Breaking the Cycle: PTSD, Veterans, and the OODA Loop of Equine Therapy

A Marine’s war doesn’t end when orders do. Matthew Ryba takes us from boot camp before 9/11 through Ramadi and Marja—lost friends, near misses, and a night spent in a fallen lieutenant’s rack that changed his trajectory—and into a lab where PTSD is measured, mapped, and, unexpectedly, met by horses. Along the way we confront hard truths: why the military’s alcohol culture magnifies risk, how drone warfare’s drive-to-work, bomb, drive-home rhythm fractures identity, and why so many veterans avoid therapies that demand retelling the worst day of their lives.

What makes this conversation different is the practicality. Matt breaks down the Man O’ War Project’s eight-week equine-assisted therapy: 90 minutes, once a week, outside the clinic walls. No trauma scripts. Just teams of veterans, skilled facilitators, and horses that mirror human arousal with astonishing sensitivity. The goals are simple—guide a horse at liberty onto a tarp, breathe when frustration rises, coordinate with peers—and the outcomes are powerful. fMRI data shows shifts in threat and reward circuits. Nearly half of participants no longer met PTSD criteria after completing the program. Dropout rates fell to 8.4 percent, a fraction of typical veteran care.

We also widen the lens. Moral injury in ambiguous wars, the way memory reshapes itself, and the role of camaraderie when the uniform comes off—all affect recovery. Matt shares how veteran-led outreach, choice among modalities (from equine work to EMDR to emerging psychedelic therapies), and nature itself rebuild agency. Healing here looks grounded and real: dirt under boots, a calm horse on a tarp, a steadier breath, a nervous system learning safety again.

If you or someone you love is carrying the weight of service—combat, homefront stress, or the long tail of loss—there are options that respect your pace and experience. Explore the Man O’ War Project at mowproject.org and the Columbia PTSD Research and Treatment Team. Listen, share with a battle buddy or family member, and if this helped you, subscribe and leave a review so more people can find their way to tools that work.

John R. Boyd's Conceptual Spiral was originally titled No Way Out. In his own words: 

“There is no way out unless we can eliminate the features just cited. Since we don’t know how to do this, we must continue the whirl of reorientation…”

A promotional message for Ember Health.  Safe and effective IV ketamine care for individuals seeking relief from depression. Ember Health's evidence-based, partner-oriented, and patient-centered care model, boasting an 84% treatment success rate with 44% of patients reaching depression remission. It also mentions their extensive experience with over 40,000 infusions and treatment of more than 2,500 patients, including veterans, first responders, and individuals with anxiety and PTSD

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Transcript

Meet Matt Ryba And Mission

Mark McGrath 0:21

So being the uh you know being the host and co-creator, co-host and co-creator of this, um naturally you're not the first Marine to have been on this, uh to have been on this podcast, Matt. Uh we've had Bruce Gudmanson, Don Vandergriff, and others. I I switched up on hats just because, as you know, being here in the city, it is freaking absolutely freezing. And so I skipped the ball cap today for the for the watch cap with the uh with the I I couldn't decide which tactical patch to wear today, so I just I just went with old faithful here. Yeah. So Matt Reba joins us now. You work with Dr. Yuvol Naria, who we just had on our show, and we've put two two posts out on our on our Substack, The World of Reorientation.

Matt Ryba 1:06

Yeah. Yeah. Uh I've been with Yuvol for about 10 years now, working with him. I was actually just reading your Substack post right before I joined the call here, and I thought your pod with him was excellent. So been working out here in the city with veterans of PTSD is kind of like the public face of a lot of our programs, the PTSD research team. I do a lot of the veteran outreach, I do a lot of veteran advocacy work, veteran myself, and yeah, just been trying to help the guys get the help they need.

Mark McGrath 1:33

So we did this, we did this with Dr. Naria. He he laid down the tracks really well of where it all began for him. And as you heard the as you heard in the pod, you know, he talks about his his entire experience, lays it down. Why don't you give us the start of all of that? Because a lot of the vets that are listening, uh certainly Ponch and I vets, but they're they're they're gonna relate to it, and we want to lay that foundation and then kind of how you got there from where you're at now. So give give us give us the Matt Rebas story. Go ahead.

Matt Ryba 2:00

So uh I was one of those guys that kind of fell in love with that. Remember the chessboard commercial with the night? Yeah, yeah, yeah.

Mark McGrath 2:11

Classic.

Matt Ryba 2:11

So I was a kid, and I think I was like 15, and I went into like a recruiting office without my parents noting, and I was like, uh, hey, I want to join the Marines. My my grandfather was a Marine, he was a Korean War Purple Heart reciprocity. Just really, I don't know, something about the uniform and knowing that they were the best of the best, whatever got in my head when I was a young kid. And the recruiters are like, oh, you're too young, come back in a couple of years. But I was the guy that made my parents find the waiver at 17. I uh graduated from high school.

Mark McGrath 2:37

Did they show you when you went in the recruiting office? Did they show you the video Warriors from the Sea? I think they did. Yeah. It's on YouTube. It hooked me. Like I saw it in 1992, I think, and it still rattles with me. Yeah.

Matt Ryba 2:53

That's that was a forgotten memory until you brought it up, but I do remember a VHS tape that I watched at the and it had to have been that. Yeah, yeah, yeah.

unknown 3:00

Wow.

Mark McGrath 3:01

They had like a night raid, you know, it had like all these, and it had this really like d-d-d-d, it had this really interesting, catchy music that who the hell? But it hooked me.

Matt Ryba 3:10

That was when when I was like 15 or whatever, and I went into the recruiting office, you know, they they're like, hey, come back. But they gave me the poster of the the guy with the uh you know the K-bar hanging off with the painted face and the and the rope and the yeah, yeah. That was hanging up over my bed throughout like all high school. I was like, Yeah, we're getting there.

Mark McGrath 3:28

But uh Man, it worked. Whatever the yeah, I I think you know, the Marides, the Marid recruiting is always the best, but boy, it it does it does work. Matter of fact, the guy that I went to the recruiting station with, we both went together and I I went naval ROTC and became an officer, but he enlisted right out of high school and he retired as a master sergeant. So well well done, Marines.

unknown 3:49

Yeah.

9/11 And Joining The Marines

Matt Ryba 3:50

But uh, so I was I was in high school in uh central Connecticut, just outside of Hartford, Manchester area. And uh I'd gone I was going to a uh parochial college prep school, East Catholic, and they had boasted for like eight years, nine years in a row that they had 100% college acceptance. And I was very proud of the fact that me and two of my buddies ended up joining the Marines in 2001 uh and the year that we graduated high school, and it ruined their statistic of like going towards 10 years of 100% college acceptance because we didn't even apply.

Mark McGrath 4:22

Was it all boys, all boys Catholic guys?

Matt Ryba 4:24

No, it was it was mixed. Um co ed. Um but I had my parents sign the waiver when I was 17, so I did like a year in the delayed entry program, uh, graduated high school three days later, shot down to Paris Island. And I was uh the June class in 2001, and uh I mentioned we were talking earlier, my graduation date was like I think it was September 7th, 2001. So I left, graduated as PFC, and came home to Connecticut, and like four days later on boot leave, the whole world changed. Boom. Yeah. So I I joined the Marines because I wanted to travel and see the world and get college paid for, and I thought, you know, it was something I always wanted to do legacy-wise, just to be proud of something that I accomplished, and then it really, really changed the whole game once uh 9-11 happened. So uh went to infantry school, and then my first unit in the fleet was 2-3, actually out in Hawaii. I know you were a Hawaii guy for a while as well. Lava Dogs. Yeah. So we were I was there, did two UDPs.

Mark McGrath 5:29

Oh, wait, were they Island Warriors or Lava Dogs? Yeah, Island Warriors. Lava dogs. Yeah, I was 3-3 America's battalion. Yep, yep. And then I did two UDPs. And they're gone now, by the way. They're that's how old we are. They're gone.

Matt Ryba 5:42

Actually, this is an interesting tie-in because General Ellison just took over third regiment, I believe, over there. And he, when he was a lieutenant colonel, was my battalion commander when I was the Jump Platoon sergeant in Marja, Afghanistan. So that's kind of a cool full story. I mean, one of the guys I was in 2-3 with in Weapons Company was my EOD tech when I was in Afghanistan. And I hadn't seen him for like eight years. So yeah, Marine Corps is a small place. Like you keep running into people over and over again.

Mark McGrath 6:13

But I was in what's fun. You want you wanna I I gotta I gotta say though, you know, so if you're in 2-3, so you eventually got to 2-3, this is post-9-11. So so on 9-11, I was in third marines. Like, so I was I I I was out there. Um, so you would have had a 2-3, you would have had Charlie battery supporting you. I was Bravo Battery once while we were supporting 3-3. But uh, isn't that interesting? Here we go.

