Winning the trust of a warhorse

Written by Eric on November 26, 2013 in: Uncategorized |

Warriors on horseback have ravaged their neighbors for millennia, but today warhorses and soldiers are joined in a new mission: healing the invisible wounds of war.

The Saratoga Warhorse Project was the inspiration of Bob Nevins, a former chopper pilot in Vietnam who personally found his own peace when he bonded with a retired race horse, accepted its unconditional trust, and began to believe in himself again.

Nevins had flown more than 500 missions in an unarmed medevac helicopter for the 101st Airborne before the day in 1971 when his chopper was blown out of the air by a rocket-propelled grenade that killed two of his four crewmates instantly and sent the craft spinning 150 feet to the ground in a fireball.

“We set the jungle on fire,” he says. “I opened my eyes and was kind of wondering why I was not dead.”

Nevins managed to get the two remaining crewmen out of the wreckage and half-carried, half-dragged them to safety. Then with the help of soldiers on patrol in the area, they managed to hold off the Viet Cong until new medevac choppers could fly in and extricate them.

After weeks recovering in a burn unit, he went back to action, but the emotional scars never left him.

“I lived for years with my near-death experience, with what I thought was going to be my last desperate moment,” says Nevins. “And the next closest experience I had was with the horse. I got unconditional acceptance from that horse, and that triggered a change in my brain. The root cause of everything we do is fear, but the fear and anxiety and human emotions dissolve. You have control over those feelings now.”

In fact, it changed his life. In 2011, Nevins retired after 24 years as an airline captain so that he could begin sharing his horse-bonding experience with other vets on his farm near Saratoga Springs, N.Y., home of the famed Saratoga Race Track.

So far, he has recruited eight retired race horses with uncertain futures, and he has brought in more than 100 vets for three-day sessions to work with the horses. The average travel and lodging cost for a visit is about $2,500, but Nevins and the Saratoga Warhorse Foundation pay the entire tab.

“We won’t take money from them,” says Nevins. “All I have to do is qualify them. And I do that by talking with them, then asking how they’re sleeping at night. When the response is, ‘Are you frigging kidding me? I haven’t slept in five years!’ I know I’ve got my guy.”

One of the key symptoms of PTSD is the hyper-tension and the hyper-anxiety that make it difficult to sleep at night. Another is the emotional numbness that results from being awash in adrenaline during unrelenting combat, an experience Nevins describes as “being like a firefighter going into the World Trade Center every day.”

Bonding with a horse helps blocked emotions to flow, Nevins is finding.

But it’s a difficult task because horses are flight animals, programmed to flee from any perceived threat, while man is a predator. That means the vet has to win the horse’s trust.

Sessions start on a Monday morning with an expert in horse behavior telling the vets how to interpret a horse’s non-verbal language, things like a horse cocking an ear toward the vet or staring directly at him or trotting around a pen while demonstrating licking or chewing behavior.

New research is also finding that horses understand humans better than almost any other animal, picking up on the subtlest of body or eye movements.

In a case study published this year in the peer-reviewed journal “Advances in Mind-Body Medicine,” Nevins described how the vet and the horse interact in a 50-foot round pen, connected only with a long rope.

The vet first let the horse run in circles around the pen, then learned to change its direction by blocking the horse’s path with his body and tossing the line out in front of the horse. As they continued to work together, he also acknowledged the horse as it conveyed its body signals of negotiation: licking and chewing, lowering its head and staring at him with both eyes.

Finally, the vet invited the horse to come in to him by taking his eyes off the horse, stepping ahead and turning his shoulder in a passive manner. As the horse came in and dropped its head, the vet rubbed the space between its eyes, a blind spot and a vulnerable area for a horse.

With that trust established, the vet was able to walk in semicircles and figures of eight, and the horse followed submissively behind him.

That moment can be life-changing, according to Nathan Fahlin of Duluth, Minn., who deployed to Iraq for 15 months in 2006-07 with the Minnesota National Guard. “When you inherently distrust everyone, you don’t know what to think when that horse trusts you,” he says. “It’s a unique moment, and it kind of gave me my life back again.”

Constant combat left Fahlin feeling numb after he returned home, and it made him withdraw from people. “Callousness is best way to describe it,” he told me. “All your nerve endings have been exposed for so long that you shut down in a lot of ways.”

But after gaining the trust of a warhorse a year ago, he’s been allowing himself to return to some of the hobbies and activities that he had enjoyed before he deployed. In particular, he’s been trekking down to the Duluth YMCA for some pick-up basketball games with his friends.

“And I’ve been sleeping through the night, unless there’s a sudden noise like a garbage truck picking up trash,” he says. “It’s a work in progress, but I’m a lot better than I was three years ago.”

