Integrative Restoration Therapy for Combat Veterans

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Table of Contents

Current Status
History
Theoretical Foundations
Summary
References

Current Status

The scope of articles about the effect of Integrative Restoration (iRest) on individuals with Post Traumatic Stress Disorder (PTSD) demonstrates researchers have studied meditation and mindfulness practices for years. Currently, research widely considers iRest/Yoga Nidra to be an effective approach to the treatment of many stress-related disorders (Thomas & Taylor, 2015). A number of these studies explore the effects of iRest on combat veterans and the adverse outcomes of their military service.

For example, a recent review by Thomas and Taylor (2015) investigated the ability of mindfulness training to improve service members’ resilience to stress and stress-related disorders. The authors noted that yoga may not only help patients to manage their PTSD, but also strengthen their psyche and reduce the rates of depression, stress injuries, and suicide. Therefore, the implementation of Yoga Nidra along with other practices yielded positive results for veterans with PTSD proving the validity of such methods. They suggested using iRest for a number of symptoms and comorbidities of PTSD.

Other recent studies also showed that the use of Yoga Nidra can have many positive results on patients. According to Datta, Tripathi, and Mallick (2017), one example of a reoccurring issue for individuals with PTSD that iRest can treat is the problem of chronic insomnia. The researchers stated that one can use this type of yoga to fall asleep. Interestingly, the authors discussed the historical use of Yoga Nidra, arguing that its “aware sleep state” is more suitable for treating stress and sleep-related disorders than other types of meditation with their “aware awake state” (Datta et al., 2017, para. 8).

In this case, the authors noted significant changes in the health of their patients. Some patients increased their sleep time, while others reported lower levels of anxiety and sleep onset latency. The findings also included reduced levels of depression and anxiety among patients, along with other complementary complaints. The study concluded that Yoga Nidra may influence patients by targeting “deficits in executive attention which characterize mood and anxiety” (Datta et al., 2017, para. 38).

An article by Hull, Reinhard, McCarron, Allen, Jecmen, Akhter, Duncan, and Soltes (2014) investigated the effects of medication and acupuncture on military veterans, thus the authors used iRest as a foundation for treatment. The authors noted that both of these practices were easy to use for veterans as they did not require any physical activity and were not difficult for patients to understand. Furthermore, this research stated that guided meditation may improve both the physical and mental state of an individual. The authors also found this type of meditation very cost-effective, which is a factor not considered in many other studies.

This approach is more accessible for patients who can learn and repeat it at home, which lowers its financial costs (Hull et al., 2014). Moreover, iRest requires only vocal and not visual guidance, which also reduces the expenses for materials. In this study, the authors listed a number of symptoms that are common for patients with PTSD including headaches, pains, trouble sleeping, energy levels, depression, anxiety, disturbing memories, and others (Hull et al., 2014). They found that iRest can influence the majority of these symptoms and have a positive impact on one’s biological and mental systems.

History

Additionally, the scope of research on Yoga Nidra has many articles that explore its effect on different types of disorders. An early article mention of Yoga Nidra is the study by Novotney (2009), who stated that the Department of Defense started using this program, iRest, for its soldiers returning from combat in 2006. These early results also showed a significant reduction in the majority of comorbid symptoms and as a result, iRest found its place among the most accepted practices for individuals with PTSD.

Early studies yield similar results to the recent scholarship, proving the effectiveness of this approach (Kumar, 2008; Novotney, 2009). However, the number of studies of PTSD and combat stress is exceptionally high (Libby, Reddy, Pilver, & Desai, 2012).

Earlier studies confirm that the special treatment of individuals with PTSD may benefit from including yoga in specialized programs. Libby et al. (2012) found that iRest has been among the most recommended practices for patients with PTSD for years. As Yoga Nidra is not full of active movements and complicated poses, one can suggest it to older individuals and people with injuries. The article highlighted other types of yoga and their usefulness for patients; however, one can see all practices the authors discuss are not physically straining. In fact, most focus on mindfulness and sensory enhancement.

A randomized controlled trial (RCT) by Carter, Gerbarg, Brown, Ware, Ambrosio, Anand, Dirles, Vermani, and Katzman (2013) also supports the effectiveness of iRest. This study of Vietnam veterans with PTSD employed an elaborate program of meditative treatments and included Yoga Nidra as an intervention. The results of this intervention showed that the program provided many changes for participants and enhanced their quality of life. In contrast, patients stated that other meditative practices induced stressful situations by causing them to relive their traumatic memories. Nevertheless, the state of these patients became more stable after the iRest intervention, which reduced the severity of PTSD and related issues.

Another example of a successful yoga intervention is the study by Staples, Hamilton, and Uddo (2013), who also examined the role of yoga in the lives of combat veterans. In this study, the mention of Yoga Nidra is short as it focused on integrating iRest with yoga postures. Such research examples showed that the significance of Yoga Nidra in treating patients has remained high through the years and has become more recognizable by researchers than ever before.

