Interview with Dr. Freda Dreher, Acus Clinical Preceptor
Acus Preceptor Dr. Freda Dreher explains how acupuncture influences the neurological and physiological processes that perpetuate PTS among military service members in this interview with Acus Acting Executive Director Brad Erickson.
Dr. Freda Dreher is a Physical Medicine & Rehabilitation physician who has been in practice for 22 years. After several years of practice, looking for a healthier approach to pain management, she took the Helms Medical Institute course for acupuncture for physicians. Since that time she has been so impressed with the benefits of acupuncture for general health conditions that she continued with the HMI training for primary care. She has also received Board Certification in Medical Acupuncture based on extensive attention to continuing medical education and continuous ongoing acupuncture practice in both inpatient and outpatient settings. Her ongoing education has not only focused on acupuncture, but has included yoga, Qi Gong and Tai Chi, positive coaching, Motivational Interviewing, and most recently hypnosis. As a clinical preceptor for Helms Medical Institute and Acus Foundation, she finds the balance of eastern and western medical approaches for the care of patients with trauma, pain and disabling conditions to be very satisfying.
BE: How did you find your way to acupuncture?
FD: During residency training and in my first few years out in practice, I had several family members with health problems, and then I myself had some serious health issues to address. Although I found my doctors and my colleagues to be bright and compassionate, I felt that personal and individualized care was sometimes missing. I sought out acupuncture treatments for my own health. My first few treatments were not terribly effective, but they were personal and most definitely individualized. Intrigued, I started reading books on Chinese medicine. After speaking with several colleagues who had taken the Helms Medical Institute training, I decided to take the plunge. The course was rigorous and it was fun. For the first year in practice I only used acupuncture for pain management, but felt that I was not a complete physician if I could not treat sinusitis, menstrual difficulties, and other such assorted common complaints. In my second time through the HMI course, this time focusing on primary care, I learned even more than I did the first time. My appetite was properly whetted for a lifetime pursuit of education in acupuncture as well as related arts and practices such as Qi Gong and Tai Chi.
BE: What can you tell us about the challenges and rewards of training military physicians?
FD: I have found that there are more rewards than challenges in training military physicians. As a whole, the students who are active duty and are treating active duty military service patients and their families are a very well prepared group. I have found that they take assignments seriously and approach the work in an enthusiastic fashion. The physical fitness level of most military physicians is higher than average and this matters in acupuncture training. Students practice on each other, and thus we have easy models for teaching acupoints locations. Even when the studying is difficult and the material is rigorous, military physicians tend to not complain. I suspect that this is related to the unique perspectives that they have gleaned during their service duties. It is rewarding to know that when they train in acupuncture, they will invariably have ready, willing and deserving military service members upon whom they can practice. The only challenge that I feel is that I have not served in the military, thus I cannot walk in their shoes. Overall, I feel that is an honor and a privilege to teach those who serve our country.
BE: Could you describe an acupuncture technique that you find particularly well suited to military applications?
FD: During my time working in the Veterans Affairs medical system, I found that I was not only able to treat Veterans, but I often saw active duty soldiers from the Vermont Army National Guard. As I was primarily seeing patients for traumatic brain injury, spinal cord injury, and amputation, I had plenty of work to do. From showing up to appointments early, to readily expressing gratitude for their care, this patient population has been about the easiest I have ever worked with. For the patients in my clinic, I found that scalp acupuncture was the most effective for immediate reduction of pain and pain related symptoms. Invariably patients in my clinic had PTS and/or ongoing high levels of stress and sleep disruption. For those problems, I have turned to basic body points. It has seemed amazing at times that a stress treatment would resolve the pain complaint. In turn, pain management acupuncture on body points can help patients to sleep better, thus in turn reducing their stress and improving their healing. I have often explained to a patient: “This acupuncture treatment neither removed nor added anything to your body. Thus, the healing is within you. I am helping by doing acupuncture, but ultimately you can learn to heal on your own.” I look at Veterans as individuals who often used to be extremely fit, capable and proud individuals. Acupuncture, as part of the medical system, can help them to rediscover those features within themselves.
BE: In a national address, President Obama referred to the “demons” that follow veterans home from war. In our military history, we’ve used terms such as “shell shock,” “battle fatigue,” and “war neurosis.” During the Civil War, this condition was called “soldier’s heart” and Germans once used the term Seelenbelastung or “burdening of the soul.” Now this is called Post Traumatic Stress (PTS) and it seriously impacts many returning soldiers. How can acupuncture help these men and women?
FD: The neurobiology of Post Traumatic Stress is fascinating. For the person experiencing such stress, it is devastating. I was first able to witness PTS at the VA where I trained as a medical student and resident, and have more recently seen PTS patients at the VA Medical Center in Vermont. Acupuncture can very much influence the neurological and physiological processes that perpetuate stress response emotions and behaviors. Research is only beginning to help us understand how and why, but it is apparent that there are very real and measurable changes in the deep brain structures when acupuncture is provided. Some of the response is related to the personal setting of care, the safe environment, and a compassionate acupuncturist. But there is definitely more to it than that. I recently treated a Veteran who spent two years serving with the United States Marine Corps in Vietnam. He came to me hoping that I could relieve a little of his back pain. Knowing that he’d had several inpatient admissions and a multitude of approaches for PTS, I chose to do a PTS treatment first. He woke the next day with no back pain and having had no nightmares. He explained to me at his next appointment that he had a renewed sense of hope. As a physician, the rewards do not get any better than that.