A C A D E M Y U P D A T E F R O M T H E P R E S I D E N T

B Y J E R R Y M O R R I S , P S Y D , A B M P

M A R C H 2 0 1 5

V O L . 4 I S S U E 1

A C A D E M Y U P -

D A T E F R O M T H E

P R E S I D E N T

B Y D R J E R R Y

M O R R I S

1

B I O G R A P H Y : D R .

S U S A N A G A L L E 2

THE FIRE WITHIN

BY DR. SUSANA GALLE

3

BREAKING NEWS:

RXP IDAHO

4

ACQUIRED IMMUNE

NEUROTOXIC ENCEPHA-

LOPATHY

BY DR. RORY RICHARD-

SON

5

T E L E M E D I C I N E :

T R A V E L I N G I N

T I M E A N D S P A C E

B Y D R S U S A N

B A R N G R O V E R

8

A N N O U N C E M E N T S

F R O M Y O U R E D I -

T O R

B Y D R J E F F C O L E

1 7

American Board of Medical Psychology Board of Directors: Susan Barngrover, PhD, AMBP - Secretary; James K. Childerston, PhD, ABMP;

Jeffrey D. Cole, PhD, ABMP, Newsletter Editor; Ward M. Lawson, PhD, ABPP, ABMP, Archives Editor; Jerry Morris, PsyD, MBA, MSPharm,

ABPP, NCSP, NBCC, CCM –President; Gil Sanders, EdD, ABMP-Treasurer; Andrea Wiltshire, administrative contact main office-660-200-7135. Editorial Consultant: Cherie Van Putten, M.ED., Training Associate at Binghamton University

Academy of

Medical Psychology

President’s Column

By Jerry Morris, PsyD, MBA,

MS(Pharm), ABMP, ABPP,

ABBHP, NCSP, CCM, Board

Certified Medical Psycholo-

gist

Colleagues I have thoroughly

enjoyed the last four years

as your President of the So-

ciety (AMP), and Specialty

(ABMP). During that time

the Board and members

have accomplished a great

many important things! We

have established our Spe-

cialty as a recognized and

elite specialty in psychology

with Government Agencies,

hospitals and healthcare

facilities that now regularly

contact us for credentialing

and re-credentialing of psy-

chologists, by several licens-

ing boards, and by

healthcare discipline associ-

ations and healthcare plan-

ning associations. We have

established a specialty jour-

nal that is abstracted by APA

and libraries across the

world. We are negotiating to

offer our journal (Archives of

Medical Psychology) in Span-

ish. We have international

members. We have estab-

lished APA accredited CE

programs (in collaboration

and cooperation with the

National Practitioner Organi-

zation-NAPPP; see

www.nappp.org) that are

evolving toward a post grad-

uate degree program. We

have established a credible

national oral and written ex-

amination for the specialty.

We have collaborated with

NAPPP on a book in Medical

Psychology and have anoth-

er in process. We have with-

stood an assault on the

board to restrict member-

ship and function and con-

trol of the specialty by pre-

scribing psychopharmacolo-

gists and those who only

respect and recognize a nar-

row path to training in the

Medical Psychology Special-

ty! We have adopted the

APA L1 (AMP Society Mem-

ber) involvement, LII

(Consulting Practice Model),

and LIII (Prescribing Model)

design of entry portals to

involvement with our organi-

zation. Like, what is charac-

teristic of full-time practition-

ers and their organizations,

we have tried to respect all

levels and styles of practice,

and the necessity for flexible

paths to training beyond the

doctorate due to our mem-

bers being “community as-

sets with pressing and vital

local practice responsibili-

ties”!

We now have specialists and

members functioning as di-

rectors of psychology and

key doctors in hospitals and

healthcare facilities, primary

care programs, and as con-

sultants to these programs.

Our specialists are leaders

in surgical, pain, and health

prevention programs, as-well

-as mental health centers

and psychiatric hospitals.

Our private practice mem-

bers are increasingly con-

tracted consultants with

these facilities as they make

effort to qualify for incentive

pay under the ACA with ac-

tive referral of identified sub-

stance abuse and mental

health patients and to have

comprehensive programing

for lifestyle and prevention

programs for chronically ill

and high risk patients. We

have specialists in the Mili-

tary, VA, Indian Health Ser-

vices, and in the Health Re-

sources Services Administra-

tion (HRSA). I was the first

Post Doc Resident in Medi-

cal Psychology to qualify for

HRSA educational loan re-

payment and served 2 years

as a HRSA officer!

While NAPPP, Government

Agencies, and legislators

have cooperated and sup-

ported our specialty, it’s

(Continued page 8 )

Page 2 V O L U M E 4 , I S S U E 1 M A R C H 2 0 1 5

We are delighted to welcome Dr. Susana Galle as the

new science editor of the Archives (note her mito-

chondrial health article in the December 2014 is-

sue). Dr. Galle brings to us her rich mosaic of disci-

plines and multicultural background, along with dec-

ades of intensive clinical practice. She is a clinical

and neuropsychologist, and psychopharmacologist.

An AMP Diplomate, she holds a prescriptive license

in New Mexico. More-

over, Dr. Galle is

qualified to practice

other health profes-

sions. She is Board

Certified by nationally

validated examina-

tions, as follows: Tra-

ditional Naturopath

(ND, CTN), Clinical

Nutritionist (CCN),

Classical Homeopath

(CCH), and Phleboto-

mist. She is an ad-

vanced Registered Yoga Teacher (RYT 500) and

Therapist (PRYT). She holds advanced certifications

in Clinical Hypnosis (ASCH), Biofeedback (BCN, BCIA/

EEG), and Forensic Neuropsychology (DABFE). She is

a Functional Medicine practitioner (IFM).

Based in Washington, D.C. and Cardiff by the Sea,

CA, Dr. Galle practices integrative care, consulting

also in NM. She focuses on the links between mental

states and physical symptoms, and the role of stress

in illness. Dr. Galle's assessment tools range from

neuropsychological testing and qEEG, to Meridian

Stress Assessment, and molecular laboratory test-

ing. She practices eclectic psychotherapy

(psychodynamic, cognitive, interpersonal) interwoven

with mind-body methods (hypnosis, yoga, meditation,

and bio/neurofeedback). Dr. Galle also uses somatic

modalities, namely, food, vitamins, herbs, homeopa-

thy, and medications as needed. She looks at drug-

nutrient-herb interactions in relation to the symptom

picture. She pays close attention to the health ef-

fects of developmental transitions throughout the life

cycle. In her view, medical psychologists hold a key

card in epigenetics, helping individuals and groups

recreate health through biopsychosocial interven-

tions.

