Health Insurance Battles: Six Tricks that Work

  by Trisha Torrey

Health insurers have lots of sneaky ways to deny insurance claims because, of course, the less they pay, the more money they get to keep. I got some good advice from professional patient advocate, speaker and radio-show host Trisha Torrey on what we consumers can do to help get coverage when the insurers are trying to wiggle out of their obligations…

 Six Secrets to Get Your Health Insurance Company to Pay

 1. Be persistent. Health insurance representatives generally will speak as if their decisions come from policies that allow for no variation. What the companies don’t want you to know is that sometimes when you get turned down by one representative, another may be more willing to give you the answer you want to hear.

 Try this: If a claim is denied, it’s worth checking to see whether you get consistent answers from two different sources — perhaps call again to see if another representative makes the same decision and/or speak to someone with more authority.

 2. Get everything in writing to even out the playing field. Insurance companies are scrupulous about keeping copies of all medical paperwork and correspondence involving your care — including letters and e-mail correspondence. They also may record telephone conversations and, if there is a dispute about who said what and when, you’ll do far better if you’ve also kept careful records.

 To play at the same level: Retain copies of all correspondence (paper and online) that you send and receive. Also keep a log of notes and details of all phone calls (date and time, the name of the person you spoke to, what you discussed, any verbal commitments, etc.). And never accept only a verbal commitment from an insurance company — always ask for confirmation in writing.

 3. If you had no choice, you had no choice. If you weren’t able to choose who your provider was, you should not have to pay higher, out-of-network costs.

 For example: When your in-network surgeon chooses to use an out-of-network anesthesiologist for your surgery… or sends you to an out-of-network lab for blood work… the choice of provider was out of your control.

 What to do: Insurers may do their best to deny the top level of reimbursement, but Torrey says to be persistent in stating your case and insisting on coverage. Similarly, when emergency care is needed and you are therefore not in control of health-care decisions, you may not be liable for higher out-of-network costs. Check your policy. Also, in some states, out-of-network emergency care coverage is mandated by law.

 4. Tell all… there’s no such thing as too much information. Requirements are tightening up for screening tests that look for signs of disease before symptoms develop, and some insurers limit the diagnostic tests they’ll cover, too. Check your policy to be sure.

 To get around this: Be sure you clearly and specifically report the symptoms you are concerned about, even if they’re embarrassing (for instance, for colonoscopy a change in bowel movements or traces of blood in your stool).

 5. Even an insurance company can be intimidated by credentials and titles. Irate consumers aren’t very scary to big insurance companies… but doctors and congressional representatives can make them nervous. If coverage is initially denied to you for a test or other service, an explanatory call from your physician might get a different outcome.

 A good strategy: On critical correspondence, copy your congressperson, state insurance commissioner or another state board that regulates health plans. You can find links to the regulatory entities in all 50 states at the Web site of the National Association of Insurance Commissioners & the Center for Insurance Policy and Research ( — check “States & Jurisdiction Map”). That way, the insurer will have to answer to them for the decisions it makes.

 6. Patient advocates know what works… and insurers know it. Insurers are not fans of these persistent, well-informed third parties who can help slice through red tape and are good at negotiating favorable coverage and settlements.

 How to find one: Start with a service you don’t even have to pay for — the nonprofit Patient Advocate Foundation ( or 800-532-5274), which provides free case-management services for people with serious diseases, such as cancer, and has lots of experience needling insurance companies. (Note: This organization is staffed by volunteers, so its phones often are busy. If you find that is the case, you can go directly to its “Request Patient Assistance with a Case Manager” form by clicking

 There are also for-profit patient advocate firms that employ nurses and other health-care professionals to argue cases on patients’ behalf. They may charge as much as $150 to $200/hour — but for a big bill, it might be worth it. You can find patient advocates in your region at Torrey’s Web site,, a directory of patient advocates.

