This August, the Pediatric Association of Naturopathic Physicians (PedANP) will be presenting its bylaws to the AANP House of Delegates with hopes of becoming the next affiliate of the AANP.

The intent of the organization is to disseminate knowledge and increase exposure of pediatric medicine education to the naturopathic community and within naturopathic medicine programs by providing webinars and continuing education credits for PedANP members. The PedANP will also work to increase opportunities for more pediatric residencies and pediatric research, and bridge the gap between conventional and naturopathic pediatric medicine. The executive board consists of prominent physicians and leaders in the area of pediatric medicine within the profession.

Membership will open at the AANP’s annual conference in Portland. In addition to the continuing education webinars, members will have access to experts in the field of pediatric naturopathic medicine and files for practice building. All NDs and students will be welcome to join.

The PedANP will benefit both those interested in specializing in pediatrics as well as family practitioners who want extra education for their pediatric patients. Watch for the September pediatric issue of NDNR to read an Association Spotlight on the PedANP.

A research team funded by the National Institutes of Health’s (NIH) National Institute of Mental Health (NIMH) has selectively blocked a conditioned fear memory in humans with a behavioral manipulation.

Participants of the study remained free of the fear memory for at least a year.

“Our results suggest a non-pharmacological, naturalistic approach to more effectively manage emotional memories,” said Elizabeth Phelps, PhD, of New York University. Phelps and colleague Joseph LeDoux, PhD, led the research team that reports on their discovery online Dec. 9, 2009 in the journal Nature. “Inspired by basic science studies in rodents, these new findings in humans hold promise for being translated into improved therapies for the treatment of anxiety disorders, (such as post-traumatic stress disorder/PTSD),” said NIMH Director Thomas R. Insel, MD.

The results add support to the hypothesis that emotional memories are reconsolidated – rendered vulnerable to being modified – each time they are retrieved. That is, reactivating a memory opens what researchers call “reconsolidation window,” a time-limited period when it can be changed. “This adaptive update mechanism appears to have evolved to allow new information available at the time of retrieval to be incorporated into the brain’s original representation of the memory,” Phelps said.

The human study conditioned human participants to fear colored squares by intermittently pairing them with mild wrist shocks. Then, a day later, the memory was reactivated by re-exposing participants to the squares. A measure of nervous system arousal confirmed that they experienced a fear response. Extinction training – repeated trials of exposure to the colored squares without shocks – followed.

Those trained after the 6-hour consolidation window remained afraid of the squares – as did a control group that received extinction training without first experiencing reactivation of the fear memory.

In a follow-up experiment to gauge long-term effects a year later, 19 of the original participants received a potent regimen to reinstate the fear: four shocks followed by presentations of the colored squares. Remarkably, those who had undergone extinction training within the reconsolidation window were largely spared significant effects. By contrast, those whose training had been delayed 6 hours or who had not experienced fear memory reactivation prior to extinction training experienced significant reinstatement of the fear response.

In a similar experiment, the researchers also confirmed that the fear memory was blocked only for the specific colored square for which fear memory was reactivated prior to extinction training. The effect did not generalize to a differently colored square associated with the shocks.

This indicated that memory re-writing during reconsolidation is highly specific and that prior reactivation with the specific stimuli is critical.

“Timing may have a more important role in the control of fear than previously appreciated,” Phelps said. “Our memory reflects our last retrieval of it rather than an exact account of the original event.”

Evidence suggests that the behavioral manipulation may work through the same molecular mechanisms as experimental medications under study for quelling traumatic emotional memories. “Using a more natural intervention that captures the adaptive purpose of reconsolidation allows a safe and easily implemented way to prevent the return of fear,” suggest the investigators. For more information, visit www.nimh. nih.gov.

The Foundations of Naturopathic Medicine (FNM) textbook unveiled a color timeline illustrating the history of the naturopathic medicine profession and its formation at the May Northwest Naturopathic Physicians Convention (NWNPC) in Portland.