Brian "Ponch" Rivera 6:39

I checked Wait a minute, wait, wait, I gotta add something. I was in Hawaii, in Hawaii on 9-11. Really? No kidding. Where where were you, Camp Smith? On the Connie, coming back. Get out. I didn't know. What are we neighbors? We were neighbors, man. I was yeah. So I was I got stuck in Hawaii, and then you know, everything. I remember that actually. I remember when the Connie was stuck in, it was in there for a while, right? Well, it it it pulled into port, and then uh we got stuck there for a few days. And my family was out there for their tiger cruise, right? Which they didn't get go on, and then we ended up, I think we got stuck out there for like 10 days.

Mark McGrath 7:12

No, I feel like I remember going down to see it at Pearl. But yeah, sorry, we were all there. Here we are. We were all there. Hey, we're all third Marines in Hawaii. I checked in, I think, December timeframe to that unit.

Matt Ryba 7:24

Yeah.

Mark McGrath 7:24

And then uh after SOI, after after school interview.

Matt Ryba 7:27

Yeah. And then so my first appointment was actually to the Philippines because they I was stood up on that, they had the Marine Security element, right? Which was like what we all thought at the time. And and I was the last generation of Marines to have to shine my boots and wear tricolor camis. They issued us all pagers, and there was like a hundred guys from the weapons company and one of the line companies that were like quick reaction for anywhere on that side of the world. And we had to do all these drills and all this extra training and stuff, and then sometime the pagers went off and they were like, no, you're actually deploying, and it was in support of JTF 510, which was uh that operation in the Philippines under OEFP. A lot of it was training the local army, but at the time uh the Burnham's had been kidnapped and there was a hostage rescue situation for them.

Mark McGrath 8:17

Were you at Fort McSai? Uh I'm sorry. Were you at Fort McSaysai up in uh up in Cabinet Tuan? Where were we in?

Matt Ryba 8:25

We went into Zamboanga and then I was on Basilon Island for Yeah, south.

Mark McGrath 8:31

I was north.

Matt Ryba 8:32

That's way south. Yeah. And then we my group was like the outer cordon security of the island. So every day was patrols around the entire island trying to keep, you know, we had some intelligence that they were on that island somewhere in the jungle, and all the high-speed guys were trying to track them down, and we were doing the outboard security on that. So that was my first appointment. Then two EDPs to Japan. I know you were in Okinawa for a while as well.

Mark McGrath 8:59

Yep.

Matt Ryba 8:59

Uh, which was like a weirdly formative experience. I didn't understand at the time because I was a kid. It was like the first one I was 19, I think, the second one I was 21. Did you get taco rice? Taco rice. Remember taco. I was at Camp Hanson, spent some time at the Hanson too. The Shangri-La rock and dance.

Mark McGrath 9:18

Out in Kidville.

Matt Ryba 9:19

Yeah.

Mark McGrath 9:20

Wait. Now I know that I know we're gonna get to the point where we're talking about PTSD, but you can certainly talk. There's a lot of post-traumatic stress from Marines at Camp Hansen in Kidville. And drinking mojo balls. Like I have PT. Oh, God. The Habusaki. Right. Habusaki. Yeah. Golden Dragon. It was all there.

Matt Ryba 9:39

Great time. Again, that's another thing that changed pretty rapidly that I felt like I was one of the last kind of generations that got to experience it in its full glory. Because my understanding is it got pretty locked down after uh our second UDP there.

Mark McGrath 9:53

Do you remember what movies you saw in the base theater when you were at Camp Hansen like 10 times?

Matt Ryba 9:57

What a good question. I saw a lot for sure. I remember having to stand you know at POA for they would always play the national anthem before the movie. But I can't remember what the problem is.

Mark McGrath 10:10

The best part, Ponch. I don't I don't we gotta tell Ponch this because so you know, Ponch be a retired Navy. The the uh the the Okinawa bases are actually AFists, not NEX, right? So the naval exchange is not theirs. So so the beginning opening national anthem, it's all Air Force guys. And it's hilarious because we're all sitting there, like the best one was like the Air Force guy, like the Air Force chef with the cake, like while they're playing the National Anthem, they have all these still shots and they're I know what you're talking about, man. I was uh totally ridiculous. Yeah, but then you also had like instead of McDonald's on a naval base, you had Burger King. Instead of you had uh Robin Hood Deli, and what was the other one? There was a pizza pizza. Anthony's Pizza.

Matt Ryba 10:49

Yep.

Mark McGrath 10:50

Yeah, again, PTSD, right?

Matt Ryba 10:53

The one movie had like uh you could rent DVDs, but it was a very limited selection, so I think I watched every single movie that they had available.

Mark McGrath 11:01

Well, the the one the one movie I remember for sure seeing in uh well, two really stand out. One was Gladiator, which was sick with the with the with a bunch of Marines, but the other one was Bring It On. Remember Bring It On, the cheerleader movie with Kirsten Dunce? That was insane. I think I think we probably saw that like 20 times in the theater while we're over there.

Brian "Ponch" Rivera 11:21

Is that where we get the phrase it's been broadened?

Mark McGrath 11:24

No, that's burr. It's cold in here. There must be some toros in the atmosphere. That's anyway. All right, Camp Hanson, keep going, tell us this story.

Early Deployments: Philippines And Okinawa

Matt Ryba 11:33

Yeah, so the two UDPs, and then I get rotated back to Hawaii. I'm a short timer, uh, they fap me out to MPs, it sucks. I do like this the abridged like one-month academy or whatever that was, hit the uh the OC spray, all the good stuff. And then I get passed out of Camp Smith just as like a gate guard. And two five had deployed to Ramadi and taken pretty heavy casualties. And they went and they were like, hey, anybody want to be a combat replacement? And I was the first one to raise my hand. I hadn't been to Iraq yet. I've done about three years and a couple months at this point. So I shot over to them uh about three months after they were in country and finished out that deployment with 2.5 and then ended my first enlistment with them as well. And that one was actually an interesting one because when I got to 2-5, they gave me like two weeks to kind of you know acclimatize and get all the back briefing on all the operations that have been going on and all the stuff they've been doing. And the dudes on Reaper 6 showed me a slideshow of all the still photos that they had taken and stuff like that that they put together to some metal music. And I noticed one Marine and I was like, wait, go back to let me see that photo again. And this kid, buddy of mine from back home that I'd been in junior high with, seventh, eighth grade, we were already talking about joining the Marines. And I remember we were in the same history class, and the last chapter was about the first golf war. So we're like, oh, I can't wait to talk about this, it's crazy. And then we kind of lost touch, went to different high schools. I knew he had joined the Marines, but he was in golf company, who was also at Hurricane Point, and I was like, that's Petrovsky, right? And I was like, Yeah, so where is he? Go check the Chow Hall, go over there and bump into him. I'm like, hey, you know, we made a pact when we were like 13 years old that we were gonna join the Marines together and fight a war someday. Don't see the kid for another 10 years. Here we are fighting a war together. So that was kind of cool. But yeah, so did the Ramadi deployment.

Mark McGrath 13:36

I was thinking I was there for wear a four get your 4J from the Fifth Marines.

Matt Ryba 13:41

And then honorable discharge after that, two years reserve, went up to Vermont, chased a girl up there, and then um got a letter in the mail from the Commandant talking about the push and uh with a handsome signing bonus to re-enlist for 0352s, saying we need combat hardened NCOs to come train the guys. Uh so I joined back up, and then that was 2008. Went to 2-6, kept the Forteger, and I did a Mew with them, 2-6 Mew, where we did a bunch of stuff in the Middle Each, chased around some Somali pirates for a little while, and then deployed to Marja, Afghanistan. It was like two or three months after the big operation there, which Mashtock was on my birthday, actually, is when that launched. And then we were there like two or three months later to relieve those guys. And interestingly, I watched your guys' uh episode with Bing West recently, and he was so I was the jump platoon sergeant in charge of taking now General Ellison at the time, Lieutenant Colonel Ellison, around the battle space, and he liked to be involved with everything, so it was a very, very busy deployment. But in addition to that, any of the dignitaries that came in or you know, high value assets we would protect. And Bing West was one of the guys that rode with us for about a week when he was ready the wrong war. He sat in my truck and we talked about everything happening in Afghanistan and his prior experience and mine and all that stuff. So yeah. Yeah, he's a legend.

Mark McGrath 15:10

That's really cool that you got to be on the deck with him. It's awesome. All right, so you're back in you're back in the gun club, you're back over there fighting. Walk us through walk us through the next part.

