By Col. Brian Rees (ret.), MD, MPH, David O'Connell, PhD, and David Leffler, PhD
December 8, 2015
Primary treatments for post-traumatic stress disorder (PTSD) such as Prolonged Exposure Therapy and Cognitive Processing Therapy are not proving effective. That's the conclusion of a recent Journal of the American Medical Association (JAMA) article calling for new ideas. The reality, the article points out, is that some two-thirds of combat veterans with PTSD are unable to free themselves from PTSD symptoms despite undergoing conventional treatments.
Here is a new idea--actually an old idea that has been around for decades--that works: Transcendental Meditation.
Research has shown that the practice of Transcendental Meditation (TM) generates significant reductions in PTSD symptoms and in a short period of time.
•In a 1985 study, American Vietnam-era veterans with PTSD who were taught TM experienced major reductions in anxiety, depression, and negative personality traits.
•Iraq and Afghanistan veterans, taught TM in 2011, had a 50 percent reduction in symptoms within a 3-month period.
•In a 2013 study of Congolese refugees who had been exposed to civil war, sexual abuse, torture, and/or the brutal slaying of loved ones, 90 percent of subjects improved into a "non-symptomatic" range within 30 days of learning TM and remained that way throughout the more than 4-month monitoring period.
•A follow-up 2014 study of Congolese refugees showed that major benefits occurred within a mere 10 days of learning TM. The benefits were determined to be larger than those seen with other behavioral and meditation, relaxation or stress management techniques.
TM is a cost-effective, easily learned, and effortless mental technique derived from ancient practices in India. It is taught in a systematic, highly structured and standardized manner by highly trained teachers throughout the world. More than 350 peer-reviewed studies, showing positive effects on mental and physical health, have been published in research journals.
Based on the science, the American Heart Association has described TM as the only behavioral technique that can be recommended for lowering hypertension. Moreover, research reviews have shown TM to be the most effective behavioral technique in reducing anxiety.
Prolonged Exposure Therapy and Cognitive Processing Therapy, conventional treatments used for PTSD, have been described as uncomfortable by many patients because they explicitly address and attempt to help patients process traumatic events and accompanying negative emotions and memories.
In contrast, TM is not a therapy per se. Practitioners regularly describe their experiences with it as being pleasant and restful. With TM, negative emotions, thoughts and memories of past trauma are not explicitly addressed. Rather, regular TM practice leads to deep rest and a kind of passive processing of trauma. TM dissolves the deep stresses incurred on the physiological level and lessens identification with the trauma on the mental level. Brain wave activity becomes highly coherent, indicating orderliness and brain integration. Stress hormones such as cortisol, epinephrine and nor-epinephrine, decrease. Measurements of relaxation and well-being, such as serotonin levels, galvanic skin resistance, and immune-modulatory effects, all increase.
Although conventional approaches to PTSD can increase one's self-confidence and sense of mastery and provide better coping mechanisms, TM practice apparently goes deeper. It provides a broader spectrum of benefits, including increases in ego development, executive functioning, personality integration, creativity, problem-solving abilities and intelligence--improvements well beyond disorder-specific symptom reduction.
Military personnel and veterans are often hesitant to seek PTSD treatment because it could be viewed as a sign of weakness. TM is a self-sufficient technique free from the possible stigma of mental health services.
The U.S. Army's Comprehensive Soldier and Family Fitness Program manual recognizes the need for "spiritual fitness." The fundamental damage in PTSD can be seen as spiritual. The individual is faced (over and over again for those tormented by intrusive thoughts and memories) with what seems to be hopelessly discouraging experiences that are irreconcilable with optimism.
The Department of Defense and the Veterans Administration have worked hard to address PTSD, but in the United States we have frequently medicalized what is essentially a moral/spiritual injury.
Resolution may lie in the benefits generated by something simple and broadly effective such as TM, where individuals can find quick and easy access to inner calm, stress release, and even bliss. With regular practice of just 20 minutes twice a day, tormented souls get measurable psychological and physical benefits--and a real chance to become more peaceful, productive, and fulfilled, and to enjoy more of what life has to offer.
Although more high quality research is needed to test TM as a stand-alone treatment as well as an adjunct to conventional and other novel PTSD approaches, we now know from existing studies that the practice works well. Very well. And our veterans should have access to it--and to any other programs that work well. They deserve it.