ROBERT SIEGEL, HOST:
The military and the VA are looking at alternative ways to treat posttraumatic stress - everything from drugs, to acupuncture, to music and yoga. But what we'll hear about next is not a standard treatment.
(SOUNDBITE OF FILM, "FIGHT CLUB")
BRAD PITT: (As Tyler Durden) I want you to hit me as hard as you can.
EDWARD NORTON: (As Narrator) What?
PITT: (As Tyler Durden) I want you to hit me as hard as you can.
SIEGEL: OK, that was Brad Pitt in the movie "Fight Club," but for a group of veterans in San Diego, getting hit is part of getting better. NPR'S Quil Lawrence reports.
QUIL LAWRENCE, BYLINE: About a dozen military veterans have locked themselves inside of a caged boxing ring in a rough part of San Diego and they're starting to throw punches. It's therapeutic, they say.
AARON ESPINOZA: People say that like, just because oh, you're just punching each other in the face. How is that helpful?
LAWRENCE: That's Aaron Espinoza, a former Marine.
ESPINOZA: It's a respect thing. I mean, it's mutual. I have to push him, he has to push me to get better, you know?
LAWRENCE: Espinoza is a regular at this mixed martial arts training session - free for veterans.
TODD VANCE: Right hand down. 10 pushups.
LAWRENCE: The coach is Todd Vance who served in Iraq. Like many combat veterans, he came home and felt adrift, and so he channeled his frustration into workouts.
VANCE: I was in a dark place for a long time and so I personally used mixed martial arts to get myself back on track. And once I was on track, I started going back to school and started studying social work.
LAWRENCE: Vance wanted to focus on helping vets, and he thought the training he did might work for others. So he founded this group, which he named P.O.W., for Pugilistic Offensive Warrior. He says it's not really about fighting. It's just an excuse to get a peer support group together.
VANCE: Honestly, it could be glassblowing for all - for all I care, but mixed martial arts is the best way to get them in here. They can tell their girlfriends or their boyfriends - oh, I'm going to go mixed martial arts training. You know, once they get in here it could be anything.
LAWRENCE: It could be anything. There are hundreds of programs to help veterans adjust and deal with PTSD. Studies are funded on everything from Transcendental Meditation to caring for puppies. Until there is better evidence of what works, many therapists encourage vets to do anything that seems to help - like a peer support group that involves beating each other up a bit. Everyone is welcome.
TURK ESCALADA: I was a little hesitant at first because I wasn't really shape and didn't really feel good about myself.
LAWRENCE: Turk Escalada was a Marine in Afghanistan's Helmand Province back in 2009. IED's were killing Marines every day. During one foot patrol, Escalada spotted a heavy jug behind a bush. He froze. There was an orange wire running from the jug to the spot right under Escalada's feet. Called out for the bomb squad and then waited.
ESCALADA: It was like 10 minutes. It was the longest 10 minutes of my life because I'm standing there - was it a pressure plate? Was it one of those - when I step off is it active?
LAWRENCE: Turns out he was on a pressure plate but it was rigged to go off with the weight of a truck, not a man. Later after he came home, Escalada says every time he felt stress or anger he felt like he was going to die. He stopped going out of the house much.
ESCALADA: I was sitting at home a lot. I was fired from my temp job in one year.
LAWRENCE: His wife heard about the martial arts group for veterans and she bugged him until he tried it.
ESCALADA: I didn't really want to be around other military guys. I kind of got too many of that. I'm not sixpack ab and the kind of Marine that everyone things we should be, kind of thing. I came out and there was no judgment. If you can do the 10, good. If you can't, do what you can. Physical contact thing - I love it. But a lot of it - going here and feeling better about myself, and actually doing simple things like getting up before noon. (Laughter).
VANCE: You're going to lift and kick your feet out. To me, fighting is the best metaphor for life.
LAWRENCE: That's Todd Vance the instructor again. He says a third, maybe half the guys who come have SD. He keeps an eye on them, but he says beating PTSD is like fighting too.
VANCE: If you're in a stressful position on your back getting punched in the face, there are certain steps that you have to go through to get out of that, right? So you have to cognitively make decisions while you're extremely stressed out and I think that transfers directly over to - I'm at the stoplight, why is that guy staring at me, OK? I'm going to stop, take a breath, calm down and assess the situation, as opposed to I'm stressed, I react and now I'm in jail. You know, so it really teaches everybody to slow down, and take a breath and take things from there.
LAWRENCE: Vance says the best way to train for that fight is with a bunch of people who you trust, who understand where you've been.
VANCE: So a couple of drills here. You're going to be on your back. Flat on our back.
LAWRENCE: Quil Lawrence, NPR News.
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