The timeline effort is led by FNM co-authors Steven Bailey, ND; Jared Skowron, ND; Craig Fasullo, ND, LAc; and Mitchell Bebel Stargrove, ND, LAc with gifts of space, registrations and graphics from the NWNPC and ongoing sponsorship from NWNPC, AANP, and Canadian Association of Naturopathic Doctors (CAND). The final timeline and associated two chapters (one led by Bailey and one by Skowron) will be reviewed prior to publication by the profession’s agencies and boards, published in the FNM textbook, and its use shared by NWNPC, AANP and CAND.

The 32-foot timeline welcomed the attention of many respected naturopathic medicine elders who contributed information and shared stories about historically and strategically important people and events. Developed as part of the history chapter of the FNM educational and collaboration project and sponsored by the NWNPC, AANP, and CAND, this timeline is truly a community celebration, a collaborative work in progress and a collective remembering. It will be updated and will make another appearance at the AANP convention in August.

There are plans to make the current timeline and future versions available to the colleges and upcoming conventions. Stop by the timeline at the AANP convention and contribute what you know to the history of our dynamic profession.

The team thanks the many members of the naturopathic community, its agencies, colleges, faculty, students, physicians and friends who submitted material to us to develop the timeline.

Additional information can be sent to Mitch Stargrove, mbstargrove@medicineworks.com. Special thanks to Iva Lloyd, ND for many citations from The History of Naturopathic Medicine: a Canadian Perspective, and to Friedhelm Kirchfeld and Wade Boyle, ND (in memoriam) for important citations from Nature Cure; and to the many institutions, organizations, sponsors and friends who have made this work possible.

Airdre Grant, ND, MEd, PhD and Elizabeth Sutherland, ND join FNM as spirituality editors.

Leading the team, Grant received her PhD from Southern Cross University (NSW) in spirituality and culture in CAM education and practice, and was an education and curriculum developer on the faculty of the Australian Center for Complementary Medicine Education and Research (ACCMER). She authored “Education in Naturopathic Medicine: What’s Love Got To Do With It?” in Integrative Medicine: A Clinician’s Journal in 2005. Sutherland has a certificate of training in human investigations from Oregon Health and Science University (OHSU) and completed a post-graduate research fellowship with the Kaiser Permanente Center for Health Research before becoming a research associate with that organization.

Currently, she is an adjunct investigator with the Helfgott Research Institute and an NIH-NCCAM post-graduate research fellow in the Arizona Complementary and Alternative Medicine Research Training Program at the University of Arizona College of Medicine. Sutherland teaches Cultivation of the Practitioner and oversees the psychology/mind-body medicine curriculum in the naturopathic medicine department at NCNM.

Her area of research is the practitioner-patient relationship. She is author of Spirituality in the Medical Encounter: The Grace of Presence, published in the spring edition of the Permanente Journal.

For more information regarding the FNM Project, contact Pamela Snider, ND at foundationsproject@comcast.net or visit www.foundationsproject.com. At NCNM, the FNM Project’s academic home, contact Susan Hunter, at shunter@ncnm.edu or visit www. ncnm.edu.

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By Lori DiBacco, ND – President

What is your mission statement? Our mission is to promote the success of naturopathic doctors and the naturopathic profession in Massachusetts through education, public awareness, advocacy, and community.

What are your goals for the next three years? One of our primary goals is the successful passage of legislation registering NDs in Massachusetts. This effort has been ongoing for over 12 years; it is our time. In addition, we must reinvigorate the MSND into a highly efficient leadership body, one that will convert into a governing board with ease. Other important goals include creating continuing education opportunities, diversifying revenue streams, and improving media coverage of naturopathic medicine in Massachusetts.

