Individuals seeking to support their health by following a vegan (total vegetarian) diet often face a multitude of advice-laden comments from friends, family, and even their physicians. Typically, these communications suggest that vital nutrients are commonly deficient in the vegan diet. The old standby, "But you can't get enough complete protein without meat," recently has been joined by, "But you need fish oil for essential fatty acids." Such advice is, of course, incorrect, being little more than the "deficiency paranoia" of the ill-informed. Knowledgeable people have few serious health concerns about the adoption of a vegan diet. Vitamin B12, however, is the rare exception.
 
Reason for concern

The concern over whether a vegan diet can ensure adequate vitamin B12 is a question that vegans must face squarely. For those who have been philosophically committed to the notion that a strict vegan diet can and will give you everything you need, we have a warning: Vitamin B12 is a material essential for your optimal health, and a strict vegan diet may not be providing this vitamin at adequate levels for you. There are legitimate scientific questions about how best to assure adequate B12 intake. In this article, we will examine carefully the "B12 Question," and offer suggestions that we believe may prove to be helpful.
 
Overview of vitamin B12

Vitamin B12 was first isolated in 1948. It is derived exclusively from bacteria. Since that time, research has established that vitamin B12 is required for a number of important functions, including the synthesis of thymidylate, a substance necessary for DNA synthesis. In addition, vitamin B12 is necessary for chemical interactions that make possible the recycling of methyl folate. If a person is deficient in vitamin B12, this recycling process can be disrupted. The deficiency then can result in problems identical to those caused by a folate deficiency, such as the death of hematopoietic cells in the bone marrow. Vitamin B12 deficiency also can result in inadequate myelin synthesis. Myelin is the fatty substance that insulates some nerves, allowing for normal neurological communication. If myelin synthesis is impaired, neurological problems can result. Difficulties can include numbness in the hands and feet, unsteadiness, poor muscular coordination, and even cognitive deficits such as confusion, mental slowness, and memory problems.

Most people obtain the majority of their vitamin B12 intake from animal products. Although most people associate vitamin B12 deficiency with vegan diets, the majority of cases occur among people who regularly consume animal products. So, it should come as no surprise that vitamin B12 deficiency can occur in vegans.
 
Finding a good source

There is no dispute that we must be concerned about obtaining adequate vitamin B12. The question is, "Do vegans need to resort to eating animal products, and expose themselves to the well-documented health risks of these foods, in order to maintain adequate vitamin B12 reserves?"

Before attempting to answer the above question, we need to consider whether animal products are naturally necessary for humans to maintain vitamin B12 reserves. This raises two important questions: "Have animal products always been the sole purveyor of vitamin B12 in the human diet?" and, "Are they the best source of this nutrient?"

We believe that the answers to both of these questions are likely to be "no." Upon reflection, we should note that in a more primitive setting, human beings almost certainly would have obtained an abundance of vitamin B12 from the bacterial "contamination" of unwashed fresh fruits and vegetables, regardless of their intake of animal products. Human vitamin B12 deficiency is very unlikely to occur in such a setting. Only very small amounts of dietary vitamin B12 are needed because our bodies do a fabulous job of recycling this essential nutrient. A person living in the ancestral environment regularly would have consumed fresh fruits and vegetables that were not consistently, fastidiously cleaned, as we routinely do today. Our current unusual degree of hygiene is useful for combating many health threats, but may leave long-term, strict vegans vulnerable to the potential problem of vitamin B12 deficiency.
 
A little goes a long way

Even in the modern environment, with our fastidious food cleanliness, a person consuming a vegan diet may never experience the need for vitamin B12 supplementation. Even the small amounts of B12 commonly found in the nodules of organically-grown root vegetables, and the small amounts produced by the bacteria in our own mouths, may be enough to sustain many of us. A very little of this substance can go a long way. For those who switch to a vegan diet, for example, there are usually stores of B12 in the liver that can last for several years, or even decades. However, the doctors at the TrueNorth Health Center work with a large number of vegan patients every year, and we have documented dozens of cases of vitamin B12 deficiency, all of which corrected with supplementation. Although many of our patients are understandably resistant to the idea that they might need supplementation, we urge them to test periodically for this possible deficiency, and to take appropriate action when indicated. We also recommend that all pregnant and lactating women include a reliable source of vitamin B12 to ensure the nutritional adequacy of their milk supply.
 
Keeping it simple

Our advice is straightforward: If you adhere to a vegan diet, we recommend that you either (1) have yourself tested for vitamin B12 deficiency every two years, or (2) ensure a reliable source of vitamin B12. The most appropriate test for evaluating B12 status is the blood or urine test for methylmalonic acid (MMA). Elevated MMA is currently our best tool for detecting vitamin B12 deficiency, and is considered to be superior to testing for serum B12 directly. We recommend that if you choose to avoid all animal products, fortified foods, and supplements, periodic testing for elevated MMA is indicated. The laboratory utilized by the TrueNorth Health Center charges less than $100 for this test.  An alternative and less costly screening blood test is Homocysteine.

If you would like to avoid MMA testing, we then would recommend that you include a reliable source of vitamin B12 in your diet. For people without a deficiency, 1000 mcg. per day (vegan capsule or liquid) should be sufficient to maintain most individual's serum B12 levels and body reserves. For those with a known deficiency, a consultation with a Hygienic physician is indicated. However, in most cases, this problem can be readily addressed with oral supplements without resorting to the injection of vitamin B12.

 We believe that a diet that includes animal products, although adequate in vitamin B12, poses many health risks that are best avoided.

Playing it safe

Unlike many unfounded "deficiency problems" associated with the vegan diet, the issue of potential vitamin B12 deficiency is real. However, B12 deficiencies, when they occur at all, take years to develop, so don't take our cautioning like the blaring of a five-alarm fire. If you choose to consume a diet consisting exclusively of whole natural foods, as we recommend, it is possible that, partly as a result of our modern cleanliness, you may become B12 deficient.

We recommend that you test periodically to assure that this does not become a problem. If it does, consult with a doctor who can advise you on how to take a responsible course of action.

With a bit of prudence, you can have the best of both worlds: all of the benefits of a vegan diet and none of the problems with animal products.

When you climb into a hot tub, it pays to edge in slowly. The water can be so hot as to be unpleasant, until you get used to it. Then it will feel pleasant. When you step into a swimming pool, the water sometimes feels cold. But after a few minutes, you get used to it. The scent of pine trees or fragrant flowers is wonderful, at first. But then you get used to it, and soon you may hardly even notice it.

How is it that our internal experience can change so dramatically, even when our environment is staying the same? How is it that we so easily "get used to" things? It turns out that scientists have carefully studied this striking phenomenon, which they refer to as neuro-adaptation. This process is called "neuro-adaptation" because it involves nerves and adaptation.

Our sensory processes are dependent upon the activation of sensory nerves. It is through the activation of various sensory nerves that we are able to see, hear, smell, sense touch, and to taste. The activity of these various sensory nerves tells our brains what is going on, and to what degree of intensity. For example, when you are sitting in a dimly lit room, and you turn on more light, your visual nerves become more active. They help your brain to notice an increase in brightness. Similarly, if you increase the volume on your stereo, your auditory nerves become more active. They help your brain to notice the increase in sound intensity. This same principle works for all of the five senses.

Relative perception

We tend to think that our nerves provide us with a very accurate depiction of real-world stimulation, but surprisingly, this is not the case. Let's go back to the example of sitting in a dimly lit room. If you turn on all of the lights, it will seem very bright. However, if you later go outside into full sunshine, that will seem brighter still. When you go back inside, it will seem dim, even though all of the lights are still on. Clearly, your nerves are not providing you with an "accurate" depiction of reality in these instances. They are providing a relative depiction. Your senses are highly responsive to change. They tell you when a new stimulus is brighter or dimmer, louder or softer, hotter or colder, and so forth, but not precisely how bright, or loud, or hot. Perception is largely a gauge of relative change.

The reason our nerves provide us with relative, rather than absolute, information is partly because our nerves are designed to adapt to a steady level of stimulation. When there is a sudden increase in stimulation, your nerves increase their rate of "firing" (the basic mechanism that communicates sensory information to the brain). Any change in the intensity of a stimulus results in a change in the firing rate of the appropriate sensory nerves. For example, when you brighten the lights, your visual nerves will increase their firing rate. When you later dim the lights, the firing rate will be reduced.

Dangerous adaptations

In this article, we shall focus on an aspect of "getting used to" things that can lead to enormous, often deadly, problems.

After we brighten the lights in a room, our visual nerves increase their firing rate, but only for a little while! After a few minutes, the firing rate will slow down, or "adapt," to the new, higher rate of stimulation. Sometimes, the nerves may even slow down their response to the level that they were previously firing at the lower level of illumination. This is why even a brightly lit room will seem merely "normal" after your sensory nerves adjust to it.

All of our sensory nerves work in this manner. When we first enter an office, we might be distracted by a noisy air conditioner. But after a while we will likely cease to notice it. When a person first starts smoking cigarettes, he is acutely aware of the smell of the smoke. He smells it on his fingers, in his clothes, and in his car. But before long, he won't notice it at all. He will have "gotten used to it." He may never notice it again unless he quits smoking. Only then will his sense of smell re-calibrate to a more smoke-sensitive state. Then he will be able to smell the smoke, just like everyone else does.

