Thomas Harris slid into the cool, salty water of a 6.3-million-gallon tank at the Georgia Aquarium and let himself float limp as kelp.
Harris, a former Army medic, gazed through a diving mask as a 21-foot whale shark brushed silently by, inches from his face, its broad, spotted back taking up his entire view. Immersed in the moment, he forgot about the world.
This is not a weekend hobby. It is part of his therapy for the post-traumatic stress disorder he has been grappling with after his tours in Iraq. And like Harris, more veterans are turning to these sorts of outside-the-office treatment.
The broad acceptance of PTSD after the wars in Iraq and Afghanistan has posed an unexpected challenge. Acknowledging PTSD has only spurred a wide-ranging debate over the best way to treat it.
Traditional medical approaches generally rely on drugs and controlled re-experiencing of trauma, called exposure therapy. But this combination has proved so unpopular that many veterans quit before finishing or avoid it altogether. This has given rise to hundreds of small nonprofits across the country that offer alternatives: therapeutic fishing, rafting and backpacking trips, horse riding, combat yoga, dogs and art collectives, among many, many others.
A decade ago, mainstream psychiatry often dismissed these therapies. But now, as new studies suggest that things like yoga and interacting with animals can be as beneficial as drugs in reducing depression and anxiety without side effects or stigma, a growing number of psychotherapists are building them into treatment plans.
The crush of veterans seeking treatment beyond drugs and exposure therapy has pushed psychologists to try to scientifically evaluate programs that were once largely dismissed as field trips. But many psychiatrists are troubled by a lack of hard evidence supporting alternative therapies.
“Interest has just exploded,” said Lt. Col. Gary Wynn, a psychiatrist who teaches at the Uniformed Services University of the Health Sciences, the military’s medical school. “I work with the VA and the military. There is no one who thinks this is just silly alternative medicine stuff anymore.”
But, he cautioned, evidence of real benefit is in many cases still often slim or nonexistent.
“If I’m studying the benefits of fly fishing, do I control for the number of fish people caught? Or for the weather?” he said. “There is still a lot of work to be done on this.”