Veterans Shell-Shocked at PTSD Treatment Denial
Wednesday, January 20, 2016
Unique tool is called a lifesaver, but many of our bravest can't get access to it
Post-traumatic stress disorder (PTSD) has been a disabling condition for many of our military personnel — and this was true even before it was given a name or label. The condition generally has meant years of cognitive therapy to help those affected learn to process their thoughts and feelings differently, along with medications for coping on a daily basis.
Ricardo Romeras, a Minnesota resident and a veteran of Operation Iraqi Freedom, returned home a changed person in 2006. While war changes everyone and some more than others, anxiety and other symptoms of his PTSD were disrupting his life. In his self-proclaimed stubbornness, he began to “self-medicate.”
Seeing how tormented he was, his wife started searching for help. She came across an innovative therapy called Eye Movement Desensitization and Reprocessing (EMDR). This tool, she was told, was being used to treat PTSD with amazing success.
As far back as 1998, a study published in The Journal of Traumatic Stress showed that 77 percent of combat veterans were free of PTSD symptoms after 12 sessions. Not only that, they remained symptom-free at their nine-month follow-up appointments.
But when Romeras and his wife requested access to EMDR through their local Veterans Health Administration, they were told it was not an approved treatment, nor was it even available through their VA. That was in 2008.
They continued to seek care, and it wasn’t long before they found an EMDR-certified therapist in private practice in St. Paul, Minnesota. Romeras began treatment.
Jane McCampbell, the licensed marriage and family therapist whom they turned to, had been using EMDR in her practice since she began training with it in 2008. In her eyes, EMDR is so successful she has been using it with 70 percent of her clients, not all of them veterans, she told LifeZette.
“My first use of EMDR therapy with a veteran was an incredibly moving experience,” said McCampbell. One statement from her patient made an emotional impact: “I slept through the night for the first time in eight years.”
The website Trauma Recovery says EMDR is a noninvasive, eight-phase treatment that identifies and addresses experiences that have overwhelmed the brain’s natural resilience or coping capacity.
"Patients are able to reprocess traumatic information until it is no longer psychologically disruptive," according to the site. Sufferers learn to process the memory in a way that leads to a peaceful resolution.
Romeras credits EMDR therapy with giving him tools to manage his PTSD symptoms and move forward with his life. He now uses the rhythmic tools of EMDR therapy to control his symptoms.
“When I start feeling the way I used to feel in the past, I tap on my hand, my heart or my collar bone and it brings me back,” he said.
Dr. Harold Kudler, chief mental health consultant for the Veterans Health Administration, has had training in EMDR therapy himself. He said the therapy has been well-documented as an effective evidence-based treatment for PTSD, along with other cognitive processing therapies.
Why it remains widely unavailable as a valuable treatment option for our veterans nearly 18 years after it was first found to be successful is a mystery.
EMDR therapy was added to the VA’s Guidelines for Care as an evidence-based option for PTSD treatment in 2010. However, the VA has not yet developed a nationwide training program for this treatment option, as they have their other two evidence-based PTSD treatment options, Cognitive Processing Therapy (launched in 2006) and Prolonged Exposure Therapy (launched in 2007).
Romeras's therapy with McCampbell over a period of three years used a combination of cognitive trauma therapy plus EMDR.
“My wife and I went into debt to pay for my therapy,” said Romeras. “At the time, I felt the only other option was killing myself, and I wasn’t going to go that route.”
Elaine Wynne, a clinical psychologist in Minneapolis who specializes in trauma recovery, has been encouraging the use of EMDR therapy for veterans since she received training in 1995. As a result, her veteran patients, she said, have had improved sleep and a lessening of the startle response associated with PTSD.
“It assists your brain in putting the memory into a stable place,” she told LifeZette.
Still, a big challenge this psychologist faces is getting the message out to veterans that the therapy is an effective treatment option for PTSD. The therapy has not been made available through the Twin City VA facilities, so she's been working with several veterans who have benefited from EMDR to inform others about it.
Out of this advocacy has come The Resilience Project, with the mission of educating veterans about the benefits of EMDR and raising funds to pay for treatment through private providers in Minnesota. The funding aims to help veterans avoid the frustration of trying to gain access to the treatment through the VA benefit system.
Under the Veterans Choice Act of 2014, veterans everywhere should be able to seek help from health providers outside of the VA and have those services covered.
“If the VA clinician agrees with the veteran that EMDR therapy would be in the best interest of the veteran, the clinician can make the recommendation for the VA to purchase these services through a community provider,“ Kudler said.
Yet what sounds like a simple solution is complicated by bureaucratic red tape. Providers still need to be on an approved vendors list to receive reimbursement for services. This, along with a list of other stipulations included in the Veterans Choice program, add hurdles that limit the services available.
So, while the mental health community as a whole debates the effectiveness of EMDR in treating PTSD versus other evidence-based therapies -- veterans such as Ricardo Romeras say it has already been a life changer.