Environmental Illness: Myth & Reality

The answer to what causes multiple chemical sensitivities in the body has proven elusive. One group of medical physicians, environmental/occupational physicians, and scientists believes that chemical sensitivities are induced by toxicological environmental agents while their peers believe that these same sensitivities are psychological in origin. Environmental Illness: Myth and Reality addresses the problem from a physiological point of view. Dr. Herman Staudenmayer advances the belief that the suffering experienced by individuals with idiopathic environmental illness, otherwise known as multiple chemical sensitivities, is physiological, not environmental in origin. The author presents scientific concepts and theories in a way that is understandable to the non-physicians who work in the area of occupational medicine. He lays out alternatives to toxicogenic explanations for symptoms attributed to low-level chemical sensitivities, or other putative environmental intolerances. Environmental Illness: Myth and Reality takes the position that chemical sensitivity resides in the mind and is expressed through the biological systems and psychophysiological mechanisms, rather than being caused by toxic agents in the physical environment around us. This book will present questions and issues of general interest that are almost universally ignored in the scientific writings of professional journals.

Table of Contents:
1 What is ""environmental illness""? -- What it is not -- Examples of what it is -- Definitions -- Naming the indefinable -- Idiopathic environmental intolerances -- Clinical ecology and EI advocates -- Prevalence -- Philosophy of science -- Competing theories of EI -- Toxicogenic theory -- History of EI -- Causal agents -- Biological mechanisms and susceptibility -- Explaining psychological symptoms -- Unique principles of toxicology -- Politics -- EI patients -- Symptoms -- Strength of belief in EI -- Personality and behavioral characteristics -- Psychogenic theory -- Belief -- Stress-response -- Psychiatric disorders -- Treatment -- Conclusion -- 2 Toxicogenic theory -- A tale of misguided exploration -- Postulates -- Threshold of onset: total body load -- Long-term effects -- Sensitization -- One-molecule effect -- Heightened sensation: hyperosmia and cacosmia -- Threshold variability -- Sensitivity to multiple environmental agents -- Tune course of a hypersensitivity reaction -- Variability of effects -- Addiction to exposure -- Auxiliary postulates, the protective belt -- Temporal cohesiveness -- Demographic diversity -- Route of exposure -- Dose dependence -- Individual variability, uniqueness -- Rapid onset and cessation of symptoms -- Hypothesized biologic mechanisms -- Limbic kindling -- Tune-dependent sensitization -- Smell and taste -- Conclusion -- 3 Unsubstantiated diagnoses and treatments -- Unsubstantiated diagnostic and treatment practices -- Provocation-neutralization testing -- Sauna depuration -- Imprinted water and EMF -- Inappropriate use of diagnostic methods -- Radiology brain-imaging tests -- Neuropsychological testing -- Self-report of psychological symptoms -- Inappropriate use of treatment methods -- Acupuncture -- Diagnoses incorrectly attributed to EI -- Attention deficit/hyperactivity disorder -- Candida albicans hypersensitivity, the ""yeast connection"" -- Conclusion -- 4 Studies supporting the psychogenic theory -- Demographics and psychiatric/psychological conditions -- Clinical case reports -- Brodsky -- Stewart and Raskin -- Selneretal -- Terr -- Fiedler, Maccia, and Kipen -- Altenkirch, Hopmann, Brockmeier, and Walter -- Witorsch, Ayesu, Balter, and Schwartz -- Black -- Case-control studies -- Pearson, Rix, and Bentley -- Simon, Katon, and Sparks -- Simon, Daniell, Stockbridge, Claypoole, and Rosenstock -- Black, Rathe, and Goldstein -- Staudenmayer, Selner, Buhr, and Selner -- A cohort study of chronic fatigue -- Perplexing questions -- Why middle-age? -- Why female prevalence? -- Symptoms without disease? -- 5 Assessment of the toxicogenic research program -- Critical reports from medical associations -- Junk science excluded from the courtroom -- Testable hypotheses: provocation challenges -- A protocol for provocation chamber challenges -- The challenge chamber -- Methods of blinding the exposure -- Statistical analysis -- The case of a true positive responder -- Controlled challenges with EI patients -- Challenges unanswered -- Conclusion -- 6 Psychogenic theory -- A disorder of belief -- Psychogenic and psychosomatic illnesses -- Psychogenic illness mistaken as asthma -- The sick role -- History of psychogenic illness: neurasthenia -- Primary and secondary gain -- Discussion -- 7 Placebo and somatization -- Definitions -- The placebo effect as nuisance -- Placebo, ritual, and provocation challenges -- Factors contributing to the placebo effect -- Food intolerance: physiology and immunology -- Somatoform disorders -- Hypochondriasis -- Somatization disorder -- Conversion disorder -- An EI case of pseudoseizure -- Conclusion -- 8 Learned sensitivity -- Pavlovian classical conditioning -- Animal conditioning of the immune system -- Conditioning after documented exposure -- Thinking and learning -- Conditioning onset of asthma -- Cognitive learning -- 1886 historical example -- Learning to control