- [Narrator] "Your Fantastic Mind," brought to you in part by Sarah and Jim Kennedy.

(no audio) (contemplative music) (contemplative music continues) - Welcome to "Your Fantastic Mind."

I'm Jaye Watson.

For as long as there have been wars, there have been veterans impacted by what many call the invisible wounds of war.

since the beginning of the wars in Iraq and Afghanistan after 9/11, close to 2 million US military personnel have been deployed in tours of duty, over half of them more than once.

In a survey from the Wounded Warrior Project, 75% of veterans reported experiencing PTSD, anxiety, and depression.

Well, this week we take you inside a program that helps these veterans finally heal those invisible wounds.

(contemplative tune) - Today's gonna be a great hike up, great hike back down.

- [Jaye] They get an early start this Saturday morning, a group of veterans led by retired Army Lieutenant General, Burke Garrett.

- Served for 36 years and started out as an infantryman.

- [Jaye] The hike is at Kennesaw Mountain National Battlefield Park.

4,000 soldiers died in the Battle of Kennesaw Mountain during the Civil War in 1864.

- It really is.

Great stories afterwards.

- Oh, yeah!

- [Jaye] Over 150 years later, these post 9/11 veterans bear scars of their own, and this hike is part of their journey of healing.

- [Burke] The purpose of the hike today is to just use Kennesaw Mountain as a symbol of where you all are at.

You've got an obstacle in front of you in life, as we all do, and we're gonna conquer that obstacle and then move on to the next one because there's always gonna be another mountain or hill or something out there in front of us.

(door shutting) (car pulling off) - [Jaye] Jared Callaway and his two brothers deployed together.

Three sons from one family sacrificing and serving their country.

Becky Dickie trained with the Women's National Soccer Team, was in ROTC, and graduated college just months after 9/11.

- I was commissioned as a second lieutenant in the Air Force the day I graduated from Mississippi State, and my job was to become a public affairs officer.

We flew in on Chinooks.

- [Jaye] Dickie was deployed to Iraq after a request for a PA.

When she got there, she learned they had wanted a different type of PA, a physician assistant.

A clerical error that would change the trajectory of her life.

- I wound up being requested to stay with them, and I wound up doing a six month deployment across 13 countries, two wars at one time between Iraq and Afghanistan all at the same time.

Hopping flights and air assaults and ground assaults and convoys.

- [Jaye] Dickie was injured multiple times.

- My brain was injured, my head was injured in combat.

My ear was too, and it felt like...

Being an athlete growing up and playing sports, you think, "Okay, well I'll just push through this."

- [Jaye] Dickie and Callaway returned to the US, but the feeling of peace and safety they expected was not there.

The war had followed them home.

- Before I went through therapy, I didn't go to a concert.

I love the Braves, I hadn't been to a Braves game in a while, you know?

I hadn't done anything fun-fun like that where it's in a crowd, because crowds would give me horrible anxiety.

(distant traffic) - [Jaye] Crowds, public places, even driving no longer felt safe.

- Being in cars, it took me a while to realize road trips were too much, like the unknown around me, what can happen with the vehicles.

- [Jaye] After suffering seizures, Dickie had brain surgery to remove a piece of shrapnel from 15 years earlier.

She had a stroke after the surgery and then suffered a life-threatening allergic reaction to medication.

- All of a sudden, this body and mind made no sense to me.

- [Jaye] Callaway and Dickie entered the Emory Healthcare Veterans Program, which is funded by the national nonprofit Wounded Warrior Project.

The Warrior Care Network is part of that.

Four academic medical centers in Boston, Chicago, Los Angeles, and at Emory in Atlanta.

- Doing really good.

- [Jaye] Most offer customized in-person two-week programs that are free for active duty military and veterans.

Emory also has a virtual program.

- But it all starts with that partnership.

- [Jaye] Vice President of Complex Care at Wounded Warrior, John Eaton.

- Seven out of 10 warriors are experiencing at least one mental health condition.

Looking a step further, when you look at PTSD, depression, anxiety, upwards of 50% are experiencing two or more of those at a moderate to severe symptomology.

(loud automatic gunfire) - [Dr. Rothbaum] We give them more therapy in two weeks than most people get in an entire year.

