Michael Linder

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Reliving combat trauma in virtual war zones shows
promise in treating Post-Traumatic Stress Disorder
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I’m plugged into a computer at USC’s Institute for Creative Technologies in Marina Del Rey, California, but my virtual reality is a village somewhere in Iraq.

VR headgear is giving me a 360-degree view of its mosques, stores and homes. I can walk in and out of buildings, the sounds of Iraqi urban life in my ears. Cars drift slowly past market stalls. Women in burkas and little kids seem to be eying me with suspicion. Suddenly, a firefight erupts.

Troops with whom I’m patrolling scatter. I see the shooter and instinctively squeeze the trigger of the M4 carbine in my hands, but nothing happens. The weapon works fine as a game controller but is programmed to prevent my returning fire. I’m vulnerable and exposed as hell breaks out around me, but for soldiers inflicted with PTSD, this could be Step 1 on the road to recovery.

“This is not a game, not a revenge fantasy or a cathartic experience. It’s not about killing Iraqis, ” says Dr. Skip Rizzo, a clinical psychologist who treated PTSD patients at Veterans Administration hospitals before leveraging graphic assets from the Xbox game Full Spectrum Warrior into an interactive therapy tool.

“The goal is to put the patient back in the environment so they can process their emotional memories and re-experience in a safe, supportive environment. Then we can aid them in processing their emotional memories.” Rizzo taps his keyboard. “Why don’t you walk up that street to the right and we’ll make some more provocative things happen.”

A missile whizzes by, its explosion flares in my goggles. The ground shakes as a vibration core rattles the platform on which I’m standing, in synch with the blast. Rizzo has shifted the scene from day to night. He’s able to dial up near-precise replications of events that may have traumatized a soldier. It’s accuracy ranks high among battlefield vets.

“Combat soldiers have tested it, people without PTSD,” says Rizzo. “They told us what we got right and wrong.”

Virtual Afghanistan is currently in development. Like Virtual Iraq, Rizzo says it will be a total sensory experience.

“We have a smell machine that pumps out the smells of body odor, cordite, gunpowder, burning rubber, diesel fuel and Iraqi spices. You feel the vibration of the motor. You feel the percussive force of the bomb.”

The system is currently in test mode at the Naval Medical Center in San Diego and at the Marine Corps’ Camp Pendleton where Rizzo says patients are somewhat dubious at first.

“What they generally say is, ‘I don’t understand. Why would they want to make me go back? I don’t want to remember these things. I don’t want to do this.’ This where the skills of a well-trained clinician come in.”

Results for the first 15 troops to undergo this VR exposure therapy are encouraging.

“Out of those fifteen, twelve no longer meet the criteria for PTSD,” says Rizzo. “Anxiety showed significant reduction, depression also shows significant reduction. The alternative is to use therapies we know don’t work and complain about why we have a lot of people in need.”

I’m now sitting behind the wheel of a virtual Humvee, driving along a desert road. This could be the outskirts of Fallujah, or the back roads of al Anbar — just about anywhere in Iraq.

Looking to my right, I see a soldier sitting at my. Two more soldiers are in the back, one manning a machine gun through a roof hatch. Rizzo taps a key and the vehicle ahead of us triggers an IED. The blast’s shock wave hits hard. Bullets riddle the windscreen, zinging through our Hummer.

The soldier next to me is hit. He’s bleeding, clutching his arm. My senses are filling in the virtual gaps. I can imagine the heat as the Hummer ahead of us explodes in a red-orange fireball. How would a soldier, who’s been through a for-real attack like this, react?

“They feel a little bit of anxiety, but not enough to push them over the edge,” Rizzo tells me. “Enough to where they feel it, they can talk about it, process it. Eventually that anxiety dissipates.”

I was in Iraq in late 1990, meeting Saddam Hussein on the eve of the first Persian Gulf war. Rev. Jesse Jackson and I were among the first allowed inside occupied Kuwait, an urban battle zone where holdout snipers lurked despite the heavy presence of Iraqi troops posting portraits of Hussein and hot-wiring Mercedes once owned by Kuwait’s elite. The scarred city, burned-out tanks and edgy atmosphere very much like USC’s Virtual Iraq.

But today’s VR experience brought back a day spent at a replica Iraq training range at the USMC’s Twentynine Palms base in the Mojave desert, a complex that includes two replica villages sprawling across hundreds of acres, staffed by Iraqi nationals playing themselves in immersive pre-deployment exercises.

There, I watched Marines take on insurgents in a fierce wax-tipped bullet firefight. As I pulled off my VR headset, that experience came rushing back in high-definition detail — things I’d forgotten, crisp and clear. I can only imagine what memories might flash through the mind of a combat solider lucky enough to have walked away from death on a Middle East killing field, now fighting for inner peace through this virtual experience.

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