Published in the Sri Lanka Guardian (6 March 2011)
Find the Best Way for Combating PTSD in the Sri Lankan Military
By Jerry Yellin and Dr. David Leffler
In their well-written in-depth article “Combat Related PTSD among the Sri Lankan Army Servicemen” published in the Sri Lanka Guardian (13 February 2011), Dr. Neil J. Fernando and Dr. Ruwan M. Jayatunge assert that the “30 year armed conflict in Sri Lanka has produced a new generation of veterans at risk for the chronic mental health problems that resulted following prolonged exposure to the war.” Their contention is backed by an interview of 824 active duty Sri Lankan soldiers referred to the Psychiatric Ward at the Military Hospital in Colombo. It reveals that: “[f]ollowing the combat trauma in Sri Lanka, a significant number of combatants were diagnosed with Post Traumatic Stress Disorder (PTSD)” and that the “affected combatants had behavioral problems, psychosomatic ailments, depression and anxiety related symptoms, self-harm, attempted suicides, alcohol and substance abuse, and misconduct stress behaviors.”
Dr. Fernando and Dr. Jayatunge report “several modes of psychological therapies have been used to treat the Sri Lankan combatants suffering from PTSD including Cognitive Behavior Therapy (CBT) and EMDR (Eye Movement Desensitization and Reprocessing)” and studies “are needed to systematically assess the mental health of the members of the armed services who had participated in the warfare.” They point out there “were no published studies of the PTSD rates among the Sri Lankan military personnel” and further argue a “study would give an insight to the policy makers in the military and care providers in the mental health sector to deal with combat trauma in Sri Lanka effectively.”
The authors salute Dr. Fernando and Dr. Jayatunge for bringing attention to the combat stress-related problems of Sri Lankan soldiers and veterans. We agree with their assessment, a study is necessary to determine the PTSD rate so “screening, case identification, effective treatment and psychosocial support can be provided to the combatants.” In addition, we urge such a study also utilize a random assignment protocol to investigate not only the present modalities of PTSD treatment currently used by the Sri Lankan military, but also a modality, which has already been extensively scientifically validated to reduce stress – the Transcendental Meditation® (TM) technique.
TM involves a simple, non-religious, psychophysiological practice, demonstrated in over 600 research studies to reduce a wide variety of stress-related problems. It is practiced twice a day for twenty minutes and is so easy, anyone who can think a thought can to do it. It carries one’s awareness to a profound level of rest, clears out deep-seated stress, and revitalizes frazzled nervous systems. Meta-analyses published in peer-reviewed journals provide more evidence for the superior effectiveness of the TM technique over other practices in the areas of anxiety reduction, reduced high blood pressure, self-development, physiological relaxation, improved psychological outcomes, and decreased use of drugs, alcohol, and cigarettes.
Research shows all meditation practices are not the same. In recent studies these practices have been classified into three categories: Focused Attention, Open Monitoring, and Automatic Self-Transcending. Techniques in the Focused Attention category are techniques requiring concentration. Those forms of meditation show brain activity associated with focusing – fast EEG called gamma (20-50 Hz). Techniques in the Open Monitoring category include mindfulness or Vipassana. They are reported to activate brainwaves associated with internal mental processing – theta activity (4-8 Hz). Techniques in the Automatic Self-Transcending category transcend their own procedure – take the attention out of thinking, analyzing, controlling, or watching to a state of pure consciousness. The Transcendental Meditation technique is in this category. During TM synchronous alpha1 (8-10 Hz) activation is seen primarily in frontal executive areas as well as over the whole brain, indicating integrated functioning of the brain.
Different meditation techniques use different procedures, have different effects on brain functioning, and so lead to different benefits. The more focused the meditation procedure, the more focused the effects. Techniques of concentration such as Zen are found to activate attentional centers. Another technique in this category, Loving-Kindness Compassion, actives emotional centers of the brain. Techniques of Open Monitoring such as Vipassana are reported to decrease pain perception and have a small effect on anxiety. TM, a technique in the Automatic Self-Transcending, is reported to have a wider range of effects, perhaps owing to the experience of pure consciousness underlying all thought activity. For instance, meta-analyses report that TM practice results in higher levels of self-actualization and greater decreases in anxiety than other meditations. In the bigger picture, research on TM practice reports significant effects on psychological measures – improved moral reasoning, creativity, cognitive flexibility, coping and problem solving, improved health – reductions in blood pressure and in hospitalization, and significant improvement on social interactions.
The TM technique is also different because it turns one’s attention inward to experience deeper levels of thought, until one goes beyond active thought and the mind comes to a state of complete inner rest. But the mind is alert. There is an inner wakefulness, and a feeling of calm and peace. This is the state of restful alertness. The brain functions with significantly greater coherence and the body gains deep rest.
