, can cause the most dreadful pain imaginable because of the gases that are produced that have no way out. Under such painful circumstances the taking of anodyne drugs will be unavoidable. A further consequence of incorrect treatment could be the infiltration of bacterial toxins into the system, a situation that is not only bad for health but can endanger one’s life. The heart may be affected; it may even stop beating momentarily. Great skill and experience in natural treatment methods would then be required to eradicate such an infiltration.
Unfortunately, even in our temperate zones it has become a hazardous thing to drink water, as was evidenced in an article published as long ago as 19 April 1964, in the journal Nationalzei-tung (No. 178), entitled ‘Carcinogenic Substances in Water’. The article discussed the results of analytical tests of the water in Lake Constance and its catchment area. According to the author, the results indicated that the water analysed contained considerable amounts of carcinogenic substances. Even though the author did not sufficiently exploit the material, his presentation of the findings was enough to make us take note. We must remember that many toxins, besides the effluents from industries, can enter rivers and lakes without our realising it. For example, quite a number of poisonous sprays are used in agriculture, and deposits of leaded petrol and diesel oil accumulate on the roads. Rain and the water from melted snow take up these and many other substances, eventually washing them into the rivers and lakes. Tests have also shown that the groundwater in certain places already contains certain amounts of such pollutants, none of which are at all conducive to good health.
Academic debate about the real origin of this illness still persists. It can be caused by micro-organisms, perhaps in the wake of an infection, or by any of a number of toxins. More often than not, we find in association with arthritis some local focus of infection which discharges a constant stream of toxins or pathogenic agents into the blood. The quantity can be so small that the person may remain totally unaware of what is going on, until the body finally reacts, and becomes seriously ill. As a rule, various changes take place in the blood and scientists such as Dr von Bremer, recently also Dr Isel, have found viruses in the blood as well. Nevertheless, no definitive and conclusive explanation has so far been presented despite all the research and theorising.
I have observed that patients suffering from rheumatoid arthritis usually have a family history of gout, arthritis or some other rheumatic disease. There would thus appear to be a definite predisposition to this condition, as it is the case with many other diseases. Not everyone with a dental abscess will be afflicted with rheumatoid arthritis.
It is theoretically possible to cure one member of a family by treating another. Freud, in the notable “Little Hans” case, did just that, curing a phobia in a small boy through work with the boy’s father. Some people claiming to be family therapists never see families, only individuals, basing their claim on the “ripple” effect of successful individual therapy. Similarly, some family therapists treat all individual intrapsychic problems as family problems, amenable to family therapy techniques. It is true that the resolution of family problems often eases the intensity of the intrapsychic difficulties of family members. Still, these seem inefficient ways of doing therapy: while the individual is being treated, the overall family can deteriorate (such cases are known to the author), or while the family is being treated as a unit, the intrapsychic problems of some members can be slighted or repressed. It would certainly appear to be true, and it has been my own experience (Witkin) that the most efficient individual, dyadic, or family therapy is when all of the significant people in the problem are treated in therapy at an appropriate time.
Holistic therapy, then, is primarily distinguished not by utilizing a variety of modalities but by the therapist’s attitude toward the patient. “What is transpiring in any therapeutic setting is not determined by whether it is distinguished as individual, marital, or family therapy. It is determined by the needs of the patients and the capabilities, versatility, and training of the psychotherapist” (Martin). In brief, the patient is treated as a whole person, the dyad is treated as two whole people trying to maintain a rewarding relationship, and the family is treated as several whole people in various stages of development with various, mutually dependent needs and satisfactions. Many treatment modalities may be required, since techniques sufficient for treating individuals may not be appropriate to treating families.
It seems likely that holistic therapy will develop along the lines of family and dyadic therapy, that is, a host of approaches and techniques deriving from the myriad backgrounds of the practitioners. It also seems likely that the holistic therapist will need a variety of skills and modalities and that among these will be those associated with sex therapy.
A third stage which was not discussed by Freud but has been suggested as part of the psychosexual progression is that of the urethral stage. Some analysts have envisioned this phase of psychosexual development as a transitional stage between the anal and phallic stages. As such, it shares some of the characteristics of the earlier anal phase and by way of anticipation some from the subsequent phallic phase. More often than not, the characteristics of this urethral phase tend to be subsumed under the phallic phase. Urethral erotism can be taken to refer to pleasure in urination and the pleasure in urethral retention similar to the anal erotic pleasure of retention or expulsion of feces. The issues here are issues of performance and control. The classic image of urethral expression is the pride of the little boy in seeing how far he can project his urinary stream. Such urethral functioning can also be contaminated with sadistic impulses, often reflecting the persistence of residual anal-sadistic urges. Similar to the loss of bowel control, loss of urethral control (enuresis) can often have a regressive significance that reactivates and assimilates itself into underlying anal conflicts.
