Veterans and PTSD

A Soldier’s Heart

June 6, 2013    BY Alicia Bessette

It is Tuesday morning at the Central Mass Yoga Institute in West Boylston, Massachusetts. Seven men have gathered for Veterans Yoga, a gentle hour-and-a-half class of postures and breath work.

Their teacher, Joan Platt, is explaining that strong abdominal muscles are important for a healthy back. She walks them through a series of leg lifts—first one leg at a time, then together. She prompts them to use their arms for support and to lower their legs only as far as they can without strain.

“We’re gonna do one more set for the Marines,” she says, scanning the room for a reaction.

“Hoo-rah!” comes a hearty shout from the corner, followed by belly laughs all around.

The hoorah is from Paul Malboeuf, a Vietnam-era veteran. In a gray Marines T-shirt, Paul is trim and handsome, with clear blue eyes. He lowers and lifts his legs eight more times, slowly and smoothly, extending his toes toward the opposite wall, letting his face and neck relax, keeping his breath steady.

For the others, the final set is more challenging. Their movements are jerky, their breathing shaky. Some alternate legs again. One veteran gives up altogether, collapsing into shavasana, sighing thickly through his moustache.

“Don’t push it too far,” Joan coaches. “You don’t want to hurt yourself.”

Paul served 13 months in Vietnam as a combat infantryman, an experience that still lives with him—a particular sound or scent can send him right back to the battlefield. “Combat trauma extends your regular senses beyond their limits,” he says. But today in Veterans Yoga—and outside of class too—Paul feels not so much like a Marine as a yogi.

Yoga makes it possible for these men, who have deeply buried pain and fear, to reclaim their lives.

“There is turmoil inside us,” he says of his fellow classmates, who, like Paul, suffer from post-traumatic stress disorder (PTSD). “We’re trying to find ourselves again. And I can sense that self through yoga.”

Yoga makes it possible for these men, who have deeply buried pain and fear, to reclaim their lives. In a practical way, yoga allows them to release memories of violence that have been haunting them for more than 30 years. Through yoga, they find permission to let go of worry and guilt, the past and the pain. Yoga’s message—live in the moment, embrace the present breath by breath—is profound and life affirming, and their asana practice is a manifestation of that message.

Mark Strait, another ex-Marine, frequently rides his Triumph motorcycle to class, arriving with a chill still clinging to his bright face, then zipping out of his leather chaps to do yoga in his jeans. “It’s great therapy,” he says. “You don’t have to try to understand your emotions or your feelings in yoga class. Instead, you just release them, whatever they are.” What speaks to him is the notion that all judgment is withheld, that you are automatically accepted, regardless of your past or your present.

In American Civil War times, PTSD was known as soldier's heart.

Veterans Yoga began as a one-time trial among the members of a support group meeting weekly at the nearby Worcester Veterans Center. A year later, the class has grown to accommodate a regular group of devoted veterans, mostly of the Vietnam War, who come week after week.

A Soldier’s Heart

During World War II, the symptoms we now associate with PTSD were known as battle fatigue. Before that we called it shell shock. In American Civil War times, it was known as soldier’s heart. PTSD is a psychological condition that can arise following life-threatening events. The men and women who suffer from it often relive those events through flashbacks and nightmares and thus have difficulty sleeping. They often feel detached or estranged from others. Among the most common symptoms are anger, anxiety, chronic pain, denial, depression, guilt, loneliness, phobias, and substance abuse. Sometimes one symptom is enough to disrupt daily life. But most veterans experience a combination of symptoms, and as a result, PTSD destroys marriages, alienates loved ones, and ruins careers.

Because of their generation’s vehement anti-war sentiments, which has compounded their denial, many Vietnam veterans have made a lifelong habit of keeping silent about their experiences. They don’t tell war stories—not to journalists, not to their wives, not even to each other. Many suffered from PTSD for decades before acknowledging it and seeking help.

The military culture intensified their denial. “In a battle, if your friend is killed, you can’t be crying and moaning and groaning,” says Michael Dziokonski, a former Marine corpsman. “Because if you do, the next thing you know you’re going to get killed. You just have to suck it up—and you’re trained to do that.”

When Vietnam veterans returned home, mental health resources were scant. Ex-Marine Thomas Conner knew as soon as he returned home that he had a problem; he simply couldn’t adjust. He was shuttled around to different military clinics where doctors described him as gun-shy or a coward, and released him.

Yoga helps those with PTSD because it is not a quick-fix, one-time solution. And, like with yoga, the mind-body connection is at the heart of PTSD.

“So I learned to repress it, to deal with it,” he says. “I have always patted myself on the back for being mentally able to overcome just about anything. I thought I could really beat this thing.” What finally brought Thomas to the Vet Center in 2004 were media reports of the Iraq war, which triggered harrowing memories.

