The Science of Sustainability

Can Meditation Ease PTSD in Combat Vets?

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Among veterans, mental disorders such as post-traumatic stress disorder are epidemic. The Department of Veterans Affairs estimates that one in every four Iraq or Afghanistan vets is suffering from PTSD. It’s one reason suicide is now the leading cause of death among active-duty soldiers.

This crisis has led the VA to explore treatments that would have been considered decidedly from-the-fringes a generation ago. Some of that work is taking place at the Menlo Park division of the VA Palo Alto Medical Center.

"My little safe zone"

John Montgomery is a Vietnam vet with a bushy gray mustache and a tattoo of a scorpion on each forearm. During his time here in the residential PTSD program, he’s been thinking a lot about his life before the war.

“We were dirt farmer kids,” he tells me. “It was the summer of 1957. We were irrigating 80 acres of cotton. My brother was yelling off in the distance and I was just laying back on a haystack…”

Montgomery trails off for a moment, lost in the memory.

“Yeah, that's my little safe zone,” he says.

But when he talks about Vietnam and what he saw there, something in his voice changes, ramps up.

The image he can’t shake – even now, nearly four decades after his return – is of Vietnamese children trying to kill him.

“Our society teaches us to go to school, live with our families and stuff, not to blow somebody else up," he says, as his voice grows louder. "They were after you, you know?”

Today, after what he calls decades of failed relationships and self-abuse, Montgomery is finally getting help for PTSD, a diagnosis he hadn’t even heard of until a few years ago.

Part of his treatment is a twice-weekly guided meditation session.

On a recent afternoon, five men settle into armchairs arranged in a circle. One younger vet in board shorts and flip flops lies down on the floor. Two of the vets served in Vietnam; three younger men served in Iraq. A couple of therapy dogs, golden retrievers named Eldridge and Elaine, settle at their owners’ feet.

Leah Weiss — a meditation trainer from Stanford’s Center for Compassion and Altruism Research and Education — begins to lead. “Let’s start with three deep cleansing breaths,” she tells the men.

An old approach, revisited

What’s taking place in this room has been happening on a small scale for decades, says Stephen Xenakis. He’s a retired brigadier general who formerly oversaw the army’s medical system.

In the 1970s, Xenakis worked as a psychiatrist with Vietnam vets at the former Letterman Army Medical Center, in San Francisco’s Presidio. He says meditation was one of several Eastern-inspired treatments he and others were experimenting with.

Even back then, he says, it was clear that meditation could help calm the nervous systems of not just veterans, but prisoners and people suffering from trauma.

But getting the VA to integrate meditation into its standard treatment was tough, especially after the late 1980s, when drugs like Prozac came on the scene. The drugs were easy to study and prescribe, cheap to administer. For a lot of patients, they were very effective.

“I think in many ways,” he says,” these other options that we had learned were helpful back in the ‘70s kind of fell off to the wayside”.

In recent years, it’s become clear that drugs are no panacea. Side effects are common. And for about half of PTSD patients, the drugs don’t work at all. A recent report from the Institute of Medicine concluded that "the evidence is inadequate" to demonstrate that SSRIs, like Prozac, are generally effective in treating PTSD.

Those limitations have renewed interest in other approaches, such as meditation.

What meditation may do to the brain

Back in the TV room at the Menlo Park VA, Weiss’s voice is calm, almost hypnotic. She tells the men to “bring to mind a stranger, maybe someone you pass by when you’re commuting.”

“Consider,” she instructs them, “that just like me, this person has had ups and downs in his or her life. Just like me, this person has had goals and dreams. Just like me, this person knows what it’s like to be disappointed, or afraid.”

This particular meditation -– it’s called “compassion meditation” — aims at a specific and widely held hypothesis about what is happening in the brain of someone like John Montgomery, the Vietnam vet.

The idea is that in combat, a switch — a fight-or-flight survival mode located in a part of the brain called the amygdala — has been turned on, and become essentially stuck. Meanwhile, another part, the frontal cortex, takes the backseat. And that’s critical. Because this part of the brain helps us relate to other people.

“The frontal cortex,” says Stephen Xenakis, “is what allows us to have relationships and families, what gives us a sense that there are rules of society and morality. It's part of what is different about our brains from even other primates, and clearly other mammals."

Whether or not this kind of meditation is effective in treating PTSD is, from a scientific standpoint, still unknown. Studies have shown that repeated sessions can increase "positive affect" and "social connectedness," both of which are deficient in PTSD patients, according to a 2012 meta-analysis on the efficacy of different kinds of meditation in treating PTSD.

Meditation in general, wrote the authors, "holds some promise" as a treatment for PTSD.


Advice from an older veteran

After about 20 minutes, Weiss asks the men to open their eyes and to reflect on what the meditation made them feel.

