There is no consensus on how to treat post-traumatic stress disorder, a debilitating condition that can bizarrely combine emotional numbness with terrifying flashbacks. No single therapy has proved to work for everyone or to have particularly impressive results.
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Dr. Brian Rees, a primary-care physician and colonel with exposure to patients with PTSD, notably during his tours in Iraq and Afghanistan, is convinced that one answer lies in Transcendental Meditation.
PTSD is usually treated with behavioral therapy, sometimes drugs too, and Rees is neither psychologist nor psychiatrist: He is a doctor who spent decades in military service and accrued much experience in treating PTSD, including in the 1980s and 1990s before the syndrome was even recognized, he told Haaretz during his visit to Israel in September. And he isn’t alone in feeling that the current battery of treatments for PTSD, which range from psychological therapy to drugs to a combination of the two, don’t work very well.
Post-traumatic stress disorder is a chronic mental condition that is triggered by a terrifying event, whether experienced or witnessed. It is normal to suffer trauma after an event that does not concord with one’s perception of what reality should be, experts say, but not for more than a month or so. Yet somewhere between 10% to 20% of the people exposed to the triggering trauma develop PTSD. The latest thinking is these people (and animals) are the ones who are genetically predisposed to it.
Symptoms may include flashbacks, an inability to stop reliving the event, insomnia and when finally asleep, nightmares. Sufferers may develop anxiety severe enough to cause profound dysfunctionality and flat aspect – an enveloping numbness, including loss of affection that can ruin relationships. Many also experience difficulty in communicating and a pervasive sense of hopelessness.
Experts recommend seeking help if the “black thoughts” last more than a month. Commonly used therapies depend on a range of psychotherapy approaches augmented, when necessary, by drugs. (In June 2014, Israel added PTSD to the list of conditions for which doctors may prescribe cannabis and scientists showed that synthetic cannabis administered to rats shortly after a triggering event is effective as a preventative. So apparently is prophylactic cortisol given to the unfortunate rat shortly after the event, says Prof. Hagit Cohen of Ben-Gurion University of the Negev.)
Conventional behavioral treatments for humans include “prolonged exposure therapy” or “flooding,” which centers on actively re-experiencing the trauma, engaging with it rather than avoiding it; and shorter-term “cognitive processing therapy,” which is based on the theory that the PTSD sufferer is experiencing guilt or some other strong negative reaction which is preventing “normal” processing of the trauma memory.
In any case, stoned to the nines or not, therapy can last months or years, and even then it may not work – though as said, claims differ enormously. Rees claims TM can achieve results, improving the life of PTSD sufferers, within days.
Existing therapies ‘weak’
Rees is a family practitioner and retired colonel, after seven years of active duty followed by 30 years of reserves with the United States military. He had long been a practitioner of TM, but only connected it with PTSD while working with the Pentagon’s Comprehensive Soldier Fitness program, which aims to bolster soldiers’ resilience – not to bullets but, as the U.S. army puts it, “the ability to meet challenges and to bounce back after difficult experiences,” in other words, the horrors of war.
In 2011 Rees published an overview of data on how meditative techniques affected soldier resilience, in the journal Military Medicine. His conclusion was that of all the clearly distinguishable meditation techniques (such as TM, Vipassana “mindfulness” and the Tibetan Buddhism practice of “unconditional loving-kindness and compassion”), TM had the greatest potential. And suddenly he had the epiphany that TM might not only help resilience but the result of the lack thereof – PTSD.
“Seeing PTSD cases develop in the theater of war finally caused the little spark in my little brain to consider that which was right in front of my nose, the potential for TM for PTSD,” he describes.
He felt there was a need. Surveys of U.S. army veterans treated for PTSD indicate that the range of treatments and therapies for the condition may seem impressively broad, but based on soldiers’ responses, none decisively work, Rees claims.
A paper he and colleagues published in February 2014 on use of TM to treat refugees from Congo (in Uganda) suggests that Transcendental Meditation may have a significantly higher success rate (though by the nature of the beast, controls for the study are scanty and there is no comparison of other techniques to help these refugees recover from their trauma, he says himself). But the findings were intriguing: They claim that all participants completed the course and all improved.
Teaching to live again
What is “success” in treating PTSD, though? The trauma happened and the memory will remain, points out Cohen, director of the Anxiety and Stress Research Unit at BGU’s Faculty of Health Sciences. Treating PTSD is about teaching the person – be it soldier or rape victim or child – to resume normal life. So success is difficult to measure objectively, she says.
How “weak” existing therapies are is debatable. Statistics on psychological treatments for PTSD are hard to nail down. Studies involving psychotherapy, a highly subjective process, cannot be controlled using placebos, as pharmacological studies can (does Pill X work better than a sugar pill if neither group knows what it’s taking). People who feel the therapy is working may prematurely leave – because it’s working; others may prematurely leave because they feel it isn’t working. It’s hard to nail down what works and what doesn’t.
Why might TM work on some people where other therapies failed to help them resume a normal life?
First of all, Rees urges to distinguish TM from other meditative techniques: They are very different and he isn’t talking about them. He’s talking about the technique of Maharishi Mahesh Yogi that, yes, was popularized by the Beatles.
TM is a mantra meditation and is all about technique, Rees explains. You do it 15 to 20 minutes a day and start with closing your eyes. The idea is to stop noticing the stimuli our senses feel and to dive inward and relax, with the help of chanting the mantra, a meaningless repetitive sound. Proponents say anyone can do it, and that if one follows the technique, that black storm in the mind will temporarily disappear as the mind enters a state of detached calm.
By practicing this every day, people can move their baseline of reaction. They can, simply, start living again, explains Rees.
“As we transcend from gross level to subtler levels we can transcend altogether to pure consciousness – pure thought – no boundaries, experience without content,” he says. “When someone transcends, they experience a unity which is a spiritual experience. I think that’s how TM ultimately addresses PTSD.”
“It isn’t that people are cured of PTSD and the trauma becomes unimportant,” stresses Cohen. “They just learn to reduce anxiety and depression. That is success. All these treatments used for PTSD are simply to help them learn to live again.”
It isn’t that TM might be having some sort of placebo effect, she says: It and other methods can really calm a person down, and learning to control their anger and anxiety is really the whole point.