Michael remembers watching firefights on the news. “The next thing I know,” he says, “I’m ready to leave home. I’m yelling at my wife and crying while I’m peeling potatoes. I was also yelling at people at work, people who were good friends. It’s because an emotion that you experienced and didn’t really deal with thirty years ago can resurface today with the same power and intensity it had in the first place.”

How Yoga Helps

Because it often develops into a chronic condition, many veterans understand their PTSD to be a lifelong struggle. And for that reason they can draw parallels between recovery and yoga practice. Though they tend to isolate themselves, they feel comfortable around other veterans. A yoga class just for them is an extension of the cohesion and empathy of their support group at the Vet Center.

In addition to support groups, PTSD treatment usually involves individual counseling sessions during which the veterans learn to cope with anxiety, manage anger, and relate in healthy ways to other people. Recovery, then, is gradual and ongoing.

Yoga, too, is a process. Every day, every moment, presents the opportunity for practice. Yoga helps those with PTSD because it is not a quick-fix, one-time solution. Even a small taste of yoga’s benefits gives the veterans reason to return to it time and again. And, like with yoga, the mind-body connection is at the heart of PTSD.

The key to recovery is to evoke the relaxation response that causes the release of neurochemicals in the body which then create a soothing effect on the mind.

Soldiers in combat are in a near-constant state of fight-or-flight, an emotional reaction also called the stress response that prepares the body to fight or flee from a real or imagined threat. During the fight-or-flight response, chemicals such as adrenaline, noradrenaline, and cortisol are released into the bloodstream. Breathing becomes rapid and shallow. Blood is shunted from the digestive tract to muscles and limbs to give them extra energy for fighting or running. The pupils dilate. Awareness intensifies.

Veterans with PTSD are stuck in the stress response: innocuous, everyday situations are perceived as threatening. The key to recovery is to evoke the relaxation response. According to Dr. Herbert Benson, founder of Harvard’s Mind/Body Medical Institute, the relaxation response causes the release of neurochemicals in the body, which create a soothing effect on the mind. Hatha yoga is one of scores of activities that evoke this response.

Pranayama is a convenient doorway into relaxation—and always available.

For these veterans, asana, the integration of body and mind through physical activity, is the most palpable way to evoke that relaxation response. It’s also one of the most important of the eight limbs of raja yoga (yama, niyama, asana, pranayama, pratyahara, dharana, dhyana, and samadhi) that Joan teaches them. Once when the topic of yoga came up in their support group, Michael, who had been practicing yoga for several years, demonstrated Virabhadrasana II. “I said, ‘The nice thing about this pose is that while you’re doing it, you have to concentrate on your breathing, your balance, and where your body is,’” Michael recalled. “I explained to them that you can’t be thinking about other things when you’re doing this. It clears your mind, and at least for one or two minutes while I’m doing that and other poses, I can’t be fussing in my mind with other people and all of my real or imagined worries.” Through asana, Michael glimpses the higher limbs of raja yoga: dharana, one-pointedness of mind, and dhyana, meditation.

Another way the veterans cultivate dharana and dhyana is through trataka, the practice of gazing at a candle flame, then closing the eyes and focusing on the image of the flame that dances in the mind’s eye. “If you have any problems or distress, just put them into the flame, and let the flame burn them up,” Joan tells the class. The veterans visibly relax as they sit in a circle around the pillar candle, knees touching, spines erect, palms open.

Joan also emphasizes pranayama, the limb of raja yoga that veterans practice most frequently outside of class. It’s a convenient doorway into relaxation—and always available. Today Joan has the veterans place sandbags across their diaphragms to strengthen the muscles that support deep, diaphragmatic breathing, and for several minutes the studio fills with the oceanic sound of ujjayi breathing.

The veterans take words about self-improvement, gentleness, acceptance, and returning to a state of childlike innocence, trust, and hope—to heart.

Each Veterans Yoga class has a theme. Today Joan is discussing brahmacharya, the fourth yama. “Think about your typical day,” she instructs the men, who are lying in shavasana. “Your activities. Sleeping, waking up, bathing, eating, talking to loved ones, driving, working. Look at your life as a pie, with each activity having a piece of the pie. Ask yourself, ‘Am I being moderate in all areas? Or am I going overboard in one area at the expense of another?’ If you’re happy with the way your pie looks, you’re an accomplished yogi. But if you’re not happy, what changes can you make to create moderation in your life?”

The veterans take Joan’s words—words about self-improvement, gentleness, acceptance, and returning to a state of childlike innocence, trust, and hope—to heart. “That verbal instruction really means something,” Paul says. “These are messages we haven’t heard in a long time, and some of us have never heard them.” He has embarked on his own personal study of the yamas and niyamas, finding them viable tools for living more easily—both physically and psychologically.

