Dr. Jeff Comer, Hospital CEO

Posttraumatic stress disorder (PTSD) in veterans is a devastating psychophysiological response to traumatic experiences encountered during military service. Rates of PTSD, co-morbidities, and suicide remain higher than the general population for veterans. The Veterans Administration (VA) has defined strongly recommended practices, which include cognitive behavioral therapy, eye movement desensitization and reprocessing, cognitive processing therapy, and prolonged exposure therapy. However, the majority of veterans do not initiate these treatments, find little symptomatic relief from the treatments, or discontinue the treatments altogether. This void of treatment success results from veterans’ shame, involving mental health stigma. The purpose of this qualitative systematic literature review (SLR) was to evaluate non-conventional treatments that embrace mindfulness techniques and their effectiveness for therapeutic inclusion for veterans diagnosed with PTSD. Mindfulness-based practices, whether cognitive or somatic, were found to be effective in mitigating sympathetic nervous system (SNS) and hypothalamus-pituitary-adrenal (HPA) activation, improving the chronic dysregulated allostatic effects of stress reactivity. Studies included in this SLR demonstrated that by reducing SNS and HPA activation, decreased PTSD symptoms and co-morbidities resulted. Three concluding recommendations for psychotherapists are proposed: (1) address stigma and shame, (2), foster eudaimonic outcomes, and (3) include mindfulness-based practices. These recommendations provide a scenario where veterans can moderate their levels of shame, derive biopsychosocial benefits from the practices themselves, diminish their PTSD symptoms, and cultivate increased meaning in life.