The invisible scars of combat can make reintegration to civilian life a challenging transition for some combat Veterans, especially for those with Post Traumatic Stress Disorder. For South Florida Veterans, a new technology combined with traditional treatments may hold the secret for a successful post-military life.
Mental health providers at the Miami VA Healthcare System are now offering a virtual reality (VR) treatment option for Veterans with PTSD. Combining VR with traditional treatments, such as prolonged exposure therapy, providers can help Veterans change how they perceive and respond to the symptoms of PTSD, which typically cause depression, isolation and anxiety.
"Avoidance, hyper vigilance and re-experiencing are symptoms of PTSD that result from memories of trauma," said Dr. Pamela Slone-Fama, Miami VA posttraumatic stress clinical team staff psychologist. "By using a recovery model approach, prolonged exposure therapy and virtual reality, most of our patients who complete this treatment don't experience the same level of stress and intensity when faced with painful memories. Prolonged exposure therapy is what makes this approach to PTSD recovery so effective."
In conventional prolonged exposure therapy, patients are gradually exposed to events they avoid because of trauma, and providers directly control the stimuli – which can be adjusted based on patients' responses and individual needs. One of the benefits of using VR in PTSD treatment is providers can control the virtual combat landscapes, sounds and even smells.
What happens during PTSD VR sessions?
Before the first VR session, providers talk with their patients about the benefits of using exposure therapy and VR to treat PTSD. If patients choose to participate, VR sessions begin during the third visit. Before beginning the session, patients are connected to the VR machine – which consists of a headset with video goggles, plastic M-4 rifle, remote to control a virtual humvee and a chair.
"Patients begin the session by recounting their traumatic memories in the present tense, while we document responses, anxiety levels and memories," Dr. Slone-Fama said. "As patients are recounting, we can see what they are seeing on our screens and try to simulate the landscapes, sounds and smells they are describing."
While repeatedly recounting their memories, patients also describe how they are feeling. Depending on how far along a patient is in his/her treatment, sessions can run anywhere between 30 to 60 minutes. Even though the VR session is an important piece of the therapy, the post session also has an important role in the recovery process.
"After VR sessions, we work with the patient on processing what just happened," Dr. Slone-Fama said. "This part of the therapy helps patients understand the events that happened to them and allows them to process the entire memory. VR sessions can be intense, so before wrapping up we always make sure the patients are ok to leave. Safety is always important."
Common Misconceptions about PTSD
While PTSD can be a serious condition, its symptoms are what cause Veterans to develop low self-esteem and unhealthy, unrealistic beliefs about themselves, according to Dr. Camille Gonzalez, Miami VA posttraumatic stress clinical team staff psychologist. She said Veterans living with PTSD frequently blame themselves for the trauma and feel hopeless.
"It's common for Veterans with PTSD to feel as though they are permanently damaged," Dr. Gonzalez said. "We try to help Veterans understand it's not their fault they experienced these events. Once they realize PTSD is a result of something that happened to them, the recovery process can begin. Even though Veterans will always remember what happened to them, therapy can help them decrease the negative impacts of those memories."