One-on-One with Dr. David Scheinfeld

My research and practice focuses on the use of therapeutic adventure with military veterans and active duty personnel from the Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn conflicts. As a therapist at the Central Texas Veterans Health Care System, I have gained specialized training in the use of evidence-based therapies to treat a wide range of mental health challenges that veterans face. As an Outward Bound instructor for over ten years, I understand the intricacies of developing customized therapeutic adventure-based curriculum to meet the needs of unique populations (veterans, those encountering grief/loss, youth/adolescents, high-risk youth/adolescents, and college-aged populations). As Director of Research, I implement large-scale, experimental-designed quantitative and qualitative research studies to examine outcomes and inform program development related to therapeutic adventure programming for veterans and active duty personnel.

Through these professional roles, I have developed specialized skills in the following areas: 1.) Implementation of evidence-based or traditional psychotherapeutic interventions to support veterans, active duty personnel and populations impacted by physical or sexual trauma to work through their recovery process, 2.) Implementation of outcomes-based research for experimental- or qualitative-designed studies, 3.) Program/curriculum development or facilitation using therapeutic adventure with the above-mentioned populations.

1.How do you think the R2R rides reduce stress in returning veterans?

Having an adrenaline outlet is very important. Oftentimes when you’re in a military/high-stress environment for long enough, you develop new neural pathways that tell your brain, “Hey, make sure you’re producing adrenaline so you’re staying at a high level of alertness, so you have the perception of safety and achievement within the role you’re in.” For many returning veterans, it’s important for them to have physical outlets, so training for rides and the actual ride itself is a great physical outlet to reduce that adrenaline. If you don’t provide yourself an outlet for that, the adrenaline can take over in the form of increased stress within your body, or anxiety, or feeling overwhelmed.

The second consideration would be that when you’re riding as a group for four to six days, you get close with one another and build camaraderie. The psychologist, Dr. Yalom, refers to it as the sense of “universality”; he suggested that when you begin to hear people similar to you talk about similar struggles it can be very normalizing. You realize that your issues are not unique to you, that it’s not your fault you have these issues, and that many others share in your experiences. That sense of universality can reduce negative thinking patterns about self, which in turn helps reduce anxiety and stress.

Also having a sense of purpose and goal-driven activities is very important to help reduce the mind wandering and being frantic — wondering “What am I doing with my life,” and so on. Having a goal-driven activity like cycling helps set a purpose and motivation in one’s life and this sense of accomplishment can help increase self-esteem.

2.What is the relationship you’ve seen specific to R2R challenges and a decrease in prescription drug use in returning veterans?

We’re looking at that data right now. In a lot of ways it’s about self-confidence and motivation. When you go on R2R, you’re faced with a big challenge of preparing for the ride, and then actually doing the ride. When you get that sense of accomplishment — not about how fast or even if you make it through the whole ride — but if you feel some level of success, it increases self-esteem, motivation and self-confidence. A critical core experience during the rides is to see a challenge, gain the skillset to address the challenge and then hopefully overcome it. The same thing can be applied to medication. They come back [from the ride] and are feeling a lot better, which I would hypothesize would serve as a motivator to reduce medication. In other words, if they have greater self-confidence to address challenges in their life, then they have a greater likelihood of not just solely relying on medication to address their physical or mental health challenges. However, they may be more open-minded and confident to reach out to gain new skillsets and coping strategies to manage their issues beyond just medication.

3.How big a problem is addiction and/or overuse of prescription drugs to our veterans?

It’s a big problem, particularly with pain medication. Pain can really interfere with life functioning to a large degree. So when that interference happens, an individual usually wants to get rid of the pain as quickly as possible. For many, pain medication will do that quickly. The problem with relying on pain medication is that for many it ends up just being a Band-Aid; in the short term it may seem helpful, but in the long term you are not addressing the root cause of the pain. It’s very important to do physical rehabilitation and use natural modalities to manage pain. The easy route is to just take meds. Not to say that veterans like to take the easy route, but when someone is dealing with a lot of tough stuff in life, be it school, work, family, what direction to go in in life, etc., you’d rather take a pill than do something that’s going to take a lot of time and work and may cause a greater feeling of pain on the front-end. But most every veteran I have known with pain issues that worked hard to learn how to work past that front-end pain, learned how to manage the pain for the long term without medication. They and their families are much more content, because it feels great when you can develop self-reliant skills to manage issues rather than relying on something external, like a pill. 

In terms of mood medication for anxiety, depression, sleep issues, etc. my perspective is that it should be used as a stepping stone to gain skills through therapies to manage the issues. I wouldn’t recommend having a goal of staying on the drugs long-term. Use the meds as an opportunity to regain focus, gain skills, then use those skills to manage. There are certain psychological disorders that are going to require medication for the long term, which is perfectly fine, but I would caution those in need to first work on skillsets that can help manage the symptoms rather than purely relying on medications.

4.What are some of the things you’ve heard from participants in the R2R challenges?

The following are qualitative responses we heard from participants at a recent ride:

“The challenge opened my eyes to my own strengths and weaknesses. Every day was a new day and a different experience. I am happy that I had the chance to meet amazing people just like me. I was able to come out of my comfort zone.”

“It showed me how to overcome obstacles, pitch in and help more in assisting others ... I’m not as close to death as I thought I was.”

“Watching my fellow riders work through their weaknesses, it motivated me to know I can work through my issues in life.”

“This challenge provided me an opportunity to connect with my brothers and sisters who had the issues that I am going through. The Ride 2 Recovery has provided me with a relaxed atmosphere and cleared my mind.”

5.You’ve been involved with outdoor adventure therapy for our returning vets. What is it about R2R cycling, specifically, that seems to have such a positive impact?

R2R does a great job of managing any veteran’s physical limitations and getting them out there to ride. They had a quad amputee riding a bicycle. They made the bicycle, and how cool is that? They accommodate all veterans’ needs. It’s hard to accommodate at that level with many other adventure-based experiences [for veterans] — where you can be that flexible with someone’s physical limitations. That’s a huge asset bicycling has. It’s also nice to be able to have flexibility in terms of how you ride — whether covering short distances and going slowly, or at a faster pace. R2R does an amazing job of accommodating everyone’s speed and ability. They group people accordingly, which reduces the level of frustration, yet still allows for camaraderie. The cycling skills you gain are also very applicable to life after the R2R event. You can keep cycling on your own without relying on other groups or equipment.

Project Hero Magazine will be providing more interviews and stories from Ride 2 Recovery participating veterans throughout the coming months. Please check back soon for the next installment, and thank you for your support.

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