Dr. Henry Grayson on Neuro Pathways: A Treatment for PTSD?

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As indicated earlier, SFTT is thrilled to have Dr. Henry Grayson as Chairman of SFTT’s Medical Task Force to help develop effective programs to treat our brave men and women suffering from PTSD. PTSD for veterans of our wars in Iraq and Afghanistan is now reaching epidemic proportions. Government studies suggest that 1 in 5 veterans suffers from PTSD. The symptoms of PTSD manifest themselves differently from person to person – but make no mistake – PTSD is a serious problem and wrecks havoc on the lives of our citizen warriors and their loved ones.

Dr. Henry Grayson brings elegance and intelligence to this discussion of PTSD for which there is no simple cure or easy solutions. It requires patience and understanding. How we support our brave warriors will tell us much about our society. Over the coming months, SFTT will be reporting on “best practices” in treating PTSD and where and how service members can receive help. Found below, is a short video from Dr. Grayson discussing how a simple exercise can create new “neuro pathways” to reduce anxieties:

Clearly, the path to full recovery for our brave heroes is a long one, but thanks to the efforts of Dr. Grayson and many others who Stand for the Troops, we can help get our young men and women the help that they need. A world without hope is a dreary place indeed.

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SFTT targets PTSD: Interview with Eilhys England Hackworth

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I recently had the opportunity to sit down with SFTT Chairperson, Eilhys England Hackworth the wife, partner, co-author, and muse of Stand For the Troops (“SFTT”) founder, the late Colonel David H. Hackworth—America’s most valor-decorated soldier—from the late 1980s until his death. Since the passing of this great American hero in May 2005, Ms. England Hackworth has kept her deathbed promise to her husband to continue SFTT’s mission to protect America’s frontline troops.

The purpose of the meeting was to hear from SFTT’s Chairperson on why post traumatic stress disorder (“PTSD”) has become such an important “hot button” for SFTT.  What follows below is are key excerpts of the interview:

SFTT:   Eilhys, thank you for your time.  I am continually peppered by questions from readers as to why we changed the name of our organization from Soldiers For the Truth to Stand For the Troops.  Can you explain the reason?

Eilhys:  Happy to do so.  Our new name speaks more easily to what we do on behalf of concerned Americans—stand for the troops—and more specifically, stand for our frontline troops, who stand tall for us and our country.  Our mission to ensure that America’s frontline troops get the best available personal combat gear and protective equipment, including body armor and helmets, remains a priority. But recently we’ve been fielding a horrifying number of cries for help pointing to a lack of adequate care for veterans of our wars in Iraq and Afghanistan suffering from symptoms of PTSD.

SFTT:  Yes.  PTSD has certainly become a serious problem for returning veterans.   How bad is it?

Eilhys:  Horrific!  Especially when every day in the United States, an average of 18 vets take their own lives – about one every 80 minutes!

 STTT:  That statistic is staggering. So exactly what is post traumatic stress disorder or PTSD?

 Eilhys: The causes or origins of PTSD vary significantly according to psychological, genetic, physical, and social factors but in shorthand:  PTSD changes the body’s response to stress. It affects the stress hormones and chemicals that carry information between the nerves (neurotransmitters).   While the military is trying to cope with the growing problem – now reaching epidemic proportions –  proper treatment is too often beyond the capabilities of our stretched VA hospitals.  Statistics suggests that at least 1 in 5 of our serving men and women suffer from PTSD and this has terrible side-effects on their families and friends.

SFTT:  When did you recognize the seriousness of PTSD for our returning veterans?

 Eilhys:  You know we’re always very connected to what’s going with our warriors.  And early this year, the stories kept hitting the radar just as the suicide and homicide stats were becoming inescapable!  We announced a new PTSD Initiative headed up by Major General John Batiste, U.S. Army (Retired) and then he arranged our close collaboration with a new treatment program, CDS Warrior Salute, with CDS President/CEO Sankar Sewnauth and Major General Robert Mixon, U.S. Army (Retired). But the full tragedy of the effects of PTSD struck home when the heart-breaking story of 36-year old veteran Staff Sgt. Brad Eifert who tried to commit suicide by firing on police officers became a front page New York Times story a few months ago.  Fortunately, Sgt. Eifert didn’t kill himself or anyone else, but it could have been a tragedy.  But then, in spite of the efforts of a compassionate judge, tireless lawyer and inspired Vet Court, who agreed that untreated combat stress disorder or PTSD had  motivated his behavior, he still was about to be sentenced in the absence of any recourse.

