Those who go through hell

24. October 2007

The internet shows its true blessings in the spheres of psycho-medicine. The therapy program "Virtual Iraq" takes the desert and grenades straight into the treatment room of traumatized US veterans. Back in the virtual hell of war they are supposed to digest repressed incidence.

Almost daily, the number ofcasualties goes up in the Iraq war – and with it the number of those withpsychological damages resulting directly or indirectly from the war. We are notjust talking about family members of the civilians and soldiers that have died,but also about those having survived a terrible incident and keep carryingaround with them those mental pictures of a massacre or a threateningsituation.

Virtual exposition makeskey situations present

Since recently, not justpsychologists are looking after US soldiers having survived the Iraq war andsuffering from a post-traumatic stress disorder. Also software programmers areworking on that issue. At the University of Southern California under the roofof the Institute for CreativeTechnologies , an according working group was founded. They have developed asoftware to help traumatized veterans of the Iraq war to rehabilitate. Virtual Iraq retrieves suppressed situations on battle fields or during assaults back to theconsciousness to enable the affected persons to better digest those incidentsor – even in some cases digest them in the first place. This is nothing new inpsycho-medicine. An exposition therapy is used for treatment of diverse panicdisorders, mainly phobias. But not just in phobias, specific triggeringsituations are avoided:" Avoidance behaviour also is one of the most importantsigns of post-traumatic stress disorders", says Dr. Michael Kramer, who workswith the new software in an army hospital in New York. It is exactly thatavoidance behaviour that keeps the trauma alive, the explosion when a close friend was rippedto pieces, the situations when innocent civilians had to die because thesoldiers feared for their own lives.

Snipers on the push of abutton

The scenarios in "VirtualIraq" are supposed to counteract. Not helter-skelter, but therapeuticallycontrolled, the patients are taken back to the moment of the trauma. One of thescenarios the software offers is for example a typical Iraqi city scenariowhere the proband is able to move around in the streets on the monitor. Thetherapist is now able to specifically let people appear who "back there inIraq" could have indicated a potentially threatening situation and are thusassociated with fear. Step by step increasingly threatening constellations canbe constructed. The affected person has to face up to it cognitively. Inanother scenario the patient drives in a military vehicle on an overland streetand experiences explosions, gunfight or similar things. In the virtual world hedoes not have the opportunity to fire back and is thus forced to face theexperience in a different manner. Vital in all those scenarios is that theexposition should be as realistic as possible. "An expositionhas to have a high panic creating effect in order to work" says Adj. ProfessorAndreas Ströhle of the Klinik für Psychiatrie und Psychotherapie (hospital forpsychiatry and psychotherapy) of the Charité in Berlin. Mid September he gave alecture at the DeutschenÄrztekongress 2007 in Berlin and his topic was the therapy of phobias andother panicdisorders.

What makes the digitalIraq as real as possible?

Exactly that is the problemmany therapists tending towards modern technologies are facing: When theydevelop virtual therapy scenarios for example to simulate a stay in highaltitudes for patients suffering from vertigo, it quickly costs quite a prettypenny. Because if the altitude does not get across reasonably realistic, youmight as well save your time and pennies. In the case of Iraq veterans, thecase is a bit different because it is not that easy to prepare realisticadequate situations in the real world for an exposition therapy if you do notwant to create a Hollywood scenery city or visit a military training base. Insuch a situation the virtual reality might be the only chance to make atherapeutic exposition possible. It does not have to simulate it. Nonethelessit requires thehighest possible level of closeness to reality: With the aid ofbackground sounds and other effects, "Virtual Iraq" tries to meet therequirements.

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