Thanks to the local World War II 100th Battalion/442nd Regimental Combat Team veterans he has treated for decades, Makawao psychologist Richard Sword has developed a better way to assist those suffering from post-traumatic stress disorder.
Sword has teamed up with internationally renowned psychologist and former Stanford University professor Philip Zimbardo on a new book released last month titled "The Time Cure: Overcoming PTSD with the New Psychology of Time Perspective Therapy."
The book focuses on patients recalling positive memories from their past and beginning to focus on a positive future. Usually those with PTSD are stuck in the "negative past," which leads to a present "fatalistic mindset," Sword said.
The book also features real-life stories about Maui people and veterans who were helped by the time perspective therapy, although names and some situations have been altered.
The time perspective therapy approach is rooted in Zimbardo's Temporal Theory that helps PTSD sufferers stop living in the negative past and have them look forward to a positive future, according to the introduction of the book.
Throughout his years of treating the World War II veterans, especially the Japanese-American soldiers, Sword said, he noticed that his patients felt the future was more important than the past. He said that instead of them crying about and dwelling on the discrimination they and their families faced in the U.S. before and during the war, they fought for their futures and worked together.
And instead of dwelling on the casualties and horrors of war, when the men got together after the war to socialize, they spoke about how much fun they had, the battles they won and their important accomplishments.
Sword noted that the men used self-meditation exercises that focused on breathing and controlling their thoughts and emotions when they got excited or overly upset.
When these men came back from war, there were no doctors to treat them for psychological issues, yet suicide was not common among them, he added.
"I figured they got to know something. They know what they're talking about," Sword said of the old 100th/442nd veterans.
Today, there is about a suicide a day among active-duty troops, up from one every 36 hours in recent years, the military reported to The Associated Press recently. Among veterans from all of the nation's wars, about 18 each day commit suicide.
Sword said that thinking about the future and remembering positive things in the past seemed a better approach to curing PTSD than the current Veterans Affairs method that involved many years of rehashing, over and over, past traumatizing experiences.
The goal of that method is to have the patient recount and master the distress over memories of trauma, according to an April 2011 report titled "Study of Post-traumatic Stress Disorder Seeks Participants" on the Stanford University School of Medicine website.
"While many patients find this helpful, a 2005 study in the American Journal of Psychiatry showed that it was ineffective for 44 percent of patients," the article said. "What's more, there are no biological markers for predicting who is likely to respond."
Sword believes the treatment method could make things worse. His new treatment method does allow veterans to talk about their negative past experiences, to prevent suppression of those feelings, but there is no repetitive rehashing of them, he said.
The Maui psychologist said he started using some of the approaches he learned from the 100th/442nd veterans and incorporating them into his treatment methods about 2005.
Then in 2008, the treatment method started to come together even better when he got to hear his longtime idol Zimbardo speak at a Hawaii Psychological Association workshop in Honolulu. After the workshop that he and his wife and colleague, Rose, attended, Sword went up to Zimbardo and told him that he was employing similar methods recommended in the speaker's other book, "Time Paradox," which examines issues including the effect of time on attitudes, thoughts, feelings and actions.
After that meeting, the two began trading emails. Sword said he worked with Zimbardo on improving his treatment method.
In the introduction of the new book, Zimbardo said that as a scientist he was skeptical of Sword's simple approach because "PTSD had never been overcome by any therapeutic treatment; at best, it might be made somewhat more bearable."
But then he saw the results.
He got mail from Sword's clients who said they experienced "amazing changes" and met one of Sword's patients at a speaking engagement in Toronto, where the woman veteran told him the technique had helped her tremendously and that she was moving on with her life.
A small study by Stanford University researchers indicated that the therapy method reduced anxiety, depression and PTSD symptoms. In the study involving 32 patients, during the time they were analyzed, none got divorced, committed suicide, were arrested or drove under the influence of alcohol or drugs - which are common characteristics of those dealing with PTSD, depression and anxiety symptoms, Sword said.
Zimbardo said in the book's introduction that he would have preferred a formal clinical trial with hundreds of participants to measure the effectiveness of the treatment method. The problem is that such a trial would be costly.
They are attempting to obtain a military grant and have written the book to get the word out about their treatment methods.
Sword will be training a Tripler Army Medical Center supervisor for mental health at one of his workshops later this month. Officials at the Pentagon also have expressed interest, Sword said.
"The Time Cure" reached Portugal and was presented at a conference, where doctors from around the world were in attendance, Sword added.
In April, Sword was made an honorary 442nd Medical Officer in a ceremony that honored his work in helping the veterans and keeping their legacy alive.
So far, the book has received good reviews, Sword said, including a five-star rating on Amazon. He said the book can be ordered online and should be available at Barnes & Noble in Lahaina.
The list price on Amazon is $26.95, although it was offering a discount this week.
* Melissa Tanji can be reached at firstname.lastname@example.org.