 SFTT:  What did you do?

Eilhys:  Within a day or two, I was able to speak with the trial judge, the lawyer representing Sgt. Eifert, the Vet Court Rep and his probation officer and then together John Batiste and I got him admitted to Warriors Salute to serve his probation there – in treatment.  A goal achieved because of inspired teamwork on every level from Michigan, Connecticut, and Rochester, New York.  I’m thrilled to report that Sgt. Eifert will graduate from the program next month with a second chance at life. And all of us are now in the process of delivering several more candidates from the court system to Warrior Salute – and their rightful chance to regain their interrupted young lives.

 SFTT:  You must be so pleased to have rescued this young man?

Eilhys:  “Pleased” is not the right word.  It is our “obligation” to help our returning heroes.  For each person that we’ve been able to reach out to, there are hundreds – if not thousands – of others that need the specific hands-on sanctuary that we’ve been able to offer.

SFTT:  What’s the answer?

Eilhys:  Well, SFTT is assembling a panel of leading experts in this field to determine “best modalities” for treating PTSD and hopefully eventually replicate the Warrior Salute state of the art and science program that evolves at strategically located regional treatment centers. In fact, Dr. Henry Grayson is hosting a seminar for Warrior Salute clinicians on December 3rd in New York City to introduce his highly effective treatment. Hopefully, SFTT   will be sharing highlights on the SFTT website.  And we’ve started developing a national/local resource with several Senators and Congressional representatives to provide an interactive list of public and private treatment options in their states.

SFTT:  This sounds very exciting, but the task seems quite overwhelming.  How can people help?

Eilhys:  Well, it’s key that we both destigmatize PTSD and raise public awareness of the terrible problems faced by our returning warriors.  The social and economic consequences to our society are staggering should we let our brave heroes down.   While many people have given truly valuable time to get our PTSD initiative off the ground, funding is required at this point for a meaningful impact.  Hopefully enough concerned citizens will join the effort by contributing anyway they can. The more members and active volunteers the greater SFTT’s ability to affect change.

SFTT:  Thank you Eilhys.  I am sure SFTT readers will flock to help our brave warriors in their hour of need.

PTSD has alarming social consequences.  If you want to help, please consider becoming a member of SFTT.  Our brave warriors will need your support long after the smoke has cleared from the battlefield.

Richard W. May for SFTT

 

 

 

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The US Military Budget Debate

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The US military budget is roughly $700 billion  a year and defense leaders are being asked to cut costs of this sizable and growing budget.    According to a recent article published by NPR, the defense budget represents approximately 50% of total discretionary federal spending.   While the Department of Defense has committed to cut $450 billion in spending over the next ten years, the sad reality is that overall military spending is likely to remain at very high levels when measured as a percentage of our Gross Domestic Product (“GDP”).

Secretary of Defense Leon Panetta has suggested that any further cuts would most certainly undermine our defense capabilities, but would they?  Several months ago, SFTT contributor Jim Magee offered his suggestions to cut several useless programs and bureaucratic fluff from our military budget and indicated that there were plenty of other programs that deserved the axe.

When it comes to a debate about our serious cuts if it were to compromise our military security.    When considering the large numbers involved, how is one to know if we are more or less secure by adding $100 billion or cutting $100 billion from current levels of spending.     Do more expenditures mean improved security?  It is impossible to answer that question without knowing where the incremental expenditures will be made, but most Congressional leaders are not prepared to be on the side of a debate to demand a more efficient accounting of military expenditures when the safety of the US is at stake.

For this reason, the proponents of increased military spending will always win the debate even if there is credible evidence that our military procurement system is broken.   How do we know?   Well, no less of an authority as the Department of Defense Chief of Acquisition says so.

