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Office of Public and Intergovernmental Affairs

Remarks by Former Deputy Secretary W. Scott Gould

VA’s Office of Research and Development (ORD) Meditative Techniques
PTSD and Complementary Alternative Medicine - Research Opportunities among VA, DoD, and NIH
Washington, DC
May 17, 2011

My thanks to all of you for coming together today to discuss the use of meditation for Post Traumatic Stress Disorder.

Dr. Briggs [Dr. Josephine P. Briggs, Director, NIH National Center for Complementary and Alternative Medicine], it’s good to see you this morning.

I am pleased to recognize Colonel Carl Castro, Director of Military Operations, Medicine Research Program, for the U.S. Army Medical Research and Materiel Command. Colonel Castro, welcome to this morning’s meeting.

I also want to note that Defense Under Secretary for Personnel and Readiness, Dr. Cliff Stanley, and Assistant Secretary for Health Affairs, Dr. Jonathan Woodson, have designated Dr. Nisha Money, Director, Psychological Health Clinical Standards of Care, to join us in this effort.

And a warm welcome also to Tim O’Leary [VA Deputy Chief Research and Development Office], Sonja Batten [VA Assistant Deputy Chief Patient Care Services for Mental Health], Madhulika Agarwal [Deputy Under Secretary for Health Policy and Services], Tony Zeiss [ Antonette Zeiss, PhD, VA Acting Deputy Chief Patient Care Services for Mental Health], Jan Kemp [Chief for Education, VISN 2 Center of Excellence], and Alex Ommaya [Alexander Ommaya, ScD, VA Director of Translational Research].

Thank you all.

Alternative forms of medicine, once only imagined or predicted as applying to the care of patients with Post-Traumatic Stress Disorder, are coming into the mainstream of healthcare solutions. It wasn’t that long ago—within the lifetimes of many of us in the room this morning—when combat- or other trauma-related stresses defied diagnosis, much less proper and timely treatment. Pablum advice like “Shake it off, you’ll be fine,” or “He’ll get over it,” or just, “Snap out of it!” only trivialized deeply rooted pain that stigmatized and ate away at the lives of too many Veterans—young and old. We may never know the number of soldiers and Veterans stricken by stress the system failed to recognize—or acknowledge—during the dark ages of our ignorance. But, as evidenced by your attendance here, and by the work you have been doing, we have shifted that paradigm.

I think it is a fair statement to say that we are adopting a more informed vision of the many mental stressors that affect our warriors and Veterans on and off the battlefield. Today, we know that many Veterans suffer from PTSD; we know their symptoms are real; and we know there are proven treatment possibilities that were once only imagined. Our mission is to provide the best care for Veterans who suffer the very real burden of PTSD. To do this, we must continually investigate treatments to determine their effectiveness in improving care.

We have done a lot of work in many areas of PTSD research that has produced effective treatments, but we are not done preventing, relieving, or curing PTSD. And that is all the more reason why we need to keep our curious minds open and receptive to new ideas. In addition to the outstanding medical care we already provide to servicemembers and Veterans, we are learning to extend that care to include many complementary alternative medicine (CAM) treatments.

One CAM treatment that we intend to explore is meditation, although this group will no doubt consider other treatments today as well. We know that meditation has been used in treatment of PTSD and we are anxious to identify its benefits and to determine if there are any potential risks to Veterans for with this condition. Therefore, in order to develop our understanding of meditation and the effectiveness of meditation, VA has issued a Request for Proposals to its field researchers to study the effectiveness of meditation on PTSD.

Related to our overall approach, I have asked our VA team to do several things:

  • First, to conduct a comprehensive literature review of all types of meditation without preconditions;

  • Second, to develop or adopt an ontology for meditative techniques;

  • Third, to construct a research effort that includes all types of meditation and, based on the literature review, support the development of individual studies appropriate to the level of scientific/clinical evidence that can be marshaled at this time;

  • Fourth, to adopt proven and simple methods to evaluate results consistently across studies; and

  • Fifth, to proceed with care and a sense of urgency.

Collaborating with one another will help us advance this research more quickly and more effectively. Collaboration is critical to success in finding solutions for Veterans suffering with PTSD.

By calling you together today to review the current evidence associated with alternative medicine treatment and PTSD, we would like you to explore the medical issues associated with providing this therapy and identify relevant research questions. We will use this input to further refine research priorities. To that end, VHA has provided $5 million in funding for the research in FY ‘11, and is prepared to provide additional funding in FY ‘12. We also have additional support from DoD which will use a research and evaluation IDIQ contract administered by the Army G4 Program Office to develop and compete studies on mediation for PTSD. The National Naval Medical Center and Walter Reed National Medical Center, among others, have reviewed and approved studies to test different forms of meditation that could offer suitable areas for investment.

With your help, our understanding of the effectiveness of meditation on PTSD will grow, as will the potential for novel therapeutic approaches to treat PTSD.

What we once imagined as a new care paradigm will find its proven and rightful place in practical applications to the benefit of our Veterans. Once we have gotten this conference under our belts, we’ll need to plan for the path forward. The urgency of our mission requires that we not let up in our effort to prevent, relieve, and cure PTSD. The next steps include:

  • Reporting on results of the conference;

  • Commencing the first round of studies; and

  • Linking to the DoD/Army G-4 effort to kick off studies in FY ‘11 at Bethesda and Walter Reed, among others.

Again, thanks to everyone here from VHA, NIH, and DoD for all you do to care for our nation’s servicemen and women, and America’s Veterans.