Matt Ryba 15:25

Yeah, I mean, the I was in an interesting kind of situation because I wasn't originally supposed to be the jump platoon sergeants. I was kind of like the first squad leader in the jump. And then the guy that was supposed to be the platoon sergeant, something had happened where his company needed one of the NCOs that had been around the block a couple of times to take charge of one of the platoons over there. So they sent him back. I ended up stepping into that role. Worked out well for me. Loved working with Colonel Ellison. He was one of I always likened him to just be a very stoic officer, I think. He was something I always appreciated about him, whether, you know, how intentional it was, but he always took the time to get the NCOs together and hear what they had to say and ask us questions about both operations, but just general, you know, things. How do we take care of our guys and stuff like that? What do we need from the command? I had one experience where I had to request masks with him and like the sergeant major, who I did not get along with at the time, really got in my face. Like it was the first time I got locked to the position of attention, you know, since I don't know, boot camp ten years later. And but I went in and the colonels uh, you know, read my complaint and he said, you know, Sergeant Rebo, you had a complaint, you went through the proper chain of command, you did what you thought was right, you were right on this issue, and uh, you know, good to go. We're gonna take care of this, and make sure you use this as a teaching moment for your Marines on how to properly use the chain of command. You know, things like that that really kind of stood out for me working for him. A lot of I mean, I don't even know how many significant events we had when we were in Marja. It was I think you can read it in the book that Mr. West wrote, like, you know, six or seven calls was an easy day where we were scooting out to a bomb going off or enemy fire being taken somewhere or having to, you know, deal with the locals on whatever issue. We lost 17 guys from our unit on that deployment and pretty heavy casualties in the deployment at Iraq as well. But the thing that really got to me, especially from the deployment to Afghanistan, once I had gotten, the number of suicides. That I mean, I personally know 10 guys who, you know, after their service took their own lives from somebody from every unit that I was with. And that one stings a little bit. For me, there was a uh there was one specific significant event in Afghanistan where we lost one of the lieutenants in a firefight, and my guys go back to their fob for the evening with the boss, and we're just trying to, you know, figure out what's going on. And they had a guest tent where they had traveling units could rack up for the night, but all the racks were taken, so I'm like, yeah, no worries, I'll just sleep on one of the trucks or whatever. And then somebody goes, Hey, Zardarible, we got a we got a place for you to sleep, but it was Zimmerman's rack, and he had just, you know, been KIA. So I lied awake in the dead man's rack that entire night thinking about all the big thought problems of, you know, combat and war and and what's his family gonna do and all this kind of stuff. And uh, I think that was a real defining moment for me knowing what I wanted my path to be when I got out. So once I left the Marines, I knew I wanted to get into psychology just because I wanted to understand what I was going through and what all the dudes I served with are going through. PTSD became a thing within psychology that I became very interested in. Originally it was like wanting to do something with forensics and profiling, because I watched a lot of like X-Files as a kid and stuff like that, and I was like, oh yeah, like I still have you know a distrust for the government that stems from that, but that's something different.

Mark McGrath 19:06

But well, you're in you're in good company on this show.

Matt Ryba 19:11

Trust the government. Trust no one really.

Mark McGrath 19:13

We talk, we've had some interesting live casts with naval aviators that may or may not have seen things flying around.

Ramadi, Loss, And Reunions

Matt Ryba 19:20

I've got a couple of buddies that I've had those conversations with as well, yeah, who are officially on record. But I I had already completed, so I went to Fordham University in New York. I got out, came to the city, and judgment educated. Yeah, yeah. Which I do appreciate. They take this stuff pretty seriously. And and one of the things was philosophy is a required course with the Jesuits. So that kind of I did a dual track for philosophy and for psychology, and ended up with both majors, with my focus in philosophy being philosophy of technology, because my whole life I'd been experiencing this kind of analog to digital shift, whether it be in the Cammis and the Marine Corps for, you know, everything coming online and kind of dealing with the technology as a piece of it ethically. I had completed my required course load for psychology, and I had found this professor who had dealt a lot in the field of trauma that was teaching a course. And I said, I'm just gonna go and take this guy's course anyway as an elective, just to kind of butter up to him and see if I can get my foot in the door in that kind of sector of psychology somewhere as an intern or as a RA or something like that. And he ended up hooking me up with the team at the Bronx VA, with uh Rachel Yehuda's group, because he had done his graduate degree with one of the doctors that is currently up there. So I did uh about three years, started as an intern, that turned into a paid position at the VA, worked with her research group for about three years, and then bumped over to Columbia, worked on the CSSRS, which is the suicide prevention measure. It's kind of like a suicidality measure that I think the DOD uses it now. A lot of veterans groups use it, but just trying to see if you have a suicidal ideology in research. It's used a lot, it's kind of used all over the place. Did that for about a year because at the time they were trying to get it into the DOD. So I joined that research lab within the week. I was down at the Pentagon talking to the guys about suicide prevention. And then one of the authors on that measure, Dr. Prudence Fisher, is also one of the co-director with Yuvol on the Made of War Project. They're the copies. So she had approached me knowing that I had a veteran background, saying, Hey, we're gonna do some media stuff for this horse therapy thing that we're thinking of putting together. Can you help us out with that? So I volunteered with her. She introduced me to Yuvol. Um, him and I got along very well. He was also interested in starting a military family wellness center, which was kind of just uh like a talk therapy free center alternative to getting therapy at the VA for veterans and family members. So I moved over to his team and I've been with him for about 10 years now in various different projects. So lots of research has been done in PTSD, lots of new modalities. We've seen hundreds of patients through the military center, lots of good data coming in and just kind of you know papers being written, trying to move everything forward in the space and find things that work for veterans that are dealing with threats.

Brian "Ponch" Rivera 22:18

So I'm curious. So I've come in contact. Back with Dr. Yehuda, uh Yehuda's about three years ago. Um can you I I that's a very important person in this whole framework. Can you talk a little bit about more of the work she does and what you were doing with her?

Matt Ryba 22:30

Yeah, she's very big on the psychedelic stuff now, uh, is my understanding. I I mean I I keep up with her kind of there's one project that our lab is kind of working with her lab on that I'm CC'd on a lot of emails on. But at the time when I was working with her, it was a lot of biometric research, not biometric, uh biomedical research on PTSD. So a lot of stuff around cortisol. Okay. A lot of stuff. She had really kind of had a very good resume with Holocaust survivors and working with that population. And then at the VA, the PTSD team there was dealing with just a bunch of just I just remember doing a lot of blood draws and cheek swabs and stuff like that. So it was really looking at the biology behind some of the PTSD stuff.

Brian "Ponch" Rivera 23:13

No, appreciate that. It's just uh for clarity. Um a lot of people you're you're mentioning are critical in the in the research now, not just for like you pointed out, like psychedelic assistant therapies and other modalities. And I did just saw that uh in the last week or so that they they're think they're thinking they can identify through biology indicators or leading indicators as to who might be suicidal. I don't know if are you tracking any of that still?

Matt Ryba 23:34

I haven't seen any of the new stuff on that yet. Yeah, I'd be interested in it for sure. I mean I appreciate that. We're in an interesting kind of situation right now. I think you volid kind of mentioned it when he spoke with you guys where we lost this block of time because of the scheduling of some of these substances and stuff like that, where it was just impossible to research any of them, that I think would be very helpful. Something I found in more of my outreach role with veterans and in trying to get people placed in the right therapies that they need, I find that veterans have a tendency, especially combat veterans, have a tendency to be more interested in trying something new that's investigative or or maybe not as conventional as some of the talk therapies uh and and see if there's an alternative method of something that might work.

Brian "Ponch" Rivera 25:18

Hey, Matt, Matt, I'm a little curious. Uh just a little bit at the background between our generation and the Vietnam era generation. What was a suicide rate then? Um do you know by any chance? I don't know.

Matt Ryba 25:30

I I really don't know It's impossible to track because of how poorly the data was kept. They say I think like the the official VA percentage is like somewhere around 10%, 11%, or something like that that have PTSD from that era. But it's like there's no shot. Like half of those guys We don't know though. Yeah. Because it wasn't the questions weren't being asked. And honestly, I don't think you're gonna get an accurate number on any of that stuff up until the GWAT wars. And um, just because the the information wasn't being tracked, it was called something else. It was, you know, there's still a huge stigma that's attached to it, which is getting better. But the amount of guys that didn't even want to be associated with being called a veteran that came back from Vietnam that were probably suffering with a lot of these ailments, you know, like all that, those numbers are just gone to the wind. So you can't get anywhere close to gunt. I can tell you, it's it's the largest veteran population now is the Vietnam guys, especially in New York. Um, and um, you know, they're aging, and there's a lot of interesting stuff that they're finding with aging in PTSD, where something might be stuffed in the back of your brain somewhere for 10, 15, 20 years.