Multilingual, she works with clients from around the

world. Dr. Galle is an alumna of the University of Cali-

fornia, Berkeley, Yale University (Psychology/

Psychiatry), and Alliant International University

(Psychopharmacology). She received her Doctorate

of Naturopathy from Clayton College of Natural

Health. Dr. Galle attended postgraduate courses

leading to a degree in Clinical Nutrition (Clinical Nu-

trition Certification Board/Toledo College of Pharma-

cy). She obtained her postgraduate Diploma in Ho-

meopathic Medicine (DHM) from BIH, and was win-

ner of the 2004 Hahnemann award.

Dr. Galle's teaching roster includes several universi-

ties. On the clinical faculty in Pediatrics at George

Washington U. and Georgetown U., she has given

workshops on Clinical Neuroscience for residents.

Dr. Galle is also on the faculty at Alliant I. University,

teaching Molecular Nutrition in the M.S. Postdoctoral

Clinical Psychopharmacology program. She has also

lectured internationally, and was a consultant to

WHO (World Health Organization) on Adolescent

Health. She has also given numerous workshops for

Latin American groups.

Dr. Galle is on the advisory board of the British Insti-

tute of Homeopathy (BIH), and the Board of Directors

of ACHENA (Accreditation Commission of Homeo-

pathic Schools in North America). She serves on the

editorial board of peer reviewed journals, APPPAH

(Pre- & Perinatal Psychology & Health) journal and

AARM (Restorative Medicine Journal), and on the

reviewers’ panel of IAYT (International Association of

Yoga Therapy). She is on the e-Advisory Board of

Douglas Labs, a nutraceutical company. Dr. Galle is

contributing author of two books, and has published

several articles with an integrative health focus in

peer-reviewed journals. But her interests reach be-

yond integrative psychology. She enjoys languages,

dance, music, gourmet cooking, yoga, and leisurely

walks with her hubby at the beach.

Dr. Galle has appeared on TV and radio in the US

and abroad. She was recently featured on NBC's

Morning program, on the topic of fall transitions in

relation to food and lifestyle. The link is http://

www.nbcwashington.com/weather/stories/Storm-

Team4-Tracking-Fall-279629582.html. Scroll down

to the third story (Pumpkin Everything...)

Susana is married to William Galle, a career invest-

ment banker and a yoga teacher/therapist by avoca-

tion, who serves on the Board of Directors of a

NASDAQ dual-listed health device company. He also

has an interest in advanced health, corporate well-

ness, and clean technologies.

Page 3 V O L U M E 4 , I S S U E 1 M A R C H 2 0 1 5

THE FIRE WITHIN: A Perspective on Pain Susana A Galle, PhD, MSCP, ND, BCN, CCN,

DHM, CCH, RYT

Persistent pain presents as a significant

health concern that threatens society's

productivity today. Though pain and fever

present with emergent sequelae driving

patients to seek medical relief, fevers usu-

ally resolve with minimal need for restruc-

turing. In contrast, pain can become

chronic. It thus lays a long, entrenched

road, pervading all facets of a person's life

experience. Understandably then, individu-

als with chronic pain arrive in the psycholo-

gist's office bewildered from their protract-

ed quest for relief.

One wonders to what extent changing atti-

tudes about suffering have propelled the

gigantic "pain control industry" now opera-

tive in the medical establishment. Or was it

the reverse? Living in high tension/high

paced environments bursting with uncer-

tainty are now commonplace. Yet our dis-

connect to human existence severs our

treatment response in a rush to anesthe-

tize pain. Moreover, these enduring stress-

ors in multiple spheres create a propensity

for inflammation: work, relationships, de-

natured food, traffic jams, a floundering

economy, climate changes, electromagnet-

ic and toxic exposure, geopolitical turmoil,

violence, and terrorism.

An Indian yogi noted that Westerners typi-

cally concern themselves with the future or

the past, leaving little margin for being

present. But our super-achieving culture

has not remained idle in its attempts to

fathom the mind and alleviate suffering.

Its seekers have gone to Eastern sources

of wisdom in a quest for answers to basic

existential woes. No wonder meditation,

prompting us to be with our own experi-

ence purely and simply, has become so

popular today. "Mindfulness" and

"TM"(transcendental meditation) are now

buzz words. Adapted to the Western men-

tality, however, those meditation methods

risk staying within the modus vivendi of a

"quick fix" when dispensed via accelerated

courses. Meditation (literally, going to the

wisdom inside) is an art to be cultivated

indefinitely, with progressive effects on

thinking, feeling, and behaving, including

the response to, and for the treatment of

pain/suffering.

Remembering age-old wisdom, one uncov-

ers concepts and explanations that stand

on fundamental elements of nature at the

roots of pain. In Chinese medicine, fire

corresponds to the heart, the seat of our

feelings. In Ayurveda and yogic science,

fire is in the solar plexus, which innervates

the gut and represents self-affirmation --

the power within. Galen, the noted Roman

physician, first proposed a typology of tem-

peraments, the choleric one having a pre-

dominance of fire. In this interpretation,

fire corresponds to anger -- much of it

stemming from stress and frustration with

no clear or acceptable outlets. Are we be-

coming enraged as a culture? What are

the links between anger and pain?

One wonders why so many people linger

on numbing drugs. They act like a screen

that "filters" discomfort and unpleasant

sensations. However, the "reward" circuitry

of their neural mechanism is short-lived,

leaving the recipient feeling more helpless

and wanting. Wanting "more". Of what?

More denial of the self as agent, propagat-

ing a passive mentality of being a victim?

Do people have options? In acute trauma

cases or surgery, hardly. But medicine's

desire to "stabilize" someone in neutral

gear, breeds psychological distortions and

adds to the existing phenomenology pro-

moting further dissonance -- let alone iat-

rogenia. Symptom suppression then gives

way to a yearning for the "fix," gradually

reducing the will to heal.

