Virtual Healing - Armed Forces Week

ADDITIONAL CONTRIBUTORS BTR Editorial

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Video games have played the scapegoat whenever technophobic media personalities and politicians (looking at you, Lieberman) try to explain violent tendencies in young America, but with the recent popularity of Virtual Reality and video game graphics engines in P.T.S.D. reduction therapy for returning American Iraq and Afghanistan war combatants, those detractors may have to put a lid on it.

To give readers an idea of how prevalent the topic of Post-Traumatic Stress Disorder in returning soldiers is in the American mainstream media, there was not a single article concerning P.T.S.D. and war veterans in the New York Times between November 26, 1999 and September 13, 2001. From that point forward, there have been 219 archived articles documenting soldiers’ returns, doctors and therapists’ mixed methods of treatment, and columnists’ frequent pleas to politicians and citizens alike to pay greater mind to the psychological terrors suffered during wartime.

Virtual Reality therapy researcher Albert Rizzo developed a project called Virtual Iraq, a therapy program based on the Xbox 360 graphics engine of Full Spectrum Warrior.

Precedence was set for the efficacy of Virtual Reality trauma reduction therapy in 1999 when a 50 year-old Vietnam war veteran with P.T.S.D. underwent a successful trial, concluding in a larger scaled 2001 VR study for 16 male P.T.S.D. patients where a large majority recovered or showed great signs of improvement.

Not to be confused with “self-help” therapy, the program relies on the expertise of a trained clinician, who operates from a “wizard of oz” administrator interface that collects narrative points from the soldier’s story and integrates them into the virtual battlefield.

A VR head unit supplies a 360 degree view of the simulated warzone, and a plastic M4 assault rifle is provided to the user for further immersion. All of this takes place on a vibrating platform to simulate Humvee rumblings, IED explosions, and other physically disruptive forces uploaded by the clinician based on the patient’s recounted story.

Included also in the experience are olfactory stimuli like the smell of goat’s meat to replicate an urban marketplace, voices and conversations, and many other reminders of an Iraqi street scene that engage the participant beyond the traditional audiovisual constraints of a video game. The goal is to associate the memory with the images from the video game rather than from real life, and by habitually reinforcing this association the patient will eventually separate the anxiety felt from those images.

Though video game therapy has indeed attracted more soldiers to actively combat their P.T.S.D., many returning service members are still loathe to participate in any sort of professionally administered treatment sessions.

The Defense Centers of Excellence press release concerning their at-home T2 Virtual P.T.S.D. Experience therapy program notes that 50 percent of service members who are clinically diagnosed for P.T.S.D. neither seek methods of treatment nor seek therapy available to them due in part to social stigmas and potential barriers to access.

The online program T2 Virtual P.T.S.D. Experience, which is based on the Second Life platform, is anonymous, interactive, and can be conducted on the soldier’s own time rather than on a clinician’s schedule. The DCOE hopes that it will inspire P.T.S.D. sufferers to seek more formal methods of treatment, but it also recognizes the propensity (and the military preference) for emotionally detached military personnel.

A recent study of returning National Guard members concluded that women are more than twice as likely to meet the criteria for P.T.S.D. than men (18.7% women to 8.7% men). Women combatants are less likely to feel prepared for battle, and less likely to experience unit cohesion during deployment. An insurance stipulation requiring that a soldier be exposed to actual combat in order to seek covered treatment for P.T.S.D. was nixed last year, but had denied many women coverage in the past.

The therapeutic philosophy supporting Virtual Iraq is derived from prolonged exposure therapy, a process that aims to separate the recollection of a memory from the memory’s psychological aftereffects. Recalling the old adage, “face your fears,” exposure therapy gets a bad reputation for its proclivity toward insensitivity. To immerse a patient in the same overwhelming pains over and over again is not a particularly comforting exercise, and many practitioners feel uneasy administering the method.

According to Albert Rizzo’s study regarding Virtual Reality therapy, “many patients are unwilling or unable to effectively visualize the traumatic event. In fact, avoidance of reminders of the trauma is inherent in P.T.S.D. and is a defining symptom of the disorder.”

Virtual Iraq attempts to liberate the participant’s painful, vivid memories from Iraq or Afghanistan by re-associating the narrative points, sensory stimuli, and shifting emotional states with the video game’s replication thereof.

The success of the VR programs show that the interactive medium of video gaming has accomplished what film, writing, and other art forms could not in the realm of improving aspects of human behavior and psychology, simply by virtue of the control inherent to their application.

Blockbuster war flicks employ Hollywood idols to tell their stories, but video games employ their participants to advance the narrative, giving players a sense of involvement and self-accomplishment. Plus video games are fun, so the stigma of therapy is lessened to a significant degree for the less therapy-inclined patients.

Whether or not other game developers will look to explore the field of psychotherapy is yet to be seen, but for now the military is grateful for the plethora of resources available to their veterans who seek and need treatment for their battle scars.

-Jakob Schnaidt

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