Mark McGrath 26:41

I was just gonna I was just my mentor that influenced me to go to the Marine Corps, who went to my same old boys' Catholic high school, was a Marine officer in Vietnam. He killed himself about 12 uh almost 15 years ago, and he was a Vietnam era vet. And I happen to know another friend from college whose father was in the worst in Vietnam, and every day goes through affirmations to prevent himself from killing himself, all these years removed from from Vietnam. And I think I mean may I maybe I'll I'll put this back to you and ask, you know, it's interesting how you know Yuvall's experience was contemporary with, you know, Vietnam as it was going down. So he's in that same age group, although, albeit, you know, different different nation states and all that stuff. But it seems like with that group, people really started to at least increase the amount of questions they were asking of what's going on. Whereas maybe in World War II or whatever, they didn't really they didn't have the the the knowledge, the study, the interest. I don't know. It was more like, ah, you're just shell-shocked, you know, versus you know, there's actually something really going on here that needs to be deep.

Afghanistan, Bing West, And Heavy Combat

Matt Ryba 27:45

Yeah, it's explored. So this might play into the moral injury bit of it a little bit too. And I'm just gonna fire off the cuff here. I don't have the data to back this, but it's a very different kind of war, right? World War II, there was a known evil, there was a different sense of patriotism, I think, in the time where everybody felt responsible in some way. And I think the events that got us into Vietnam were somewhat questionable, right? And I think that was a big thing. And I think now we're learning with the with the GWAP veterans too. You know, the reasons we went into Iraq and the reasons that we went into Afghanistan might not have been fully expressed properly with the release of the Afghan papers and all that kind of stuff, right? So it's like we're getting more information, and I think that there's I have no question in my mind that anybody who went over there to do their job was doing it for the right reason, which was, you know, to take care of the guys to your left and your right, and and just mission accomplishment and the betterment and patriotism for their own country to protect their own people. That being said, the amount of information people can get now is much higher than it was back in World War II. So, you know, one of my interests, maybe this is part of the philosophy thing of it too, is like I'm really I've always been interested in like the good old Americana propaganda. I've got a great book series that uh it's a US, Japan, Russia, Great Britain, and the Allied forces, and it's basically all of like the recruiting posters and like the stuff that they put out during the World War II era. And you can kind of bounce, you know, the different countries off of each other and see how like the story was being told from different areas of the world, depending on what side you were on. So yeah, the way that you take in the information, I think you're right, people were questioning Vietnam a lot more in that era, starting to question why we're doing the things we're doing in war fighting. And I think it's even more so now than it was then. You know?

Mark McGrath 29:47

Well, and I I was and I would add the interest in the mental health, because I think that the the way the Vietnam veterans presented versus World War II, and maybe it was the benefit of the medium being the message and having technology and more people could learn about it than than they could in World War II, unless you had first hand experience.

Matt Ryba 30:07

But it wasn't even something that was really studied too much prior to that era, right?

Mark McGrath 30:11

That's what I'm saying. Yeah, the revolution of the 60s and all that was kind of like Yeah, well, it started, it it helped, it helped uh accelerate, I guess, maybe is the right word. Maybe it helped us before.

Matt Ryba 30:22

And it's become more and more normalized since then, right? So now people, everybody has a therapist now, right? That you talk to on the street. And like it's become this kind of thing where it's the part of the whole health model that people understand that mental health is part of, you know, it affects your sleep, it affects your physical health, it affects this, and those things all affect your mental health as well. And it's kind of like an in tandem thing that you have to work on. So I think that there's more and more acceptance around seeking help now for mental health issues than ever before in history. And that that helps us with the research. And to my point that I was making, that veterans being interested in trying new things to see if uh those might help.

Mark McGrath 30:59

Well, the um, you know, the the the suicide rate from not just guat, you know, global war and terror. I mean, you know, as we were saying earlier, we you know, there's still Vietnam vets that do it. It's it's unacceptable that we've lost more people to suicide than than combat deaths. Yeah. It's just it's absolutely unacceptable. I mean, we all know people directly. Um, I could, you know, talk about roommates and friends and you know, um, it's a very nuanced problem, too, right?

Matt Ryba 31:28

Because you have this kind of warfighting culture where you you you have a certain subset of people who are primed to join the military in the first place, right? That the this warrior culture that exists that people in for all of history have fought for their people, right? So you have that group. Yeah. And then how much more susceptible are they to these wounds from trauma? One the exposure is increased, sure. But also like a lot of people that joined the military have issues going into the military that pre-exists, whatever happened in the military, also. Well, that's well, that explains the marine commercials then.

Mark McGrath 32:05

You're not you're not wrong. No, no. I mean, you know, you said you said earlier uh 2-5, you know, what what movie featured 2-5 prominently, you know? Full Metal Jacket. You know, they were that was Hotel 2-5. And it's funny how a movie like Full Metal Jacket got the opposite effect. It was supposed to discourage people from going into the Marine Corps, but it did the opposite. It actually, oh, I want, you know, I want to do, I want to do that. One of the things that we were kind of laughing about earlier, too, but but when you think about it, I guess when we start to unpack it, it really is a big problem. Is, you know, we were laughing about Kinville and Camp Hansen. And, you know, you think of any Liberty call, I mean, there's one constant thread to every Libo incident. It's booze. And it's in alcohols in our service songs in the naval branches uh for both the Navy and the Marine Corps. Alcohol is uh given on ship at Steel Beach Victics. Uh there historically was a grog ration or a rum ration. Um we have the grog bowl at Mess Nights. You know, the Army Navy games always almost always brought to you by you know Miller High Life or who whoever the hell does it now.

Matt Ryba 33:17

Let's not forget where the Marines were founded.

Mark McGrath 33:20

In a bar, yeah. So there's that. Yeah. So the Marines were founded at Ton Tavern, 10 November 1775. I guess the point of the point of the story is I I never thought about it when I was in it because you know, we were all just, you know, it was it it it really is like a fraternity. But when you go back and you start to unpack it, you think of all the LIBO incidents, even the ones that are legendary and funny, and some are not, some are horribly tragic. Alcohol is almost always a constant, a constant threat. It's also a constant thread in a lot of the problems, of course, DUI, of course, you know, sexual assaults and other things. But then I never had thought about that from a cultural standpoint. And then when you think about it, when people revert to ways to mitigate their trauma that they experienced in the Marine Corps or the Navy or, you know, any of the branches, I guess, you start to really wonder like how prominent was alcohol? Like we were so heavily influenced and alcohol was so normalized. Did alcohol have a an exacerbating effect to the trauma as it was happening? Because you read about those stories and you know those stories where people turned to drinking right away when they were still in and then exacerbated it after they got out. So they weren't doing things like equine therapy or psychedelic therapy or or or you know not drinking. So what was the role of alcohol?

Matt Ryba 34:40

Yeah, I mean healthy coping behaviors versus unhealthy coping behaviors, right? Yeah. You can argue that alcohol is being unhealthy, but it is so in your face. And you bring up a really interesting question. And I wonder if not only dealing with the trauma, right, but you're taking a group of people who are already have a very high risk tolerance. You're introducing a substance that makes that risk tolerance even higher, right? Like lowers your inhibition and stuff like that. So yeah, it's a gunpowder keg waiting to go off. And yeah, it's culturally an interesting phenomenon that that you bring that up. And I'd never really thought about that. How do we reckon that?

Suicides, A Defining Night, New Purpose

Mark McGrath 35:19

You know, because I I I did dry, I started dry January, right? It's it's January now as we record this. I started dry January, January 1st of 2020, is when I I I wanted to see if I could do a dry January. And I and it's been ever since. I just stopped. Like I just I just literally literally stopped. And I came to the conclusion that every bad decision that I ever made involved probably involved alcohol, right? Like so it's like Homer Simpson. Yeah, right. Well, it's like, well, think about it, like all the things that make the stories legendary, you know, again, there and and in the legends, you know, let's let's be honest, those legendary stories that we all know as naval people from from Libo and pulling into port or whatever, there's a really extreme thin line between legend and like complete abject tragedy or dishonorable discharge or or you know, something. But at the same time, again, it was it was so ingrained and embedded in the culture. Why would we expect people to mitigate trauma from that experience differently? You know, why, why, why would we be shocked that they drank too much or they they have an alcohol problem or whatever when you're when you're coming from an organization that didn't do anything to back away from it, that has it so ingrained in the DNA?

