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Sunday, June 22, 2008

Virtual Iraq 50 patients in 3 years does not live up to hype

Facing demons in 'Virtual Iraq'
A 3-D simulator in which soldiers see, hear and smell the rigors of combat may help ease war-induced stress


Washington - To a soldier who has been in Iraq, the sights, sounds and smells are familiar: the pop of an AK-47, the flash of a bomb, the stench of cordite.

The location, however, is not.

Here, in a small, windowless room at the Walter Reed Army Medical Center, researchers are using the latest video game technology - plus a smell machine and a vibration platform - to help patients suffering from post-traumatic stress disorder.

Known as "Virtual Iraq," the treatment may help many soldiers who don't find relief from medication or traditional psychotherapy.


"It really jogs their memory," says Col. Michael Roy, who runs the digital therapy program at Walter Reed. "It puts them back there very powerfully and makes them realize a lot of things they had consciously or subconsciously repressed."

Proponents of the new treatment say that once these memories are available, patients can begin to talk with therapists, eventually rendering the phantoms less terrifying.

Nationwide, only about 50 soldiers have undergone the treatment in the past three years - leading some critics to say the treatment is still unproven.


Some researchers are skeptical that the new method improves on traditional therapy.

"We don't have empirical evidence that virtual treatment is needed. And it's quite expensive," says University of Pennsylvania psychologist Edna Foa, an expert on exposure therapy. "I want to see what motivates this, other than a fascination with gadgets."

Foa, who works with PTSD patients - including soldiers - in both the U.S. and Israel, says the images in virtual therapy may be too generic to effectively elicit patients' own memories.
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50? That's it? That's all? And they have been passing this off as some kind of wide spread miracle cure? How can 50 out of thousands prove anything? Why hasn't this been used more widely and tested on a lot more veterans before they even began to publicize it?

Using people who survived 9-11 is not the same as treating combat veterans. There is a huge difference between victims of trauma and participants in it. Keep in mind, as I remind my readers often, I am not a psychologist or a psychiatrist. I admire these people greatly and need them where they are so that when I'm finally able to get some of these veterans to the point where they are ready to ask for treatment, I have someone to send them to. However, that said, I've studied PTSD for over 25 years, talk to them, emailed with them and listened to them as well as living with one of my own.

The ones who are cut the deepest are the combat troops. First because of the re-exposure to traumatic events. It's not just one time they experience a traumatic event but they do so on a daily basis. They are also part of the traumatic events instead of just bystanders in the wrong place at the wrong time. The second deepest cut comes to the police force. They are also participants in traumatic events. They are not exposed to them as often but they are a close second. Then the emergency responders, like firefighters. They are not participants in the events but rescuers. They have a whole other set of things to deal with. Everyone else usually experiences a traumatic event on a one time basis. There is a huge difference between all of them and cannot be treated the same without taking all of this into account. PTSD is not a one size fits all wound. Some cuts are deeper than others because of how many times the trauma hits.

I am not impressed with virtual reality treatment now that I know we are talking about 50 nationwide who have been through the program.

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