PARK CITY — On a blue-sky, fluffy-cloud, crisp October day, several service members are way above the ground on a ropes course in Utah’s mountains, helping a handful of their kids and spouses slide threaded boards that serve as steps to cross a high wire. They’re laughing and shouting strategy tips and it’s hard to tell from below that steps they are taking across the rope are part of a journey back from the worst days of their lives.
Roger Sparks participates in a ropes course with his son Ozric during the R&R program at the National Ability Center in Park City on Oct. 19, 2016. | Ravell Call, Deseret News
Pararescue jumper Roger Sparks is still reeling from a 2010 recovery operation in Afghanistan where he cradled four dying men and clawed his way through hell to help bring others safely home.
Jim Mullins stays on the ground beside the ropes course, but he’s trying just as hard to come back from an ambush in Vietnam that left him wounded and stranded for days among the bodies of dead buddies more than 40 years ago.
Kerry Shurtz doesn’t offer specifics but says he’s been confronting every traumatic event from two duty tours in Iraq, while Theolene “MJ” Johnson is trying to outrun near-constant nightmares from service in Iraq and Germany.
They are among participants in a special program called The R&R Program for service members and veterans with post-traumatic stress disorder (PTSD), its aim to help them lead stable lives and, in the most extreme cases, prevent suicide. It is a collaboration between the National Center for Veteran Studies at the University of Utah and Park City’s National Ability Center. NAC provides education and recreation, from camps to equestrian programs, for people of different ability levels including those with special needs, in a beautiful outdoor setting.
This group is the first official run-through of the program, following a successful pilot project at the same venue to prove its effectiveness. The R&R Program shortens what’s normally 12 weekly cognitive processing therapy (CPT) sessions into two weeks with daily individual therapy and group therapy. R&R also invites service members and veterans to bring family along on the healing journey.
The program’s name, R&R, doesn’t stand for anything specific. Veterans can pick what it means to them, says psychologist Craig Bryan, executive director of the NCVS: Rest and recuperation? Rehabilitation and recovery? Regardless, it very much fits “the military concept of taking a break,” Bryan adds.
Regardless, it very much fits “the military concept of taking a break,” Bryan adds.
PTSD is a mental health condition triggered by something terrible, whether experienced or seen. It can show up days or even years later as nightmares, flashbacks, debilitating anxiety, rage or something different. PTSD often lives alongside traumatic brain injury, chronic pain, substance abuse, depression and insomnia.
Efforts to count how many service members have PTSD have largely failed. The military says as many as one-fifth of Iraq and Afghanistan conflict military personnel develop PTSD, as do 15 percent of Vietnam vets in a given year — even decades after war's end. Lifetime occurrence for combat veterans is between 10 and 30 percent, the VA adds.
The Department of Defense/VA and the Institutes of Medicine say two treatments work: CPT, or Cognitive Processing Therapy, which the R&R program uses, and prolonged exposure therapy. Bryan's research shows CPT reduces suicidal thinking and that brief cognitive behavioral therapy reduces suicidal behavior among military personnel by 60 percent. He hopes their similarities mean CPT will prevent suicide, too.
PTSD is a minefield filled with myths, from who gets it to how it manifests. There's also a notion — completely wrong — that it cannot be treated or that it will require years of treatment, Bryan says.
Among the heaviest burdens placed by PTSD is stigma, especially in conjunction with military service.
AnnaBelle Bryan talks with Corey as she pets Corey's dog Tiny during the R&R program at the National Ability Center in Park City on Wednesday, Oct. 19, 2016. | Ravell Call, Deseret News
That's why an Alaska pararescue jumper named Corey, 34, says he's happy to talk about R&R, but won't give his last name. "The country freaks out about PTSD. I don't want that anytime someone Googles my name."
Cognitive processing therapy and prolonged exposure therapy test equally well as PTSD treatments. “There’s an extremely high recovery rate for both,” says Bryan. “When you compare these to other types of therapy, they crush the competition.”
Research shows daily therapy works as well as weekly therapy, opening the door to intensive short-course therapy like R&R uses, says Bryan, who served in Iraq as a psychologist and whose wife, AnnaBelle Bryan, is the U. veteran center's director of education and outreach.
The goal is five two-week sessions a year, reaching out to suffering service members and veterans. This group includes two Vietnam veterans and service members who served in Iraq and Afghanistan. Some have combat-related PTSD; at least one experienced military sexual trauma. They represent the Army, the Air Force and the Marines.
Luis Garcia participates in a ropes course with his daughter Zinnia during the R&R program at the National Ability Center in Park City on Oct. 19, 2016. | Ravell Call, Deseret News
One participant, Luis Garcia of Los Angeles, does not have PTSD, though he, too, has experienced service-related trauma, including seeing a helicopter crash in the Helmand Province of Afghanistan on June 9, 2010, that killed two close friends. He was invited to participate in R&R to see if providing CPT up front — teaching coping skills before they're needed — can head off PTSD. Bryan is hopeful it will.
Each morning, participants have an hour-long individual therapy session, before joining family members for lunch and fun activities. Over the two weeks, they’ve gone biking and engaged in recreation and team-building tasks. After dinner they do group therapy and hang out or wander. One of the participants likes to visit the horse stable, while another hikes up a mountain to practice meditation skills learned during evening group sessions. In the sitting room, everyone's careful not to bump the table containing a Monopoly game that has spanned two days.
