iRest helps vets reflect on war, trauma

By Kate Harrison

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Richard Vandemark was talking about the young veteran he’d agreed to meet with, a 21-year-old who had served tours in Afghanistan and Iraq and – by his own account — had shot so many people he “could stack them up in your living room and fill it.”

The young man told Vandemark about an altercation with a South Tucson gang member who stuck a gun to his head. “Go ahead,” the young vet told his assailant. “Put me out of my misery. And you’ll be miserable the rest of your life in jail.”

Vandemark, a former Marine whose own war stories from Vietnam are no less chilling, shakes his head at the toll these wars, like so many before them, continue to take on the young men and women in combat. Rather than shrug it off, he’s doing something about it by joining forces with long-time friend and naturopathic physician, Dr. Teri Davis, to start an eight-week program called the Mindful Veterans Project.

The project is part yoga, part meditation. At its core is Mindfulness-Based Stress Reduction (MBSR), a program to help people deal with issues ranging from chronic pain to Post-Traumatic Stress Disorder (PTSD). The brainchild of Jon Kabat-Zinn of the University of Massachusetts Medical Center, MBSR emphasizes present-moment awareness and breathing techniques to reduce stress and help people make better lifestyle choices.

Reaching veterans

Davis offers the classes through her Tucson-based non-profit, Purple Mountain Institute, which she started in 2001 when she and her spouse began taking at-risk kids and other special-needs groups on hiking and camping trips. Leading “hoods in the woods,” as Davis calls it, was fulfilling, but she wanted to do more to fuse her medical background with a special population. But who?

“I asked for a sign,” Davis recalled from the cozy West University cottage she uses as an office. A colorful glass wind chime hangs near a sunny corner window, and the musky smell of incense wafts into the room.

“Not long after that I found myself in an airpoProxy-Connection: keep-alive
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with one other passenger … a veteran who hadn’t been on a plane in 40 years and had had some really traumatic plane experiences.” Davis counseled him through the stress and had her sign: Open a free clinic for veterans.

Need is great

The Veterans Affairs Department stated in a Jan. 11 report that the suicide rate among vets age 18 to 29 jumped 26 percent from 2005 to 2007. Log onto the VA’s website and the first “pop up” features a large photo with a phone number on suicide prevention.

That’s no coincidence. If any good news came from the VA’s startling January report it was that vets who embraced the VA system were less likely to kill themselves.

Vandemark, a Marine like his father, brother and grandfather before him, has wrestled with his own demons since 1966. That’s when he inadvertently killed two children in a mortar attack near a village.

When he returned from Vietnam in 1967, Vandemark enrolled in college, “became a hippie and smoked dope,” he recalled. But the demons always won.

Vandemark tried it all: the campus health center, the VA, the Vet Center –  storefront clinics the government opened for ex-G.I.s intimidated by the vast bureaucracy of VA hospitals. He even had a VA therapist cry when he shared his war stories.

“I think about my war every day,” he said. “You just can’t get rid of it.”

Vandemark learned to cope when he discovered meditation and, specifically, the Kabat-Zinn MBSR program. Today he firmly opposes the wars in Afghanistan and Iraq, but cheerfully greets active-duty personnel and vets with a “Semper Fi,” his unit designation, and an MBSR brochure.

Judy Cooper received one of those brochures. It’s what brought the mother of a 24-year-old combat veteran to the Ada Peirce McCormick Center on the University of Arizona campus earlier this year for MBSR training.

The elementary school teacher and single mother said the MBSR classes have been “phenomenal.” The group sharing and daily meditation homework – “was annoying at first,” she said – but have enabled her to set aside time for herself.

“I am much more balanced now.  I don’t take things as personally,” Cooper said.

Her biggest challenge has been to not force MBSR on her son. “I was hoping by him seeing how it helps me that it would help him also, but he’s not quite open to that.”

That may disappoint her, but “part of the mindfulness is acceptance and respecting where he is now and being OK with that,” Cooper observed. “This just happened to come into my life when I was ready for it.”