 As Torrey notes, insurers are a wily lot — but you can get real results by using these secrets to turn the tables on them and get the health coverage you need and deserve.


Trisha Torrey, patient advocate, syndicated newspaper columnist, radio talk-show host and national speaker based in upstate New York. She is author of You Bet Your Life! The 10 Mistakes Every Patient Makes (available February 2010). Visit her blog at

The Right Fiber Soothes IBS

   by Andrew L. Rubman, ND

If you’re one of the 20% of Americans who suffer from irritable bowel syndrome (IBS), you’ve probably been told that consuming more fiber will alleviate your symptoms — but were you told what kind? A new study, published in British Medical Journal, finds that the soluble fiber found in psyllium supplements may be more effective than insoluble bran fiber for relieving the constipation, bloating and diarrhea that accompany IBS.

 Researchers at University Medical Center in Utrecht randomly assigned participants to one of three groups. Each participant took 10 grams of psyllium, insoluble bran or a placebo (rice flour in this case) twice daily for 12 weeks. Researchers evaluated patients at one, two and three months to see how they fared in terms of relief of symptoms, severity of abdominal pain and overall quality of life.

 Over the course of the trial, psyllium was significantly better than both bran and the placebo at reducing abdominal pain and other issues with IBS — and this was true whether a patient’s IBS was dominated by constipation or diarrhea or both. Even more surprising, though, was the fact that the bran did worst of all — in fact, the bran actually seemed to worsen patients’ symptoms.

 Why Bran Bombed

 This result was so unexpected that I checked in with our medical editor, Andrew L. Rubman, ND, to see whether he had any theories about why the bran group got such poor results. Dr. Rubman pointed out that the study was relatively small — 275 patients — and that by the end 40% of the participants had dropped out. He found it telling that, though participants initially did not know which group they belonged to (psyllium, bran or placebo), the research report noted that most of them were able to guess correctly which treatment they were getting.

 Dr. Rubman believes these results are likely due to the fact that bran must be metabolized, and people with IBS lack the “good gut bacteria” necessary to properly break it down, which made life unpleasant for that particular study group. Dr. Rubman noted that bran is insoluble and has a rough texture that sometimes acts as an irritant on the stomach lining in those with chronic gastritis.

 Psyllium, on the other hand, can soothe the stomach lining. Psyllium is soluble, meaning it disperses in water, and forms a gel which travels through the digestive system, coating and calming its lining, making for a very different journey.

 So, if you have IBS and currently take bran, you may want to ask your doctor whether it’s advisable to switch to psyllium. If you decide to give it a try, keep in mind that plain psyllium seed husks are best. There’s no need to buy expensive products touting exotic sources, special compounding benefits or exclusive additives that supposedly improve the material. Also avoid commercial psyllium brands sweetened with loads of sugar. Dr. Rubman suggests buying psyllium in bulk at health food stores, where the best stuff also happens to be the least expensive.


Andrew L. Rubman, ND, medical director, Southbury Clinic for Traditional Medicines, Southbury, Connecticut.

Relief from Grief and Other Sadness

by Antonio Sausys

 Letting go of what you love is hard… whether it is the passing of a person or pet, a home where you’ve been happy, or even something far less tangible, such as your ability to play a good, hard game of tennis (sorrow that, of course, is also about the often-painful loss of youth).

 Unacknowledged and unaddressed grief doesn’t just evaporate, however — it often turns into anxiety, depression, even illness. Though some people process feelings by talking or writing about them, many don’t know what to do with the feelings of sadness, which are often overwhelming. I was intrigued when I heard about a program that uses yoga for this purpose — developed by yoga therapist Antonio Sausys and used in the “Degriefing Process,” a holistic grief-counseling program created by certified grief counselor Lyn Prashan.