What current projects is the association working on? Who is involved and how are they progressing? The MSND Board is completing work on a new and improved website. We expect the website will be a powerful tool for education, awareness, and promotion of naturopathic medicine in Massachusetts. One of the new features is a Members Only section that will encourage an open exchange of information and support among members. In addition, the News & Events page will help advertise programs and events for both members and the MSND. To help advertise our doctors further, we hope to have a scrolling list of MSND members and their photos on the home page. Of course, the website will also assist the legislative efforts by connecting viewers easily with their legislators. The board is also working to implement a Strategic Plan for MSND’s short and longterm success. We recently met with a strategic planner who helped us clarify our strengths and challenges, and build a road to success within that framework. We are excited to have this guidance document for MSND leaders to rely on and follow in the future.

What obstacles are you contending with as you work to meet your goals? The Massachusetts Medical Society is the strongest opponent to our licensure efforts. They oppose our bills at every hearing, but fail to show evidence of their claims. Another obstacle to the legislative process includes the long 2-year legislative process where it is hard to build and maintain any political or supporter momentum. Fundraising for our efforts is also a challenge. Our current revenue streams depend largely on corporate sponsors and membership dues.

As president, what do you most want to accomplish while in this position? I want to promote a sense of community among the NDs in Massachusetts. I want to help build an organization that supports its members, and I wish to create paths for improved communication and participation.

What methods are you using or will you use? To achieve these goals, my immediate tasks were to create a new website we could all be proud of and a Strategic Plan to provide direction to current and future MSND leaders. In addition, our vice president Anne Kelty, ND, has taken on the role of Director of Media/ Public Relations. She spearheads efforts to promote naturopathic medicine in local and statewide media outlets. This year, I hope to expand both social and business interactions among the NDs of Massachusetts via quarterly conference calls, our annual meeting, frequent email communication, and a few social events. Since we are spread out across a long state, we are considering regional meetings. On the political front, several years ago the MSND created a dedicated position for a Legislative Chairperson. This person maintains constant contact with our lobbyist, attends key political meetings, and keeps the organization abreast of any political developments. Each legislative session, MSND members typically testify at committee hearings and have a lobby day at the State House.

What is the most challenging part of your job? The most challenging part is trying to run and build a successful organization with volunteer doctors who are simultaneously running a practice in order to make a living. We have no shortage of passion, commitment, and good intentions, just a finite amount of time in each day. I wish we could afford a dedicated staff to run this important organization. Also, the licensing effort has been long and arduous, and the requisite level of energy can be difficult to maintain.

In what ways within, and from the greater ND community, do you receive support for the association’s mission and goals? Thankfully, I have the guidance and support of many past presidents and presidents of other associations. In addition, the AANP has several organizations to provide support and education, and an opportunity for State leaders to communicate about the legislative process, progress, or issues within organizations. These avenues also provide a sense of community, which helps prevent burnout or feelings of isolation. The staff of AANP is always available as a resource. AANP has done a fantastic job of collecting legions of data for our use in marketing materials, legislative materials, etc. Finally, the D.C. FLI (Washington, D.C. Federal Legislative Initiative) has provided many of our doctors with additional leadership and lobbying training. The AANP has organized this federal lobbying day for over 5 years. ND students and state representatives unite in May of each year and visit our federal senators’ and representatives’ offices to educate, lobby, and promote naturopathic medicine or issues pertinent to our cause.

What do you think naturopathic medicine’s role is in your region and how do you see that furthering the medicine globally? Massachusetts is a key state in medical thought and policy. Recently, Massachusetts became the first state to mandate health care coverage for all. As a result, there is a massive shortage of primary care providers: Naturopathic doctors are poised to fill this need. We know our current bill will not make us primary care providers, but it will put us on the right path. Achieving licensure in Massachusetts will hopefully accelerate the licensing efforts in other states and bring our culture closer to a proper respect for natural medicine and a proper balance between naturopathic and allopathic medicine.