Matt Ryba 36:39

I mean, I couple that even with, you know, the stigma that at least when I was on active duty that existed in areas where you wouldn't even think of it as a stigma. But like if you wanted to go talk to the psychiatrist at the naval hospital, or or you're having problems, or you're mandated to go do it through your command or whatever, they would always say, go see the wizard, right? Like immediately discounting that there's any scientific validity in whatever they're doing, and it's some kind of magic spell that they need to cast on your brain so that whatever the pain is goes away. You know? Yeah, it's it's an ongoing battle and it's tough. And I find myself even with it's a good for me to be working, it's almost therapeutic for myself to be working in this field with these people that have these extreme traumas because it forces me to look at my own traumas more seriously because I fall into that trap all the time where I'll stop talking about the things that happened to me, or I'll not acknowledge it, or I'll go have a couple of drinks instead of dealing with something. And it takes, you know, somebody else telling their story and me hearing it to be like, wow, you're supposed to also be a leader in this space. You should start looking at this differently and telling your story as well. Maybe somebody can benefit from your experience.

Mark McGrath 37:53

Talk about, you know, veteran trauma. It's not limited to people that had shots fired at them in anger and vice versa. It's also it also includes people that survived something, or it includes people that didn't get to go because of a B-billet or or um I don't know. Um I was reading an article, the the guy that played not Darth Maul, what's what's uh what's the Marine he played Kylo Wren? Yeah, Adam Driver. Adam Driver. So he's a Marine and he got severely injured in like a mountain biking accident and he couldn't deploy with his unit. And he was an 03 something, like he was an infantry guy. So someone like that, like you know, you that that I wonder, does he ever talk about trauma or someone just say in that hypothetical situation of someone that didn't get to go but their buddies did, and they missed out and they weren't there when someone got killed or hurt or whatever.

Matt Ryba 38:47

I mean, it's the whole reason I volunteered to go to Iraq. I didn't have to do that. I could have stayed at the gate and waved the generals into the, you know, their building every morning. But like you train your whole career for something, you know there's guys out there doing it, you want to be able there to help them to get through it, to figure it out, to accomplish the mission. So of course I'm gonna go, you know. So I totally get that. Where if you're unable to be involved in something that could cause it, turning it, turning it a little bit differently.

Mark McGrath 39:17

Uh maybe you know something about this. I'd been reading too that drone operators that are in Conus that you know, for all intents and purposes, they're playing a video game and lives are being lost or whatever taken. So I've read that they're they're having an extreme amount of trauma.

Brian "Ponch" Rivera 39:32

Aaron Powell Look, look at the context though. So let's talk about that. You're in Creech, Nevada, or wherever it is, Falanadrone, or you're on an aircraft carrier, right? The difference is, or you're in Aviano Airbase in Italy and you're getting ready to go do something. Okay, so on a carrier in the Marine Corps, so when we're when you're afloat or afloat, we go back to our spaces, right? We don't go home. We don't have to transition from being a war fighter to a dad that day, right? Or a mother. Um, and that's that's a different type of warfare that uh we've seen in the last 20 years is believe me, when I heard about these folks getting these Air Force personnel getting awards and getting dismissed for PTSD, I'm like, what the hell are you talking about? But you look back into it and you start to go, wait a minute, you you drive into work, you go drop a bomb, you watch something horrific, you know, uh launch something off of uh off a predator, drive home, and now you're a mom or you're a dad, right? That context switching, you're you're transitioning from your identity, intelligence, and intent. That is, we'd never see anything like that. Whereas in the Marine Corps and the Navy, you you go away, right? You you take home stays at home and you go and do your thing and you come back. That's not the way we fight wars anymore. It's that's a different way, right?

Mark McGrath 40:50

That's really interesting.

Matt Ryba 40:51

You make an excellent point there. I would like it closer to law enforcement, right? You got cops that are dealing with getting shot at and whatever, like any traffic stop could be your last, and then you go home and have to be, you know, a parent or a spouse or whatever immediately following. You know, there was that interesting kind of graphic in Grossman's book on killing, where he talked about how close you are to the actual killing and how that affects the trauma of it, the act. You know, a knife kill is the most visceral and you're you know, hand-to-hand combat versus shooting somebody from 300 yards versus a mile versus dropping bombs from up in the air and the different effects that those have. And for exactly what you're talking about in having that mental switch of like having to switch back and forth and and your two realities kind of blending together, I think that's why that graphic maybe doesn't hold up anymore. And I've had this conversation with colleagues and other veterans as well. Whereas, you know, they're kind of like, ah, grossman, maybe at the time it made sense, but like we because of the technology, because of other things, like the whole idea of warfighting has been spun upside down. So we can't rely on medium is the message, right?

From Fordham To PTSD Research

Brian "Ponch" Rivera 41:58

So and then the other thing is how we misremember the past, right? So I I remember this uh a few years ago. I was visiting some friends in Texas and we're there's alcohol involved uh seven, eight years ago. And I remember uh the one of the guys I used to fly with recounting a mishap we had. And he was not in the mishap. But the way he recounted, he he was the wingman. And I'm like, holy shit, do I remember the right past? Am I you know I'm not saying he's right or wrong. I'm just it's as time goes on, trauma can be carried vicariously from from stories and others and experiences, and you almost forget where you were, right, in that in that story. And that's just uh, I think that's human nature, our psychology, the biology or neuroscience, whatever you want to call it, cognitive science tells us that that we misremember the past. And this is why what Dr. Aria was telling us about is uh it's kind of like that that snow globe. Once you shake it up a little bit, we get to go through that counterfactual and disconnect those emotions from that event. Uh and remember that event, and this goes back to Moose's point, we don't have to experience that event. We just have to have a memory of it. Right. Right? Or a connection to it. Right. Which which means, let me rephrase that. We don't actually have to experience the event. We have to have some type of understanding of the event. I think I think that's another way to say it. So yeah, Moose, I I think you know, the different types of trauma you get from you know, a spouse having to deal with uh a husband or or a family member that comes home and just the way they act, that that that creates some type of trauma as well.

Mark McGrath 43:25

I mean, I know someone that wanted to get away that could deal with his domestic life, that he volunteered to go back and was killed because he he didn't want to deal with his spouse.

Matt Ryba 43:35

I always tell people that the most, I think, visceral, the most realistic portrayal in Hollywood of PTSD that I, at least I personally have a lot of people. Well, can we guess? Yeah, go for it.

Mark McGrath 43:49

Uh Jimmy Stewart in the movie It's a Wonderful Life, because he was actually dealing with it and using that as an outlet for for what he had experienced as a bomber pilot in the Eighth Air Force in World War II.

Matt Ryba 44:03

Trevor Burrus, Jr. That's an interesting guess. I was nowhere close to that, actually.

Mark McGrath 44:06

I wrote an article about it. I'll send it to you. No, no, he he no, he he he he uh he was washed up from Hollywood because of his and you look at the picture before and after of like three years of combat, like he looks from like a young boy to an old man, and no, no studio would touch him. And Frank Capra put him in that movie, and when he there's the scenes where he's praying at the bar or where he's crying with the kid, that those are complete I got I get chills thinking about it. Every time I watch, I I've never watched that movie at Christmas the same way again. He's actually he's actually had a place where he was allowed to let all that go, and Frank Capra let him do it. Um, and it helped his career. But but anyway, okay, hold on.

Matt Ryba 44:47

So I should say I should because that seems like it was actually real. So let me rephrase this. That was real. Yeah. Let me rephrase this a Hollywood depiction of what PTSD is in a film, the most realistic that I've Okay.

Mark McGrath 45:01

Punch and I are gonna we're both gonna take a guess. Go ahead, Punch. You got you got yours?

Brian "Ponch" Rivera 45:05

Uh American Sniper.

Matt Ryba 45:07

Good one, but not the one I was thinking of.

Mark McGrath 45:09

That's a good that's that's a good one. Uh Deer Hunter. Also a good one. It's this business. We're both wrong.

Brian "Ponch" Rivera 45:15

Come on. What was it? I've got another one though, right? Wait, wait, wait, go ahead. Go ahead. You ready for this one? Yeah. There's a move there's a the story about uh a pilot whose father was lost to Vietnam in a phantom, so he didn't grow up with a father. He didn't get into the Naval Academy, he lost his mom. Pete Mitchell. Pete Mitchell, right? You can look at all loses goose, he loses broken relationships. That whole story is about traumatic events. But he but the amazing thing about that story is he's fine, right? And the reason he's fine is because he can't become depressed, uh, he doesn't have PTSD, he doesn't suffer from TBI, doesn't become an alcoholic, uh, doesn't become addicted to drugs, drugs, doesn't become homeless, and a doctor will never prescribe him benzos for anxiety, right? Why is that? Because it's not real. Yeah, yeah. But we can use top gun, though, right? No, it is top gun.

Mark McGrath 46:08

It is top gun. Well, no, I was the top gun? No, no, no. Michael. Okay, wait, wait, hold on, hold on. Wait, wait, wait, wait, wait, don't tell us. Okay, give us a hint, bracket us in, because we we we watch a lot of war movies. So bracket us in give us an era.

