Advancing Heros – The Best Thing That’s Happened to Me

By Allen Nohre, Terros

Today, many veterans and active service members are returning from combat with physical battle wounds, but some also have deep emotional scars, including Post-Traumatic Stress (PTS). The effects of PTS include flashbacks, nightmares, sleeplessness, anger, anxiety and depression. Many live in fear of triggers, from large crowds or noises that remind them of explosions or gunfire, to something as simple as someone walking by the apartment. The fear, an aftermath of the traumatic incident, can lead to isolation and withdrawal from people and places and overuse of alcohol or drugs. And families may be in disarray trying to adjust to a changed person. The Rand Corporation reports that nearly twenty percent of military service members who have returned from Iraq and Afghanistan – 300,000 in all – report symptoms of PTS, and slightly more than half have sought treatment.

I Have Been My Own Prisoner

Dominic, a 28 year-old veteran of the Iraq war, struggled with the effects of PTS for more than eight years. Through his active participation in Advancing Heroes, a program that works collaboratively with veterans and active duty service members to determine and remove the obstacles to recovery, Dominic is finding hope.
With passion and conviction, Dominic says, “Since my medical discharge, I have been a prisoner of my fear. We went over there to protect freedom for our families, friends, and country, and some of us came back without our own freedom. Here’s an example of how fearful I have been. As a favor for my brother, I offered to stay in his apartment while he was on a trip. Naturally, people walk by apartment buildings and there are noises. I was so anxious, I kept looking out the window, fearful about my safety and I was not able to go to sleep. I went two days without any sleep and I collapsed from exhaustion. But because of Advancing Heroes, I am no longer a slave to myself, constantly fearful and avoiding people. I am happier, less stressed, sleeping better and much freer to be my real self.”

Uncovering the “Stuck Point”

Cognitive Processing Therapy (CPT), an effective therapy for PTS, is a key component of Advancing Heroes. Ray Young and Mireya Roe, Terros clinicians trained in CPT, do not ask the veterans to re-live their trauma. Dominic and other veterans wrote out their traumatic event at the beginning of the CPT group. But attention is directed to their current thoughts and beliefs that originated from the event and are blocking recovery. Group members learn to identify what they call their “stuck points.” Dominic’s stuck point was “you can’t trust anyone.”
When Dominic was in Iraq, his military group was in a combat zone, and they had a translator they trusted. But she betrayed the group by providing mission details to the enemy, and Dominic’s vehicle was hit by an improvised explosive device (IED). Dominic was severely injured, with wounds to his legs that required multiple surgeries. After the explosion, Dominic came to the conclusion, “you can’t trust anyone,” and he firmly held to that belief. His overwhelming mistrust began to get in the way of the process of recovery. In the CPT group, Dominic was gradually able to see that he was generalizing that no one can be trusted because of the translator. Uncovering his belief that every person could be a threat to him and realistically examining that belief, he began to realize it was the translator who couldn’t be trusted, not everyone else.

The Power of Alternative Medicine

Advancing Heroes combines wellness activities and CPT to get the body and the mind effectively working together. Participants in Advancing Heroes are able to choose from a variety of wellness activities, including acupuncture, yoga, equine therapy, art activities, pet therapy, spinal networking, therapeutic recreation and a two-day family experience. Dominic chose to participate in three wellness activities: acupuncture, equine therapy and yoga.
 “Relax with five needles in each ear? Are you kidding me? But that is what happened,” exclaimed Dominic. “As my body slowly began to relax lying in the lounge chair with needles in my ear, I felt deep, deep emotions inside and I began to ‘leak’. We don’t use the word ‘cry’. I felt the hate and resentment from the attack in 2006 leak out of me in my tears and I laid there a bit more relaxed and somewhat more peaceful. My stress was decreasing.”

Acupuncture has been used for about 2,500 years. Today, it is an adjunctive treatment for stress, anxiety, depression, chronic pain, post-traumatic stress, and drug and alcohol withdrawal. Auricular acupuncture focuses on treating alcoholism, substance abuse, or chemical dependency, as well as provides the benefits of relaxation and stress relief. Cathy Paddack, certified auricular acupuncturist at Terros, administers auricular acupuncture and has given the Advancing Heroes group members the names of acupuncture practitioners so they can continue with acupuncture after the program ends.