The program goal is recovery, says Bryan; a cure is more controversial. He likens it to breaking a bone: With great care, it mends, although the break may be visible on X-ray. Critically, he notes, after the bone heals, it becomes stronger.
Kerry Shurtz is interviewed during the R&R program at the National Ability Center in Park City on Oct. 19, 2016. | Ravell Call, Deseret News
No two the same
Shurtz, 47, of St. George, Utah, is a self-described workaholic who couldn’t imagine taking two weeks away from his National Guard unit. He was diagnosed recently with PTSD. Over the last 15 years, he says he’s become quiet and inactive due to PTSD. He’s lost a lot of his joy and desire to socialize. “My hope and what I think I am seeing is I am becoming who I once was. I don’t feel like I want to be isolated.”
That’s high praise for a man who arrived with trepidation. “As a soldier, as a man, as a service member, it is not normal for us to want to talk about our feelings,” he says. "(But) it's not been a waste of my time in any way. I'm focused working on me personally and those demons that are causing me to live a life of isolation and avoidance.”
Corey said he’s long tried to avoid looking inside himself. When the program forced him to do that, he was frustrated to discover how easy and pain-free it was. “I am realizing now how simple the problems are.... I want to shout out to others who may be experiencing a difficult time since their service to the country. There are some really logical tools to help us focus. (PTSD) doesn’t have to change our lives.”
Decades of trauma
Vietnam broke Jim Mullins, but R&R is helping him put himself back together. During the ambush that changed his life in 1974, 28 of 39 troops were killed. He was stuck several days in a Vietnam jungle with the bodies and has been haunted since.
The impact wasn’t just misery. He’s been both jailed and in inpatient programs and he’s had a string of broken relationships. He is restless and moves often.
But he says this treatment feels different, like he's "standing on a cliff where for the first time I can see what’s below in every direction."
It's a bit scary. He must "rebrand" himself because a lot of people have given up on him.
Who has he become?
“I am a man that believes in hope and idealism and I want to be a better person, finding happiness and some kind of inner peace,” he says.
Jim Mullins and his wife Melanie Tafoya share time together during the R&R program at the National Ability Center in Park City on Oct. 19, 2016. | Ravell Call, Deseret News
His wife of three years, Melanie Tafoya, has come with him and they laugh together easily. She says she’s “happy to see him find a new vision of himself.”
Bryan gently reminds Mullins there will be bad days; memories have not been erased, they're just becoming manageable. “Whatever that day was for you, it was a bad day,” says Bryan. “The trauma you experienced was legitimate and sad.”
What has changed, he adds, is who drives the car. Trauma sits in the back seat now.
Roger Sparks stands 6-foot-8, so he looks like a giant atop the ropes course, holding the hand of his son Ozric, 12, as he directs him to “moonwalk” one of the boards to the next one. His voice is soothing, his face calm, and it settles the boy.
Sparks, 42, is here from Eagle River, Alaska, with his wife Jennifer and his son. They were high school sweethearts. He proposed right after he joined the Marines and completed basic training. Another son lives in Texas.
He did reconnaissance for the Marines as a young man, but 13 years ago decided he wanted something a little safer and to have more time with family. Like Corey and Garcia, he became an Air Force pararescue jumper, a PJ, choosing the elite, highly specialized job because it felt more "virtuous, trying to salvage lives." He has, but he also jumped into a nightmare.
The details of how Master Sgt. Sparks became a hero during a 2010 operation called Bulldog Bite, one of the bloodiest battles in Afghanistan, aren't something he likes to share, but they're widely known. Of 60 U.S. service members engaged with the enemy, 49 were wounded. Eleven died, four of them in his arms. He'd gone in to retrieve the bodies of two soldiers who were killed — a job his wife calls “the other, sad side of rescue.”
Sparks was awarded a Silver Star for his heroism, nearly unheard of for someone whose job is rescue and retrieval.
“A lot of what we work with here is esteem and gratitude,” says Sparks, who has tried other forms of therapy. This time, with professional help, he looked at the “stuck points,” and learned to reframe his own thinking to move on.
In CPT, service members work with a therapist to understand their own thought processes about their traumatic events. They learn new ways to think about it.
Johnson experienced military sexual trauma in Germany and was wounded in Iraq. Her nightmares leave her exhausted, shaky and often unable to do even simple tasks. Here, she's learned to look at her "problematic thinking in a positive way," she says. "It's allowed me to open up about the deeper, harder stuff."
“What it forced me to do is focus and accept every traumatic event I’ve had and analyze it," says Shurtz. "I have reached the realization it is part of my life. It doesn’t control me anymore, actually — or at least I am working on that.”
Shurtz, who did two tours in Iraq, has a game plan for later. “There will be days when I slip up and have feelings of self-destruction or nights with nightmares. If it happens, it doesn’t mean, okay, it’s back, it didn’t work.” He’ll talk things over with someone he loves, accept it and move on. "No more hiding or isolating, shame or disgust," he says.
At the end of the program, evaluators not involved in the treatment interviewed participants to determine their diagnosis. Five no longer scored in the range that indicates PTSD — and the score of the sixth improved greatly.
"They are all recovering, with new tools to help them meet challenges," says Bryan.
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