 Yoga for Grief Relief

 After a loss, feelings of grief become imbedded not only within our psyche, but also in our physical bodies, Sausys explained. For instance, many grieving people take on a particular posture — curving the back and hanging the head down a bit, almost as though to protect the heart. “The heart chakra, in the center of the chest, is the energetic center that relates to emotional bonding,” he says — noting that this is where grief gets “processed.” Sausys’s program incorporates yoga as a tool to ths end. The goal is to bring some of the physical symptoms of grief to a conscious level of awareness — this helps people to accept the reality of their loss and to move through the pain in a way that enables them to continue with their lives. His program includes specific exercises for the muscles and functions that are related to this chakra — mainly the pectoral muscles, the mid-spine and the circulatory and breathing systems.

 Pranayama (Breath)

 “Notice that when you’re happy and content, your breath is slow and deep, and when you are agitated or unhappy, it becomes fast and shallow,” says Sausys. “Working with your breath is working with your life — one breath in and one breath out, what you do with your breath is what you do with your life.” Pranayama is the practice of deliberate and mindful breathing based on the belief that prana (vital life force) is held within the breath. Deepening awareness and control over your breathing helps unite your conscious and unconscious minds.

 What to do: Begin by spending a few minutes just being aware of your breath. You don’t have to control it, rather just feel it — be present to the flow, in and out, which will help you become present for what’s happening in your life.

 Try this: Sit in a comfortable position, keeping your spine as straight as possible. Bring the tip of your fingers to the tip of your shoulders, pulling your elbows together in front of your chest. As you inhale, bring your elbows up and then back… then, as you exhale bring them down and again back, following a fluid circular movement. This counteracts the natural tendency of the pectoral muscles to contract protectively and often quickly brings about an ability to feel more open.


 In yoga, asanas are physical poses, each of which has a particular purpose. You can use specific asanas to address the physical manifestations of grief, including pain and the tendency to hunch over to protect your heart. His program includes specific exercises for the pectoral muscles, the mid-spine, and the circulation and breathing systems, such as shoulder stretches and backbends. If you haven’t done yoga, try a class or DVD to find poses that feel good to you.


 A series of purifying techniques called Shatkarma can help in the release of thoughts and emotions, as well as of memories of painful experiences that may have become trapped within the body and mind, says Sausys. Grief is stressful, often triggering the fight-or-flight response. Since this response is integrated through the pituitary gland, you can do a group of Shatkarma exercises for the eyes, called Tratak, to help bring balance to the pituitary gland and reduce the intensity of your feelings. For instance, gazing at a flower, candle or other beautiful object not only helps to release eye tension but can also induce cleansing tears.

 How to do it: Light a candle. Sit in a comfortable position where you can see it at eye level and at arm’s length. First relaxing your facial muscles, stare steadily at the dark part in the center of the flame for two or three minutes. Then close your eyes and focus on the image of the flame that remains… when the image fades, open your eyes and repeat the exercise.


 Grief is stressful, Sausys says, and therefore can take a major toll on your health and well-being. A basic way to reduce your stress is to simply lie on your back on the floor, repeating to yourself as you exhale: “Relax now.” Draw out your exhalations so that they are twice as long as inhalations. While any and all relaxation methods that work for you can be helpful, Sausys suggests that a good approach is to follow a guided relaxation CD or DVD, which can help you to maintain your focus.

 Sankalpa: Resolution

 In the yoga tradition, Sankalpa means to bring something to resolution. To this end, Sausys recommends choosing an affirmation, voicing an intention, or saying a prayer, and repeating it over and over. “This can help focus your mind on the positive,” he says, noting that over time it becomes a symbolic way you can move your thoughts away from negative repetitive thinking toward healing.

 An example: Formulate a statement that expresses a specific wish in a positive way and in the present tense — for instance, “tonight I sleep deeply.” (Sleep disruption is one of the most common symptoms of grief, says Sausys.)

