Veterans in the Dallas-Fort Worth area are experiencing a powerful new program “Training Mindfully with Qigong Principles,TM” to manage their post-combat stress. It’s part of a new patient-centered health care initiative sponsored by the VA.
Qigong involves using the breath to move the body through a series of learned techniques to increase physical strength, mental focus and emotional balance. It is the deepest root of traditional Chinese medicine and martial arts. The new VA-sponsored program introduces vets to eight Qigong principles during a 12-week, 24-class program. It uses a series of simple breathing techniques, nine fundamental exercises, and nine Qigong movements in a group therapy setting to help vets reframe their thoughts and emotions.
It’s a radical departure from the traditional method, which brought vets in for therapy sessions to talk about their trauma, then sent them home with bags full of pharmaceuticals to numb them up and dumb them down until their next appointment with a counselor.
“What we’re doing is just the opposite,” says Sifu Chris Bouguyon, co-founder of SimplyAware, who says he has worked with thousands of vets. “When tools like medications become the solutions, that’s when the problems start. If you really want to heal, there’s no substitute for self-exploration and hard work.”
The VA approached SimplyAware, the business run by Chris and his partner Fayne Bouguyon, and asked them to provide a class in Tai Chi, Chris told me. “But I’ve been working with vets for the past 20 years, and I’ve found that someone with TBI or chronic pain will quickly become very frustrated with Tai Chi, which appears simple, but is actually fairly complex to learn. Qigong, the great grandfather to Tai Chi, can be broken down into simpler parts. We teach a system using basic principles which allows vets the opportunity to learn useful tools for their daily lives and to become self aware on a physical, mental and emotional level.”
Qigong (pronounced chi-gung) is one of the energy system therapies, like acupuncture and acupressure which posit that the chi, or life energy, flowing through the body will become stagnant if blocked. Instead of needles, electric current or pressure on acupressure points, however, Qigong uses simple exercises and a strong focus on breath work to focus the mind, strengthen the body and enhance energy flow. “Think of the difference between a puddle of water and a flowing river — which one feels healthier? Without proper circulation, the mind, body and emotions all become stagnant, often leading to illness and dis-ease,” Chris says.
It’s a forerunner of EMDR (eye movement desensitization and reprocessing) and EFT (emotional freedom techniques), both of which involve remembering past traumas, then using immediate motion like rolling the eyes or tapping acupressure points in the body to help defuse their emotional content.
“Fear, worry and anxiety are future emotions. Guilt, grief, sadness are from the past. When we are overwhelmed by these we are no longer present, in the now. By encouraging the breath to mindfully move the body, we shift that person into the present moment,” Chris says. “As the mind focuses on ‘now’, emotions settle. From there, vets can process uncomfortable thoughts and emotions from a much less vulnerable place. Neurologically, by moving the breath into a dominant role over the body, you’re shifting the para-sympathetic nervous system (rest and digest) into the dominant role over the sympathetic (fight, flight or freeze). These two halves of our most primal nervous system simply cannot be active at the same time. Deep mindfulness training, like Qigong helps us choose which one we want active.”
The Training Mindfully with Qigong PrinciplesTM program presents eight fundamental training principles, one at a time, encouraging vets to explore them on a physical, mental and emotional level. They include “grounding energy” which explores structural stability from the core to the floor (your roots), techniques to quiet the mind, and awareness of how emotions can be uprooting. The second principle, “rising energy,” draws attention up the spine, guiding you into stronger postural alignment and exploring how your mental and emotional state can affect your posture and thus physical health. Each principle builds on the previous one and encourages you to look deeper inside yourself for answers. “We want vets to stop relying on symptom-focused drug treatments frequently used to ‘solve’ internal strife. By empowering them to look deeply and learn about themselves, we guide them towards the life they deserve to live,” says Chris.
For an example of looking deeply, let’s look at anger. “By itself, anger is simply one of our base emotions. It can protect us or weaken us depending on what tools we have in place,” says Chris. “If we’ve got a vet who thinks that everyone is against him, he will turn his anger outward and likely lash out at everyone around them.” Similarly, if someone was traumatized as a child, anger may have been the best defense against further pain, acting as a shield. But now, as an adult, that same protector or shield is blocking the ability to develop or maintain healthy relationships. “When elevated, anger blocks our reasoning ability,” says Chris, “we act from a primal place and cannot think very clearly. The fight-or-flight mode is fully activated. By learning to take a step back, “breathe deeply’ (3rd principle) and ‘listen’ (7th principle) you can regain control and operate from a more focused, available place in your mind and heart.”
