No Talking, No Drugs—Spec-Ops Vets Pioneer Quiet PTSD Therapy
With a seemingly endless backlog of cases facing the armed forces, a new treatment—Accelerated Resolution Therapy—is giving new hope for patients.
HOLIDAY, Florida – You feel a little foolish, but you never have to say a word—about remembering your own blood pooling warm around you, with its iron smell, the reek of a thousand matches invading your nose, or the surge of pain, then panic at not being able to move.
That’s what I remembered from 10 years ago, when a car bomb ripped through an army foot patrol, my CBS News television camera team, and me.
You need say nothing out loud. You just keep your body still and your eyes follow the tic-toc of the therapist’s hand going back and forth, while you think silently to yourself about the sights, sounds, and emotions that you want to loosen from your head, heart, and soul.
It’s called Accelerated Resolution Therapy, a new tool to treat acute trauma, post-traumatic stress, anxiety, and depression that is being adopted into the menu of treatments available at Walter Reed and other army centers, and a vanguard of trailblazing veterans groups.
Partly because it works so fast, military leaders hope it could help handle a backlog of PTSD cases, and encourage more troops to seek treatment. It requires no surgical procedure, unlike another new-ish treatment called stellate ganglion block, in which local anesthetic is used to numb or block part of the nervous system.
The other advantage: unlike talk therapy or other commonly used methods, where the subject shares what’s bothering them out loud, the soldier need share nothing with the therapist.
Instead, the patient watches the therapist’s hand with their eyes, while bringing up in their own mind the disturbing memories or images, first tuning in to how the body reacts. Through deep breathing, the patient focuses on the tension and releases it, and then focuses on the memory piece by piece, progressively remember it, then mentally painting over the image or memory, and finally replacing it with a new image. It doesn’t erase the memory, but helps it fade. The therapist need hear nothing.
By that, she means how many snapshots of things you saw, felt, or did that you can’t get out of your head. “It can erase images from view, and what they are left with is just the facts, which are stored in the different part of the brain,” she explains. The other upside of the therapy: the therapist doesn’t have to share the service member’s nightmares.
“Therapists are happier. They have less burnout and compassion fatigue,” Rosenzweig explained.
Rosenzweig’s barely concealed frustration at spending the last decade trying to get the technique recognized hasn’t always helped advance her cause, but ART has finally been federally approved, thanks in large part to a $1 million University of South Florida study, funded partly by the Pentagon but mostly by Outback Steakhouse co-founder Chris Sullivan.
The technique seems to work by mimicking what scientists think the brain does at night during rapid eye movement or REM sleep. Neuroscientists believe the brain cycles through the day’s memories, making sense of them and filing some while discarding others, or storing them more deeply, according to University of South Florida’s Dr. Diego Hernandez, who helped run the clinical trial of active duty troops and veterans.
Instead of classifying post-traumatic stress disorder as a “fear-based reaction where the brain is overloaded and creates an illness,” Hernandez said, the idea with ART is that these are just bits of film stuck in the brain’s projector that have to be untangled and filed properly. And it’s not just for troops but for anyone who has dealt with trauma and loss.
“We can even process the memory of the doorbell ringing for a Gold Star family,” Hernandez said, referring to the pain of the horrifically life-changing moment for a military family when a notification team comes to the door to tell them their loved one is lost. ART can help them ease the anxiety that fills them when they hear a doorbell or a phone ring, bringing them back to that awful moment.
The University of South Florida study—the second of a series, with the largest yet underway—caught the attention of PTSD guru and Army research scientist Dr. Charles Hoge.
“You can sometimes see very dramatic response to treatment after one or a few sessions of treatment,” said Hoge, the senior scientist at Walter Reed Army Institute of Research and the Office of Army Surgeon General. He took Rosenzweig to Washington, D.C. to train a pilot group of his therapists.
“Several of us have seen patients recover from pretty significant PTSD after one, two, or three sessions,” Hoge said.
He calls it a top tool to use alongside others like prolonged exposure therapy, EMDR (eye movement and desensitization and re-processing), and cognitive behavior or “talk” therapy.
“One of the real advantages of ART is it’s very body focused,” Hoge said, referring to the way the therapist instructs the recipient to focus on how the memory brings tension to the body. “It helps a person not be physiologically triggered,” say when a car backfires and it sounds to the serviceman like a bomb blast, and they jump or hit the deck.
Hoge said he wants to see more research, like the third wider study that’s now underway at the University of South Florida, but said there’s already “interest in getting clinicians trained at additional posts.” He’s also not sure it will work with people with years and layers of trauma, and is careful not to say it’s better than the other therapies he works with.
It’s hard to find critics of ART, because it’s so new. Practitioners of some of the other more tested treatments say it’s just a souped up version of EMDR, but Rosenzweig said her system guides the user to go beyond uncovering the memory, to “resolving” it through visualization.
Rosenzweig hopes to expand services to veterans and civilians as well. She’s in talks with the Chris T. Sullivan Foundation to provide training for therapists across the U.S. and beyond.
“This therapy has been proven to help even kids—anyone who has suffered any kind of trauma,” said Patricia Thompson, executive director of Tampa-based foundation, in an interview. “Chris just thinks this can help a lot of people.”
