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Moving beyond talk therapy for PTSD — a challenge for the next VA secretary

January 9, 2017 (Photo Credit: Staff)
As president-elect Trump continues to fill his cabinet and inner circle of advisers, it’s not surprising that perhaps the most difficult job — that of Veterans Affairs secretary — will be the last to be filled.

The next secretary will inherit a variety of challenges. In addition to managing hundreds of thousands of employees and tens of billions of dollars, he or she will be required to navigate a massive bureaucracy and overcome a growing negative public perception.

I would argue, however, that the secretary's greatest challenge, which will only get worse as our post-9/11 veteran population ages, is battling the psychological wounds of combat so many of our veterans endure. This problem — a problem that's growing each day — will take more than the VA to solve.

The VA rightly states that there is a national shortage of mental health workers. Not only are there not enough, but according to the Rand Corporation, many of these mental health professionals are not trained to deal with or understand the types of trauma our veterans experience. This is compounded by the fact that for many veterans, seeking “therapy” is inconsistent with their military backgrounds.

The next VA secretary will not only have to understand the nature of psychological wounds and the magnitude of the problem, but also to lead an organization that some consider resistant to change and to use new and innovative approaches to mental wellness. There are growing concerns that the current handful of talk therapies and medications are marginally effective and that they reduce those veterans struggling with PTSD to a set of homogenous symptoms.

In August 2015, the Journal of the American Medical Association called for a “new and innovative approach to PTSD among veterans.” Indeed, we need to pay more than lip service to nontraditional approaches. We need to fund studies looking at the benefits of meditation, exercise, recreational therapies and other noninvasive approaches to achieving and maintaining health.

We also need to change how we think about and discuss mental health issues. Retired Navy Capt. Charlie Plumb was a prisoner of war in Vietnam for nearly six years. While Plumb spent years being tortured and held in an 8- by 8-foot cell, an experience that anyone would find traumatic, he will tell you that these were the best growth years of his life. Plumb came back many pounds lighter, but immeasurably stronger. He was not suffering from post-traumatic stress disorder. To the contrary, he was benefiting from post-traumatic growth — an age-old concept supported by modern-day science. 

The VA can’t care for our veterans alone. Likewise, no new secretary, no changes in bureaucracy, no privatization of services, nor bags of money, will completely heal our veterans of their invisible wounds and reintegrate them into communities.

We need a national dialog and innovative approaches to reframe the “disorder and dysfunction of PTSD” to the “opportunity for growth.”
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