0:00:00.924,0:00:02.453
Carlos,

0:00:02.477,0:00:04.030
the Vietnam vet Marine

0:00:04.054,0:00:07.838
who volunteered for three tours[br]and got shot up in every one.

0:00:08.650,0:00:10.752
In 1971, he was medically retired

0:00:10.776,0:00:13.075
because he had so much[br]shrapnel in his body

0:00:13.099,0:00:15.217
that he was setting off metal detectors.

0:00:16.279,0:00:19.380
For the next 42 years,[br]he suffered from nightmares,

0:00:19.404,0:00:21.618
extreme anxiety in public,

0:00:21.642,0:00:23.653
isolation, depression.

0:00:23.677,0:00:25.581
He self-medicated with alcohol.

0:00:25.605,0:00:28.511
He was married and divorced three times.

0:00:28.535,0:00:31.256
Carlos had post-traumatic stress disorder.

0:00:32.129,0:00:35.706
Now, I became a psychologist[br]to help mitigate human suffering,

0:00:35.730,0:00:40.217
and for the past 10 years, my target[br]has been the suffering caused by PTSD,

0:00:40.241,0:00:42.763
as experienced by veterans like Carlos.

0:00:43.356,0:00:48.573
Until recently, the science of PTSD[br]just wasn't there.

0:00:49.161,0:00:51.537
And so, we didn't know what to do.

0:00:51.561,0:00:53.925
We put some veterans on heavy drugs.

0:00:53.949,0:00:56.753
Others we hospitalized[br]and gave generic group therapy,

0:00:56.777,0:00:58.875
and others still we simply said to them,

0:00:58.899,0:01:02.213
"Just go home and try to forget[br]about your experiences."

0:01:03.534,0:01:06.877
More recently, we've tried therapy dogs,[br]wilderness retreats --

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many things which may[br]temporarily relieve stress,

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but which don't actually eliminate[br]PTSD symptoms over the long term.

0:01:14.654,0:01:16.011
But things have changed.

0:01:16.451,0:01:21.607
And I am here to tell you[br]that we can now eliminate PTSD,

0:01:21.631,0:01:23.458
not just manage the symptoms,

0:01:23.482,0:01:25.030
and in huge numbers of veterans.

0:01:25.054,0:01:28.032
Because new scientific research[br]has been able to show,

0:01:28.056,0:01:30.434
objectively, repeatedly,

0:01:30.458,0:01:33.933
which treatments actually[br]get rid of symptoms and which do not.

0:01:33.957,0:01:35.605
Now as it turns out,

0:01:35.629,0:01:40.859
the best treatments for PTSD use[br]many of the very same training principles

0:01:40.883,0:01:44.735
that the military uses[br]in preparing its trainees for war.

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Now, making war --

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this is something that we are good at.

0:01:50.993,0:01:55.133
We humans have been making war[br]since before we were even fully human.

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And since then, we have gone[br]from using stone and sinew

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to developing the most sophisticated[br]and devastating weapon systems imaginable.

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And to enable our warriors[br]to use these weapons,

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we employ the most cutting-edge[br]training methods.

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We are good at making war.

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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,

0:02:18.200,0:02:21.387
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,

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most of humanity lives[br]in far more peaceful societies,

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and when there is conflict,[br]we, especially in the United States,

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now have the technology to put[br]our warriors through advanced training,

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drop them in to 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've told me

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that one day they're in a brutal[br]firefight in Afghanistan

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where they saw carnage and death,

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and just three days later,[br]they found themselves

0:03:16.361,0:03:18.945
toting an ice chest[br]to their kid's soccer game.

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"Mindfuck" is the most common term.

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(Laughter)

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

0:03:27.775,0:03:29.299
And that's exactly what that is.

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Because while our warriors[br]spend countless hours training for war,

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we've only recently come to understand

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that many require training[br]on how to return to civilian life.

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Now, like any training, the best[br]PTSD treatments require repetition.

0:03:43.757,0:03:44.908
In the military,

0:03:44.932,0:03:48.172
we don't simply hand trainees[br]Mark-19 automatic grenade launchers

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and say, "Here's the trigger,[br]here's some ammo and good luck."

