Healing Combat Trauma

Helping Vets with PTSD: Rolling up Your Sleeves vs. Keeping an Arm's Length Distance

We've talked before on this blog about Paul Tillich's fabulous quote, that "the first duty of love is to listen." 

Here's a story that neatly conveys the polar opposite of that; or at least how someone, a VA provider, got actually PUNISHED for doing that (thanks to Ilona Meagher for noticing the story). But first, an aside.

I was at a dinner a while back that concluded a week's worth of focused training for health care providers, mostly psychologists, psychiatrists and social workers -- many of whom dealt with combat veterans.  Seated across the table from me was a VA provider, a Ph.D. psychologist who, to his credit, was of the Vietnam era but hadn't served, and who had gone into working with the VA so that he could "help" his generation of veterans, who he saw as being tremendously underserved.  True and good, so far.

As we sat at dinner, he told the private practice psychiatrist to one side of him, and the veterans service officer (and Iraq War combat vet/single mom) to the other side of him, about something "new" called "EMDR," that neither one had ever heard of, and that he had just learned about, and  was fairly enthusiastic about himself.  EMDR, for "Eye Movement Desensitization and Reprocessing," for one thing, is NOT new.  It's been in existence for years -- since the 80s, when it was developed by Francine Shapiro, Ph.D..  Something like 16 clinical trials have shown its efficacy. Heck, we've got several blog posts about it, from two years ago. So it's not really great news that the provider was "just learning about it" recently.  EMDR was one of the first quasi-"alternative" treatments offered in the psychological community for PTSD.  It's been widely studied and fairly widely recommended for PTSD ever since.  It's also something I've personally tried, so my ears perked up when I heard it.  "This stuff is so great," the VA psychologist enthused, warming to his true point: "You can treat people, and you don't even have to hear their stuff!"

Ohmigoodness.  If that isn't just the gold standard of what we want to be doing.  I'm holding out hope we'll find an arm's' length cure for healing combat trauma (kidding, absurd).

In this article, a VA provider who seems like a serious, intense, and concerned practitioner -- as well as a favorite among the veterans who were her patients -- gets fired and reprimanded for "talking an Iraqi vet down off the ledge," so to speak.  It's a pretty shocking story.  The provider has yet to be re-instated, and the OIF/OEF veteran who narrowly survived killing himself, thanks to her intervention, also has been left scarred by the situation, and more antisocial/less trusting than before.  Ugh.  Is this the kind of care we really want to be delivering?

The VA, particularly now (as in, these days) is supposed to be "very concerned" about its reputation, and really adamant about "no more bad PR."  If that's the case, maybe it's time to examine some of the decisions that get made, and why they get made -- from what happened in this story, to the psychologist above who was so thrilled to learn about a treatment mode that he could practice without having to get too involved.

Somehow, this seems to be the EXACT OPPOSITE of the care and concern and COMPASSION that someone like Sarah Haley exhibited, herself a VA psychiatrist, through whose landmark work the shame of My Lai was able to come forth and be addressed, etc. A true hero in the pantheon of those who addressed PTSD at its roots -- and, coincidentally, ALSO someone very well loved by her patients.  Hmmmn.  There might be a not-so-subliminal message in that. 

Here's what Gerald Nicosia, author of Home to War: A History of the Vietnam Veterans' Movement, says in part about Haley (to whom he devotes more than a dozen pages of narrative):

"The other horn of this troubling dilemma was that the traumatized person, especially if he was a Vietnam veteran, would almost never come in and spill his guts to a perfect stranger.  Trauma patients need to establish trust with a therapist, and the Vietnam veterans coming into the VA clinic were never being given the chance to do this.  It was by the merest lucky chance that the My Lai veteran had seen something in Sarah Haley that made him believe he could confide in her, thereby opening the door not only to his own dark secrets, but also to possible help for a whole generation of trauma victims."

 

And, separately:

 

"What Haley did not realize was that John [the aforementioned patient, who spilled the beans on My Lai] had come to her initially because he had been told she was trustworthy by his friend Mike, whom she had treated previously.  A year later, John showed up in her office again under the pretext of bringing Mike back for further counseling.  At this time, John confessed to her that "he had needed to believe that just one person cared, that one person could be trusted to know what he had done, and not reject him.""

 

Hmmmn.  Food for thought, all the way around: but most especially for the VA, and their apparently quite shabby treatment of psychologist Sidney Ornduff, and by extension, the other veterans whose lives she could have been helping.

 

Gimme Five: Can EMDR Work in as Few as Five (5) Sessions?!

Here's an interesting concept or challenge: what if something like EMDR ("Eye Movement De-Sensitization and Reprocessing" therapy, to the uninitiated) were able to improve symptoms of PTSD / combat trauma within as few as five (5) sessions?  What if, even further, the benefits of treatment continued, even after treatment was discontinued?  Those are two pretty heady claims -- but one researcher says they're actually both true.  And cites two internationally-published studies that support those assertions.  Click here for the link to discussion of the studies.  Hmmmn.  At the very least, what a good way to improve people's baseline level of health, while they're continuing to recover from trauma.  Worth a look...

EMDR Books on Combat Trauma / PTSD

To be a little more explicit about the books about EMDR -- eye movement de-sensitization and reprocessing therapy -- referenced in an earlier post, a few of the better and/or more important ones are as follows: "Eye Movement Desensitization and Reprocessing (EMDR), Second Edition: Basic Principles, Protocols, and Procedures," by Francine Shapiro. Ph.D.; and, "EMDR: the Breakthrough 'Eye Movement' Therapy for Overcoming Anxiety, Stress and Trauma," also by Francine Shapiro, Ph.D.

EMDR for Trauma: The Eyes Might Have It

The military-oriented news site, the Stars and Stripes, has an article today about how EMDR is becoming a treatment of choice at Landstuhl Regional Medical Center.  Hmmmn.  It's a little disappointing that the military is just now hearing about EMDR, which has been around since the late 1980s, and initially came into prominence as a way to treat Vietnam veterans and other trauma survivors, to lessen the impact of their violent memories.  EMDR, or Eye Movement De-sensitization and Reprocessing therapy, was developed by Francine Shapiro, Ph.D.  If you would like to read more about Francine Shapiro, Ph.D., EMDR, find out more about the history of EMDR, learn whether or not EMDR works for PTSD, or how to find a clinician trained in EMDR in your geographical area, click the hyperlinks for more information.  There are also a number of books published about EMDR, by Shapiro and others, and they're listed in the sidebar, about halfway down.  If you're a clinician and you'd like to find out more about being trained in EMDR, visit Dr. Shapiro's website for more information.

Editor's note: EMDR shows much promise for treating PTSD and symptoms of combat trauma.  It is not talk therapy, nor is it a pharmaceutical-based approach.  It is, however, not the only treatment low-tech, high-touch therapy that shows promise for treating combat trauma.  However, with almost 30,000 troops injured in Iraq and Afghanistan, plus affected family members -- because not only servicepeople suffer from trauma's effects, but also their family members can -- it's very much a significant step in the right direction.