Not a Video Game


A scene from Virtual Iraq Image courtesy of Skip Rizzo hide caption

toggle caption Image courtesy of Skip Rizzo

On today's show, Albert "Skip" Rizzo told us about Virtual Iraq, a virtual reality environment used to help returning soldiers deal with Post Traumatic Stress Disorder. The theory is that by immersing soldiers to virtually relive their trauma in a safe environment, you can help them better process their memories. I've watched some direct feed from Virtual Iraq. It looks like a video game, but knowing that what I'm seeing is a representation of something that might have actually happened to someone makes it feel like something else entirely.



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I am a Reserve Medic facing a possible deployment to Iraq. Does this program have potential for preparation for deployment? Currently, the Army Medic course involves pictures and video of real injuries for desensitizing. Could this be the next step?

Sent by Katie B | 2:52 PM | 5-27-2008

Virtual reality seems like a gimmicky therapeutic process to me, despite the excitement of those speaking about it. I do a lot of trauma work and the one thing I know well is not to retraumatize and that is exactly what virtual reality seems to do for those traumatized. There are other methods that have also been demonstrated such as working with someone under hypnosis to moderate experiences that remain stuck or even better EMDR, which has been validated by various branches of the Armed Services. This eliminates the traumatic emotions and leaves the memory but without the pain.

Sent by Gil Shepard MFT | 3:03 PM | 5-27-2008

We are actively developing a virtual reality model for use in the physical rehabilitation of persons with Multiple Sclerosis. Because of the broad range of symptoms that MS encompasses our model has engendered interest from NASA, MIT, and even ONO Academic College in Israel. Our model is home-based and is carried out over the web and utilizes force feedback (haptics) to train or retrain the patient. Because of the declining economy we have expanded the scope of our project to include home based job training as well. The implications for use in the rehabilitation of veterans is obvious. With the number of physical therapist declining and the number of persons requiring therapy increasing a single therapist can effectively treat a much larger population and provide therapy to a much more geographically diverse set of patients.

Whether you are confined to a spacecraft 30 million miles out in space or confined to a wheelchair 30 minutes from your therapist virtual reality can be an invaluable addition in your arsenal of methods to overcome the obstacles life has put before you.

Sent by David S. | 5:47 PM | 5-27-2008

I only caught the tail end of your show about PTSD. I wonder if you are familiar with a free program to help Vets who have any kind of traumatic brain injury, including PTSD? It is called Homecoming For Veterans, and there are providers all over the states offering this service free of charge to vets. A quote from their site: Homecoming for Veterans is a national outreach program to provide free Neurofeedback training for veterans for the rehabilitation of Post-Traumatic Stress Disorder and issues of brain performance resulting from traumatic brain injury, blast injury, concussion, whiplash, and chemical exposure.

The EEG Institute, a world leader in Neurofeedback research and training, and the Brian Othmer Foundation are offering this cutting-edge treatment, at no cost, for veterans suffering from Post-Traumatic Stress Disorder (PTSD) through a network of clinicians across the country.

Their web site is

Sent by Barbara Lance | 4:46 PM | 5-28-2008

In response to Gil and Barbara's comments above...there is nothing gimmicky about the use of technology to better deliver a form of therapy that has the best documented clinical efficacy (CBT Exposure Therapy) of any PTSD treatment approach. And in a form that may have more appeal to the current generation of returning military and encourage them to seek treatment. Have a look at last fall's National Academy of Sciences Institute of Medicine report, where they reviewed all the available PTSD treatment research and came to the same conclusion--CBT exposure is the only therapy where there is enough scientific proof from solid controlled clinical outcome studies to support its efficacy. While EMDR, Hypnosis and Neurofeedback are often cited as approaches that can be helpful to some folks, the data from existing research is not adequate to make the same claim. And many PTSD researchers see the active ingredient of EMDR as being the exposure and resulting emotional processing that may occur within the EMDR format, and that the eye movement component is irrelevant. Further, in the hands of a well trained clinician, no one is "retruamatized" when using exposure therapy--the patient is guided through the process in a gradual and supportive fashion--no one is ever pushed beyond what they choose to handle! And so far, the data are very encouraging. I think a bigger concern in this area, is when clinicians continue to use methods that have no scientific support for effectiveness and call it good therapy. Group counseling is a classic example of this. While support groups are a very helpful tool as an adjunctive option, they are ineffective as a primary and exclusive therapy approach to PTSD. The same challenge can be leveled at exclusive pharmacological approaches (SSRIs). Unfortunately, group therapy and pharmacological approaches continue to this day to be the primary forms of therapy that these folks are typically offered when they turn up at the VA and elsewhere (although that is hopefully starting to change now!). So to conclude, I fail to see the "gimmicky" aspect of an approach that takes an empirically validated treatment approach and tries to deliver it in a more effective fashion using the best technology available. Thanks for your time.

Sent by Skip Rizzo | 10:52 AM | 5-30-2008

Trauma and phobias are two different things. It would seem the emotional numbing from combat and military training would be increased. Soldiers know how to look good on the outside, shiny and clean uniforms, and hide the falling apart on the inside. No matter what they have been through they report: "I'm fine."

Exposing them to more of the traumatizing environment would make them more emotionally numb. And they will walk away feeling "fine." They will return to a combat mode, which kept them alive (surviving not living).

Emotional numbing is a combatant friend. I was career military: burn and amputee wards during Vietnam, Gulf War, and Somalia. Therapist having difficulty understanding my trauma was a primary factor for me returning to school and getting a Masters in Psychology. And for a long time I was just "fine. "

Ask a combat veteran if he can handle fire works on the 4th of July. Trauma or phobia!

Sent by Andy S. MA | 6:04 PM | 6-24-2008

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