How are you making your association and/or its efforts known or visible in mainstream society? Our new website will be a great resource for our patients and doctors and encourage ongoing participation in legislative efforts. The News & Events feature will easily provide the latest legislative news and post any classes, talks, programs, or other ND news. Also, our VP/ Director of Media has been increasing ND coverage in local newspaper, radio, and television.

What sort of inroads have you made politically within your local government? We have made tremendous strides in the state legislature at acceptance of our profession. When we started our licensing effort our profession was not known at all. Over the years we have gained respect and garnered many supporters among legislators and staff. We also received a favorable recommendation for licensure from the Massachusetts’ Special Commission on Complementary and Alternative Medicine in 2002. Unfortunately, this did not convert into immediate success for passing our bill. In early February this year, Senate Bill 889 successfully passed out of the Public Heath Committee and was sent to the Health Care Finance Committee. These are joint committees containing members from both the House and Senate. We hope the bill will move quickly through this committee. With this movement of our bill, we have great hope that we have sufficient time to pass our bill this session. In the last two legislative sessions, we have passed successfully through either the House or the Senate. Unfortunately, both sessions ended before we had passage through both the House and Senate.

Do you have any particular stories that highlight the accomplishments of your association? Over the years, a key state senator has been a committee chair and in a position to block our bill from advancing. With continued discussion with him and his staff members, he is no longer opposed to our bill, which has passed out of his committee for the last two sessions.

By Alexander P. Cortina – Boucher Institute of Naturopathic Medicine (BINM)

The Future of Naturopathic Medical Education

Naturopathic medical education and practice are constantly immersed in debates that push for the need to move beyond the establishment and challenge the status quo or support the need to organize or structure a formal standing that strengthens and justifies the profession. For the purposes of this article please allow me to refer to the previous role as that of an artist/explorer and the other as reflecting the nature of a scientist/legislator accordingly. Please note I am not referring to science as a model of seeking validity/reproducibility, but rather to a scientist mind frame that seeks to determine a particular static reality, even momentarily. The need for balance and sometimes further influence by one aspect over the other has been clearly validated and seen in naturopathic medical history many times in the past according to the circumstances experienced by the profession. Generally, it has been the role of the institutions (schools, licensing bodies, associations, etc.) to work to secure validation and structure. It has been the role of individual practitioners, particular interest groups and corporations, to question the established agreements as to what is naturopathic medicine and how it should look in the future. It is also apparent that these roles or functions sometimes seem conflicted in the eyes of certain individuals. For example, a student in naturopathic medical school feels trapped by the system and unable to explore or move further in his/her learning because of curriculum limitations. A hard working and dedicated naturopathic physician has selflessly offered countless hours serving in organizations which have succeeded in validating naturopathic medicine within governments, accreditation bodies as well as industry, and feels frustrated by other individuals pursuing a less productive agenda. Not only naturopathic medical education, but medical education in general, has relied on the legislator/scientist role to guide what is considered to be the appropriate role of schools: to offer the basic foundation on which practitioners can build their own expressions of medical practice. Some students may argue that this role is unnecessary and generates considerable waste of time; while some faculty members may argue that this is the only role that can actually provide the broad experience needed for any (naturopathic) medical practitioner to flourish and be of benefit to others. Considering that the legislator/scientist approach has been generally seen at the center of medical education in North America, I was highly impressed by a particular study funded by Health Canada and prepared by the Association of Faculties of Medicine of Canada (AFMC) titled: The Future of Medical Education in Canada: A Collective Vision for MD Education (www.afmc.ca/fmec). The main question was to look at “how the education programs leading to the medical doctor (MD) degree in Canada can best respond to society’s evolving needs given the “enormous challenges health care in general faces in the near future.” In a bold and, in my view, very effective approach, the AFMC offers 10 formal recommendations to all traditional medical schools in Canada for consideration and implementation. These are: • Address Individual and Community Needs • Enhance Admissions Processes • Build on the Scientific Basis of Medicine • Promote Prevention and Public Health • Address the Hidden Curriculum • Diversify Learning Contexts • Value Generalism • Advance Inter- and Intra- Professional Practice • Adopt a Competency-Based and Flexible Approach • Foster Medical Leadership As I read this list and the supporting documentation, I am surprised to notice that the great majority of these suggestions would make a strong case to support the artistic/ exploratory nature of medical education and practice rather than the scientific/legislative one. Many of these suggestions actually appear to me as if they might have been previously developed or considered in a CAM educational setting. The need for connection, humanization, leadership, diversification, flexibility, community, and prevention as well as the need to address “hidden” or stereotypical curriculum/practices, is clearly noted and brought into the center of the dialogue for Canadian MD schools. As many educational scholars have noted, for any form of education to be relevant, it must stay true to the needs of society as well as that of graduates and practitioners. It is clear by the accounts of the AFMC that the health care needs of the future in Canada, and some may argue in North America, will demand medical practitioners become: more human, more artistic, more flexible, more connected, more diverse and better leaders; instead of: more rigid, more structured, more disconnected, more specialized and more compliant. The concept of ‘relevance-based education’ always brings into question what is to be understood as relevant. Canadian and American governments are both facing the same pressures, regardless of the structural differences of both systems: the demographic curve representing the majority of the population is now above 50 years of age, underscoring the need to do everything possible to support this reality. This is clearly important. This is clearly relevant. It is heart-warming and very positive for me to see these suggestions coming from the medical school establishment as the key to address this reality. As naturopathic medical leaders, students, faculty and practitioners, why not consider looking into our curriculum and teaching methodologies; our standards of practice and code of ethics; and our regulations, bylaws and legislation. Let’s see how these AFMC suggestions may be either already a part of what we do, or if not, in what ways can we introduce or enhance them. Furthermore, and I believe more importantly, it would be even more interesting to challenge all involved in naturopathic medicine by asking: “If mainstream medical schools are currently taking this direction, should we understand this as a call to action for naturopathic medical schools and other naturopathic medical institutions to embrace the artistic/explorer aspect of our profession more, and strive to go even further?” How would this look? What would this entail? Certainly naturopathic food for thought…

