Virtual Reality Is Real Therapy for Vietnam
Veteran

April 1999
by Jan Northstar

You are standing in a clearing, a grassy field, alone and in silence. Down to your right, a few paces away, is something brown and murky. You walk toward it, step in it, realize it's a swamp and hastily back out. Turning around, you see darkened woods in the distance.

Anxiety soars as rifle fire begins to peel off in the distance. You look for cover. You see the trees but you are not in control of your legs. You try to scramble to the safety of the trees. As you do, the distinctive sounds of an Army helicopter chop the air. It lands.

Rifle fire fills the area.

Mortars explode.

You are still desperately trying to find cover. You think you see the sniper in the woods and maneuver out of his range.

Instantly, all of the sounds are gone and you are again standing in the grassy field, alone and in silence. You remove the head-mounted display and step down from the platform. You have just left the virtual reality war zone.

It's More Than a Game. It's Therapy

For most people, this is a fun and exciting virtual reality experience. For veterans who served in Vietnam and are suffering from the chronic effects of post-traumatic stress disorder (PTSD), this could be an important milestone in confronting the catastrophic experiences of war.

The Atlanta VA Medical Center, in collaboration with Emory University and Georgia Tech, is taking advantage of the latest in computer technology and combining it with traditional methods of therapy in an effort to effectively treat veterans diagnosed with PTSD. They are currently looking for Vietnam veterans diagnosed with PTSD to take part in a research study using virtual reality technology to help treat symptoms associated with the condition.

According to Dr. Renato Alarcon, chief of the VAMC's mental health service line, virtual reality exposure (VRE) therapy was used in a controlled study by Dr. Barbara Rothbaum at Emory to treat acrophobia, the fear of heights. Rothbaum worked with Dr. Larry Hodges, associate director of Georgia Tech's Graphics, Visualization and Usability Center, to develop the software.

"The procedure put their acrophobia patients in a position to be therapeutically accessible without the expense and time associated with traditional treatment [frequent visits to tall buildings, bridges, etc.] and they were successful," said Alarcon. "The next step was to move on to a more complex clinical condition and PTSD was the next logical choice because it is triggered by and related to unpleasant experiences and exhibits a large number of symptoms.

"This is the first application of computer technology used specifically in this manner for the treatment of PTSD. The partnership between our staff, Emory and Georgia Tech in pioneering this treatment provides the veteran who undergoes the effects of PTSD with a wealth of expertise," he added.

Said Dr. David J. Ready, psychologist, Atlanta VA Medical Center (VAMC), who has been working with veterans and VRE therapy, "We all have memories of negative events that happen in our lives, but they are just memories. With sufferers of PTSD, these memories take the form of nightmares and flashbacks. The nightmares are so horrific that they wake up feeling as if something has taken them over. They are in the past, not here," he said. "It is coming at them in an uncontrollable way.

"VRE therapy lets the patients recall and actually get re-immersed into the experience in a graduated and controlled fashion. We can slow it down with the cooperation of the patient. Most of the veterans we see are either flooded with their past experience or trying to stay away from it," said Ready.

According to Ready, treatment is free and available for Vietnam veterans who appear likely to benefit from this study, based on an independent evaluation at Emory. Veterans who participate will go through eight to ten sessions of VRE therapy and four assessments. Sessions generally last an hour and a half.

During that time, the veteran's heart rate is monitored while he or she is introduced to the computer-generated surroundings. Situations gradually increase in intensity as the veteran feels more comfortable. Throughout the session, veterans are asked to describe what they are seeing and feeling, while being provided with adequate corrective therapeutic interventions.

Georgia Tech Students Developed the Virtual Reality Software

The virtual reality software, developed by students at Georgia Tech, has two combat-oriented scenarios: the landing zone in a grassy field, and riding in a helicopter gunship. In the helicopter scenario, participants are asked to sit in a bucket-like seat that simulates helicopter vibration while flying at various altitudes. The visual is simulated terrain in Vietnam.

Both Alarcon and Ready agree that virtual reality exposure is intensive therapy. Exposing veterans to the painful memories that they have been avoiding is a delicate process.

"Some patients will never be able to do it," said Ready. "Some will work up to it and some are ready to do the therapy right now. We need those people," Ready said.

For More Information

For more information or to participate, call Dr. David Ready at the Atlanta VAMC at (404) 321-6111, ext. 7082.

About the Author

Jan Northstar is a public affairs specialist in the Office of Public Affairs in the Atlanta Regional Office of the Department of Veterans Affairs.