Matt Ryba 46:20

It's it's a the era is the the uh the G Wat era. It's the the recent wars. And I picked it because maybe that that's my era also, so I can identify with it's a symptom and the way that the person has.

Mark McGrath 46:34

And it's and it's not and it's not Restrepo, which is like a documentary.

Matt Ryba 46:38

You're talking about a movie where Hollywood depicted Hollywood film, and the main character has an episode, and for me it was like this is what it actually feels like.

Mark McGrath 46:48

It's not American Sniper.

Matt Ryba 46:49

Well, it's it's either Lone Survivor or uh what's the EOD movie? The Hurt Locker. It is the Hurt Locker. It is the Hurt Locker. And it's the scene at the end when he's his wife says, get cereal at the grocery store, and he's standing there and there's a million different boxes, and he's just lost and he can't figure it out, and he just drops his basket and walks out of the grocery store because I used to I and I tell my wife all the time like the simplicity of being in combat is you just have to stay alive to your next meal, right? And all the other things that are happening in the world to your point, Ponch, of like tune it out. We're over there, we're deployed, somebody else is taking care of all that stuff. I'm not worried about this back home, I'm not worried about whatever. And I think that there's something to do with having that space and dealing with trauma versus if you are a drone pilot and you immediately have to go grocery shopping after, you know, bombing a building and taking out 20 guys.

Mark McGrath 47:50

Yeah. And okay. So the vets that are listening, and it's not just vets, as you say, it could be law enforcement, it could be someone that was assaulted, it could be, it could be anybody that's experiencing trauma, you know. Talk about what you do, what you've all shared with us a little bit around the animal connection, you know, that that horses and dogs in your in in the Man of War project is is is horses, but what is it about that and how would you frame that to someone that's listening that needs help if they don't want to do psychedelics or they don't want to do, you know, whatever? How would you help frame equine therapy for them?

Psychedelics, Biomarkers, And Stigma

Matt Ryba 48:32

So what we did, which was kind of novel at Columbia, equine therapy has been around for a very long time. There's not been good, rigorous scientific effort to show in a standardized way that it works. There's tons of anecdotal stories from veterans, from trauma survivors, from all groups of people. I feel so much better, I'm dealing with these issues better after doing the cycline therapy, but there was no way that it was actually being tested. So we developed a protocol, the Man of War Project, where we have different testing phases. First of all, in the studies that we did, in the scientific studies we did, everybody had to be diagnosed with PTSD, had to be a military veteran. We did a uh pilot study. It's a group therapy. So we did a pilot study which had two groups as a proof of concept of eight veterans in total that went through. It went well. So we did an open trial that was uh 16 groups of 63 veterans in total that took several years to go through. And we uh put together a protocol of eight sessions once a week for 90 minutes, where a group of you and your veteran peers with a shared experience go and learn new skills around horses, learn horsemanship skills, kind of learn different team building skills, different communication skills. And a lot of it stems from being in the moment and understanding what's happening using the horse is sort of a uh reflection as yourself in some way, because there's a lot of interesting social features with horses in particular that are similar to humans, and being able to, and other ones that are like beyond us, you know, they can feel your heartbeat from like a hundred yards away or whatever, but they're very cute into their environment. They're typically, you know, prey animals. They're not, they're skittish. They they are group social animals, they move in packs, and you can see when you're interacting with a horse, if you're giving off kind of like a certain energy of being nervous or being scared or whatever, they'll also be nervous or scared. But the calmer you become, the calmer they become because they're constantly looking for cues from you on what they're supposed to do, right? So it's like this interesting way of kind of informing the trauma people, in our case the veterans, of how they're presenting themselves and what they can do kind of interpersonally to make those adjustments. And we find that that is really helpful for them in going about their everyday lives and stuff like that. So part of it is like releasing the stress. I use this example all the time. If you are living in a place like New York City, concrete jungle, millions of people, nonstop input just coming in constantly, traffic, noise, bumping into people on the street. Everybody in New York is late for something always, right? So like you just constantly go, go, go, go, go.

Mark McGrath 51:29

And you remove your stuck on their screens too, isn't it? Everything that's crazy.

Matt Ryba 51:33

I'm taking a meeting and this year while I'm doing this and this, it's just nonstop. Remove yourself from that environment, go to a green space in nature with animals where it's quiet. That alone is like a decompression down, right? And then when you start going through the protocol, and what's unique about our protocol is every group has a team where there's a mental health person that is there to deal with any issues that might come up. An equine specialist that's there to kind of relay the information that's coming from the horses in a way where the individuals can understand what's happening and kind of ground themselves in that. And then a horse wrangler, of course, for safety. And we start, you know, every group with a kind of grounding exercise. The horses are part of it, they're part of the team, so they're in the circle with all the veterans and with, you know, the the clinical team and really kind of working it out as them being just a part of this unit. We had great results. And I think a lot of it was we had people who maybe were not interested in traditional therapy, didn't want to talk about their problems. A lot of veterans don't want to talk about their trauma. The VA says prolonged exposure therapy is the gold standard. It works like, I don't know, 40 something percent of the time, which is good, but that's a lot of people that aren't being helped. And everybody's trauma is individualized, it's different, it needs a different remedy, antidote, whatever. We had different time points where we tested people in pre and midterm, four weeks in, at post at the end of the eight weeks, and then three months later in follow-up. 51% of people showed clinical improvement that went to the program at post. It was a little bit higher, it was like 54% at three months. Forty-six percent of the people that did the research study no longer met diagnostic criteria for PTSD after going through the program. So nearly half of the veterans who had a diagnosis of PTSD went through this eight-week program and at the back end of it no longer had the symptoms to carry a diagnosis of PTSD. So we're like, okay, this is great. Now we have a standardized model of like here's a manual, it's a thick manual, it's a couple hundred pages, two hundred pages. Everything's spelt out, like these are the steps you can do, these are the things we can test. We gave them different self-report measures, different clinical measures along the way to test things in depression and PTSD, anxiety, different measures, sleep quality, stuff like that. And actually had like the evidence. And on top of that, we had a sub-study that was, I think it was like 17 or 19 people in the main group of the open trial who underwent um fMRI before and after and did functional testing with brain imaging. And the areas of the brain where the gray matter uh was not as dense post equine therapy, or the areas of the brain that were lighting up more and like the thalamus, the pleasure-seeking areas of the brain, were like more active uh post-therapy. So we had actual brain scans that kind of corroborated what we had found in the data that this works if you do it in this way. Right? I think a big piece of it is not talking about the trauma. I think a big piece we've also found in some of our other work in the clinic that like the interpersonal stuff is much more popular with veterans than the exposure stuff. And learning about your feelings and how to manage your feelings seems to be more highly successful. Yeah, I d I can't speak much about dogs other than they are two completely different things. But the one point that I bring together, and uh I actually wrote about this in in a book that we produced about a year ago. Last February, we published a book called The Guide to Equine Therapy. And the chapter I wrote was about the military history of use of horses in the military, right?

Mark McGrath 55:21

So this is an it's a big, it's a big, replete history. It's massive. And it's something that we never talked about when investigating. There's a whole branch. It's called the cavalry.

Matt Ryba 55:31

It's like it's something we never investigated when we were doing the initial research for this. And I was like, there's a natural relationship between horses and military folks that has happened for thousands and thousands of years. And the other animal that's used by the military is dogs. I mean, I guess you can argue on the Navy dolphins on occasion, fine mines or whatever, but it's dogs and and horses are the two combat animals that are frequently used throughout all of history. And there's just like this weird military connection where I think veterans might be more prone to work with those animals for therapy in some sense. That kind of stems from the military history as well.

Mark McGrath 56:07

It's amazing. I grew up an army brat. You know, my dad's a retired army officer, and I was born on Fort Knox, the home of cavalry, you know. Um, and even at West Point where he went, they have massive stables. And matter of fact, Thayer Hall, which is one of the large academic buildings now, it was res it was renovated because it used to be a big giant open building where all the riding courses were taught inside it. And this is as recent as right before World War II. So, I mean, there were there were horse cavalrymen up to right up to World War, right up to World War II. The Polish Marines.

Matt Ryba 56:41

Cavalry fought in World War II on horseback. Yeah. And they still to this day do mounted patrols along the borders. I just saw something about a week ago about one of the Polish Army's uh mounted patrols.

Mark McGrath 56:52

Yeah, I mean, now they're more ceremonial, but a lot of the old bases, when you go to them, they had uh they have refurbished buildings that used to be stables and riding grounds. In fact, at West Point, they they keep the stables because the mules that are the mascot for for the football, you know, are there, but they call it Buffalo Soldier Field. And the Buffalo soldiers that fought with the 10th Cavalry in the in the what's called the Indian Wars, you know, that were the African American soldiers that Bob Marley sang about, they they became instructors at West Point. They became riding instructors. And that was like a big that was a big part of the curriculum was uh was horseback riding. So yeah, it's a lot of people.

