On the ground and in the field: Advancing our understanding and treatment of PTSD
Through their work and research, medical alumni Michael Roy ’84 MD’88 and Landis Mitchner MD’99 RES’03 are supporting veterans who struggle with the psychological effects of combat.
Across the U.S., millions of veterans of the armed forces struggle with post-traumatic stress disorder (PTSD), even years after coming home. According to the National Center for PTSD, the number varies depending on the conflict and era, from 10% of Vietnam veterans to 29% of veterans of Operations Iraqi Freedom and Enduring Freedom. Untreated PTSD can lead to struggles with anger, depression, sleep problems, substance misuse, and more, and can sometimes result in suicidal ideation or attempts. According to the U.S. Department of Veterans Affairs, over 6,000 veterans committed suicide in 2020 alone.
Two alumni from The Warren Alpert Medical Schoolhave been diligently working toward more effective approaches to treating PTSD, making their mark on the field of psychiatry and helping combat veterans who are suffering to find a path toward wellness.
A new reality
Retired Army colonel Michael Roy ’84 MD’88 is a professor of medicine and director of the Division of Military Internal Medicine at Uniformed Services University. After graduating from Brown, Roy completed his residency in internal medicine at the Walter Reed National Military Medical Center, where he honed his skills in the assessment of depression and anxiety. It wasn’t until he began working with Gulf War veterans in the mid-1990s, however, that he saw just how far-reaching the effects of PTSD can be, adversely impacting other psychological conditions and medical conditions like diabetes and hypertension.
That revelation propelled Roy into his research on Reconsolidation of Traumatic Memories (RTM)—a trauma-focused therapy that does not employ more widely used exposure techniques. Instead, it asks patients to imagine a movie theater in which they leave their body in their seat in order to project a short, black-and-white movie that represents their trauma on the screen. According to Roy, this therapy is much better tolerated and is achieving impressive results.
Brown was instrumental in helping me to consider the whole person and to think outside the box about what might work to help them get better.
Michael Roy ’84 MD’88
Roy is also conducting a study that uses virtual reality, in which participants walk on treadmills while being presented with music and images that they selected to represent their traumatic experiences. Through this method, Roy has found that patients begin to uncouple the physiological responses to trauma from their memories, instead associating these responses with exercise, and remain more engaged in treatment overall. Since patients suffering from PTSD are more likely to drop out of treatment than those with other conditions, finding a way to keep them engaged is essential, says Roy.
In reflecting on his time in medical school, Roy credits Brown’s patient-centered, humanistic medical training as a key influence on his approach to care, saying “Brown was instrumental in helping me to consider the whole person and to think outside the box about what might work to help them get better.”
Overcoming the stigma
Landis Mitchner MD’99 RES’03 has been providing clinical care for almost 20 years. He is a staff psychiatrist at the Veterans Affairs Boston Healthcare system and an assistant professor in the department of psychiatry at Harvard Medical School. His clinical interests and expertise include the psychopharmacological management of mental health disorders. He provides individual and group psychotherapy to more than 500 veterans annually, both virtually and in person, while also mentoring psychiatry residents.
In addition to patient care and mentoring, Mitchner speaks locally and regionally to nursing students, psychology majors, social workers, and first responders where he seeks to combat disinformation about PTSD and other mental health disorders. During the COVID-19 pandemic, Mitchner was interviewed on local media about suicide prevention, social isolation, and loneliness.
Whether in his clinical or teaching roles, he keeps the human side of medicine front and center.
“I will always continue to strive to decrease the stigma of mental health care by serving as a role model of a psychiatrist who treats others with unconditional high regard, listens to understand, provides empathy, and inspires hope,” says Mitchner, adding that he remains “committed and excited” to continue training the next generation of practitioners to serve communities in need.
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