Taste troubles

Like our other sensory nerves, our  taste buds also will "get used to" a given level of stimulation, and this can have horrific consequences. The taste buds of the vast majority of people in industrialized societies are currently neuro-adapted to artificially high-fat, high-sugar, and high-salt animal and processed foods. These foods are ultimately no more enjoyable than more healthful fare, but few people will ever see that this is true, because they consistently consume highly stimulating foods, and have "gotten used to" them. If they were to eat a less stimulating, health-promoting diet, they soon would enjoy such fare every bit as much. Unfortunately, very few people will ever realize this critically important fact!
A gruesome tale

If a frog is placed in a pan of water, it often just sits there. If the pan is heated, ever so slowly, the frog may never notice that the water temperature is rising. He will "get used to" the increasing heat, and may be unaware that anything is amiss. Even with no barrier to his escape, he is as likely as not to sit in the pan, and boil to death. His sensory capabilities may fail to adequately warn him that action is required for his survival, and he may only survive if the heat is turned down.

For the past several decades, the modern American diet has been increasing in animal protein, animal and vegetable fats, refined carbohydrates, and added oil, salt, and sugar. In just the past two decades, our caloric intake has slowly escalated by 650 calories per person, per day. Not surprisingly, obesity and other diseases of dietary excess are at all-time highs. But just a few decades ago, our nation's dietary habits were remarkably different. Meat was an expensive commodity, for some, a "treat." The same was true for refined flour products, refined sugar, and oils. But times have changed. Today, almost everyone in America can have all they desire of these rich foods, and they do, virtually every day.

From the perspective of our natural history, a daily life with such dietary choices is extraordinary. For hundreds of thousands of years, our ancient ancestors scratched and scraped, struggling against the harsh forces of nature in order to get enough food to survive. Even today, in undeveloped countries, significant food shortages are still a great concern, with millions dying each year from starvation. Yet, in a mere blink of history's eye, in just a few decades, industrialized societies have arisen from environments of scarcity and have transformed themselves into societies of unprecedented abundance. The most striking feature of that abundance is a virtually unlimited supply of food.

Artificial appeal

An abundance of food, by itself, is not a cause of health problems. But modern technology has done more than to simply make food perpetually abundant. Food also has been made artificially tastier. Food is often more stimulating than ever before, as the particular chemicals in foods that cause pleasure reactions have been isolated, and artificially concentrated. These chemicals include fats (including oils), refined carbohydrates (such as refined sugar and flour), and salt. Meats were once consumed mostly in the form of wild game, typically about 15% fat. Today's meat is a much different product. Chemically and hormonally engineered, it can be as high as 50% fat or more. Ice cream is an extraordinary invention for intensifying taste pleasure, an artificial concoction of pure fat and refined sugar. Once an expensive delicacy, it is now a daily ritual for many people. French fries and potato chips, laden with artificially-concentrated fats, are currently the most commonly consumed "vegetable" in our society. These artificial products, and others like them, form the core of the American diet. Our teenage population, for example, consumes 25% of their calories in the form of soda pop!

Most of our citizenry can't imagine how it could be any other way. To remove (or dramatically reduce) such products from America's daily diet seems intolerable, even absurd. Most people believe that if they were to do so, they would enjoy their food, and their lives, much less. Indeed, most people believe that they literally would suffer if they consumed a health-promoting diet devoid of such indulgences. But, it is here that their perception is greatly in error. The reality is that humans are well designed to fully enjoy the subtler tastes of whole natural foods, but are poorly equipped to realize this fact. And like a frog sitting in dangerously hot water, most people are being slowly destroyed by the limitations of their awareness.
A pleasure trap

Figure 1 (above left) depicts a devastating dietary trap. People consuming a whole natural foods diet will experience a normal range of pleasure from eating low-fat, high-fiber, unprocessed foods, shown as Phase I. However, if concentrated, adulterated, processed foods are consistently allowed in the diet, they quickly will become preferred.

In Phase II, we see that these products are typically experienced as better, that is, more pleasurable, than natural foods. This is the result of the heightened pleasure-inducing characteristics of artificially-produced foods. However, within a short period of time (a few weeks), the taste nerves adapt to this higher level of stimulation, and reduce their firing rate. This reduces the pleasure experience of artificially-stimulating foods back down to normal levels (Phase III).

Phase III is the culmination of a process of extraordinary importance. It is within Phase III that most people live out their lives. And it is from within Phase III that most people will engineer their own health crises. Phase III occurs when we have become used to the extreme levels of stimulation present in artificial foods, yet ultimately experience no more pleasure than had we remained on a simpler, more healthful diet! Yet, we will rarely notice this process, just as we rarely notice the process of getting used to a brightly-lit room.

A challenging escape

Once in awhile, a person may actually become aware of important dietary knowledge. Despite the tremendous commercially motivated misinformation campaigns waged by the dairy, cattle, and processed food industries, sometimes a person actually comes to understand the truth about diet. At such times, determined individuals might attempt to change their diet toward whole natural foods, in spite of dire and unfounded warnings from their families, friends, and doctors.

But along the way, they are likely to be met with a formidable obstacles: their own taste neuro-adaptation to artificially intense foods. This challenge is depicted as Phases IV and V, wherein a change to less stimulating foods typically will result in a reduced pleasure experience. In the early stages, this process is dramatic because natural foods often are not nearly as stimulating.

Scientific evidence suggests that the re-sensitization of taste nerves takes between 30 and 90 days of consistent exposure to less stimulating foods. This means that for several weeks, most people attempting this change will experience a reduction in eating pleasure. This is why modern foods present such a devastating trap, as most of our citizens are, in effect, "addicted" to artificially high levels of food stimulation! The 30-to-90-day process of taste re-calibration requires more motivation, and more self-discipline, than most people are ever willing to muster.

Tragically, most people are totally unaware that they are only a few weeks of discipline away from being able to comfortably maintain healthful dietary habits, and to keep away from the products that can result in the destruction of their health. Instead, most people think that if they were to eat more healthfully, they would be condemned to a life of greatly reduced gustatory pleasure, thinking that the process of Phase IV will last forever. This is an extraordinarily deceptive and problematic situation that I describe as a "pleasure trap."
A fast way out

For many people, knowing how this trap works is a great ally to their self-discipline. But for others, this trap can seem just too difficult to manage. For them, the road may seem too long, and even minor indulgences often keep them in the trap. Fortunately, there is a second method for escape, one that greatly speeds up the process of taste re-calibration.

A properly-supervised period of water-only fasting is a safe and effective way to quickly re-sensitize taste nerves so that whole natural foods can be fully enjoyed. At the Center for Conservative Therapy, we have noted that for most people, one week of consuming nothing but water in an environment of complete rest is enough to substantially re-calibrate their taste buds. Patients find that after a fast, healthful fare tastes as good as the artificially-intense foods that they may have been eating previously. Sometimes natural foods taste even better.

Avoiding the trap

The modern American diet contains concentrations of chemicals that we were never meant to consume. As food manufacturers have sought to compete with each other, foods have become increasingly artificial, loaded with ever-higher concentrations of pleasure-inducing chemicals, such as sugar, salt, and fat. But curiously, though the concentrations of these chemicals have escalated, the actual pleasure from eating has always stayed about the same. We now understand why.

As our modern foods have become increasingly stimulating, our taste nerves are becoming desensitized, neuro-adapting to the modern diet's excessive stimulation. This sets the stage for a devastating trap, wherein a health-promoting diet is relatively unappealing.

Fortunately, you now understand what it takes to escape this deceptive dietary trap. With consistent discipline, or perhaps an occasional period of supervised, water-only fasting, you can always get yourself back on track. In doing so, you will discover, or perhaps re-discover, that the diet of our natural design can be very enjoyable.

Develop an understanding of these basic principles and you will be well on your way to health

Health can best be described as an optimum state of physical, mental and social well-being, with the emphasis on optimum. Since health results from healthful living, the only way we can hope to achieve this optimum state of well-being - our personal health potential - is through ongoing conscious effort.

We must provide our bodies with all of the requirements of health. At the same time, we must avoid, or at least minimize, the things that can compromise health-environmental stressors and our own destructive behaviors.

Heredity plays an important role in determining a person's health potential. Unfortunately, we cannot change our inherited constitution, nor can we control any permanent effects of our former living habits.

There are, however, four major components of healthful living we can control. To help remember them we use the mnemonic DEAP (pronounced like deep) which comes from their initial letters. The components are Diet: what and how we eat;  Environment:  how we select and modify our surroundings;  Activity: how we exercise, rest and sleep; and Psychology: how we view ourselves and interact with others.

We must learn to identify the specific requirements of health, as well as the stressors, for each of the four categories. Only then can we formulate effective strategies that lead to optimum health. Since all of these categories are worthy subjects in and of themselves, we will limit ourselves to a description of a number of key points for each.

Diet

Diet is the sum total of all substances taken into the digestive tract. For most Americans, it is not difficult to get all the nutrients our bodies require, including protein, fat, carbohydrates, vitamins, minerals, fiber and water.

A diet made up of a variety of fresh fruits and vegetables, raw nuts and seeds, whole grains, and legumes provides all the necessary nutrients in abundance. If our diets consist exclusively of these items in their whole, unrefined state, we will not only meet our requirements, but also avoid the numerous dietary stressors that can destroy health. Most importantly, we will avoid the excessively concentrated  rich diet that is the main threat to health today.

As a result of the aggressive marketing efforts of the meat and dairy industries we have been miseducated about the "necessity" of including animal products in our diet. This purported need for meat, fish, fowl, eggs and dairy products is in direct contradiction to mainstream scientific research that shows that these high protein, high fat, no fiber foods are detrimental to health. In fact, it is impossible to keep fat and protein intakes at optimum levels when animal products are eaten in significant quantities.

Excess protein is associated with osteoporosis (loss of bone density) and kidney disease. Excess fat, especially the fat found in animal products, is associated with cardiovascular disease (heart attacks) and cancer (especially breast and colon cancer). Low fiber is associated with constipation and colon cancer. Incredibly, in spite of the facts, people are still being encouraged to consume animal products three or more times a day.

