Emory Report

September 20, 1999

 Volume 52, No. 5

Virtual reality therapy helps Vietnam vets cope with past

The sound of a low-flying helicopter brings to mind rush-hour traffic reporters or police surveillance to most people. But for some veterans of the Vietnam War, the loud whir of a helicopter's rotating blades or the pop of firecrackers may precipitate terrifying and uncontrollable memories of war experiences they would just as soon leave on the other side of the world.

A new virtual reality therapy developed by researchers at Emory, Georgia Tech and the Department of Veterans Affairs Medical Center is using high-tech tactics to help Vietnam vets afflicted with Post-traumatic stress disorder overcome the effects of memories that can be not only distressing but, in some cases, debilitating.

Patients undergoing the treatment, called Virtual Reality Exposure Therapy (VERT), use headsets and video scenes to recreate the landscape associated with their particular phobia. Virtual reality integrates real-time computer graphics, body tracking devices, visual displays and other sensory input devices to immerse a participant in a computer-generated virtual environment.

The Vietnam environment includes a Huey helicopter ride over rice paddies, river and jungle, or the experience of walking exposed in the middle of an open field surrounded by jungle. Audio effects can vary from simple jungle noises to mine explosions, mortar fire, gunfire, men yelling and helicopters.

The most effective treatment for fears or phobias is to expose the sufferer to the feared object in a therapeutic manner, according to Barbara Rothbaum, associate professor of psychiatry and behavioral sciences in the School of Medicine. Exposure most often occurs when patients imagine the feared situation (imaginal exposure) and/or put themselves in the actual situation (in vivo exposure) until the fear subsides, she said. The obvious drawbacks of these two methods are lack of realism with imaginal exposure, and higher cost and greater impracticality with in vivo exposure. The virtual reality treatment can make exposure more realistic and more practical at the same time.

"We aren't using the virtual reality therapy to get people used to the bad things that have happened to them--just used to the memory of them," Rothbaum explained. "They have to come to terms with the memory so they can go on with their lives. Virtual reality therapy is a way to help put the memory in perspective and move it to the past.

Rothbaum and Larry Hodges, associate director of Georgia Tech's Graphics, Visualization and Usability Center, first used VERT to treat patients with a fear of heights. Successful results of that study were published in the April 1995 issue of The American Journal of Psychiatry. A subsequent study, still ongoing, was designed to treat individuals with a fear of flying. In 1996 Rothbaum and Hodges formed the start-up company Virtually Better Inc. to market their virtual reality systems.

The Virtual Vietnam project is being conducted at VA Hospital under the leadership of David Ready. "In extreme cases of the post traumatic stress syndrome, Vietnam veterans may be unable to work or perhaps have problems with depression or substance abuse," Ready said. "They may have flashbacks, triggered by the sound of a helicopter, for instance. Many people describe being emotionally numb and having problems concentrating and sleeping."

Individuals interested in knowing more about the Virtual Vietnam clinical study should call 404-321-6111, ext. 7082.

-Holly Korschun

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