FORT BLISS, Texas - The practice of holistic medicine is not new to William Beaumont Army Medical Center (WBAMC).
The command has steadily progressed in pain management and interdisciplinary medicine modalities since the beginning of the global war on terror. The hospital’s dedicated research and practices have positioned WBAMC as leaders of a multi-national effort.
The first NATO report on integrative medicine, following a five-year long study, was published by NATO’s Human Factors and Medicine (HFM) Task Force 195, detailing the panel’s research concerning a holistic approach to treating combat and noncombat injuries and illnesses for military armed forces.
“The NATO committee formulated the concept of integrative alternative healing,” said Col. Richard Petri, chairperson of HFM Task Force 195 and WBAMC special projects officer. “That’s the concept that William Beaumont had since 2003. We were the first alternative medicine center in the Department of Defense.”
The NATO report details complementary and alternative modalities for recovery concerning wounded service members such as: mindfulness-based practices such as meditation, spirituality and religion as a resource, Watsu (water activities), and the Cardio Biofeedback program (monitoring skin temperature).
“Through integrative health and healing, we’re forcing the evolution quicker” said Petri. “Integrative health is outside the normal or Western modalities, which provides the ability to empower a patient to be responsible for their health.”
According to the Association of Military Surgeons of the United States (AMSUS), complementary and alternative medicine practices have been well received by veterans. Auricular acupuncture is seen as an attractive treatment option because of its low cost, portability, minimal side effect profile, and ease of use in clinical and operational settings.
“The goal of integrative health and healing is to have the patient understand that they are the driver of their own health care,” said Petri. “Integrative medicine is no different from Western medicine if it doesn’t allow the patient to participate in their own care.”
A 2014 study found high rates of chronic pain (44 percent) and opioid use (15.1 percent) in the U.S. military after returning from combat deployments. The high rate of chronic pain and psychological distress Soldiers face after returning from combat is cited in NATO’s report as “A hallmark of these wars” that requires a different approach to management than would be used for the usual civilian traumas.”
Narcotics such as morphine and codeine have been used for chronic pain treatment since the Civil War. This type of passive treatment is known to trigger patients to anticipate relief through medication rather than self-healing.
“The patients become devoid of ownership of the condition when they are a passive participant in their own care,” said Petri. “This leads to poor outcomes, problems with multiple prescriptions, and some patients’ disillusion with the medical system.”
Pain management is one of many ailments NATO focused on. As with pain, psychological distress such as PTSD and other traumatic injuries may also benefit from alternative management.
In 2012 WBAMC opened the Interdisciplinary Pain Management Center at Fort Bliss. The center aimed to combat chronic pain and psychiatric wounds.
“Prescriptions are a quick fix,” said Dr. Elizabeth Delgado-Torres, a contributor to NATO’s research and a clinical psychologist at the IPMC. “[Therapy] takes longer, is harder work and requires a proactive approach to treatment. “
WBAMC’s pioneering efforts encouraged NATO studies to evaluate medical practices of foreign forces. Mentioned in the report are the meditative practices of German military personnel, biofeedback techniques of French firefighters, energy medicine of Japanese forces and movement practices of Oriental cultures.
Through NATO’s multi-country platform, researchers are collaborating ideas and initiatives to improve the treatment of troops everywhere.
“We’re trying to advance it from us vs. them, Western vs. Eastern - to the whole individual; mind, body, spirit, soul and community to give them a better quality of life,” said Petri. “The effort has to include the community and family.”
NATO’s exchange of modalities between foreign healthcare professionals promotes integrated practices with a global footprint. The health of the troops is being evaluated with a focus on healing as opposed to numbing pain and distress.
“The task force has set up an avenue for partnerships between us and our European colleagues to do cross-cultural investigations of modalities that in some cases are ancient,” said Petri. “It gives us the opportunity to look at cultural differences and perspectives toward medicine that we wouldn’t otherwise have.”
In most dictionaries, pain is defined as suffering or distress. According to Delgado-Torres, physical pain affects mental/stress levels and vice versa.
Psychological treatment and integrating a proactive approach is vital, said Delgado-Torres.
Self-empowering Soldiers to integrate treatment into their household is as important as going to the clinic.
In 2009 the Army launched a Pain Management Task Force and found the cause of pain is multimodal and complicated, affecting every aspect of the individual: physical, emotional, and spiritual, as well the family and community.
“There is no simple solution to this complex problem,” said Petri. “Treatment needs to be interdisciplinary and multimodal in its approach. But more than that, it needs to incorporate all the aspects of the individual, Family, and community and not just focus on the physical etiology of the pain itself.”
The National Intrepid Center of Excellence, a Department of Defense center created explicitly for treating traumatic brain injury and psychological health concerns, already conducts numerous evaluations of holistic medicine approaches to wounded service members including; animal-assisted therapy, computer-assisted rehabilitation, firearms simulation, healing arts therapy, integrative medicine and recreational therapy.
The holistic approach to recovery requires effort not just from the military but also from the communities around military installations. Petri notes that although pain management clinics such as WBAMC’s IPMC may offer alternative therapeutic treatments, the healing process also involves support from those around troops.
“The community at-large will have people who want to help the soldiers,” said Petri. “Even people that aren’t in the military will engage in helping because [Soldiers] are part of that community.”
While other NATO forces have reported positive feedback to the committee, statistical data for troop recovery is not available. Patients have noticeable changes in behavior based off observational results, said both Petri and Delgado-Torres. William Beaumont Army Medical Center is currently undergoing an analysis of spouses’ perceptions on Soldier healing.
“Based on observation and because I do involve spouses, they’re seeing changes. They’re seeing change at home,” said Delgado-Torres. “Instead of pulling people apart, you have an integrative whole.”