0:00:00.948,0:00:02.641
Carlos,

0:00:02.641,0:00:04.217
the Vietnam vet Marine

0:00:04.217,0:00:08.255
who volunteered for three tours[br]and got shot up in every one.

0:00:08.255,0:00:12.266
In 1971, he was medically retired[br]because he had so much shrapnel

0:00:12.266,0:00:16.279
in his body that he was[br]setting off metal detectors.

0:00:16.279,0:00:19.549
For the next 42 years, he suffered[br]from nightmares,

0:00:19.549,0:00:21.786
extreme anxiety in public,

0:00:21.786,0:00:23.820
isolation, depression.

0:00:23.820,0:00:25.747
He self-medicated with alcohol.

0:00:25.747,0:00:28.676
He was married and divorced three times.

0:00:28.676,0:00:32.030
Carlos had post-traumatic stress disorder.

0:00:32.030,0:00:35.913
Now, I became a psychologist to help[br]mitigate human suffering,

0:00:35.913,0:00:40.978
and for the past 10 years, my target[br]has been the suffering caused by PTSD

0:00:40.978,0:00:43.524
as experienced by veterans like Carlos.

0:00:43.524,0:00:49.328
Until recently, the science of PTSD[br]just wasn't there,

0:00:49.328,0:00:51.727
and so we didn't know what to do.

0:00:51.727,0:00:54.114
We put some veterans on heavy drugs.

0:00:54.114,0:00:56.941
Others we hospitalized and gave[br]generic group therapy,

0:00:56.941,0:00:59.062
and others still we simply said to them,

0:00:59.062,0:01:03.701
just go home and try to forget[br]about your experiences.

0:01:03.701,0:01:06.989
More recently, we've tried therapy dogs,[br]wilderness retreats,

0:01:06.989,0:01:10.047
many things which may[br]temporarily relieve stress

0:01:10.047,0:01:14.583
but which don't actually eliminate[br]PTSD symptoms over the long term.

0:01:14.583,0:01:16.590
But things have changed,

0:01:16.590,0:01:18.571
and I am here to tell you that we

0:01:18.571,0:01:21.820
can now eliminate PTSD,

0:01:21.820,0:01:23.593
not just manage the symptoms,

0:01:23.593,0:01:25.617
and in huge numbers of veterans,

0:01:25.617,0:01:28.183
because new scientific research[br]has been able to show,

0:01:28.183,0:01:30.584
objectively, repeatedly,

0:01:30.584,0:01:34.101
which treatments actually[br]get rid of symptoms and which do not.

0:01:34.101,0:01:38.215
Now as it turns out,[br]the best treatments for PTSD

0:01:38.215,0:01:41.401
use many of the very same[br]training principles

0:01:41.401,0:01:42.602
that the military uses

0:01:42.602,0:01:45.442
in preparing its trainees for war.

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Now, making war,

0:01:47.994,0:01:51.152
this is something that we are good at.

0:01:51.152,0:01:55.691
We humans have been making war[br]since before we were even fully human,

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and since then we have gone from using[br]stone and sinew to developing

0:01:59.702,0:02:04.273
the most sophisticated and devastating[br]weapons systems imaginable.

0:02:04.273,0:02:06.264
And to enable our warriors[br]to use these weapons,

0:02:06.264,0:02:08.680
we employ the most cutting edge[br]training methods.

0:02:08.680,0:02:10.785
We are good at making war.

0:02:10.785,0:02:14.533
And we are good at training[br]our warriors to fight.

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Yet when we consider the experience[br]of the modern day combat veteran,

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we begin to see that we[br]have not been as good

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at preparing them to come home.

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Why is that?

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Well, our ancestors lived[br]immersed in conflict,

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and they fought right where they lived.

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So until only very recently[br]in our evolutionary history,

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there was hardly a need to learn[br]how to come home from war,

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because we never really did.

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But thankfully today, most of humanity[br]lives in far more peaceable societies,

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and when there is conflict,

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we, especially in the United States,

0:02:49.516,0:02:53.429
now have the technology to put[br]our warriors through advanced training,

0:02:53.429,0:02:56.143
drop them into fight[br]anywhere on the globe,

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and when they're done,

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jet them back to peacetime suburbia.

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But just imagine for a moment[br]what this must feel like.

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I've spoken with veterans who have told me[br]that one day they're in

0:03:08.145,0:03:10.431
a brutal firefight in Afghanistan

0:03:10.431,0:03:13.638
where they saw carnage and death,

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and just three days later[br]they found themselves

0:03:16.254,0:03:19.474
toting an ice chest[br]to their kid's soccer game.

0:03:19.474,0:03:23.194
"Mindfuck" is the most common term.

0:03:23.194,0:03:24.868
(Laughter)

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It's the most common term[br]I've heard to describe that experience.

