As reported by the New Haven Advocate, November 16, 2010.

UConn's New Approach to PTSD Among Veterans

The Echoes of Combat

By John F. Hoctor

Like a sniper’s bullet, post-traumatic stress disorder cares not about its victim. PTSD violently strikes, tearing into a warrior’s soul, destroying from the inside out.

The eyes of “Matt Murphy” dart from ceiling to floor, window to door. The Iraq veteran’s rough hands — hands that poked dead animals and probed human body bags in search of enemy explosives — now wrap tightly around a cup of coffee he probably doesn’t need. Talking about the realities of Iraq, he remains wired, wound tightly — a buff, tough sergeant ready to explode inside a local Starbucks.

“Yeah, I knew I had a problem in Iraq when I wanted to start machine gunning whole towns,” the former 82nd-Airborne soldier recounted. Matt returned to Norwalk from active duty in late March of this year after an extended deployment.

“I wanted to start tearing people’s heads off,” Matt would tell anyone willing to listen.

Looking to continue the physical discipline of the Army, Matt enrolled in a six-month program to become a personal trainer. However, his conduct in the classroom caused his classmates to recoil and ultimately keep their distance. He repeatedly buttonholed them to listen to his ravings and tales from Iraq. He screamed at the television when an Arabic speaker came on and jumped when someone dropped a pan in the training school’s pantry.

He was a stocky, sinewy soldier, with a martial arts Ultimate- Fighting-Championship build, who always donned the same GI-Joe cartoon T-shirt and stocking hat. He had a brooding and sullen stare and remarked, incessantly and uncontrollably, on the stressors of his war experience as his one and only life experience. His classmates gave him the nickname “McMurphy” after Jack Nicholson’s iconoclastic, charismatic mental patient in One Flew Over the Cuckoo’s Nest.

“Those guys on the side of the road with the cardboard signs — I can see how they get there,” Matt says. “I’m afraid of losing everything I came home to.” The 35-year-old soldier bitterly calls himself a poster child for PTSD.

A diagnosed anxiety disorder only since 1980, PTSD has reared its ugly head all too often among veterans of the Iraq and Afghanistan wars. According to a study by the Institute for Operations Research and Management Sciences, researchers anticipate PTSD rates as high as 35 percent among this generation of veterans.

“I’ve got some serious issues.” Matt offered flatly.

And whereas soldiers were welcomed home to euphoric support earlier in the wars, now they come back to a changed America, where the wars have been forgotten thanks in part to the economic straits of the country.

Enter the clinicians, psychiatric “experts” tasked to reach out to Matt and others like him. They are currently seeking bold new solutions to treat new injuries from new wars.

“One of the biggest challenges right now is that most people with PTSD have at least one other problem, often two other problems, or more,” said Dr. Matthew Friedman, executive director of the Department of Veterans Affairs’ National Center for PTSD. “They may often be depressed or they may have a drinking or a drug problem. Or with the new vets from the new wars, they may have a mild traumatic brain injury on top of their PTSD.”

Matt is a graduate of the Department of Defense’s sometimes brutal “exposure therapy,” but still feels gripping anxiety. However, during the past few months he has connected with what he feels will finally stabilize and keep him together: TARGET.

“TARGET” is the acronym for Trauma Affect Regulation: Guide for Education and Therapy. Hoping to decrease the number of veterans exhibiting dysfunctional and/or criminal behaviors, the U.S. Justice Department awarded the University of Connecticut Health Center a $750,000 grant for a two–year study that will compare the effectiveness of TARGET versus conventional treatment for PTSD. Researchers are seeking 90 male veterans of the Iraq and Afghanistan wars to participate. Participants like Matt will receive free therapy and be placed randomly in either a group treated with traditional therapies or a group treated with TARGET techniques.

“The goals of the two therapies are very much the same,” said Julian Ford, psychiatrist and principal investigator for the study.

In the first, more traditional and widely used treatment, patients face their fears head on while concentrating on hurtful memories, Ford said. Professionally referred to as “prolonged exposure” therapy, this treatment also places patients in situations they would normally avoid.

TARGET, on the other hand, focuses on increasing a veteran’s skills for controlling anger and other emotions, Ford continued.

According to the University of Connecticut Health Center, more than 13,000 men and women in the state have served in Iraq and Afghanistan. Nearly 40 percent will develop PTSD and at least half will have anger issues. Males constitute 85 percent of Connecticut veterans.

Ford has worked with veterans who suffer from PTSD and their families for 25 years. He emphasized that people naturally have great coping skills, and added that by focusing on their emotions, as is done with the TARGET process, veterans have experienced success in dealing with stress over time.

UConn researchers hope that the new TARGET therapy will be at least as effective as the well-established prolonged exposure method.

Matt has made progress adjusting to what he calls “the blur of home.” He said stigmatization of veterans seeking out treatment for PTSD still exists in the Army, where advice has remained the same: “Suck it up.”

“Even though I witnessed an Iraqi girl shot down three years ago,” Matt said, “it’s fresh in my mind.”

Matt bolted heatedly from a lecture on the Iraq war at Norwalk Community College because the history teacher was a liberal. “I just don’t want all of it to be for nothing,” the recently honorably discharged soldier lamented. “This took a big chunk of my life away — and I want it to count for something.”

Matt’s large shaved head descends into his hulk-sized hands. When he looks up, there are tears welling in his eyes.

“Sorry,” he says softly. “I’m sorry.”

No one seems to understand, and he cannot yet explain.