Brian Anderson can remember every single detail of the day two of his friends were killed in Afghanistan on Sept. 29, 2010.
And it haunted him.
When he returned home from deployment, he starting having panic attacks. He would see his friend’s face in the car driving next to him and imagined bullets going through his own head.
“I was just tormented on the inside,” said Anderson, 36, a former Army Green Beret and National Guardsman. “I was isolating. I was pushing my family further away, all those kind of things.”
Anderson was diagnosed with post-traumatic stress disorder and tried various forms of therapy, in which he would talk about his memories of the experience with a therapist. Nothing worked long-term, though, he said, and whenever he talked about the day he lost his friends, Calvin and Mark, he felt himself getting angry and hypervigilant.
But not anymore. Since trying accelerated resolution therapy, an emerging treatment for PTSD that requires fewer sessions than traditional forms of therapy and doesn’t require patients to talk out loud about their experiences, Anderson is able to share the story of that September day without getting agitated. As he recounts details of what he said and did just moments before Calvin and Mark were killed, he no longer gets angry.
“I’m not attacked by the historical emotional reaction that I (had) back then,” he said.
That’s the goal of accelerated resolution therapy, or ART, which was developed a decade ago and has been used by some in the military community to treat PTSD for several years. While it’s still a lesser-known psychotherapy method, a growing body of research points to its positive effects on people with post-traumatic stress, which include 11 to 20 percent of the Iraq and Afghanistan-era veteran population, according to Veterans Affairs Department estimates.
In an article in the Military Medicine journal last month, researchers from the University of South Florida note that the treatment can be particularly appealing to service members and veterans because of its brevity and format. In contrast to some of the more commonly used forms of PTSD therapy that take several weeks or months, studies have shown ART to be effective in an average of about four sessions. And instead of talking to a therapist, patients who go through ART don’t have to verbalize or even write down the details of their traumatic experience.
“This can be relevant to service members and veterans with exposure to classified operations and those who do not wish to share details of highly emotional experiences involving shame or guilt, such as those involving combat losses and sexual trauma,” write researchers Kevin Kip and David Diamond.
“I’ve had people that haven’t told me a word about (their trauma) — honest to God,” said Brenda Stutler, an Orlando-based mental health counselor who uses ART in her practice and is also certified to train others how to use the therapy. “They leave my office and I have no idea what we just processed. It doesn’t matter.”
In ART, a therapist will direct a patient to think about a scene he or she wants to process and identify the beginning, middle and end. Then, the therapist waves a hand from side to side, stimulating rapid eye movements as the patient thinks about the traumatic event. After a couple rounds, the patient is told to imagine their scene happening the way they would have preferred — that Anderson’s friends had made it back to base with him, for example — as a way to weaken the original memory.
ART teaches the brain to separate traumatic events from their associated emotions, Stutler said. “It’s like changing the images in your mind into a narrative, and it gets filed away as a narrative instead of the images which have emotions attached to them.”
In the Military Medicine article, Kip and Diamond evaluated four studies done on ART, three of which focused on service members and veterans. In their analysis of more than 200 people who had completed the treatment, they found nearly 75 percent experienced a clinically significant reduction in symptoms associated with PTSD.
In a 2015 survey of 16 practitioners at Fort Belvoir Community Hospital in northern Virginia who had been trained in ART and at least one other evidence-based therapy, 88 percent believed that ART was easier on the patient than other leading techniques.
Army Col. Wendi Waits, chief of adolescent inpatient behavioral health service at the hospital, has used ART regularly in her practice with active-duty service members, retirees, military spouses and adolescents since 2014, she said in an email. Previously, she oversaw training for more than 80 Defense Department providers and said many have reported clinically significant improvements in their patients.
“Although we have not conducted formal research here in the (national capital region), feedback from providers at this hospital has been overwhelmingly positive,” said Waits, who will be presenting on the benefits of ART at an American Psychiatric Association conference next week.
She said patients with single trauma frequently respond in just one to three ART sessions but that it may take longer for individuals with more complex traumas that occur over time or are associated with loss or guilt. In those cases, she said, ART may be more beneficial as an add-on to other forms of psychotherapy.
ART doesn’t just apply to PTSD, but can also be used to mitigate other forms of stress, such as stress brought on by military transition, said Diego Hernandez, another University of South Florida researcher and licensed clinical psychologist who has trained military providers in the therapy.
“With ART, we can focus on whatever the individual identifies as a priority and work with them through those memories and experiences,” he said. “Individually, I’ve seen it just transform and change lives.”
Anderson, now an advocate for ART through his nonprofit Veterans Alternative, still uses the therapy. He said it’s even helped with things like procrastination and better understanding the differences between military and civilian life.
“For the longest time I couldn’t see past that very moment that I was in. I was looking back and I was feeling like I shouldn’t even be here, like I didn’t belong, like I really did die in combat and there was nothing left for me here,” he said. “Now, I feel like I have a beautiful life to live, and there’s a lot of people I can help. There’s a huge difference in my overall outlook on life.”
Natalie Gross has been reporting for Military Times since 2017. She grew up in a military family and has a master's degree in journalism from Georgetown University.