The Meadows Blog

Military Issues

Military Issues (14)

The US Department of Veterans Affairs (VA) has invested heavily in the dissemination of prolonged exposure therapy and cognitive processing therapy (1), yet 30-50% of veterans participating in these therapies fail to show clinically significant improvements. Evidence suggests that mindfulness-based stress reduction, an intervention that teaches individuals to focus on the present moment in an accepting way, can result in reduced symptoms of PTSD (1).
Compulsive sexual behavior (CSB) is highly prevalent among men, often co-occurring with psychiatric disorders and traumatic experiences. Psychiatric disorders and trauma are common among military veterans (1). Researchers have noted that some veterans may use sexual behaviors to cope with trauma, and CSB has also been linked to traumatic brain injury, for which combat-exposed military personnel are at an increased risk.

Per the Tricare press release posted on their website:

TRICARE expanded mental health and substance use disorder (SUD) services, adding intensive outpatient programs and expanding options for opioid treatment. In addition to other improvements, this expansion improves access to care and increases opportunities for mental health and SUD treatment. It also makes it easier for beneficiaries to access the right level of care for their health and wellness needs. 

Research published in the Journal of the American Medical Association in 2015 showed that the most commonly used treatments for PTSD—cognitive processing therapy (CPT) and prolonged exposure therapy (PE) may not be as effective as those in the medical community had hoped.

Friday, 11 November 2016 00:00

Dr. Bessel van der Kolk on Veterans and PTSD

Meadows Senior Fellow Dr. Bessel van der Kolk is world-renowned for his work pertaining to the treatment of Post-Traumatic Stress Disorder (PTSD), childhood trauma, and abuse.

In a video interview on, Dr. van der Kolk explains how the emotional and relational difficulties faced by war veterans shaped the diagnosis of PTSD and how the effects of trauma are major contributing factors.

By Dr. Jon Caldwell, D.O., Ph.D. Chief of Psychiatry at The Meadows

Note: This post was originally published on The Meadows is proud to be a TRICARE Preferred Provider of behavioral health and addiction inpatient services in the West Region. Call us today at 800-244-4949.

Trauma is part of the human experience. Being alive comes with the inevitable risks of stress, injury, sickness, loss, and death. There’s no escaping it. Critically though, these threats to health and life are perhaps most pronounced for individuals who serve in the military. Few other circumstances in modern times make these threats more real than military service. Military service members are required to complete their mission while facing significant risk and threat.

Constant Threat and Chronic Stress

Fortunately, humans are equipped with a highly functional nervous system that, under typical conditions, can successfully deal with most stressors and threats. For example, relatively common experiences like nearly running over a piece of garbage on the freeway, an argument between two people in a retail store, or being disappointed by a loved one are stressful and somewhat threatening situations that are usually managed effectively by most people’s nervous systems.

In circumstances like these, most people feel a temporary surge of adrenaline and hyper awareness to the potential threat; their nervous system prepares them for “fight or flight” and mobilizes the necessary resources to effectively deal with the situation. In relatively short order, the fight or flight reactivity usually subsides naturally, and they are able to return to the flow of their lives: driving, shopping, and social engagement.

However, under extreme or chronic conditions of stress and threat, as is common in military service, the nervous system can become overwhelmed. In fact, the chemical and physical make-up of the brain-body stress response system can be altered by experiences of extreme or chronic stress (i.e., trauma). For many service members, this can result in decreased “resiliency”, or the capacity to effectively manage everyday life circumstances. This shift in resiliency can occur immediately after the experience of trauma, but very often it can occur down the road, sometimes years later.

What is PTSD?

For some service members, the trauma-related changes to the nervous system progresses to the point where he or she qualifies for the diagnosis of Post-Traumatic Stress Disorder (PTSD). The diagnosis of PTSD is made when a person was directly or indirectly exposed to an extremely stressful or threatening event or series of events that resulted in symptoms of intrusion (e.g., disturbing memories, nightmares, flashbacks), avoidance (e.g., avoidance of thoughts, people, places, and things associated with past trauma), negative alterations in thinking and mood (e.g., self-blame, guilt, shame, isolation, withdrawal, depression), and alterations in arousal and activity (e.g., insomnia, hypervigilance, irritability, anger, self-destructive behavior).

These trauma-related symptoms are very distressing. But, for a variety of reasons, many service members don’t seek help and, despite their best efforts, are unable to manage the symptoms on their own. Therefore, it is common for these individuals to cope with their symptoms by turning to addictive behaviors, like alcohol and drugs, pornography and sex, gambling, video games, and disordered eating. Of course, while these behaviors may temporarily modify unpleasant trauma-related symptoms, they frequently result in more distress and added functional limitations.