What promotes and maintains inflamma-

tion at the root of pain? Injury, infection,

insomnia, and other "I's"... The list of pro-

inflammatories marches on: obesity, die-

tary choices, and unsustainable methods

of coping with stress. How we process

daily life plays a major part in hurting and

healing -- the psychological link. Some of

us may have genes that predispose to

inflammation. For example, the ISR

(Integrated Stress Response)-regulated

transcription factor CHOP (C/EBP Homolo-

gous Protein) promotes liver inflammation

and cancer. Moreover, inflammation and

free radicals increase the risk of brain cell

damage.

Our lifestyle choices, including our food,

sleep quality, and nutrient intake modify

DNA expression, promoting health or dis-

ease. Among the foods we eat, sugar and

gluten increase inflammation. On the other

hand, exercise, caloric restriction, and

curcumin all activate the Nrf2 gene, which

helps reduce inflammation. Furthermore,

the use of green tea extract, broccoli,

resveratrol, DHA, and garlic have anti-

inflammatory properties that also reduce

cell death. Thus epigenetics wins the bat-

tle to modulate and quench inflammation

as well as protecting from disease in the

long run. In injury and acute illness, inflam-

mation plays a protective role while, chron-

ically, it is a miscarried form of adaptation.

Within limitations, depending on the na-

ture and type of pain, inflammation can be

reversed in a biopsychosocial model of

intervention, which transforms the mind-

neuroendocrine immune (MNEI) connec-

tion, as follows:

Bio: biochemical pathway normalization

through individualized metabolic nutrition

(nutrigenomics) and an anti-inflammatory

diet that eliminates food sensitivities and

detoxifies the system.

Psycho: analytic/dynamic, cognitive, and

interpersonal psychotherapy, CBT, medita-

tion, yoga, tai chi. Specific awareness

methods of pain neutralization are found

in biofeedback, hypnosis, and creative

visualizations.

Social: relationship processes that pro-

duce trusted attachments, and participa-

tion in networks and/or community activi-

ties that foster a sense of belonging.

In addition, the umbrella of energy treat-

ments covers modalities such as acupunc-

ture, homeopathy, micro-electrical stimula-

tion, massage, and spinal manipulations.

Although the recipient's organism interacts

on some level with these treatments, they

do not need to engage the mind actively in

order to be effective. In contrast, exercise

programs at the core of rehabilitation re-

quire conscious intent, attention, and grad-

uated goals. Since they reinforce compe-

tence, such programs have transformative

effects for many. But this class of treat-

ments often remains outside of the scope

of traditional psychologists.

The above lexicon includes an extensive

menu for medical psychology, when tailor-

ing individual pain treatments. Our work

has far-reaching societal implications: We

have the option to support people existing

in the twilight zone versus kindling the

inner light of their own awareness, direc-

tion, and empowerment. Medical Psycholo-

gy is alive and blossoming as we meet

patients at a divide between the ephemer-

al, potentially addictive relief that ema-

nates from narcotics and the challenging

but rewarding process of awakening to the

power within the curative flame. Let us

turn raging, fiery pain into constructive self

-assertion, imbued with creativity and affili-

ation. Such is the flame igniting life force --

with its profuse mitochondrial structure --

when properly nurtured and allowed to

thrive. Behold! Our methods reach into the

heart and soul of healing.

Susana A Galle, PhD, MSCP, ND, BCN, CCN,

DHM, CCH, RYT

Director, The Body-Mind Center

Washington, DC

Medical/Prescribing Psychologist

Albuquerque, NM

doctorsusana@gmail.com

Page 4 V O L U M E 4 , I S S U E 1 M A R C H 2 0 1 5

Breaking News: RxP Bill Passes Idaho Senate!

[The following message from APA, Division 55 President, Dr. Michael Tilus was forwarded to

the AMPABMP Listserv]:

“A fourth generation Idaho-ian, Dr. Farber was a force to be reckoned with. Highly intuitive,

graceful, with the years of overlapping professional and personal relationships with so many

key Idaho parties, she has navigated an amazing path for RxP for Idaho! Although she her-

self will not be prescribing, she reported to me that she believes this is the path for psycholo-

gy and wants to provide that opportunity to the next generation of psychologists!

That kind of selfless service is mirrored by everyone on her team! A leader, who leads!

Testimony was lively with expected antagonists attacks. Very positive testimonies in support

of Senate Bill No. 1060 from independent practicing psychologists; social work; CEO from

inpatient drug and alcohol counseling program; retired psychologist who ran large county

mental health services.

And of course, our own eminent faculty member and RxP trainer, Dr. Marlin Hoover! In pow-

erful testimony yesterday, Dr. Marlin Hoover hit a home run! Open hearted with robust non-

inflammatory responses, Marlin reflected the best of us with his explanations of why we

studied; what we do; and how we collaborate!

Marlin is a "Mission Multiplier" for the RxP movement. As a RxP leader, we are blessed to

have him as he emanates care from "a good heart with good medicine!" He truly sets the

standard of personal and professional integrity that will guide our movement in a flourishing

way…..

….Closing argument for Pro Vote offered by attorney who has served in almost all the highest

levels of judicial courts, and who authored the text of the bill. Extremely eloquent and articu-

late professional who clearly owned the room and the bill! He volunteered a personal fact

that his family holds a 'mentally ill person on medication', that clearly softened the Repre-

sentatives and became a living witness! The bill became a living document!

This prior defense attorney's presentation might be the most powerful and activating testi-

mony I have ever heard from someone who believes in and supports us! What an honor it

was to be in attendance! What an honor it was to be among this group of dedicated and gift-

ed people who are seeking to enlarge the capacity of the professional delivery of psychology

to their Idaho families and children! Idaho Psychological Association represents the best of

us!

Very exciting! Senate Bill No. 1060 passed with a vote of 9-6. It will now go to the full Sen-

ate later this week or next week.

Honor to Serve!”

———————————

Reprinted from Listserv communication by permission of the author:

LCDR Michael Tilus, Psy.D., MSCP

President, Division 55, APA,

American Society for The Advancement of Pharmacotherapy

Page 5 V O L U M E 4 , I S S U E 1 M A R C H 2 0 1 5

Acquired Cumulative Neuro-

toxic Encephalopathy: Look

Toward the Future

Rory Fleming Richardson , Ph.D. ,

ABMP, TEP

Over the las t centu ry, ou r world

has become more toxic . Our re -

search looks at d i f ferent

toxins in t e rms of l imi ted and

long - term exposure, but in the

rush to p rovide new

preparat ions to so lve agricul tu r-

al , heal th , and industr ia l prob-

lems, many of the toxic

s tudies look at more shor t - te rm

exposures with varying dosages .

