Combat Stress

By Magnuson, Stew | National Defense, December 2008 | Go to article overview
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Combat Stress

Magnuson, Stew, National Defense

To heal psychological trauma, troops relive war in virtual reality

MARINA DEL REY, Calif. - Sitting in a chair with goggles strapped on, the subject peered out into a virtual battle zone. He was driving down a dusty Iraqi highway. It was dusk. There was one humvee ahead and a fellow Marine riding shotgun next to him.

The roadside bomb exploded. A shaker table beneath him simulated the shock wave. High-tech speakers blasted the sound of AK-47 fire around him.

Turning the head to the right revealed that his companion was seriously injured. Blood oozed from his wounds.

Although the software was adapted from a computer simulation designed for war fighters heading overseas, this program is aimed at those returning from battle.

Virtual Iraq, developed at the University of Southern California's Institute for Creative Technologies, is one of two programs being used by the U.S. military to help victims overcome the sometimes debilitating effects of post traumatic stress disorder.

"It's based on the idea that fear burns itself out," said Lt. Cmdr. Robert McLay, a psychiatrist at the Naval Medical Center in San Diego, and the service's primary investigator of virtual reality systems used to treat PTSD.

"If you tell the story over and over again, the story no longer becomes fear provoking. It becomes boring."

This method is called exposure therapy. And although there is some disagreement in the mental health community as to the best way to treat the disorder, most clinicians practice this method.

Traditionally, the therapists will ask the patient to think back and recreate the traumatic scene that led to the disorder in his or her mind's eye.

"It's a tall order to imagine in detail the things that are haunting them," said Skip Rizzo, research scientist at the institute, and co-creator of the program.

Virtual Iraq is intended to be a tool for a well-trained clinician experienced in treating post traumatic stress disorder, he said.

"We're not going to erase someone's memories ... that's not what this is about. This is about dealing with the anxiety, getting it out, and over time going to where the anxiety structure, the fear structure gets out of the brain and no longer haunts you."

McLay said the military and the U.S. Department of Veterans Affairs has seen an increasing number of patients suffering from PTSD since the beginnings of the wars in Afghanistan and Iraq.

A Rand Corp. research brief, "Invisible Wounds: Mental Health and Cognitive Care Needs of America's Returning Veterans," said 18.5 percent of U.S. service members who have returned from Afghanistan and Iraq suffer from post traumatic stress disorder.

Roughly half of them do not seek treatment, and only half of those who do "get minimally adequate care," said the brief.

PTSD has been around since man first took up arms, said McLay. One of the first described cases in literature was Achilles in Homer's The Iliad.

From the Civil War to World War II, the condition had many names - "battle fatigue" and "shell shock" are two. In World War I, sufferers risked receiving a dishonorable discharge for suffering battlefield stress.

Treatment for what became known as PTSD became more enlightened and refined in the mid-1980s as the condition affected many Vietnam War veterans.

"Unlike physical wounds, these conditions affect mood, thoughts, and behavior and often remain invisible to society," the Rand report said.

Left untreated, sufferers have a higher risk of engaging in unhealthy behaviors such as drinking, smoking, unprotected sex and have higher suicide rates.

Not everyone who has been through a traumatic event suffers from PTSD. Immediately after an event, just about everyone will have similar symptoms, Rizzo said. It's normal to lose sleep, and replay the scene over and over in the head in the days and weeks after an event.

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