What PTSD Looks Like

The everyday situations mentioned above will be used here to better understand the experience of PTSD. For many service members, a piece of garbage on the freeway would likely elicit thoughts, memories, or flashbacks about Improvised Explosive Devices (IEDs). This experience could easily result in driving-related stress and hypervigilance, intrusive memories or flashbacks, poor concentration while driving, fear and avoidance of driving, or anger and road-rage.

When encountering an argument between two people in a retail store, a service member who is affected by past trauma might experience a pronounced fight or flight response. If it is a fight response, he or she may experience intrusive memories or flashbacks of previous violent encounters and surges of adrenaline in preparation for defending oneself or attacking others. If the individual has a flight response, he or she may experience overwhelming urges to leave the store, avoid that store and similar retail stores, and retreat further from public places and crowds.

If a military service member who is affected by trauma is disappointed by a loved one, he or she may escalate quickly to irritability and anger, perhaps reacting by yelling, throwing things, or becoming violent. Alternatively, the anger might secretly fester into resentments that result in addictive acting out behaviors. On the other hand, being let down by a loved one might result in painful feelings of being misunderstood, guilt and shame, self-loathing, sadness, and depression.

As these vignettes illustrate, services members can have pronounced nervous system reactivity in response to everyday situations as a result of their history of traumatic experiences. This reactivity takes them out of the present moment flow of routine life and leaves them feeling uncomfortable in their own skin and disconnected from other people. In this state, they are more likely to resort to addictive and unhealthy behaviors. Sadly, many service members suffer in silence, and some don’t get help before it’s too late.

Help is Available

Fortunately, it’s never too late to get help, and there is hope! Appropriate treatment can help to identify past traumas, current symptoms, and unhealthy coping mechanisms. Additionally, treatment can help reduce nervous system reactivity and restore its natural capacity for self-regulation. Treatment can help affected service members to let go of shame and self-destructive behaviors. Restoration of resiliency means that service members will once again feel confident in their abilities to manage everyday life situations. Lastly, service members who receive appropriate treatment can reestablish safe connections to peers, loved ones, and the world around them – they are able once again to enter the flow of life and experience all that it has to offer!

Wednesday, 13 January 2016 00:00

Serving Members of the Military with TRICARE

Did you know that The Meadows is an approved TRICARE Provider and is in-network in the Western Region? This means that 2.9 million eligible beneficiaries can receive world-class mental health treatment services by accessing benefits available to them.

This is an incredible benefit because The Meadows is typically a private pay facility. In fact, our agreement to be a TRICARE Provider in the Western Region is The Meadows’ only insurance contract. The Tricare Western Region includes Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (excluding the Rock Island Arsenal area), Kansas, Minnesota, Missouri (excluding the St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (the southwestern corner only, including El Paso), Utah, Washington, and Wyoming.

The Meadows world-class team of Senior Fellows, psychiatrists, therapists, and counselors has a high desire to be of service to active duty military members, retirees, and dependents covered under this plan. We are honored to provide behavioral health and substance abuse inpatient services to TRICARE beneficiaries, with an emphasis on emotional trauma, PTSD, addictive disease disorders, and behavioral and sexual addictions.

Decades of Experience

The Meadows has been a leading provider of trauma and addiction treatment services for nearly 40 years. At our confidential and tranquil campuses just 90-minutes from Phoenix, Arizona, our multidisciplinary treatment team uses state-of-the-art trauma therapies and neuroscience to address the underlying issues that cause patterns of self-destructive behavior, allowing the patient to begin the process of healing.

Committed To Helping

The Meadows has a long history of working with members of the military and their families. We are tremendously proud to help serve the health care needs of service members, veterans, and their families, and would be happy to help determine eligibility and benefits that can be utilized at The Meadows. We are committed to helping military beneficiaries and partnering with all aspects of the TRICARE Healthcare Alliance.

Give us a call today to discuss how we can help. 800-244-4949

Tuesday, 11 November 2014 00:00

We Celebrate Veterans Day

Veterans Day is an opportunity for Americans to honor ALL of our Veterans, both living and deceased. It is a day that the United States has set aside to thank veterans for their dedication and loyal service to their country. November 11th of each year is the day that we ensure veterans are aware of how deeply we appreciate the sacrifices that they have made in order to keep our country free.

