Sometimes the best way to overcome a traumatic experience is to relive it. Researchers at Emory have been exploring ways that combat-related post-traumatic stress disorder could be tackled by using virtual reality. The results of a new study of 156 veterans of the Iraq and Afghanistan wars show promise for PTSD being treated successfully—and quickly—this way. We talked with lead researcher Barbara O. Rothbaum, director of Emory’s Trauma and Anxiety Recovery Program.
How does virtual reality compare with traditional PTSD therapy? In the most common treatment, we ask somebody to go back in their mind’s eye to the time of the traumatic event and recount what happened. You do that over and over and over until it gets easier. Some veterans can be very emotionally disengaged, and it’s hard for them to get into the exposure therapy. They can give you the words, but they’re not feeling it. With virtual reality, it is a more potent stimulus. Because it’s more evocative, it’s harder to avoid. They’re hearing it, seeing it, feeling it, smelling it, and remembering it.
What were the virtual scenes like? We wanted to create scenarios that work for as many people as possible. One of the most common stimuli is a Humvee driving down the desert highway. We also had a Middle Eastern city that people could patrol on foot. People in Iraq and Afghanistan gave us information to create the scenes.
Describe the study process. Right before the virtual reality therapy, some participants took d-cycloserin, or DCS [an antibiotic that has been used in PTSD treatment], and some took Xanax. We found that everybody got better, but cortisol, which people know as the stress hormone, decreased more in the group that got DCS. The normal course of talk therapy is nine to twelve sessions. Using virtual reality, we had success with a much smaller dose—only five sessions.
Virtual reality has been used before to treat PTSD. What’s new in this study? This is the first time we’ve been able to show that virtual reality is effective with this group of veterans. It is also the first study combining it with medications in this way.
Will the effects of this therapy last? We follow people at three months, six months, and twelve months, and I really do think we’re creating permanent changes. In general we see continued improvement rather than relapse. As time goes on, they handle events better or differently, and they aren’t triggered like they were before. Of course, there will be certain situations that are never neutral. Around Atlanta, one of the biggest triggers is traffic.
This article originally appeared in our August 2014 issue under the headline “Screen Therapy.”