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Jan 28, 2005

VR to treat PTSD

From Wired

SAN DIEGO -- While the real Iraq is more than enough for most people to handle, there's a virtual Iraq lurking on the laptop of psychologist Skip Rizzo, a research scientist at the University of Southern California.

With a push of a button, special effects will appear -- a mosque's call to prayer, a sandstorm, the sounds of bullets or bombs. "We can put a person in a VR headset and have them walk down the streets of Baghdad," Rizzo said. "They can ride in a Humvee, fly in a helicopter over a battle scene or drive on a desert road."

This is no video game, nor is it a training device. Rizzo and colleagues are developing a psychological tool to treat post-traumatic stress disorder, or PTSD, by bringing soldiers back to the scenes that still haunt them. A similar simulation is in the works for victims of the World Trade Center attacks.

PTSD treatment, the newest frontier in the intersection between virtual reality and mental health, is one of the hot topics this week at the 13th annual Medicine Meets Virtual Reality conference, which began Wednesday in Long Beach, California. Rizzo and others will explore plans to expand virtual reality's role in mental health by adding more elements like touch and the ability to interact with simulations. "The driving vision is a holodeck," Rizzo said. "If you look at the holodeck, and all the things people do in Star Trek, that's what we'd like to be able to do."

Powerful computers are cheaper -- the necessary machines used to cost as much as $175,000 but now the Virtual Reality Medical Center in San Diego, one of about 10 private VR mental-health clinics in the United States, picks up its hardware at Fry's Electronics. VR helmets -- which allow users to turn their heads and see things above, below and behind them in the 360-degree virtual world -- cost as little as a few thousand dollars. And perhaps most importantly, the graphics are more advanced, thanks to partnerships with video-game developers.

At the San Diego clinic, graphics designers are developing a remarkably realistic virtual world based on digital photos and audio from San Diego International Airport. Patients afraid of flying will be able to take a virtual tour of the airport, from the drop-off area through the ticket counter, metal detectors and waiting areas. The simulation is so precise that users can enter restrooms, peruse magazines at the newsstand or wander around the food court; recordings will allow the virtual PA system to offer the requisite incomprehensible announcements.

The clinic already offers a simulation of a flight. At $120 a session, patients sit in actual airplane seats and watch a simulation of a takeoff, accurate all the way down to announcements by flight attendants and pilots. At takeoff, actual airplane audio -- engines revving, landing gear retracting -- is channeled into subwoofers below the seat, providing a dead-on simulation of what a passenger feels. Even the view outside the window is based on actual digital video from a flight.

"Exposure therapy" has long been a common treatment for phobias. "It's a gradual reversal of avoidance," said psychologist Hunter Hoffman, a researcher who studies VR at the University of Washington. "You start by having them hold their ground. A lot of phobics have mental misunderstandings about what would happen if they face the thing they're afraid of. A spider phobic, they may think they're going to have a heart attack -- they think if they don't leave the room, they'll go insane. They have these unrealistic theories about what will happen."

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