30 June 2009

Virtual Iraq: Confronting combat stress with high-tech exposure therapy

While Virtual Iraq may look cartoonish, therapists said that in previous virtual reality therapies used to treat other forms of PTSD, patients projected their own memories into the environment. One Vietnam veteran reported seeing tanks and people that were not part of the program. Courtesy of the University of Southern California’s Institute of Creative Technologies.

An insurgent in Virtual Iraq, a simulated warzone designed to help troops suffering from post-traumatic stress disorder confront and overcome the incidents that scarred them. Courtesy of the University of Southern California’s Institute of Creative Technologies.

Exposure therapy is nothing new. Let's say you have a fear of spiders. During an exposure therapy, you are gradually exposed to spiders in a non-threatening environment. The goal is to develop new associations with the object of your fear, which replace your former fear-based reactions and experiences with a more rational view.

This program goes a step further. The Air Force, Navy and Army, in conjunction with the University of Southern California and Virtually Better Inc. have created a virtual world in which service members can actually relive traumatic experiences and confront the related memories in a safe environment.

With Virtual Iraq, a troop is back driving a Humvee down an Iraqi highway, or exploring a city on foot patrols, [Dr. Beth Davis, a deployment behavioral health psychologist at Andrews Air Force Base] said. Ambient sound recordings including prayer calls, gunfire, men yelling and taunting, can be varied in intensity by the therapist.

The smell of fire, diesel, cordite, body odor and burning rubber are also used to facilitate memory recall and emotional processing, Davis said.

"It allows the therapist to manipulate the situations to best suit the individual in a standard therapy hour," she said. "We can re-create this scenario in an environment that is safe."

A local child waves to the convoy in Virtual Iraq. Courtesy of the University of Southern California’s Institute of Creative Technologies.

"Once their fear has decreased enough that they can really look at the situation and what happened and what they did, more than likely they will come to think about it differently, and realize, for example, it wasn’t their fault, or there was nothing they could have done differently, or they did the best they could under the circumstances," says Dr. Barbara Rothbaum. Rothbaum is a psychologist and director of Atlanta’s Emory University’s Trauma and Anxiety Recovery Program, a pioneer of virtual reality therapy, and a co-founder of Virtually Better, Inc.

An airman tries out the Virtual Iraq program at a Virtually Better training site. Courtesy of Virtually Better Inc.

There are currently about 40 Virtual Iraq systems in Defense Department and Veterans Affairs hospitals and clinics. The Air Force has eight Virtual Iraq systems at base clinics in the US and is setting up another at Ramstein Air Base in Germany this fall. Some of the Air Force-run clinics' scenarios are specialized for Airmens' deployment experiences, but since about a third of the patients are Army other scenarios are available. A Virtual Afghanistan is also in the works.

Post-traumatic stress disorder is among the most common diagnoses made by the Veterans Health Administration. Many service members are reluctant admit they are having problems and to seek treatment. The wide and ready availability of this technology to both veterans and active duty troops is an important development in the treatment of non-physical combat injuries.

See the whole article at Stars & Stripes.

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