The pathological traits deriving from this period are those of competitiveness on the one hand and ambition on the other, probably connected with the need for compensating an underlying sense of shame due to the loss of urethral control. The conflicts over this issue may be the beginnings of the development of penis envy in connection with a feminine sense of shame and inadequacy in being unable to match the male urethral performance. Successful resolution of the urethral phase builds healthy personality traits, which are somewhat analogous to those derived from the anal period. Urethral competence offers a sense of pride and a feeling of self-competence derived from successful urethral functioning. The area of urethral functioning is one in which the small boy can begin to imitate his father’s more adult performance. In this sense then the resolution of urethral conflicts begins to set the stage for and make significant contributions to the shaping of gender identity and the subsequent gender-related identifications.
Changing the attitudes and beliefs of an individual who has accepted a traditional view of women is no easy task. As Rosen and Jerdee have pointed out, there are many potential motivations for holding sex stereotypes. They suggest, for example, that past costly experiences with women, perceptions of women as a potential threat, commitment to traditional values, or needs for clarity in our complex world all are reasons for the maintenance of stereotypes and rigid adherence to them. Depending upon which of these (or other) motivations support stereotypic belief systems, the most effective change-strategy would differ.
It also should be remembered that, as Terborg first suggested, sex stereotypes have two separate although often overlapping components. Different dynamics may underlie each, and thus different change processes may be needed to change them. It is conceivable furthermore that both have to be changed if certain forms of sex discrimination are to be eliminated. Even if one’s stereotypes about women’s attributes are altered successfully, and women are viewed as equally competent as men, it may still seem inappropriate for them to take positions of authority. Or conversely, even if one views a position as suitable to a woman, assumptions about her lesser competence can prevent her from obtaining it. At least in some cases, it would be essential to change both normative expectations and stereotypic perceptions of attributes if women are to be treated in an unbiased manner.
For the most part, the programs developed in recent years have been built upon the implicit assumption that the basis of the stereotyping of women is ignorance—ignorance of what women really are like and ignorance of what women’s life experiences are. Consequently, their focus is on raising awareness of stereotypical conceptions and on transferring information about the realities of sex discrimination.
Human-relations training and other workshops dealing with these issues have become common within organizational settings. A host of exercises have been developed for individuals and groups to explore personal and societal prejudices and misconceptions. Techniques such as role-playing have been utilized to encourage men and women to experience the other’s dilemmas. Educational programs have become widespread. To fill in the presumed knowledge gap, facts, theory, and research findings are presented and discussed.
Unfortunately, the effects of these programs are rarely assessed systematically, so no conclusions about their effectiveness can be made. It is likely that such programs are successful only when an individual’s assumptions about women have been sustained as a convenience, or because they simply have never been put to the test. In these cases, forcing people to confront their stereotypes about women and to come to grips with the consequences of them should be sufficient to bring about change. But when stereotyped views are deeply rooted in value systems, such programs are likely to fail. Information by itself has little impact on value-laden convictions.
An incidental but nonetheless important point about implementation should be mentioned. Kanter warns of the consequences of using mixed-sex group techniques in change efforts. The very activities necessary to explore sex stereotypes fully—expressing one’s emotions, being open and honest, being concerned about the welfare of others, and collaborating rather than competing—are those consonant with the stereotypic attributes women are assumed to possess. Although Kanter’s concerns were related to the lack of opportunities for skill development available to women in such groups, the point she raises is no less important when one’s concern is the altering of sex stereotypes. Participation in such groups conceivably can reinforce rather than change men’s images of women, unless care is taken to ensure that women also have the opportunity to display behaviors that contradict and challenge the stereotypes men are likely to have.
Changing individuals’ sex stereotypes can be a very complicated process, and it is likely to be an expensive one. The training and development needed to accomplish such a change, if indeed it can be accomplished, are not realistic in terms of the money and time required.
In many societies, ideas about sexuality assume more concrete form. In fact, the pronounced nature of sexuality in other societies has taken some anthropologists by surprise. For example, Harold Schneider writes of his work with the Turn, “I did not set out to study sexual behavior, but became acquainted with an important dimension of sexual roles in the normal course of a predominantly social anthropological study”. Schapera made much the same transition upon contacting the Kgatla: “I was continually struck by the open importance they attached to the sexual aspect”. In addition to these comments from Africa, the openness of sexuality has left impressions on researchers working in Polynesia, South America, the Caribbean, and Melanesia.
