Virtual Reality and the Treatment of Post Traumatic Stress
May 24th, 2008 |
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
©Copyright 2008 by GoodTherapy.org All Rights Reserved. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry.
14 comments so far
This seems to be to be a horrible treatment method! I understand hw prolonged exposure to something could desensitze you but it seems that if you have personally experienced a traumatic event that something like this could bring it all back. This is terrible to me that anyone would even consider this as “therapy” for a patient.
I agree that it sounds pretty horrific; the thing is, there are good studies showing that it really helps people, and rather quickly. Hard to know what to think. I myself will stick to EMDR for trauma.
This method makes me think about the ethical considerations of the so-called “re-traumatisation of the client”. Personally, as a therapist and a survivor of trauma, I don’t think that this method is ethical. It is based on the idea of “catharsis” as discharge, that construes a person like something similar to a steam engine. But is it a “true” description or just one of the possible ones? Does the client have the right to say “no”, or s/he has to follow what the “expert” therapist has in store for him/her?
But isn’t this what any good treatment method is all about anyway? Allowing you to face your past and your demons in a safe envirnoment so that you can encounter them and no longer feel threatened and stunted by that which has happened to you in the past?
Of course exposure to something will leave you less sensitive to it but I still do not see how this would treat someone and the problems they were having associated with it. I cannot imagine having to go through this or allowing that treatment for soemone that I love.
Yes, the good old extinction theory…but indeed with virtual reality being so real it does seem like the danger of re-traumatization is strong and could be un-ethical. The training period must be very important for the therapist and they must be very sensitive to the ability each individual has to tolerate how much ‘little-by-little’
I guess I can see the pros and the cons of this style of treatment. It does force you to confront your demons but at what cost? Will you simply continue to go through life traumatized? I think there are better therapy solutions than what this presents.
I see no positives to this treatment style at all. I have a relative who experienced a very traumatic event in her own life and I cannot imagine someone asking her to relive this again and again as a part of a treatment session. That is just unheard of. Therapy should be gentle and compassionate, not even more stressful to the patient.
Post Traumatic Stress Disorder or PTSD has been shown to have a genetic and environmental connection. A study conducted by Kerry Ressler, of Emory University in Atlanta, established that an individual may be at an increased risk for developing PTSD if he/she possesses a particular gene variant in combination with a past traumatic experience. The research team examined the effects of a gene called FKBP5 and concluded that the presence of this gene could mean a predisposition to PTSD. Every individual has a different mechanism to deal with stressful situations like violence, accidents, natural calamity and war.
And what about those who cannot deal effectively with this kind of trauma? How will therapy like this in any way help them? To me it seems like this could only set them back rather than advance their treatment.
I totally agree. this sounds like the most backwards “treatment” mthod I have ever heard of. I would never allow a family member of mine be subjected to this.
Margo I totally agree. Anyone who did agree to this really has lost their mind!
I have very conflicted emotions about this treatment method. There are pros and cons to it I suppose just like there is everything in life. I am sure that exposure to certain things over and over again can in some ways allow you to confront and deal with irrational fears. This is not always a bad thing now is it? And surely those who employ this treatment method are trained to know when enough is enough and would remove the trigger from the patient in order to ensure that a healthy mental state is maintained.
I was really eager to know how virtual reality is used to treat patients of post traumatic stress disorders while I found these lines “Virtual reality is also used in the medical community. Therapists use virtual reality to treat phobias and Post Traumatic Stress Disorders. Physical therapists use virtual simulations to help their patients reach treatment goals. But the method you depicted here sounds horrifying.