Healing Combat Trauma

Mind Body Medicine: Healing the Wounds of War

When I started this blog over two years ago now, I was hoping that somehow James S. Gordon, M.D., and the Center for Mind-Body Medicine which he founded in Washington, DC, would somehow get involved in the prospect of bringing mind-body medicine to the troops.  Gordon is a Harvard-trained psychiatrist, with impeccable credentials, who has a lifetime interest in expanding patient care into new areas, particularly Complementary and Alternative Medicine (CAM), and mind-body medicine in particular.  (Mind-body medicine is a shorthand way of re-combining the two "halves" of medicine perhaps unjustly sundered in an arbitrary Cartesian mind-body split.  Much of Eastern thought, rather than Western, never saw them divided at all.)  In a previous lifetime, where I interviewed luminaries in the natural medicine field, Gordon was a favorite interviewee - smart, genial and with a very forward-thinking grasp of what mind-body medicine could accomplish.  Gordon, who was featured in the Bill Moyers series on PBS, Healing and the Mind, was a frequent lecturer at the Smithsonian Institution in Washington, DC, and for years had served as the head of the White House Commission on Complementary and Alternative Medicine.  He is also a Clinical Professor in the Departments of Psychiatry and Family Medicine at Georgetown University Medical School.

But more to our purposes, when war broke out in Kosovo, he and the Center for Mind-Body Medicine (CMBM) took their methods into the region, creating a program called "Healing the Wounds of War," to help war-torn schoolchildren and their caregivers manage the trauma they had undergone, through a sustained, devastating conflict.  What I was hoping -- and I kept checking the CMBM website periodically to find out -- was that they would leapfrog off their successes with PTSD in Bosnia and Kosovo, and Israel and the Middle East, and develop something geared to PTSD in servicemembers, and the conflicts in Afghanistan and Iraq.  For years, nothing was obvious (yet), but here's some of their success with children in Kosovo.  Notice what symptoms the program helped with, how impressive the statistics are, and make the conceptual leap to how this might help with combat veterans and/or their families:

The clinical efficacy of the CMBM program with traumatized children has been repeatedly demonstrated. In a pilot study in which high school teachers in the Suhareka region of Kosovo used the CMBM model, levels of posttraumatic stress disorder in high school students were reduced from an average of 88% to 38% in only six weeks (read the research, published in Journal of Traumatic Stress, April 2004, linked here). Participants have also reported the following documented effects of CMBM trainings, including: the alleviation of their own stress and trauma; decreases in anxiety and depression; increased optimism; decreased anger; and increased capacity to help others.

You can read more about the program's specific successes, here.  Or, you can read a general overview of the program and what's involved, here.  You can also read Dr. Gordon's bio, here.

When PTSD Sufferers Can't Sleep, Award-Winning "Pacific Light" DVD Brings Some Healing Peace

Hyperarousal or heightened anxiety.  Flashbacks, nightmares, intrusive memories.  Intense physiological stress symptoms: pounding heart, rapid breathing, nausea, muscle tension, sweating. Difficulty falling or staying asleep.  Irritability or outbursts of anger. Difficulty concentrating. Hypervigilance, or being constantly “on guard.” An exaggerated startle response, or jumpiness. Inability to relax. All these symptoms are very familiar to PTSD sufferers and their families.

Pacific Light, Wind and Waves Healing Music DVD for Stressed and Anxious Patients.

Into this mix comes the award-winning "Pacific Light" DVD, and the elusive promise of an interlude of healing peace, that might even involve a good night's sleep.

Time, Inc. awarded Pacific Light its first place award for health and medical media.  Alternative Medicine mgazine calls Pacific Light "a breathtakingly beautiful video."  And over 400 hospitals use "Pacific Light" to help provide an atmosphere of healing peace for distressed patients and their families.  Walter Reed, the Mayo Clinic, the U.S. Army, U.S. Navy and the U.S. Marine Corps at Twentynine Palms, plus hundreds of other institutions are becoming fans of this DVD, a combination of stunning cinematography of some of the West Coast's most beautiful locales, filmed at sunrise and sunset, with no cheesy voiceover instructing patients to relax -- instead, the Grammy-nominated, award-winning soundtrack of R. Carlos Nakai's cedar flute music, as arranged by Billy Williams.

