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07-12-08, 06:34 AM
Relearning peace after war
ECU lab uses biofeedback to help Marines manage stress disorder
Jay Price, Staff Writer
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GREENVILLE - A year and a half after he left Iraq, Sgt. Terrell McClain is still fighting the sniper who shot him in the arm and the mortar shells and rockets that rattled his brain. His weapon: biofeedback.

About once a week, McClain, 24, and a handful of other Marines travel from Camp Lejeune's Wounded Warrior Barracks to a lab at East Carolina University, where they are strapped with sensors that measure stress via perspiration, body temperature and heart and brain rhythms. They are taught methods of controlling anxiety, such as breathing techniques or thinking of pleasant topics. Computer screens let them see the effects in simple terms such as a computer-generated roller coaster that starts moving when they reduce anxiety and stops when it rises again.

The idea is to train the wounded Marines to control outbursts of anger and anxiety and other symptoms of post-traumatic stress disorder and traumatic brain injury.

"There's nothing abnormal about these guys," said Carmen Russoniello, director of ECU's psyschophysiology and biofeedback lab. "They are having normal responses to the situations they were in, and we're just training them to have better responses."

McClain said he was skeptical when he started the program in March but is now a believer, because it has helped him control his hair-trigger temper, a typical PTSD symptom.

"I still express my emotions, but I don't act wild," he said. "It's helping a lot, and I mean a whole lot."

Biofeedback is only one part of Russoniello's program, which is designed to reduce anxiety and stress through relaxation, recreation and social interaction.

Meet the civilians

Therapists also are using activities such as kayaking, Frisbee golf and wheelchair basketball, and more traditional forms of therapy, such as group counseling. Even getting off the base and interacting with college students is part of the therapy, since many of the wounded Marines will soon be moving back into the civilian world, Russoniello said.

"We do serious training, but life isn't just serious," Russoniello said. "It's also about having fun, and it's about things like checking out who you are in relationship to others. Whatever we do, it has to make sense as far as real life."

Russoniello served with the Marines in Vietnam and said for years afterward he struggled to cope with the things he had seen and done. He wanted the nation's latest generation of combat veterans to have it better.

Many will need help: This spring, the Pentagon released data showing that more than 40,000 troops who served in Iraq and Afghanistan had been diagnosed with PTSD, and military leaders say that more have gone undiagnosed. Thousands more have traumatic brain injuries, typically from the blast of the improvised bombs used so often by insurgents in Iraq.

Russoniello's lab is working with the Marines assigned to Camp Lejeune's Wounded Warrior Barracks while they recover. Many in the barracks have PTSD, brain injuries or both. They also often have physical problems, and the recreational therapy in the ECU program helps them improve things such as balance and coordination.

The program started in February. It's operating on a shoestring, Russoniello said, but last month it opened an office next to the barracks. That will make it easier for Marines to get therapy more than once a week.

The program is weeks from adding a new therapy even closer to the cutting edge than biofeedback: Marines will be immersed in a highly detailed "Virtual Iraq" where they will assume a digital form and encounter the very things that caused their problems -- bombs, ambushes, snipers.

The idea, which has been under limited use in several places around the country in the past couple of years, is to desensitize those who have experienced trauma and give them more control over their memories of combat. Therapists will control the number and type of "surprises," stopping the sessions periodically when the Marines' stress levels spike, to work with them on controlling their responses.

Boosting the chaos

The wounded Marines will use the techniques learned from the simpler biofeedback equipment to control their stress levels. From session to session, therapists will gradually boost the level of chaos, allowing the Marines to come to terms with tougher and tougher experiences.

The "Virtual Iraq" program is being donated by a treatment center on the West Coast that is working with Marines there. The program has been in use elsewhere for a few years.

Therapies based in virtual worlds have several advantages, Russoniello said, including the ability of Marines who deploy again or who leave the service and move to a distant state to continue working with the same therapist.

McClain, the sergeant who was shot by a sniper, said more wounded troops should try the innovative therapy and the techniques like "going to a happy place" in your mind.

"To be able to calm down, that's a big thing," he said.

Of course, those who aren't familiar with the Marine Corps' band-of-brothers camaraderie might be startled at the happy place McClain goes to in his mind: Iraq, 2006. With his Marine buddies.

jay.price@newsobserver.com or (919) 829-4526