Research shows the deep rest gained during TM practice is more profound than deep sleep. This allows the body to rid itself of deeply-rooted stresses, especially the stress associated with traumatic conditions like PTSD. For instance, a peer-reviewed, random assignment study on Vietnam veterans who practiced TM (Journal of Counseling and Development, 1985: (64); 212-215), found the technique effectively influenced the neurobiological aspects specifically affected by PTSD. The University of Colorado School of Medicine researchers demonstrated that TM practice had positive effects on symptoms associated with PTSD. Instruction in the technique, followed by three months of regular TM practice, significantly reduced emotional numbness, anxiety, startle response, depression, alcohol consumption, insomnia, and family problems. The TM group also reported improvements in sleep and obtaining/keeping employment. Seventy percent of the TM practitioners reported that they no longer required the services of the veteran’s center.
In a new pilot study (under review), Iraq and Afghanistan veterans experienced a 50% drop in PTSD symptoms by the fourth week of TM practice, and greater improvements by two months and three months. This study is summarized in the book The Resilient Warrior: Healing the Hidden Wounds of War (2011) by authors Jerry Yellin and Dr. Sarina Grosswald.
But even with impressive results like this, critics might argue that military personnel would not be willing to practice the TM technique. Initially this might be the case, but the results of the practice speak for themselves. For instance, Lt. Col. Brenda Marlinbanks, a U.S. Army Reserve officer, expressed her initial skepticism about learning the TM technique. “It seemed too wimpy for an Army person,” she said. But a U.S. Air Force officer advised her to learn it because she had gone through some personal difficulties and was coping very well.
Marlinbanks took her advice, and was grateful she did. “A few days after I began TM, I was able to sort through all the loose thoughts and tasks that were fogging up in my mind.”
She said TM gave her the clarity to prioritize the important things and discard the junk eating up her precious time. “Now I have more time and feel less anxious and stressed…It’s hard to believe that something so simple could be so effective and so fast.”
For those concerned a perceived “machismo pushback” for meditation may prevent Sri Lankan warriors from learning to meditate, read the following “war story.”
The late Lieutenant Dan Burke, (combat veteran of the U.S. Navy SEAL Teams) found the TM technique to be “tremendously beneficial” during combat operations in Panama while serving with the US Navy SEALS in 1989. He writes:
To the right is a photograph of me in Panama during combat operations in 1989. My teammates and I were on a rest break during a jungle patrol. While sitting in our security perimeter, I closed my eyes and practiced the Transcendental Meditation technique and a friend took this picture. I found the technique tremendously beneficial during those weeks in terms of stress relief as well as performance enhancement, e.g. more energy, more vitality and more clarity of mind. This experience was invaluable to me, perhaps even life-saving. I think governments should provide TM training for military professionals on active duty, as well as for veterans who suffer from combat stress, anxiety and Post-Traumatic Stress Disorder (PTSD).
As a SEAL on active duty, it was easy to see the benefits of TM practice on the individual level. This came from my own direct experience as well as from the numerous scientific research studies on the TM technique, for example, regarding improved performance, broad comprehension, field independence, greater alertness, quicker reaction times, etc. I even remember coming across a study that showed improved night vision.
These findings were very motivating for a young elite warrior aspiring to be the best that he could be. Later in life I realized that, on the one hand, training for peak performance was a thrill and an achievement, but on the other hand, I was fully capable of serving in and leading top-performing groups without ever having to prove myself in combat.
LT Burke also mentioned that after two solid days of leading his SEAL team in this combat operation, sleep deprivation had seriously lowered his combat effectiveness and that of his men. After the deep rest gained from his short meditation, Dan was again an alert, ready and finely-tuned warrior. He gained an “unfair advantage” not only over his team, but obviously also over his opponent. Wise warriors know that in war nothing is unfair, and therefore one takes whatever advantage one can to gain the upper hand over an enemy.
If we think back through history to great examples of alert, ready and finely-tuned warriors, the ideal might be martial arts experts like the samurai. They represented the total integration, the total union, of mind and body – quick, clear thinking combined with a precise strong body, working as one. This intimate connection between mind and body is now beginning to be rediscovered in several militaries in Latin America. For instance, an Ecuadorian General was very receptive to the concept and decided to have his warriors instructed in the TM technique on 8 March 2010. As a test case, the General selected two units from training centers where young soldiers received their six months’ basic military training before they were sent to operational units. Each training unit had 300 soldiers who were taught the TM technique, and 200 among them who became advanced experts. The General set the time and place for the soldiers to practice their meditation program in a group in accordance with their duty routine.
After one month of practice, a test was done together with military psychologists in order to check the validity of the TM program. Here is a summary of the warriors’ statements:
- 96% thought it was a very practical activity
- 95% said it was completely satisfying
- 92% declared they improved dealing with stress and had better performance in their actions
- 96% declared their relationships with others improved.