Le thal dosages of

toxins and medicat ions a re iden-

t i f ied . Some of the fac tors which

may be overlooked, but

also need to be examined include

the fo l lowing:

Is there t issue -binding or s to rage

of d if ferent e lements present?

Can the levels of d if fe ren t

elements of the toxin o r med i-

cat ion accumulate over

t ime?

What is the long - te rm impact of

accumulat ions on t issue, cel ls , and

the organism?

What a re the d if ferences between

indiv iduals as to thei r ab i l i t y to

el iminate and/o r

to le ra te bui ldups of these ele -

men ts?

Are there b yproducts of the ele -

men ts , and/or the in te ract ion

with human t issues ,

which may resul t in toxic i t y?

What a re the fac tors ( i .e . ,

nutr i t ion , environment ,

genet ics ) that impac t an

indiv idual 's ab i l i t y to

el iminate toxins f rom the

body?

To what extent is there an impact

on the indiv idual 's DNA?

What is the potent ial impact on fu-

ture generat ions?

Occupat ional and envi ronmental

med icine has made s ignif ican t

contr ibut ions to the

cl in ica l f ie ld because these spe-

cia l t i es specif ica l l y examine

long - term exposures . Many

t imes the d i scovery of problems

with spec if ic subs tances is af ter

the publ ic has been

exposed. This puts the onus on

the heal thcare communit y to de-

ve lop ways of help ing to

undo the damage done. Unfortu-

nate ly, there a re wel l known ex-

amples of events tha t

have resul ted in uncont ro l led

exposure of the publ ic to var ious

toxins ( i .e . , chemical ,

radiat ion , o ther ) . When one can

not cont ro l the amount o r leve l

of exposure, we a re

faced with having to f ind ways

of e l iminat ing the toxins f rom

the bod y, minimizing

exposure and t rying to be t te r

support the bod y's abi l i t y to

heal . Obviousl y, some

damage can not be undone, but

we can t ry to help individuals

cope with the resu l ts and

opt imize funct ion .

The impac t of accumulated neu-

ro toxins on the cent ral nervous

sys tem have been seen in

indiv iduals suf fer ing form hepa-

t i t is , mercury poisoning, and

s imilar condi t ions . The

toxins can reduce our bodies

abi l i t y to metabo l ize and absorb

needed nut r ients and

minerals . Some t r igger genet ic

condi t ions which resul t in dys -

funct ion of the b ra in and

inf lamat ion . As the body be-

comes more deple ted , opportun-

is t i c d iseases can develop,

further impai r ing our immune

sys tems and resul t ing in reduced

res is tance to even more

dangerous condi t ions . There is

a lso the poss ib i l i ty of a l t erat ion

of our gene t ic coding

impact ing not onl y our l ives but

those of our chi ld ren .

The p rocess of e l iminat ion of

toxins f rom the bod y is natural ly

done through the l iver and

the kidneys but t issue -bound

toxins requi re some add i t ional

ass is tance. There a re foods

that help to el iminate toxins

f rom the bod y. These inc lude

organica l l y grown garl ic ,

Chlore l la , Ci lant ro , pect in - r ich

f ru i ts , Braz i l nuts , broccol i ,

cranberr ies , g inger, onions ,

turmeric , and o thers .

There a re also a variet y o f sup-

plements and chemical s which

can he lp the t is sues to

re lease toxins . But the ac-

ceptance of there use has been

l imited b y the mains tream

medical communi t y s ight ing the

r isks of such chemicals and the

re lease of the toxins .

There is a common event which

occurs when th is release of tox-

ins is t r iggered which is

cal led "a hea l ing c ri s is " . During

th is period , when toxins are re -

leased , the bod y is

shocked b y there p resence unt i l

they can be el iminated b y the

kidneys and l iver . This

process of t r iggering a re lease of

toxins , and reviewing the r isks

versus benef i ts , should

be d iscussed with a t ra ined, ex-

perienced heal th p ract i t ioner . In

most cases , the severi t y

of the "heal ing c ris is " can be

reduced b y modula t ing down the

detoxif ying agent .

Symptoms of a "hea l ing c ris is"

can include headaches , swea t ing,

sore muscles , fa t igue,

skin i r r i ta t ion , and nasal drain -

age. S ymptoms of too rap id of

detox can inc luding

elevated h is tamine response,

suppresses the immune response,

glucose imbalance, and

elect ro l ytes imbalance.

Once the toxic i t y i s minimized,

prepar ing the envi ronment for

heal ing to occur is the

focus . This is done th rough: (1 )

minimiz ing exposure to further

toxins , (2) p rovide

opt imum nu tr i t ion through clean

or , pure wate r and o rganic foods ,

(3) good heal thhabi ts ( i . e . , exer -

cise , posi t ive menta l prac t ices ,

(continued pg. 9)

Page 6 V O L U M E 4 , I S S U E 1 M A R C H 2 0 1 5

Special Commentary on

RxP

Following on the success of the Idaho

RxP movement and the progress of

their bill through the Idaho Senate,

eminent psychologist and past-

President of APA, Dr. Jack Wiggins —

who has been part of the RxP move-

ment since its early days — shared

these thoughts on developing a

stronger RxP position for psycholo-

gists:

There have been many way to ex-press our rationale to seeking rxp. I suggest we use a standard for-mat as a mantra in seeking rxp for psychologists. My suggestion is we seek rxp privileges for PTSD and other mental disorders in be-half of Veterans as “doctors, li-censed psychologists” specializ-ing in clinical and medical psychol-ogy. This the use of doctor comes first acknowledging that we were doctors first before we specialized in clinical and/ or medical psychol-ogy. We were authorized to use the title of doctor by the same universities that authorized physi-cians to use this title. We add the specialty of practice granted by

the State Boards licensing occupa-tions medicine, osteopathy, podi-atry, optometry etc. Thus, the title of “doctor, licensed as a clinical psychologist” is a note of distinc-tion of who we are and is not an encroachment on an other profession. The title of “physician” may be protested by state law, but the use of the title “Doctor”is not. I believe use of “ Doctor, licensed clinical psychologist” would help educate legislators and the public who we are an help hiring psy-chologists in the VA and include psychologists in Title 38 in the VA --- and including us among the Medicare titles of Physician as well. It also acknowledges our re-spect for our academic training and separates it from our post doctoral specialty. Best, Jack