For former Green Beret Brian Anderson, ART was the key to erasing the nightmares and daytime hallucinations of his two best friends, both killed in Afghanistan during a 2010 firefight with insurgents.
“I would actually drive down the road and look at the car next to me, and Calvin would be driving that car,” Anderson said. “I would walk through the mall and I would have Mark walk by me. I would have images of bullets going through my head and feel rage.”
Anderson had tried everything else the military had to offer to erase the intrusive images, including several bouts of prolonged exposure therapy, with no effect.
After he left the army, he came across ART on the web, and called Rosenzweig for treatment.
“One session of Accelerated Resolution Therapy, and all those images I was having trouble with went away,” Anderson said. “I still had other triggers related to combat that I needed to work through and since then I’ve gone through maybe 15 or 20 sessions of ART for various things.”
Anderson founded the Veterans Alternative in Holiday, Florida, to offer the services for free to the 35,000 veterans who live in the immediate area, and to active duty folks from nearby Central Command or Special Operations Command in Tampa, willing to make the trek. A British Special Forces veteran even flew in recently and stayed a couple days to do an intense series of treatments.
There is no bar with $1 Bloody Mary specials or pool tables, in contrast to veteran’s clubs of yesteryear like ones just around the corner from the Veterans Alternative. Anderson and his team combine ART with classes of CrossFit, TRX, and integrative yoga taught by co-founder and Air Force veteran Janel Norton. Anderson and Norton have plans to expand to Fayetteville, North Carolina, near Ft. Bragg as well as to California.
One of the club’s volunteers is a Vietnam veteran, who was referred to the place by his VA psychologist who hadn’t been able to make headway using traditional therapies.
“I had the bad memory, and after my first session, I thought instead about after a mission, sitting around with the guys smoking a doobie, and drinking beer,” said Jerry Sableski, who served in combat in Vietnam from 1968-’70, patrolling the Mekong Delta south of Saigon.
“Now every time my mind starts to go to that bad thought, poof, right away, I’m sitting there smoking a doobie with my buddies,” he said. He declined to describe the “bad thought.” He hasn’t shared those thoughts with anyone, from his wife to the Veterans Alternative therapist.
He’s had two ART sessions since last October, and when he’s ready, he plans to have more. He still remembers everything, but he says it doesn’t stick the same way, and instead of nightmares every night, he has them maybe every third night.
ART founder Rosenzweig said with such complex cases with multiple bad memories, she asks the patient to pick the worst three out of 15, and do one session each on those three worst memories.
“The brain seems to then generalize the lesson and apply it to the rest,” she said.
At Veterans Alternative, where I first heard of this therapy about a year ago, resident therapist Alison Voisin said she was skeptical it would work.
“It seems fairy tale, it seems magic,” Voisin said. But she’s now able to get through in one session what used to take weeks or months.
“You look at those memories, and you use these bilateral eye movements which are designed to calm the body, which are designed to place things away in the brain the right place so they’re not up front just constantly bugging you and bogging you down,” she said.
“You find another way to see it and experience it, that’s healthier for you, that works for you, and you get to leave that day with relief,” she said. Voisin has treated more than 400 veterans and active duty troops, as word of its success spread by word of mouth.
For me, it’s been a decade since the Memorial Day bombing in 2006 that tore through our 4th Infantry Division foot patrol in the center of Baghdad, killing the commander of the team we were filming, Army Capt. James Alex Funkhouser, his Iraqi translator “Sam,” and my team, cameraman Paul Douglas and soundman James Brolan. Four other soldiers and I were left fighting for our lives and spent many months in the hospital recovering from the car bomb, which I was later told was traced to al Qaeda of Iraq, the precursor to the so-called Islamic State.
I’ve told the story in interviews and speeches a thousand times. I thought to myself, “I’ve ‘processed’ it plenty. What’s to uncover?” My doctors had told me I had acute stress but never developed PTSD because my symptoms like nightmares and flashbacks of the bomb scene didn’t last longer than six weeks.
But there was still latent emotion from survivor’s guilt, and it turns out ART can dig that out.
Frame by frame, as my eyes alone followed the therapist’s hand, Voisin walked me through a script that had me recall each “scene” from a memory of my choice, reawakening it and tuning in to what it did to my body—a suddenly tense throat, a feeling of wanting to cry—and a knotted feeling of guilt that lives in the spot just above my chest that my colleagues were killed, and I’m still here.
At the end of my hour-plus session, I had walked through my memory of the bombing in my mind, bringing up sights, smells, and emotions, painting them over and replacing them. I still had to work to quiet my mind from wondering how tired my therapist’s arm was getting, waving back and forth in front of my face.
At first, I found her last instructions the hardest to take: imagine the day from start to finish as you wanted it to go. Maybe imagine what you’d say to your friends now.
It seemed foolish, and selfish, but I ran through the exercise. I imagined us filming the soldiers doing what we’d filmed a hundred times before, patrolling, talking to Iraqi soldiers, and driving back to the base, safe and unharmed. I even thought about how Paul would have called the day “boring” and teased me about how I’d have trouble coming up with a good piece.
Voisin told me to imagine a bridge. It just kind of took shape in my mind. Then I saw my two friends standing on one side of it with me. They each smiled and gave me a bear hug, and with a wave, walked to the other side.
But as I write this on the 10th year since the bomb struck, for the first time I am not depressed. I think I have let them go.