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Virtual Reality and the Treatment of Post Traumatic Stress

Posted Dec 12 2008 6:45pm

A GoodTherapy.org News Update

Therapists first began the use of virtual reality in the treatment of stress 20 years after the Vietnam War ended. In 1997, researchers in Atlanta created Virtual Vietnam, a program that produced the sights and sounds of war: Huey helicopters with whirring motors, rice paddies, jungle clearings. The idea was to use exposure to the traumatic events to help relieve veterans of the effects of Posttraumatic Stress.

Exposure methods to treat trauma were first used by Edna Foa in the treatment of rape victims. The idea, in using “prolonged exposure”, is to disconnect the patient’s memory from his or her reactions to the memory. Studies have shown that after prolonged exposure, the memory remains but the “cues” that trigger trauma response–sounds of gunshot or a car backfiring, say–are reduced to insignificance. “The trauma thus becomes a discrete event, not a constant, self-replicating, encompassing condition,” reports Sue Halpern, in a recent New Yorker article on Virtual Iraq.

Virtual Iraq was invented by Albert Rizzo, a clinical psychologist at the University of Southern California. Rizzo began with two basic scenarios, a market street scene, and a Humvee traveling along an Iraqui highway where all the signs are in Arabic. As he continued work on the program it became more sophisticated. The therapist can manipulate Virtual Iraq in a variety of ways, visual, aural, tactile, olfactory. Only a click of the mouse and the patient is in the driver’s seat; or he is in the passenger seat, or in the turret behind the machine gun.

A very young infantryman, Travis Boyd, described to Sue Halpern his experience with Virtual Iraq. He was telling the therapist about a firefight he’d been in. “I’m talking about the firefight and she turns on this vibrating thing so you feel like you’re in a shaking building.” Bit by bit (and timing, according to one therapist who uses virtual reality, is all) Boyd’s therapist added effects. “Each time she added something, like an I.E. D. Going off, or a plane flying over, I’d become more emotional. We’d do it over and over, and it would become easier, and then she’d add something more and the same thing would happen.

Virtual Iraq is beyond video, Boyd explains. “When it’s only visual it’s not really real–it’s just a video game–but when the ground starts vibrating and you smell smoke and hear the AK-47 firing, it becomes very real. I’d be shaking.”

Karen Perlman, a civilian psychologist who uses Virtual Iraq with patients at the Naval Medical Center San Diego, had worked as a clinician for twenty years before trying prolonged exposure therapy with patients. Its power surprised her. (She spent 4 days being trained in the use of prolonged exposure technique at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania.) “I’ve seen patients recover in five or six weeks,” Perlman says.

The first thing Travis Boyd noticed, after a few weeks of treatment with Virtual Iraq, was that he could sleep without medication. Toward the end, he was able to talk about his wartime experiences without breaking down. He said, “I felt like the weight of the world had been lifted from me.”

By Colette Dowling, LMSW. Click here to contact Colette and/or see her GoodTherapy.org Profile

This entry was posted on Saturday, May 24th, 2008 at 8:59 pm and is filed under News Items. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

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