- [Jaye] Psychologist and researcher, Dr. Barbara Rothbaum, is the Director of the Emory Veterans Program.

- And what we think with PTSD, it's a disorder of avoidance.

So people don't wanna think about it, they don't wanna talk about it, they don't wanna do anything that reminds them of it.

But what that does is it doesn't give them a chance to process it, and then it just festers and that's how it haunts them.

But what we've shown, if people still have PTSD symptoms three months after the traumatic event, then it'll continue for years or for decades without treatment.

- [Jaye] In 1980, PTSD became an official diagnosis in response to Vietnam veterans who were suffering.

In the brain, the amygdala, hippocampus, and prefrontal cortex are often impacted in lasting ways by traumatic events.

- [Doctor] You're going to kind of situate this part on you, your eyes go here.

- [Jaye] Rothbaum is the pioneer of virtual reality therapy.

- [Doctor] Sounds like, "IED, get down."

Fire, fire on the side of the road, debris on the side of the road, people yelling out orders.

- [Jaye] And her team can recreate specific wartime events for the veterans to begin to help them process the trauma they have avoided for years.

- So this is safe, totally fake firearm.

I'm gonna hand it to you.

- They're wearing, yes, it's called a head-mounted display and it's got two little television screens, one in front of each eye, it's got earphones, and it's got a position checker.

So just like I move my head and my view changes in reality, so it does in the virtual reality.

- And then that's when the shots start ringing out.

(muffled automatic gunfire) - So it's very immersive.

They're sitting on a raised platform with a speaker, a base shaker underneath it.

So for example, you can feel the Humvee engines, you can feel the explosions.

(muffled explosion) (muffle chaotic shouting) One is of a convoy, one's of a single vehicle on a desert highway, one's someone on foot patrol in a Middle Eastern city.

And it's got the sounds and the visual, and we've put acoustic startle probes.

We've put loud noises in those clips and in blue screens in between.

And what that does is it helps us measure startle response.

So exaggerated startle response is one of the hallmark symptoms of PTSD.

And we like it because we can measure it.

It's a translational tool, all mammals startle, and we measure it, you may not realize it, but when you startle, you blink your eyes.

And so we can put electrodes right under the eye and measure that pretty accurately.

- So here we are, if you just wanna follow me.

- [Jaye] The startle booth also measures biological and physiological responses to stress.

- Just make sure that's comfortable, - [Jaye] Such as heart rate and sweat response.

- Here we are.

- [Jaye] The pairing of a puff of air and noise is meant to startle, as experienced by this staffer.

(loud air blowing) (staff yelps) But veterans with PTSD often startle more easily with larger startle responses.

- It makes me so happy to see that people's bodies are becoming less reactive to these fear cues after treatment.

- And now that I know this is happening, I had probably very, I had very little startle response, right?

'Cause I know, I'm prepared for it.

When you work through that during chronic exposure, then you're learning that, you're teaching the brain that actually right now there's no danger.

- Their startle response is coming down, their heart rate's coming down, their skin conductance in reaction to these cues that trigger this threat response.

- [Ad Reader] Emory Healthcare Veterans Program.

- [Jaye] The core of the veterans program is prolonged imaginal exposure therapy.

Rothbaum started the first study of prolonged exposure therapy for PTSD in 1986 with rape survivors.

- I see a fire burning ahead.

- [Jaye] Prolonged exposure calls for people to repeatedly confront what they've been avoiding.

- We're worried that there's gonna be an ambush.

- [Jaye] Sometimes for decades.

- We ask people to close their eyes and go back in their mind's eye to the time of the traumatic event and recount it out loud repeatedly in the present tense.

So, "I'm driving back to base" and just go from there.

We will tape record that, now usually on their phones, to ask them to listen to it for homework 'cause what we wanna do is do a lot of exposure to this memory and other reminders and let them process it.

Their distress will go up, and then if they stay with it and repeat it, their distress will come back down.

Once their distress comes back down, they can start thinking about it maybe differently.

- There's so much yelling between them all.

- [Jaye] This is a clip from one of the first prolonged exposure sessions for Becky Dickie.

She's recounting when she was attacked by an insurgent inside a Humvee through an open window.

- And there's hot air everywhere.

I didn't take pictures, I didn't... Just didn't feel like it.