Other dietary stressors include alcohol, tobacco, coffee, refined carbohydrates (including sugar and honey) and oils. Unfortunately these substances (with the possible exception of tobacco) are still socially acceptable, and it will take a little effort on our part to avoid them. But new, more accurate health education programs are beginning to draw attention to the health risks posed by these things and it is fast becoming more socially acceptable to abstain from them.

Environment

It is tempting to ignore the environmental factors of health because they often seem beyond our personal control. But there are environmental factors we can and must control if optimum health is to be obtained and maintained.

A health-promoting environment includes clean air, pure water, appropriate sunshine, and esthetics. It avoids environmental stressors including excess noise and toxic substances. We have quite a bit of control over each of these aspects.

Air pollution is pervasive, especially in large cities. Individually we have several options for dealing with air pollution. We can move. We can purchase an air purifier for our home and perhaps for our place of employment. We can avoid smoky places. We can avoid using toxic chemicals, commonly known as household cleaners, in our homes. We can use respirators when exposed to paint and other fumes, etc. By carefully analyzing our daily routine we can eliminate a sizeable percentage of our exposure to air pollution.

Similar strategies can be applied to other environmental concerns. To avoid the toxins associated with water, including heavy metal and pesticide contamination, toxic by-products from chlorination and fluoridation, etc., we can purchase or make purified or distilled water. Overexposure to ultraviolet radiation from the sun can be mitigated with the use of proper clothing, including wide-brim hats and sunscreen. Earplugs offer protection from high noise levels. The first step to take is to identify areas of potential environmental stress, then develop appropriate strategies to minimize or eliminate these stressors.

Activity

The category "activity" includes exercise, rest and sleep. There is much confusion about the role that exercise and sleep play in health. Like diet, activity is an area where each person can take control.    

Vigorous physical activity puts demands on all body systems to work harder. The body responds to these demands by becoming stronger and more efficient. The health benefits of exercise include improved metabolism, increased muscle and bone strength, more efficient cardiovascular (heart and blood vessel) function, larger lung capacity, tension reduction, and improved sleep.

The most efficient way to obtain these benefits is through regular aerobic exercise. Aerobic exercise involves the large muscles of the body, particularly the legs. Examples include brisk walking, jogging, swimming and bike riding. Exercise is most enjoyable when it is incorporated into recreation and becomes a regular part of your normal daily activities.

The benefits of regular aerobic activity are becoming more widely understood and accepted; however, the benefits of sleep are often ignored. Sleep deprivation can suppress the body's immune system, and has been associated with depression. Healing activity is accentuated during sleep. Two aspects of sleep must be considered: quality and quantity.

Many people just don't allow enough time for sleep. They regard it as a waste of time and use drugs such as caffeine to stimulate their exhausted bodies into action. Some people allow plenty of time for sleep, but the quality of their sleep is poor. Regular exercise is often effective in helping people improve their ability to fall asleep. Physically fit people spend more of their sleeping time in deep sleep, and in REM (rapid eye movement), or dreaming sleep, the more restorative stages of sleep. People who are getting enough sleep wake spontaneously and feel refreshed.

Psychology

Psychological health is characterized by high self-esteem and is dependent on two primary features: productive activity and effective interpersonal skills.

Productive activity is any life-enhancing activity that you feel is worthwhile and that is performed to the best of your ability. The positive feedback of successfully performing tasks increases feelings of well being and promotes self-esteem. This process begins in childhood with simple activities and builds in complexity as skills are mastered. The satisfaction and pleasure of successful performance is sometimes lost as people grow older and perceive themselves to be doing meaningless tasks that they attempt to accomplish with the least possible effort. Lack of meaning and effort are damaging to psychological health.

Effective interpersonal skills are the tools that enable people to get what they need and want from life. A baby cries to let others know its simple needs. Older children are much more skillful and subtle in their communication. Adults require a large, complex array of skills to effectively interact with fellow workers, friends and family. Each type of interaction requires different skills if the relationship is to be successful. These skills are learned to differing degrees in the process of growing up. They can be refined and improved by adults who are striving for a more satisfying lifestyle.

There's more to Hygiene than cleanliness and sanitation. And society is getting the message.

Hygiene is defined in the dictionary as the science of health and its preservation. But just what does that mean?

Science, the dictionary tells us, is the systematic observation of natural phenomena for the purpose of discovering laws governing those phenomena. In other words, science is the process we use to figure out how things work.

Health is defined as a state of optimum physical, mental, and social well-being, and not merely the absence of disease. Natural hygiene is a broad term, which encompasses the techniques that man has developed to learn about the natural laws that determine health. The more you learn about these laws, the better prepared you are to make the choices that will determine to a large extent both the quantity and the quality of your life.

Over 100 years ago a few disenchanted medical doctors began to publicly challenge the medical approach to health care that included in its therapeutic arsenal leeches, bleeding, withholding of water from patients, etc. These early natural hygienic pioneers criticized the use of drugs in the treatment of disease and advocated fresh air and sunshine, good diet, and the avoidance of social poisons such as tobacco, alcohol, and coffee. Since the mid-1900s, natural hygienists have tried to convince a resistant world that health is a state of vitality and that health is self-generated by the human organism when it is provided with the prerequisites of health and is put under no more stress than is within its inherent and developmental capacities.

Here are some quotations. After reading them, we can decide together whether or not natural hygienists have been successful in influencing America's attitudes about health.

"Most Americans choose the way they will die. How you live, hour by hour, day by day, more than anything will determine what will kill you and when."

"For the most part, unnoticed bad living habits - not germs - are the big killers in industrialized society."

"Over the past 50 years our unhealthy living habits have grown into a gigantic new disease that kills 7 of each 10 people. The biggest killers today-heart disease, cancer, and stroke, along with cirrhosis of the liver, bronchitis, emphysema, and asthma - kill 76 percent of the 2 million Americans who die each year. There are no vaccines to prevent such threats to life. Cleaning up our life-styles is the cure. Ironically, rather than improving, lifestyles are getting worse."

"Changes in diet, smoking, exercise, and alcohol consumption, and a reduction in physical and psychological stresses of our environment would do more to improve health than doubling outlays in medical care."

Before I give you any more quotations, perhaps I should reveal the source of this information. The American Natural Hygiene Society? A chiropractic brochure? A book from a health food store?

No. All of these quotations come from a booklet put out by none other than one of the largest insurers of medical care in the country, Blue Cross.

Now let me provide you with a few more quotations from this Blue Cross booklet.

"The next major advances in the health of American people will come from the assumption of individual responsibility for one's own health and a necessary change in the lifestyle," according to Dr. John H. Knowles, president of the Rockefeller Foundation.

"It has become clear that only by preventing disease, rather than treating it later, can we hope to achieve any major improvement in the nation's health," according to the Department of Health, Education, and Welfare.

"By switching from a bad lifestyle to a healthier one, a person can figure on adding about 14 years to his life," said Dr. Lester Breslow, Dean of the School of Public Health at the University of California at Los Angeles.

Benjamin Lipson, an insurance consultant, said, "Bad lifestyles are such a threat to health that the so-called average healthy American with a self-indulgent living pattern is a far worse insurance risk than a mild adult diabetic who watches his diet."

Health experts are beginning to realize that crisis medicine has become a bottomless pit. No matter how much money is put into it, it has not improved the health of the people. H. Robert Cathcart, chairman of the board of trustees of the American Hospital Association, has said. "In the last few years we have come to recognize that the demand for our services is infinite. We can begin now to act on the lifestyle issue and join others in helping individuals to modify their lifestyles, to lead healthier lives, and thus to reduce the use of the expensive services that we offer."

Natural Hygiene

Have natural hygienists been successful in obtaining recognition of their philosophy? I believe the answer is a resounding Yes. The public, government, and even the medical establishment are opening their eyes. It's true that there is still much education that needs to be done, but never before have more people had more information available about how to get and stay healthy. Concepts relating to prerequisites of health have been well accepted.

Natural hygienists have long stated that the prerequisites of health include good diet and environment, appropriate activity-including rest, work and play-a sound psychology and functional homeostasis, or balance. As for diet, they recommend that the diet should be a vegetarian-oriented diet emphasizing fresh raw fruits and vegetables. They advocate regular exercise and rest as well as productive activity, and they emphasize the importance of the environment, not only in broad terms of air and water quality but also in terms of work conditions and aesthetic beauty.

Natural hygienists have long recognized that a sound psychology is predicated on self-awareness, self-acceptance, and self-responsibility. These components are becoming accepted, mainstream, popular. This is good-and about time.

But there are still some concepts that have not gained widespread understanding or acceptance. Natural hygiene offers a unique view of the very nature of health and disease. Currently the average person's concepts of health and disease have been manipulated by the economic interests of the food industry, the drug industry, and, perhaps most of all, by the pseudoscientific proclamations of the medical industry, abetted by the popular media.

Modern Medicine

The modern medical establishment would have you believe that the 300-plus billion dollars a year that are spent on so-called health care is buying an ever-increasing standard of health. In recent years there has been an outcry even from individuals within the scientific and medical community.

Rick Carlson, in his book, The End of Medicine, states that current medical practice has very little to do with health. Although the medical establishment attempts to take credit for decreased incidence of specific disease processes and claims responsibility for an increase in life expectancy, Rene Dubos, an eminent bacteriologist and holder of a chair at the Rockefeller Foundation, published a book entitled Mirage of Health in which he states that modern medicine's purported achievements are not all they are cracked up to be. He points out that it was the social reformers-that is, the early natural hygienists who campaigned for purer water, better sewage disposal, and improved living standards-who were chiefly responsible for the reduction in mortality from so-called infectious disease.

