The Resilient Responders Program

Salvatore Cassano
Commissioner FDNY (Ret.)
National Chairman TM for Firefighters Initiative

SWAT Officer Steve Gordon: Overcoming the Nightmare of Traumatic Stress

Salvatore Cassano was a chief with the New York City Fire Department during September 11th. He saw the Twin Towers come down. He remembers everything that day. He can’t forget. He doesn’t want to. After the attack he led FDNY’s effort to rebuild the Fire Department after they lost 343 members of the FDNY on Sept 11th. In 2011, he was promoted to FDNY Commissioner and learned TM. “Meditating is easier than I ever imagined. I get more done in the hours after meditating than I would if I just worked right through the day. I am clearer, more focused, and I enjoy my life much more—an unexpected benefit that I never saw coming.” Commissioner Cassano helped bring a pilot TM program to NYC firefighters through a partnership between the Center for Resilience and the FDNY.

A sustained commitment for addressing our national crisis of posttraumatic stress (PTS), substance use disorder, and suicide among law enforcement officers, firefighters, and other first responders

The Center For Resilience

Our Mission

For more than 15 years, the Center for Resilience of the David Lynch Foundation, a 501(c)(3) nonprofit organization, has successfully delivered the evidence-based, trauma-healing Transcendental Meditation ® (TM) technique to several targeted populations, including military veterans, the New York City Firefighters, the New York Police Department, and the Herndon (VA) Police Department. Extensive research, including numerous randomized controlled trials, has documented the benefits of TM for reducing symptoms of PTS, stress, anxiety, depression, substance use disorder and hypertension.

An Introduction to TM

TM is a simple, easy-to-learn, effortless technique, which allows the body to gain a unique state of profound rest and relaxation while the mind simultaneously settles down to a state of inner calm and wakefulness—without concentration or effort. The TM technique is practiced sitting comfortably for 15 to 20 minutes twice a day. To date, more than ten million people of all ages, nationalities, and religions have learned the technique.

More than 400 peer-reviewed published studies on TM have documented improvements in a wide range of stress-related disorders as well as significant improvements in cognitive function and overall health and well-being. The National Institutes of Health and the Department of Defense have awarded nearly $35 million in grants to research the benefits of TM on posttraumatic stress, anxiety, bumout, and resilience.

First Responder
Programs

PTSD Program: Developing Resilience for Law Enforcement

Video: PTSD Program - Developing Resilience at the Herndon, VA Police Department

SWAT Officer Steve Gordon
Overcoming the Nightmare of Traumatic Stress

A Message from Retired FDNY Commissioner Salvatore Cassano, National Chairman, TM for Firefighters Initiative
  • TM put me in a head space where I was completely receptive to the topic
    and content of understanding mental health.”

    NYPD Officer and Military Veteran
  • “I learned to meditate and it has allowed me to be more patient.”
    NYPD Officer and Military Veteran
  • “I learned a better way to manage everyday stress
    and it is easy because it can be done anywhere.”

    NYPD Officer and Military Veteran
  • “TM is integral in supporting mental health.”
    NYPD Officer and Military Veteran
  • “TM can improve your mental wellness.”
    NYPD Officer and Military Veteran
Protecting those who protect us

Michael | Retired Senior Investigator | New York State Police Special Federal Agent DEA Task Force | 22 years service

PTSD Relief Program for Firefighters,
EMS and Law Enforcement in NYC and LA

Our law enforcement officers, firefighters, and other first responders experience first-hand some of the most traumatic events that happen in our communities. The cumulative effect over time of the stress caused by both witnessing and responding to these events can have a significant impact on their physical and mental health and well-being. Police and firefighters, when compared to the general civilian population, are at heightened risk for depression, posttraumatic stress (PTS), and suicide. An estimated 400,000 first responders in America have at least some symptoms of PTSD. The health and wellness of our first responders is critical not only to themselves, their families, and their brothers and sisters on the job but also to our public safety as a nation.

According to the National Alliance on Mental Illness and SAMSHA:
  • Both police officers and firefighters are more likely to die by suicide than in the line of duty.
  • Fire and EMS professionals have contemplated suicide—nearly 10 times the rate of American adults. In addition, 6.6 percent of fire and EMS professionals reported having attempted suicide as compared with just 0.5 percent of civilians.
  • Roughly 1 in 3 first responders develop PTSD In comparison, the incidence of PTSD in the general population is 1 in 5 people.

If we can identify major risk factors that cause PTSD and treat them before they have the chance to develop into full-blown posttraumatic stress disorder, or PTSD, we can improve the quality of life for police officers and perhaps other emergency responders, and better help them deal with the stressors of their work," according to researcher Charles Marmar, MD, the Lucius N. Littauer Professor of Psychiatry atNYU Grossman School of Medicine.