Being a lefty, the seatbelt was over here and I basically couldn't get to my own pistol when all this was happening, and it was seat belted in and I was just desperately trying to get it out.

And the guy behind me put the M16 right here, and that was that.

And the fact that I can tell you about that right now goes to show how much progress and how amazing that program is at Emory.

Crowds were kind of creeping in on the Hummer and the guys were panicking.

Not totally panicking.

- [Jaye] With the help of her therapist, Dickie repeatedly confronted and processed a memory that had caused seizures, a memory that had kept her housebound for almost 20 years.

Towards the end of her two weeks in the program, this is Dickie talking about the same event - I thought it was doing what I should be doing, taking pictures.

(Jared sniffles) - Probably about two years before I went through the program, about a mile down the road, I used to sit in a church parking lot with a gun in my lap, thinking about ending it.

- [Jaye] Dr. Rothbaum says we believe our own stories instead of the truth, and that was the case for Jared Callaway.

- In Iraq, I was a Bradley driver, which a Bradley fighting vehicle is a version of the tank.

It's an APC, so it carries personnel in the back of it and then it has a 25 millimeter cannon on top of it.

We're driving through the apartment complex area, and there's a little market, it's just a real tight market and I'm driving a 33 ton tank.

And it's a two lane street, but that tank takes up both lanes.

And this van pulls out in front of us and I had no time to stop.

So I'm halfway over this van, and there's a kid, an older lady, and then everybody starts throwing stuff at us, my lieutenant's trying to deescalate the crowd in the market.

It's crazy, it's chaos, it's mayhem.

(somber instrumental music) - [Jaye] Callaway says that accident haunted him and he blamed himself.

- There was definitely shame and guilt.

And I think that that transformed over the time in therapy.

I know that it was an accident.

It's easy to say, "I didn't mean to hit that person.

I didn't mean to take their lives.

It was a complete accident," right?

It's easy to say that, but it's tough to feel that.

(somber instrumental music) - Hi, Jared.

- Hey.

- How are ya?

- That's the thing with prolonged exposures, is you feel every time and you slowly process with the team what those feelings mean, what those feelings can turn into, so that we don't allow those feelings to then control the rest of our lives.

- We treat all of the invisible wounds of war.

- [Jaye] Rothbaum says 75% of people who go through the program experience clinically significant gains.

Many don't have PTSD anymore.

93% of those who start the program, finish it.

(crowd cheering) How do those numbers translate to real life?

- [Commentator] Join in the singing of our national anthem!

- [Jaye] Those numbers mean Becky Dickie went to watch her daughter sing at an Atlanta Braves baseball game.

♪ Oh, say, can you see ♪ - [Becky] And to be able to go into my ultimate nemesis, which is a large crowd.

♪ At the twilight's last gleaming ♪ - [Becky] But to be able to go with all the tools that Emery trained me with, to make it through that ball game and to see my daughter sing, it gives me chills.

It makes me so happy.

♪ And the home of the brave ♪ (crowd cheering happily) - [Jaye] Callaway has also returned to the ballpark.

- [Commentator] Please welcome our hometown hero from Stockbridge, Georgia, Sergeant First Class, retired, Jared Callaway!

- [Jaye] And he has gotten 17 other veterans to go through the program.

- But I just want it so bad for everybody else, and I want everybody to have the same opportunity to be freed from that burden that weighed me down for all those years.

- Treat it just like any other team and any drill and any mission you've ever been on.

This one is in your mind, and stick with it and get through it because it's absolutely possible to retrain your brain and win this one.

A whole complete life is waiting for them.

- Now let's shift our focus to another often overlooked group in need of assistance; mothers grappling with substance use during pregnancy.

We are delving into groundbreaking research, shedding light on the effects of maternal substance use on the developing brains of infants and children.

Plus we'll bring you a firsthand account from a mother who navigated this challenging journey and emerged on the other side.

(infant crying) It is a parental rite of passage; dealing with a less than happy baby.

After his mom nurses him and he falls asleep.

- [Doctor] We've actually already started.

- [Jaye] He is placed in an MRI.

- We are running a localizer, which will give us a few snapshots.

- [Jaye] Where the research team takes images of his brain.