Pacific Light is the second DVD in a series by Thomas Day Oates, Jr., an amazing person and personal friend, whose own bouts with serious illness changed his career path into cinematography.  Oates has a very strong conviction about the importance of distressed patients and their families being able to create a space for "healing peace" - he believes the words are almost synonymous -- and that without a sense of peace, people can't begin to heal.

Apparently, a number of hospitals, hospices, and patients agree -- the testimonials are pretty impressive; and even without them, watching a clip of the gorgeous scenery and its peace-inducing soundtrack make the point instantly accessible.  For hospitals and institutions, click here. For individuals and families, click here. Website linked here.  Ordering info: 1-877-835-0838. Special pricing for veterans and their families: $19.98, including shipping and handling (within the U.S./APO/FPO). Call to inquire.

Editor's Note: You know who/where else needs this DVD?  Balad Military Hospital in Iraq. Landstuhl Regional Medical Center in Germany. The Combat Stress Control Unit. Mologne House Hotel in DC. Military chaplains in Iraq, Afghanistan, and stateside.  PTSD residential programs at the VA. VA Medical Centers.  Wounded warrior units.  Wounded troops, wherever they are recovering, at home and abroad.  The possibilities are practically endless.  And not just for the troops themselves: for their caregivers as well, who often are also suffering from vicarious trauma.

James S. Gordon, M.D., Founder and Director of The Center for Mind-Body Medicine

James S. Gordon, MD, a Harvard-educated psychiatrist,is a world-renowned expert in using mind-body medicine to heal depression,anxiety,and psychological trauma. He is the Founder and Director of The Center for Mind-Body Medicine, a Clinical Professor in the Departments of Psychiatry and Family Medicine at Georgetown Medical School, and recently served as Chairman of the White House Commission on Complementary and Alternative Medicine Policy. He also served as the first Chair of the Program Advisory Council of the National Institutes of Health’s Office of Alternative Medicine and is a former member of the Cancer Advisory Panel on Complementary and Alternative Medicine of the NIH.

 

Dr. Gordon has devoted over 35 years to the exploration and practice of mind-body medicine. After gradating Harvard Medical School, he was for 10 years a research psychiatrist at the National Institute of Mental Health. There he developed the first national program for runaway and homeless youth, edited the first comprehensive studies of alternative and holistic medicine, directed the Special Study on Alternative Services for President Carter’s Commission on Mental Health, and created a nationwide preceptorship program for medical students.

 

Dr. Gordon has created ground-breaking programs of comprehensive mind-body healing for physicians, medical students, and other health professionals; for people with cancer, depression and other chronic illnesses; and for traumatized children and families in Bosnia, Kosovo, Israel and Gaza as well as in post-9/11 New York and post-Katrina southern Louisiana. Nearly 3,000 health and mental health professionals throughout these regions have been trained by Dr. Gordon to more effectively address the psychological trauma within their communities, including supervision and training of a local leadership group within each region which enables the CMBM model to be fully integrated into and sustainable within the local healthcare community.

 

Dr. Gordon’s most recent book is Unstuck: Your Guide to the Seven Stage Journey Out of Depression (Penguin Press). His also the author of Comprehensive Cancer Care: Integrating Alternative, Complementary and Conventional Therapies and Manifesto for a New Medicine: Your Guide to Healing Partnerships and the Wise Use of Alternative Therapies (both Perseus Books). In addition, Dr. Gordon has written or edited 9 other books, including the award-winning Health for the Whole Person, and more than 120 articles in professional journals and general magazines and newspapers, among them the American Journal of Psychiatry, Alternative Therapies in Health and Medicine, Journal of Traumatic Stress, Psychiatry, The American Family Physician, The Atlantic Monthly, The Washington Post, and The New York Times. He also helped develop and write the educational materials to supplement the public television series “Healing and the Mind with Bill Moyers”.