On the 11th hour of the 11th day of the 11th month of 1918, an armistice, or a temporary suspension of hostilities, was declared between the Allied nations and Germany in the First World War, which was then known as “the Great War.” Commemorated as Armistice Day beginning the following year, November 11th became a legal federal holiday in the United States in 1938. After the tragedies of World War II and the Korean War, Armistice Day then became known as Veterans Day, a holiday dedicated to American veterans of all wars.

A Tribute to Our Veterans

The Meadows is committed to supporting members of our nation’s military who have selflessly served our country. Our treatment staff and world-renowned Senior Fellows have dedicated themselves to developing treatments and becoming a proven resource for our military service members and their families. We are profoundly aware of the sacrifices and courage that has been asked of our veterans.

That is why today, and every day, The Meadows works hard to extend our deepest gratitude and appreciation to everyone who has given so much on our behalf.

To all of the Veterans, “Thank You.”

Written by a former active duty military personnel, currently employed at Gentle Path at The Meadows

In a world that is constantly in strife and war, we as a nation call upon the select few that have dedicated their lives in service to our country—the protectors of our freedom. Although the sound of military life may seem glamorous to some, the situations that these men and women find themselves in not only affect their lives, but the people’s lives who love them the most.

What soldiers experience in deployment will last longer than the smoke and sounds of gun fire; it is a constant memory that haunts you when awake and terrifies you when asleep. The nightmares are never ending until you finally face the trauma that haunts your life.

In these dark days a soldier tries to find hope in anything he or she can, not only for themselves, but for their families; it’s the little things, things that so many take for granted in the normal hustle and bustle of life. Things like the laughter of a child, the rain pouring down, a warm thank you from a stranger, a gentle kiss on the check, and even the wind on your face can for a second take away the gnawing pain in your heart. But even in these moments the things you did, the things you’ve see, the lives you impacted, the faceless terrors you encountered, hide in the shadows constantly reminding you of those memories, of that pain, every day.

However, in the midst of all of this pain and hurt, service men and women stand on the military values: Loyalty, Duty, Respect, Self Service, Honor, Integrity and Personal Courage. Finding a place that shares in these values and longs to see lives changed is hard, but it is an important part of healing and a necessary path that we must walk on. I asked myself several times how important it was for me to face my demons, and the answer was always “Very.” Waking up in a cold sweat—my best friend sitting there worrying, trying to make the nightmares leave—I realized that trauma doesn’t just change your life, but all the lives of the people you love most.

What kind of a soldier would I be if I didn’t protect those I love? Without facing my demons, how can I overcome them? Without overcoming them, how can I truly be free? Without being free how can I fully live in love, life, beauty and everything else this world has to offer away from the wars I faced? So I have the choice to face it, putting a new example on the idea of personal courage and self-sacrifice, still holding true to those values that I swore to honor and respect and carry with me as part of the uniform I wore.

Every day military personnel put on that uniform, tie up their boots and head into the fire fights that await, battles by our side, with our families praying at home, dreaming that one day their loved one will come home safe. However, even at home these individuals are not fully safe from themselves and the memories that torment them with every breath. But there is hope for a better life, and there is a future once the smoke fades and the ringing of the bullets dies.

The importance of healing from the effects of war can make or break the rest of your life. Support is rare, and it’s often hard to find a positive place to work out the battle wounds—a safe place to heal with no judgment. However, it does exist and there is hope. When searching for a safe place to do my own work, I was urged to look for someone/some place that holds my same values—sage advice.

It’s called LIFE, it’s called FREEDOM and it’s what we fight everyday to defend, so it’s time to fight for ourselves and our families by taking back our FUTURES.

Need Help?

The Meadows is honored to provide behavioral health and substance abuse inpatient services, with an emphasis on trauma, PTSD, and addictive disease disorders, to active duty military members, retirees and dependents of the TRICARE West Region. The Meadows has a long history of working with TRICARE beneficiaries as a non-contracted provider. We are tremendously proud to help serve the health care needs of service members, veterans, and their families, and would be happy to help determine eligibility and benefits that can be utilized at The Meadows. We are committed to helping military beneficiaries and partnering with all aspects of the TRICARE healthcare alliance. For more information, call us at 800-244-4949 or go visit our contact page.