As for increased life expectancy, Thomas McKeown, in his book, The Role of Medicine, explains that the statistics purporting to show a great increase in life expectancy have been misleading. The increase has largely been the consequence of higher living standards and a decrease in infant mortality. Life expectancy for those who have reached adulthood is little higher today than it was at the beginning of the century. Ivan Illich, in his book, Medical Nemesis, says that the medical profession concentrates almost all of its resources on treatments for which they get paid-rather than on prevention, which, if effective, would reduce their income and status.

In The Diseases of Civilization, Brian Inglis quotes Halfdan Mahler, director of the World Health Organization, who states that there has been a mystification in medical care, which has continued, almost unchecked.         

Absorbed in its own preoccupations, the medical profession has allowed the gap between health care and medical care to continue to widen. At the same time it has exploited its monopolistic position to create an unnecessary dependency of the population upon the holders of these mysteries.

Inglis also reminds us how adept the medical profession is at abusing statistics to try to prove its case. Hardin Jones, a professor of Medical Physics at the University of California, Berkeley, bluntly told his colleagues that patients whose cancers were inoperable were being used by surgeons as the controls or comparisons in trials, giving the false impression that those patients who were being treated for cancer with surgery and radiation were benefiting. Correcting the statistics to allow for this bias, Jones calculated that the life expectancy of untreated cancer patients was longer than those receiving treatment.

Patients are often told by medical practitioners: "Learn to live with it"... "What do you expect at your age?"... "There is nothing that can be done." If patients question their doctors about alternative approaches, they are often told: "We don't know what causes your problem. We don't know what will help you. We are not trained in natural therapeutics-but they couldn't possibly be of help." And if you are a woman and your test results come back negative, you may be told that "It's just your hormones"... or "It's all in your head."

When patients who have recovered their health through natural means go back to the medical practitioner who made the original diagnosis, patients are often greeted with hostility for daring to go outside what Robert Mendelson, M.D., describes as the church of modern medicine.

In his book, Confessions of a Medical Heretic, Dr. Mendelson states, "I believe that despite all the super technology and elite bedside manner that is supposed to make you feel about as well as an astronaut on the way to the moon, the greatest danger to your health is the doctor who practices Modern Medicine." He contends that the treatments for diseases are seldom effective and that they are often more dangerous than the diseases they are designed to treat.

What Is Health?

The single most important problem with the modern medical profession is its misconception about the very nature of health and disease. Dorland's Medical Dictionary defines health as the absence of signs and symptoms-that is, the absence of any evidence to the doctor or patient. In fact, even if there are symptoms, if they are not much worse than the symptoms of the other patients seen by the doctor, he may still pronounce you healthy. This is a kind of health by default. But health is not merely the absence of symptoms. It is a state of vitality where the human organism has the capacity to successfully adapt to the stresses of its environment.

What about disease? Disease is defined in the medical dictionary as a definite morbid process having a characteristic train of symptoms. If you look up morbid, you'll find it defined as having to do with disease. That's what you might call a circular definition.

Modern medicine has defined disease as both the degeneration and death of the cells that are the building blocks of tissue, as well as the processes that precede this degeneration. In other words, they believe that the reactive processes of the body-such as fever, inflammation, vomiting, diarrhea, etc.-and the death or degeneration of cells are bad. Those who study health realize that this is a serious misconception. While we all agree that the degeneration and death of the body's tissue is a bad thing that must be prevented, we strongly disagree with the concept that the self-healing mechanisms of the body-such as fever, inflammation, etc.-are negative. We recognize that not only are these "disease" processes natural, but they are essential if the body is to restore balance and prevent damage.

It is absolutely essential to understand that the body generates disease processes in an attempt to restore normality. Fever, vomiting, diarrhea, and inflammation all have very important functions in the recovery of health, if these processes are interfered with through the indiscriminate use of drugs, surgery, even "natural" therapeutics, this interference with the body's self-healing mechanisms may prevent it from making a complete recovery. The invasion treatment may be successful in eliminating the symptoms, but it may actually make the individual less healthy.

For example, fever is the word we use to describe an increase in the body's temperature. If the organism needs to increase its metabolism to fight off the effects of unfriendly microorganisms, one of the many responses of the body is to increase its basal metabolism. This increases the rate that chemical reactions take place in the body. This increased metabolism helps the body regain balance. It has also been noted that many microorganisms have difficulty synthesizing certain essential nutrients at increased temperatures and that the fever of acute illness is important in giving the body the upper hand.

The increase in temperature also creates some side effects, such as increased perspiration, headache, etc. A doctor practicing modern medicine may see fever as an enemy, since it makes the patient uncomfortable, and the doctor may proceed to "attack" the fever by poisoning the body with a variety of toxic substances.

If the doctor is "successful," the patient may feel more comfortable for a while. Unfortunately, the cause that created the need for the fever has not been addressed, and the symptoms often return at a later date, occasionally in a different form. Instead of working against the body's natural healing mechanisms, we must learn to support the body and allow it to restore its natural balance.

Fortunately, medical doctors are becoming aware of the tremendous damage they have inflicted on too trusting patients, and they are now beginning to avoid the indiscriminate interference with fever.

Care of the Sick

Natural hygienists do not claim that the body is always successful or always capable of overcoming each and every obstacle. Neither do they claim that there is never a role for drugs or surgery. Their recommendation is to avoid the causes of disease and, in cases where intervention becomes necessary, that conservative techniques should be used whenever possible, and that every attempt should be made to support the body's inherent healing mechanisms. The human organism is very well designed. And when the body is provided with the prerequisites of health and is not stressed beyond its inherent capacities, it is self-healing, self-regulating, and self-directing.

The critical issue is: What is the best way to avoid damage to the body? Obviously, the first choice is prevention. But once an injury or problem develops, what is the best way to resolve it?

Modern medicine generally takes an overly invasive, aggressive approach that often poses more risk than the process being addressed.

Drugs and surgery are often directed at the symptoms of problems rather than the actual problems. The important question to always consider is: What factor or set of factors is responsible for this set of symptoms? What can be done to remove the causes? What can be done to support the body's healing mechanisms?

Most of us realize that the symptom-oriented quick-fix promises of modern medicine are on the way out. But what will replace them? Recently "natural" therapies have come into vogue. However, most of these are nothing more than allopathic medical practices minus the toxic (drug) substances, or with less toxic ones. The philosophy is still the same. Although therapists may talk a lot about natural healing, it is, in fact, merely a game of words. The ancient concept that a special substance, vitamin, potion, or treatment is needed to allow the body to be healed is still being promoted. Instead of the potent pharmaceutical drugs of modern medicine, the "natural" therapists utilize milder herbs, homeopathics, and other exogenous agents.

Nothing but the body can heal. All healing is generated by the body. The body requires the prerequisites of life and the opportunity to heal. No drug, herb, or treatment can speed up, increase, or allow healing except in that it provides the body with a needed raw material or removes an interfacing factor.

In order to heal itself the body often generates such processes as fever, inflammation, etc. It is important to understand the role of these healing crises. When the various stress factors of life-physical, chemical, emotional, etc.-exceed the body's ability to maintain optimum health, the body will attempt to restore its natural healthful balance. It may generate what can be called a healing crisis. This is not to say that healing crises are desirable. In fact, we want to learn to live so that the need for a crisis is eliminated. But when one is required, we should support the body and not interfere with its efforts.

For example, if a toxic substance is introduced into the intestinal tract-whether it is from food, microorganisms, or any other source-the body will attempt to eliminate the poison before it can be absorbed. Vomiting and diarrhea may ensue. Attempts to interfere with these may actually increase the amount of toxin absorbed. If the body is unable to keep all of the poison from being absorbed, it may increase its metabolism (fever) and mobilize its defense mechanisms (white blood cells, etc.) to isolate and remove these poisons. These processes of the body, though uncomfortable, are both natural and necessary for our health. They would collectively be termed a healing crisis.

Choosing Health

Health is the optimum state of well being. Disease processes are attempts by the body to heal itself. Degeneration is the alteration of tissues that takes place when the body is unable to overcome stressors. Avoid the indiscriminate use of the practices of modern medicine that interfere with the natural mechanisms of the body. Support the body by providing it with the appropriate quantity and quality of the prerequisites of health and by limiting the stress factors of life within your control. It is important that everyone understands how health can be regained and maintained. Each of us must be allowed the opportunity to construct a rational model of health that is consistent with reality.

You now have this opportunity. The question is: What will you do with this information? You have a choice. And that choice will determine to a large extent the quantity and quality of your life.

Dietary facts can help simplify your life.

Many people have difficulty sticking with their diets because they are not getting enough to eat!

At the recent ANHS International Conference, many questions were asked about food.  Since many were prompted by common misconceptions about the Hygienic diet, we asked Dr. Alan Goldhamer to comment and describe a realistic starting point from which they can begin to design a diet that meets their individual needs. Dr. Goldhamer is president of the International Association of Hygienic Physicians (IAHP) and director of the TrueNorth  Health Center in California.

Newcomers to NHA conferences often ask about getting all the nutrients they need from a whole-food, plant-based diet. Many people have a specific concern about getting enough protein. Should they be concerned?

 A diet derived exclusively of whole, natural foods, including fresh fruits and vegetables, and the variable addition of whole grains, nuts, and legumes, provides us with the quantity and quality of nutrients needed for optimum health. These nutrients include protein (for its essential amino acid components), fat (for its essential fatty acid components), complex carbohydrates (as a clean-burning source of fuel), vitamins (for their role as catalysts and cofactors), minerals (that serve as structural components), fiber (as a necessary source of roughage), water (the universal solvent), and phytochemicals (for the possible role they play in supporting and protecting the body).  On the specific issue of protein - a healthful, calorie-sufficient, whole-food, plant-based diet will supply between 50 to 80 grams of high quality protein per day.

Many people say that they do not feel "full" or "satisfied" when they go for more than a few days or weeks on raw foods, and then they tend to go off their diet and binge.