 Taken together and used regularly, these tools can provide the necessary framework and support to help grief-stricken individuals come to terms with their loss. It won’t go away and you’ll never stop feeling the sadness — but over time it can stop feeling so painful. In the words of the Degriefing program creator, Lyn Prashant, “we never get over our grief — we only change our relationship to it. Grief is a normal human reaction not just to death, but to loss. What we must do is find a way to relate to it.”


Antonio Sausys, BA (Psychology), MA (Body-Oriented Psychotherapy), is a somatic health practitioner and yoga instructor specializing in one-on-one yoga therapy. He teaches and lectures at University of California-Berkeley, the California Institute of Integral Studies, College of Marin, and has been a faculty member at the International Yoga College and the former Honorary Secretary of the International Yoga Federation for the U.S. His Web sites are and


by David J.A. Jenkins, MD

Though not without its detractors, the Atkins diet has been found effective for weight loss and reducing insulin resistance, lowering triglycerides and raising HDL (good) cholesterol — but the key criticism from doctors and nutritionists has been that eating such large amounts of animal protein can cause harm to your health. In part, this is what prompted University of Toronto researchers, headed by David J. A. Jenkins, MD, PhD, DSc, the scientist who developed the glycemic index, to study the effects of a similar diet based on plant protein and oils rather than on animal protein and fats. The diet is called “Eco-Atkins” because it’s not only better for the people on it, but many believe also for the planet.A Better Way Than Atkins

 The four-week study involved 44 men and women, all overweight and with elevated LDL cholesterol levels, randomized into two groups. The control group ate a low-cal, high-carb, lacto-ovo-vegetarian diet (which means they were able to eat dairy and eggs). The difference for the Eco-Atkins group was a lower proportion of carbohydrates — they ate a low-carb, lacto-ovo-vegetarian diet high in protein from nonanimal sources, including gluten, soy, nuts, fruits, vegetables, cereals and vegetable oils, plus a small amount of psyllium. Both groups consumed 60% of their normal caloric requirements and lost eight to nine pounds, but the Eco-Atkins group showed greater improvement in LDL and total cholesterol… reductions in other blood lipid markers… and also small but significant reductions in blood pressure.


 Using protein (primarily from animal muscle meats) as an alternative source of glucose is the foundation of the Atkins diet. However, protein is also abundant in plants — for instance, one cup of brussels sprouts has 5.64 grams of protein and one cup of oatmeal has 5.9 grams. Animal protein contains greater amounts of some essential amino acids, and the levels of various types of protein differ among plants — but Dr. Jenkins adds that the old idea of balancing amino acids and proteins through combinations of cereals and legumes (rice and beans, pasta and fagioli, etc.) provides complete protein that rivals animal protein. (To learn more about how to combine foods to meet protein requirements, visit To find plant-based protein foods, go to


David J.A. Jenkins, MD, PhD, DSc, professor, department of nutritional sciences, University of Toronto.

Soothe Anxiety with Probiotics

by A. Venketeshwer Rao, MSc

You already know that chocolate can do wonders for a dark mood — but… yogurt? If you buy the kind that contains active probiotics, it may indeed brighten your spirits. A new study from Canada demonstrated that probiotics can help modulate anxiety.

 The study involved 35 patients with chronic fatigue syndrome (CFS) who experienced a host of gastrointestinal problems, including irritable bowel syndrome (IBS) and constipation. Participants were divided randomly into two groups, one taking a probiotic drink containing Lactobacillus casei strain Shirota (LaS), and the other taking a placebo that was identical in taste and appearance but had no probiotics. Results: After two months, the probiotic group had a significant decrease in anxiety symptoms, while the placebo group did not. The probiotic group also showed a significant increase in Bifidobacteria, which are beneficial for gastrointestinal health, compared with the placebo group.