__________________________

In addition to serving as president of APA Dr. Wiggins is also a Board Mem-ber Emeritus of ABMP, the governing board of AMP and credentialing body for medical psychology. He has won multiple awards for his tireless work for the practice of psychology

[

Page 7 V O L U M E 4 , I S S U E 1 M A R C H 2 0 1 5

BOOK REVIEW

Review of: Nicholas A. Cummings: Psychology’s Provocateur”

By Carol Shaw Austad, PhD

Reviewed by:

Jerry Morris, PsyD, ABMP, ABPP

Board Certified Medical Psychologist

Today I read the book "Nicholas A. Cummings: Psychology's Provocateur", by Carol Shaw Austad, PhD. This is a

delightful tale of one of the "real developers and guides of the Practitioner Movement in

Psychology"! For some time, I've encouraged the development of more history of the Practitioner Movement, and of

the actual (rather than American Psychological Association [APA] sanitized, corporatized, academicized, and dis-

torted history of psychology we usually get) historical accounts of Practitioner Leaders. I have said, "the coming

generations need the real development of the Practice Movement outside of (and oft against opposition and under-

mining from) APA.

This masterful book is one of those soon to become seminal and essential documents for practitioners and the next

and future generations of practitioners. It is one of the pieces that I've encourage NAPPP to put together so that fu-

ture practitioners can understand the reality of what allowed leaders to carve out healthcare practice in psychology

and occasionally pry it from the curtailing hands of the academic industrial complex and APA.

Dr. Austad, with intimate knowledge of the players and the work of Dr. Cummings has put together a thrilling, in-

formative, and highly specific and human account of the development of the man "Nick"! The work is complete

with heritage, major moves and accomplishments for practice, the important practice colleagues and players, the re-

cruited institutions, and the successes and failures. This book is not just about Dr. Cummings, but is about the Prac-

titioner Movement! It is a window into all the facets of the movement! It recounts the development of an alternative

training system that sought to take the training of practitioners out of the hands of the academic industrial complex

that serves the lust for grants and Government funds. It names, and even talks with seminal leaders in the history of

the Practitioner Movement. It touches, the necessary personality development of a practitioner, educational needs,

practice management and entrepreneurial necessities of the work in healthcare, and the necessity of advocacy and

linkages with like minds and visionaries! It is chocked full of vision, constructs essential to applying psychology to

healthcare, and the pragmatics of the essential business wisdom and skill necessary to make any product relevant and

to create demand for psychological services.

This book is essential reading for any practitioner, student of practice, or supervisor that trains healthcare and Medi-

cal Psychologists. It is a necessary supplemental text in any History and Systems of Psychology course, Professional

Issues course, for specialist preparation in any specialty in the Practitioner Movement, and for any course on The

Emerging Healthcare System.

The book can be found at: Amazon Books:

http://www.amazon.com/s/ref=nb_sb_noss?url=search-alias%3Dstripbooks&field-

keywords=Nicholas+A.+Cummings%3A+Psychology%27+Provocateur

Page 8 V O L U M E 4 , I S S U E 1 M A R C H 2 0 1 5

(President’ Column continued from

page 1)

emergence and growth, and imple-

mentation in health facilities, we

received no help (and even great

resistance from APA and specific

relevant Divisions within APA) from

some psychological associations as

has been well chronicled by various

expansion efforts historically among

practitioners in psychology

(insurance reimbursement, licen-

sure, hospital privileges, develop-

ment and strengthening of practice

organizations, Medicaid and Medi-

care inclusion, development of the

professional schools, etc.). It great-

ly saddens us that this has always

been an undercurrent and dynamic

barrier and resistance that the prac-

titioner and which we must watch-

dog to prevent contamination and

watering down of movements once

we do break through (as has hap-

pened to the Professional School

Movement). It greatly saddens me

that we never got a single “kind

word” or “offer of encouragement

and help” from APA or any of its

(continued on page 7)

This is characteristic of what many

have chronicled who led in the Pro-

fessional Movement in Psychology,

and in conversations I’ve been privi-

leged to have with members of the

famed “Dirty Dozen” who fought

against APA opposition and eventu-

ally forced the development of what

was originally called “The Practice

Directorate” (and was eventually

largely organizationally neutered,

the valiant leader-Dr. Welch fired,

and evolved into the now “PO”! It,

therefore, did not surprise me, but

casts a character trait for the APA

which continues to be problematic

for practitioners!

Now it is time to develop and ele-

vate new and youthful leaders in

the specialty. I will be retiring as

your President in January of 2015,

and the board has nominated good

candidates for the Presidency and

has elected Ward Lawson, PhD,

ABMP, ABPP, who is training as your

new President. I will stay on for sev-

eral years as your Executive Director

and as a Board Member. Dr. Law-

son was elected the 2015-2017

President of our organization. I

want to thank the board for nomi-

nating two fine candidates with a

good track record of accomplish-

ments and service to our socie-

ty. Dr. Lawson has served our soci-

ety and diplomats as our Student

Board Member, after ABMP exami-

nation and training as a board

member, as the Managing Editor of

our Publications Committee and of

The Archives of Medical Psychology,

and as faculty of our CE Center and

Committee. He is a board certified

Diplomate in Medical Psychology, a

graduate of the NAPPP CE training

program, and a graduate of our

AMP online Preceptorship Pro-

gram. He has presented at NAPPP

and AMP Conferences, and has

published in our refereed journal

and other journals. Dr. Lawson has

a board certification in Family Psy-

chology and has completed family

psychology and Neuropsychology

post-doctoral residencies. He has

owned and operated medical and

mental health facilities that are ac-

credited by various groups and Gov-

ernmental agencies including

NAPPP affiliate accrediting body for

programs and facilities. He is a

NAPPP practitioner member, He

has served on the ABPP Board for

Family Psychology.

Dr. Lawson deserves and will need

your help. Please contact him to

volunteer for Committee Work

(Government Relations, Publica-

tions, Credentials, Finance, Educa-

tion, Standards). He has a great

board. I have particularly enjoyed

working with this very positive, pro-

fessional, and dedicated board. I

want to especially thank Dr. Ward

Lawson, Dr. Gary McClure, and Dr.

Jack Wiggins (Board Member Emeri-

tus), Dr. Susan Barngrover, and Dr.

Jeff Cole for their huge contribu-

tions and the fact that they never

turned down a request for work or

service. It is easy to “be on a

board”, but people on boards who

do work and service are special.