 

Dr. Gordon’s work has been featured on Good Morning America, The Today Show, CNN, CBS Sunday Morning, FOX News and National Public Radio, as well as in The Washington Post, USA Today, Newsweek, People, American Medical News, Clinical Psychiatry News, Town and Country, Hippocrates,  Psychology Today, Vegetarian Times, Natural Health, Health, and Prevention.

Mind-Body Medicine Conference - Includes Therapies for PTSD

A conference is planned for October 25-29th in Minneapolis, MN on Mind-Body Medicine, geared towards practitioners -- training the trainers -- around the topic, "Integrating Mind-Body Medicine into Clinical Practice, Medical Education & Trauma Healing."  The conference is sponsored by James S. Gordon, M.D.'s Center for Mind-Body Medicine in Washington, D.C.  The Harvard-trained Gordon is a luminary in the field of mind-body medicine, having authored numerous books on the subject, been featured in Bill Moyer's PBS series, Healing and the Mind, and has been a frequent speaker at the Smithsonian, in their public lecture series.  He is a clinical professor at Georgetown University School of Medicine, and is the former chairman of the White House Commission on Complementary and Alternative Medicine Policy.  The Center has done significant work with trauma in the Middle East, Kosovo, in Louisiana with victims of Hurricane Katrina, with 9/11 rescue workers, etc. 

The conference information is linked here. Dr. Gordon's bio is linked here.  The Center for Mind-Body Medicine is linked here.

Travis Twiggs' Widow, Kellee, Puts a Human Face on the Suffering of PTSD

I come away just so impressed with Kellee Twiggs, the grieving, sympathetic widow of the late USMC Staff Sergeant Travis Twiggs, who passed away recently, one might say, from PTSD complications, after a long and difficult battle with that powerful adversary.  Kellee was as much in the dark about the events immediately leading up to Twiggs' suicide as anyone else watching this painful scenario unfold; but she was and is very clear on the ravages PTSD took on her wonderful husband, who she dearly loved.  There's been a great raw video interview footage on the Web for the last few days of Arizona tv reporter, Suzanne Kennedy, interviewing Kellee Twiggs about PTSD and her husband, Travis.  Because it's unclear how long that video will stay on the Web, and also because so much of the Twiggs' story is worth knowing, I took the time to create a transcript of the interview, a downloadable copy of which is available here, Download transcript_of_kellee_twiggs_interview.pdf.

In the interview, Kellee Twiggs, who I very much hope has a future as a patient advocate, given what she's gone through, and how personally she knows the ravages of PTSD in a combat veteran's life, comes across very well -- as a kind, sympathetic, reasonable person, who ultimately feels that the Marine Corps did not do enough to save her husband's life (and that the current courses of treatment for PTSD -- at least the ones Travis was exposed to, with their emphasis on locked wards and overmedication with a slew of pharmaceuticals -- aren't the most effective treatments possible.  From her vantage point, they were tried with her husband, and they just didn't work.  Is her point of view that of a treatment professional?  No.  But it's very much as someone who loved her husband, and cared what he was going through -- and ultimately saw the system fail.  One of the most interesting parts of the video to me was how she isolated the need to address the guilt that her husband felt, and was apparently unable to overcome, from letting others down.  It's a very interesting video interview.  Watch the entire clip, here; or read the transcript, linked above.  And keep the Twiggs family in your thoughts and prayers this Memorial Day and after.  It's hard enough to be a military family with a deployed servicemember.  It's even harder to be a military family grieving a terrible, combat-related loss, as the Twiggs are presently.

Hey Mama: Celebrating Mother's Day for Veterans

Happy Mother's Day to the mothers who've served in combat, and to the mothers, stepmothers, grandmothers, and adoptive or foster mothers of those who've served, not to mention the wives and girlfriends of combat veterans.  The veteran pays a heavy price for his or her sacrifice; but so do the generally unsung heroines on the homefront.  They're the ones struggling to make sense of the distance and loneliness; trying to hold down a job to keep the family afloat and tend to the children as well; and they're often called upon to pitch in as 24/7 caregivers or patient advocates when the need arises after injury.  Some of these women who we know personally are truly amazing role models, and due an enormous debt of gratitude and respect.  However, they're ALL worthy of appreciation for the mighty roles they fill.  Let's hope this Mother's Day they get just some of the gratitude they deserve.