 Intestinal Flora and Your Brain

 A. Venketeshwer Rao, MSc, PhD, the study author and professor emeritus of nutritional science at University of Toronto, says that there has been skepticism in the medical world about the role intestinal flora plays in the system of gut-brain communication (the enteric nervous system, often called “the second brain”). He said that this study provides evidence that through their metabolism in the gut, probiotic bacteria can boost levels of the mood-elevating chemicals tryptophan (an amino acid) and serotonin (a neurotransmitter).  He added that the regions of the brain affected by CFS also house anxiety and depression. “These parts of the brain seem to respond to changes in the microflora, and most of our behavior patterns are controlled by these areas,” he says.

 Dr. Rao says there still is much to learn about the role of gut flora. But many, if not most people, could improve their health by taking probiotics. The study used a probiotic drink, but Dr. Rao says that probiotic supplements may be even more effective, depending on what types and how many of the live microbes they contain. He advises looking for a product that contains Lactobacillus Shirota and Bifidobacteria, with 100 to 120 billion live probiotic bacteria.


A. Venketeshwer Rao, MSc, PhD, professor emeritus of nutritional science, University of Toronto.

Suddenly Celiac Disease Is Everywhere — Why?

  by Joseph Murray, MD

Until the last few years, celiac disease was an obscure, little-known condition and people who had it were extremely limited in terms of what they could eat or even where to turn for help managing their condition. That has changed dramatically with new studies on celiac disease, abundant online information and support, and a generous selection of gluten-free products, including bread, cookies, cereal and the like in specialty markets. In fact, gluten-free food is one of the fastest-growing categories in today’s supermarket.

 This is one time food marketers were ahead of the curve. Though it has been recognized that celiac disease (an autoimmune response triggered by gluten, the protein in wheat, rye and barley) is on the rise, the extent came as a surprise to researchers from the Mayo Clinic, who discovered that young people today are more than four times as likely to have celiac disease than was the case 60 years ago.

 The study looked for the antibody triggered by celiac in blood samples taken between 1948 and 1954 and compared findings with recent blood tests on two groups of residents of Olmstead County, Minnesota. One group was the same age as those tested in the original study… the other group consisted of people born in the same years as those tested in the original study.

 Joseph Murray, MD, professor of medicine and immunology at Mayo Clinic, was the lead author of the study. He told me that this increase undoubtedly is due to environmental causes. One possible factor relates to the fact that wheat has been genetically altered to heighten gluten content. Another might be the huge increase of gluten-containing food products. Gluten is used extensively today because it reduces manufacturing and processing costs of foods.

 Even Worse…

 But there was a second startling finding of the study — people with so-called “silent” celiac have four times greater mortality than people without celiac. To explain… the majority of people with celiac are not diagnosed or treated, so they continue to consume gluten — perhaps with symptoms, and perhaps without. Although the disease can cause severe digestive distress, it also can lead to other conditions that seem unrelated, such as infertility, headaches, osteoporosis (especially early onset) and anemia, or it might cause no apparent problems at all. But even without symptoms, Dr. Murray says that celiac is damaging the intestines and weakening the body, and also may be increasing vulnerability to other diseases, including cancer. 

 What to Do

 It is possible to develop celiac at any age. Dr. Murray says to consult your doctor about the possibility of celiac in the event of digestive problems, including diarrhea, excess gas and bloating, anemia or accelerated osteoporosis — especially if you have a family history of celiac or if you notice a problem when you eat foods containing wheat, rye or barley. Do not eliminate gluten from your diet before being tested, as this may decrease the accuracy of the tests.

 Even in the complete absence of symptoms, some experts advise avoiding wheat, rye and barley in all forms — including such things as soy sauce and many canned soups — entirely to see whether it makes a difference in how you feel. I have done this, in fact, and felt so much better that I’m rarely eating wheat at all these days… and I’m not missing it either.


Joseph Murray, MD, professor of medicine and immunology, department of gastroenterology and hepatology, Mayo Clinic, Rochester, Minnesota.