By Isabel Nino de Guzman, PhD, CSAT Licensed Psychologist at Gentle Path at the Meadows

News stories about sexually addictive behaviors in the armed forces over the past several years seem to be increasing at an alarming number, calling greater attention to the issues arising between the men and women who serve their country for us. A quick Google search using the terms “Sexual Addiction in the Military” brings an abundance of articles published in military publications regarding sexual addiction and the effect it has on military personnel. One such article published in The Army Times states that one in ten civilians may suffer from pornography addiction while the percentage may be as high as twenty percent of military personnel. Source

Gentle Path at The Meadows has a history of treating active duty military members and retirees for sexual compulsive behaviors so they understand the challenges these individuals face. As a Tricare network provider, Gentle Path at The Meadows provides behavioral health and substance abuse inpatient services, with an emphasis on trauma, PTSD, and addictive disease disorders, to active duty military members, retirees and dependents of the TRICARE West Region. Military personnel and the demands of their service require special consideration in their health care treatment. Through a close relationship with the military, the therapists, nurses, physicians, and administrators at Gentle Path at The Meadows are very familiar with the unique challenges of these individuals. Military members who serve their country are needed back on the job, back doing the vital service that they were trained to do, and Gentle Path at The Meadows specializes in returning these individuals back to duty.

Military personnel thrive in a structured environment with a scheduled day and required tasks. Gentle Path at The Meadows’ inpatient treatment process is a task-centered model that military personnel can relate to. This structured environment also makes sense to an addict because their lives have usually become convoluted and chaotic. The daily regimen of the Gentle Path at The Meadows program, created and overseen by the pioneer in the sexual addiction field, Dr. Patrick Carnes, is tailor-made for the treatment of sexual addiction in military personnel.

Dr. Carnes’s research findings reveal that more than 90% of the Gentle Path at The Meadows patients report experiences of severe trauma (Carnes, 2014) and a significant number exhibit symptoms of adult post-traumatic stress disorder. For the past 25 years, The Meadows, the parent program of Gentle Path at The Meadows, has examined how trauma affects psychological and biological processes, and how the damage caused by overwhelming life experiences can be reversed. An important component of the Gentle Path at The Meadows program is treating both sex addiction and trauma, given the intricate connections between these two. On the one hand, sex addiction treatment that addresses trauma has proven to be more effective and successful than clinical practices that do not take trauma into consideration. And, on the other hand, the rate of relapse when sex addiction treatment that is not trauma-informed is significantly higher than other therapeutic treatment that does not take trauma into consideration.

A direct implication of traumatic situations is the person’s loss of the natural sense of safety, meaning, purpose, and understanding of the world and life experiences. Because the fight or flight response cannot be deactivated, the sense of self, the world, and the future may become unsafe. Re-experiencing the event and avoiding reminders of the situation can be part of the normal adjustment process. However, it can also result in a disorder that alters the person’s cognition, arousal, and reactivity, behavior, and a sense of self.

Sex addiction is often a response to unresolved trauma. Paradoxically, it entails new sources of trauma; there is a proneness to re-victimization that results from the risky behaviors and/or dangerous relationships that are inherent to this disorder. A first goal in trauma-informed treatment for sexual addictions is the establishment of real safety and avoidance of further damage. Breaking through denial and admission of powerlessness are the essence of the First Step at Gentle Path at The Meadows and the beginning of the process, or stabilization that will lead to understanding the connection between trauma and sex addiction and recovering from it.

“Healing does not occur in a vacuum,” says Allan Benham, Executive Director for Gentle Path at The Meadows. “The therapeutic milieu at Gentle Path at The Meadows helps our patient create a new sense of safety and trust within the context of personal connections and safe relationships. Patients learn about resilience, new choices, and renewed skills, values, and ideals. Additionally, they learn to frame their own destiny by participating in a collaborative relationship with the clinicians at the program.”

Gentle Path at The Meadows provides a therapeutic environment in which:

  • The cycle of sex addiction and trauma repetition is stopped
  • Fear is substituted with a sense of safety
  • New, healthy relationships break the sense of isolation, and the concept of intimacy is re-learned
  • Coping skills are developed
  • New choices create a sense of genuine empowerment and self-pride
  • Self-abuse is replaced with self-nurturing
  • Spiritual healing becomes possible
  • Chaos is replaced with renewed structure, and a sense of balance is achieved

Most importantly, patients are able to grieve the sexually addictive behaviors that once served to soothe them when trauma occurred.

Military Addiction Treatment

Every journey begins with one step. If you are a service member in need of military addiction treatment or PTSD treatment for military issues, please call us today. To learn more about the Gentle Path at The Meadows or if you have an immediate need, please contact us or call 855-333-6076 or go to

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