US Air Force veteran finds hope in suicide prevention therapy that focuses on stress responses

SAN ANTONIO – For many people, this is a ray of hope based on research.

Recent research demonstrates a new way of thinking suicide preventionand both experts and patients believe that it is already saving lives.

Retired U.S. Air Force veteran Nancy Dickinson spent part of her 23 years in combat zones like Iraq.

“My family, who were in the medical facilities, trying to keep the generators going, were being bombed all day, all night,” Dickinson said.

Dickinson brought this trauma with her when she retired and settled in San Antonio.

“I knew that if I didn’t get help, things would go downhill fast. I was dealing with suicide,” Dickinson said.

She knows very well that many active military and veterans do not call for help.

“It breaks my heart that I have brothers and sisters who are afraid to ask for help. And we lose as much as every day. It’s not okay,” Dickinson said.

That’s why Dickinson wants everyone to know about the innovative therapy that changed her life.

“Historically, we have thought of suicide as a symptom of mental illness or a consequence of mental illness, even though most people who die by suicide do not have a mental illness,” said Dr. Craig Bryan, a psychiatrist. professor and researcher at Ohio State University.

Brian works closely with UT Health San Antonio’s STRONG STAR program focused on psychiatric care for the military. It is a consortium consisting of 50 institutions, including the military.

“Everything we’ve learned about suicide, we’ve done all these things, and it doesn’t seem to work. So maybe it’s time for us to rethink that whole approach, and maybe we’ll be successful if we do that,” Bryan said.

At a conference in San Antonio this week, Bryan was scheduled to present his book, Rethinking Suicide, filled with years of research and a breakdown of targeted therapies.

The therapy is called Brief Cognitive Behavioral Therapy for Suicide Prevention (BCBT).

It’s just 10-12 sessions that target the stress response, not just anxiety, depression or post-traumatic stress disorder (PTSD). This means that it can be applied to anyone who meets only one criterion: having suicidal thoughts or attempts.

“We are watching how you react to stressful situations. How do you think about yourself, about the situations in which you are? And we help people identify these unhelpful patterns, usually overly critical or overly negative thoughts. We’re saying let’s maybe start taking a more balanced view, which then leads them to make different decisions,” Bryan said.

Patients then spend weeks practicing and rehearsing coping strategies.

“Over time, a person begins to react and respond. You still get upset. Life happens. But people make different decisions,” Brian said.

The therapy involves something called crisis response planning, making a precise checklist of what to do if thoughts turn negative.

“It blocks the tunnel vision, and then people can easily do something that helps them sort of jump-start the problem-solving process. To manage what I’m feeling, to reach out to others for support,” Brian said.

Although crisis response planning is part of BCBT, clinicians can also extract this and use it separately for other patients.

“It is extremely effective. It reduces suicide attempts by approximately 76% compared to traditional suicide prevention strategies,” Brian explained.

If patients have mental health disorders, such as post-traumatic stress disorder, they are also appropriately treated at the same time.

“Historically, there’s been a kind of mindset among psychiatric clinicians that we shouldn’t treat PTSD when someone is suicidal; it’s too risky. And the work that we did during my time here at STRONG STAR about ten years ago and continues to this day, we now know that this is actually wrong,” Brian said.

The paradigm shift is so promising that the military is partially funding it.

“Many service members and veterans volunteer to participate in research studies to help us make these treatments even better than they are now,” said Bryan.

It will be a full circle of progress.

“We can learn from them, and as we make new discoveries to improve quality of life, to prevent suicide, to improve recovery from trauma, we’re going to give it back to them,” Bryan said.

However, progress in terms of integration into military health care has been slow.

“It’s not integrated at the moment. This, I believe, is one of the key problems. There is now a big gap between military funding and finding solutions, but then actually using them. So we hope that in the coming years we can work with the military to change that,” Brian said.

Although there is no military integration yet, Dr. Bryan’s team is already training other clinicians in this therapy.

UT Health San Antonio provided the infrastructure for this training, and the USAA Education Foundation is funding it.

“The most important thing is that after that, clinicians continue to meet with some of our experts to get supervision to teach them how to use the therapy effectively. It’s harder for you to really reliably use procedures when you have someone in your room, in your office, who says, “I’m thinking about killing myself.” And so we provide very close, ongoing support and oversight to kind of help the clinicians,” Brian said.

Knowing firsthand how many lives it can save, Dickinson is excited to see this shift in thinking open the door to more discussion and less stigma.

“20 years have passed, and I still go to consultations. I am still on meds for PTSD. It changed my life,” she said.

Dickinson hopes that anyone else suffering from suicidal thoughts, with or without mental illness, will seek help.

If you are struggling with suicidal thoughts, there is help. Call or SMS 988 for assistance or visit 988 Lifeline website.

Military or veterans can contact STRONG STAR at 210-562-6700 or visit website.