- The first days, weeks, months, and even the first few years of life are periods of exponential growth in development, and not surprisingly, exponential growth in brain.

The difficulty comes when you're scanning children.

- [Jaye] Cognitive neuroscientists, Daniel Dilks.

- To date, however, we don't know exactly how that brain changes from days to weeks to months to years.

- [Jaye] A 10 year study from the NIH is following over 7,000 children to deepen that understanding, including in the brains of babies exposed to substances before they are born.

- [Daniel] We need to know what happens to this developing brain after it has been exposed to some substance, for example, so that we can intervene.

- Yes, I love the banging!

Okay, good work!

Look, see the cow?

- [Jaye] Intervening and understanding the brains of children exposed to substances is what Dr. Claire Coles has devoted her career to.

- She says, "Baa."

- [Jaye] A globally renowned expert in the field of prenatal exposures and child development.

- Is he babbling?

Is he saying, "Da da da?"

- [Jaye] She is one of the lead investigators of this study at 27 sites around the country, - Approximately 20% of women use alcohol in pregnancy.

Slightly fewer, maybe 15%, smoke in pregnancy.

10 to 15% use marijuana.

Maybe 1% uses stimulants like cocaine and methamphetamines.

And about 0.5% use opioids.

This particular test... La, la, la, la la.

Is a test that's used with infants to look at development.

Flat on his back on the table.

- [Jaye] With funding from the state of Georgia... - Yes, good job!

- [Jaye] Coles and her team at the Emory Neurobehavioral Exposure Clinic, the only one like it in the Southeastern United States... - Can we put him on his tummy?

- [Jaye] Assess exposed babies and children from birth onward, providing diagnoses and care.

- We provide hopefully an accurate diagnosis because we get children in who are exposed to drugs and alcohol.

(rubber duck squeaking) People often attribute to the drug everything that's going on with the child, so we try to sort that out.

(gentle instrumental music) - [Jaye] In 2020 in the United States, one out of 12 newborns, 300,000 infants, were exposed to alcohol, opioids, marijuana, or cocaine before they were born.

The National Institute on Drug Abuse reports this can double or triple the risk of stillbirth and can cause neonatal abstinence syndrome in which the baby goes through withdrawal after they're born.

All of this impacts a baby's developing brain and can lead to various long-term issues, ranging from developmental delays and intellectual disabilities to behavioral and emotional issues.

- We found 5% of children in first grades had an effect of alcohol.

- Yeah!

(giggles) - [Jaye] Coles and her team have treated over 4,000 children and see 200 new cases a year.

- [Dr. Goldsmith] The issue is multifold.

- [Jaye] The other critical piece of Dr. Cole's work with children?

The mothers.

Psychiatrist, Dr. Toby Goldsmith, treats women before, during, and after pregnancy.

- I think stigma and fear are the two issues that keep most women from pursuing any kind of treatment with someone because they're afraid that someone's either going to judge them, or even worse, someone's gonna take their child from them.

- [Jaye] Dr. Goldsmith says those most likely to use during pregnancy tend to be younger, less educated, not married, and of a lower socioeconomic status.

The state of Georgia helps to fund another program Dr. Coles heads up; the Maternal Substance Abuse and Child Development Program.

- Those women need to have support.

They need appropriate care by people who are willing to work with pregnant women who are substance users, which often is a problem 'cause people don't wanna do that.

Substance use treatment programs don't want pregnant women, and people who work with pregnant women often don't wanna address the issue of substance abuse.

If I find out that you're a substance using, where do I refer you?

Who's gonna help you?

What is the treatment program available?

Not there.

And as a result, the woman can't get the care she needs.

(gentle instrumental music) - [Deena] A honor roll student, captain of the cheerleading team, homecoming queen, you name it, the last person that anybody in my town thought would end up the places that I ended up.

This one's me when I was a baby.

- [Jaye] Deena Davis was 21 when a boyfriend gave her some methamphetamine.

- I knew I was in trouble right away.

I mean, the second I did it, I was automatically trying to figure out how I was gonna get more.

When I found out that I was pregnant with Rylee, I'd had just gotten outta jail.

- [Jaye] Davis used meth before she knew she was pregnant with her first child, but stopping was difficult.

- Pregnant women do not wanna be using substances.

