Illustration by Natalie Clapp

The need to treat those psychological issues has grown increasingly important as medical advances enable more soldiers to survive battlefield injuries, even as greater numbers arrive home with damaged psyches. A landmark study by the RAND Corporation in 2008 estimated that one in five soldiers returning from Iraq and Afghanistan—300,000 at the time—suffered from PTSD or major depression, but little more than half sought treatment.

In war, “what happens is that you compartmentalize,” says retired Col. Patricia Lillis, a Bethesda physician who experienced paralyzing migraines and insomnia after serving as a hospital commander in Iraq in 2004 and 2005.

Lillis, whose interest in yoga nidra and alternative therapies grew after her service, is president of Warriors at Ease, a Silver Spring-based program she founded in 2008 with Soltes and Carnes that trains yoga and meditation teachers throughout the country to work with military populations.

Lillis says compartmentalization is necessary on the battlefield, but is the main reason soldiers feel fragmented when they come home. “You can get so good at compartmentalizing that the trauma gets buried,” she says. “And then these mundane triggers come along, but it’s beyond you to rationally unpack it and deal with it.”

Negative emotions associated with a traumatic event, such as avoidance of anxiety, guilt and anger, prohibit acceptance and keep soldiers stuck in a state of post-traumatic stress. Paired with traditional talk and exposure therapy, iRest can teach soldiers to cultivate an attitude of acceptance of their worst memories of war, Golden says.

The Specialized Care Program, which has since ended at Walter Reed and is expected to resume at Northern Virginia’s Fort Belvoir, offered a comprehensive mix of physical therapy, individual and group therapy, acupuncture and iRest for soldiers who were “train-wreck people…open to anything” that would make them feel better, says Golden, now the DHCC’s special assistant for strategy and integration.

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Soldiers initially were skeptical of iRest, but embraced it after they started sleeping and dealing with stressful situations better, Carnes says.

“Trauma is the opposite of acceptance,” she says. “When things happen that feel like they’re threatening our being, you shut down and say ‘no’ to this experience. That means the experience doesn’t get integrated and we feel disconnected from ourselves, from our families, and disconnected from being able to make meaning” out of the experience. 

Morning light seeps through a set of double pane windows in an unremarkable room at the VA Medical Center, where Ben King is participating in an iRest class led by Soltes. It’s just past 7:30 a.m., and a half-dozen men, mostly Vietnam veterans, settle into cushioned, high-backed chairs that line the room’s periphery. They’ve taken off their shoes, removed eyeglasses and put up their feet.

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Soltes gently challenges the men to pay attention to their breathing, get out of their heads and stay in the moment. Conversation dies down and stillness settles over the room. A few veterans slip in and out of sleep as Soltes’ voice guides them on a mental journey through their bodies.

“Feel behind the eyes…feeling all the way to the back of your head, sensing the back of the neck. …Sense the inside walls of the throat. Now, sensing the entire right arm and hand, feeling its vibrancy and radiance. …Notice how sensations are constantly changing, pulsing. …Feel the breath moving in and out of the nostrils. Remember, it’s more feeling the breath instead of visualizing it.”

It was this approach that enabled King to reconnect with the trauma—particularly a near-fatal incident on New Year’s Eve in 2006—that he’d carried since leaving Iraq.  

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It was around 10 that night when King and members of his company were cracking jokes as they patrolled the area around Baghdad’s Forward Operating Base Loyalty, built in a neighborhood that once was home to Saddam Hussein’s intelligence services. That September, the Iraq War had entered a particularly bloody phase with roadside bombs and mortar attacks on the rise.

King was in the driver’s seat when a tube of explosives hit their Humvee—injuring him and the other men. In pictures from that night stored on King’s iPad, the driver’s side window resembles crushed ice, with a giant bulge in the middle. A photo from the scene of the explosion three days later shows King standing stoic and proud by the vehicle, which is pockmarked with holes.

King wrote of the incident in a leather-bound journal, remembering a fellow soldier “sitting in the turret bleeding out of his face” and recalling his own lucky break:

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“I remember looking at the door and seeing where the blast was headed straight for my head and laughing. …I remember getting out of the vehicle and screaming, ‘You can’t kill me’ just like I had planned in my dreams. I remember being in such a good mood. Kind of like the only way you can experience the relief and joy of a cop letting you go with only a warning is to be pulled over in the first place.”

King suffered shrapnel wounds to his legs, hands and groin. He nearly lost his left testicle, but it was saved by a skilled surgeon at a base hospital. His injuries earned him the Purple Heart and, more importantly, a sense of accomplishment and a feeling of victory and validation that he so desperately sought.

“I had acquitted myself of my manhood,” he says. “This is what you wanted, to see if you could handle the worst they had to offer.”

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By 2008, King was back home and serving in the reserves. He appeared to be adjusting to civilian life, earning a graduate degree in anthropology at American University while pursuing a career as a personal trainer. He’d met Alena Lyons on a blind date and they’d hit it off immediately. Iraq was no longer at the forefront of his life, but it hadn’t faded completely into the background either.

“I really did for a long time have a sense of wholeness, completeness, like I really thought that here I had gone off to war and I had done it,” he says. “I had achieved my mission. I was whole, and nothing could ever get in the way of that.”

Then Alena got a phone call from King at 3 a.m. one night. “He was just sobbing,” she says, “and he said, ‘I haven’t slept in three days. I just can’t fall asleep and it’s making me crazy.’ He was at his wit’s end, and it was just so sad to hear.”

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She invited him to her apartment, lit some candles and drew a bath, which he sat in until he fell asleep.  

The incident marked the start of what they both call King’s “meltdowns,” infrequent but emotional outbursts triggered by a disagreement between them or routine matters such as a bathroom renovation in his Friendship Heights condo that seemed to take forever.  

“The first one I experienced, I thought it was just him,” Alena says. “I didn’t think it could be related to PTSD. That just never crossed my mind.”

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Even the couple’s honeymoon to Iceland and Sweden was marred by King flying into a rage at Reykjavik Airport. King didn’t sleep during the trip, in part because of the longer daylight hours and the noise from the city’s party-all-night atmosphere. They were standing in the security line at the airport, and Alena spoke King’s first name sharply to remind him to keep moving forward. “That just wigged him out that I had said his name that way,” Alena says, “and so there was screaming at the airport.”

King, who writes about his experience with PTSD on his blog Armor Down, created a triptych of images to describe what he thinks of as the distinct phases of his panic attacks. The first image shows the deep center of a powerful whirlpool; the second shows a man falling; and the third, a grotesque-looking demon. This final image captures the “dark, evil, terrible place” where he feels near-suicidal despair.

Since becoming a regular at Soltes’ Thursday morning iRest class, King has developed the ability to create a space between himself and the intrusive, negative thoughts that would take hold of his mind—the churning whirlpool in the triptych.

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A recent trip to the mall in Richmond, Va., might have ended the same way as the Kings’ honeymoon were it not for the techniques Ben King has learned from iRest. As the couple shopped, King was eager to get back to his parents’ house to watch a Redskins game, but “Alena wasn’t moving fast enough.”  

Remembering the incident in the airport security line, King says he “recognized right away that I was getting angry.” He was able to return to a “clean, beautiful place”—like the one Soltes urges soldiers to create for themselves when life becomes overwhelming—and was able to “roll through” his anger.

King says iRest “gave me a choice to respond in a way that wasn’t awful…to see my feelings as something I could influence and not something that was necessarily influencing me. It boils down to choice.”

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Archana Pyati is a writer based in Silver Spring who contributes to several local and national publications.