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N.M. prepares for a novel method for treating vets' PTSD
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It took the federal government decades to recognize the psychological wounds many veterans carry home from war.
Treating post-traumatic stress disorder in veterans of Vietnam and older wars has often proved just as long a haul, with varying results.
But with hundreds of New Mexico veterans of the wars in Iraq and Afghanistan already seeking psychological help, a new state initiative is aiming to train counselors in what might seem like a novel technique: using eye movements to treat traumatic memories.
So far, 25 counselors from across the state have received training in a method called "eye movement desensitization and reprocessing." A second state-sponsored training session is scheduled for next month.
About 400 New Mexico counselors are already certified in the technique, but the 25 being trained through a $55,000 appropriation from the Behavioral Health Division of the state Department of Health were selected specifically for helping veterans.
"When you go to war, you see the most evil and vile side of human nature there is. Sometimes it's an experience your heart needs some help to get over," said Lou Helwig, director of field operations for the state Department of Veterans Services, which is helping to coordinate the training.
"The VA is not going to be able to provide everything veterans need."
In EMDR treatment, patients call to mind traumatic memories while following a counselor's finger with their eyes, said Peggy Moore, an Albuquerque social worker and one of the trainers in the state program.
Exactly how that process helps a patient isn't fully understood.
"No form of psychotherapy is, because we don't fully understand the brain," Moore said.
Normally, the brain processes a traumatic event through a course of initial reaction, fear and then eventual understanding.
"We come to think of it as something that happened in the past," she said. "But sometimes, a highly traumatic event gets stuck and doesn't process that way."
EMDR helps unstick the memory, alleviating symptoms like flashbacks and nightmares that form the basis of PTSD. When it works, Moore said, it's permanent.
Not everyone is convinced it's the treatment of the future. Evelyn Sandeen, director of inpatient psychiatry at the Department of Veterans Affairs Medical Center in Albuquerque, said EMDR has proven effective in some cases, though not necessarily more so than other treatments that push patients to confront traumatic memories.
"Some people make it seem like a miracle treatment, but it's not," Sandeen said. "It's not a panacea."
Moreover, Sandeen said, EMDR is most effective with patients dealing with a single traumatic episode, like sexual assault victims. Most veterans with PTSD, she said, confront a number of traumatic memories.
But as the VA for the first time tries to treat large numbers of recent veterans suffering from PTSD, which wasn't officially diagnosed until a decade after the Vietnam War ended, EMDR gives therapists another option, and some do use it, she said.
Although Tricare, the military equivalent of health insurance, considers EMDR "unproven," the Department of Defense, the Department of Veterans Affairs and the American Psychiatric Association have rated it among the most effective treatments for PTSD.
Lou Masica, the training program's director at the state Department of Health, said the idea for the program came out of a work group studying causes of suicide. Several counselors with the department, veterans themselves, believed EMDR could help other veterans.
"They were determined to get this together, and they came up with the money, basically out of some nooks and crannies in our budget," he said.
Part of the focus is to train caregivers across the state, not just those at the VA Hospital in Albuquerque.
"This is a rural state, and in a crisis intervention on a Friday night, the VA's not going to have anything nearby," Helwig said.
While PTSD afflicts people from all walks of life, Helwig said the influx of veterans returning from Middle East war zones means the state must increase the availability of mental health care. At least one-quarter of the 2,000 new veterans enrolled at the VA Medical Center are receiving mental health care, and that number is only going to increase, Helwig said.
"PTSD is a wound," he said. "The same as a bullet wound, except it doesn't heal as easy."

