The signature wounds of the Iraq War are traumatic brain injury and post traumatic stress disorder (PSTD). Due to an emergent need to address the symptoms of these wounds in returning Marines and navy corpsmen, a memorandum of understanding between the U.S. Marine Corps and East Carolina University's Psychophysiology Lab and Biofeedback Clinic was signed and training services were begun in February 2008. The Training for Optimal Performance program involves a biofeedback circuit-training method in which marines and navy corpsmen participate in a graded exposure protocol that includes virtual reality, cognitive retraining, neurofeedback, heart rate variability, and relationship and resiliency training. Preliminary results indicate that this approach is effective in ameliorating symptoms of traumatic brain injury and PTSD.

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