Alexander Cortina, MEd is president at the Boucher Institute of Naturopathic Medicine (BINM) in British Columbia, Canada. He graduated with a masters in educational administration and leadership from the University of British Columbia, and is currently finishing a doctoral program in the same field based at the University of Calgary. He additionally holds two bachelors degrees, one in philosophy and ethics and the other in higher education. Cortina has 15 years of senior educational management experience, five of which were devoted to serving as dean of student affairs at BINM. He currently serves as AANMC board treasurer. E-mail: acortina@binm.org.

NEWS BRIEFS

Greenspan Dies

David Greenspan, ND, a well-known and well-respected member of the naturopathic community, died March 13. Shortly after graduation from NCNM in 1990, Dr. Greenspan opened the Greenspan Good Health Clinic in Tigard, Oregon. In addition to the devotion he paid to his patients, he was a dedicated member of the naturopathic community, serving as an NCNM board member, as president of the Oregon Association of Naturopathic Physicians (OANP) for two terms, and as a member of the OANP’s continuing education committee. Dr. Greenspan also developed a Portland public access TV program called “Nature’s Way.” Dr. Greenspan is survived by his two children, 10-year-old Kyle and 3-year-old Abby; his longtime partner, Kellie; and his mother and two sisters.

Web Site Offers Free ND Directory

MedicineTalk.org, a website that supports the naturopathic community through public outreach, awareness and education, now offers a free online directory called Find an ND. The directory allows NDs to reach patients in their area through an online listing that includes address, phone, e-mail, website address, photograph, area of specialty, and practice description. Registration to be included in the directory is free, and is open to NDs who have graduated from an accredited school only. A membership at MedicineTalk.org is not required for the public to view listings. For more information, visit the ND Corner at www.MedicineTalk.org.

