VR Sim Therapy for Combat Stress

A fascinating piece in this week’s New Yorker on "Virtual Iraq" – a virtual reality sim environment for working out the post-traumatic stress disorders of Iraq combat veterans. The article references the Institute for Creative Technologies at the University of Southern California, where the project is hosted, as well as several precursor efforts, a more primitive "Virtual Vietnam"  among them. There’s a 2005 Defense Update report on the program here. Talk about persuasive technology. This, from the writer:

The first time I put on a head-mounted display and headphones and entered Virtual Iraq had been in this same room, at Walter Reed, a few months earlier, after Rizzo presented preliminary results from a study site to a small gathering of military officials. Rizzo was having trouble linking his laptop’s PowerPoint presentation to the Walter Reed audiovisual system, and he had to speak without notes, often from a crouch behind the podium as he picked through a jumble of cables searching for one that was live. “The last one hundred years, we’ve studied psychology in the real world,” Rizzo told the group. “In the next hundred, we’re going to study it in the virtual world.” He threw out some numbers. Of the five subjects who had completed treatment, four no longer met the diagnostic criteria for P.T.S.D. A fifth soldier showed no gain. (To these he would add, a few months later, the results for ten others, eight of whom had got better. Of the six research sites, San Diego was the first to have preliminary results.) After talking more generally about the features of Virtual Iraq, Rizzo invited everyone present to the fourth-floor psychiatric wing to try it out.

Although I had seen Virtual Iraq in one dimension on a computer monitor, encountering it in three dimensions, with my eyes blinkered by the headset and my ears getting a direct audio feed, was different. It still felt like make-believe, but I was fully engaged. Rizzo placed a dummy M4 rifle in my hands, and guided my fingers to a video controller fixed to the barrel. (By design, patients who use Virtual Iraq do not fire weapons; the M4 is a mood-setting device, for verisimilitude.) One toggle moved me forward, another moved me back, and a third sped me up or slowed me down. Because the display tracked with the orientation of my head, whichever way I moved determined not only what I saw but where I went. I pressed the forward button and strolled down the market street and, at Rizzo’s instruction, turned at a doorway and entered a house. Inside were two insurgents, one on his knees, with his hands tied behind his back, the other dead on the ground. A baby was crying. I moved on.

The next time I put on the headset was in Marina del Rey, California, at an Institute for Creative Technologies lab space called FlatWorld, most of which was given over to life-size “mixed reality” worlds that could be negotiated without special equipment. (It was so realistic that when a virtual insurgent popped up across the virtual street from the virtual building in which I was standing, his bullets made successive holes in the virtual wall behind me and seemed to shower plaster dust through the air.) The Virtual Iraq design team, two artists and a programmer, worked out of FlatWorld, and it was their system, with the most recent improvements and additions, that I was using. This time, Rizzo sat me in a chair placed over a bass shaker, which is also known as a tactile transducer, a device that transmits the feel of sound. I slipped on the display and the headphones, and Rizzo pressed some keys on his computer and made me the driver of a Humvee, with a soldier in desert fatigues sitting next to me and another in the back. (Because the gunner was in the turret, when I looked in the rearview mirror I saw only his boots and his pant legs.) As soon as I started up the vehicle, the floor under me began to vibrate and my ears filled with the hum of tires on pavement. Suddenly, a gunman appeared on the overpass above me and started to shoot. Off to my right, a car burst into flames. Half a second later, the explosion entered my body through my feet and ears. It was startling, the way any unexpected loud noise is, but it wasn’t frightening. Even when the guy in the seat next to me was shot, and his shirt sprouted a red bloom, it wasn’t frightening. I had never been to Iraq. I had never been to war. The scene did not conjure any memories for me, traumatic or otherwise. It was, as JoAnn Difede said of stairs on September 10th to a person who worked in the World Trade Center, neutral.

I had seen, though, what might happen if it triggered an emotional response, when an actor named Ed Aristone, who had been cast in a movie about the Iraq conflict and wanted to get a sense of what combat was like, put on the head-mounted display at FlatWorld and found himself in the midst of a war. Rizzo cued up car bombs, shouting soldiers, ambient city sounds, blinding smoke, inert bloody bodies, the call to prayer, a child running across the street, the cough of an AK-47, snipers, a nighttime gale—all ten plagues and their cousins at once. Aristone started to sweat. His heart was racing. His hands were numb. He was having a hard time holding the rifle. His face went white. He bit his lips. After ten minutes, he said he’d had enough.

Halpern, Sue. "Virtual Iraq: Using Simulation to Treat a New Generation of Traumatized Veterans." New Yorker (19 May 2008).

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