Veterans
Programs

The Center for Resilience has instructed thousands of veterans, active-duty personnel and military families in TM, including through the Bronx VA Resilience and Wellness Center (RWC). The RWC is an innovative program focused on suicide prevention. The RWC targets vulnerable veterans by augmenting traditional treatments with complementary and integrative health interventions. The Center for Resilience has partnered with the RWC since its inception in October 2018 and since then more than 150 high-risk veterans have learned to meditate.

Multi-year partnerships also include many Veteran Administration hospitals nationwide, including Manhattan VA, Bronx VA and Brooklyn VA; National Defense University in Washington, DC; UCLA Veterans Family Wellness Center; EOD Warrior Foundation; New York City Veterans Mental Health Coalition; City University of New York Office of Veterans; New York City-based residential substance abuse treatments centers; and numerous military bases, including Fort Bragg, Fort Gordon, Fort Belvoir, and Fort Hamilton.

Air Force Veteran LaToya Mack
Military Sexual Trauma Survivor
Overcoming Suicidal Ideation

Air Force Veteran LaToya Mack
veterans programs

research & evaluation

Research on TM and PTSD Highlighted by
New England Journal of Medicine
and Journal of the American Medical Association

Hundreds of peer-reviewed studies have been conducted on the benefits of TM at over 100 independent universities and medical schools during the past 50 years. The National Institutes of Health and the Department of Defense have provided nearly $35 million to fund research on TM and stress, heart health, and PTSD. The most recent third-party validation of this research came in January 2020 when the Journal of the American Medical Association published an article on the current state of VA treatments noting that TM is as effective as the VA’s first line recommended treatments for PTSD. This was based, in part, on the findings of a $2.4 million DoD-funded randomized control trial at the San Diego VA which the New England Journal of Medicine’s “Journal Watch” listed as one of 2019’s top 10 psychiatry publications. This study of 203 veterans with PTSD compared TM with Prolonged Exposure (PE), one of the VAs first line treatments for PTS, and a PTSD education active control. The study was published in The Lancet Psychiatry in November 2018 and found TM to be at least as effective as PE and significantly more effective than a PTSD education control group.

Results include:

  • 61 percent of the TM group (68 people) had clinically significant symptom improvement
  • 42 percent of those who received PE (68 people) showed similar improvement
  • 32 percent of those who received PTSD education (67 people) showed this improvement

Nidich S, et al. Non-trauma-focused meditation versus exposure therapy in veterans with post-traumatic stress disorder: a randomized controlled trial. The Lancet Psychiatry 2018 5:975-986.

A Phase 3 Clinical Trial on TM Meditation
and Posttraumatic Stress,
Suicide, and Substance Use in Veterans

In 2023, the David Lynch Foundation’s Center for Resilience launched the largest study ever to be conducted on the impact of meditation on veterans and first reponders with PTSD. The study is a multi-site randomized controlled trial that will evaluate whether the Transcendental Meditation ® (TM) technique is effective as a first line treatment for PTSD. Secondary outcomes will include depression, suicidal ideation, alcohol craving/usage, sleep quality and quality of life. The 6-site study will take place at research universities around the U.S. with approximately 300 subjects.The goal of the study is to secure long-term government funding for TM.

Outcome Measures

The primary outcome measure in this clinical trial will be the Clinician-Administered PTSD Scale (CAPS) for DSM-5. Secondary outcome measures will include the Columbia–Suicide Severity Rating Scale, Posttraumatic Stress Disorder Checklist (PCL)-5, Patient Health Questionnaire (PHQ)-9 for depression, Insomnia Sleep Index, Timeline Follow-Back (TLFB) interview of alcohol consumption and other non-prescribed substance usage, and the Quality of Life Enjoyment and Satisfaction Questionnaire (QLES-Q). A cost-effectiveness analysis will be conducted to determine the cost-saving value of the TM program in the treatment of PTSD.

Expected Impact

The impact of this study will be substantial. The research will be used to secure government approval for the implementation of TM as a treatment option in VA healthcare and other military settings. The availability of an alternative and evidence-based PTSD therapy will benefit patients by offering a greater range of treatment options and by serving as a secondary modality for those not responding to prior therapy. In particular, because TM is a non-trauma focused treatment it is often preferred to other existing treatments for PTSD therapies that involve confronting anxiety-provoking thoughts and stimuli. TM is relatively low cost and provides a life-long tool for promoting mental and physical health. Other advantages of the TM treatment for veterans is that the technique is less emotionally demanding for practitioners than other PTSD therapies, it produces documented benefits within the first month of practice, and it is more self-empowering to veterans because of the component of regular daily home practice.