Matt Ryba 57:29

Yeah, I wrote about, you know, Ulysses Grant, obviously probably one of the best horse soldiers in American history, and he had tons of horses, four of which he brought to the White House with him after he was president to live in the stables.

Mark McGrath 57:42

Well, doesn't it go back like you think of Alexander the Great, you think of Bucephalus's horse. Oh, yeah. I mean all the way back. A leader in this horse goes, you know.

Vietnam To GWOT: Moral Injury And Media

Matt Ryba 57:50

It's ancient Sumeria. It's literally thousands and thousands of years. The Greeks had the guide to chariot fighting, which was like I'm gonna misquote myself because I can't remember, but it was like the 1400s, 1300s, something like that. Like it's old.

Brian "Ponch" Rivera 58:04

So they just I'm wondering if we can I'm just wondering if we can go back and and we talk about John Boyd's Observe Orient Decide Act the loop quite a bit on here. So I want to go back to the horse and the disposition of the horse's oodaloop and some of the things you brought up. So genetically, they're predisposed to be very attuned to the external environment, right? That and that external environment can be a human. And you pointed out that 100 yards, they might be able to be know your heart rate. They can sense things, they can sense things. And the reason for that is because of their disposition as prey in the environment. They're not predators, right? So they have to have that extra sense. Whereas humans, we may not we have that capability, but we just kind of forget about it. And what you're doing here is you're bringing two different oodloops together, and and one of them is sensing signals from the human that that we don't normally pay attention to. And then what we're doing as humans is we're starting to get indicators from the horse's actions based off of our actions in the environment, the things that we're emitting out there. So this is fascinating. And Moose, I just want to bring this up. This is a fantastic way to illustrate what the OODA loop looks like between two animals, just two living systems.

Mark McGrath 59:09

It's it's almost like from the human end. I think of it the way you just described it. I think of like the the horse, the horse relationship reorients the person differently than someone that doesn't have it and thus influences your implicit guidance and control. Do you ever read what's that uh about Kwana Parker, the Empire of the Summer Moon, about the Comanche, the the Comanche Indians?

Matt Ryba 59:31

I'm familiar with it. I haven't read it myself, but I know what I think.

Mark McGrath 59:34

Yeah, I mean they were you know, other than the Mongols under, you know, they were probably the greatest horsemen that ever that ever took the battle, but there is like a symbiotic relationship, I think, at some point where it's almost like this, Punch. It's almost like the horse is uh I I don't I don't want to say people ideas things. The horse is a because you know a horse isn't a person, but a horse is like a thing that enhances your orientation. Like it broadens your orientation because you're interacting with a horse. It's against the medium, it's the medium is the message.

Brian "Ponch" Rivera 1:00:04

So one step further, control is outside and bottom up, right? Yeah. There you go. And that's what even with psychedelics, we can say that psychedelics are, you know, they they don't necessarily control you, but the control of the system is outside and bottom up. You're borrowing from the environment, ingesting it, and then it's got it's it to me, it's the same relationship. And this just for clarity, Matt, we're talking about Boyd identified early on that any living system is controlled by the external environment, right? So by introducing that that horse into that environment, you're inviting that reorientation, right? Moose. So this no, this is we'll be the right about this.

Mark McGrath 1:00:38

This is fascinating. And and the medium, and and the medium does become the message because it's changing, you know, even though a horse is not a piece of technology. But to your point, you said the horse, the horse is the environment or part of the environment that affects that affects the person. That affects how they see, shape, sense, decide, act, work, learn, everything.

Matt Ryba 1:00:58

So that's the nuts and bolts of the therapy, right? So like we have specific exercises that we design design to get the horse to do something. There's an objective, right? And you have to see ways that you can get the horse to do what you want it to do by communicating with it. You obviously can't talk, and it's funny because you'll see some people who fall back on their relationship.

Mark McGrath 1:01:19

Whoa, whoa, whoa, whoa, whoa, hold on, hold on. I I saw this show where there was a talking horse. And his name was Mr. Ed, and I I have seen this horse talk on the phone, surf. He could do all kinds of things. Are you telling me that's fiction? There's always an outlier.

Matt Ryba 1:01:34

Okay.

Mark McGrath 1:01:34

Okay. If it's not so if it's not if it's not Mr.

Matt Ryba 1:01:37

Edwards, if it's not Mr. Ed, you know, it's it's funny, you'll see people that are going through the exercises. So, for example, we have something we call the tarp exercise, which is where you have to lay out a tarp, you and your group have to get the horse to walk onto the tarp and stand on the tarp and stop there, right? But he's not on a lead rope anymore. He's at liberty. You have to be able to communicate with him to get him to do what you want to do. And you'll see people who are like, try different methods. Some, you know, you teach them how to direct a horse using your hands and move them a certain way. Some people will do that. You'll see people, you know, get down on their hands and knees and like try to show the horse what they want it to do to see if that registers. You'll see him like tapping, you know, over here, like they're communicating with their dog, come sit next to me, kind of a thing. And you and you're learning what works and what doesn't work, to your point. That kind of oodaloop of like observing something and then reorienting and then trying something else and over and over again to try to solve this problem. A simple task of getting the horse to move in the direction that you want it to, right? So it's like there's there's different grades of exercises, and each week when you meet, it builds off the last week of what you learn. So you're constantly kind of growing in that sense with the horse and building that relationship. And the veterans love it. And it really opens them up to like trying other therapies that they normally would not have been amenable to. We had like half of the people that went through the research protocol end up saying, you know what, I'm ready to go to the military center and talk to somebody about my issues now. That was not nearly as bad as I thought it was. It's it's a good, we thought, introductory step into healing yourself if it didn't work completely for you, where you kind of, you know, therapy light, because it doesn't feel like therapy. It feels like you're learning a new skill. It feels like you're working with an animal, it feels like you're creating a relationship and doing all these other things.

Mark McGrath 1:03:24

When does it like you know, maybe share an experience of where it doesn't work well for someone? Like because I can't imagine it's a hundred percent.

Matt Ryba 1:03:31

I mean, no. And like I said earlier, everybody's trauma is different, it's individual to them, and different therapies work for different people. There's no therapy that's on it.

Mark McGrath 1:03:39

Well, it's like it's like you've all you've all told us, and that was the title of the article today that I put out on the World Reorientation is that PTSD is not one size fits all. By the way, just a plug here for the work that you're doing, Matt, and Dr. Naria's doing, and we're doing on Substack. I I put that on LinkedIn. I have 6,000 followers. After over an hour, I only had like 57 looks at that, which is just if you put anything you know useful or life-saving on LinkedIn, it'll never it'll the algorithm won't catch it, which is disgusting.

Matt Ryba 1:04:13

Um that's another conversation we have to have on how psychological implications of all this stuff. Because I have a lot of so technology, as I mentioned, was my focus in in philosophy. I've got a lot of things that kind of overlap between the two.

Brian "Ponch" Rivera 1:04:26

But if you write a people to introduce to you. If you write an article about the five leadership lessons I learned from my horse, that'll get 10 times.

Mark McGrath 1:04:34

Well, and you'll get a hundred thousand views if you talk about like how leaders clean up horse manure in the stables and what it taught me, you know, like something like that, which is you know, garbage, but anyway. Offline I'll share with you pontry members that remember that parody LinkedIn ad I made with the the horse and the anyway. We'll show you that later, Matt. Maybe our founding strategists in our in our in our private uh our private chat will show them that. But this is this has been great. I mean, we um let me just add one more thing, too, about the yeah.

Alcohol, Culture, And Coping

Matt Ryba 1:05:05

So so it doesn't work for everybody, but one interesting statistic that we did learn from doing this is we had the lowest dropout rate for anything that I've ever seen in the field of trauma therapy with veterans. The total amount, so we had 71 people that signed up for the study in total 8.4%. We only had six people that dropped out of the study over the course of the several years that we did it. Now, just to give you an idea, the national average of veteran patients who like start a therapy modality and then drop out before completion is somewhere between 36 and 68%. There's a huge variance there because it depends on what kind of therapy it is. But let's call the mean average 42. So 42% of veterans who start a therapy, whether it's psychedelics or talk therapy or prolonged exposure or cognitive therapy or animal therapy, whatever, 42% will drop out. Now, if you compare that to the general population, it's roughly 24%. That was a meta-analysis that was done across a bunch of different studies. So the general pop is like half the military rate is doubled for dropping out of therapy of the general population, right? We just don't know.

