Virtual reality treatment speeds recovery from PTSD

Published March 4, 2009
By Maj. Vanessa Hillman
60th Air Mobility Wing Public Affairs

TRAVIS AIR FORCE BASE, Calif. -- The Air Force has recently introduced new virtual reality-based software to help Operation Iraqi Freedom and Operation Enduring Freedom veterans combat post traumatic stress disorder.

The software, introduced to eight bases in the Air Force, is designed to create a safe environment for redeployers with PTSD to recreate a traumatic situation they have experienced.

"Post Traumatic Stress Disorder is an anxiety disorder in which the individual has extreme difficulty adjusting to a traumatic event," said Dr. (Capt.) Joel Foster, 60th Medical Operation Squadron psychologist. "An event is traumatic if it causes extreme terror and fear of dying. Redeployers with PTSD have nightmares or flashbacks of the trauma, feel emotionally detached, avoid anything resembling the trauma, and are constantly on edge, distrustful, vigilant and hypervigilent to real or imagined danger."

"This new VR technology compliments the evidence-based treatment we are using to treat redeployed members, called 'Prolonged Exposure Therapy' and other research proven approaches to help our deployers successfully integrate their deployment experiences into their concept of themselves, the world, right and wrong and other challenges that face today's warriors," said Dr. (Col.) Frank Budd, 60th Medical Operation Squadron, Mental Health flight commander.

"Most specifically, we have a generation very familiar with 'computer gaming,' so a computer simulation treatment methodology makes perfect sense to them. The Virtual Reality treatment for PTSD also helps redeployers deal with their deployment in a way they control, with a focus on their experiences that allows them to bypass the anxiety that sometimes comes from having to do strictly face-to-face talking therapy."

"However, it is important to underscore that VR is a useful clinical "tool" not an independent therapy itself. It is used in addition to therapy to facilitate exposure-based interventions for PTSD," added Dr. Foster.

The virtual reality software is a human-computer interaction tool meant to more realistically recreate a traumatic scene. The redeployer uses a head-mounted display, similar to a pair of sunglasses, which has separate screens for each eye and a head tracking device.

The display is then connected to a computer graphics workstation that introduces sights and sounds designed to make them feel like they are in a situation such as on patrol in the city, or driving a Humvee. There is even a vibrating platform and a mock M16 instead of a typical game controller to more successfully engage the redeployer in the experience and speed their recovery.

During the session, the redeployer describes the trauma they experienced in detail to the therapist. They verbally recall everything they can to the therapist in the present tense. They recall features such as sights, sounds, smells, thoughts and feelings, according to Dr. Foster.

The therapist then recreates the scene for the member to experience. During the session, the therapist has the redeployer rate their overall distress at several points of the program. The redeployer will go through the same scenario several times until they are able to process the memory and view the experience differently, basically coming to terms and peace with the experience.

"It is ideal for redeployers who find it difficult to engage in visual imagery, who have patchy or clouded memories, who may have blacked-out during their trauma experience, or who are unable or unwilling to experience the full range of anxiety and distress they felt when traumatized," said Dr. Foster. "The beauty and effectiveness of VR treatment is that the redeployer can control their amount of exposure guided by the support and coaching of the therapist."

Doctor Foster explained that exposure therapy is like helping a child who is afraid of dogs because a dog once jumped up and scared them. He said after that event, the child becomes fearful of all dogs and escapes the situation by running away or avoiding them altogether. Because he is fearful, seeing the dog heightens the anxiety and then the escape reinforces the fear, according to the doctor. He said what was initially a way of coping, avoidance, soon dominates the individual's life impairing their relationships, work and emotional stability.

"Over repeated sessions, their arousal response is less intense, more controlled, and they feel less overwhelmed by memories that previously bombarded them and consumed their life," he said.

"PTSD, along with Acute Stress Disorder and Combat Stress, generally, in my opinion, are more prevalent now because more of our deployers are directly in harms way -- facing mortars, improvised explosive devises and direct fire," said Dr. Budd. "Research has consistently shown that it is exposure to combat that causes the most stress and is directly correlated to the development of PTSD. Additionally, OIF/OEF deployers are seeing the effects of this combat up close and personal. They are witnessing death, horrific loss of limbs, and in the OEF theater we see this impact on families, especially children."

But with the help of this new Virtual Reality software, members affected by PTSD have a new way of dealing with overcoming their experiences.

"Most importantly, this software can help the Air Force/Army and all returning warriors deal with the stress or trauma of their deployment quickly so that we do not have the problem with ongoing PTSD we still see in Vietnam-era veterans," said Dr. Budd.

"Proven-effective treatment is available today, and we want to be in partnership with warriors to help them heal and be able to press on with their lives in a healthy way."

Travis PTSD