If there are other factors involved such as chronic pain, then Chris and Fayne help the vet determine which one is the weakest link. Is the pain feeding the anger or is the anger pushing the pain levels up? Whichever one is in charge is the one to explore first. It has become clear to Chis and Fayne that as we address one issue, other issues begin to settle. “This is in part because as vets begins to develop better tools (communication and coping skills), they feel better and have sharper tools for the next challenge. All of this takes mindful practice which is why our program is 24 classes long. There is no escape from hard work.”
Deep breathing exercises can provide relief from surging emotions. “We worked with a vet who had been having very heated arguments with his wife,” Chris says. “As she started in, his automatic defense mechanism was to come back on her, often getting out of control. Instead, he sat back in a chair and practiced deep breathing exercises. That defused him and confused her. Then it defused her too. Next we had to teach this vet how to identify the source of his anger and improve communication with his wife to help defuse her anger without an argument. Once you are able to settle an overwhelming thought or feeling, that is when the work really begins.”
Chris and Fayne also work with vets on understanding the things that trigger their anger or anxiety. And they have a healthy respect for those triggers.
“These triggers can set off patterns of behavior which can be productive or destructive,” he says. “They’re the product of our deepest survival instincts. Humans don’t learn as well from success as we do from failure or pain. If I’m a soldier in combat and experience a trauma, my primal instincts will take in as much information as possible about the situation — all five senses will be fully engaged. The goal is to lock in the experience so that I never have to go through that again. That’s why you get triggers: to remind your whole being of the potential dangers. They’re simply part of a normal, healthy survival warning system. But vets have to be able to put them in perspective and realize that when back in the civilian world they are no longer in an active threat. Thousands of vets just push those emotions down and don’t realize what those triggers are really for.”
Understanding what triggers certain patterns of behavior can help us change the behaviors that aren’t working. In their workbook, Chris and Fayne give the following example:
“You are driving down the highway and suddenly someone cuts in front of you, forcing you to slam on your brakes to avoid a collision [This is the Trigger]. Your mind has assumed the worst of that driver, you have labeled them an idiot or something similar and you are now moving into a state of rage. Your heart is racing, you feel overwhelmed by your mental, emotional and physical responses [This is your Pattern]. You have a strong urge to race
ahead of them, cut them off and slam on your brakes to “teach them a lesson.” Nothing else matters in this moment [This is your Tool]. Your reaction and behavior are so automatic you don’t feel like you have a choice. Your Trigger-Pattern-Tool set has become habitual. Something so familiar, you don’t think about it before reaching for that tool in your toolbox. Now, consider instead of habitually reacting with an aggressive ‘eye for an eye’ tool, you choose to slow down,
drift back to a safe distance from the other car, use your deep breathing tools and begin to settle down [This is a new Tool]. Once the incident is over and you are settled, it is time for the hard work to begin. While it is fresh in your mind, try moving through the following steps:
Identify: You must be able to clearly identify the trigger and subsequent pattern of behavior. In this case, the trigger is the act of being cut off by another driver while in traffic. The pattern is to assume the worst of the other driver and the tool to help you feel better is to react with aggression, creating a feeling of superiority.
Question its Origin: Once your tools have settled you down and you have identified the trigger and pattern, it is time to ask the question – Where did this aggression come from? As you sit with your breath, you begin to realize that you had little control over the situation that triggered your pattern of feeling vulnerable, victimized and in fear for your safety. The tool was to act out with aggression. Digging deeper you find the base emotion involved is fear. Once you connect with the base feeling, dig deeper and ask, “When was the first time I can remember feeling vulnerable, victimized and turning to anger for protection?” In your questioning, you realize that you were bullied as a child and anger was your best defense to make it stop. At that point in your life, the pattern made perfect sense. It kept you safe. I was victimized and anger protected me.