However, that which takes the ethnographer by surprise—sometimes requiring her or him to re-think the focus of a project—comes as no surprise to the native. “Alligatoring” makes sense to the Mehinaku. Sexual segregation at work and in ceremony makes sense to them too. It is this sense that the symbolic anthropologist hopes to reveal and understand. With this approach symbols are investigated as the basic building blocks of the ideological system. Symbols stand in relationships; they do not stand for something else.
Returning to the matter of Mehinaku extramarital sexual activity, we find that Gregor resorts to a Durkheimian notion of mechanical social cohesion in his explanation. Mehinaku affairs create relationships which keep the community together, though one wonders how. “Extramaritality,” to coin a workable expression, is also an important basis of economic distribution, according to Gregor. Women receive “modest but regular amounts of fish throughout the year” if they are sexually active.
There is yet a third component in Gregor’s analysis. Extramaritality engenders what Gregor calls an “underground kinship system,” “wherein the relationships engendered by extra-marital affairs are performed discreetly so as not to embarrass or anger the cuckolded spouses”. Crocker, studying the Canela Indians of Brazil, reports on an “underground kinship system” that goes one step beyond the Mehinaku system. The Canela (or at least the men) appear to speak to their “underground kinsmen,” the consanguinal relatives of the “classificatory wives” or mistresses’ with the appropriate affinal term of address. He will even refer to their children as “my children,” and assume other aspects of the paternal role.
The Mehinaku and the Canela provide examples of systems in which the form of kinship relationships is extended to persons (and to persons related to persons, in the Canela case) understood to share paternity through sexual acts. In one case from Africa, however, the political dimension is constructed somewhat differently. Harold Schneider’s analysis of mbuya (“lover,” or “paramour”) among the Turn of Tanzania argues that the Turn family organization is based on productive cooperation, not romantic love. Apparently the Turu have learned that the political dimension of marriage is complicated enough without adding to that burden the emotional peaks and valleys of romantic love. In short, Turu love and marriage do not go together. Marriage is a “lease of rights in a woman to her husband in return for bridewealth”. A smart husband would hesitate to divorce a productive wife, so presumably the fact that they have romantic affairs outside of marriage is tolerated by the husbands. Wives show similar tolerance. Schneider argues that “this tenuous marriage . . . would be endangered by romantic love, with its ups and downs”. Whether or not Schneider is correct, that is, if romantic love would indeed contribute serious instability in a basically political relationship, he has directed our attention to a group whose ideology places marital relationships (I hesitate to call them sexual) and extramarital sexual relationships in tension and opposition.
The opposition appears to be somewhat differently structured among the Mehinaku and Canela for whom it has been reported that “kinship” is extended through the possibility of “multiple paternity.” For these people we probably will not find a sexual/political opposition as with the Turu; instead, they have achieved levels of kinship structure—the so-called underground and above-ground system of ratified kinsmen—that contribute to the tensions of social life. Although a Mehinaku or a Canela may have scores of kinsmen, groups of kinsmen are set off through an opposition between those who are related to ego through ego’s mother’s husband, and those whom ego knows to be related to him or her as partial fathers through their sexual activity with ego’s mother during her pregnancy. Acknowledgement of this latter group of kinsmen, on the instructions of ego’s mother, is a recognition of the multiple sexual relationships of the mother, in which case we can say that her sexuality contextualizes the child’s social world.
This cultural structure contrasts with the ideological universe of the Turu, who live in two worlds, a body politic and a body sexual, as it were. The important point here is that sexual symbolism can form part of the structure of a bisected world, the other world being political (e.g. the Turu case), or it can provide an overarching structure in which ratified and surreptitious kinsmen are identified and opposed (e.g., Mehinaku, Canela). These two contrasting cases illustrate the insight into cultural systems possible when sexuality is studied within a framework of ideology, rather than separately.
According to the Kinsey data, masturbation is chiefly a phenomenon of young unmarried men, although it occurs to some extent among both sexes at every age and marital status level. Eighty-eight percent of the single males from sixteen to twenty in the Kinsey sample masturbated; the proportion of married males at this age level was considerably less (39%), presumably because marital intercourse was a preferred substitute. For young single males, masturbation represented the highest proportion of total outlet (60%). After age forty, masturbation was a relatively lower percentage of the total outlet (about 40% for the active sample). The average frequency of masturbation in the active single male sample dropped from 1.7 times per week in the teens to once a week or less by age forty. Kinsey did not report masturbation data for single males over fifty. Masturbation accounted for a lower proportion of the total outlet for married males than single males at every age. The average frequencies per week were from four to five times lower for married men.