0:03:51.412,0:03:56.108
No. We train them, on the range[br]and in specific contexts,

0:03:56.132,0:03:57.818
over and over and over

0:03:57.842,0:04:00.631
until lifting their weapon[br]and engaging their target

0:04:00.655,0:04:02.491
is so engrained into muscle memory

0:04:02.515,0:04:04.843
that it can be performed[br]without even thinking,

0:04:04.867,0:04:07.787
even under the most stressful[br]conditions you can imagine.

0:04:08.630,0:04:11.364
Now, the same holds[br]for training-based treatments.

0:04:11.875,0:04:15.206
The first of these treatments[br]is cognitive therapy,

0:04:15.230,0:04:18.599
and this is a kind[br]of mental recalibration.

0:04:19.166,0:04:20.795
When veterans come home from war,

0:04:20.819,0:04:23.415
their way of mentally framing[br]the world is calibrated

0:04:23.439,0:04:26.098
to an immensely[br]more dangerous environment.

0:04:26.860,0:04:32.016
So when you try to overlay that mind frame[br]onto a peacetime environment,

0:04:32.040,0:04:33.245
you get problems.

0:04:33.269,0:04:37.724
You begin drowning in worries[br]about dangers that aren't present.

0:04:37.748,0:04:41.071
You begin not trusting family or friends.

0:04:41.935,0:04:45.999
Which is not to say there are no[br]dangers in civilian life; there are.

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It's just that the probability[br]of encountering them

0:04:49.118,0:04:50.388
compared to combat

0:04:50.412,0:04:52.720
is astronomically lower.

0:04:53.675,0:04:56.815
So we never advise veterans[br]to turn off caution completely.

0:04:56.839,0:04:59.223
We do train them, however,[br]to adjust caution

0:04:59.247,0:05:00.888
according to where they are.

0:05:01.685,0:05:04.170
If you find yourself[br]in a bad neighborhood,

0:05:04.194,0:05:05.449
you turn it up.

0:05:05.878,0:05:07.527
Out to dinner with family?

0:05:07.551,0:05:09.479
You turn it way down.

0:05:09.975,0:05:12.747
We train veterans to be fiercely rational,

0:05:13.271,0:05:16.825
to systematically gauge[br]the actual statistical probability

0:05:16.849,0:05:20.657
of encountering, say, an IED[br]here in peacetime America.

0:05:21.460,0:05:25.724
With enough practice,[br]those recalibrations stick.

0:05:27.193,0:05:29.507
The next of these treatments[br]is exposure therapy,

0:05:29.531,0:05:31.958
and this is a kind of field training,

0:05:32.453,0:05:35.514
and the fastest of the proven[br]effective treatments out there.

0:05:35.974,0:05:37.531
You remember Carlos?

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This was the treatment that he chose.

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

0:05:42.333,0:05:43.639
for him, challenging ones:

0:05:43.663,0:05:45.609
going to a grocery store,

0:05:45.633,0:05:48.258
going to a shopping mall,[br]going to a restaurant,

0:05:48.282,0:05:50.772
sitting with his back to the door.

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And, critically --

0:05:53.032,0:05:54.545
staying in these environments.

0:05:55.791,0:05:57.501
Now, at first he was very anxious.

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He wanted to sit[br]where he could scan the room,

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where he could plan escape routes,

0:06:01.990,0:06:05.017
where he could get his hands[br]on a makeshift weapon.

0:06:05.041,0:06:07.881
And he wanted to leave, but he didn't.

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He remembered his training[br]in the Marine Corps,

0:06:11.285,0:06:13.129
and he pushed through his discomfort.

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And every time he did this,[br]his anxiety 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,

0:06:20.867,0:06:25.777
he had effectively relearned[br]how to sit in a public space

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and just enjoy himself.

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

0:06:33.046,0:06:35.227
over and over and over.

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He listened until those memories[br]no longer generated any anxiety.

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He processed his memories so much

0:06:43.005,0:06:46.234
that his brain no longer needed[br]to return to those experiences

0:06:46.258,0:06:47.543
in his sleep.

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And when I spoke with him[br]a year after treatment had finished,

0:06:51.977,0:06:53.348
he told me,

0:06:53.372,0:06:57.773
"Doc, this is the first time in 43 years

0:06:58.472,0:07:00.058
that I haven't had nightmares."

