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Musical healing for TBI and PTSD

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Music therapy has gained acceptance as an evidence-based treatment for TBI and PTSD. Learn more and watch a video of music therapy in action.

Music therapy is an evidence-based therapeutic application for the treatment of brain and psychological injuries such as traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). TBI and PTSD can be life-changing events that cause physical, cognitive, sensory, and/or emotional impairments. However, a trained music therapist can use music to activate injured areas of the brain involved in the control of movement, cognition, speech and emotions.

Substantial scientific evidence supports how and why music therapy works, but it also can be understood intuitively. Music evokes emotions and influences mood, whether happy or sad, relaxed or pumped. Music also inspires movement: Think how a good beat can induce foot tapping or dancing.

Injured nerve pathways actually can be stimulated by music. Music also can be used to stimulate speech and facilitate cognitive function. In those with PTSD, music can arouse memories that need to be accessed and processed during the healing process. Music can help to promote movement affected by TBI. Watch this video from the National Endowment for the Arts (NEA) and DoD to see music (and other arts) therapy helping injured service members.

Music therapy is part of the rehabilitation process at places such as NICOE, Walter Reed National Military Medical Center, and VA centers around the U.S. The VA also sponsors the National Veterans Creative Arts Festival, where veterans showcase their work. This TBICreative Forces fact sheet describes the NEA Military Healing Arts Network and lists several creative arts therapy locations.

Tai Chi for post-traumatic stress

Filed under: Exercise, PTSD, Tai Chi
Learn how this Asian form of exercise can be used to reduce the symptoms of PTS.

Tai Chi is a form of exercise and mind-body practice that can provide many physical, psychological, and social benefits. It can also be used to reduce symptoms of post-traumatic stress (PTS, formerly referred to as PTS). Tai Chi involves slow, gentle movements and controlled breathing. It can improve sleep, pain management, strength, and flexibility for many individuals. Practicing Tai Chi can also reduce depression, stress, and anger, which are often symptoms of PTS. The mental focus, relaxation and breathing techniques, and physical health benefits associated with Tai Chi might explain this reduction in depression and improvement in overall mood.

This Chinese form of exercise promotes relaxation and enhances alertness and attentiveness. Hyperarousal (that is, increased heart rate, rapid breathing, tense muscles, and sweating) is a common symptom of PTS, and Tai Chi can help individuals regulate their arousal levels. Tai Chi and other mind-body practices such as yoga and mindfulness can help individuals cope with chronic pain and health ailments that commonly accompany symptoms of PTS.

You don’t have to be diagnosed with PTS to experience the benefits of Tai Chi, though. It is a low-impact workout for anyone who would like to sweat a little and relax the mind. Also, it is offered at many MWR facilities on military bases around the world. If you would like to try it first in the comfort of your own home, there are videos online you can watch to get an idea of the practice and what it involves. Look at your gym schedule to see if Tai Chi is available to try out too!

Dogs fighting depression and PTSD

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Service dogs and therapy dogs can help wounded and ill service members recover. Learn how these dogs can help in multiple ways.

The U.S. military supports the use of service dogs and therapy dogs to help wounded warriors obtain a higher level of independence, well-being, and purpose.

There’s an important distinction between service and therapy dogs. Service dogs are trained to do work or perform specific tasks for those with disabilities (as defined in the Americans with Disabilities Act). The dog becomes a full-time companion for the person it serves. Service dogs also can retrieve objects, turn on lights, or open doors for those with mobility issues. Guide dogs assist visually impaired individuals, and signal dogs alert those who are hearing-impaired.

Therapy dogs offer goal-directed emotional, psychological, and (sometimes) physical support. They’re trained to provide comfort, affection, and unconditional acceptance. They can complement treatment for depression and post-traumatic stress disorder (PTSD) too. A therapy dog usually belongs to its “handler,” who accompanies it on visits to patients. Such dogs also complete special training, but it’s less lengthy than that of service dogs.

The value of animal-assisted interventions (including service and therapy dogs) has become widely accepted. The range of benefits includes positive physical and psychological health effects. Just physically touching a dog can reduce blood pressure, anxiety, stress, and hopelessness. These dogs are helping injured and ill service members at military and veterans’ hospitals across the country.

A special program exists where the roles of dogs in service and therapy come together: Veterans with PTSD train service dogs for veterans with mobility issues. This is a win-win: Both the veteran-trainer and the mobility-impaired veteran benefit from the same dog. Veteran-trainers learn and use positive methods of shaping a dog’s behavior, and as they do so, regain control of their own emotions, focus their attention, improve their social competence, and gain a sense of meaningful purpose.

