Curing PTSD without talking about trauma

NY Times   Individual therapy is not the only way to treat PTSD. In January, a young man with the nickname of Trin (he asked that his real name not be published) sat down in a small, drab, room at a Veterans Affairs clinic in New Orleans with nine other men. All were veterans — of Iraq, Afghanistan, Operation Desert Storm or Vietnam; Trin had served in Iraq. All had PTSD. The men took chairs facing each other around tables pushed into a square, along with two women, who were running the group.

The facilitators asked everyone to do three drawings: of how they felt, where they were and where they wanted to be. Trin drew himself with no facial features. The next week, the facilitators put on some music and everyone stood up, faced a wall, and bounced to it. At other sessions they took large sheets of paper and colored in their family trees, with different colors for divorces, early deaths, conflicted relationships. And at almost every meeting over 10 weeks, they practiced conscious breathing and mindfulness.

“When they asked us to draw and color, people were rolling their eyes,” Trin said. “We had older gentlemen, and some people might have thought this is kind of soft — not my lane.” [...]

The Center for Mind-Body Medicine’s program — the one Trin did — is the most comprehensive of all of them, giving participants a variety of different strategies to choose from: breathing, meditation, guided visual imagery, bio-feedback, self-awareness, dance, self-expression, drawing. And it is the one with the strongest evidence that it works to cure PTSD. In a trial in a Kosovo high school, students with PTSD who did the 10-week program had significantly greater reductions in PTSD than a control group of students assigned to wait for the course. Other before-and-after studies (with no control group) in Gaza have found an 80 to 90 percent reduction in PTSD with the technique, and those results still held months later. This is significantly better than any currently used individual therapy. [...]

Mind-body medicine and the other alternative therapies, moreover, may be more attractive to soldiers than the individual treatments, which have a 20 percent dropout rate. Both C.P.T. and prolonged exposure ask the patient to relive his trauma — an upsetting prospect for many soldiers. Some veterans avoid psychotherapy because they do not want to be singled out, judged and labeled deficient.

The alternative medicine groups, by contrast, have a dropout rate of virtually zero. Members can talk about their past trauma if they wish, but there is no pressure to do so. Instead, the groups are centered on the present, helping members to learn practical skills they can employ immediately. The facilitator does not sit in judgment — she’s a participant in the group, sharing skills she might use herself for better sleep or stress reduction. Everyone, after all, can use help dealing with the stress of re-entry to civilian life. Going to a skills group instead of psychotherapy could remove much of the stigma of treatment.