0:07:01.412,0:07:05.590
Now, this is different[br]than erasing a memory.

0:07:06.087,0:07:09.082
Veterans will always remember[br]their traumatic experiences,

0:07:09.106,0:07:10.763
but with enough practice,

0:07:10.787,0:07:15.993
those memories are no longer as raw[br]or as painful as they once were.

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They don't feel emotionally[br]like they just happened yesterday,

0:07:19.964,0:07:23.770
and that is an immensely[br]better place to be.

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But it's often difficult.

0:07:27.677,0:07:31.315
And, like any training,[br]it may not work for everybody.

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And there are trust issues.

0:07:33.931,0:07:35.213
Sometimes I'm asked,

0:07:35.237,0:07:37.891
"If you haven't been there, Doc,[br]how can you help me?"

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Which is understandable.

0:07:40.244,0:07:44.615
But at the point of returning[br]to civilian life,

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you do not require[br]somebody who's been there.

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You don't require training[br]for operations on the battlefield;

0:07:51.125,0:07:55.038
you require training on how to come home.

0:07:58.626,0:08:00.891
For the past 10 years of my work,

0:08:01.336,0:08:04.084
I have been exposed to detailed accounts

0:08:04.108,0:08:06.708
of the worst experiences[br]that you can imagine,

0:08:06.732,0:08:07.961
daily.

0:08:07.985,0:08:10.083
And it hasn't always been easy.

0:08:10.107,0:08:13.472
There have been times[br]where I have just felt my heart break

0:08:13.496,0:08:15.343
or that I've absorbed too much.

0:08:16.150,0:08:19.473
But these training-based[br]treatments work so well,

0:08:19.497,0:08:22.579
that whatever this work takes out of me,[br]it puts back even more,

0:08:22.603,0:08:25.849
because I see people get better.

0:08:26.754,0:08:28.577
I see people's lives transform.

0:08:30.656,0:08:33.994
Carlos can now enjoy outings[br]with his grandchildren,

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

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And what's amazing to me[br]is that after 43 years of suffering,

0:08:41.648,0:08:45.467
it only took him 10 weeks[br]of intense training to get his life back.

0:08:46.001,0:08:48.309
And when I spoke with him, he told me,

0:08:48.333,0:08:52.350
"I know that I can't get those years back.

0:08:53.088,0:08:57.997
But at least now, whatever days[br]that I have left on this Earth,

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I can live them in peace."

0:09:01.114,0:09:04.586
He also said, "I hope that these[br]younger veterans don't wait

0:09:04.610,0:09:05.958
to get the help they need."

0:09:06.588,0:09:07.874
And that's my hope, too.

0:09:09.020,0:09:10.206
Because ...

0:09:11.003,0:09:12.446
this life is short,

0:09:13.383,0:09:16.555
and if you are fortunate enough[br]to have survived war

0:09:16.579,0:09:18.659
or any kind of traumatic experience,

0:09:18.683,0:09:22.198
you owe it to yourself[br]to live your life well.

0:09:22.629,0:09:25.270
And you shouldn't wait[br]to get the training you need

0:09:25.294,0:09:26.679
to make that happen.

0:09:28.663,0:09:33.978
Now, the best way of ending[br]human suffering caused by war

0:09:34.883,0:09:36.383
is to never go to war.

0:09:37.422,0:09:39.588
But we are just not there[br]yet as a species.

0:09:40.157,0:09:41.417
Until we are,

0:09:41.441,0:09:46.674
the mental suffering that we create[br]in our sons and in our daughters

0:09:46.698,0:09:48.246
when we send them off to fight

0:09:48.682,0:09:50.932
can be alleviated.

0:09:51.675,0:09:57.761
But we must ensure that the science,[br]the energy level, the value

0:09:57.785,0:10:00.717
that we place on sending them off to war

0:10:01.516,0:10:03.426
is at the very least mirrored

0:10:03.450,0:10:07.056
in how well we prepare them[br]to come back home to us.

0:10:07.868,0:10:09.441
This much, we owe them.

0:10:10.186,0:10:11.369
Thank you.

0:10:11.393,0:10:18.324
(Applause)