Most of these men have been taking part in these sessions for a couple months now. They’ve been listening to CDs with Weiss’s voice back in their rooms. They say they feel calmer, more compassionate to other people.

But one of them, Esteban Brojas, is newer to this. Brojas served during the Iraq invasion in 2003. In some ways, he says, it’s like he’s still there.

Coming back to civilian life has been “a culture shock,” he says. “You’re still with that adrenaline; you’re still hyper-vigilant.”

Brojas’s wife gave birth to their daughter while he was in Iraq. When he came back, he didn’t know how to hold her. “After taking someone's life? It’s hard,” he says.

As he speaks, Brojas’s voice starts to tremble and speed up. He rubs his hands together quickly as he rocks back and forth in his armchair.

“After the fact that you're going into a building and there's a grenade being popped and there's a woman and a child in there? It's hard. To come home and hold your daughter in your hands?”

Doreen, the therapist steps in. “I would say…” she begins, tentatively.

But it's John Montgomery, the Vietnam vet across the room, who knows what to do.

“You're not there,” he tells Brojas, firmly. “You're right here. You're not there right now. You’re in it. It'll take time. It's like a wave coming. It’ll subside.”

Montgomery’s doing something he thought he had forgotten how to do: feel compassion. In a few weeks, he’ll leave this program and go back to his family – a different man, he hopes, than he was when he came here.

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About the Author ()

As a radio reporter for KQED Science, Amy's grappled with archaic maps, brain fitness exercises, albino redwood trees, and jet-lagged lab rats, as well as modeled a wide variety of hard hats and construction vests. Long before all that, she learned to cut actual tape interning for a Latin American news show at WBAI in New York, then took her first radio job as a producer for Pulse of the Planet. Since then, Amy has been an editor at Salon.com, the editor of Terrain Magazine, and has produced stories for NPR, Living on Earth, Philosophy Talk, and Pop Up Magazine. She's also a founding editor of Meatpaper Magazine.
  • peter_rabbit_the_original

    Thanks for the article. Extremely important topic.

    The medical-educational-industrial complex is clearly geared towards education and profit by pharmaceutical and other "health for-profit" corporations. So, instead of making use of meditation and other well known viable thousand-years old practices, such as nutrition, breathing and visualization techniques, or yoga, "doctors" and other "health professionals" have been indoctrinated in the pop-a-pill-make-pharma-a-billion allopathic medicine.

    The suffering of so many who received no help, and probable further injury by the myriad of pharmaceutical side-effects of mental health artificial pharmaceuticals, has at long last revealed the near-fraudulent shortcomings of mass-consumption pharmaceutical remedies, which create more problems than they heal, and the wisdom and viability of such "natural alternatives" as nutrition, breathing techniques, yoga, and meditation.

    Hope to see more of these journalistic endeavors, so as to decrease unnecessary suffering.

  • BILL IN RECOVERY

    CHANTING HELPS TOO.
    FOR ME, CHANTING IS EASIER, MORE PHYSICAL, ACCESSIBLE, AND DOES NOT REQUIRE I CALM MYSELF AND FIND FOCUS BEFORE STARTING.
    I LEARNED TO CHANT FROM MY NEIGHBOR. NICHERIN BUDDHISTS CHANT AT THEIR CENTER BEHIND PIEDMONT LUMBER IN OAKLAND, CA.
    I NOW RELY ON CHANGING DAILY AND HAVE BEEN DOING IT WITH MY WIFE FOR 1 YEAR.
    HELPS IMMENSELY WITH MY DEPRESSION.
    WOULD PROBABLY WORK WELL WITH MEDITATION AS WELL.

    BILL, WITHOUT BOOZE FOR 28 YEARS AND CHANTING

  • Rawrface

    My older brother is a veteran. He was Infantry and he saw a lot of things he didn't need to. I saw the pain in his eyes everyday.
    I meditate daily, personally, and I felt an overwhelming urge to show him. I googled forever to find a way to get it across to him [he's closed minded a bit] and I found something even his short attention span can follow [lol jkjk]. It's a technique used to enter a sort of 'instant' zen meditation. It DOES take some reading, but after you comprehend… Bliss. Here's a link to it if anyone is interested: http://ow.ly/eAsF6.
    DEFINITELY can't hurt, this can only help you.
    Metta, <3

  • Sad sister

    My brother returned home from Iraq last year and just entered civilan life in Oct. He is living at home with us for now, but I think he may be suffering from some symptoms of PTSD. I am not sure how to deal with this. I am trying to be supportive, but he get very aggitated very quickly and screams verbally degrading things in front of my two year old son. I understand the need for compassion, but I am not sure that I can keep this up while he waits for his VA paperworks to process to help him get treatment. Someone please help?? I love my brother so much, but this is not the brother I had four years ago.