Sarah Goodwin

Kathi Ovnic
Holly Korschun
September 2, 1999

The sound of a low-flying helicopter brings to mind rush-hour traffic reporters or police surveillance to most people. But for many veterans of the Vietnam War, the distant whir of a helicopter's rotating blades or the pop of firecrackers may precipitate terrifying and uncontrollable re-experiencing of the war, called flashbacks.

A new virtual reality-based type of psychotherapy developed by researchers at Emory University, the Georgia Institute of Technology and the Department of Veterans Affairs Medical Center (Atlanta) is using high tech tactics to help Vietnam vets with Post-traumatic Stress Disorder (PTSD) overcome the ill effects of war memories. These memories can be not only distressing, but in some cases totally debilitating.

Patients undergoing the treatment, called Virtual Reality Exposure Therapy, wear a head-mounted display that creates a sense of immersion in a Vietnam-like environment. Virtual reality integrates real-time computer graphics, body tracking devices, visual displays and other sensory input devices to assist the patient in having the experience of being 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. The open-field environment 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, says Barbara O. Rothbaum, Ph.D., associate professor of psychiatry and behavioral sciences at Emory University 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 explains. 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. Dr. Rothbaum and Larry Hodges, Ph.D., associate director of the Graphics, Visualization, and Usability Center at the Georgia Institute of Technology, first used Virtual Reality Exposure Therapy 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, which is 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 The Atlanta VA Medical Center under the leadership of Renato Alarcon, M.D. "In many cases of the post-traumatic stress disorder, Vietnam veterans are unable to work, there are disruptions in their family life and they frequently have problems with depression or substance abuse," Dr. Alarcon says. "They frequently suffer from Vietnam nightmares and flashbacks, triggered by the sound of a helicopter or loud noises. Many people describe being emotionally numb and having problems concentrating and sleeping."

"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," Dr. Rothbaum explains. "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."

The Virtual Vietnam psychotherapy is being conducted by VA staff psychologist David Ready, Ph.D. Anyone interested in knowing more about the study should call Dr. Ready at 404-321-6111, ext. 7082.