Virtual Reality Brings Therapy to PTSD Patients

Imagine a virtual world where U.S. soldiers can walk the roads of Iraq with a standard issued M-4 in hand, feel the shockwave from an Improvised Explosive Device (IED) blast, experience the feeling of being ambushed by Iraqi forces and then smell the scent of gunpowder from fired weapons after the battle is finished.
 
Dr. Greg Reger, a clinical psychologist at the Telehealth and Technology Center of the Defense Center of Excellence, is utilizing such a world.
 
Created by developers at the Institute of Creative Technology at the University of Southern California, Reger does not use this virtual world to train soldiers for deployment, but rather to help them after coming home. While some service members are able to easily transition from war to life back home, others may have a more difficult time as a result of post-traumatic stress disorder (PTSD).  PTSD, an anxiety disorder, can develop after traumatic or life threatening events and cause those affected to be irritable, numb, or re-experience the stressful events through nightmares or flashbacks.   
 
“The standard-of-care treatment for PTSD is exposure therapy,” said Reger. “Traditionally, this is done by asking people to call [the traumatic experience] to mind, see themselves there again and tell their therapist exactly what they experienced.” By repeatedly imagining and talking about their experiences, patients will generally feel less anxiety.     
 
But, Reger noted, not all patients can respond to this type of traditional talk therapy. 
 
“Soldiers are very good at emotionally distancing themselves from difficult stuff – it’s adaptive, it’s part of the job. And yet, when they come into therapy, it can actually get in the way of the clinical outcome,” Reger said, adding that many of the patients who come in for this kind of treatment tell their story in a disengaged manner, as if it had happened to someone else. By being detached from the memory, patients have a harder time confronting the trauma and their PTSD becomes difficult to treat.
 
“For those individuals, we believe that the multi-sensory nature of virtual reality, with its sights, sounds, smells and vibrations, can help activate that memory which is necessary for them to really confront it,” he said.
 
But “Virtual Iraq” doesn’t just provide a standard battle scene for soldiers to experience; it allows each soldier to re-enact their specific traumatic event. Reger can adjust variables in the virtual environment like the soldier’s position, time of day, weather and the intensity of battle, in order to match each simulation as closely as possible to the soldier’s experience in theater.
 
Along with visually reconstructing the landscape in the virtual world, Reger uses some other innovative tools to re-create the experience. A scent machine can create smells like gunpowder, diesel fuel, sweat and garbage, and patients are able to feel the rumble of a Humvee or the rock from a nearby explosion. Reger placed a lot of importance on using these supplementary cues in the simulation, saying that a familiar odor or feeling can help to bring a patient back to the scene of a traumatic event.
 
To Reger, the most exciting feature about this project isn’t the graphics or the powerful subwoofers that explode with gunfire, or even the smell of sweat filling the room. Instead, Reger is most excited about the virtual world’s potential to overcome the stigma surrounding mental health treatment.
 
Reger explained that while many service members don’t like the idea of traditional talk therapy, virtual reality therapy may appeal more to young, technologically savvy service members. His team at Madigan polled 352 service members after they came home from deployment and more than half said they would be willing to use this kind of therapy.
 
“We think that soldiers, airmen and marines who may be having difficulties but look at traditional talk therapy and say, ‘I don’t want to sit down with a doctor and talk about my feelings,’ might look at an approach like this and say, ‘you know, that sounds interesting, let me check that out,’” said Reger.

To find more deployment news and resources, visit The Deployment Center.