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Wed November 21, 2012
Around the Nation

Through Meditation, Veterans Relearn Compassion

Originally published on Wed November 21, 2012 4:52 pm

Marine Esteban Brojas is rocking back and forth in his chair in a rehabilitation center for veterans in Menlo Park, Calif. He rubs his hands together so quickly you can hear them.

"You know, you're going into a building, and you know there's a grenade being popped in there," he says, "and there's a woman and a child in there ... and you're part of that?"

When Brojas came back from Iraq in 2003 to his home in Greenfield, Calif., he reunited with his wife and met his newborn daughter for the first time. His wife was excited to see him, but he found himself not wanting to pick up his daughter.

"The fact of holding my daughter in my arms, you know, or even being intimate with my wife? Very difficult. Very difficult because of the trauma," he says.

Multiply Brojas by the hundreds of thousands of newly returned servicemen and servicewomen the Department of Veterans Affairs estimates are suffering from PTSD, and you can see the scale of the problem here. These men and women cannot leave combat completely behind.

The Search For New Solutions

Despite how common this is, there are no easy answers for how to treat PTSD. Talk therapies can work, but they take a long time and not all vets stick with them.

Antidepressants, like Prozac, have been disappointing. In 2007, a VA study found that no drug should be considered effective for PTSD in vets, but today, they're still widely prescribed, and a lot of vets do find them useful.

In general, PTSD is a huge problem with only a handful of half-answers. The VA Medical Center in Menlo Park is exploring new possibilities through its residential treatment center.

Five men, including Brojas, sit in armchairs in the center's rec room. A couple of therapy dogs — golden retrievers named Eldridge and Elise — are curled up on the floor.

Two things are surprising about this scene. One is that half of these men are in their 50s and 60s — vets from the Vietnam era, not more recent wars. The other is that they're here to meditate.

Leah Weiss, a meditation expert at Stanford University, has been leading a weekly guided meditation and discussion group here for a year.

Similar scenes are happening at VA clinics in Texas, Virginia, upstate New York and Michigan. These projects look at several different types of meditation — mindfulness, transcendental — to see what works in treating PTSD.

This particular technique is called "compassion cultivation training." Weiss, who helped develop it, tells the men to think of a person they care about and to "allow yourself to feel the presence of this person." There's a phrase Weiss repeats, like a mantra: "That person is just like me."

"Consider that, just like me, this person's had ups and downs in his or her life. Just like me, this person's had goals and dreams," she says.

The idea here is that in combat, the way to stay safe is to think of everyone as a potential threat. Fear and distrust are default. But with PTSD, it stays that way, even after combat is over. The soldier with PTSD has lost the ability to relate to people as just people. Compassion meditation is about getting that ability back, learning to see oneself in others.

'Just Like Me'

After about 20 minutes of this, Weiss brings the meditation to an end. The men open their eyes, readjust in their chairs and stretch a little. Weiss opens up the discussion.

The Vietnam vets talk first. Some say they'd never even heard of PTSD until a few years ago. Now that they're getting treatment, it's like they're making up for lost time.

"The idea, of you saying, 'just like me,' that does a lot for me in a sense because I know how I'd like to be treated or how I want to feel," says John Montgomery, who has a bushy gray mustache and a tattoo of a scorpion on each forearm. "So if I'm showing that to somebody else, I find myself looking at me a little better and being satisfied with what I see."

Montgomery says he knows that what the meditation is teaching him sounds incredibly basic: Treat others the way you want to be treated; it's Human Relationships 101. And yet, it's completely at odds with the person the Vietnam War trained him to be.

"You're in a situation where you don't negotiate. You either make it or you don't," he says, "because we were taught to survive."

When he came home, Montgomery says, he had forgotten how to be a son, a parent, a friend. This lasted for decades.

John Perry, a soft-spoken Vietnam vet from Phoenix, steps in.

"It's pretty much just a self-imposed prison," he says. His story is much the same as Montgomery's.

"I didn't talk to anybody. No one would ask me any questions about it. I wouldn't answer if they did," Perry says. "So isolation has been my problem for 40 years."

Breaking The Spell

No one says it out loud, but it's clear what these vets are saying to the younger guys in the room: Fail to deal with this now, and we are your future — decades of isolation, substance abuse, ruined relationships.