0:03:27.795,0:03:28.045
And that's exactly what that is,

0:03:29.538,0:03:33.336
because while our warriors[br]spend countless hours training for war,

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we've only recently come to understand[br]that many require training

0:03:36.970,0:03:39.288
on how to return to civilian life.

0:03:39.288,0:03:43.944
Now, like any training, the best[br]PTSD treatments require repetition.

0:03:43.944,0:03:48.052
In the military, we don't simply hand[br]trainees MK-19 automatic grenade launchers

0:03:48.052,0:03:51.603
and say, here's a trigger,[br]here's some ammo, and good luck.

0:03:51.603,0:03:56.132
No. We train them on the range[br]and in specific contexts,

0:03:56.132,0:03:57.934
over and over and over

0:03:57.934,0:04:00.746
until lifting their weapon[br]and engaging their target

0:04:00.746,0:04:02.703
is so engrained into muscle memory

0:04:02.703,0:04:05.054
that it can be performed[br]without even thinking

0:04:05.054,0:04:08.805
even under the most stressful conditions[br]you can imagine.

0:04:08.805,0:04:12.042
Now the same holds for training[br]base treatments.

0:04:12.042,0:04:15.526
The first of these treatments[br]is cognitive therapy,

0:04:15.526,0:04:19.326
and this is a kind[br]of mental recalibration.

0:04:19.326,0:04:22.631
When veterans come home from war,[br]their way of mentally framing the world

0:04:22.631,0:04:26.346
is calibrated to an immensely[br]more dangerous environment.

0:04:26.346,0:04:29.813
So when you try to overlay[br]that mind frame

0:04:29.813,0:04:32.196
onto a peacetime environment,

0:04:32.196,0:04:33.354
you get problems.

0:04:33.354,0:04:37.924
You begin drowning in worries[br]about dangers that aren't present.

0:04:37.924,0:04:41.935
You begin not trusting family or friends,

0:04:41.935,0:04:44.910
which is not to say that there are[br]no dangers in civilian life.

0:04:44.910,0:04:46.123
There are.

0:04:46.123,0:04:49.484
It's just that the probability[br]of encountering them

0:04:49.484,0:04:50.649
compared to combat

0:04:50.649,0:04:53.716
is astronomically lower.

0:04:53.716,0:04:56.848
So we never advise veterans[br]to turn off caution completely.

0:04:56.848,0:04:59.247
We do train them, however,[br]to adjust caution

0:04:59.247,0:05:01.829
according to where they are.

0:05:01.829,0:05:04.337
If you find yourself[br]in a bad neighborhood,

0:05:04.337,0:05:06.045
you turn it up.

0:05:06.045,0:05:07.717
Out to dinner with family?

0:05:07.717,0:05:10.150
You turn it way down.

0:05:10.150,0:05:13.438
We train veterans to be fiercely rational,

0:05:13.438,0:05:17.072
to systematically gauge[br]the actual statistical probability

0:05:17.072,0:05:21.492
of encountering, say, an IED[br]here in peacetime America.

0:05:21.492,0:05:23.633
With enough practice,

0:05:23.633,0:05:26.278
those recalibrations stick.

0:05:26.278,0:05:29.370
The next of these treatments[br]is exposure therapy,

0:05:29.370,0:05:32.612
and this is a kind of field training,

0:05:32.612,0:05:35.851
and the fastest of the proven[br]effective treatments out there.

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You remember Carlos?

0:05:37.675,0:05:40.520
This was the treatment that he chose,

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and so we started off[br]by giving him exercises,

0:05:42.691,0:05:44.020
for him, challenging ones:

0:05:44.020,0:05:45.863
going to a grocery store,

0:05:45.863,0:05:48.511
going to a shopping mall,[br]going to a restaurant,

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sitting with his back to the door,

0:05:52.095,0:05:53.263
and, critically,

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staying in these environments.

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Now, at first he was very anxious.

0:05:57.637,0:06:00.152
He wanted to sit where he[br]could scan the room,

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where he could plan escape routes,

0:06:02.188,0:06:05.200
where he could get his hands[br]on a makeshift weapon,

0:06:05.200,0:06:08.390
and he wanted to leave, but he didn't.

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He remembered his training[br]in the Marine Corps

0:06:11.464,0:06:13.685
and he pushed through his discomfort,

0:06:13.685,0:06:16.891
and every time he did this, his anxiety[br]ratcheted down a little bit,

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and then a little bit more[br]and then a little bit more,

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until in the end, he had effectively[br]relearned how to sit

0:06:24.800,0:06:26.479
in a public space

0:06:26.479,0:06:29.371
and just enjoy himself.

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He also listened to recordings[br]of his combat experiences

0:06:33.201,0:06:35.818
over and over and over.