We are continuing to encourage

society members and diplomates to

volunteer to work on Committees

and to evolve in the organization

(through service) to board member-

ship. We don’t do member elec-

tions to avoid Honors Board Mem-

bers and to find service and accom-

plishment oriented Board Members

who have a real work effort and will-

ingness to make a contribution.

This has worked well!

Finally, I want to personally thank

the members for the patients with a

budding specialty and society and

the time it takes to build infrastruc-

ture, organizational vision and mis-

sion, commitment and knowledgea-

ble and trained leaders and staff,

and organizational traditions! You

have been great. I cherish your in-

put, attitudes, and support, and you

are the organization. We have tried

to keep that in mind during my

term! Always, we sought to lead in

a way that appreciated Practition-

ers, and their many roads to exper-

tise and serving patients and the

public!

~End~

Page 8 T H E A M P F E B R U A R Y 2 0 1 5

EMERGING PRACTICE TRENDS

Telemedicine: Traveling In Time and Space

by Susan Barngrover PhD MS ABMP

Confined by cabin fever and restricted by your

patients overreliance on search engines? Are

you tired of rebuffing the “I looked it up on

Google and what do you have to offer?” Why

not start with the patient's tautological repre-

sentation of psychology and gently enlighten

them with your phenomenonological expertise

providing a humane blend of medical science

and technology for effective and meaningful

care, while remaining relevant in today’s com-

petitive marketplace. The virtues of a medi-

cal psychologist making “house calls” within

the modern framework of telehealth, pro-

motes seamless treatment opportunities

while traveling through virtual space and time.

As defined by AMP’s 2010 standards tele-

health is the “face to face real time interac-

tions delivered by distance media in an en-

crypted format for a dr/pt relationship which

engages in diagnosis, testing and treatment

recommendations”. As a leader in ethical

standards and advocacy, AMP recently re-

sponded to ASPPB’s promulgation of new

standards for APA. AMP recommended inter-

jurisdictional practice across state lines to fa-

cilitate enhanced coordination for patient tri-

age, disposition and treatment as well as co-

ordination and consultation across a wider

array of providers for ongoing professional

training and utilitarian practice management

(see AMP’s web site).

According to a 2013 study by the Healthcare

Intelligence Network, 67% of medical practic-

es already utilize telehealth for clinical/

nonclinical purposes. This same poll cites the

top 5 targets for telehealth interventions as

CHF, diabetes, hypertension, COPD and men-

tal health. Currently, reimbursement remains

patchy for commercial insurance, but 43

states now approve telehealth for Medicaid

recipients. While the VA offers telehealth to

28,000 veterans, Medicare continues to ap-

prove only those services delivered in a HPSA

(health services shortage area).Whether par-

ticipating as part of a primary care team, a

hospital or other institution based program, or

as a consultant to a commercial telehealth

platform, telemedicine provides a flexible ven-

ue for ameliorating stigma while supplying

time sensitive quality care.

In a large review of the literature by NHS , no

differences were found between telehealth

and traditional methods of treatment but the

most robust improvements were found for

chronic illnesses [1]. In the American Tele-

health Association Evidence-Based Practice

Standard’s review of 5300 mental health

studies, satisfaction was high for both the pro-

viders and the patients “with significant evi-

dence patients adapt, establish rapport… and

provide information for treatment” [2]. Sup-

port for treatment and cost savings is espe-

cially noted with difficult to engage popula-

tions ie; rural, inner city, school based, incar-

cerated, and acute care [2]. Several studies

(continued on page 14)

APA Changes

Page 9 V O L U M E 4 , I S S U E 1 M A R C H 2 0 1 5

(Acquired Cumulative Neurotoxic Encephalopathy; cont’d from page 5)

sunlight, etc.), and replace nutrients and minerals which may have been impaired in their uptake or impaired in their uptake or

leached from the body by toxins (i.e., zinc, calcium, magnesium, iron, alkaloids, citric acid, Vitamin D).

Toxins impact our gut bacteria, liver enzymes, absorption of nutrients, level of inflammation, and body chemistry which has been

repeatedly shown to be present in various neuropsychiatric conditions. Toxins also reduce our resistance to opportunistic infections.

The results can mimic depression, anxiety conditions and other maladies which are seen by clinicians every day. With the increasing

demands on medical personnel, the likelihood that these medical issues are caught prior to psychologists being asked to provide a

diagnosis is reduced. Since psychiatric diagnoses are dependent on first ruling out medical condtions, this is innately problematic

and places the onus on us to screen for possible mimics and complicating factors. It is essential that we learn more about the toxins

we are being exploded to and provide some guidance in reducing these complicating factors which impact diagnosis and the healing

process.

Clinical Pearls

In a Peer Consultation for ABMP specialists Dr.

Morris provided some useful clinical “pearls” that

are shared here for the reader’s benefit.

By Dr. Jerry Morris, Executive Director

[The] case illustrates several points. First, and as I and other psychologists and psychiatrists have written, "meds may control 25% of these disorders, but have never been a stand alone or adequate treatment". What Christine is running into is typical of the course and treatment of SMI patients and their families. Drugs were never going to significantly curb the course of the ill-ness, but tranquilization and interfering with firing of neurons (calcium and ion channel blockers) are helpful "techniques in a comprehensive tx plan". Next, the data is real clear now that major mental illnesses, or Serious and Persistent Mental Ill-ness (SMI), has about a 11-16 percent genetic loading (and some of that is triggering of gene switches due to early life trauma and chronic and even spiked episodes of stress (See the ACE Studies of Fillette-go to ACE studies on the web), and the rest is multi-generational transmission

and chronic stress related (majority). So it is a mistake to park these patients with family mem-bers for 80 or more percent of their philosophical and relational and social input (context). Use ac-tivation and resocialization techniques of getting them involved with positive institution and repar-enting and resocialization techniques (even the ACA healthcare act recognized this research and ensconsed Multi-systemic therapy, Assertive Community Treatment, and Behavioral Family therapies in the law for SMI patients. They need years of matruation triggered by intense and pos-itive external structure such as Day Treatment with multi-disciplinary interventions and staff, high structure until identification and internaliza-tion of new part-objects can occur to enhance self-regulation, and brain growth occurs. Next, never, and I mean never, treat SMI patients with-out intensive family assessment and family ther-apy, and you almost always run into family mem-bers that also need intensive individual therapy to allow the primary patient to individuate and mature. Hope this helps!