Squeaky Clean and… More Likely to Get Breast Cancer?

 by Sabrina McCormick, PhD

Are you using personal-care and household products that are linked to breast cancer? While cancer experts estimate that 5% to 10% of breast cancers are hereditary (associated with the BRCA1 and BRCA2 genes), the majority of women who get breast cancer have no family history and no known risk factors for the disease. In an effort to explain the breast cancer epidemic, health experts are looking for clues in the environment… and in the bathrooms, kitchens and pantries of our own homes.

 According to medical sociologist Sabrina McCormick, PhD, American Association for the Advancement of Science Fellow in the National Center for Environmental Assessment at the Environmental Protection Agency and author of No Family History: The Environmental Links to Breast Cancer, dangerous chemicals found in many of the everyday products we use — cosmetics, lotions, shampoos, household cleaning products and food packaging — may be associated with as many as 90% of breast cancer cases.

 Scientific Evidence

 Dr. McCormick’s theory is based on the association between two parallel trends in the same time frame — the rise of breast cancer over the past 60 years (from a lifetime risk of one in 22 women in 1940 to one in eight women in 2008) and the mass production and widespread usage of toxic chemicals that occurred during that period. “As more people have been exposed to carcinogenic chemicals, and as they accumulate in their bodies over time, studies show that several different kinds of cancers have emerged — in particular breast cancer,” she said. Throughout her book, Dr. McCormick cites studies that support the link between toxic chemicals and breast cancer — for example, there is evidence of increased breast cancer risk in the vicinity of polluting facilities. In fact, regional breast cancer rates are highest in the Northeast, which also has the longest history of industrial development and toxic exposure.

 Is Estrogen the Culprit?

 How do exposures to toxic chemicals raise one’s risk for breast cancer? Estrogen seems to be the common denominator, according to Dr. McCormick, who explained that the more estrogen a woman is exposed to over her lifetime, the higher her risk for breast cancer and other reproductive cancers (such as ovarian and uterine cancer). The “estrogen disruptor hypothesis,” which purports that xenoestrogens, chemicals that mimic or disrupt estrogen (found in an abundance of modern-day products), can cause breast cancer is widely accepted in the scientific community. The fact that several of the known risk factors for breast cancer (early onset of menstruation, late menopause, and excess weight) are themselves related to estrogen lends credence to the hypothesis. A number of animal studies provide further support by demonstrating that xenoestrogens cause mammary tissues to grow and also can disrupt sexual and neurological development. In addition to xenoestrogens, other chemicals known or suspected to be carcinogens are found in a variety of everyday products and also could raise one’s risk for breast cancer and other cancers.

 What Not To Use…

 A wide range of personal-care products, household-cleaning products and food packaging contain chemicals that may cause breast cancer or cancer in general. These have been classified by the Breast Cancer Fund, an environmental health advocacy group, as Animal Mammary Gland Carcinogen (AMGC), Human Carcinogenic Risk Classification (HCRC), known Endocrine Disruptor (ED) and other categories described below. To access the Breast Cancer Fund charts by category, go to Following is a list of some of the more worrisome substances …

 Cosmetics and Personal-Care Products

  • Parabens, which are chemical preservatives used in cosmetics, deodorants, lotions, ointments and shampoos, are known endocrine disruptors, said Dr. McCormick. While the European Union regulates the use of many parabens in their products, the US does not. (ED)
  • Dibutyl phthalate (DBP), which among other purposes is used to make plastics softer, is an ingredient in children’s teething toys, nail polish, perfumes, moisturizers and cleaning solvents. (ED)
  • Ethelyne Oxide, a compound that adds fragrance to shampoos. (AMGC, HCRC)
  • Dioxane, a compound found in shampoos, body washes and sudsing products. (AMGC, HCRC)
  • Petrolatum (PAH), which is what petroleum jelly is made of… also used in lipsticks, lotions and oils. (AMGC, HCRC, ED)
  • Formaldehyde, benzene and toluene, all found in nail polish and nail polish removers.
  • Urethane, found in hair-care products, such as mousses, gels and sprays, and in sunscreens, mascara and foundation. (AMGC, HCRC)

Making matters worse, notes Dr. McCormick, many cosmetics also contain ingredients that act as skin penetrators, which makes it even more likely that these dangerous substances will be absorbed into the skin. Also, beware of products marketed as “youth enhancers” that contain estradiol, estrone or estriol… all forms of estrogen that can be absorbed into the skin that should be used only with medical oversight.

