Integrative Healing for Veterans’ PTS
“People with PTSD lose their way in the world. Their bodies continue to live in an internal environment of the trauma. We all are biologically and neurologically programmed to deal with emergencies, but time stops in people who suffer from PTSD. That makes it hard to take pleasure in the present because the body keeps replaying the past. If you practice yoga and can develop a body that is strong and feels comfortable, this can contribute substantially to help you to come into the here and now rather than staying stuck in the past.”
~ Bessel A. van der Kolk, MD Clinician and post-traumatic stress researcher and teacher
According to the U.S. Department of Veterans Affairs’ National Center for PTSD, the percentages of Post-Traumatic Stress (PTS) in veterans is estimated to be 30% for those who served in Vietnam, 11-20% for Iraq and Afghanistan and close to 10% for the Gulf War’s Desert Storm. PTS can be further compounded by traumatic brain injuries, bodily injuries, amputations and other physical and emotional ailments as well as the effects of multiple deployments. Tragically, veterans account for 20% of suicides and veterans of the last two wars are four times more likely to commit suicide than veterans of other wars. According to a Columbia University report, the lifetime costs of treating brain injuries and veterans’ disability payments for the war in Iraq were estimated to be $35 billion and $122 billion, respectively (Stiglitz and Bilmes, 2006). It is imperative to utilize both conventional and complementary medicine modalities to battle this wily killer.
Symptoms of PTS can include hyperarousal, intrusive deployment memories, avoidance symptoms, anxiety, depression, emotional numbing, insomnia, nightmares and concentration issues as well as other accompanying problems such as chronic pain issues and substance abuse. The stigma of having PTS, being in psychotherapy and reliving the PTS-causing events can deter many active duty members and veterans from seeking help. The perceived stigma was so concerning that the VA recently dropped the use of the word disorder in the name.
Commonly known as complementary and alternative medicine (CAM), integrative medicine techniques offer tools to alleviate some of the anxiety, sleep, physical and relaxation problems and work in conjunction with traditional therapies and medications when veterans seek help. With the increase in evidence-based research on the effectiveness of various modalities in treating veterans with PTS, more funding and general acceptance and usage of these modalities as part of treatment plans may follow. A 2011 survey conducted by the VA’s Health Care Analysis and Information Group found that the most common CAM modalities the VA referred patients to were meditation, stress management/relaxation therapy, guided imagery, progressive muscle relaxation, biofeedback, animal-assisted therapy, music therapy, acupuncture, yoga and hypnosis/hypnotherapy. Chiropractic is considered standard care and the VA is prohibited from prescribing herbal or nutritional supplements, so these techniques were not considered in the survey.
Susan Griffin, LAc, of the Veterans Acupuncture Clinic of Hartford, who trained with Acupuncturists Without Borders (AWB), utilizes the National Acupuncture Detoxification Association’s (NADA) protocol for PTS. This involves only 5 needles in specific spots on the ear to alleviate stress, trauma and pain symptoms. Following the mission of AWB’s Military Stress Recovery Project, the Clinic offers free acupuncture treatments for veterans and their immediate family members. Griffin found that after acupuncture, veteran attendees with PTS were more relaxed, able to sleep better and experienced decreases in residual pain. “Veterans need a lot of different modalities to work on their healing. The Veterans Acupuncture Clinic is a simple, safe way for them to begin to address PTS symptoms in a non-judgmental group setting,” she says. “The Veterans Acupuncture is just one small way we can address a huge issue.” Recognition of acupuncture’s effects is illustrated by recent training of physicians as medical acupuncturists to do battlefield acupuncture as a resource to combat pain.
Several area organizations are training yoga teachers to work with veterans’ special needs, including the Connecticut-based Veterans Yoga Project. Daniel J. Libby, PhD, RYT, a licensed clinical psychologist and yoga teacher, conducted a survey (Libby, Reddy, Pilver and Desai, 2012) to examine how and which yoga, mindfulness and meditation programs are delivered in VA facilities. Of the 125 facilities that completed the survey, 36 offered yoga, 96 included mindfulness and 32 offered meditation. The top barriers named for not offering these services were lack of trained staff, funding and space rather than lack of veteran interest. Libby, Founder and Executive Director of the Veterans Yoga Project, developed the Mindful Yoga Therapy for Recovery from Trauma intensive program to prepare yoga teachers to better understand and work with the unique needs of veterans. In addition to offering veterans a quiet space to work on their bodies and minds, yoga can be another tool to temper the hyper vigilant feeling they experience and be more at ease in the present moment. “Yoga has helped my racing mind stop racing,” testifies Heather, an Iraqi War veteran who worked with Libby.
Homeopathy helps practitioners treat an emotional problem just by knowing the physical symptoms. Lauri Grossman, DC, CCH, RSHom (NA), a New York-based homeopath, integrative healthcare consultant and educator, found in her work with veterans that they would frequently open up afterwards and tell her their story as the charge associated with their physical ailments and the PTS-causing events subsides. Self-prescribing homeopathy for PTS is not advised as the protocol for each person is very individual. Grossman says the most common homeopathic remedies she uses for veterans are Aurum Metallicum, Stramonium and Natrum Muriaticum.
Veterans’ use of integrative medicine continues to expand within the VA system and the civilian world. The Bob Woodruff Foundation-sponsored CAUSE Program offers Reiki, reflexology and massage through Walter Reed Hospital and the Wounded Warrior Programs at several Army bases. Reiki helps reduce stress, anxiety, depression and pain while speeding up natural healing for wounds and after surgery. Therapeutic massage is utilized in all eleven Integrative Medicine PTS military programs. Reflexology’s effect on PTS symptoms in Israeli soldiers in the 1973 Yom Kippur War showed that treatment frequency immediately following the trauma was key in improving depression, outbursts, muscle tension, concentration, sleep and medication reduction (Teichman and Zaidel, Institute of Human Ecology). Reflexology treatments can also help the body detoxify while boosting the immune system and circulation to decrease inflammation and headaches.
Holistic practitioners have adapted their practices to consider veterans’ anxieties and reactions. Griffin set up a group environment where the veterans are in chairs, have control over when they are done and don’t have to share their experiences. Background music does not include loud, sudden noises, a calming slide show plays and the room is well lit. It is common for many yoga teachers to touch their students to adjust a posture while teaching. Libby instructs teachers to avoid unnecessary, unannounced touching as that can trigger a physical response from combat-trained veterans. Other aspects adapted to bring yoga into the veterans’ comfort zone include toning down the “new age” or Sanskrit rhetoric and arranging mats against the wall in line of sight of the door. Libby says, “There may not be one right way to do yoga with veterans but there are several bad ways to do it.”
We are facing an epidemic to save and support those who fought for us. Suicides amongst our veterans are at an unacceptable rate. These men and women that battle and relive their experiences every day need our help to cope yet are reluctant to reach out. Integrative medicine - including conventional avenues such as medications, psychotherapy and physical therapy - is proving critical to their physical and emotional reawakening and healing.
The Veterans Yoga Project will be holding its next local teachers’ workshop February 28-March 2, 2014 in Hamden, CT.
Ariana Rawls Fine is an Assistant Editor for Natural Awakenings who lives in Stratford, CT.