When Shauna Springer told me that a simple shot in the neck could bring resolution of chronic post-traumatic stress symptoms, it sounded too good to be true. Current therapies help a lot of people, but many of those with chronic PTSD spend years treated with medications and therapy and still don’t get better. So how could a single shot make a difference?
People with chronic PTSD do the best they can to live their lives with their bodies on overdrive. Because they’ve experienced life-threatening or traumatic events, their whole nervous system has gotten locked into protecting them from danger. The world feels unsafe and their stress hormones run on high all the time.
Now mounting research evidence shows that innovative therapies can help those with post-traumatic stress. Even better, they help much faster than conventional treatments do.
One of these is a shot called the Stellate Ganglion Block (SGB), and it works by an injection into the bundle of nerves that sends signals of fight or flight to the body. This calms things down fast for those with post-traumatic stress, and gives them a chance to heal. But SGB is not the only trauma therapy helping people quickly and without medication. New psychotherapies are getting results in 3-5 sessions.
PTSD is Hard to Treat
PTSD happens when people experience something so frightening, their threat response floods the brain with stress hormones and the memory of the event is stored differently. Instead of feeling like a normal memory, trauma memories feel like they are still happening, right now in the present. At the same time, the brain stays in fight or flight mode, constantly feeling threatened even when the person is safe.
The current standard of care for PTSD is trauma-focused exposure and desensitization therapy. This can come in different forms, but they all require people to talk about their trauma and to re-experience it again and again. It works for a lot of people, but it doesn’t help everyone. In fact, some people find they get worse, and start avoiding therapy because re-experiencing their trauma is such a problem. Eventually, such survivors may find themselves on multiple medications, without feeling any better.
The Wounded Heroes Film
In fact, that’s what got actor and producer Michael Gier interested in post-traumatic stress. He was doing research for a fictional film about two veterans with PTSD when he met Carl, a veteran medic. “I was shocked when he told me that he was on 16 different prescription drugs, down from 18,” Gier told me. “And what’s worse, he said they didn’t really help, that they were just a band-aid. I knew there had to be better options and that set me on a three-year journey across the country to find alternative treatments that would make a significant difference in the lives of people battling PTS.”
This led Gier to make Wounded Heroes, which comes out on all the major streaming services in March. “My goal in producing this film was to save lives. The 20+ per day suicide rate among our Veterans is ridiculous, and that doesn’t even take into account the high suicide rate among our police officers, firefighters, doctors, nurses, and other first responders,” said Gier. In the film, Gier shares stories of veterans who have made remarkable recoveries from post-traumatic stress through options like equine therapy, stellate ganglion block, and new trauma psychotherapies.
One of these is Accelerated Resolution Therapy (ART) which Kevin E. Kip, PhD from the University of South Florida describes as a “director intervention” in the film. “You get to direct like in a movie, changing the ending and changing it to how you would have liked how it would have ended,” says Kip in the film. “If it was a firefight, the firefight never happened. Or maybe even though my comrades were wounded, they were taken off to safety. We are trying to replace negative imagery in the brain with positive imagery, almost like overriding a file on a computer.”
In one randomized controlled trial (the best way to study treatments) veterans who got ART had significant improvements in just 3-4 sessions as compared to controls. And a recent review article concluded that ART is an “effective, efficient and versatile form of therapy.” And the best part? Survivors don’t have to talk about the trauma to their therapist.
The film is packed with stories of healing. “I talked to people all over the country who in the past had no hope and were suicidal,” said Gier. “Now they have their lives back, they’re no longer on the drugs, they can sleep at night, keep a job, have great relationships, and more. As one person said, ‘life is worth living again.’”
Stellate Ganglion Block: a shot for PTSD
But some of the most remarkable stories in Gier’s film came from those who were treated with SGB. And it’s not just those veterans who are passionate about the results from SGB; psychologist and leading expert on PTSD Shauna Springer is excited too. In fact, she believes SGB is so promising, that she became the Chief Psychologist at Stella Center, an organization dedicated to making SGB widely available.
Springer points out that while applying Stellate Ganglion Block to PTSD may be relatively new, the procedure has been used for nearly 100 years for pain conditions, including shingles and phantom limb pain. In fact, the injection is done by skilled anesthesiologists and uses an anesthetic that is approved by the FDA.
During SGB, the anesthetic is injected into either the stellate or C6 ganglions on the side of the neck, and numbs the nerves for 8 hours. When the numbness wears off, patients report an immediate difference. There are a number of studies that show success rates between 80-90% with SGB.
Before she was at Stella, Springer worked extensively with the VA, and points out that SGB has become commonplace in the military. SGB is now a go-to treatment in some Special Forces Units and is offered routinely at many military hospitals, including Walter Reed. SGB is also used in the expeditionary setting to get operators and flight nurses back on the line. And it is now offered at about 10-12 VA facilities.
“Many of my patients say just after the injection that “the colors in the room look much brighter” than before or that they “can see more of what’s around them with more clarity,’” said Springer. “My working theory is that since PTS causes “tunnel vision” which I’ve learned has a medical name – “foveal vision” – that when those who suffer from trauma get calm in their own bodies again thanks to Stellate Ganglion Block, their tunnel vision literally expands and they are able to take in a greater, more vivid visual array.”
She’s right about that. Activation of the fight or flight response in the sympathetic nerve causes foveal vision. It helps when we face a threat, because it heightens our focus on that threat. But it’s a miserable way to live when we are trying to enjoy life. The fact that SGB literally changes the way people with PTSD see the world points to something really important about how it works.
The thought is that when you numb the nerve bundle responsible for sending the fight-for-flight response from brain to the body, you allow the system to reset. Instead of chronic fight or flight, the body can actually return to normal.
But Stella doesn’t simply treat people with a shot and send them home. Patients are also engaged with a therapist after the procedure to consolidate the healing process with talk therapy.
Springer says we are in a race against time to save the lives of the 17 veterans who die by suicide every day in America. Getting people trained in new therapies like ART takes time, and Springer believes that SGB is the only therapy that can be scaled up fast enough to reach enough people. And Stella Center is scaling quickly: it now offers SGB in multiple cities and hopes to reach anyone with PTSD, whether civilian or veteran.