There are numerous psychological and physiological factors that may contribute to why a person may binge on food. One reason may be that the person is not getting enough to eat and simply may crave more food! They might not be getting enough available energy from the foods they are eating.

Uncooked vegetables, ripe fruits, and nuts are healthful, extremely nutritious, and easy to prepare.

Some people argue that a raw-food diet is the natural and ideal diet of humans. This may be more of a romantic notion than a practical reality for most people.

If you decide to eat a diet made up of raw foods only (i.e., fruits, vegetables, and nuts), you will need to eat a very large volume of food in order to get sufficient calories to maintain your weight and energy levels. On average, raw vegetables contain 100 calories per pound; fruit contains approximately 300 calories per pound. Because most people need about 2,000 calories per day, you would need to eat at least 12 to 15 pounds of fruits and vegetables each day.

A diet of only fruit over a prolonged period of time can present serious problems for many individuals. Modern, hybridized fruit is high in sugar and relatively low in mineral concentration. Contrary to the unsubstantiated claims by some that we are natural "fruitarians," a diet of only fruit often leads to a compromise in health.

The inclusion of raw nuts increases the caloric and mineral density of the diet, but also increases the percentage of calories from fat, yielding a high-sugar, high-fat diet that is far from ideal for most individuals. The inclusion of large volumes of raw vegetables helps increase the mineral and fiber content, but salad only provides approximately 100 calories per pound, most of which is used in its digestion and elimination.

Starches such as potatoes, yams, hard squashes, etc., are a good source of calories, without the excess fat and protein. Grains and legumes are, too, but some people are intolerant of the gluten found in wheat, rye, barley, etc. Rice, quinoa, millet, lentils, and soybeans are preferable, but even these foods can present a problem for some people.

Is the raw food diet the "ideal diet"?

The argument that raw food is "natural" because most other animals obtain their food in the uncooked and unprocessed state is not a strong one, since those who champion this proposition do not recommend, at the same time, the other lifestyle necessities that accompany it-specifically, that animals do little else than eat, sleep, and mate during their relatively short lives.

Many people find it difficult to eat the quantity of raw food necessary to get sufficient calories. They may be much better off eating some steamed vegetables because lightly steaming vegetables does not substantially decrease the nutrients and makes it physically easier to eat and digest more food.


Can you recommend a starting point for people who want to design a healthful diet that meets their individual needs?

I recommend to most of my patients that they eat large volumes of fresh, raw fruits and vegetables (three to five pounds per day, yielding 600 to 1,100 calories) and get enough cooked, starchy vegetables (such as potatoes, yams, and hard squashes) and whole grains and legumes (such as brown rice, millet, quinoa, corn, lentils, and other beans) so that they can maintain good strength and energy levels and not get too skinny. If vegetable foods naturally high in fat and protein are used, I recommend limiting them to half of an avocado, or one to two ounces of raw nuts, or three to four ounces of soy products per day.

By volume, the diet is mostly raw; however, as a percentage of calories, cooked foods make up a significant part of the diet. The use of heat helps to break down some of the otherwise indigestible fiber, increasing the potential available energy from these cooked foods. Starchy root vegetables are an excellent source of calories, vitamins, minerals, fiber, and water, as well as an abundant source of phytochemicals.

When general advice is not enough to resolve your concerns, consult an IAHP doctor and allow him or her to review your history, perform a physical examination, order necessary laboratory testing, and design an individualized diet and lifestyle recommendations.        

Separating the Facts from the Myths

Speculation about longevity, aging, and rejuvenation has flourished since antiquity.

Most of us have heard of the myth of Shangri-La, where people live for a thousand years, free from all earthly ills, in a land of perpetual sunshine. This is just one example among many.

People in all places in all times, including our own, have woven facts, fantasy and fallacy into the theories of longevity that come down to us not only in folklore and mythology but also newspapers, books, and on the TV screen. It is important that we be able to intelligently separate the accurate, useful information from the inaccurate, exaggerated and distorted.

Many interesting claims about longevity can be found in ancient writings. In the book of Genesis, Adam and six of his direct descendants are said to have lived for more than 900 years. The oldest, Methuselah, was said to have lived 969 years.

The famous legend of the Fountain of Youth can be traced back to at least 700 B.C. In the fable of Cyavana, an elderly Hindu priest revealed certain religious secrets to two demigods in exchange for rejuvenation in the Fountain of Youth. This Fountain theme is elaborated in ancient Hebrew, Greek, and Roman writings. In 1513 Ponce de Leon went searching. He discovered Florida, but he never found the Fountain of Youth.

In more recent times there have been tales of people living extremely long lives in primitive and mountainous regions of Pakistan, Ecuador, and Russia. These areas include the province of Hunza in northwestern Pakistan, the isolated village of Vilcabamba in the Andes Mountains of Ecuador, and the district of Abkhazia in the Caucasus Mountains of the USSR

These areas have been the targets of extensive scientific studies by many investigators. In 1978 an international convention was held to examine all the known information about these modern-day Shangri-Las.

It was revealed that all three areas have much in common. Life involves hard physical labor. The diets (by Western standards) are low in calories, protein, and fat. And the aged continue to be active and respected members of their communities into advanced age.

But careful scientific evaluation of physical and biochemical parameters revealed that the age of individuals living in these areas was significantly exaggerated. A study of more than 500 individuals claiming to be between 120 and 170 years old revealed that all were in fact under 108 - and most were in their 80s.

In 1959, for example, the famous super-centenarian Vakutia had deserted from the Army in World War I and, with forged documents, had assumed his father's name. He was actually only 78 years old. In many areas it was common practice to assume the identity of one's father or even grandfather to avoid conscription into the army.

Here in the U.S., Charlie Smith was reported to be 137 years old in 1979. In fact, he was 104.

If human beings don't live to 130 or 170, how long do they live?

The oldest reliably documented human life span at present is 122 years, 164 days in the case of Jeanne Calment of France (Feb. 21, 1875 – Aug. 4, 1997). We cannot prove that no one will ever live longer than 122, but there is no conclusive evidence that anyone has.

Life extension has always been a much-desired goal, but the concept of a longer life without the preservation of health is repugnant. The fear of infirmity is found in legends past and present.

The Greek legend of Eos and Tithonus is a good example. The goddess Eos asks Zeus to give her mortal lover Tithonus eternal life. Unfortunately, Eos forgets to also request eternal youth for him. Needless to say, she is less than pleased with the outcome.

Life extension has become a popular term used to include two related but entirely independent concepts. The first relates to the extension of maximum life span. The second relates to an increase in the functional years of life. If life extension meant merely to extend the period of time in which a person suffered infirmity, it would have no appeal.

There are two fundamental reasons to seek advanced age: (1) You are currently doing something with your life that gives it great meaning and satisfaction, or (2) You would like to have some more time to have a chance to. Clearly, longevity has no value unless it is accompanied by a great love for and a great enjoyment of living.

So, when we explore the possibilities of life extension, we are essentially looking for answers to two basic questions: How long can we live? And how well can we live?

Maximum life span refers to the amount of time that one can survive if provided an optimum environment free from illness or accident. Much research indicates that maximum life span is genetically determined. Most research indicates that maximum life span is less than 120 years, although some researchers believe that it is potentially much higher.

An increase in the functional years of life refers to the number of years an individual can survive and maintain a high level of physical and mental function. In other words, extending life by slowing down the aging process.

In order to examine these two major aspects of life extension, we have to define some commonly used but often misunderstood terms.

Life Expectancy

Life expectancy is a term used to describe the anticipated average age at the time of death. When the media report that life expectancy has risen, they are stating that someone born today will live, on the average, longer than someone born years ago. It is worth mentioning that it does not mean that someone born 10, 20, or 50 years ago will live longer, and it does not mean that more and more individuals are living to advanced ages.

What makes life expectancy go up?

The popular media often imply that increases in life expectancy are due to the wonders of modern medicine. This is false. Increases in life expectancy are due almost entirely to a decrease in the infant mortality rate.

Infant Mortality Rates

Infant mortality rates are statistics based on the number of infants born alive who do not survive. High infant mortality rates mean that many children are dying at an extremely young age. As more and more infants survive birth and early childhood, the infant mortality rates go down. And as these children grow into adulthood, their "additional" years of life make the average age at death go up.

Infant mortality in the U.S. has decreased from more than 100 per 1,000 in 1920 to 10.9 today. During this same time, life expectancy has been said to have increased from 54 to 74 years.

At first glance it looks like people are living 20 years longer now than in the past. But this figure is misleading because it is just an average. It could mistakenly lead you to think that in 1920 most people lived to approximately 54 years of age and that now they live to approximately 74. This is not the case.

Consider these facts. In 1920 an adult 60 years old could expect to live an average of 16 more years, to about 76. Today an adult 60 years old can expect to live 20 more years, to about 80. That is only a four-year difference that appears in the life expectancy figures.

Adults are not living 20 years longer now than they did in 1920. In fact, adults today live little longer than they did in 1920, which is before the development of the powerful modern medications that are often credited with life extension. What has dramatically improved is our chance of surviving to 60.

Lies and Statistics

Mark Twain proclaimed that, "There are lies, damn lies, and statistics." Surely he is not alone in the conclusion that statistics don't lie, but liars use statistics. The statistics commonly used to describe "advances" in the area of life expectancy are misleading, at best.

The number of Americans who could expect to live to age 60 in 1830 was only one-third. By 1900 it was one-half. By 1940 it increased to two-thirds. And today, the number who survives to age 60 is over 80%.

People are still dying prematurely, compared to what is believed to be our genetically determined maximum life span. But what we are dying from has changed greatly.
 