Learn more about training dogs for service. And watch the Military Health System’s video of therapy dogs at work.

Yoga for pain relief

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Learn more about how adding yoga to your pain management plan can help.

Adding yoga to your existing pain management plan can help ease pain from injury or illness. An integrative mind-body approach, it often combines meditation and breathing with exercise and stretching. It can be done home, either on your own or with the help of a video, or in a class with an instructor. Yoga and other mind-body practices are recognized by DoD as treatment strategies to help regulate and manage pain-related stress. In addition, yoga and meditation can help relieve symptoms of PTSD. Read the full article for more information... 

How post-traumatic stress affects your brain

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Understanding how your brain works might help you better understand post-traumatic stress. Learn more about effective treatments.

Sometimes just understanding what’s going on can help the process of recovery. If you’re experiencing post-traumatic stress disorder (PTSD), it might help to have a better idea of how your brain functions and how the various parts are supposed to work. This also can help you understand the treatments used to help “rewire” your brain, so it can work properly again.

PTSD is a mental health condition stemming from traumas—experienced during combat, disasters, or violence—that impact brain functioning. The alarm system in your brain, that normally helps ensure your survival, malfunctions; it becomes triggered too easily. In turn, parts of your brain responsible for thinking and memory stop functioning properly. When this happens, you have difficulty comparing what’s happening now with safe events from the past. Read more...

Can virtual reality relieve post-traumatic stress?

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Learn how video-game technology could help veterans overcome post-traumatic stress.

There’s a promising therapy that uses virtual-reality simulation to help treat service members with post-traumatic stress disorder (PTSD). According to the National Center for PTSD, 10–18% of returning Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) veterans experience PTSD. The good news is that treatments such as virtual-reality exposure therapy (VRET) might help them work through their challenges.

Trained therapists use VRET to re-create stressful events or situations such as combat scenarios in a virtual-reality environment. The patient wears a headset and interactively reacts to possible sights, smells, sounds, and vibrations that have been visually re-created. This makes the experience realistic for the patient as it provides a strong sense of “being there.” Veterans learn to work through emotions such as fear, tension, and anxiety in a safe environment.

Healthcare providers have successfully used virtual-reality simulation as a resilience-training tool too. It helps builds service members’ confidence and coping skills so they feel stronger and ready for what comes next.

Visit the National Center for PTSD to learn more about post-traumatic stress. Here’s what VRET looks like in action.

Cope with emotions through mindfulness

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Mindfulness can help you to face hard emotions instead of running from them. Learn how.

Mindfulness can help you feel better equipped to handle difficult emotions. It’s a process geared to help you tune in to emotional experiences rather than try to escape from them. It’s easy to be overcome by depression, anxiety, PTSD, addiction, or other mental health problems. And you can make it worse by trying to forget the cause. For example, a service member afflicted with PTSD desperately wants to avoid experiencing certain traumatic events. Ironically, the actual effort to forget can cause him to relive difficult events through dreams, flashbacks, or memories. To illustrate this idea, right now, try NOT to think of weapons. You probably thought about them that much more. Read more here

Adapt and thrive: Emerge from trauma stronger

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Filed under: Mind, PTG, PTSD, Resilience
Nobody wants to experience trauma, but there may actually be an upside. Learn more.

Not everyone is affected the same way by exposure to injury and death. Many who do experience psychological wounds, however, come out stronger as a consequence, and so can you. If you’ve experience a traumatic event or experiences, there can be an upside: It’s called “post-traumatic growth” or PTG. It’s about finding a “new normal” that is even better than how things used to be. PTG can mean better relationships, openness to new possibilities, personal strength, spiritual change, or heightened appreciation of life. In addition (and researchers are still trying to understand why), if you get PTSD, you’re actually more likely to experience PTG. Nobody wants to experience PTSD, but if it happens, you may have an amazing opportunity to come out the other side with some unique strengths.

Help for Warfighters at NICoE

Filed under: PTSD, TBI, Therapy
The National Intrepid Center of Excellence provides healing for Warfighters with TBI, and PTSD or other psychological problems because of combat.

Walk into the new facility of the National Intrepid Center of Excellence (NICoE) on the campus of Naval Support Activity Bethesda, and one of the first things you will see is a sign commemorating the center’s origins, including the fact that the $65 million facility itself was donated by the Intrepid Fallen Heroes Fund. NICoE is committed to the interdisciplinary diagnosis, treatment, and long-term healing of Warfighters, and educational support for their families, from all branches of service.

