Fort Bliss Center Using “Holistic” Approach To Treat PTSD
May 14, 2008
PTSD is a topic that I covered a lot here at ASM. It’s a topic that’s on the minds of many of us, as we deal with our Troops, whether that’s through the various Troop Support Organizations we’re involved with, through our jobs or because we have a family member who’s in the military. The treatments for PTSD are evolving as more and more Troops are returning from combat zones and experiencing difficulties readjusting to life at home. PTSD is being addressed in the military as well as in the VA centers across the country.
At Fort Bliss, their new treatment program is one that is revolutionary in the way PTSD is approached and treated. The program, the brainchild of clinical psychologist John E. Fortunato, is one that uses a holistic approach to treating PTSD. According to Fortunato, his proposal wasn’t one that was met with open arms initially, because it involved utilizing holistic approaches such as yoga, massage therapy and other nontraditional approaches in the program. Fortunato was driven to develop the program, from his frustration in seeing Soldiers with PTSD who had difficulty coping, being forced out of the military against their wishes. He pushed for the program and was able to gain approval for his prototype program. Fortunato was convinced that the traditional methods of treating PTSD weren’t long enough in duration, weren’t intense enough or comprehensive enough. So he set his sights on creating a program that would address all aspects of PTSD and treat the “whole soldier.” The Fort Bliss Restoration and Resilience Center opened last summer. The participants in the program, all volunteers, typically take about half the amount of medication that people in the more traditional mental-health programs take.
“That’s because we’re doing a bunch of other things,” Fortunato said.
One of the symptoms of PTSD that many Soldiers experience is hyper arousal. At the center in Fort Bliss, staff treat those symptoms with techniques such as medical massage and “Reiki” which is a Japanese stress-reduction technique. Accupuncture has also proven to be extremely effective, in treating the anxiety, panic and tension induced physical pain that many of the Soldiers experience.
According to Fortunato, there is a big physical component to the program as well. Soldier’s who participate in the program are required to walk at least 10,000 steps per day, which includes a 45 minute power walk. They are also involved in playing water polo three times per week, which forces them to interact with other people. Often, people suffering from PTSD would rather avoid interacting with other people, preferring instead to isolate themselves from family and friends.
“That’s another piece of PTSD. They want to socially isolate. They don’t like to interact with other people,” he said. “So we have them interact with the people they feel most comfortable with: other Soldiers with PTSD.”
The Soldiers are also involved in field trips throughout the program to places such as the mall and Walmart. Two places that they’d rather avoid, because those places are typically too big, too crowded and too noisy. They’re taught ways to regulate their stress level, so that they can handle the stress of the crowds and noise in those environments. Concentration and memory are other symptoms of PTSD that are addressed. Fortunato says that the programs mix of physical activity and calming techniques, appears to help with those areas. Soldiers also do yoga, tai chi, Quigong, which is a centuries old Chinese self-healing technique, as well as biofeedback.
“We have a meditation room that looks like it came out of a Zen monastery,” Fortunato said.
Though most people don’t think about it, PTSD also can cause damage to the “learning center” of a person’s brain. According to Fortunato, that’s due to the fact that the body’s stress hormone is elevated too high and for too long - quite common in combat troops.
“The good news is, the learning center is one of only two parts of the brain that can grow new cells,” he said.
To address this aspect of PTSD, participants are required to sit at a computer several times a day and work on mental exercises. This helps them to regain their cognitive functioning. With the goal of confronting and treating the “whole Soldier”, emotional and spiritual aspects are also addressed.
“Few Soldiers come back from war without images and events in their head,” Fortunato said. “Many ’suck it up and soldier on’ in the combat theater, because they have no choice. But when they return home, these issues can percolate to the surface as nightmares and other problems.”
To address these issues, the program uses “rehearsal therapy” to help them confront their most painful memories and experiences of combat. The Soldier tells that story, over and over again, until they’ve emptied it of it’s emotional punch. While they’ll never forget what happened, it doesn’t have to have the “grip on their guts” that it once did. Many Soldiers also find that combat has shaken their core spiritual beliefs and values as well. Chaplains work closely with them to address the spiritual aspect of their struggle with PTSD.
“We weren’t doing much to address this before,” Fortunato said, “But it’s critical to a Soldiers healing.”
The new prototype approach to treatment of PTSD seems to be successful so far. None of the techniques are new, they’ve just incorporated them all together, to treat the “whole Soldier.” 12 of the 37 Soldiers who initially volunteered for the program have now graduated and returned to their units. One of the recent graduates was a Soldier who was in a catatonic state last August and is now free of all signs of PTSD. According to Fortunato, only two of the 37 washed out of the program and were medically discharged from the Army.
Fortunato said that the program isn’t for everyone. He says thatthe program is a difficult one, with participants being required to participate in treatment 35 hours per week, which includes daily psychotherapy, daily group therapy and integrative medicine. Participants typically are busy from 8:30 am to 4:30 pm. Because of this, Fortunato said that the Soldiers have to be highly motivated to be able to take part in that much treatment each week. There isn’t a set timetable for completing the program, however Fortunato said that they’re seeing that 6 months appears to be the optimal time for most of the Soldiers who’ve participated.
“As long as they are working hard, we are going to hang with them,” he said.
Fortunato feels that the cost of treating the Soldiers, between $14,000 and $20,000 is a bargain, compared to the cost to recruit and train a new Soldier and to provide lifelong disability payments and medical care to a Soldier who is discharged. He estimates that cost to be around $400,000. He’s convinced that the program is in the best interests of the Soldiers, and the Army as well.
Earlier this month, Defense Secretary Robert Gates visited the Restoration and Resilience Center at Fort Bliss. He was impressed and called the visit an ‘extraordinary experience.’
“They are doing some amazing things here in terms of helping Soldiers who want to remain Soldiers but who have been wounded with post-traumatic stress disorder,” Gates said. “It is a multi-month effort by a lot of caring people and they are showing some real success in restoring these Soldiers.”
Gates went on to say that he considered the center an example of the new approaches the military is taking to ensure Soldiers suffering from PTSD, receive the care they need. He said that he’s considering the idea of possibly replicating the Fort Bliss prototype to other military posts. I’m excited by this approach. It’s something that I’ve thought for a long time, would be a more effective way of helping our Troops deal with the effects of PTSD. I hope that the program continues to show success and their techniques and ideas can eventually be used at other military installations.