Veterans and First Responders:
PTSD and Suicidality

Air Force Veteran LaToya Mack Military Sexual Trauma Survivor Overcoming Suicidal Ideation

ADDITIONAL RESEARCH ON TM AND PTS

  • TM decreased multiple features of post-traumatic stress disorder in US war veterans, with reductions indepression, anxiety, insomnia, severity of delayed stress syndrome, emotional numbness, alcohol consumption, family problems, and difficulty in obtaining employment.

    Rosenthal JZ, et al. Effects of Transcendental Meditation in veterans of Operation Enduring Freedom and Operation Iraqi Freedom with posttraumatic stress disorder: a pilot study. Military Medicine 2011; 176:626-630.

  • TM practice decreased PTSD symptoms in war veterans to below clinical levels after one month, withfurther reductions after three months. The study found those veterans who practiced TM twice a day (recommended schedule) had a 30% greater decline in symptoms of PTSD than veterans who practiced TM only once a day, a dose-response effect that suggests causality.

    Herron RE and Rees B. The Transcendental Meditation Program's Impact on the Symptoms of Post-traumatic Stress Disorder of Veterans: An Uncontrolled Pilot Study. Military Medicine 2017;1:1-7.

  • Active duty military service members with PTSD or anxiety who learned TM showed reduced medication usage and an overall decrease in severity of psychological symptoms.

    Barnes VA, et al. Transcendental Meditation and psychotropic medication use among active duty military service members with anxiety and PTSD. Military Medicine 2016; 181:56-63.

TM Based Resilient Responders

A Three-Phase Program

1

Phase One
Introduction to the TM Technique

This session provides an introduction to the evidence-based TM technique and an overview of the structure and content of the First Responders Program.

Session 1 (Group, on-site or remote; 60 minutes)

Topics include:
  • The urgent need for an evidence-based meditation technique to support veterans’ mental and physical well-being in today’s highly stressful work environment
  • Meditation defined: Understanding the mechanics and scientific research on the three main approaches to meditation: (1) focused attention, (2) open monitoring, and (3) self-transcending
  • Understanding the mechanics of TM practice: How it works, what it does, and how it is taught
  • Highlights of the published research on the benefits of TM for improving mental and physical health, creativity and cognitive function, productivity and performance
  • Questions and answers

2

Phase two
Instruction in the TM Technique

The participant is instructed by a certified TM instructor in how to meditate correctly for maximum benefit in daily life. TM instructions will be carried out in partnership with affiliated institutions.

Four instructional sessions held over four consecutive days (On-site; 60 minutes each)

  • Session 1: Personal instruction in the TM technique (Individual, on-site)
  • Session 2: Ensuring you are meditating correctly and gaining the benefits (Group, on-site)
  • Session 3: Understanding the mechanics of how TM restores balance and reduces stress in the nervous system (Group, on-site)
  • Session 4: Exploring the long-term benefits of regular TM practice for optimizing mental and physical health (Group, on-site)

3

Phase three
foLLow-up semiNARS

These seminars help stabilize correct practice of the TM technique and deepen participants’ intellectual understanding of its mechanics and effects.

Four seminars held once a month (Group, on-site or remote; 45 minutes each)

Each seminar includes:

Deeper knowledge on a range of topics, including:

  • Effects of TM on neuroplasticity: the capacity of the brain to heal stress and trauma and forge new neuralpathways for healthier behaviors and lifestyle
  • Enhancing resilience as the key to reducing the impact of stress and promoting wellness
  • mpact of TM on improving cardiovascular health, strengthening immunity, and slowing the aging process
  • Growth of happiness, self-actualization, and development of consciousness through regular TM practice
  • A review of key points for correct TM practice
  • Questions and answers
  • Group meditation

Lifetime Support and Follow-Up

Following the three phases of the First Responders Program, a lifetime of individual and group refresher courses is available for free, remotely or in-person, through more than 200 TM Teaching Centers within the United States.

Suggested Reading

  • Transcendence: Healing and Transformation through Transcendental Meditation by Norman Rosenthal, M.D. (Tarcher-Penguin 2011)
  • Super Mind: How to Boost Performance and Live a Richer and Happier Life through Transcendental Meditation by Norman Rosenthal, M.D. (Tarcher-Penguin 2016)
  • Strength in Stillness: The Power of Transcendental Meditation by Bob Roth (Simon and Schuster 2018)
  • The Resilient Warrior by World War II Veteran Jerry Yellin