Sixty-two percent of Kinsey’s total female sample reported that they had masturbated at some time, and 58% of these women had masturbated to orgasm. Among the single active sample, the average frequency of masturbation was .3 to .4 per week; for married females the mean was directionally lower (.2 per week). There was very little change in the active median frequencies for single and married women from the late teens through the fifties. Masturbation represented the highest percentage of total sexual outlet for single women; for married women, it accounted for 10% of the total outlet. Average frequencies of masturbation for single women showed virtually no decline with age (about 1 per week from the late teens through the fifties). For married women, average frequencies per week went from 1 in the teens, to .60 at age forty, to .2 at age fifty. For every age group, the percentage of total outlet was from three to seven times as great for single as for married women. Based on their clinical experience, Masters and Johnson suggest that both married and single women who masturbated during their adult years continue to masturbate in old age, although the frequency declines after age sixty. Christenson and Gagnon reported that 25% of a sample of postmarital women in their seventies were masturbating.
We live at a time when science is pursuing so many fields of research, and in the medical field so many more drugs and medications are available to improve our health. The growth of our population over the age of sixty-five can be due at least in part, to the availability of effective medicines and vaccines. The D.H.S.S. reports that during 1984 as many as 53 per cent of prescriptions dispensed in England were for women over the age of sixty and for men over sixty-five. Of course, it is only natural that older people have more long-term illnesses (such as arthritis, heart disease and hypertension). And it is not uncommon to have a number of disabilities or diseases at the same time for which you need to take a number of different medications. But have we become an over-medicated society?
Generally speaking, the elderly can have different reactions to medicines than the young or middle-aged, probably because of the decrease in the percentage of lean tissue (including muscle) and an increase in the percentage of fat. Consequently, these differences can affect the drug amount that is absorbed by body tissues and the length of time it remains in the body. Older people seem to have more undesirable reactions to drugs than younger people, probably because organs like the kidneys and the liver are working less efficiently, so that drugs (including alcohol) are slower to leave the body.
Prescription drugs are generally more powerful and may have more side reactions than over-the-counter medicines; and yet when large quantities of non-prescription drugs are taken, if they have strong ingredients, they might equal or exceed a dose available in a prescription. Some medicines (including antacids, alcohol, cold remedies, laxatives and vitamins) can create difficulties if overused or abused or taken in combination with prescription drugs, causing dizziness or drowsiness that could result in stumbling or falling. These few basic rules can help you use medicines, mineral and vitamin supplements more safely:
1. Before you have a new prescription, tell your doctor all the
other medicines you are taking, including oral contraceptives, insulin, non-prescription drugs and those prescribed by other doctors, plus vitamin and mineral supplements. If you are pregnant, a heavy smoker, or a heavy drinker, ask your doctor if there are any special foods, alcohol or aspirin to avoid, and if medicines should be with or between meals. Ask specifically what effect the new medication will have on your bone mineralization (especially if it is cortisone, an anticoagulant, anticonvulsant, tranquillizer or stimulant), and if additional calcium or vitamin supplements may be necessary.
Tell your doctor about previous adverse reactions you have had with medications (dizziness, rashes, indigestion, constipation, etc.). Know exactly what the medication is supposed to do for you, and ask about any side effects that may occur with a new prescription. Phone your doctor immediately if you have unusual effects.
Understand exactly what the dosage should be and how frequent, and take precisely the dosage your doctor prescribes. Oral contraceptives, oestrogens and a few other drugs usually have an information leaflet detailing risks and benefits. Read this brochure carefully.
Never take medicines prescribed for a relative or friend, or give your medication to anyone else, even though you may have similar symptoms or illness. Medicines can produce different effects in everyone.
Make a complete daily record of each drug and supplement you are taking, particularly if you are taking more than one. Note the name of the drug, the amount you take and the times of day for the dose, and don’t forget to tick off each dose as you take it.
Ask the chemist for easy-to-open containers if child-proof tops are difficult for you. Be sure to keep all medicines and supplements locked up and well out of the reach of children. Ask the pharmacist about any special storage requirements for the medicines you take, such as refrigeration.
Ask your chemist to put large type on the medicine label if you find the usual type difficult to read. Make sure you have the name of the medicine clearly on the label with the dosage
directions, and that you understand them. If you have any doubt that they are different from what your doctor has told you, mention this to your pharmacist or doctor.
Never put medicines into unlabelled containers. Fancy pill boxes are not always suitable.
Never take medicines at night without turning on the light. Be sure you can see clearly what you are taking and how much.
If you feel a medicine may be doing you more harm than good, don’t stop taking it without asking your doctor; he may want to change the dosage or substitute another medication that is more suitable to your changing needs.
Never resume taking a drug you happen to have in the medicine cabinet without checking with your doctor.
Many medications lose their strength and effectiveness over a period of time, so expiry dates should be carefully checked. Old medicines should be cautiously discarded and the labels clearly marked ‘Empty’ (to give peace of mind if children are found playing with the old jars or bottles).