Mark McGrath 1:06:14

So what role so this is so when I hear that I I mean because it obviously it's complex. It's not it's not complicated, it's very complex. I mean, I I I what role say like I immediately go to alcohol, um, not being successfully mitigated, and the other one I go to is that SSRIs that people they get they get trapped and hooked on those.

Matt Ryba 1:06:36

I think those can be two factors. I think it could be just the nature of the complex trauma could be a factor as well, right? If you're deployed for nine months and getting shot at every day, it is very different from being in a cart wreck. So when you have gen pop, that was and I misspoke, I'm sorry, it's 20 percent for general population that um don't complete.

Mark McGrath 1:06:54

Um when you have more Do you find so back just really quick to SSRIs, do you find that the equine therapy reduces the need for those?

Matt Ryba 1:07:03

Or or I don't think we're at a point in the research yet where we can say yes or no. We didn't as long as they were stable on meds, they were allowed to be on meds in the study. So you have you know a period of time where you have to be taking it and become stable. I can't remember exactly. Exactly what it was in the protocol. I think probably like two months is usually standard, six weeks, two months, somewhere around there. They could also be in concurrent therapy. We didn't want them to change anything. But we did have people who were in concurrent therapy whose therapists were all of a sudden like, wow, this person's making leaps and bounds all of a sudden when they weren't before after the going through the equine therapy. So we don't know if equine therapy alone is going to be enough, but as a concurrent therapy in conjunction with something else, it could work fantastic. And these are, you know, we need to do a larger random control trial to really figure out these questions.

Mark McGrath 1:08:02

I mean, I guess for uh I would I guess we would call it Aquine Therapy. I've heard of uh restful waters, they do or healing waters. They do uh fly fishing. You know, they teach veterans how to fly fish. And I think I think they all kind of align though to what you're saying is like there's some kind of like like Pancho's saying, like their orientation is realign something that becomes like a symbiotic relationship with something natural and non-judgmental. Maybe there's less there's there's there's more incentive to be yourself and let go a little bit.

Matt Ryba 1:08:37

I mean, not for nothing, but if you want to get really philosophical on it and in the evolutionary theory, like we're the only species that tailors our environment to us. Every other species just adapts to their environment, right? So like we're meant as humans to be living in caves and eating berries. And instead, we're getting bombarded with TikToks and all this nonsense on the news.

Brian "Ponch" Rivera 1:08:57

Crazy talk. You know? So No, I thought I thought we were supposed to be chained work desk looking down at our iPhones.

Mark McGrath 1:09:04

This is the most amazing time ever. What are you talking about?

Matt Ryba 1:09:07

There's some there's some benefits for sure, but I don't think all of it's good, you know. And uh I think all that takes a toll in the in the obvious human psyche, and having to deal with just living in the world today as a human being is tough as compared to what it was, you know.

Mark McGrath 1:09:22

It is funny though, we we were out west last week in in Idaho and Montana and Utah, and you when everything just opens up and you see mountains and there's very few people and there's woods and there's snowy woods, and you're walking around in the snow and whatever, there's a completely different feeling. It does almost realign you to what you may have been naturally or you know, like we were talking about Hawaii earlier. You go to like you go to some of those waterfalls and you go on some of those trails and you're just like, wow, something is really missing, or something somewhere, or something got distorted. Let me ask you this. So, because you mentioned that, what effect does that have on trauma? You know, the fact that we don't adapt to our environment, we force the environment to be like us. What what role does that have on trauma?

Matt Ryba 1:10:05

I don't know if I have an answer for that. I think humans are very tricky, you know? Yeah. And again, it's that one size fits all thing, right? Like for some people it can be very beneficial. For some people, it can be disastrous. And it's dependent on how you're able to adapt.

Mark McGrath 1:10:22

It really is like what role does we we kind of talked on this with Dr. Naria, you know. You know, my partner, she's she observed me with Marines. You know, my uh brothers from my unit, and she's like, it's amazing to me how when I see you guys interact, you're closer than family. So like that bond, we we we we talked, like I said, we talked about a little bit with Dr. Naria, like that bond, that shared picture, that shared trust in each other, that shared um you know, willing to sacrifice for each other. I don't know what I don't know what the technical word for that is. You know, I I would think that it's it is one of those things that's very unique to the military that people don't realize that's what we we miss the most. I mean, you know, shooting cannons and blowing things up is really cool, but really what you what you miss when people ask me, what do you miss the most? It's the Marines.

Matt Ryba 1:11:18

Yeah, it's the camaraderie. There's a dependence on each other that kind of goes beyond any other kind of relationship. I think just because of the situations that you're put in and and how you need to have complete and total trust in the guys to your left and your right. And I think that is a huge factor. Because we know when veterans leave service, that first year is is the most hardest time, right? Like you either catch them when they're leaving all those structured environments and the people that they trust in the and the community that they're with and get them into something successful, or that's where like the shit hits the pan and things just go south. Um and I think because, you know, what's interesting is we found with the with the groups with the equine therapy, it didn't matter if it was mixed genders, it didn't matter if it was mixed service, didn't matter if it was mixed traumas. But the fact that it was all veterans that were together supporting each other was enough where it had that like shared experience understanding that like, okay, I can foster a relationship with this person because they at least know where I'm coming from. I think we also have seen it with a lot of the work that we've done at the the military center as well. Part of the reason why they have me doing the outreach and on staff is because I can talk to other veterans with my background and say, listen, I understand. You know, this is my story. And veterans, much like their hesitants, of maybe not just the government, but also of these large medical, you know, whatever. Like I know the people I can trust, I know the people I'm not sure I can trust, and I'm not gonna just go tell some doctor all my defective secrets about the worst things that ever happened to me because they say I should, but I'll talk to my buddies about it because they understand it and they know where I'm coming from. So there's like an interesting, you know, we've always tried to have veterans or people with veteran experience on staff clinically to be able to work out those kind of issues and kind of foster that relationship and being like, I understand where you're coming from. Maybe that's a cue to be able to help us get you better. I'll add that the 24% statistic that was locked in my brain, that was our own center. That was the Military Family Wellness Center at Columbia Presbyterian. So we have the dropout rate of 24%, whereas the general population is 20%, and nationally all the other veteran programs are 42%. So there's something in fostering that veteran relationship and letting the veteran make decisions and not telling them what to do, giving them the information, the clinical information. So you have a menu of options. What do you think will work for you? You know, that kind of a thing. Maybe it is horse therapy, maybe it's talk therapy.

Drone Warfare And Homefront Switch

Mark McGrath 1:13:57

Well, bring bring us home to a close with this, Matt. I mean, it seems that whether it's psychedelics or other things, I I I feel confident and better about where we are now than I did maybe say 20 years ago, where it seems that people are getting not only more help, but also more awareness of alternatives that are out there other than pills, you know, other than other than suicide. You know, there's there's there's there's outlets and there's things that you can do. Um it seems like it's overall it's it's made but dramatic improvements, yet at the same time, we still have a lot of we have a lot a long way to go, but I'm confident and encouraged. Man of War Project is certainly something that that that gives me a lot of, you know, we don't ever want to say we're Marines, right? We don't say hope is a strategy, but it does give me a lot of a really good feeling to see it.

Matt Ryba 1:14:43

You just said it yourself. It's we have to keep questioning and we have to keep moving forward and trying new things because we know what we have works a little bit, but it doesn't work all the way. And it's that constant, you know, find the right thing that fits for you. It's why the work that we're doing with the equines is so important, it's why the psychedelic work is so important. And I think we are getting in a place where people are just the average person is more educated now because of the information access that they have than ever before. They can investigate their own things, they can research their own things, and they have more options that are out there. And ultimately, I think that's what's going to get everybody.

Mark McGrath 1:15:18

So so for all the vets out there that are listening or or law enforcement or assault victims or whatever, whatever you may be that are suffering from trauma, that are listening to this episode, or if you know somebody, you hope that people will share it with with others. But for those that are listening and resonate with any of the things that you've talked about, where should they go? Send them where they need to go.

Matt Ryba 1:15:39

Uh we have a website that's mowproject.org that you can go to and check out some information on the Man of War Project. There is a contact sheet there. Eventually that will get back to me if you fill that out and I'll be talking to you. Also, look up the PTSD research and treatment team at Columbia University for any other options that we might have. Excellent.

Mark McGrath 1:16:00

All right. We will say uh thank you in uh Semper Fidelis Matt Rebuff for the Man of War Project that you do with our previous guest, Dr. Yuval Maria. We're really uh looking forward to having you back on the show at some point. Absolutely. And hopefully, maybe who knows? Maybe we'll do a live cast, come down and witness uh down the deck veterans getting the help that they need with uh with that quant there. Thank you. Thanks for uh thanks for joining us on No Way Out. Absolutely.