Causes of Death

Acute disease processes, such as tuberculosis (TB), predominated in 1840. In 1900 the death rate from TB was 194 per 100,000. By 1925 it had dropped to half that number. By 1940 it had been cut in half again. By the time the drug streptomycin was introduced in the late 1940s, more than 90% of the TB cases had already been eliminated. Deaths from all acute diseases declined more than 98% in the first 80 years of this century.

Credit for the decline in TB and other acute disease processes cannot be claimed by proponents of modern medicine. The decline came about primarily because of improved housing, sanitation, nutrition, and other lifestyle measures introduced by the early hygienists, most of whom were disenchanted medical doctors-and other health reformers.                      

With the virtual elimination of acute conditions resulting in death, there has been a shift in the recorded causes of death. Today, chronic conditions are the predominant cause. Atherosclerosis, cancer, diabetes, arthritis, emphysema, and cirrhosis cause more than 80% of deaths and 90% of disability.

Obviously, any attempt at life extension must include a plan to delay, minimize, avoid, or eliminate these chronic degenerative disease processes. Since Natural Hygiene places emphasis on removing the causes of disease and on supplying the requirements of health, including the areas of diet, environment, activity and psychology (DEAP), it offers us the greatest plan and opportunity for a long and vital life and a chance to fulfill our full biological potential.

 In 1989, Congress struck a blow to the Safe Drinking Water Act when it stipulated that public drinking water supplies must be made available "economically." This requirement meant that standards involving contaminants must consider not only the quantity of contamination but also the cost of removing contaminants.

When drinking water is declared "safe," it means only that the water's purity meets government standards. Now that the requirement of "economy" has been thrust into the drinking water safety equation, it is questionable whether we can count on government standards to protect our health.

In 1986, the U.S. Environmental Protection Agency estimated that some 40 million Americans were using drinking water containing potentially hazardous levels of lead. Acute lead poisoning can cause severe brain damage and even death. Effects of chronic, low level lead exposure are subtle, and infants and children are most vulnerable. Learning disabilities and hyperactivity have been associated with lead exposure, as have increased blood pressure, stroke, loss of hearing, chronic anemia, nerve damage and infertility.

Current government standards permit 50 ppb (parts per billion) of lead in drinking water. A stricter standard of 7.5 ppb has been recommended, but it is estimated that it would cost $5 billion to accomplish this. To reduce the lead in public water to 5 ppb would cost an estimated $21 billion.

Is it worth the cost?

There is no "safe" level of lead in drinking water. And keep in mind that the government's 50 ppb standard only applies to water as it enters your house, not how it comes out of your tap.

Most lead enters the water from home plumbing. Plumbing installed before 1930 most likely includes lead pipes. Even in homes built more recently; the solder used to connect copper pipes may contain lead.

Unfortunately, lead is merely one of the possible contaminants in your water. Testing by an independent laboratory may disclose that there are unacceptable levels of other toxins. Fortunately, there are various methods of home water treatment available for specific problems.

Water contaminants

There are five principal groups of water contaminants: 1) particulate, which includes particles of rust, dirt and sediment; 2) dissolved inorganics, including heavy metals (mercury, lead, chromium, silver, etc.), and asbestos; 3) organics, which include calcium and magnesium carbonates, the components that make water "hard," and nitrates, chemical solvents, pesticide residues, and industrial pollutants; 4) radiological contaminants, both natural and industrial, such as radon and radium; and 5) biological pathogens, including bacteria, viruses and protozoa.

Particulate

Problems associated with the particulate category involve mainly appearance, smell and taste. Particulates can be removed with simple filters. Filters are inexpensive and are made from fabric such as cotton, wool or fiberglass. Filters are effective only against larger particles. They are ineffective against dissolved toxic chemicals.

Dissolved inorganics

Dissolved inorganics are a very serious problem, especially lead, as previously discussed. However, another major inorganic pollutant is nitrate. Nitrate contamination occurs mainly in groundwater, especially in agricultural areas. Chemical fertilizers and manure from animals are particularly concentrated sources. The danger is particularly great for children. Nitrates are converted to nitrites in the digestive tract, and nitrites interfere with the ability of blood to carry oxygen, which can result in brain damage and death.

Organics

Dissolved organics include some serious problems. Many public water supplies contain low levels of organic compounds created as byproducts of water chlorination. Although these compounds are highly toxic, they are justified as acceptable because of the effect that chlorination has on microorganisms. Pesticides, industrial effluent, and hazardous waste sites are other sources of organic pollutants. These chemicals are associated with liver, kidney, and nervous system damage, and possibly cancer.

Dissolved organics include some harmless, although annoying, chemicals such as calcium and magnesium carbonates. These may leave deposits on sinks and tubs, and they may interfere with the effectiveness of soap. From a nutritional viewpoint, these minerals are present in extremely small amounts, and, even if fully absorbed, would contribute little nutritional benefit.

Radiological contaminants

Radiological contaminants, such as uranium, radium and radon, occur naturally in various parts of the country. The most serious effects of radiation exposure include birth defects and cancer.

Biological pathogens

Biological pathogens, such as viruses, bacteria and protozoa, are uncommon in public water supplies due to chlorination. But some organisms are becoming resistant to chlorine, and this may become more of a problem in the future.

Water purity checks

Remember, private water supplies are not subject to government testing, and it is up to the individual to periodically test for biological contamination.

To determine the level of purity of your water, there are several options.

If you have municipal water, ask the local utility for a copy of its latest water analysis. Federal law requires periodic testing and making the results available for inspection. These tests, however, reveal only the conditions of the water as it leaves the reservoir or treatment plant. They do not reveal if lead is leaching into your water from your plumbing. You can have lead levels checked by a private testing laboratory.

If your water is from a well, you can call the local public health department to inquire about groundwater problems in your area. In general, if your water is from a private well, you should also test for organic chemicals. In agricultural areas, nitrates and pesticides should be among the requested tests. If your house is more than 30 years old or contains copper pipe, you should test for lead.

Independent tests

Independent state-certified laboratories should do tests. They are often listed in the yellow pages under "Laboratories-Testing." There are also mail order laboratories. Three that were listed by Consumer Reports in January, 1990 are: WaterTest (33 South Commercial St., Manchester, NH 03101, telephone 800-426-8378); National Testing Laboratories (6151 Wilson Mills Rd., Cleveland, OH 44143, telephone 800-458-3330); Suburban Water Testing Laboratories (4600 Kutztown Rd., Temple, PA 19560, telephone 800-443-6595).

Tests can cost from $30 to $200 depending on how many tests you request. Consumer Reports found the tests to be generally reliable but recommended a test by a second lab to verify any suspicious results.

Home water treatment

You can do quite a bit to improve your water purity. The three primary home water treatment methods are: 1) activated carbon filters, 2) reverse osmosis systems, and 3) water distillers.

Activated carbon filters

Activated carbon filters work by a process known as adsorption whereby the carbon attracts and holds various pollutants in a honeycomb of tiny channels and pores. They are best suited for removing bad tastes, odors, chlorine, organic chemicals, and pesticides. They are not effective against microorganisms, lead or heavy metals, sodium, fluoride, or minerals that produce hardness.

Drawbacks-Carbon filters can become breeding grounds for microorganisms. Sediment in water can clog the filter. Effectiveness declines over the period of use-it is necessary to be diligent about replacing cartridges.

Advantages-Activated carbon filters are the least expensive of the three main water treatment methods. The solid carbon filters are considered the best, while powdered carbon filters are the least recommended.

Reverse osmosis

Reverse osmosis uses semipermeable membranes, which keep out many pollutants. Water pressure, minimum of 40 psi (lbs. per square inch) forces the water against the membrane.

Reverse osmosis is effective at removing inorganic contaminants, such as dissolved salts, fluoride, nitrate, lead and some organic contaminants. It is not effective against high levels of hardness minerals.

Drawbacks-Reverse osmosis systems waste a lot of water. Only 10-25% of the water passing through the unit is forced through the membrane. The rest goes down the drain. Reverse osmosis is slow, 3-6 gallons per hour. There are two types of membranes. The faster, more efficient of the two degrades in the presence of chlorine. Reverse osmosis systems should be used in conjunction with prefilters for sediment and post-carbon filters to remove dissolved organic chemicals, such as pesticide residues, etc. Efficiency drops with low water temperature. These systems can be expensive to install and maintain.

Advantages-Reverse osmosis systems do not use electricity, and the cost per gallon of treated water is less than distillation.

Water distillation

Water distillers work by boiling water and then condensing the steam into purified water. Distillation is most effective at removing sediment, dissolved inorganics (including heavy metals), radiological contaminants, and biological pathogens. It is less effective against some volatile organic compounds unless combined with a carbon filter.

Drawbacks-Water distillation is slow and uses considerable electricity, making it the most expensive method of water treatment. Distillers require regular cleaning, are noisy, and may vent off volatile chemicals. They also give off considerable heat and are expensive to purchase.

Advantages-Distillation, especially when combined with a carbon filter, is the most effective means of home water treatment.

Recommendations

Which system of home water treatment to choose depends on the type of contamination to be removed as well as financial considerations.

The accompanying chart summarizes which systems are effective against various contaminants. Activated carbon filters can be used in combination with reverse osmosis or distillation for complex problems.

Another alternative is to purchase treated water from bottled water companies. We recommend water purified by steam distillation because "purified" water or spring water may not be better than what comes out of the tap.

Learn why it is so important to plan in advance for your health success

When it comes to healthful living, knowing what to do isn't always enough! Translating good intentions into good behavior can be hard to do. One of the biggest obstacles to healthful living is the problem psychologists refer to as "channel factors."  To understand what is meant by "channel factors," think about how water runs down the side of a mountain. It "channels" itself into the path of least resistance, doesn't it? Even minor obstacles, such as a small rock in the path, can "channel" the water into a different direction. Psychologists have noticed something similar in human behavior: Behavior has a strong tendency to be channeled into paths of least resistance. In fact, studies have shown that often seemingly minor situational factors or obstacles are actually major determinants of what people do in real life.  This is a very important lesson for those of us who are pursuing better health. We must pay attention to these "channel" factors because they can dramatically influence whether or not we actually engage in health-promoting behavior that we know is so important.

