Transforming Trauma


By Patricia Kime

Two years ago, retired Army Lt. Col. Andy Kaufmann had a plan to work with injured combat veterans and first responders to help them reintegrate and thrive in their communities. But the former OH-58 Kiowa pilot, who served in Iraq in 2004, had issues of his own: mental struggles and physical pain that required antidepressants, sleep medications, opioids, and fentanyl.

“All of my [post-traumatic stress] was getting in the way of everything else,” Kaufmann says. “It was keeping me from reaching my goals.”

He heard about a relatively new program for combat troops offered at a veterans’ retreat in the foothills of Virginia’s Blue Ridge Mountains. When he was invited to attend the Warrior Progressive and Alternative Training for Healing Heroes (PATHH) program at Boulder Crest, he jumped at the opportunity, even though he wasn’t quite sure what he was getting into. Kaufmann arrived with five other combat veterans for a week of transcendental meditation and activities such as yoga, hiking, kayaking, painting, archery, and caring for horses.

The casual observer easily might have mistaken the gathering at the 37-acre resort as a “guys’ weekend,” with its luxury lodging, activities in a gleaming clubhouse, and expansive countryside views. But this was no holiday. Kaufmann’s week, with each activity selected to promote introspection, awareness, and personal growth along with soul-baring discussions around a campfire, was emotionally grueling and life-changing.

“You are getting this intense therapy without even recognizing that you are getting it,” Kaufmann says. “It totally saved my ass.”

Holistic approach

While the VA offers treatment for post-traumatic stress at all of its medical centers — from one-on-one and group outpatient treatment to intensive inpatient and residential programs — these center largely around scientifically proven methods for treating post-traumatic stress, namely psychotherapy and medication.

For many veterans, these interventions work. But for others like Kaufmann, they have proven ineffective or, in some cases, debilitating. For these former troops, nonmedical, peer-to-peer support programs offered by various nonprofit and private organizations across the U.S., such as Boulder Crest, Save A Warrior, Mighty Oaks, and Wounded Warrior Project’s Project Odyssey, have proven to be lifesaving.

“We call it ‘war detox,’ ” says Save A Warrior founder Jake Clarke, a former Army National Guard captain. “Previous generations have found peer support at [Veterans of Foreign Wars], American Legion, AMVETS. But sitting around a smoky bar telling your stories doesn’t appeal to this group of veterans — they want the immersive, experiential model.”

This means an all-in physical and mental experience based on holistic healing to foster personal growth. While each program has unique features, at their core, they focus on wellness through acceptance, humility, self-forgiveness, patience, physical well-being, and teamwork. According to program sponsors, the goal is to decrease or eliminate post-traumatic stress symptoms and restore veterans’ confidence to become productive members of their communities.

Boulder Crest founder Ken Falke calls this post-traumatic growth (PTG), a phrase coined by psychologists at the University of North Carolina-Charlotte in the 1990s to describe the idea trauma can be a catalyst for positive change.

“If you take the time to answer these tough questions — ‘Who am I? What do I want to be?’ — and if you set goals and work for them, you can really be something special. You can take it and improve the world,” Falke says.

Clarke doesn’t use the term PTG but says the ideas are the same at Save A Warrior, based on ancient tenets that warriors can “travel through their experiences and come out focused and stronger” when they receive spiritual and emotional support.

According to the VA, roughly 14 percent of veterans who served in Iraq or Afghanistan have post-traumatic stress. For Persian Gulf War veterans, the rate of a post-traumatic stress diagnosis is 12 percent and for Vietnam veterans, 31 percent. With some studies indicating the high rate among Vietnam veterans has caused debilitating lifelong problems, psychiatrists, counselors, and therapists are in a race to help post-9/11 troops now, before their conditions become chronic.

“We spend weeks and months training these people to be soldiers and go to combat, and then at the end, we send them to a measly one-week course to teach them how to get a job,” Falke says. “We aren’t giving them the skills they need to be leaders in their communities.”

Holistic programs steer clear of traditional psychotherapies and pharmaceuticals and focus instead on activities that explore a veterans’ personal and emotional status and build on existing strengths.

Many of the programs start and end with veterans engaging in art therapy such as drawing mandalas. They learn meditation and tackle physical challenges like rock-climbing or ropes courses that require teamwork. They get uncomfortably close with horses. They spend time — a lot of it — mindfully walking in labyrinths.

