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Recalling Iraq's Terrors Through Virtual Reality

In one case, it helped a 26-year-old executive work through her stress after the destruction of the towers. She had flashbacks so frequently that she couldn't sleep, refused to watch TV news and became intensely angry about minor things. Efforts to try to get her to revisit the events yielded "a flat emotionless tale," her therapists wrote in a research report. But when she was exposed to the scenario gradually over a 14-week virtual-reality program, she began to open up. She said that as she struggled to flee the area through a crush of falling bodies, a woman had called out to her. She remembered meeting the woman's eyes and thinking that if she stopped to help, she might not be able to make it out. She looked down to see that the woman's legs had been severed.

Once she had unearthed that memory, her symptoms receded.

Military psychologist James L. Spira uses virtual reality to treat patients who have post-traumatic stress disorder. (Ariana Eunjung Cha -- The Washington Post)

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The high-tech treatment may be more appealing to the macho culture of the military than traditional counseling, said Russell Shilling, a medical director at the Office of Naval Research in Arlington, which is funding the study. It is estimated to cost at least $4 million over three years and will compare the effect of virtual-reality exposure to having people revisit events by imagining the scenarios.

"There's still a stigma to seeking mental-health therapy," Shilling acknowledged. He hopes more troops will be open to the virtual-reality technology because it is like a video game.

The terrors in Iraq are of a variety and intensity that, many say, has been unseen since the Vietnam War: masked insurgents ambushing even humanitarian and reconstruction convoys, makeshift bombs at every turn in the road, Internet videos of kidnapped victims being beheaded. The mounting U.S. death toll, coupled with the stress of uncertain deployment times and multiple rotations, add up to intense stress.

When fighters return home, many find themselves trapped between two worlds. The sound of a car backfiring -- or even a certain type of food -- may evoke a memory of Iraq.

"The events keep coming back. They have nightmares, flashbacks. They can't get away, and they want to get away," said James L. Spira, a staff psychologist at the Naval Medical Center in San Diego who is a lead investigator in the virtual-reality study. Some turn to alcohol or drugs to block out the experiences, he said.

At first, said Sarah Miyahira, who works for the Department of Veterans Affairs in Honolulu, post-traumatic stress disorder may manifest itself as "simply a sensation, a deep pit in their stomach. . . . The human psyche protects itself by repressing memory, but . . . you're not going to have a whole sense of control if you don't understand what causes you to react the way you do."

The standard treatment is antidepressants plus "talk therapy." Virtual-reality scenarios are considered a supplement.

Within a few months, the virtual-reality treatments will begin to be offered to troops at three locations: the Naval Medical Center and Camp Pendleton Naval Hospital in California -- which together hope to enroll roughly 180 patients -- and Tripler Army Medical Center in Hawaii, which hopes to enroll about 75.

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