Payoffs: Often, we can feel as if we have no control over a pattern, feeling helpless to change it, effectively living on autopilot. We know the pattern is painful, we don’t like it, but we find ourselves doing it anyway. In this case, it is very important to understand that when we keep repeating a pattern, there is a payoff. We are in some way being rewarded for maintaining the pattern. When we dig deep and identify the payoff, we can then determine if it is worth the effort to keep it going. As long as these patterns are allowed to run on autopilot, we are helpless to stop them. Without this level of work and understanding, you can never be truly free of any behavior loop.”
Chris did say one thing that really surprised me, although, in retrospect, perhaps it shouldn’t have. I’ve run into it in the past several times and suspected it in other cases.
“In virtually every case I can think of, we’ve found that trauma started in childhood, not in combat. That’s in line with a study in Denmark on resiliency in soldiers. They found a strong correlation between unresolved childhood trauma and subsequent PTSD,” Chris says. Before their combat experience, many of these vets were functioning well, even after having experienced difficult childhoods; however, the stress of combat somehow triggered a dormant response which was amplified by their personal history.
Those traumas include the accidental deaths of family members and friends; parental alcoholism; physical, emotional and sexual abuse; being bullied and witnessing domestic violence. “When soldiers who were previously subject to domestic violence encounter similar behaviors while in combat, they feel compelled to step in to break it up,” Chris says. “One soldier came across several men raping a boy and intervened, only to find that these were the tribal elders that were punishing the boy with the consent of the father for something he’d done wrong. But for this soldier, it brought back vivid memories of being repeatedly raped at about the same age; powerless to act then and now, it left him feeling suicidal afterward.”
Chris remembers another soldier who was taught defensive driving by his horribly abusive father, the kind of high-speed evasive driving that a moonshiner or a lawbreaker might employ. He became an excellent combat driver, except that in combat situations, he didn’t care who or what was in front of him. It was as though, when stressed, he fell back into his own father’s abusive personality. The guilt of his behavior when he was the one in power has often been overwhelming for him.
There have been calls for a baseline psychological examination to determine which soldiers might be vulnerable to PTSD due to previous childhood trauma, but Chris is skeptical. “There’s absolutely no incentive for anyone to be honest in a preliminary psych eval,” he says. “In addition, there’s no training, for example, to help a sniper deal with what it feels like to pull the trigger and watch some guy’s head explode through your scope. Then, what do you do with those feeling when you come home? My ideal would be to provide soldiers with effective coping skills before they are exposed to combat and offer a training path back to civilian life upon their return. A kind of reverse boot camp which helps them de-escalate and reintegrate into their family unit and life in a healthy way. I believe this would greatly reduce the amount of money we spend on post-trauma care on several levels. Medical costs would go down, legal interventions such as for domestic violence and divorce would be reduced, and there would likely be less drug and alcohol abuse.”
The Training Mindfully with Qigong PrinciplesTM program offers the kind of training and dialogue which is a testament to a more enlightened form of therapy that the VA has been promoting with its Patient-Centered Care Program. When it rolled out this program three years ago, the VA told its employees that it would introduce creative arts into the healing environment, ensure emotional and spiritual support, encourage involvement of family and friends, provide for physical comfort and management of pain, and incorporate the nutritional, cultural and nurturing aspects of food into its treatment.
Dr. Tracy Gaudet, who was brought in to run the program in 2011, says that the medical model of America is focused on disease care, which is an essential aspect of enhancing health, but that it is incomplete because it doesn’t take into account the rest of a veteran’s life and the challenges that he or she faces.
“If we continue to approach our veterans only through the paradigm of the current medical model of the United States, much of what they need to live their life fully and optimize their health and well-being goes unaddressed,” she says. That is why the VHA is working to transform its health care from the “find it, fix it” disease care model to a personalized, proactive approach that is driven by the individual needs of the veteran, says Gaudet.
“Our goal is to design a system where we partner with our veterans to be mission ready for the rest of their lives, optimizing their health in service of what matters to them,” she says. “In the past we asked, ‘What can I fix?’ Today, we say, ‘How can I help what’s wrong with you?’ In the future, we need to say, ‘How can I help you live your life fully?’ The real opportunity for transformative health care in this country is when we put the person and their life at the center; when we get the process right, we will get the outcomes and the costs right.”
For more information on Chris and Fayne’s program, “Training Mindfully with Qigong PrinciplesTM,” visit their Web site: www.SimplyAware.com