Those are the stakes for Iraq vet Brojas, who sits across the room from Perry and Montgomery. This discussion has thrown him into a memory so intense and real, it's like he isn't even in the room.

"Knowing the fact that there's a man running from you, and you unload [your weapon] ... and he's dead right in front of you," he says. "It's a close-combat situation when that happens. And it's hard."

Dorene Loew, the director of the Menlo Park trauma program, steps in. She knows that every time Brojas relives this memory, he falls deeper under its spell. She needs to bring him back.

"You're not there right now. You're right here," Montgomery tells Brojas. "You're in this environment, here."

Montgomery knows exactly what to say.

"I mean, it'll take time. It's like a wave coming. It'll subside," he says.

It works. Brojas comes back and calms down. He says he'll be back for more meditation sessions, and he's finding other ways to ground himself, like taking deep breaths.

Meanwhile, Montgomery has done something he thought he had forgotten how to do: feel compassion. In a few weeks, he'll leave this program and go back to his family — a different man, he hopes, than he was when he came here.

Copyright 2013 KQED. To see more, visit http://www.kqed.org.

Transcript

AUDIE CORNISH, HOST:

From NPR News, this is ALL THINGS CONSIDERED. I'm Audie Cornish.

ROBERT SIEGEL, HOST:

And I'm Robert Siegel. The Department of Veterans Affairs estimates that one in every four Iraq and Afghanistan vets, suffers from post-traumatic stress disorder. That epidemic has led the VA to explore treatments that would have been considered unthinkable, a generation ago. As Amy Standen - of member station KQED - reports, they're part of a broad, national effort that's reaching both young vets, and those who've struggled with PTSD for decades.

AMY STANDEN, BYLINE: It's one thing to hear about post-traumatic stress disorder in combat veterans. And we've all heard by now how common it is, how disruptive to people's lives. But it's a very different thing to hear someone who is utterly, in its grip.

ESTEBAN BROJAS: You know, you're going into a building and - you know, there's a grenade being popped in there. And there's a woman and a child in there, you know. And you're part of that?

(SOUNDBITE OF RUBBING)

STANDEN: Esteban Brojas is rocking back and forth in his chair. He's rubbing his hands together so quickly that you can hear them.

(SOUNDBITE OF RUBBING)

STANDEN: When Brojas, a Marine from Greenfield, California, came back from Iraq in 2003, he reunited with his wife; and met his newborn daughter for the first time.

BROJAS: Of course, they were happy; they were excited I was back. But it's like a culture shock, you know. It's like, OK - you know - what now?

STANDEN: He found himself not wanting to pick up his daughter.

BROJAS: The fact of holding my daughter in my arms, you know, or even being intimate with my wife - very difficult, very difficult because of the trauma.

STANDEN: Multiply Esteban Brojas by the hundreds of thousands of newly returned servicemen and women the VA estimates are suffering from PTSD, and you can see the scale of the problem here - men and women who cannot leave combat completely behind. And despite how common this is, there are no easy answers for how to treat PTSD. Talk therapies can work. But they take a long time, and not all vets stick with them. Antidepressants, like Prozac, have been disappointing. In 2007, a VA study found that no drug should be considered effective for PTSD in vets - although today, they're still widely prescribed, and a lot of vets find them useful. But in general, PTSD is a huge problem with only a handful of half-answers - which brings us back to the room where I met Esteban Brojas.

LEAH WEISS: Come this way, John. There's a little ...

JOHN MONTGOMERY: OK.

WEISS: ...opening...

STANDEN: We're at the VA Medical Center in Menlo Park, California, inside a residential treatment center for vets suffering from PTSD. Five men settle into armchairs, in the center's rec room. A couple of therapy dogs - golden retrievers named Eldridge and Elise - curl up at their owners' feet. Two things are surprising about this scene. One is that half of these men are in their 50s and 60s - vets from the Vietnam era, not more recent wars. The other is that they're here to meditate.

WEISS: So let's go ahead and start with three deep, cleansing breaths, inhaling through your nose...

STANDEN: Leah Weiss is a meditation expert at Stanford University; and she's been leading a weekly, guided meditation and discussion group here, for a year.

(SOUNDBITE OF BREATHS)

STANDEN: Similar scenes are happening at VA clinics in Houston, Virginia, upstate New York and Michigan. These are demonstration projects, looking at several different types of meditation - mindfulness, transcendental - to see what works in treating PTSD. This particular technique is called compassion cultivation training. Leah Weiss helped develop it.