For more information about the Saratoga Warhorse project, visit its web site: http://saratogawarhorse.com/

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Improper VA TBI diagnosis

Written by Eric on November 13, 2013 in: Uncategorized |

A Veterans Administration psychologist at Fort Harrison violated several of Montana’s administrative rules when he dropped an Iraqi vet’s traumatic brain injury disability rating from 70 to 10 percent, a state licensing board has concluded in a relatively rare order.

Although it’s a state ruling, it’s an important case for all vets because it clearly sets forth the professional standards of care that alkl psychologists should use in evaluating a vet’s TBI.

In its nine-page ruling, a screening panel of the state Board of Psychology concluded late last week that Robert J. Bateen of Helena was not qualified to make the TBI diagnosis, that he used an inadequate test, and that he incorrectly characterized the results of that test.

“To the extent Licensee asserts he was following the procedures of the VA, Licensee has an independent professional obligation to ensure his work as a psychologist complies with the statutes and rules governing his license,” added the panel, noting that the board has the power to revoke, suspend or limit Bateen’s license to practice.

A spokeswoman for the federal agency was asked Tuesday whether the Fort Harrison VA would change its policies, continue to employ Bateen, and re-evaluate the other TBI diagnoses he has made over his years on the job.

“Since the matter is pending before the State of Montana Board of Psychology, we are unable to provide comment,” Terrie Casey, voluntary services chief for the VA at Fort Harrison, responded Tuesday.

The case involves Charles Gatlin, now a 38-year-old graduate student at the University of Montana in Missoula.  A Ranger-qualified former Army captain, Gatlin suffered a brain injury after a large truck bomb knocked him unconscious near Kirkuk, Iraq, in 2006.

The Army put Gatlin through a three-day battery of neuropsychological tests in 2006, 2007 and 2009 and concluded he had suffered significant attention problems, processing speed deficits and persistent frontal lobe dysfunction. After three years, the final test concluded, the injuries had stabilized and appeared to be permanent.

Retired with a 70 percent TBI disability rating, Gatlin and his wife, Ariana Del Negro, returned to Montana. At the Fort Harrison VA hospital, Bateen ran Gatlin through a short screening exam, concluded that his cognitive deficits were not significant, and dropped his TBI disability rating to 10 percent, although he also added a 30 percent rating for post-traumatic stress disorder.

Gatlin has appealed that decision to the Board of Veteran Appeals in Washington, D.C., and he also filed a complaint more than a year ago with the state licensing board.

In its decision Friday, a screening panel found that Bateen was not qualified to evaluate Gatlin’s disabilities because he is not a clinical neuropsychologist. It also said Bateen should not have used the Repeatable Battery for the Association of Neuropsychological Status (RBANS) screening tool because it was designed to assess dementia in elderly patients, not executive brain dysfunction. And it said Bateen also concluded Gatlin’s score was in the average range when it was not.

“Because Gatlin’s medical history established that he had a TBI and had significant deficits three years post injury, it was improper for Licensee to use RBANS as the testing instrument to determine Gatlin’s cognitive functioning and to use it as the basis to formulate his evaluation  conclusions,” said the screening panel.

“Incorrectly categorizing Gatlin’s attention score and erroneously ascribing it to PTSD and generally failing to address or reconcile Licensee’s findings with those of the previous evaluations are examples of Licensee’s failure to conduct the assessment in accordance with the applicable standard or care,” it said.

That violated two sections of the state regulations for the practice of psychology, said the ruling signed by Special Assistant Attorney General Tyler G. Moss.

“Licensee created an unreasonable risk of physical or mental harm or serious financial loss to Gatlin, regardless of whether actual physical or mental injury or harm was suffered by Gatlin, when Licensee (a) used the incorrect assessment tool; (b) failed to incorporate or properly consider prior, applicable evaluations; (c) offered opinions in a specialized area of psychology for which he was not qualified; or (d) failed to meet the standard of care,” concluded the ruling.

Bateen now has 20 days to decide whether to accept the ruling or appeal it to the full board, which has a range of 10 disciplinary measures ranging from revocation of his license down to a fine not to exceed $1,000 for each violation.

“Generally, most of the licensees enter into stipulations to agree to remedy the situation somehow after receiving such a ruling,” the chief counsel for the Montana Department of Labor and Industry, Judy Bovington, said Tuesday. “They agree they did something that wasn’t right and agree to change the way they practice. The percentage of these cases that choose to litigate is fairly small.”

Bovington said only two of Montana’s 236 licensed psychologists have faced disciplinary action in the past five years.  There have been 33 complaints in that time period, and four complaints are still pending before the board.

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