Unlike many military environments, the facility is curved, spacious, quiet, and pleasant. Some notable features are the high ceilings, artwork, and state-of-the-art treatment rooms.

Patients at NICoE typically are active-duty service members with mild traumatic brain injuries (mTBI) combined with other psychological health conditions such as post-traumatic stress (PTS), anxiety, and depression. Most have already begun treatment elsewhere, often with many medications. The tranquil environment of NICoE instantly helps put them at ease and often leads to more effective treatment with fewer medications.

Recognizing that traditional therapies can’t heal all wounds, NICoE has rooms dedicated to art therapy, virtual reality, and meditation. Beautiful masks line the entrance to the art therapy room, providing a small glimpse into Warfighters’ individual and unique roads to recovery. The virtual reality room allows Warfighters to face traumatic scenarios at a pace that makes sense, an incredibly lifelike setting full of sound, movement, scents, and images. The spirituality room lets in natural light to a space with a beautiful wood floor surrounded by natural plants and a speaker system that plays sounds of nature.

An interdisciplinary approach, combining traditional and integrative medicine, contributes to NICoE’s 99% satisfaction rate, with more than 600 patients from all different services having completed their four-week program. There is no one-size-fits-all approach to healing, and the interdisciplinary makeup of the clinical team enables patients to pursue various treatment options. Providers can collaborate regularly and have cutting edge equipment at their disposal.

Patients usually bring a non-medical attendant, often a spouse or parent. Children also are welcome at NICoE. A private family room with frosted glass includes a children’s play area, and a playground is located behind the facility.

NICoE also focuses on research to help ensure long-term treatment success. There has been discussion of opening their doors to a wider range of Warfighter patients (treating more conditions) and opening more NICoE satellite centers. Referred to as Intrepid Spirits, such centers are open already at Fort Belvoir and Camp Lejeune. The Intrepid Spirit at Fort Campbell will open this summer, and ground was broken recently for one at Fort Bragg. Other bases that may receive an Intrepid Spirit include Forts Hood, Bliss, and Carson, along with Joint Base Lewis-McCord and Camp Pendleton.

Cope with emotions through mindfulness

Mindfulness helps you to face hard emotions instead of running from them. Learn how here.

Mindfulness can help you feel better equipped to handle difficult emotions. It’s a process geared to help you tune into emotional experiences rather than try to escape from them. People can feel overcome by depression, anxiety, PTSD, addiction, or other mental health problems, which, ironically, can be exacerbated by trying to forget the cause. For example, a Warfighter afflicted with PTSD often relives difficult events through dreams, flashbacks, or unwanted memories, because he/she desperately wants to avoid experiencing those events. To illustrate this idea, right now, try NOT to think of weapons. You probably thought about them that much more.

Practicing mindfulness mediation means focusing on whatever you are experiencing in the present moment. It can be a structured meditation activity, but because mindfulness is about being present, you can purposefully engage in mindfulness anytime, anywhere. A common meditative approach is to focus on a physical experience such as your breathing, noticing where your attention wanders, and gently guiding it back to your breath; it allows you to experience sadness, anger, fear, and other unpleasant emotions, letting them pass without clinging to the idea of making them go away.”

If you have ever “white-knuckled” your way through an amusement park ride (or ridden in a car with a driver you didn’t trust), you may remember thinking, “When will this be over? Please let it be over…” This shows that focusing on how long something lasts can make it feel like an eternity. By engaging in mindfulness, you will feel less threatened by certain emotions, and you will be less likely to engage in problematic forms of escape (such as drinking, drugs, or simply spacing out).

When people experience difficult emotions, they often cope by engaging the language center of the brain, using words internally to wrestle with the experience. But when people have difficulty re-evaluating why they feel the way they do, this leads to a circular internal debate (such as “I shouldn’t feel this way, but I do, but I shouldn’t…”), which can be pointless and can actually cause more distress. Emotions can be dealt with not just through words but also by tapping into their physical elements (noticing how you feel in your body). When people engage in regular mindfulness practice, the parts of their brains tuned into physical sensations are activated while they experience hard emotions. And people who regularly have this part of their brain activated tend to be more emotionally steady.

Unfortunately, it’s difficult to escape unwanted emotions. And more problems will probably pop up as you try to escape. But if you’re willing to face hard emotions, letting them come and go like waves on a beach, then mindfulness practice can help you have a different experience. Tune in to HPRC for more mindfulness resources, and take advantage of the fact that mindfulness is everywhere now, whether part of your martial arts or yoga class or filling the self-help shelves of your local bookstore. Become more mindful, and you can feel better equipped to handle tough emotions; your mind and body will engage them more productively.

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