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One veteran's mother, Frances Richey, did something unusual.  She wrote a book of poetry about being the mother of a son at war, called The Warrior.  Amazon.com, in its product description, calls it "A heartwrenching and powerful memoir in verse from a mother grappling with the reality of her son at war in Iraq."  Richey, a single mother, raised a son who went through West Point and became a Green Beret, serving multiple tours in Iraq.  Recently, the Seattle PI wrote an article about the book, called "Mother's poetry illustrates the pain she felt while her son fought in Iraq."  Click here for a link to the book, and here for a link to the article in the Seattle PI.   

"Abandon Hope, All Ye Who Enter Here..."

It sounded like potentially good news for veterans and their families at the time, but I'm wondering if it ever really happened.  Human guides were proposed to lead wounded veterans through the maze of healthcare.  On November 1, 2007, the Kaiser Daily Health Policy Report published a news item called "DOD, VA Team To Provide Care Coordinators for Servicemembers, Veterans."  These "Federal Recovery Coordinators," as they were termed, were established "to help veterans with health care and recovery." 

According to the Kaiser Daily Health Policy Report, the Department of Veterans Affairs and the Department of Defense would establish “federal recovery coordinators” responsible for helping guide wounded servicemembers and veterans through their health care and recovery.  Apparently this was an idea introduced by the Dole-Shalala Commission, although it also could be a common sensical approach conceived of by any overburdened friend or family member of an injured veteran.  The concept was that ideally these coordinators would not just aid their clients in navigating the healthcare options available to them, but also produce better coordination between the two departments, Defense and Veterans Affairs.  Strangely enough, the goal to have ten coordinators trained and ready to go by January, 2008 -- a mere two months later -- and in place at the largest veterans healthcare installations. 

It's mid-2008, and I don't know about you, but I've not heard another thing about this.  Do they exist?  Was the plan scrapped because it was too ambitious or otherwise untenable?  Are they out there, but keeping a very low profile?  Inquiring minds want to know...

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This is what the Kaiser Report said at the time:

The departments of Defense and Veterans Affairs on Wednesday signed an agreement to establish "federal recovery coordinators" who will be responsible for guiding wounded servicemembers and veterans through their medical care and recovery, the Washington Post reports. The recovery coordinator position was a key element of a presidential commission's recommendations to help improve health care services for military members and veterans returning from the wars in Iraq and Afghanistan (Vogel, Washington Post, 11/1).

The coordinators will be responsible for overseeing care coordination between the two departments' health care systems, and they will assist family members as well (AP/Contra Costa Times, 10/31). The first 10 coordinators, who will be provided by VA and trained by January 2008, will be assigned to large military health care facilities. Michael Dominguez, principal deputy undersecretary of defense for personnel and readiness, in a statement said, "This agreement will help ensure our nation's wounded warriors and their families receive the care they need and deserve at the right time, right place and by the right person across the continuum from recovery through to their reintegration into their communities" (Washington Post, 11/1).

All we want to know is, then what happened?

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Editor's note: for all the non-literature majors in the crowd, the title comes from Dante's Divine Comedy, and is supposed to be what the poet imagined was written over the gates of hell.

Helping Families to Recognize Veterans' PTSD

The Northern California news website, InsideBayArea.com, has a good article in today's edition, entitled, "Families Can Help Spot Vets' PTSD."  Click here for the link.  The article quotes Byron J. Wittlin, M.D., Director of Mental Health Services at the VA Clinic in San Bruno, CA.  Says Dr. Wittlin, "I think it's crucial for (military) family members to be aware of the potential mental health problems of their loved ones."  It's great to see the VA doing outreach to family members, who are in a unique position to see for themselves veterans' difficulties readjusting to life after combat.  (For a very good video about veterans, PTSD, and readjustment issues, click this link to an earlier blog post, where we highlight the "PTSD and Veterans: Beyond the Yellow Ribbon" video put together by the Norfolk County District Attorney's office, in Canton, Massachusetts.)