Survey Says Med School Students Support CAM

A published survey funded by the National Institutes of Health (NIH) concluded that knowledge of complementary and alternative medicine (CAM) could help Western doctors better perform their job. Findings from the survey included: • 99% agreed that a patient’s mental state influences his or her physical health. • 80% agreed that the focus of a primary care physician should be on promoting health rather than treating disease. • 74% believed that a blend of conventional and CAM would be “better than either approach by itself.” • 77% believed patients would benefit if their conventional doctors knew more about CAM. The findings were based on 1,770 responses to a 30-question survey sent to 126 medical schools. View the full article online from Evidence-Based Complementary and Alternative Medicine at http:// ecam.oxfordjournals.org/cgi/content/ full/nep195.

NDs Added to Loan Forgiveness Program in Oregon

The Oregon Association of Naturopathic Physicians (OANP) successfully lobbied the state’s House Health Care Committee to introduce and pass an amendment to add NDs to Oregon’s loan forgiveness program. The program is intended to partially compensate physicians who practice in rural communities by helping repay some of their medical school loans. Legislature introduced in February expanded the program to compensate participants up to $25,000 per year for serving 3-6 years in a qualified site. The bill also proposed expanding the program to include underserved urban communities in addition to rural communities, but maintained the existing definition of “physician” as MDs or DOs. Despite opposition from three conventional medical groups, the OANP amendment including NDs in the definition of “physician” passed both the Oregon House and Senate, and will be signed by the governor. This was only the first step in the process, according to Laura Farr, OANP executive director. She notes that the vote was merely a “policy victory” because the program is presently unfunded. Step two of the process will be to work with the 2011 legislature to allocate funding so that all professions included in the program will be able to manage their debt payments while working in rural and underserved communities.

CoAND Update

The Colorado Association of Naturopathic Doctors (CoAND) is not introducing legislation this year, but is networking with allied health groups to build awareness of naturopathic medicine and forge bonds for future efforts.

In other CoAND news … The group continues to seek speakers on hydrotherapy, botanicals, homeopathy and autoimmune disease for its 3rd annual Nature Cure conference Oct. 22-24 at Mt. Princeton Hot Springs, Colo. For more information on the conference, visit www.coloradond.org.

Naturopathic Pharmaceutical Course a Success NDs in British Columbia who complete BINM’s pharmaceutical upgrade course will gain prescription rights of up to 550 medications, according to Quinn Rivet, ND, director of continuing education at BINM. The first cohort session of the course was completed earlier this spring, and educated 80 attendees. Two more cohorts remain, for a total of 240 attendees. According to Rivet, the overall consensus from attendees is that the course is a great success. BINM’s continuing education department, in conjunction with the British Columbia Naturopathic Association, will endeavor to continue upgrades for pharmaceutical prescribing in years to come.

Study Promotes Qigong as Treatment for Type 2 Diabetes

Findings from the first three-armed randomized, controlled clinical trial research study examining the impact of qigong therapy on type 2 diabetes show that qigong may help lower some of the markers associated with Type 2 diabetes. Scientists from the Research Institute at Bastyr University compared the effects of qigong with those of progressive resistance (resistance exercise) training or usual care in people with type 2 diabetes. Participants assigned to the qigong group practiced for 30 minutes two times a week for 12 weeks. In addition, participants met with a certified instructor for one hour once a week to ensure the exercises were being done correctly. Those in the progressive resistance training group used resistance exercises for the same amount of time as those in the qigong group. The control group followed their usual care as recommended by their primary care physician. The researchers measured fasting blood glucose levels before, during and at the end of the study, while various hormone levels and perceived stress and depression were measured pre- and post-intervention. The results showed the qigong therapy group had significantly lower levels of fasting blood glucose and stress, as well as improved ability to use insulin. They also lost weight. Participants in the progressive resistance training group reduced body weight slightly, but were found to have higher blood glucose levels. These findings indicate that qigong therapy affects glucose levels and insulin resistance independent of changes in body weight, and works on different mechanisms than exercise. “It is thought that the meditation, slowed movement and breathing exercises associated with qigong promote relaxation and reduce stress, which may improve how the body functions,” said Guan-Cheng Sun, PhD, assistant research scientist at Bastyr University and the study’s principal investigator. “Qigong may also play a role in restoring the mind-body connection and the harmony between the pancreas and the liver. The conclusions of this study promote qigong therapy as a significant treatment method for type II diabetes.” The findings are published in the January 2010 issue of Diabetes Care, the official American Diabetes Association journal.

