Restoring Mental Health in Long-term Veterans with PTSD
by Siegfried Othmer | November 8th, 2013by Carol Kelson, MFT
Something exciting is happening at The Salvation Army Bell Shelter in Los Angeles that I want to share with you this Veterans Day. It started this past May with a small group of veterans who volunteered to be part of a neurofeedback pilot study. The veterans were randomly selected to be either part of the treatment group or the non-treatment, waitlist group. For four weeks during the month of May, the veterans in the treatment group were given five 30-minute neurofeedback sessions. At the end of 20 sessions, five veterans in the treatment group were compared to five veterans in the non-treatment group. I am happy to report the results were astounding.
The five veterans who received 20 sessions of neurofeedback had a statistically significant reduction of PTSD symptoms, as compared to the control group of five veterans who did not receive neurofeedback. When evaluating the composite mean difference between the two groups, the treatment group’s 23 PTSD symptoms remediated over the course of 4 weeks, while the control group PTSD symptoms remained the same or worsened over the course of the study.
The Analysis of Variance concluded that the composite scores for the two groups showed significant difference in the overall measures (p=0.0004), as well as the differences between the two groups showing significant deviation in the degree of decrease over time (p=0.01). The treatment group improved in all 23 symptoms of PTSD. However, the categories with the greatest significance in remediation were: feeling distance or cut off from other people (p=.001); having trouble falling or staying asleep (p=.008); avoiding thinking about or talking about a stressful experience (p=.002), being super-alert or watchful or on guard (p=.002), having suicidal thoughts (p=.002); and having addictive behavior (p=.002). The PTSD symptom categories with more resistance to change were: having repeated disturbing dreams (p=.27); having physical reactions (p=.49); and experiencing poor short-term memory (p=.39). Today, however, I want to share the deeper more personal stories behind the statistics.
First off, I want to share that Salvation Army Bell Shelter is the largest transitional housing center west of the Mississippi.
It was founded in 1988 and incorporates the original philosophy of the Salvation Army, which is to meet the spiritual and physical needs of the poor and destitute. Therefore, Bell Shelter houses up to 350 homeless men and women a night and serves over 1,000 meals a day. Bell Shelter offers many services to its men and women believing that a higher quality of life can lead to greater independence and self-sufficiency. In fact, the veterans treated during and since this neurofeedback study in May have demonstrated that the increase in their well-being from neurofeedback has resulted in a more positive living environment at Bell Shelter, a higher quality of life for those receiving treatment, and greater success in independent living.
Consider the benefits that were achieved from the participants in the treatment group during the study. Take Aaron who would yell commands in his sleep and wake up his neighboring bedmates at Bell Shelter. During the course of treatment, his neighboring bedmates reported that he was no longer shouting out commands and therefore no longer waking them up in the middle of the night. Brian, another veteran, could not stay focused long enough to watch a half hour television episode; during his course of treatment with neurofeedback he was able to watch a 2-hour movie in one sitting. Brian’s fellow veterans made comments that he was engaging with and joking much more often with others. Casey had a constant ringing in his ears, increasing his feelings of irritability throughout the day; after neurofeedback training and a decrease in his tinnitus, Casey’s mood improved. Now when Casey comes to neurofeedback, you will find him significantly more animated, singing and smiling as he enters the room. Derrick reported a decrease in headaches and was pleased that he felt more connected to others at Bell Shelter. He said that normally he felt he did not fit in and did not want to speak up or participate in groups. After receiving neurofeedback, he had a desire to say “hello” to others, to make more connections with those at the shelter, and to speak up in groups. Ellis had thoughts of suicidality before he started neurofeedback and by the end of week one of treatment he had more hope and the suicidal thoughts had dissipated. Frank could not believe the effect neurofeedback was having on his life and shared that on numerous occasions he was offered his drug of choice during the course of treatment. To his amazement, he was able to consider the long-term consequences and say “no” to the offer every time. He also found that he felt less aggressive and was able to avoid confrontations and fights in situations that would normally cause him to get angry or act out. All of these veterans reported an improvement in sleep both in quality and duration. Many of them reported relief of chronic pain and headaches. They also reported an improvement in mood and focus. Since the study, Aaron was elected to be the leadership representative for the veterans group. Brian and Derrick, after months of seeking housing, were accepted by landlords and are both moving to an apartment this month. Casey and Ellis were moved from the general homeless area at Bell Shelter to the independent living portion of Bell Shelter where one shares his living space with one or two roommates.
Currently, both veterans and non-veterans are receiving neurofeedback at Bell Shelter. They are coming primarily due to the results that they have seen from the original study group. At Bell Shelter, Ben Miller is coordinating the neurofeedback program to continue the work that was initiated during the pilot study in May. He reports that the men receiving treatment are continuing to have amazing results. For example, Gordon stated at his intake that he was having severe panic attacks every day. Since receiving neurofeedback, Gordon has experienced a significant reduction of panic attacks. He will go days or even weeks without having an attack. Harry was just released from an 18-year prison term. He had anxiety about walking around free and required someone to escort him to the building next door where neurofeedback treatment was offered. After six sessions, he now reports lowered anxiety and an ability to walk around on his own much more freely. Isaac, a young veteran, has seen people killed right in front of him as well as having to kill others in combat. He came to treatment with a number of PTSD symptoms including hyper-vigilance and an inability to sleep well. He reported having the “best nap of his life” after only one treatment. Joseph has had a long history of drug and alcohol abuse. After 12 sessions, he reports feeling more relaxed and able to stay away from situations where he might use.
Other veterans have been going back to school, have been selected to be part of work programs, and are having more motivation to follow through on finding housing, obtaining insurance information, and clearing up VA, social security, or disability paperwork. Their hygiene and appearance is improving and their mood and affect has also greatly improved. The gratitude the veterans have for neurofeedback is expressed outwardly as they continue to receive treatment. Although the veterans are expressing gratitude, as the Veterans Day holiday approaches, we as neurofeedback clinicians feel blessed to be in a position to support them in their progress. It is an honor to serve those who have willingly served our country on our behalf.