0:06:35.818,0:06:40.618
He listened until those memories[br]no longer generated any anxiety.

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He processed his memories so much

0:06:43.203,0:06:46.455
that his brain no longer needed[br]to return to those experiences

0:06:46.455,0:06:48.182
in his sleep.

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And when I spoke with him

0:06:50.105,0:06:52.154
a year after treatment had finished,

0:06:52.154,0:06:53.372
he told me,

0:06:53.372,0:06:58.211
"Doc, this is the first time in 43 years

0:06:58.211,0:07:01.500
that I haven't had nightmares."

0:07:01.500,0:07:06.087
Now, this is different[br]than erasing a memory.

0:07:06.087,0:07:09.264
Veterans will always remember[br]their traumatic experiences,

0:07:09.264,0:07:14.112
but with enough practice, those memories[br]are no longer as raw

0:07:14.112,0:07:16.547
or as painful as they once were.

0:07:16.547,0:07:20.131
They don't feel emotionally[br]like they just happened yesterday,

0:07:20.131,0:07:25.024
and that is an immensely[br]better place to be.

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But it's often difficult,

0:07:27.645,0:07:32.033
and like any training,[br]it may not work for everybody,

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and there are trust issues.

0:07:34.138,0:07:38.003
Sometimes I'm asked, "If you haven't[br]been there, Doc, how can you help me?"

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Which is understandable.

0:07:39.762,0:07:44.925
But at the point of returning[br]to civilian life, you do not require

0:07:44.925,0:07:47.934
somebody who has been there.

0:07:47.934,0:07:51.289
You don't require training for operations[br]on the battlefield.

0:07:51.289,0:07:55.146
You require training on how to come home.

0:07:58.318,0:08:01.336
Now, for the past 10 years of my work,

0:08:01.336,0:08:05.575
I have been exposed to detailed accounts[br]of the worst experiences

0:08:05.575,0:08:08.136
that you can imagine, daily,

0:08:08.136,0:08:10.257
and it hasn't always been easy.

0:08:10.257,0:08:13.496
There have been times where I have[br]just felt my heart break,

0:08:13.496,0:08:15.849
or I have absorbed too much.

0:08:15.849,0:08:19.497
But these training-based treatments[br]work so well

0:08:19.497,0:08:22.162
that whatever this work takes out of me,[br]it puts back even more,

0:08:22.162,0:08:26.929
because I see people get better.

0:08:26.929,0:08:30.154
I see people's lives transform.

0:08:30.154,0:08:34.233
Carlos can now enjoy outings[br]with his grandchildren

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which is something that he couldn't[br]even do with his own children,

0:08:37.798,0:08:39.314
and what's amazing to me

0:08:39.314,0:08:43.254
is that after 43 years of suffering,[br]it only took him 10 weeks

0:08:43.254,0:08:46.152
of intense training to get his life back.

0:08:46.152,0:08:48.483
And when I spoke with him, he told me,

0:08:48.483,0:08:52.877
"I know that I can't get those years back,

0:08:52.877,0:08:58.021
but at least now, whatever days[br]that I have left on this Earth,

0:08:58.021,0:09:01.226
I can live them in peace."

0:09:01.226,0:09:04.773
And he also said, "I hope that these[br]younger veterans don't wait

0:09:04.773,0:09:06.771
to get the help they need."

0:09:06.771,0:09:11.178
And that's my hope too, because

0:09:11.178,0:09:13.463
this life is short,

0:09:13.463,0:09:16.783
and if you are fortunate enough[br]to have survived war

0:09:16.783,0:09:18.824
or any kind of traumatic experience,

0:09:18.824,0:09:22.769
you owe it to yourself[br]to live your life well,

0:09:22.769,0:09:25.433
and you shouldn't wait to get[br]the training that you need

0:09:25.433,0:09:28.475
to make that happen.

0:09:28.475,0:09:34.694
Now, the best way of ending[br]human suffering caused by war

0:09:34.694,0:09:37.029
is to never go to war,

0:09:37.029,0:09:40.348
but we are just not there yet[br]as a species.

0:09:40.348,0:09:44.193
Until we are, the mental suffering[br]that we create

0:09:44.193,0:09:48.486
in our sons and in our daughters[br]when we send them off to fight

0:09:48.486,0:09:51.675
can be alleviated.

0:09:51.675,0:09:57.957
But we must ensure that the science,[br]that the energy level, that the value

0:09:57.957,0:10:03.597
that we place on sending them[br]off to war is at very least mirrored

0:10:03.597,0:10:05.817
in how well we prepare them

0:10:05.817,0:10:08.035
to come back home to us.

0:10:08.035,0:10:10.369
This much we owe them.

0:10:10.369,0:10:12.195
Thank you.

0:10:12.195,0:10:18.331
(Applause)