The Dharma of War

In his sessions with other veterans, Tom Boyle, a readjustment counseling therapist at the Vet Center, encourages the men to view PTSD as a friend. “All the defensive reactions that you had during battle kept you alive,” he tells them. “If you can realize that it’s your PTSD at work when you’re overreacting, you have a better chance of working it through.”

This notion—that PTSD is a friend—is similar to the yogic concept of embracing life’s difficulties. In the Bhagavad Gita, the battles facing Arjuna are inner battles. And the real war these veterans once faced is now contained inside of them.

"With yoga, I'm finding things in my body I didn't know I had--joints and muscles. They open up, and then every opens up—your mental capacity, your perception—and you begin to feel and see and taste things again."
- Thomas

“Krishna’s fundamental message to Arjuna at the beginning of the Gita is, ‘If you claim your life as it is now and go forth into the battle of reclaiming your soul, then you will prevail,’” says Garrett Sarley, president of the Kripalu Center for Yoga and Health and a 30-year practitioner of yoga. “Everybody’s struggle is much greater when they resist their trauma than if they face it. Krishna’s message is, ‘This battle is perfect for you.’”

If veterans with PTSD can learn to relax into an asana, they can learn to relax into their stressors—or at least greet them with a calm breath and know them for what they are. Thomas, for example, says that yoga reprogrammed him. “In Vietnam I lost so many friends,” he says. “You learn to become immune to it—just numb. We learned to treat people as objects. That’s how you deal with it. But it takes its toll because you bring that back to the States with you. There is no program to wash that out of your system. But yoga can actually do that. With yoga, I’m finding things in my body I didn’t know I had—joints and muscles. They open up, and then everything opens up—your mental capacity, your perception—and you begin to feel and see and taste things again.”

Mark agrees. “It’s a good thing to be able to do something physical to help yourself mentally,” he says. “‘Close your eyes, relax into the floor, breathe out all the bad thoughts’—those messages are very important to us, more than the exercises. It’s not just ‘Do a bunch of jumping jacks.’ Sure, physical exercises will clear your mind. But in yoga you’re moving your body in order to release bad stuff so that you can think about good stuff, even if it’s only for the moment.”

Widening the Circle

Lucy Wagner, the owner and founder of the Central Mass Yoga Institute (CMYI), first introduced the veterans to yoga when she visited Tom Boyle’s support group at the Vet Center and led them through a few simple postures. She now offers one free class a month for veterans at CMYI, and the class is growing. She also travels around the state to vet centers and yoga studios, giving demonstrations on how yoga benefits veterans, and how teachers can learn to teach them. “There is such a tremendous need,” she says. Lucy hopes yoga for veterans will catch on, sparking a trend in yoga studios and vet centers nationwide.

Eventually, Lucy turned the regular Veterans Yoga class over to Joan, the current teacher, who completed her 200-hour teaching certification from CMYI. Joan, whom her students describe as soothing and patient, considers working with veterans the ultimate privilege, and she is always looking for new ways to reach them. Last summer she was inspired by a weeklong immersion in Yoga of the Heart, led by Nischala Devi, a disciple of Swami Satchidananda, and has now made it a part of Veterans Yoga. Originally developed for cancer patients and people with heart disease, Yoga of the Heart features extremely gentle postures and deep relaxation, which clearly benefit the veterans.

"If you can realize that it's your PTSD at work when you're overreacting, you have a better chance of working it through."
- Tom Boyle

Those benefits are being recognized not only locally, but also by the state. The Massachusetts Board of Higher Education’s Office of Veterans Education has certified the Central Mass Yoga Institute as an approved agency for veterans’ vocational rehabilitation training. This means that a veteran can take CMYI’s yoga teacher-training program for free.

Veterans Yoga soon will be revamped into a full-blown wellness program where veterans attend workshops on diet and nutrition, relaxation techniques, pranayama, seated and walking meditation, developing a personal yoga practice, and keeping a journal. To mark their progress, the veterans will complete written evaluations of their mental, emotional, and physical health before and after participating in the program.

What is more, Lucy and Tom Boyle anticipate the new generation of vets will try Veterans Yoga. The Walter Reed Army Medical Center in Washington, D.C., estimates that one in six Iraq vets experience depression, anxiety, or PTSD. The Pentagon now requires all military personnel to undergo three mental health assessments in their first three months after returning from Iraq, so these vets will not suffer in silence for decades before being diagnosed and treated, as many of their Vietnam counterparts did.

At the Worcester Vet Center, Vietnam veterans are reaching out to Iraq veterans. “Vietnam vets want to see to it that the vets of this era are getting what they need,” Tom says. “They don’t want to see these kids denied help.”

At its best, devotion to yoga makes us generous, brave, and clear-sighted. The veterans of Veterans Yoga are learning the practice as well as the philosophy—and living both.

Alicia Bessette
Alicia Bessette is a reporter for The Landmark newspaper in Massachusetts and contributes to the Bryn Mawr Alumnae Bulletin.

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