Facing Fears through Virtual Reality

© On the Brain—Posit Science

It was called soldiers heart during the Civil War, shell shock, traumatic war neurosis, combat exhaustion, or operational fatigue during World War II, and combat fatigue during the Vietnam War. Today, combat stress comes under the diagnosis Posttraumatic Stress Disorder (PTSD), a psychological illness that can develop in those who have been exposed to excessively distressing, harrowing events, including war combat. Its effects can be debilitating and can cause sleep disturbances, flashback episodes, nightmares, feelings of guilt, as well as depression and emotional numbness.


The National Center for PTSD reports that one in twenty World War II veterans suffered war trauma, while the National Institute for Mental Health states that 30 percent of Vietnam veterans suffered from PTSD at some time, and about 8 percent of those who served in the Gulf War suffered from the disease.  According to an article in the New England Journal of Medicine (July 1, 2004), about one in six members of the military serving in Iraq suffers from some form of PTSD.  


Clinical Psychologist Dr. Albert “Skip” Rizzo III and his team at University of Southern California’s Institute for Creative Technologies have been studying combat stress and are currently working on a therapy tool to treat the disorder in members of the armed forces returning from Iraq. Funded by the Office of Naval Research (ONR), this $4-million program involves a virtual reality computer application that simulates three-dimensional representations of battlefields in Iraq using visual and auditory stimuli and forces soldiers to face and relive situations they encountered there.


Using the cognitive behavioral therapy approach—in which people gradually and repeatedly relive the frightening experience under controlled conditions to help them work through the trauma—the clinician guides the patient through the various aspects of the virtual reality environment. Commonly used to treat other anxiety disorders such as fear of heights, fear of flying, or fear of public speaking, the cognitive behavioral approach has been most efficacious in treating anxiety disorders such as PTSD, Dr. Rizzo says.


Neuroscientists are excited and encouraged by Dr. Rizzo’s work. “When we alter how we perceives things, we are in fact engaging our brain’s plasticity,” says neuroscientist Dr. Henry Mahncke, Vice President, Research & Outcomes at Posit Science.


“Our aim here is not to re-traumatize people, but rather to re-expose them to relevant traumatic events in a graduated way that they can handle.” Rizzo says. “Our goal,” Rizzo adds, “is to help military personnel begin to manage the difficult emotions that are sometimes the byproduct of combat-related experiences.”



Albert “Skip” Rizzo, PhD is a member of the Posit Science Scientific Advisory Board.