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Virtual reality
program designed to help veterans
(May
2008 Issue)
By Catherine Robertson Souter
There are times when something you see, hear or especially smell,
can bring you, in an instant, to a place or a time from your past.
With luck, these unbidden memories are pleasant - the smell of mud
a reminder of the first baseball practices of spring when you were
10, the sound of a Bee Gees song taking you back to a high school
prom, the sight of a child with a puppy a reminder of your own son
when he was young.
In other cases, memories can bring you back to something you never
want to revisit - the terror of abuse or a fear of being lost or
injured. For soldiers returning from Iraq and Afghanistan, these
are the types of memories that can be debilitating and result in
the most troubling symptoms of posttraumatic stress disorder (PTSD):
depression, anxiety, loss of sleep and appetite, irritability, difficulty
concentrating.
Hartford Hospital's Institute of Living has begun recruiting test
subjects for a novel approach to the treatment of PTSD for returning
solders. Using graphics from a popular video game, researchers created
a virtual reality program designed to immerse patients in the Iraq/Afghanistan
experience. This immersion therapy, a common treatment modality
for anxiety disorders, is expected to desensitize PTSD sufferers
and lower symptoms.
The hospital is one of 10 sites now running studies of the software
across the country including several Veterans Administration hospitals
as well as military sites Walter Reed Medical Center, the Madigan
Army Medical Center in Tacoma, Washington and the Naval Medical
Center in San Diego.
"Early intervention is key," said the Office of Naval Research
program manager Cmdr. Russell Shilling in a release. "Virtual reality
therapy has proven effective in treating a wide variety of anxiety
disorders and we hope that it will be effective against acute PTSD
related to combat."
In a darkened room, alone except for the therapist seated at a
computer station, the patient sits or stands on a rubber floor mat,
wearing a pair of goggles and headphones and holding a game controller.
The program envelopes him in the sights and sounds of the Middle
East along with the aromas common to the region - spices or diesel
fuel - and a vibration similar to that of a motorized truck. In
one scenario, the viewer will see a typical desert scene as if riding
inside a Humvee. The other option is a Middle Eastern city and marketplace.
Through use of the game controller, the patient can move himself
within the scene, turning to the side, moving forward or back or
even stepping into a building.
Meanwhile, the therapist, seeing the same scenario on a video screen
simultaneously, actively influences the events that the patient
experiences, all depending on his reaction to the stimuli.
"The therapist has control over things happening within the scene,"
says Christina Gilliam, Ph.D., a post-doctoral fellow at the Institute
of Living. "Bombs going off, insurgents approaching, etc. We ask
the patient if the trauma occurred during the day or night or even
during a sandstorm and we can do all of those things. This is the
closest to actually being there."
The patient is monitored for heart rate, perspiration, skin temperature
and asked to provide feedback during the treatment.
Created by a software company, Virtually Better, along with the
University of Southern California and the US Army Training and Doctrine
Command Simulation Technology Center, the program offers the patient
a chance to relive a traumatic experience in a safe environment.
Based on the X-Box game, "Full Spectrum Warrior," the program was
developed with input from experts in the Army's infantry school,
Gilliam explains.
Because of intense stigma against mental health care within the
military, this population does not lend itself to seeking out standard
therapy. The researchers hope this type of treatment will be able
to circumvent those concerns.
"We hope that this type of therapy, with its videogame-like qualities,
will resonate well with the current generation of war fighters,"
says Shilling.
"One recent survey said that the rates of mental illness are higher
within the military but that a lot of vets reported that they are
less likely to go for treatment because of the stigma associated,"
says Gilliam. "We are talking about a group of men and women who
grew up with video technology. Maybe this will be seen less as recognizable
psychiatric treatment."
The Institute of Living is beginning a recruitment of male test
subjects and plans to deliver nine to 12 weeks of treatment over
the course of the next two years. So far, they have had several
inquiries and interviews. It is the type of program for which typical
advertising doesn't apply.
"We have been told that the way to get people in here is through
word of mouth," says Gilliam. "Once you get one or two people in
and they have a good experience, you won't have a problem with
recruitment."
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