MedicineTalk.org, a Web site that supports the naturopathic community through public outreach, awareness and education, now offers a free online directory called Find an ND. The directory allows NDs to reach patients in their area through an online listing that includes address, phone, e-mail, Web site address, photograph, area of specialty and practice description.

Registration to be included in the directory is free, and is open to accredited NDs only. A membership at MedicineTalk.org is not required for the public to view listings.

For more information, visit the ND Corner at www.MedicineTalk.org.

Non-Invasive Technique Blocks a Conditioned Fear in Humans

A research team funded by the National Institutes of Health’s National Institute of Mental Health (NIMH) has selectively blocked a conditioned fear memory in humans with a behavioral manipulation.

Participants of the study remained free of the fear memory for at least a year.

“Our results suggest a non-pharmacological, naturalistic approach to more effectively manage emotional memories,” said Elizabeth Phelps, PhD, of New York University. Phelps and colleague Joseph LeDoux, PhD, led the research team that reports on their discovery online Dec. 9, 2009 in the journal Nature.

“Inspired by basic science studies in rodents, these new findings in humans hold promise for being translated into improved therapies for the treatment of anxiety disorders, (such as post-traumatic stress disorder/PTSD),” said NIMH Director Thomas R. Insel, MD.

The results add support to the hypothesis that emotional memories are reconsolidated – rendered vulnerable to being modified – each time they are retrieved. That is, reactivating a memory opens what researchers call “reconsolidation window,” a time-limited period when it can be changed.

“This adaptive update mechanism appears to have evolved to allow new information available at the time of retrieval to be incorporated into the brain’s original representation of the memory,” Phelps said.

The human study conditioned human participants to fear colored squares by intermittently pairing them with mild wrist shocks. Then, a day later, the memory was reactivated by re-exposing participants to the squares. A measure of nervous system arousal confirmed that they experienced a fear response. Extinction training – repeated trials of exposure to the colored squares without shocks – followed.

Those trained after the 6-hour consolidation window remained afraid of the squares – as did a control group that received extinction training without first experiencing reactivation of the fear memory.

In a follow-up experiment to gauge long-term effects a year later, 19 of the original participants received a potent regimen to reinstate the fear: four shocks followed by presentations of the colored squares.

Remarkably, those who had undergone extinction training within the reconsolidation window were largely spared significant effects. By contrast, those whose training had been delayed 6 hours or who had not experienced fear memory reactivation prior to extinction training experienced significant reinstatement of the fear response.

In a similar experiment, the researchers also confirmed that the fear memory was blocked only for the specific colored square for which fear memory was reactivated prior to extinction training. The effect did not generalize to a differently colored square associated with the shocks. This indicated that memory re-writing during reconsolidation is highly specific and that prior reactivation with the specific stimuli is critical.

“Timing may have a more important role in the control of fear than previously appreciated,” Phelps said. “Our memory reflects our last retrieval of it rather than an exact account of the original event.”

Evidence suggests that the behavioral manipulation may work through the same molecular mechanisms as experimental medications under study for quelling traumatic emotional memories.

“Using a more natural intervention that captures the adaptive purpose of reconsolidation allows a safe and easily implemented way to prevent the return of fear,” suggest the investigators.

For more information, visit www.nimh.nih.gov.