Virtual Iraq used to treat post-war trauma in US vets

Continuing yesterday’s virtual reality theme, The New Yorker has an in-depth article about how US Iraq veterans diagnosed with post-traumatic stress disorder are being treated in a VR simulation of battle situations.

The VR simulation is actually a modified version of Full Spectrum Warrior, a military tactics video game that was first developed to train US army soldiers before being released as a commercial product.

PTSD is an anxiety disorder that can be diagnosed if a person has experienced a potentially life threatening experience, and has intrusive traumatic memories, persistently increased arousal, and avoids reminders of the event.

Helping someone re-visit aspects of the original experience is an important part of the psychological therapy. This is relatively easy for someone who was traumatised in a traffic accident, but is considerably more difficult for a soldier who was traumatised in a distant and still-active war zone.

Virtual reality aims to safely simulate the environment and features of combat. The idea is that the intensity can be controlled by the therapist to manage exposure and to make sure the patient is never challenged with more anxiety than they can manage.

“This shows you why you need a trained therapist,” Rizzo said, turning off the machine and watching Aristone, who was bent over, with his hands on his knees, taking deep breaths. “Someone who knows exposure therapy, who knows how little things can set people off. You have to understand the patient. You have to know which stimuli to select. You’d never do what I just did—you’d never flood them. You have to know when to ramp up the challenges. Someone comes in and all they can do is sit in the Humvee, maybe with the sound of wind, and may have to spend a session or two just in that position. For P.T.S.D., it’s really intuitive. We provide a lot of options and put them into the hands of the clinician.”

One of these is Karen Perlman, a civilian psychologist who uses Virtual Iraq with patients at the Naval Medical Center San Diego. Perlman is an apple-cheeked, middle-aged native Californian with cascading brown hair, who, when I met her, was wearing an elegant short black dress with a pink-blue-and-purple tie-dyed silk scarf. At first glance, Perlman does not seem to be the sort of person a young marine would cotton to, but Rizzo says that she has a gift, and so far eight of the nine patients she has treated no longer meet the criteria for P.T.S.D. (This number does not account for those who dropped out.) “It’s a very collaborative relationship,” she told me in February, when Skip Rizzo and I drove down to San Diego. “I know which stimuli I’m going to add as the therapy progresses. I’m not going to overwhelm them. There are no surprises. I say, ‘I think you’re ready for the I.E.D. blast or for more airplanes.’ I’m not only adding more, but increasing the duration of each one. It’s intensive, but for P.T.S.D. you need a treatment that is intensive.”

The team have published some published some initial studies from the treatment which looks promising.

The project joins a growing number of studies that have found VR a promising method for treating trauma.

Link to New Yorker article ‘Virtual Iraq’.

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