Veterans and PTSD

There’s been quite a lot in the news about PTSD and veterans in the last few weeks. The latest is a leaked email from a VA psychologist discouraging the diagnosis of PTSD, courtesy of Ken Pope. The article appears in the Washington Post. There’s also been an emerging discussion about whether veterans diagnosed with PTSD should be eligible to receive the purple heart. And furthermore, a Department of Defense press release outlines a comprehensive treatment of PTSD (see below). The bottom line is that diagnosed PTSD is going to cost the government big bucks. Here’s quote on projected costs:

A Rand Corp. report released in April found that repeated exposure to combat stress in Iraq and Afghanistan is causing a disproportionately high psychological toll compared with physical injuries. About 300,000 U.S. military personnel who have served in Iraq or Afghanistan are
suffering from PTSD or major depression, the study found. The economic cost to the United States — including medical care, forgone productivity and lost lives through suicide — is expected to reach $4 billion to $6 billion over two years.

A recent program being implemented by the department of defense takes a more holistic approach than many of the usual psychological treatments. This is good news for veterans, and lines up with the findings of trauma expert Van der Kolk. The treatment is comprehensive, it’s not hard to see why it’s costly:

The new program is the brainchild of clinical psychologist John E. Fortunato, who uses a holistic approach to treating PTSD at the new Fort Bliss Restoration and Resilience Center.

Fortunato conceded that his proposal “wasn’t an easy sell” initially, particularly because it wove yoga, massage therapy and other nontraditional approaches into its treatment program. But driven by the frustration of seeing soldiers with PTSD forced to leave the Army
against their wishes, Fortunato pressed forward and won approval for his prototype program.

Many PTSD-afflicted soldiers experience “hyper-arousal,” which the center staff treats with techniques like medical massage and “Reiki,” a Japanese stress-reduction technique. Acupuncture has proven to be “extremely effective” in treating the anxiety, panic, and tension-
induced physical pain many experience, Fortunato said.

There’s a big physical component to the program, too. The soldiers must walk at least 10,000 steps a day, including a daily 45-minute “power walk.” They play water polo three times a week, forcing interaction that Fortunato said many would rather avoid.

“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.”

Field trips during the program take the soldiers to the local mall and Wal-mart, “two hells” to many of them because they’re too big, too crowded and too noisy, Fortunato said. “We teach them ways to regulate their stress level so they can handle those kinds of environments.”

Many afflicted soldiers have trouble with concentration and memory, Fortunato said. For them, the program’s mix of physical activity and calming techniques appears to help. They do yoga; tai chi, a Chinese martial art; “Quigong,” a centuries-old Chinese self-healing method; and
biofeedback, which uses the mind to heal the body. “We have a meditation room that looks like it came out of a Zen monastery,” Fortunato said.

Kalea Chapman, PsyD


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Clinical Psychologist practicing in the Los Feliz neighborhood of Los Angeles, California.

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