Albany

After he returned from some of the deadliest fighting of the Iraq War in the surge to retake Fallujah in 2004, Jay was tormented by nightmares and struggled to sleep.

The U.S. Marine Corps veteran kept a loaded gun on the bed beside him.

He was 23 years old and psychologically broken. He knew Marines who had died in combat, and others who died by suicide after they got home. He tried to numb the pain with booze and drugs.

"I spent a lot of time alone in the bottle," said Jay, who is 35 now and lives in Saratoga County. He asked that his full name not be used.

On Jay's first mission in Iraq as they prepared to land at an airfield near Fallujah, the LC-130 flight mechanic watched in terror as tracers from anti-aircraft guns sliced the air around him. He thought he was going to die. A seasoned pilot's evasive maneuvers narrowly saved the plane, and the crew's lives.

It was Jay's first traumatic experience of war, and it seared itself into his memory. Those few moments haunted him for years. He deteriorated mentally, but denied having what was later diagnosed as post-traumatic stress disorder.

After nearly sliding into homelessness, he wound up as an outpatient of the Veterans Administration. He was prescribed anti-depressant drugs and standard cognitive behavioral therapy. Neither provided much relief.

"I would leave the VA treatment session feeling worse than when I went in," he said.

While working for the Albany Housing Coalition, which provides housing and employment services to homeless veterans, Jay agreed to participate in a clinical trial. A new PTSD protocol promised a 90 percent success rate without drugs and only a few hours of therapy.

Jay was skeptical and so was his boss, Joe Sluszka, executive director of the Coalition, which serves more than 400 veterans — whose combat service ranges from Vietnam to Afghanistan — each year.

"I was a doubter at first," Sluszka said.

"I thought Joe was crazy when he told me about it," Jay said. "But I figured I couldn't get screwed up any more than I already was, so I might as well try it."

During the sessions, Jay sat across from a counselor trained in the new PTSD treatment technique, known as Reconsolidation of Traumatic Memory, or RTM.

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The counselor guided Jay through 90-minute sessions that asked him to imagine the traumatic memory of nearly being shot out of the air as a movie projected on a large theater screen. The counselor guided Jay in playing the movie in his mind very slowly and then gradually faster and faster, dozens of times in succession. The counselor had Jay imagine he was watching the movie being played backward, and then in black and white.

For Jay, it worked better than the drugs or other treatments.

"It worked even better as time went on," said Jay, whose nightmares have stopped and who now sleeps peacefully. He and his wife have a 7-year-old son and he works in adolescent services.

Jay recruited other vets in the Albany area for the clinical trial.

"I've been in this field for 15 years, and it's the most effective PTSD treatment I've seen based on what the veterans tell me," Sluszka said. "It gave these guys their lives back."

According to the National Institutes of Health, PTSD affects 7.7 million adult Americans. Combat veterans suffer especially high rates of the condition, with up to 30 percent of Vietnam War veterans and 20 percent of Iraq and Afghanistan veterans experiencing it. Hundreds of thousands of U.S. veterans are disabled by PTSD and an estimated 22 veterans a day — 8,000 per year — die by suicide.

PTSD's symptoms of insomnia, irritability and withdrawal also stem from a wide range of traumatic incidents such as being held captive, car accidents, bombings and natural disasters such as floods or earthquakes.

In 2006, Frank Bourke, a retired clinical psychologist based in Corning, Steuben County, founded The Research and Recognition Project. He treated about 250 survivors of the 9/11 terror attacks on the World Trade Center and refined the technique. His not-for-profit organization has developed, revised and clinically tested the innovative RTM protocol. It promises a drug-free, cost-effective and highly successful treatment for PTSD in veterans. It can also be used to help first responders, victims of sexual assault or child abuse, and others debilitated by traumatic memories.

"I know I sound like a snake oil salesman," conceded Bourke, now 75. "I take vets who have been suffering from the same terrible nightmare for more than 40 years and I say we can fix it within a few hours and without drugs. Our clinical trials prove we've got a cure that works over 90 percent of the time."

Bourke explained that traumatic memories are stored in the hippocampus, a part of the brain associated with memory, which does not allow any changes. The memory becomes fixed, with vivid and specific images similar to a movie. The RTM protocol is a sort of neurological interdiction that uses talk therapy. With a trained counselor, the neurological connection between the memory in the hippocampus and the emotional reaction place in the brain is severed.

"It changes the movie," Bourke said. "It does not change what the person with PTSD thinks or does, (but) it neurologically flips a switch and separates that traumatic memory from having the associated experience of nightmares, flashbacks or terror."

Bourke, who calls his treatment "the biggest advance in the treatment of PTSD in the last 50 years," has published his data in the Journal of Military, Veteran and Family Health. Before-and-after EEG scans of patients' brains following therapy showed noticeable differences in brain activity. With a $300,000 grant from New York, 25 of 26 veterans treated in the Albany area had their PTSD symptoms alleviated after five sessions.

Bourke is seeking an additional $2 million in state funding, and wants to discuss the project with Gov. Andrew Cuomo. His goal is to train 10,000 counselors across New York state to become proficient in administering the new PTSD protocol. With the support of veterans' groups, Bourke and his team have trained more than 75 counselors in the past year in San Diego, Calif., Albuquerque, N.M., Orlando, Fla., and Albany. They have treated about 400 veterans so far.

B.J. Costello, an Albany attorney and Vietnam War Navy veteran with his own traumatic memories — his gasoline tanker was attacked and fellow sailors were killed during the 1968 Tet Offensive — is offering pro bono legal work for Bourke.

"I was very lucky I did not suffer, but PTSD destroyed some of my sailors," Costello said. "I want to make this treatment more widely available. It can help a lot of people."

Paul Grondahl is the director of the New York State Writers Institute at the University at Albany and a former Times Union reporter. He can be reached at grondahlpaul@gmail.com.