 For an up-to-date listing of dangerous cosmetics and personal-care products, visit the Environmental Working Group’s online cosmetic safety database (

 Household Products 

  • Polyvinyl chloride (PVC), a plastic that leaches phthalates, found in cling wraps, plastic bottles, detergents, window cleaner bottles and vinyl shower curtains. Many houses also contain pipes made of PVC, which is a Carcinogen By-product of Manufacturing (CBM) and Hormone Disruptor (HD).
  • Diethylene Glycol Monoethyl Ether, found in floor finish, tile and grout cleaner, and microwave oven cleaners. This substance affects the central nervous system and is a reproductive toxin.
  • Nonylphenol Ethoxylate, found in cleaners, degreasers, foaming cleaners, air fresheners, spot and stain treatments and metal polish. (ED)
  • Nitrilotriacetic Acid, found in carpet-care products, is classified as a Reasonably Anticipated Carcinogen (RAC).
  • Tetrachloroethylene, found in spray polish and laundry spot removers.

Food Packaging 

Many food packages and containers are made with compounds that have been linked to breast cancer, most especially when the package is heated…  

  • Bisphenol A, used in the linings of cans and water bottles. (ED)
  • Polystyrene, found in Styrofoam food containers, disposable containers, egg cartons and plastic cutlery. (CBM)
  • Polycarbonate, found in plastic water bottles and metal food can liners. (ED)

Consumer Tips 

While it may be impossible to avoid all of the products that contain known or suspected breast carcinogens, Dr. McCormick suggests that whenever possible we should use simple, natural personal-care products and buy organic food products to minimize exposure to pesticides and chemicals. She advises using nontoxic cleaning and household products whenever possible, and notes that any household cleaners should be used only in well-ventilated areas. Other precautions include installing a water filter to rid water of contaminants…  and avoiding packaging that uses plastics and plastic derivatives.


Sabrina McCormick, PhD, author of No Family History: The Environmental Links to Breast Cancer (Rowman & Littlefield) is a Fellow at the American Association for the Advancement of Science in the National Center for Environmental Assessment at the Environmental Protection Agency and is an assistant research faculty at the School of Public Health, George Washington University. She was previously a Robert Wood Johnson Health & Society Scholar at the University of Pennsylvania.