T H E A M P F E B R U A R Y 2 0 1 5 Page 11

“Greetings,” and Services Offered, From Our Highly Trained and Credentialed Membership

~*~

Dear AMP members and ABMP diplomatEs:

If you would like to have a copy of your business card included on the page please scan your card and email the scan to me, Dr. Jeff

Cole, Editor “The AMP” at:

DrJeffDCole@gmail.com

and, your card will be included on our Business Cards page with the next issue of "The AMP"!

There is a $20 fee for the service, payable to "Academy of Medical Psychology" deliverable to our Nevada, Missouri corporate office

address as shown on our home page.

http://www.amphome.org/

Perk!: the $20 fee is waived for all Board members and AMP governance and for editorial staff of our "Archives of Medical Psychology" peer-

reviewed journal!! Dr. Cole

Editor, “The AMP”

T H E A M P F E B R U A R Y 2 0 1 5 Page 12

Invitation for Contributions

“The AMP” NewsleTTer -- newsletter of the Academy of Medical Psychology (AMP) – invites

you to contribute short articles and brief pieces for our upcoming issue!

Our theme is the integration of psychological and medical theory

and practice and movements within psychology that increase psychology’s role in both

mental healthcare and medicine, all falling under the rubric and specialty designation of

“Medical Psychology”.

Specific topics that past articles have addressed, or that would be welcomed, include but

are not limited to the following:

*Psychological and behavioral approaches as first-line treatments and in

combination with medication and other medical treatments

*Behavioral health, placebo phenomena, and psychosomatics in healthcare and

mental healthcare

*Interdisciplinary practice, e.g., Psychologists as part of — or leaders of — health

teams in clinics and institutional medical and mental health settings

*Reviews and discussions of scientific and scholarly articles and books supporting

medically and psychologically- integrated understanding of psychiatric and

medical illnesses, e.g., research into stress and immune response, stress and

protective factors (e.g.., relationship and oxytocin phenomena), cardiovascular

health, epigenetics

*Commentary, on matters associated with relevant to Medical Psychology e.g.,:

DSM, and other diagnostic nosologies their uses, abuses and relevance

to healthcare; RDoc

*Emerging Practice Trends, e.g., Articles on Telehealth and other alternative delivery

modalities

We have a column specifically dedicated to student writing. “Student” can include any

one in the course of his or her formal learning process, e.g., undergrad, grad,

post-doctoral or specialty/diplomat training

If you would like to sample previous editions of “The AMP” to see what sort of entries are

there, here is the link to our newsletter archives:

http://www.amphome.org/newsletter.php

Page 13

V O L U M E 4 , I S S U E 1 M A R C H 2 0 1 5

The Academy of Medical Psychology received final approval of its trademark and logo of the Ar-

chives of Medical Psychology in November 2009. The Board of AMP and ABMP seeks your assis-

tance in the editing and publishing of the Archives of Medical Psychology.

The Academy of Medical Psychology was founded as an organization of practitioners for practition-

er interests through volunteerism. Service on the Board is an unpaid duty of psychologists dedicat-

ed to the advancement of Medical Psychology. Medical Psychology's goal is to enhance access to

specialty behavioral health care that is in such short supply that it has been declared an emergen-

cy in some states and recognized by military and veterans’ services as a critical shortage. State

prisons have been designated as mental health shortage areas by HRSA and prisons in some

states are in the hands of federal receivership. Thus, the Academy has a crucial role as practitioner

organization in advocating for the health and safety of the public at large and the military and other

governmental agencies designed to serve public needs. The advocacy role for public health service

must be a primary mission of the Academy.

The Archives of Medical Psychology, on the other hand, is a repository of information that can serve

this advocacy function of the organization and collect valuable new data for continuing education

of members of the Academy. Editing of the Archives must be by people that have the necessary

experience in medical psychology and the skills to carry out these functions. Editing also requires

electronic communication skills for the actual publication of the Archives. The variety of the skills

necessary for publication in the journal are unlikely to be found even in a complete Editor. Mem-

bers of the Board of the Academy are already assigned specific tasks and duties within the organi-

zation and cannot be expected to contribute routinely in the editing and publishing of the Archives.

Therefore, the Board has begun a search for members of the Academy to volunteer in the editing

and publishing of the Archives and ask your personal support. The Board of AMP invites you to

contribute your services to the Archives. We welcome AMP members with prior publishing experi-

ence and those with computer expertise who are willing to learn the rudiments of editing and elec-

tronic publishing. For further information contact Ward Lawson at ozarkscare@yahoo.com .

Page 14 V O L U M E 4 , I S S U E 1 M A R C H 2 0 1 5

Dr. Ward M. Lawson: Editor

Call for Manuscripts

The Archives of Medical Psycholo-

gy began its fifth having just released its Win-

ter 2015 issue. The Archives is now accepting

submissions for the next issue. We welcome

original articles of interest to readers of medi-

cal psychology. For information about require-

ments for submission of articles go to

www.amphome.org and click on Journal Ar-

chives in the left-hand column or simply type

in Archives of Medical Psychology on Google.

Editor at OzarksCare@yahoo.com.

T H E A M P F E B R U A R Y 2 0 1 5 Page 15

AMP NEWS and HAPPENINGS

After four years of highly productive and dedi-

cated service, Dr. Jerry Morris makes his

farewell announcement as President of AMP

and ABMP. Dr. Morris is now the Executive

Director of AMP and the Board.

Dr. Ward Lawson is our new President of AMP

and ABMP. Dr. Lawson is an ABMP diplo-

mate, specialist in medical psychology and

neuropsychologist, with years of service as

Student Director on the Board. Starting with

the next issue of “The AMP” Dr. Lawson will

be greeting us with his President’s Column, a

regular “The AMP” feature.

********************************

Our esteemed colleague, medical psycholo-

gist and ABMP diplomate Dr. Susana Galle is

our new Science Editor for Archives of Medi-

cal Psychology. Welcome Dr. Galle.

Emerging Practice Trends (cont.’d from p..)

suggested treatment success

across all major diagnostic

groups including; depression and

suicide prevention, anxiety, panic

and PTSD, schizophrenia, addic-

tions including substance de-

pendence and smoking cessation

as well as eating disorders [2 , 3].

Several reviews also found tele-

health is applicable across varied

populations including children

and the elderly (as long as they

are familiar with the technology)

and with ethnically and geograph-

ically diverse groups [2, 3].