allergies -- Fear and anxiety -- Learning and phobia -- The psychodynamics of phobia -- Discussion -- 9 The stress-response -- Hypothalamic-pituitary-adrenal axis -- Psychologic effects of AC1H and corticosteroids -- Stress and aging: the glucocorticoid cascade hypothesis -- Role of psychological factors -- Catecholamine system -- Norepinephrine -- Epinephrine -- Dopamine -- Pupillary reflex -- Autonomic nervous system -- Inhibitory systems -- Serotonin -- GABA -- Opioids and endorphines -- Psychoneuroimmunology -- Effects of the stress-response on cognition -- Conclusion -- 10 Panic attacks and anxiety disorders -- Psychophysiological theories of emotion -- Anxiety -- Panic attack -- Panic disorder -- Trme course -- DSM-IV criteria for PTSD -- Experimental models of PTSD -- Learned helplessness -- Trme-dependent sensitization -- Hyperosmia or cognitive priming? -- Conclusion -- 11 Trauma and post-traumatic stress disorder -- War -- Epidemiology -- Psychophysiology -- Cognitive dysfunction -- Pre-war risk factors -- Childhood trauma and adult sequelae -- Childhood emotional deprivation -- Childhood physical abuse -- Childhood sexual abuse -- A case of sexual abuse and EI -- Neurobiologic effects of childhood sexual abuse -- Conclusion -- 12 The limbic system and trauma -- The limbic system -- Electrical stimulation of emotion -- Emotions activate the limbic system -- Reticular activating system -- Disruptive effects of trauma -- Limbic system symptoms -- PTSD, limbic abnormalities, and trauma -- Hippocampal abnormalities -- EEG abnormalities -- Developmental stage and vulnerability -- Conclusion -- 13 Personality disorders -- Depression as a symptom -- Personality -- Psychological defense mechanisms -- Personality disorders -- DSM-IV Axis II classification -- Self-management of explosive affect -- Self-management of implosive affect -- A case of folie a deux -- Dimensional models of personality -- Limitations of categorical diagnoses -- Dimensional diagnostic approaches -- Discussion -- 14 Iatrogenic illness: exploitation and harm -- A medical cult -- Quacks -- Patient vulnerability -- Devotion to the guru -- Bias and expectation invalidate provocation challenges -- Doctor's expectation and treatment outcome -- Counterphobic rituals and obsessive-compulsiveness -- State revokes license of mercury amalgam guru -- Harmful effects -- The lady in the desert -- Isolation and ineffective rituals -- Munchausen syndrome by proxy -- Where are the bodies? -- Discussion -- 15 Treatment -- The path of psychotherapy -- Difficult patients and resistance -- Transference and countertransference -- Hateful and dangerous patients -- A depth model for selecting an intervention strategy -- Trust, empathy, and rapport -- An exposure event as an organizing concept -- Pitfalls -- The environmental care unit as a sanctuary -- Hope, magic, and the art of healing -- Psychotherapeutic interventions -- Stress management -- Behavior modification: systematic desensitization -- EI case-report involving desensitization -- Cognitive-behavioral therapy -- Cognitive distortions -- Dichotomous thinking -- Selective abstraction -- Arbitrary inference -- Circular logic -- Overgeneralization -- Undergeneralization -- Catastrophizing -- Decatastrophizing -- Misattributed causality -- Rationalization of lies -- Restructuring beliefs -- Psychodynamic psychology -- Treatment of personality disorders -- Psychotropic medications -- Discussion -- 16 Politics -- Victims and a herd of sacred cows -- Blaming social ills -- Reasonable accommodations? -- Victims: a neglected population? -- Politics of intimidation and the law -- Unrealistic product safety regulations -- ""More research"" -- Conspiracy theories -- Media -- Manufacturing industry -- Insurance industry -- Radical politics -- Discussion -- 17 Future directions -- TILT -- Scientific honesty -- The personal factor in disposing of contradiction -- Adversaries -- Paradigm shifts -- Endless rhetoric -- Model for a progressive research program -- Objective measurement and biomarkers -- Predicted outcomes for competing theories -- True positive -- False negative -- True negative -- False positive -- Conclusion -- Appendix A. A methodology of scientific research programs -- Appendix B. Court rulings

About the Author :
Staudenmayer\, Herman

Review :
"…courageous book in an attempt to investigate and debunk the 'myth of environmental illnesses'…This book is very timely in contributing to this debate." --Vivien Swanson, in Progress in Environmental Science Promo Copy "This is a passionate book. Dr. Staudenmayer is deeply concerned for the welfare of people alleged to suffer from (environmental illness)... He is a true advocate for his patients. His book is worth very serious consideration." -from the foreword by Henry N. Claman, M.D., Distinguished Professor of Medicine and Immunology, University of Colorado School of Medicine "...The book combines scientific thoroughness and strong personal convictions. Drawing upon a vast data bank of research statistics, clinical trial results, and personal case studies, the author presents a compelling case in favour of the psychogenic theory...this book has something for everyone."-Euroabstracts, April 1999 "…courageous book…to investigate and debunk the "myth of environmental illness..This book is very timely…" Progress in Environmental Science