We don't pick up meth in our second trimester just to celebrate that we're having a baby.

It didn't work like that!

If we're using and we're pregnant, we can't stop.

I know what that feels like, to wake up and to have to fight the urge to use drugs while you have a baby growing inside of you, and hating yourself.

Oh my God, this is every single day.

It was like a fight every single day.

The world was telling me I didn't love my kids.

If I loved my kids, I would stop.

And that's what I was starting to believe.

- [Jaye] After Rylee was born, Davis went back to using and had stints in and out of jail.

- The first time I saw Rylee crawl, my mom brought her.

I was in Cobb County jail and my mom brought her up to that visitation, and there's that metal ledge and that plexiglass and she put that baby on that metal thing on all fours and I watched her crawl across that metal, that cold hard metal.

- [Jaye] That crawling baby girl... - [Deena] Rylee is the sugar cookie girl.

(Deena laughs) - [Jaye] Is now 22 years old.

- All right.

- Just thought that everyone's parents, you know, spent a long time in the bathroom and didn't have power and heat and food.

We weren't allowed in the kitchen 'cause it was disgusting and there was flies and bugs and there was fleas in the hallway, and literally could not go in the hallway without fleas jumping all over you.

It sounds gross, but that's how it was.

- Oh, the baby.

- Aw.

- [Jaye] Rylee was seven years old when her mom got into recovery.

That year has a permanent place on her arm.

- 2008.

The year I got sober.

- I'm super proud to brag about how good she's done.

Whenever she got better, she immediately started educating us.

So I mean, I didn't even touch a sip of alcohol till I was almost 20.

And even still, I don't even drink like that.

I've never tried any drugs or anything.

- [Deena] My favorite one is the one with your whole face in it.

(Rylee giggles) - We talk every single day.

- This is when we did our girls trip last Christmas, right?

I feel like they're proud of me, and I know that I'm proud of them.

- We know that the more exposure a child has, the poorer the outcomes will be.

We know that separation from birth family is going to lead to poorer outcomes.

So logically it makes sense to change our practices and look at prevention.

- [Jaye] Peggy walker is a senior judge in the juvenile courts for the state of Georgia.

She's also a national leader in child welfare and juvenile justice policy, and spearheaded programs to help children, mothers, and pregnant women with substance abuse problems.

- We always hold people accountable for the choices they make, but we have to realize that we have an obligation to serve that child that is not yet born.

And we cannot serve that child that's not yet born taking an attitude that we must punish this mother.

This mother's going to have more children, and if we do this and we do this well, we can put her on the road to recovery and the other children will not go through what this child's going through.

If we do it right, this child will have minimal exposure and less stressors.

- [Jaye] One of the mothers held accountable in Judge Walker's courtroom was Deena Davis.

- Hey.

It's so good to see you.

I remember most the fear and the embarrassment and the shame that she was feeling.

- I used to say that Judge Walker took my kids from me.

And as I've stayed in recovery, I realized that she saved my kids.

She saved my family.

Still trying to help families.

- [Jaye] For one year, Deena, now the mother of two daughters, worked to stay in recovery while her girls live with her parents.

- [Rylee] Happy birthday, so proud of your recovery.

- [Jaye] In 2009, her daughters returned home to her.

- They really wanted me to get sober and they wanted me to reunify with my kids and they wanted us to be happy.

(gentle instrumental music) - [Jaye] The experience changed her life so much, she made her lived experience into a career as a certified peer support specialist in the family treatment court she went through.

- So if you had told me that we would work together and do this work together and have the same passions and the same desires to better our communities and be able to sit side by side and do it, I would've told you had lost your mind.

- [Jaye] All these years later, Davis can say to these mothers the words she needed to hear.

- I can sit across from a mom or a dad and relate that you know and tell them, "I know, I really do know what it feels like to not have your kids.

And you never have to use again, and you never have to be alone again.

And if you'll just trust me and trust this process, we'll walk through this hand in hand and you'll come out the other side of this."

(gentle instrumental music) (music fades) - That's gonna do it for us this week.

See you next time on "Your Fantastic Mind."

(contemplative music) (contemplative music continues) (music fades) - [Narrator] "Your Fantastic Mind," brought to you in part by Sarah and Jim Kennedy.

(no audio)