As 1 out of 4 Americans have

been diagnosed with a mental

disorder and 77% of US citizens

have access to the internet it

seems judicious that telehealth

become a viable alternative for

reducing needless suffering [4].

As medical psychologists we are

primed to deliver complex ser-

vices to a tailor made audience

and possess the judgment and

quantitative skills to balance this

burgeoning medium within the

economic realities of current

medical practice, eager to reach

to infinity and beyond.

References:

1. McLean, S., Sheikh, A., Cresswell, C.,

Nurmatov, K., Hemmi, A., Mukherjee J.,

and Pagliani, C. The impact of telehealth

care on the quality and safety of care: a

systematic overview. PLOS one. 2013;

8; (8).

2. American Telemedicine Association.

Evidence-based practice for telemental

health. 2009.

3. Hailey, D. et al. The effectiveness of

telemental health applications: a review.

Canadian Journal of Psychiatry.2008; 5;

769-778.

4. Comer, JS and Barlow, DH. The occa-

sional case against broad dissemination

and implementation Retaining a role for

specialty care in the delivery of psycho-

logical treatments. American Psycholo-

gist. 2014; 69; 1-18.

—————————————-

Susan Barngrover PhD MS ABMP

Board Member and Secretary,

American Board of Medical

Psychology

Dr. Galle brings vast experience and knowledge to

her role and we look forward to her regular partici-

pation in our publications and other AMP projects

and initiatives.

************************************

Congratulations to Dr. Mary Sa who completed her

requirements to obtain her ABMP diplomate, medi-

cal psychology specialty status. Dr. Sa has a

range of experiences integrating psychological and

medical approaches including in her interdiscipli-

nary work with Indian Health Services (HIS) in New

Mexico and in treatment of ADD/ADHD children

where she applied her integrative skills to deftly

apply psychological interventions as first-line treat-

ments augmented with medical intervention.

************************************

Please do not forgot to stay current on your dues!

If you change your email address, be sure to notify

the central office at: The Academy of Medical Psy-

chology, 815 S. Ash, Nevada, MO, 64772, or,

cmhcjerry@sbcglobal.net.

T H E A M P F E B R U A R Y 2 0 1 5 Page 16

©

S E E T H E A R C H I V E S A T O U R W E B S I T E

Manuscript submissions:

Dr. Ward M. Lawson, Editor, at OzarksCare@yahoo.com

Join the Most Sought After Specialists in

the Emerging Era of Integrated Care

Four opportunities that involve different designations in Medical Psychology;

Medical Psychologist (American Board of Medical Psychology Diplomate).

Fellow of the Academy of Medical Psychology.

Member of the Academy of Medical Psychology, or Student Member of the Acad-

emy of Medical Psychology, is someone interested in the area, but not qualified

for diplomate status at this time.

Qualifications for each of these AMP Membership categories are described on

our website at www.AMPhome.org.

A Psychology Specialty Encompassing

Behavioral Healthcare,

Psychopharmacology, and Mental Health

Treatment in Multi-disciplinary and team

Treatment Approaches and Healthcare

A M E R I C A N B O A R D O F M E D I C A L P S Y C H O L O G Y

S E E : W W W . A M P H O M E . O R G

Affirmations to Diplomates: Our society is a growing and vibrant specialty representing the highest

trained and most relevant psychologists in America to the emerging healthcare system. During the next

year, our specialty will appear in The National Psychologist, The Psychology Times, and in various APA

Scientific and Professional Journals. We represent specialists and those interested in Medical Psycholo-

gy across America. We are setting standards in our field and influencing practice standards with govern-

mental agencies. We are becoming recognized by states and practitioner associations. We are develop-

ing integrated care and hospital practices, becoming leaders in prevention and lifestyle management,

and our specialists are being asked to present at national physician societies and professional work-

shops. We prescribe complex psychological treatments, recommend and/or prescribe psychotropic

medications, treat addictions, and establish treatment and prevention for patients with chronic illness-

es such as obesity, diabetes, hypertension, asthma, etc. You are a member of an im-

portant psychological and healthcare specialty!

Academy of Medical Psychology

815 S. Ash,

Nevada, MO 64772

E-mail: cmhcjerry@sbcglobal.net

A C A D E M Y O F M E D I C A L

P S Y C H O L O G Y

A N N O U N C E M E N T S F R O M Y O U R E D I T O R

The AMP

AMP’s new journal needs specialty editors and authors. Help us have a great place to keep our specialists aware of emerging practice is-

sues, science, and opportunities. Volunteer! Sign up for the Journal at http://amphome.org/.

Jeffrey D. Cole, PhD, ABMP

Email address:

DrJeffDCole@gmail.com

Or

By US Mail:

35 Riverside Drive

Binghamton, NY 13905

The Official Journal

of the American Board of Medical Psychology

Dear membership:

Dr. Jerry Morris, who has

served AMP and presid-

ed over our Board

(ABMP) for four highly

productive years — in-

spiring growth of our

organization, increased

membership and our

expanded reach through

our initiatives and pro-

jects — says his final

farewell in this issue’s

“President’s Column.”

Dr. Morris will continue

to be in a leadership role

as Executive Director

while our new President,

Dr. Ward Lawson now

takes the helm of our

organization and our

Board. Dr. Lawson

brings a wealth of clini-

cal and leadership expe-

rience via his roles as a

director in clinical set-

tings, acumen in medical

psychology and neuro-

psychology and the good

relationships he has

developed with our

membership and Board

over the years. Dr. Law-

son was a member of

our board for many years

before his election as

President and he is

highly conversant with

our initiatives and pro-

jects. He is also Manag-

ing Editor of our journal

Archives of Medical Psy-

chology. A hearty wel-

come to Dr. Lawson.

The Academy of Medical

Psychology and “The

AMP” newsletter contin-

ue to grow in parallel

with increasing numbers

of members and special-

ists (ABMP diplomates)

contributing to our publi-

cations and to organiza-

tional projects and initia-

tives.

Dr. Susana Galle, our

new Science Editor for

our Archives of Medical

Psychology peer-

reviewed journal, has

contributed an article,

both fascinating and

highly informative, to our

current issue of “The

AMP” on integrated ap-

proaches to assessing

and treating pain. And,

Dr. Rory Richardson, one

of our specialists, is

becoming a regular con-

tributor with an article

on environmental toxins

on our health in this

issue.