Helping Our Heroes

VA Helps "Dear John" Veteran Recover from PTSD

April 22, 2010 - Iraq War Veteran Todd Vance's life in the Army has been portrayed in two major books and a top box office movie. He was the inspiration for the fictional main character in the best selling novel and hit movie, "Dear John," and his real experiences as an Army team leader for a Stryker brigade also were chronicled in the critically acclaimed book, "My War: Killing Time in Iraq."

But the latest chapter in Vance's life today is not portrayed in either a book or movie — he has successfully recovered from Post Traumatic Stress Disorder (PTSD) as a result of counseling he underwent in the VA health care system.

Todd Vance the Veteran now goes to college, has a part-time job as a personal trainer and teaches Muay Thai kick boxing at a gym in San Diego. He tells Veterans about his recovery and treatment at VA, and often refers Veterans to seek counseling and services at VA.

"The therapy (at VA) made me learn who I am as a person," Vance said. "Whenever I can, I encourage other Veterans to go to VA and encourage them to do something physically active to help get rid of that pent up energy they have."

The "Dear John" book and movie came about when novelist Nicholas Sparks — author of other best-selling books such as "Message in a Bottle" and "The Notebook" — heard Vance tell about his combat experience in Iraq when Vance was home on leave in 2004.

"I drew heavily from a cousin (Todd) who served in the Army. Like Todd, my character was in the Army, had nearly completed his tour when 9-11 happened, and chose to re-enlist (something he really didn't want to do), for duty's sake," said Sparks, in a posting on his web site.

Vance also talked about the significance of getting letters from home from his then girlfriend. Some aspects of his relationship with the girlfriend and the time frame were changed in the book and movie. While fictional character John Tyree is wounded in battle in the movie, Todd Vance did not suffer any physical wounds. However, some of Vance's combat experiences in Iraq also are depicted in Colby Buzzell's critically acclaimed book, "My War." Vance and Buzzell became good friends when they were stationed at Fort Lewis in Washington State before they went to Iraq.

After Vance returned safely from Iraq in 2004, he went back to Fort Lewis, then moved to the San Diego area. At first, things seemed all right. Then problems started.

While not physically wounded, Vance had witnessed severe human suffering during his time in Iraq, ranging from seeing fellow soldiers killed from blasts from IEDs and sniper fire to scenes in which Iraqi children were blown up. His experiences had taken a toll, and Vance's girlfriend, Lauren, set up an appointment for him at the VA Medical Center San Diego.

"Three or four months into it, I just had a crash," Vance said. "The nightmares got to a point where I could not function."

At VA, he was referred to Michael Kilmer, the medical center's OEF/OIF Case Manager, who also served as a mental health provider. Kilmer's position was unique during the 2004-2005 time period. VA now has OEF/OIF Case Management Teams in each of its facilities that include a Program Manager, Case Manager(s), and Transition Patient Advocate, in addition to expanded mental health programs and post deployment clinics.

Vance credits the therapy for PTSD he received for several years with helping get his life straightened out.

"Todd is an example of why educational outreach to family, friends, and loved ones of returning Veterans is vital," Kilmer said.

"He was one of the most avoidant Veterans and would not engage in 'therapy' despite those around him seeing the need," Kilmer said. "However, he was willing to work on transition, life, and relationship challenges impacting his life and coping skills to manage his anger, anxiety and hyper arousal symptoms so he could be the person he wanted to be himself and loved ones.

"At first, he went three or four times a week. Later he moved on to working on positive thinking, thinking about how we are going to stay calm and collected once we reach an elevated state," Kilmer said.

Vance realized by avoiding life situations that reminded him of his military experiences and avoiding his memories, his life was continually impacted by nightmares, poor sleep, hyper arousal and vigilance, impacted interpersonal relationships. Vance was ready to participate in 12-15 sessions of Prolonged Exposure (PE) Therapy for PTSD that Kilmer guided him through.

"Todd's devotion to recovery, with the support of his loved ones, by honoring his appointments, following through on his "In-Vivo Exposure" (real life exercises that exposed him to situations that he previously avoided), and other homework assignment was remarkable," said Kilmer, who is now Network Program Coordinator for Returning Veterans Transition & Care Management at the VA Desert Pacific Healthcare Network.

Most of Todd's therapy focused on normal life situations for a Veteran dealing with PTSD and transitioning from military service to civilian life. With Kilmer's guidance using PE, an empirically supported therapy, Vance became better. He no longer goes to therapy, though he and Kilmer stay in close contact.

Now, Vance tells other Veterans about his experiences at VA.

"The therapy helped me learn who I am as a person," Vance said. "I'm confident and I'm happy where I am in life. I don't have any embarrassment about it. People ask me about and I tell them I went and that if you're a Vet you should go to the VA."

Vance also made use of his VA benefits, and earned an Associate of Arts of History. He is pursuing a Bachelors degree in Social Work, with a goal of serving Veterans. Kilmer helped get him in a work study program to provide him with experience in working with Veterans.

He is working his way through school as a personal trainer, and teaches Muay Thai kick boxing and other martial arts classes at the Undisputed Fitness and Training Center in San Diego. Vance is moving on with his life. His relationship with the girl he wrote letters to while serving in Iraq is over, though the two remain friends. He is single, and remains in touch with a lot of his Army friends, including Buzzell. He has a great relationship with his parents and feels he is on a very good track.

Once he completes his four-year degree, he's considering a graduate level degree. He is interested in pursuing a job at VA to serve fellow Veterans.

"I would like to see if there is a way I can combine my two passions — helping Veterans and teaching martial arts," Vance said.