While one doesn’t want to minimize the challenges ahead, particularly the escalating medical costs of treating our war veterans for PTSD and other medical ailments, Congress and our military leaders must make some tough and realistic decisions without raising the specter of compromising US security.  Do I think this will occur?  Of course not.

 

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Dream Therapy to Treat PTSD

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Several news organizations have commented on a new treatment using comforting sights. The world will be one he’s built himself in visits to his clinic, where, using biofeedback to track his response, he has trained himself to relax when he sees these images.”

The program reminds me of Stanly Kubrick’s Clockwork Orange, where “society” tries to rehabilitate the main character Alex DeLarge through a programmed treatment to alter behavior based on stimuli to a series of slides and film clips.  The issue with this dream therapy treatment is whether it is therapy or something different: mind control or brainwashing.

While SFTT does not want to disparage this new treatment, we reported earlier  the US Army’s controversial “Comprehensive Soldier Fitness Program” where it appears that we are programming or engineering young men and women to respond in a certain manner of a set of troubling physical and mental stimuli.

SFTT’s panel of medical analysts will be commenting soon on this dream therapy program; however, we should be very careful how we characterize or define therapy.  In my opinion, therapy helps provide the patient with the tools and self-confidence to deal with his or her particular set of circumstances.   Is brain engineering or programming considered therapy?   I’m not sure.  It is certainly not a black and white issue.

Richard W. May

 

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VA Care for Patients with PTSD

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As military service members deployed in Iraq begin come home, the alarm bells are beginning to sound as the Veterans Administration (“VA”)  now seems over-stretched to deal with alarming number of cases of service members with PTSD.

According to a recently published Rand study, excerpts of which are reported  by Health Affairs, “There is a large and growing population of veterans with severe and complex general medical, mental, and substance use disorders including schizophrenia, bipolar I disorder, PTSD, and major depression. Substance use disorders may occur alone or in combination with any of these other diagnoses. Over the five-year study period, the population of veterans with mental and substance use disorders grew by 38.5 percent, with the largest growth occurring in veterans receiving care for PTSD. Half of the veterans with mental and substance use disorders also had a serious medical disorder. Study veterans also accounted for a much larger proportion of health care use and costs than their representation among all veterans receiving VA health care. “

The sad reality is that this report is based on statistics compiled by Rand for 2007 and, as such, the severity of the problem is likely to be far greater for veterans with additional deployments past 2007.

As Jason Ukman of the Washington Post reports, “the cost of medical care for veterans is expected to skyrocket in coming years.”   According to sources referred to by Mr. Ukman, “The number of veterans seeking mental health services has increased sharply. Last year, more than 1.2 million veterans were treated by the VA for mental health problems. In fiscal year 2004, the figure was roughly 654,000. The largest increase has been among veterans diagnosed with PTSD.”

The severity of this problem is already taxing over-stretched VA resources and is likely to increase as  troops in combat zones return home.  How we deal with these troubled warriors will say much about our military and political leadership.

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PTSD: Light at the End of the Tunnel?

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Mental health problems and self-destructive behavior have always been difficult subjects to discuss, let alone diagnose and cure.   Since the 2008 Rand Corporation study on Post Traumatic Stress Disorder (“PTSD”) entitled Invisible Wounds of War:   Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery,  there has been growing preoccupation with the high incidence of psychological disorders affecting military men and women serving in Iraq and Afghanistan.  According to the Rand study, it is estimated that one in five veterans suffers from some form of mental disorder.

In February of this year,  Mental Health America (“MHA”) hosted a proof-of-concept conference consisting of 35 experts to help achieve the following goal:

By September 11, 2011, all­ active duty, retired, or separated National Guard, and Reserve Operation Enduring Freedom (OEF; Afghanistan) and Operation Iraqi Freedom (OIF; Iraq) veterans, and their dependents, will have access to unlimited, free mental health counseling which meets an established nationwide standard for military-specific, trauma-informed care.

While this goal is still far from being realized, the MHA conference had what we consider to be the finest assessment of the current difficulties we have in dealing with this growing epidemic.  Because of it relevance to providing our brave warriors with access to the best treatment for PTSD, we are quoting MHA’s Key Discussion Points in their entirety.