A surprising study

Psychologists John Darley and C. Bateson decided to investigate this "little factors are important" aspect of channel factors in a study on helping behavior. They based their study on the parable of the "Good Samaritan," using young seminary students at the Princeton Theological Seminary as subjects. The students were perfect subjects because in class they had been studying the parable of the Good Samaritan, a man who stops to help a stranger in distress.

Here is how the study worked. Students were called in - one by one - by the experimenter. Each student, in turn, was told that he was to give a brief talk in a nearby building on the Good Samaritan parable. What the students didn't know was that they were secretly being divided into two experimental groups.

Seminarians on the run

When a student from the first group was called in to the experimenter, he was told, "It will be a few minutes before they're ready for you, but you might as well head on over." When a student from the second group was called in to the experimenter, he was told, "You're late; they were expecting you a few minutes ago, so you'd better hurry." Except for these two different comments about how much time they had, the instructions were exactly the same for all of the students.

On the way to the other building, each of the students came upon a man slumped in a doorway, head down, coughing and groaning...clearly in need of assistance. What do you think happened?

Of the students who were told that they had "plenty of time," 63% stopped to offer assistance. Only 10% of the students who were told they "were late" stopped to help, and some of them even stepped over the body of the person who was "in their way"!

This study demonstrates that "niceness" was not the primary determining factor in whether or not assistance was offered. The main determining factor was a channel factor, a subtle situational factor: "you have plenty of time" vs. "you are late" that largely influenced whether or not the needed helpful behavior actually took place. The seminarians who "were late" would have been six times more likely to stop if they only "had more time."

Making the time for health

When assisting people in making the transition to healthful living, the most frequent problem I hear is frustration with what I call "convenience factors." At the Center for Conservative Therapy and at our Health Promotion Clinic, I conduct group therapy workshops to assist people in planning successful lifestyles.

Among the issues on which we focus our attention and take very seriously are these subtle situational channel factors. We have found that if people don't get themselves organized, they simply "won't have time" to live healthfully, and we all know where that leads. Some of the strategies we utilize are discussed below.

Some helpful strategies

One key strategy to eating more whole natural foods is to make sure that an abundance is available! People have a natural tendency to not want to waste food, and whole natural foods will eventually "go bad" if not eaten. That is why so many people in the world are eating mostly processed foods - because these foods are convenient and are rarely "wasted." If you look on some cereal boxes, the manufacturers suggest that the food is so well preserved (with chemicals) that it will be good for a couple of years!

One "channel factor" issue to work in your favor is to have an abundance of whole natural foods in the house. If you have to run to the store every time you want to make a healthful meal, the "channel factors" will very often defeat you. That is why it is so important to keep plenty of healthful food in the house, even if it means you buy too much at first and you have to throw some away. You may feel uncomfortable throwing food away, but until you get adept at buying the right amount, it is just part of the price of healthful living.

Some of our patients get hungry in the car, and the ease of pulling into a fast-food driveway to satisfy their hunger is just too easy, relative to the hassle of ferreting out a healthy meal or snack. Once again, planning ahead for these moments can really improve your health habits. Keep a small cooler or other container in the car, with some healthy snacks tucked away. Some of those snacks might be apples, oranges, cashews, or cold baked potatoes or yams. One of our patients packs a small bottle of low-sodium ketchup to go along with her baked potatoes, and she raves about it.

A weekly menu plan also can be helpful. If you have a standard weekly menu, with a corresponding shopping list ready, it can make your week sail along, meal after healthful meal, according to a preset schedule. Of course, if you want to deviate from the schedule, feel free! But the idea is that the more habitual we make good habits, the easier they are to follow, and the more often healthy behaviors will result. If you are planning and shopping every few days, with everything different, the decisions and hassles can become channel factors, and then it can get easier to "slip."

Finding your own way

The above suggestions aren't meant to be prescriptions for how you should do things. Everyone needs to find his or her own way. But if you are having trouble staying on track, these kinds of ideas might well be worth a try. If you are "slipping" a lot, it may be partly because of some subtle situational factors. And getting more control of these "channel factors"  can sometimes make the difference between success and failure.

Stroll through any modern bookstore's psychology/self-help section, and you will see numerous books addressing concerns about stress management. People in today's society are often stressed out, and the authors of these books offer their thoughts about how to correct the situation.

Some of these books make many fine suggestions, such as encouraging people to learn relaxation techniques, and to look at life's stressors more critically to determine if a particular stress response is truly indicated. This latter technique can be most useful, since people are able to make mountains out of molehills quite easily in our modern environment. By contrast, in my grandmother's day, she and her family really did have to worry about having enough to eat, and enough wood for the Idaho winter. Today, our worry-responses sometimes can be out of proportion.
 
Buffer zone approach

Although techniques such as relaxation training and perspective-taking can be useful, there is an entirely different approach to stress management that is rarely discussed. The techniques of this approach involve making life choices in a manner that leads to reducing the probabilities that stress responses will occur in the first place. I call this the buffer zone approach.
 
Three key life values

Threats to three particular areas of life consistently cause stress. These key areas are health, wealth, and reputation. When any of these areas is threatened, stress responses naturally result, as they should. Stress responses are built into our natural psychology in order to help us deal more effectively with threats to important values! Stress responses such as increased vigilance, worry, rumination, and heightened arousal are potentially useful. Our ancestors were people who worried and got very focused when important values were threatened. Stress responses helped to increase their survival prospects. Less concerned people were less successful biologically.

Stress responses are an important component of our biological heritage, and can serve us well. If a person quits his job because he doesn't like the boss, but has no way to pay his rent or feed himself in the interim, he doesn't have an effective stress-response system. If a person takes a short-cut down a dark alley in a big city late at night in order to save a few steps, she may pay severe consequences for her lack of a sufficiently pessimistic imagination, a useful component of the stress response.

Health protection

In nationwide surveys aimed at determining the most important factors influencing human life satisfaction, health consistently comes out on top. It is the number one factor associated with psychological well-being. This is probably not due to the fact that everyone thinks about his or her health very much. Rather, it is probably because when health is seriously threatened, the stress response is so great that it tends to dominate the person's overall quality of life experience, as it should! Therefore, the number one key to stress management is to make healthful living a top priority.

No one needs the stress of discovering a growth or a tumor, and then hoping it is benign; or discovering that one's shortness of breath is the result of one's arteries being almost completely clogged. In my view, the best stress-management technique is to avoid health-related stress altogether, if possible! You can do this by making daily choices to maintain, or even improve, your health.

Don't be content just because you are not obviously ill. What you want to do, ideally, is to build a buffer zone around your health, your most precious asset. You want to make it as unlikely as possible for any accident or short-term illness to end in disaster. If you don't take care of yourself, at some point, even a subtle stressor may result in serious, permanent problems.

Many people are walking time bombs, so vulnerable that even a short-term stressful event can result in a heart attack or a stroke. One woman of my acquaintance was so unhealthy that one fateful day, when she sneezed, she experienced a paralyzing stroke. Now, she and her family must live, every single day, with the consequences of her previous lifestyle habits, which caused her health buffer zone to become paper-thin. A key stress management strategy is to consistently invest in your health, so that you have some leeway in your health buffer zone when life sends you trouble.

Wealth protection

Today, people spend a good deal of time and energy worrying about money. This isn't surprising, because so many people have a paper-thin financial buffer zone! If you don't have a few months, savings in reserve, each time the boss looks a bit displeased, stress responses, such as anxiety and tension, can result. If you need a reliable vehicle to get to work, but cannot afford potentially expensive repair and maintenance bills, every strange noise your car makes can initiate a stress response.

Building a sufficient financial buffer zone is one of the most effective things a person can do to reduce his or her life stress. You can do this with a very simple philosophy. Make a habit to consistently produce more than you consume!

Regardless of how much or little you can afford, start saving this month. If you can save $300 per month, in a year you will have saved $3,600. With interest earned, at that rate you will have saved over $20,000 in less than five years. Through the consistent practice of a prudent philosophy, you will have succeeded in building a very substantial buffer zone into your financial life. This will reduce your stress in many ways.

Reputation protection

Your reputation, what those who know of you think about you, can be either a tremendous asset, a serious liability, or anything in between. What others think of you is beyond your direct control. You can influence what they think, however, in reasonably predictable ways.

For example, by making a habit of regularly doing a bit more than is expected, and by always striving to be honest and fair, one can build an excellent reputation over time. This can act as a stress-reduction strategy, since a fine reputation can act as a buffer zone should your judgment, or motives, ever be called into question.

A man of my acquaintance once told me that he had made a regular habit of showing up for work early, for seventeen years. I asked him what others seemed to feel about this. Curiously, he said that he was both admired and envied.

Co-workers observed his unusual habit of doing a bit more than was expected, and this simple strategy had contributed to the development of his remarkable reputation. I asked what he thought would happen if his judgment were ever called into question, or if he needed time off because of a family emergency. He laughed, and said that he was certain his employer would be there for him. It is an insurance policy that he hopes he never needs to use. But should he ever need it, he expects that it is there. That knowledge provides him with a reputational buffer zone each and every day of his life.
 