While discussing the different types of meditation and mindfulness, all presented studies mentioned Yoga Nidra as one of the basic interventions for patients with stress disorders. In contrast to the studies about Yoga Nidra, however, the research did not show significant changes in the health of its participants. Although the levels of PTSD symptoms were lower following the intervention, the authors’ state such differences are not especially notable. On the other hand, other studies investigating the benefits of Yoga Nidra yield more apparent and effective results (Thomas & Taylor, 2015). Thus, the conclusions of this article highlight the exceptional nature of iRest and its high levels of effectiveness.

Earlier studies explored different types of yoga and used iRest for comparison. For instance, Stoller, Greuel, Cimini, Fowler, and Koomar (2012) only briefly mentioned Yoga Nidra in their review of many practices but stated it can help patients and impact one’s PTSD significantly. In comparison, other types of meditation are more active, focused on poses, and do not influence patients in the same way. In fact, the authors argued the breathing emphasized in the teachings of Yoga Nidra was more effective in the treatment of stress than the use of special poses.

Theoretical Foundations

Parker, Bharati, and Fernandez (2013) explained the concept of Yoga Nidra and provided scholars with some definitions and theories behind its effectiveness. According to the description by Swami Veda Bharati, Yoga Nidra is “a state in which an individual demonstrates all the symptoms of deep, non-REM sleep, including delta brain waves, while simultaneously remaining fully conscious” (Parker et al., 2013, p. 11). The study also outlined multiple levels of this practice, including deep relaxation, creativity, and invention, the transition to Yoga Nidra, and the state of aware sleep (Parker et al., 2013). Different levels correspond with treating various conditions such as headaches, insomnia, and stress.

Overall, the theoretical foundations of Yoga Nidra have many explanations of its impact, including its influence on one’s brain and breathing process. Studies, which explore people’s brain activity during these practices, find a correlation between one’s breathing and state of health (Parker et al., 2013). Moreover, articles find many uses for iRest for patients with a wide range of conditions (Datta et al., 2017; Parker et al., 2013).

Summary

Although research covering the connection between Yoga Nidra and PTSD is vast, there are still gaps present. For example, while most works mentioned different issues and problems of military workers, almost none discussed these people’s relationships with their friends and partners. Thus, it remains unclear what effects iRest can have on people who complete this intervention together.

The process of guided meditation, its benefits, possible limitations, and areas of implementations are currently covered by the research. This research provides a significant amount of data, which support the positive influences of iRest/Yoga Nidra. Nevertheless, the sphere of human relations remains largely unexplored and practically untouched by scholars. No cases and trials attempt to investigate the treatment of families and their interpersonal influences.

References

Carter, J., Gerbarg, P. L., Brown, R. P., Ware, R. S., D’Ambrosio, C., Anand, L. … Katzman, M. A. (2013). Multi-component yoga breath program for Vietnam veteran post traumatic stress disorder: Randomized controlled trial. Journal of Traumatic Stress Disorders Treatment, 2(3). Web.

Datta, K., Tripathi, M., & Mallick, H. N. (2017). Yoga Nidra: An innovative approach for management of chronic insomnia – A case report. Sleep Science and Practice, 1. Web.

Hull, A., Reinhard, M., Mccarron, K., Allen, N., Jecmen, M. C., Akhter, J.,… Soltes, K. (2014). Acupuncture and meditation for military veterans: First steps of quality management and future program development. Global Advancements in Health and Medicine, 3(4), 27-31.

Kumar, K. (2008). A study on the impact on stress and anxiety through Yoga Nidra. Indian Journal of Traditional Knowledge, 7(3), 401-404.

Libby, D., Reddy, F., Pilver, C., & Desai, R. (2012). The use of yoga in specialized VA PTSD treatment programs. International Journal of Yoga Therapy, 22(1), 79-88.

Novotney, A. (2009). Yoga as a practice tool. Monitor on Psychology, 40(10), 38-40.

Parker, S., Bharati, S. V., & Fernandez, M. (2013). Defining Yoga-Nidra: Traditional accounts, physiological research, and future directions. International Journal of Yoga Therapy, 23(1), 11-16.

Staples, J. K., Hamilton, M. F., & Uddo, M. (2013). A yoga program for the symptoms of post-traumatic stress disorder in veterans. Military Medicine, 178(8), 854-860.

Stoller, C. C., Greuel, J. H., Cimini, L. S., Fowler, M. S., & Koomar, J. A. (2012). Effects of sensory-enhanced yoga on symptoms of combat stress in deployed military personnel. American Journal of Occupational Therapy, 66(1), 59-68.

Thomas, K. H., & Taylor, S. P. (2015). Bulletproofing the psyche: Mindfulness interventions in the training environment to improve resilience in the military and veteran communities. Advances in Social Work, 16(2), 312-322.

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