by Barbara H. Fiese, PhD

With New Year’s Eve just a few days away, what plans have you made? I used to put a lot of pressure on myself to make December 31 the best night of the year, and more often than not this led to disappointment in the face of all those high expectations. I look at it differently now. New Year’s Eve is not just another night, nor does it have to be a great big party… it’s an ending and a new beginning and a ritual in its own right, and I like to make it meaningful and memorable.
I spoke with Barbara Fiese, PhD, a clinical and developmental psychologist and author of Family Routines and Rituals, who affirmed that it can be a good thing to choose a symbolic ritual of your own to consciously mark the transition to the new year as a way to both clear the mind and move forward.
Many people like to choose rituals that are cultural in nature. “If you practice a ritual that’s been passed down through family generations, it connects you to your ancestors and preserves your identity for the future,” Dr. Fiese points out. Other considerations may include whether you want to mark the end of a year that was particularly difficult… or joyous… or (as I so often find) both. You may want to focus on being “in the moment” of transition from old to new… or it may be that you want to celebrate the possibilities that lie ahead, whether you have specific hopes and dreams for the new year or just want it to be wonderful in its own, yet-to-be-revealed way.
There are rituals for all these purposes, and more. If you’re looking for a New Year’s ritual to call your own, here are a few to consider:
• In the Thai culture, water represents both cleansing and renewal, and the New Year is celebrated with rituals of splashing water. Water is tossed out of doors or windows (checking first for passers-by!) or into public fountains, and, more personal, young people tenderly pour scented water over the shoulders of their elders as a sign of respect and an act of blessing.
• In Japan, people spend the last day of the old year cleaning their homes to welcome the New Year’s harvest god. Clearing away clutter and creating a clean, peaceful environment can be a tangible and meaningful way to symbolize the clearing out of old energy from the current year in order to create a welcoming space for new, positive events and opportunities to move into your life.
• A Native American tradition can easily be adapted even to urban environments. Go to a park, hiking trail, your garden or some other place in nature that’s significant to you. Dig a small hole in the ground, and place your regrets, fears or worries (represented by a slip of paper on which you have written them, a photograph or some other symbol) from the past year into the hole. Replace the dirt and cover the spot with leaves or stones so that the earth can absorb the past and leave you unburdened for the coming year.
• Physically releasing something tangible into the world — such as balloons, butterflies, doves or bubbles — can represent the release of the past. An easy, elegant and environmentally correct way to do this is by blowing bubbles — perhaps even twice: First at sunrise, to release regrets, worries or cares… then at dusk to release your hopes, consciously sending out a wish to the universe each time you blow a new set of bubbles.
• The Jewish New Year (which occurs in the autumn) is marked by atoning for the transgressions of the past year in order to enter the new one spiritually cleansed. You can adapt this as an end-of-year ritual by making a list of all the hurts, injustices and regrets you faced or created during 2009. Contemplate each as you write them down, bringing them to mind for one last review. Next, build a fire in a fireplace (indoors or outdoors) and burn the list. Take the ashes outside, and scatter them or sprinkle them into the wind or over moving water (a brook or the beach) to carry them away.
• Another ritual of repentance is part of the annual New Year celebration in Buddhist temples in Japan, where bells are rung 108 times in order to dispel the 108 worldly desires. Consider engaging in a personal bell-ringing ceremony, with each toll representing something you wish to let go of or something you hope to call into your life in the months ahead.
• Plant seeds in an indoor pot, each seed representing a particular hope or desire that you can bring into being. Nurturing the plant as it pushes through the earth and grows toward the sun can be symbolic of your dreams coming to fruition.
• In many parts of South America, people take a traditional walk around the block carrying a suitcase (try a backpack if you find a suitcase awkward or uncomfortable) each New Year’s Eve, which is said to ensure that your dream journey will manifest.
• Some churches and communities sponsor labyrinth walks, which are a form of moving meditation that allows the walker to reflect on life while moving slowly and mindfully, one step at a time, along a prescribed path. This can represent moving away from the past and toward the future. The World-Wide Labyrinth Locator’s site at can help you find a labyrinth near you.
Rituals can be as simple as a moment of silence, a letter to yourself or someone else, or even a prayer, religious or otherwise. Or you may prefer to go all out, planning something elaborate, extravagant and even (if you can afford it), expensive such as a trip to a special place. A New Year’s ritual can be solitary or a celebration with your partner, family and friends, or — as is done in many cities around the world — at a party where everyone in the community is welcome. It’s the deliberation and focus on what matters to you that is most important and that ultimately gives your choice meaning, whether you do it only this year or every year going forward from now on.


Barbara H. Fiese, PhD, is the Pampered Chef, Ltd., endowed chair in family resiliency and professor of human development and resiliency studies and director of the Family Resiliency Center at the University of Illinois at Urbana-Champaign. She previously served as chair of the department of psychology at Syracuse University. She is a clinical and developmental psychologist whose research interests focus on family factors that promote health and wellbeing in children. Her most recent book is Family Routines and Rituals ( Yale University Press).