Even before she left for Afghanistan, Katie Helmer knew she was going to have trouble when she got back.
As a member of the Minnesota National Guard, she was assigned to monitor casualties at a military hospital at Bagram Airfield. From a previous deployment in Kuwait, Helmer knew the psychic toll the ordeal would take on her.
When she came home in 2013, she jumped at the chance to get free treatment for post-traumatic stress through a pilot program for a therapy called EMDR, which uses sensory stimulation to connect to triggers from trauma and neutralizes them. After several sessions, she said it worked.
"I've never been a therapy type of person, but it worked because it was a different kind of therapy, and I didn't have to do too much of the talking," Helmer said.
Out of that pilot program emerged the Veteran Resilience Project, a Minnesota nonprofit that offers EMDR therapy -- which stands for eye movement desensitization and reprocessing -- to vets, and says it is getting positive results.
There is a rub: The U.S. Department of Veterans Affairs (VA) says the treatment is effective but not one of its top choices for addressing post-traumatic stress disorder (PTSD). In Minneapolis, in fact, the VA doesn't use it at all.
The VA has no objection to the therapy, but it seldom will refer patients for treatment because the VA has the resources -- and pays for -- other therapies.
So EMDR practitioners are joining a growing list of groups seeking to help veterans who say they often find themselves in a David vs. Goliath battle with the VA. And they have not been afraid to step up to make their point.
Building a nonprofit
The Veteran Resilience Project is the brainchild of Elaine Wynne, a Minnesota EMDR therapist.
Wynne tried for six years to start an EMDR project focusing on veterans, but found the VA and the Defense Department resistant because of concerns that the treatment was not evidenced-based. Undaunted, she won a grant from a national EMDR program and set off on her own in 2013 to conduct a 20-month pilot project.
Using 25 therapists to serve 30 veterans, she documented that 74 percent of the respondents after treatment no longer showed signs of PTSD and that 100 percent had significantly reduced symptoms.
In 2015, Wynne took $10,000 she had left from the project and put it toward the newly formed nonprofit, with most of the money going to reimburse therapists for their work. Paul Riedner, an Iraq veteran with a penchant for social media and marketing, was brought on as executive director.
Since then Riedner, a former Army diver, has been directing outreach with podcasts and seeking funding through crowdsourcing and grant writing. He said his mission is particularly important since fewer than half of veterans use the VA, and most National Guard and Reserve troops do not receive VA services.
Since January 2015, the project has treated 14 vets and now has a waiting list of more than a dozen. For now, the project can only treat vets with insurance or those who can self-pay. When vets who show up can't pay, they are monitored and put on a waiting list.
While it is pursuing more grants, the project relies on private donations and fundraisers like a recent one through the VFW. The group hopes to secure funding for treatment throughout Minnesota, particularly for underserved veterans in rural areas.
In its short life, the Veteran Resilience Project's feistiness has raised some eyebrows in the established veteran community. When Riedner recently wrote a commentary introducing the project in the Star Tribune, the headline caused a stir: "Forget the VA: We can help heal trauma of PTSD."
Riedner's presumption moved Al Zdon, editor of Minnesota's American Legion newspaper, to defend in print what he saw as the VA's successes. "The VA doesn't do a lot of things that can help veterans," he said. "They don't give them horse rides. They don't provide them with pets."
Project leaders say the VA's lackluster response to EMDR has discouraged funders and has cost them clients and resources. A potential funder may get excited at the first meeting, Wynne said, and then next time "may say something like, 'We asked the VA and they say they don't use EMDR.' "
EMDR is designed to help the brain unlock traumatic memories and reprocess them into more positive thoughts. During a session, the client may be asked to focus on a memory while stimulation is used such as eye movements, tapping or sounds. After each association is processed, the "bilateral" stimulation continues until the original issue is no longer disturbing.
EMDR is offered sparingly across the VA system, but access depends on resources available at a local facility, said Paula Schnurr, executive director of the VA's National Center for PTSD in White River Junction, Vt.
"There's a good body of evidence that EMDR is effective," Schnurr said.
In a statement, Minneapolis VA mental health officials said the Twin Cities hospital instead relies on two other established forms of treatment: prolonged exposure (PE) and cognitive processing therapy (CPT), both proven to be highly effective. The Minneapolis VA, in fact, provides training to other facilities in the two approaches.
"We have not developed this service and have instead focused our efforts on providing the highest quality services in PE and CPT," the Minneapolis VA said in a statement.
The St. Cloud VA, the only other VA hospital in Minnesota, said it does offer EMDR to a small number of veterans as part of the hospital's outpatient mental health program.
'I had to be proactive'
Just as she had done in Kuwait, Helmer collected information in Afghanistan on patients and provided updates to the Army as a member of a Casualty Liaison Team.
"I knew I was going to have issues," she said. "I knew I had to be proactive about it."
After a handful of EMDR sessions, she said, she was able to recognize the triggers to her trauma and guide herself to a more positive place, using vibrating wands to help direct her eye movements. The nightmares that once seemed like a never-ending movie stopped, and she began to reconnect with friends.
She stayed in the Guard and went to work as a preschool teacher.
Just a few weeks ago, she said, the nightmares began again. She has sought help from the VA, and said she would be willing to try EMDR again if the VA offered it.
As a testament to the success of her treatment, Helmer said she wouldn't hesitate if asked to serve another deployment.
"I would go back and do it again in a heartbeat," she said. "You were so focused that nothing bothered you. Now that you have other things to go and do, it comes back. It's something I'll deal with for the rest of my life."