Meditation technique helps Veterans with PTSD

Thought leader—Dr. Jill Bormann of the San Diego VA has led efforts to develop, teach, and evaluate a VA meditation program called the Mantram Repetition Program. (Photo by Kevin Walsh)
See also: A meditative Marine

VA researchers and colleagues have reported promising results from a study of a simple meditation technique in which war Veterans silently repeated a word or phrase that was spiritually meaningful to them. The technique helped lessen posttraumatic stress in nearly a third of the participants, say researchers at the VA San Diego Healthcare System. The findings appear online in the journal Psychological Trauma: Theory, Research, Practice, and Policy.

According to nurse researcher Jill Bormann, PhD, RN, the study's lead author, the Veterans were first taught to silently repeat a "mantram" during non-stressful times throughout the day and before falling asleep. They then learned how to use the mantram when facing stressful situations, such as traffic jams, flashbacks, arguments, or physical pain.

The study also taught two related techniques: mentally slowing down, and doing only one thing at a time. Bormann said all three techniques work together to promote a sense of inner calm and wellness.

She defines a "mantram" as a "sacred, powerful word or phrase." Veterans in the study chose mantrams that had personal meaning for them. Bormann points out there are distinctions between "mantram" and the more familiar "mantra," which is often used as an affirmation or motto. The mantram method is based on the work of Indian-born spiritual teacher Eknath Easwaran. Bormann has adapted it over the past decade to be relevant to Veterans' needs.

The study included 146 Veterans of various ages, mostly men, all with military-related PTSD. All received standard treatment—medication and case management. VA also offers psychotherapy for PTSD, including prolonged exposure therapy, but the Veterans in the study had not yet engaged in this form of treatment.

The study volunteers were divided randomly into two groups. One group took part in weekly classes to learn the mantram method, known formally in VA as the Mantram Repetition Program. After six weeks, the researchers tested their mental health. They saw greater improvements among the mantram group than among the standard-care group. The areas that benefited most included core PTSD symptoms such as hyperarousal; depression; overall mental health-related quality of life; and spiritual well-being.

While all the Veterans improved somewhat across most measures, 30 percent of those in the mantram group no longer met the diagnostic criteria for PTSD, compared with only 14 percent in the standard-care group.

Bormann says mantram repetition differs from most other relaxation or meditation techniques in that it can be used discreetly anywhere, anytime—even in traffic, for example, or in line at the supermarket. "It's personal, portable and invisible," she explains. "It's a non-drug approach that is safe, immediately available, and inexpensive."

Her past studies have found positive effects from the technique among Veterans, family caregivers, and VA employees. VA recently funded Bormann for a new study of 324 Veterans with PTSD that will compare the Mantram Repetition Program over eight weeks to a treatment called Present-Centered Group Therapy.

While the new study will evaluate mantrams as a stand-alone therapy, Bormann points out that the technique could also play a role in helping Veterans engage in prolonged exposure therapy. In this treatment, patients are guided by therapists as they gradually re-experience the painful emotions surrounding their trauma. Some Veterans are reluctant to try the therapy, but Bormann believes the mantram technique could make it more tolerable for them.

VA also recently funded two new studies of a meditation technique known as Mindfulness-Based Stress Reduction to see if the method can help Veterans with PTSD. Those studies are based in Minneapolis and Tuscaloosa. Bormann's completed study was supported by the Nursing Research Initiative of VA's Health Services Research and Development Service.

Bormann and study coauthors Steven Thorp and Ariel Lang are with the Center of Excellence for Stress and Mental Health at the VA San Diego Healthcare System. Other coauthors were Julie Wetherell and Shahrokh Golshan, both with VA and the University of California, San Diego.