VA’s changing role

Cooper’s son is getting help from the VA, a behemoth bureaucracy that’s been forced to find new ways to adapt not only to the influx of veterans from two wars but also to aging vets from previous wars whose PTSD has been triggered by the recent conflicts.

Davis said she’s getting a growing number of referrals from the Southern Arizona VA Healthcare System, which she said has a “very progressive mental health program.” That “system” comprises a main campus on 3601 S. Sixth Ave. in Tucson, community-based outpatient clinics in northwest and southeast Tucson, Casa Grande, Green Valley, Safford, Sierra Vista and Yuma. Vet Centers also are located in Tucson, Yuma, Chinle, Hotevilla, Mesa, Phoenix, Prescott and Yuma.

The VA of today is doing much more than simply dispensing drugs to stressed vets, evidenced by the work going on at a Mind-Body Clinic at the VA’s Community-based Outpatient Clinic in northwest Tucson.

The clinic sees patients for issues ranging from chronic pain and anxiety to PTSD, said its director, Dr. Stephen Panebianco. At the clinic, patients work with Panebianco and his team to examine lifestyle habits such as diet, exercise and sleep as well as the physiological basis of stress and how to respond.

For example, breathing techniques to reduce stress and center one’s thoughts “can easily be taught in an office visit,” says Panebianco. He discusses a concept called “free won’t” with patients – think the opposite of free will – noting that vets can make the decision to not choose a thought.

“It’s important for the vet to realize they can write a new story,” says Panebianco, a board-certified physician in family medicine and holistic medicine who traveled extensively in India and Tibet observing integrative approaches to medicine.

Panebianco was asked to start the Mind-Body Clinic last year as the VA copes with the growing numbers of vets returning from the wars in Iraq and Afghanistan. MBSR is a component of what the clinic offers, he said, in addition to one-on-one sessions and newly formed mind-body skills groups.

“I like to have a menu of options for the vet to choose from,” said Panebianco, noting that vets who can take increasing ownership of their health care may lead to few office visits and cost savings for the VA.

Nationally, veterans’ care is even getting ink in Yoga Journal with an article in the August 2010 issue on veterans who are practicing yoga to combat PTSD. The article discusses groups like the “Exalted Warrior Foundation” and “Yoga Warriors” that are popping up around the country. The Defense Department, according to the article, has asked a Harvard professor to conduct a 10-week study on yoga for veterans with PTSD. And the practice of yoga nidra, or yogic sleep, has even gotten a name change that military brass believe is more palatable to vets: iRest.

Class time

Participants at a recent MBSR class sit in a circle in the bookshelf-lined room at the UA’s McCormick Building while Ginger, an orange-and-white tabby, moves languidly among outstretched hands.

The evening’s two-and-a-half hour class, which included a mixture of veterans, VA employees and others, consisted of breathing meditation, poetry, thoughts on the previous week and discussion.

Natasha Korshak has led three of the MBSR classes since they began in fall 2009 at the UA.  She trained with MBSR’s founder, Kabat-Zinn, and has taught mindfulness for a dozen years at Miraval, the exclusive spa and resort north of Tucson. Korshak believes MSBR’s strengths lie in its eight-week format that pairs class time with daily homework and meditation.

“Nowadays everybody talks about the body-mind connection, but there’s not many things that really truly teach you how to develop it,” she said. MBSR encourages participants to slow down and make choices “moment-by -moment, hour-by-hour, day-by-day,” said Korshak. For vets and others, that can mean learning to reach inward when a stressor hits, instead of for booze, brownies, a bong.

Vandemark, in his straightforward, kid-from-Jersey style, says MBSR “is the only thing that ever worked for me.” That’s why he’d like to see more veterans, particularly young ones returning from Iraq and Afghanistan, try it.

“It’s like brain surgery for yourself,” he explains. “You’re taught the techniques, but you’ve got to do the stuff. You have to learn how to live in your skin.”

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