The article covers some important topics, including typical PTSD symptoms, veterans' reluctance to seek care, the perceived stigma surrounding mental health issues, and whether or not a loaded gun is wise to keep in the house.  Wilkins offers some hope about PTSD, that sufferers can get better.  And while he acknowledges that it takes a trained expert to actually diagnose PTSD, family members can play an important role in moving that process along, and encouraging their veteran to get help.  According to the article, "We encourage family members to be supportive, to mainly listen," Wittlin said. "And if they feel the vet needs some help, to call the VA and to refer them into us. This is really a complicated problem. And in our system, we have a lot of experience. And this is one of the services we want to offer."  Excellent news, for veterans and their families.

Editor's note: The Dept. of Veterans Affairs facility in San Bruno, CA is linked here.

Military Chaplains Carry, and Comfort in, Grief

Yahoo News has a good story today about the role of military chaplains in honoring the sacrifices of servicemen and women who have died in combat.  It profiles the experiences of four military chaplains, who've served in Vietnam, Afghanistan or Iraq.  The article is called, "Chaplains Salute Each of the Fallen," and it's linked here.  As the article points out, "Military chaplains don't carry weapons, don't engage in combat, and yet they know as well as any the human cost of war," and this "human cost" very much takes its toll, even on those most qualified by their faith, so to speak, to offer comfort and support.  Said one chaplain, quoted in the article, with each subsequent death, "you lose part of yourself that you're never going to get back."

Those of us who were raised on M*A*S*H have a probably very skewed view of what chaplains do in wartime, but there's no question that they're a special breed -- needing to be there to offer words of comfort and support to the troops, in the midst of struggling with their own very real grieving over loss.

In related news, congratulations are in order to fellow PTSD blogger, Kathie Costos, for just last week passing the test to become one.  With her extensive, 25 years of personal experience caring about combat trauma and its effects on the troops, as well as her personally offering comfort to those who suffer, she should really be one sensational chaplain.  Kudos to her for a wonderful accomplishment.

Mental Health of Veterans' Family Members Deserves Attention, Too

Just a quick note to mention that Todd Bowers, Director of Government Affairs at the highly pro-active Iraq and Afghanistan Veterans of America ("IAVA") recently testified before the House Veterans' Affairs Subcommittee of Health about an additionally important topic: the mental health of veterans' family members.  The topic?  "Mental Health Treatment for Families: Supporting Those Who Support Our Veterans" -- that would make a great slogan.  (A few days later, the Christian Science Monitor also covered this topic, in an article entitled, "A New Push to Help Families of Veterans."  That article is linked here.)

It's no secret though perhaps it should get much more attention that combat trauma affects not only veterans but also those in their immediate families.  A veteran's suffering affects his or her family members significantly, as the burden of caregiving falls most strongly on the veteran's immediate family.  There are physical, emotional, social and financial costs to caregiving, not the least of which is strained mental health.  At least with Vietnam veterans, studies have shown that children of veterans with PTSD are at increased risk for suicide themselves. (Although it's the subject of some controversy, an Australian government study of their own Vietnam veterans concluded that children of veterans were three times as likely as the general population to commit suicide.)  It's great to see that the IAVA is making the case that more resources need to be allocated for families' mental health resources as well.  For more information on this important topic, see the IAVA blog entry linked here, or the House subcomittee's site, linked here.  For a link to the audio coverage of the hearings, click here.  For earlier blog posts on caring for the caregivers, click here; or about the family, click here.

Editor's Note: It's interesting to note that just today, the Australian government published its conclusion, that counseling services would be made available to their veterans and families.  To read more about it, download this PDF.  To learn more about the Australian Vietnam veterans health studies, click this link to a subsequent blog post.