MHA’s Key Discussion Points

  • Little has changed in the three years since the 2008 RAND study.  Approximately 18.5% of deployed personnel will experience PTSD or depression.
  • The group concurred that there are currently several significant barriers to care for military family members facing mental health challenges:
  • Lack of awareness of existing programs
    • Personal shame or embarrassment (internal stigma)
    • Organizational discrimination (external stigma)
    • Cost
    • Bureaucratic, burdensome process
    • Availability of trained expertise
    • Quality of care
    • Accessibility (phone, online, face-to-face)
    • Friendliness of initial contact
  • Passive programs whereby the military member is required to find the program and take a series of steps to receive benefits from the program are probably not adequate to fully meet the need.  Several group members felt strongly that programs needed to assertively reach out to military families to offer help.
  • One participant cited recent studies that indicate that, contrary to common belief, suicides appear to have no statistically significant correlation to deployments but occur evenly throughout the current worldwide,U.S. military population.
  • The most effective current programs empower the client to define precisely what help s/he needs and place the client in contact with “culturally competent” advisers/counselors.  There are many programs offering services that are inappropriate for the unique mental health needs of military service members and their families.
  • To have significant impact and to reach the target population effectively, programs must ensure that their representatives are “culturally competent”, that is, sufficiently familiar with the military culture to quickly establish a bond of shared life experience with the individual asking for help.
  • National efforts should focus not on developing new programs but on creating systems which lead those in need to effective existing programs.  This will require a nationwide, single-message marketing effort and a “navigator” function whereby a trained expert partners with a client to connect them with the best and most appropriate programs available within their community.
  • The availability of confidential care—within the legal constraints that mandate reporting potentially harmful behavior—is essential.  Our society in general and the military culture in particular, will not eliminate the stigma associated with mental health issues in the foreseeable future.  Thatsaid, the American public is now probably more receptive to the need for integrated care than ever before as a result of the wars in Iraq/Afghanistan.
  • Counseling must be evidence-based.  There was general consensus at the conference that the scientific community knows how to treat posttraumatic stress and its co-morbid conditions such as depression, substance abuse, etc.
  • Several in the group highlighted the need for a “navigator” to lead a military service member or family member through the maze of available resources in their communities and link that client with those programs.
  • Counselors should, whenever possible, be trauma-informed.
  • Any solution must serve military service members and their families not located within a military community or near a Department of Defense (DoD) or Department of Veterans Affairs (VA) treatment facility.
  • Community programs and services that are currently offering help must be consumer ratable in order to begin to establish a “gold standard” of care and to identify those programs that are working and those that are not.
  • There was unanimous consensus within the group that peer counseling works to establish a bond with the service person and enhance engagement, and that it should be a part of any comprehensive solution.  Specific features of an effective peer counseling network include:
    • Process to properly screen peer counselor applicants
    • Peers should be paid for their services
    • Peer specialists who are culturally competent
    • Peer specialists who are trauma-informed
    • Continuity; a sustained, trusting relationship with the client
    • Direct, clinical peer supervision and support
    • Systemic indicators to identify “compassion fatigue” among the peer counseling network
    • Near permanent client/peer assignment
    • Casual, relaxed atmosphere
    • Formal peer training and certification
    • Precise job descriptions
    • Ideally, phone or face-to-face counseling only, with an emphasis on face-to-face counseling

SFTT will be devoting an increasing percentage of its attention and resources on helping our brave warriors and their families to deal with the crippling effects of PTSD.  It is important to note that the consensus among the MHA experts that attended this conference is that “National efforts should focus not on developing new programs but on creating systems which lead those in need to effective existing programs.”   This panel of experts argues that we have the necessary resources to deal with the problem and help these brave warriors, but that we need “to establish a ‘gold standard’ of care and to identify those programs that are working and those that are not.”

SFTT is committed to that effort and over the next several months will begin unrolling a national resource center to our brave warriors find the support they need and, most importantly, deserve!

If you would like to help, consider becoming a member of SFTT.

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