For soldiers returning home from deployments in Iraq and Afghanistan, the end of war does not necessarily connote the end of hardship. In an effort to combat Post-Traumatic Stress Disorder (PTSD) — a disorder expected to affect 20 to 30 percent of soldiers, according to Archives of General Psychiatry — , two Emory professors have developed an innovative form of therapy.
Barbara Rothbaum, professor of psychiatry and director of the School of Medicine’s Trauma and Anxiety Recovery Program, and Kerry Ressler, assistant professor of psychiatry and behavioral sciences, offer virtual reality exposure therapy combined with one of three medications to treat veterans of Iraqi and Afghan conflicts.
“People are haunted by something that happened to them in their past. I’ve had people tell me, ‘I don’t know why I fought so hard to survive if this is what my life would be,’” Rothbaum said. “And I’ve had people tell me after treatment, ‘I feel like the person I was before this happened, and I didn’t think it was possible.’ It doesn’t happen to everybody, but I know it’s possible.”
PTSD is a severe anxiety disorder that can develop after exposure to a traumatic event, according to the National Institute of Mental Health.
Unlike standard PTSD treatment, in which patients close their eyes and repeatedly recount their traumatic past to a therapist, virtual reality therapy keeps patients’ eyes open while a therapist uses a virtual world to match the traumatic event. Since the therapist can control changes in the virtual environment, this alternative method acts as more than a simple computer-generated program.
During a session, the patient wears a head-mounted helmet fitted with screens that shut out the outside world and provide a 360-degree visual. For example, a patient who describes driving a humvee — a military vehicle — when a roadside bomb explodes would see that scenario played out on the screen, while driving using a joystick. A subwoofer would replicate the explosive sound, and a scent machine would release the odor of smoke.
According to Rothbaum, the approach has improved their patients’ health in fewer therapy sessions than the standard approach would have required.
“We want their fear and anxiety in thinking and talking about it to decrease,” Rothbaum said. “Prolonged imaginal exposure has more evidence that it works for PTSD than any other treatment.”
A National Institute of Mental Health grant funds the virtual reality therapy conducted at Emory. All treatment is free and confidential. Given the successful results of virtual reality therapy evidenced at several facilities nationwide, the Department of Defense has begun to expand its use in Veterans Affairs hospitals.
Emory University has been long involved in this novel treatment for PTSD. The University founded Virtually Better Inc., a start-up company that specializes in the development of virtual reality therapy, in 1996.
Virtual reality therapy is complemented by single doses of a placebo called D-cycloserine or of Xanax to help eliminate fear and to expedite treatment. According to Rothbaum, this combination helps reduce the necessary number of therapy sessions from 12 to six. She added that this therapy does not require the patient to continue taking the same medication after the six sessions.
According to an article in Times magazine, researchers also hope virtual reality therapy can help reduce the stigma associated with seeking treatment for PTSD. Because of stigma, many instances of PTSD are not reported, though the infliction is common among returning soldiers from conflicts abroad.
Rothbaum said she believes the treatment’s potency can help eliminate years of PTSD symptoms in several weeks.
“I am a real believer in the resilience of the human spirit,” Rothbaum said. “It’s really amazing what we can get over, but sometimes we need some help.”
— Contact Fayyaz Mujtaba