WEISS: Now, bring to mind a person you care about - a family member, a friend - and allow yourself to feel the presence of this person.

STANDEN: There's a phrase Weiss repeats like a mantra: That person is just like me.

WEISS: Consider that just like me, this person's had ups and downs in his or her life. Just like me, this person's had goals and dreams.

STANDEN: The idea, here, is that in combat, the way to stay safe is to think of everyone as a potential threat. Fear and distrust are default. But with PTSD, it stays that way, even after combat's over. The soldier with PTSD has lost the ability to relate to people as just people. So compassion meditation is about getting that ability back; learning to see yourself in others.

WEISS: Just like me, this person wants to be happy, and free from suffering.

STANDEN: After about 20 minutes of this, Weiss brings the meditation to an end.

WEISS: So if your eyes have been closed, you can take your time. But go ahead and open them; take in the sights of the...

STANDEN: The men readjust in their chairs, stretch a little. Weiss opens up the discussion.

WEISS: What was that like, to do today?

STANDEN: The Vietnam vets talk first. Some of them say they'd never even heard of PTSD until a few years ago. Now that they're getting treatment, it's like they're making up for lost time.

MONTGOMERY: The idea of you saying, just like me...

STANDEN: John Montgomery has a bushy, gray mustache, and a tattoo of a scorpion on each forearm.

MONTGOMERY: That does a lot for me, in a sense, because I know how I'd like to be treated; or how I want to feel. So if I'm showing that to somebody else, I find myself looking at me a little better, and being satisfied with what I see.

STANDEN: He says he knows this all sounds incredibly basic, what this meditation is teaching him. Treat others the way you want to be treated. It's Human Relationships 101. And yet, it's completely at odds with the person the Vietnam War trained him to be.

MONTGOMERY: You know, you're in a situation where you don't negotiate. You either make it, or you don't - and we were taught to survive.

STANDEN: Montgomery says when he came home, he'd forgotten how to be a son, a parent, a friend. This lasted for decades.

MONTGOMERY: It's just - uh -

JOHN PERRY: It's pretty much just a self-imposed prison.

STANDEN: John Perry, a soft-spoken Vietnam vet from Phoenix, steps in. His story is much the same as Montgomery's.

PERRY: I didn't talk to anybody. No one would ask me any questions about it - but I wouldn't answer them, if they did. So isolation has been my problem for 40 years.

STANDEN: No one says it out loud, but it's clear what these vets are saying to the younger guys in the room: Fail to deal with this now, and we are your future; decades of isolation, substance abuse, ruined relationships. Those are the stakes for Esteban Brojas, who we heard from earlier. He sits across the room from Perry and Montgomery. And this discussion has thrown him into a memory so intense and so real, it's like he isn't even in the room with us.

(SOUNDBITE OF RUBBING)

BROJAS: (Sighs) And knowing the fact that there's a man running from you, and you unload a whole dumbbell of 249 SAW in his back and he's dead right in front of you. It's a close combat situation to happen. And it's hard.

(SOUNDBITE OF RUBBING)

STANDEN: Dorene Loew, the director of the trauma program here, steps in.

DORENE LOEW: I would say, so now?

STANDEN: She knows that every time Brojas relives this memory, he falls deeper under its spell. She needs to bring him back.

LOEW: Just try to...

BROJAS: I'm sorry.

LOEW: No, not at all. Just...

BROJAS: I'm sorry.

STANDEN: Then, Vietnam vet John Montgomery speaks to Brojas directly.

MONTGOMERY: You're not there right now. You're right here. You're in this environment, here. You know.

STANDEN: He knows exactly what to say.

MONTGOMERY: I mean, and it'll take it - time. It's like a wave coming. It'll subside, you know?

PERRY: You're not alone.

MONTGOMERY: Yeah.

STANDEN: It works. Brojas comes back, calms down. He says he'll be back for more meditation sessions. And he's finding other ways to ground himself, too.

BROJAS: Carrying water or just taking deep breaths - stuff like that.

STANDEN: Meanwhile, Montgomery has done something he thought he'd forgotten how to do: feel compassion. In a few weeks, he'll leave this program and go back to his family- a different man, he hopes, than he was when he came here.

For NPR News, I'm Amy Standen in Menlo Park, California. Transcript provided by NPR, Copyright NPR.