“The Horses Taught Us”

Another wellness activity Dominic chose was equine therapy. It was introduced into the United States in 1960, with therapeutic origins dating back to ancient Greece, and is used as a supporting therapy for many conditions, including PTS. Dominic said, “It is hard to believe, but during our sessions of equine therapy, the horses actually taught us about ourselves. The horses can feel what we are feeling. The horse I chose during our first session was Sam. He came up to me, and he really picked me as much as I picked him. We had an important connection. When I walked other horses around the obstacle course and they veered away from an obstacle, I saw myself. It was like the horse was a mirror and I could see myself in what the horse did. During the six sessions, we never rode the horses. Just walking with a horse and being with him was a learning experience.”
Sahika Riley, equine therapist at Horse Rhythm Foundation, wraps up each session with the horses by helping the veterans understand what was going on between them and the horses.

“Allowing Me to De-stress”

Christy Burnette, yoga instructor from Yahweh Yoga, describes yoga as a blend of movement, meditation and breath work to support emotional and physical shifts of the body. Here is what the veterans said about their yoga experiences:
“Yoga has been amazing for my body. My limbs are moving in ways they haven’t in years. I’ve been able to get back to old hobbies of mine, and it has also improved my overall strength.”
“The breathing and relaxation techniques transfer to my everyday life, allowing me to de-stress, like when I am stuck in traffic.”
“Yoga has improved my ability to trust. During the first session, I wasn’t able to close my eyes for more than a second. Now I am able to close my eyes and completely relax at the end of every session.”
Four members of the group have already selected yoga studios near their homes to continue their yoga practice after the conclusion of 12-week Advancing Heroes program.

Finding Hope and Healing

Advancing Heroes’ mission is to work collaboratively with veterans and active duty service members to determine and address obstacles to recovery so each participant can begin to heal from their unique traumas. The CPT group helps the veteran get “unstuck,” and the alternative therapeutic activities aid each person’s healing process. Dominic is a testimony to the process.
Ray said, “The change in Dominic is amazing. He and others in the group have moved forward because this process is really working for them.” Mireya also stated, “I believe the program has been very helpful for these veterans, and I look forward to working with more groups of Advancing Heroes.”
To ensure that his recovery continues, Dominic is going to continue with yoga, acupuncture and go on an Equine Retreat. He is also offering his services as a peer volunteer mentor to the next group of Advancing Heroes. He has shared his story with the readers of Together AZ so others can learn about the program. He said “This is the best thing that has happened to me.”

Advancing Heroes: About the Program

Six months into his second tour of duty in Baghdad, Brian Mancini was hit by a roadside bomb and suffered major facial and head injuries. It took nearly four years of surgeries and rehabilitation to learn how to talk and walk again. In addition to his physical injuries, Brian struggled with PTS. He knew he needed something more. “I needed to find help — more than I was receiving and I found it in alternative therapies.” Brian discovered that wellness activities like yoga, pet therapy, tai chi, recreational therapy, and fly-fishing helped him reduce the amount of medication he was on and continue on a path of wellness and healing. Brian personally discovered the benefits of wellness activities to cope with his PTS. He says, “I know from my experience that there are innovative ways we can help vets and their families help themselves. That’s the good news.”
Inspired by Brian’s story, Terros talked with veterans and their families in order to learn how our veterans could be better served, not only with traditional therapies, but also from a broader perspective of overall health and wellness. In focus groups, they said they wanted help with issues such as anxiety, returning to normal sleeping patterns, being part of a healthy family, and addressing issues like depression and excessive use of alcohol or drugs. They also said the complicated struggles that are a result of PTS and TBI need to be addressed.
Terros presented the Arizona Department of Veterans’ Services (ADVS) with the need to address PTS with our veterans and active duty service members and ADVS provided startup funding to develop and deliver a program. The design of the 12-week innovative program, Advancing Heroes, began to take shape.
“Many people are exposed to traumatic events. In the time immediately following a trauma, most people will have the symptoms of PTS. However, over time, for many people, those symptoms naturally decrease, and they are not diagnosed with PTS. In other words, they naturally recover from the traumatic event. There are some people who do not recover and are later diagnosed with PTS. Based on that, it is helpful to think of PTS as a problem of recovery. Something got in the way of that natural process of recovery.” (Cognitive Processing Therapy: Veteran/Military Manual)
You can view Brian’s story and more about Advancing Heroes on the YouTube link below.
http://www.youtube.com/watch?v=CT0QtTKPTMA

Information and Support
To learn more about Advancing Heroes, please call Marianne Watts at 602-658-6074 or Marianne.watts@terros.org You can contact Marianne if you or your organization would like to donate in-kind services or supplies, volunteer, donate dollars or have ideas you would like to share to contribute to this innovative effort.

Allen Nohre is a writer for Terros. He has held senior management positions with healthcare companies in Minneapolis, Chicago and Phoenix.

Terros is a healthcare organization helping to create life solutions for people, families and communities. Terros offers substance abuse, mental health, community prevention and primary care medical services. For information or assistance, call 602-685-6000 or visit www.terros.org