“It may sound like mumbo jumbo, ... but it’s not. Fortunately, the science is catching up with metaphysics,” Clark says. “This program helps create the ideal conditions to disrupt or dislodge this path to illness or suicide and [gives] veterans another way to go.”

Falke says many veterans want this type of program because they don’t want to revisit their trauma, they distrust the VA, or they have tried treatment and found it failed to help.

“What we are doing for veterans in respect to the medical model ... is not working. … We just can’t keep doing the same thing over if it doesn’t work,” Falke says.

Care at the VA

Dr. Sonya Norman, a psychologist and director of the PTSD Consultation Program at the VA National Center for PTSD, disputes that assertion. She says post-traumatic stress once was viewed as a chronic condition similar to, say, diabetes, which can be managed but not cured. But therapy for post-traumatic stress has developed to a point where three months of treatment can be highly effective.

“It doesn’t mean they’re completely symptom free or exactly the person they were before the trauma, but it certainly means they can feel better emotionally, and their symptoms can be reduced,” she says.

Every VA health facility offers post-traumatic stress counseling and treatment; most provide evidence-based therapies — psychotherapies and/or medications that have been proven to work in research and clinical trials. This includes cognitive processing therapy, which focuses on changing people’s thoughts on their experiences; prolonged exposure therapy; and EMDR (eye movement desensitization and reprocessing), which promotes rapid eye movement similar to the movements in deep sleep that helps guide a patient to “see” trauma in a less disturbing way.

Some VA facilities also offer complementary and alternative medical treatment (CAM), such as yoga, chiropractic care, and meditation, but program availability depends on the medical center. One study found 89 percent of VA facilities do offer some form of CAM, but for the most part, VA physicians rely on standard treatments, since scientific research has proven they work.

Growth experiences

Falke hopes a study under way at Boulder Crest will contribute to the research on alternative therapies for post-traumatic stress and support anecdotal evidence that programs like Warrior PATHH and Save A Warrior work just as well as traditional treatments.

University of North Carolina-Charlotte professor Dr. Richard Tedeschi, who, along with psychologist Dr. Lawrence Calhoun developed the term post-traumatic growth in the 1990s, is working with former Army psychologist Dr. Bret Moore to follow 50 Warrior PATHH participants through their one-week intensive stay at Boulder Crest, the 18-month follow-on program they continue at home, and beyond to examine their abilities to manage their physical and mental well-being, relationships, and work.

Tedeschi is a psychologist who has spent 30 years studying trauma victims, survivors of violent crime, and bereaved parents who believe they experienced positive change after dealing with a traumatic event. This observational study is an opportunity to see if PTG can be facilitated and fostered.

“People experience this growth naturally — you don’t have to go to a psychologist to have someone produce this in you,” Tedeschi says. “But we have seen that if you have a trauma and you experience a great deal of distress … where you might be questioning your core beliefs … that questioning process very often leads to positive change. And that’s what they are doing at Boulder Crest: helping with this questioning process.”

A new study at North Carolina State University examined the relationship between post-traumatic stress, PTG, and time, finding those who reported the highest growth also were those who said their trauma “fundamentally challenged the way” they saw the world, spent a lot of time thinking about their event, and had the highest rates of post-traumatic stress. The study also showed growth could occur quickly or unfold over time.

“In other words, while recovering from trauma can be a painful and difficult ordeal, veterans and their families can have hope,” says Jessica Morgan, a researcher with the nonprofit health research firm RTI International and principal investigator on the study.

But like Tedeschi, Morgan says more research is needed on PTG.

Even without evidence, young veterans are signing up for these programs, which are offered for free, in droves. Save A Warrior has a waiting list of at least 200 and seeks to offer the program through partnerships with other therapy centers. Boulder Crest just purchased a ranch in Arizona to expand to the West Coast.

Kaufmann himself has established an equine therapy program for veterans near Ashland, Va. When he gets in a rough spot, he heads to the barn or meditates — coping skills he learned at Boulder Crest. He turns to the one phrase that stuck in his mind from Warrior PATHH: “Stop looking in the rearview mirror.”

He wishes other veterans could find the peace he has found through holistic healing. “Without [the program] I wouldn’t be where I’m at,” Kaufmann says. “Boulder Crest helped me see things 180 degrees differently than I did before.”