By Evan Bleier
At the Steven & Alexandra Cohen Military Family Clinic at New York University, doctors are treating service members with a simple idea: start with the mind and body, and you will help the soul.
Midtown Manhattan is a long way from the streets of Fallujah and the alleyways of Kabul. But the wounds American soldiers incurred in battle in those cities and myriad others in Iraq and Afghanistan are being treated in the center of the city that never sleeps.
Doctors and other healthcare professionals at the Steven & Alexandra Cohen Military Family Clinic, which is affiliated with New York University’s Langone Medical Center, specialize in treating the invisible injuries that members of the military suffer during service. It’s a system that focuses on helping servicemen and servicewomen adapt to civilian life without forgetting the importance of family members’ participating in treatments.
When an improvised explosive device (IED) or sniper’s bullet rips into its victims, the pain is not only inflicted on the unlucky troops who are hit but on their loved ones, too. That reality is something doctors like Dr. Irina Komarovskaya know very well.
“What people miss about the military is the camaraderie and the intense sense of connection that’s formed. The stakes are very high and those relationships save lives,” Komarovskaya says.
A clinical assistant professor of psychiatry at NYU, Komarovskaya became the clinic director after completing postdoctoral fellowships at Bellevue Hospital and Langone. She specializes in the diagnosis and treatment of traumatic stress, complex trauma, depression, anxiety and relationship difficulties. She admits that her time as director has revealed how much she, and the medical community in general, still have to learn about the hidden wounds of combat.
Dr. Komarovskaya believes in a comprehensive approach to treatment. “What we’ll often see now is that there are camps of thought. People who feel that the cognitive behavioral intervention approach is the only way to go or others who feel that treating the body is where to begin,” she says. “What I’m learning is that to really effectively treat a lot of these cases you have to be well versed and not too dogmatic about any approach. It’s a condition that affects the whole person.”
The result is an integrated model that doesn’t follow a rigid recipe for treatment. Physicians are trained differently so treatment follows various approaches but always relies on evidence-based principles according to Komarovskaya.
Using that approach, the doctors working at Langone face the range of ways in which combat affects victims and their families. They treat alcohol and other substance abuse; grief and loss; military sexual trauma; parenting concerns; and children’s behavioral or academic problems. The objective is always to put veterans first, letting them know that any and all assessments and diagnoses are designed with the aim of providing the best care for each case.
In addition to established treatments for trauma, anxiety and depression, like Cognitive Behavioral Therapy (CBT), Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE), the clinic also offers complementary approaches such as yoga and art therapy to treat Post Traumatic Stress Disorder. Veterans, as well as active duty service members, are encouraged to bring spouses, children, siblings, parents, grandparents and significant others with them to sessions.
Individuals or extended family members who are not interested in being cared for at a particular time are reminded that the door at the clinic is always open to them. That welcoming policy has led to almost 750 people receiving treatment in three-and-a-half years.
Michael Grant, a Vietnam vet who’s majoring in political science at Columbia University says going to the center was the beginning of his journey to healing and to making his life whole again. “The healing led me back to Columbia,” Grant says. “PTSD or any traumatic experience is permanent, and with therapeutic assistance, the very best we can hope for is to become functioning and productive citizens. It’s an ongoing journey.”
That journey includes getting help with something many Americans struggle with – relationships. Komarovskaya says that when veterans return to civilian life, the value system on which relationships are based can seem trivial. “That can be one way a sense of isolation extends back into families and friends,” she says.
Komarovskaya believes society can help by understanding that the transition to civilian life requires a huge transformation. The stigma associated with PTSD and mental health problems is an area that needs attention, in part because it can keep veterans from seeking help. The importance of support for those receiving treatment is well documented. The Langone Center is showing the importance of extending treatment to the family members who are welcoming a veteran home. That dual approach is one reason doctors like Komarovskaya are making a difference.