Perfection not necessary

The buffer zone approach to stress management does not demand that we seek perfection in our lives. We cannot always make the most healthful choices. We cannot always save more than we spend. We cannot always do more than is expected. Perfection is not the point. The buffer zone approach is part of a philosophy that encourages us to consistently seek to invest in our health, wealth, and reputations, so that should life send misfortune or difficulty in our direction, we are better prepared, and have a greater margin of protection. Some may call this approach old-fashioned, but in my practice as a psychologist, I continue to relearn timeless and valuable ideas. Sometimes simple ideas are the most profound, and an ounce of stress prevention is often worth many pounds of cure.

A significant source of stress in life can come from struggling with major decisions. Complex decisions, such as whether or not to change jobs, to make particular investments, to agree to a recommended surgery, or to stay in a relationship, can result in increased tension, confusion, and psychological distress. While we cannot avoid making such decisions, we can learn how to make them in ways that can minimize the stress.

Major decisions in life sometimes can be clear-cut and easy to make. When I was offered my first "real" job as a psychologist, I was thrilled. I jumped at the offer, which represented both an increased income as well as a greater level of professional responsibility. I had prepared for such an opportunity for years. When it finally arrived, I had no second thoughts, just pure excitement. But, not all major decisions are nearly this easy or clear-cut.

Real-life issues are often complex. They can involve situations in which we have important values and priorities on opposing sides of a decision equation, situations where we are not certain of what we will care most about in the long run. Our internal psychology has a way of letting us know when we are in such situations. During such times, we tend to ruminate, worry, procrastinate, and change our minds (perhaps several times). These processes are indications of dissonance, a psychological process that results from being forced to make a choice between two or more alternatives, where the choice is not clear-cut, and where the choice may result in some degree of psychological, physical, or financial distress.

Dissonance is not limited to unpleasant circumstances, such as considering whether or not to realize a loss on an investment or trying to decide whether to end a personal relationship. It can result even from very positive situations.

Suppose that you have been considering a job change, and have sent out a few resumes. Then, suppose that a few weeks later, two companies make very similar offers that are substantially superior to your present situation. You are delighted and excited, of course. But, when you have to choose between the two offers, you may well experience psychological exhaustion as you fitfully consider the two appealing, but perhaps nearly equivalent, alternatives.

Invaluable guide for action

The experience of dissonance, the tension, worry, rumination, and confusion that are characteristic of a difficult choice situation, is an adaptive process. Just as physical distress can be an invaluable guide for health-supportive action (such as when the pain from a broken ankle signals us not to walk on it), so, too, can psychological distress. The dissonance experience is a special kind of psychological pain. It might be described as "integrity pain," because it specifically signals to us when we have closely equivalent values on the various sides of a decision path. Integrity is about attempting to keep one's actions integrated with one's most important values. A dissonance experience can be a signal indicating that finding the highest integrity path is going to require careful consideration.

By stating that dissonance is an adaptive process, a potentially very useful process, I do not mean to suggest that we have to like it. The pain of a sprained ankle is very useful, but certainly not pleasant. Likewise, dissonance is useful. But, as with physical pain, it should signal us to seek appropriate methods of distress reduction. We can accomplish this by following a decision-making method, which takes into account a modern understanding of how the human mind works.

Neural circuits

Our minds are made up of many millions of neural circuits, most of which are essentially independent of one another. For example, you have circuits that monitor the temperature of your big toe. And should you stick your big toe into a Jacuzzi filled with overly-hot water, those circuits will activate evasive, pain-avoidance behavior (you will jerk your toe out of the water). You have neural circuits that are noting things like the scent of nearby flowers, the angle of the sun in the sky, and how long it has been since you have last eaten. All of these circuits are evaluating different pieces of information, all of which may be important; and they essentially are doing this independently of one another.

Consider what happens when you are trying to make a tough decision. As you imagine the impact of making various potential decisions, numerous independent neural circuits start firing. You then try to "read" the feelings associated with these imaginings ("Should I step into this hot Jacuzzi?"), in order to get a sense of your long-term best interests. This use of fantasy (our imaginations), in order to get a sense of how we might feel, given the likely consequences of alternative courses of action, is a powerful, and perhaps uniquely human, capability. Very often, these fantasies are all that we need to help us decide, with confidence, which path to take.

Sometimes, however, using imagination is not enough. Even after much rumination and imagination, we sometimes cannot decide with confidence and inner peace. We still have dissonance, with all of its unpleasant characteristics of genuine confusion and psychological distress.

Decision-making strategy

In order for you to make good decisions when you experience dissonance, it can pay to utilize a sound decision-making strategy. The general strategy that I use in my practice to help clients with critical decisions is a marriage of both general modern psychology theory and specific personal decision-making research.
 
Three basic principles

This strategy utilizes three basic principles: (1) Make the least risky moves first; (2) Use experiments whenever possible; and (3) When all else fails, go with your "gut."

1. Make the least risky moves first. Suppose that Mary is very unhappy in her current job, and wants very much to quit. She dislikes her boss, and believes that she is being exploited. She hates to get up in the morning, and dreads facing another day at the office. She ruminates continually about winning the lottery, quitting immediately, and never working another day in her life.

Mary heard a television self-help guru explain that in order to get anywhere in life, you sometimes have to "go for it," "take risks," and "not give in to your fears." She is starting to consider quitting her job, and then looking for her "dream." She feels great anxiety when she thinks about quitting. But, this is balanced by moments of euphoria that sometimes come from imagining being free of this particular workplace. She is experiencing dissonance, and is under great psychological tension.

By using the first principle, Make the least risky moves first, Mary should not make quitting her job her first move. There is no need to quit her current job before finding out what the realities are for her in the marketplace. It may be that currently she is overpaid, not underpaid. After getting feedback like that from other potential employers, she may not feel so exploited after all! This data alone may shift how she feels, and make her current job situation quite tolerable. Hopefully, however, Mary will discover that she can improve her situation. By shopping the market, while continuing in her present job, she will eliminate the need to make any major decision until the evidence favoring a decision becomes more clear-cut!

Sometimes, however, you cannot get the crucial information you need without actually making changes; and, thus, making one or more significant decisions. In such cases, you should attempt to utilize the second principle for making major decisions: Use experiments whenever possible.

2. Use experiments whenever possible. One reason we experience dissonance is that we often don't have enough information to predict our future satisfaction of a choice with confidence. Whether we are trying to choose between two cars, two job offers, or two prom dates, dissonance can result when we are uncertain of how much we will like a given choice, relative to possible alternatives. Sometimes we have to make a difficult choice. But, we often can reduce the tension around a big decision by making smaller, temporary decisions, in order to gain additional information.

For example, suppose that a successful couple who love sailing have decided that they are "tired of the rat race," and want to move to the Caribbean to semi-retire. They plan to operate a small business, taking tourists out on their boat for snorkeling and diving. They envision a relaxed, low-cost, low-stress lifestyle, one that in fantasy seems infinitely preferable to their current way of living. They plan to quit their jobs and make the bold move. However, in the process of making plans, they experience considerable dissonance.

While their imaginations may be indicating a need for a serious life re-evaluation, the couple might benefit from running a time-limited experiment. Instead of making a full decision, one that might burn bridges and unnecessarily eliminate alternatives, they might decide to experiment with their "grand plan." Perhaps they could take a leave of absence from their current employment, and offer to work for a company doing their "dream" work, at a low fee. In doing so, they might be able to conduct a relatively inexpensive experiment, lasting a few weeks or months, which could help clarify what would bring them the most happiness.

Using experiments is a way to learn more about the realities of your alternatives, including your own true valuations. An experiment is a way to discover these facts while attempting to limit risks. In this way, the use of experiments is really just a variation on the first basic principle: make the least risky moves first.

If small experiments are not enough to help you to clarify your feelings, you may need to use increasingly risky experiments. A couple contemplating marriage, for example, may discover that one or both persons are experiencing considerable dissonance. A series of experiments: couples' counseling, a short "break" in the dating relationship, or perhaps a decision to date others for a while, may be necessary to help clarify each person's alternatives. While such experiments are potentially "risky," they also may be useful in helping to clarify the most important values in a given decision situation.

3. When all else fails, go with your "gut." Suppose you have studied a difficult situation, used (and overused) your imagination to help guide you, consulted knowledgeable people, and made all the lower-risk moves you can think of, yet your feelings are still not clear. You still aren't sure which house to buy, which job to take, or whether to marry. At that point, the best advice is probably to distract yourself for a period of time, relax and rest, and then make a "gut" decision.

This homespun-sounding advice actually has been well documented in the psychological laboratory of Professor Timothy Wilson, of the University of Virginia. For more than 20 years, Dr. Wilson has conducted research on choices and choice-satisfaction, with a particular emphasis on what strategy is used to make choices. Dr. Wilson has been able to show that, in general, people who go with their "gut" reactions wind up more satisfied with their choices than those who attempt to carefully analyze their reasons.

The reason why "gut" reactions so often work best is not clear. But, it may be because they are responses to a more complete set of all of the relevant neural circuits in a decision, compared with a more analytical approach. Exhaustive analysis may inadvertently lead us to focus on just a few considerations, and to cause us to lose "touch" with other overall relevant values.

An inescapable part of life

Making major decisions is an inescapable part of the process of living. Dissonance, the psychological pain that accompanies many of these decisions, is a natural and useful signal that the decision in question involves a difficult and complex assessment of the involved values. This need not overwhelm us, nor cause us to be fundamentally tentative in our decision-making. And, like ankle pain that recedes when the healing has been mostly accomplished, dissonance tends to recede once we have truly decided on a course of action.

In my work as a psychologist, I often am called upon to assist clients in making critical decisions. This "critical decision counseling" often is very short-term. Generally, one to three sessions or phone consultations are enough to map out an effective decision-making strategy.

Like most psychologists, I generally try to avoid giving decision advice. But, I have no such hesitance about helping clients to formulate a decision-making strategy in an effort to help them get to a psychological place where their decisions become much less difficult to make. I have found the three principles outlined above to be very helpful in this process.