One week ago, a colleague and I had the privilege of attending the Third National Summit of the National Initiative for Arts & Health in the Military at the National Institutes of Health. Throughout the summit, we heard from many of the military personnel, medical professionals, creative arts therapists, and researchers serving as leaders in this field. We found it incredibly inspiring to learn about all of the work these individuals do with veterans and their families throughout the military continuum, and we’d like to share some of the information discussed at the conference with you in this week’s blog post.
Many of the summit’s speakers work with returning service members who fought in Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), or Operation New Dawn (OND). In studies, 47% of OEF/OIF/OND veterans have reported experiencing chronic pain after deployment, and more veterans have said they sought medical care for pain than for any other reason. This pain has physical, emotional, cognitive, behavioral, environmental, and social components.
Already complex to begin with, pain becomes more complicated in instances of polytrauma. Polytrauma is fairly common in the military, as 60% of veterans with chronic pain also have PTSD, 55% have TBI, and many have all three of these conditions. PTSD can cause symptoms such as flashbacks, avoidance, hypervigilance, nightmares, or re-experiencing trauma. TBI can lead to headaches, sensitivity to light/noise, nausea and vomiting, vision problems, or dizziness. Individuals with either PTSD or TBI may experience fatigue, anxiety, depression, irritability, or insomnia as well.
For me, the most interesting part of the day was hearing how creative arts therapists alleviate these symptoms of pain and trauma at the National Intrepid Center of Excellence (NICoE). NICoE provides four-week intensive outpatient programs for active-duty service members with comorbid TBI and psychological health conditions. Families are often encouraged to participate as well. NICoE leadership believes in using a combined interdisciplinary approach where a team of professionals from 17 different disciplines, including art and music therapy, participate in the healing process.
On the first day of the program, service members tell their stories. They share what they hope to accomplish in their lives, as well as the barriers that stand in their way. Throughout the program, the NICoE team addresses three different goal sets to help them fulfill their aspirations. First, they tackle concerns related to safety, sleep, and pain. After removing these concerns from the front of veterans’ minds, they focus on higher-level goals related to discovery and self-awareness. Finally, the NICoE team helps service members develop skills that will help them regulate emotions without medication.
NICoE’s Healing Arts Program plays a critical role in the attainment of these goals. In addition to providing motivation and inspiration, participation in the arts can particularly help veterans who have experienced trauma, since trauma inhibits Broca’s area, a speech-related section of the brain, and the arts allow individuals to express themselves nonverbally and thus begin the coping process. For this reason, the NICoE team uses visual art therapy, music therapy, and creative writing to manage pain and anxiety, provide relaxation, stabilize vitals, promote greater self-awareness and expression, improve emotional regulation, foster group cohesion and appropriate communication, engender a positive sense of self/accomplishment, and assist with the reintegration process.
Veterans can attend sessions individually or in groups. Art therapy begins with the creation of masks, as recently discussed in a fascinating National Geographic article. Masks show how the veterans see themselves and often demonstrate themes like patriotism, grief, and a split self. They help support the healing process by sparking conversations among the veterans and therapist. A couple of weeks later, veterans reflect on the progress they’ve made in the program by painting montages that incorporate where they’ve come from and where they’re going.
In addition, veterans participate in songwriting activities with a music therapist during their time at NICoE. They follow a blues template and write lyrics that outline a problem, explain how they feel about the problem, and provide a solution. The music therapist helps veterans process the final products and directs them to follow up with other professionals as necessary. Through projects such as this, veterans build problem solving skills that they can apply long after leaving NICoE.
Research has shown that NICoE’s Healing Arts Program has increased patient satisfaction, improved expression, and relieved symptoms. In my next blog post, I’ll take a closer look at the research done by NICoE and other presenters at the conference. Remember to come back and hear more about this research, as well as some additional resources you can explore to discover what others are doing to provide arts programming to veterans and their families!