Wounded and traumatized military as well as healthy military personnel need – and deserve – every opportunity to regain and/or sustain their health. Research also shows that practitioners of the TM technique rise to a higher level of health. For instance, a 1987 study in Psychosomatic Medicine, a mainstream medical journal, monitored for five years the medical care utilization of 2,000 people who regularly practiced the TM technique. The findings: 50 percent fewer doctor visits and hospital admissions than non-meditators of comparable age, gender, profession, and insurance terms.
Multiple statistical reviews published in respected scientific journals provide powerful evidence for the superior effectiveness of the TM program in the areas of blood pressure and anxiety reduction, self-fulfillment, physiological relaxation, improved psychological outcomes, and decreased use of drugs, alcohol and cigarettes. If you are interested in the research, visit this web site https://www.tm.org/research-on-meditation.
Today’s warriors train their minds and bodies, but separately. They fill their minds with information about how to respond to every imaginable situation, and train their bodies for strength and endurance. Strong protective armor is provided to protect their bodies from physical harm, but nothing for their minds to protect them from stress. Research on the TM technique indicates that the practice produces beneficial effects for the mind and body, opposite to those of chronic stress. The TM technique is a portable strategy. After learning the technique, all one needs is a comfortable place to sit and close the eyes. No additional resources are needed. The self-reliance of this approach appeals to the “warrior mind-set.”
Why not try this innovative approach in Sri Lanka and conduct a randomized study comparing it to other modalities of treatment to find the best way to treat PTSD? If this proposed project is successful, military leaders could provide this innovative approach in the healing mix of services to more effectively and efficiently treat the wounded minds of the warriors who protected Sri Lanka. TM offers a do-less-and-accomplish-more approach that can not only help the precious minds and lives of Sri Lanka’s warriors, but also save money in the process.
For more information about the TM technique and PTSD see:
Highlights of the David Lynch Foundation inauguration of a program called “Operation Warrior Wellness,” which will make the TM technique available to military personal and veterans (also described by the Fox News video and The Wall Street Journal article linked to below) are available here: https://www.davidlynchfoundation.org/videos.html
Fox News – “Meditating With the Stars” – Stars like Russell Brand lend a hand to veterans suffering from Post-Traumatic Stress Disorder through the practice of Transcendental Meditation: http://video.foxnews.com/v/4458178/meditating-with-the-stars/ (note the video showing people meditating is “B-roll footage” of people practicing another type of meditation. The TM technique can ideally be practiced in a comfortable chair without crossing the legs.)
Also, see article online “Filmmaker Introduces Veterans to Meditation” published in The Wall Street Journal on 26 November 2010: http://online.wsj.com/article/SB10001424052748704638304575636911988306800.html
More information about combating PTSD through Transcendental Meditation (including online videos) is available at: http://davidleffler.com/2008/combat-stress-solution/
About the Authors:
Jerry Yellin was a P-51 Pilot in WWII who flew 19 missions over Japan. Jerry and Helene, his wife of 61 years, have four sons and six grandchildren – three living in America and three in Japan. Jerry is a member of the Military Writers Society of America, author of three award winning books, Of War and Weddings, The Blackened Canteen and The Letter; and is an honorary board member of the Iwo Jima Association of America. His new book is The Resilient Warrior: Healing the Hidden Wounds of War.
David Leffler, Ph.D. a United States Air Force veteran, is the Executive Director of the Center for Advanced Military Science (CAMS) http://www.StrongMilitary.org. Dr. Leffler later served as an Associate of the Proteus Management Group at the Center for Strategic Leadership, US Army War College. The Journal of Management & Social Science recently published his paper “A New Role for the Military: Preventing Enemies from Arising – Reviving an Ancient Approach to Peace,” indicating that the military application of the Transcendental Meditation is merited. Dr. Leffler is a certified teacher of the Transcendental Meditation technique.
Other related articles published in the Sri Lanka Guardian include:
- South Korea Needs a Defense System Beyond Nuclear Weapons by Dr. John Hagelin and Dr. David Leffler (1 June 2009),
- “Bomb of Silence” – Invincible Defence Technology for Sri Lanka by Dr. Michael Larrass, Maj. Gen. Kulwant Singh (Indian Army, Ret.) and Dr. David Leffler (17 May 2009),
- ‘Yogic Flyers’ can keep Lanka united, says German veteran by Lt. Col. Gunter Chassé (German Air Force, Ret.) (3 April 2009), and
- A Scientifically Verified Means to End Protracted Violence in Sri Lanka by Maj. Gen. Kulwant Singh (Indian Army, Ret.), Dr. John Hagelin and Dr. David Leffler (10 January 2009).