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WaPo: How virtual reality therapy can help make bad memories more manageable
A patient who was seriously injured in a car crash, which killed the other driver, and experiences severe PTSD cannot find therapy that quells their nightmares, sleepless nights, anxiety and depression. Making them relive that moment seems counterintuitive to overcoming that event.
Yet they must.
First, as an outsider watching the crash from a distance. Then through meeting with a virtual avatar of the other person, a time during which the survivor might explain feelings of guilt and ask for forgiveness, a time to say goodbye. Lastly, they might meet the virtual avatar of the crash victim once more, getting to know them and their family before once more saying goodbye. All interactions are done with a VR headset.
Trauma is misunderstood by most, even its victims. How one responds to an inciting incident is itself trauma, not the incident itself. And new treatments in the virtual reality space are aimed at plunging survivors of car crashes and roadside bombings back into the moment that touched off their glance with trauma. Exposure therapy is one of the tenants of a form of cognitive behavioral therapy (CBT) known as prolonged exposure (PE). Virtual reality exposure therapy, used now by the Department of Veterans Affairs, is supported by recent papers published by the National Institutes of Health, but have not reached mainstream.
It exists as another non-evidence-based treatment like eye movement desensitization and reprocessing treatment. Both treatments, including ever-increasing support for hallucinogenic remedies, are part of an institution of modalities that may not be backed by science but work for some. Some is enough when addressing a growing mental health crisis, experts say.
VA has been studying VR therapy — a form of psychiatric treatment known as prolonged exposure therapy — since the late 1990s in an effort to help military personnel deal with trauma. These days, the therapy is gathering support. Recent papers published by the National Institutes of Health suggest a high efficacy rate, although the treatment has yet to be used as a substitute for traditional forms of cognitive behavioral (CBT) or exposure therapy.
It is one of several treatments that have patients revisit emotionally disturbing memories with the guidance of a therapist, including eye movement desensitization and reprocessing (EMDR). Interest in such alternative therapies is being driven by patients frustrated that standard mental health treatments, including “talk therapy” and prescription medications, are not bringing them relief.
Although VR treatment has not been subjected to randomized controlled clinical trials, considered the gold standard for evaluating medical interventions, psychiatrists who work with it say trauma victims often show marked improvement after going through it.
Studies suggest VR treatment may be helpful for treating schizophrenia, dementia, PTSD, substance addiction and some phobias (an early use was for acrophobia — a fear of heights — in 1995). The treatment also has been seen as effective in reducing paranoia, anxiety disorders, persecutory delusions, and hearing or movement limitations in real life.
To find out more about the treatment and those who’ve benefited from or rejected the treatment, you can find my latest story on the cover of Tuesday's Washington Post Health section:
Read the full story here: How virtual reality therapy can help make bad memories more manageable
Later this week, I’ll publish a supplemental, exclusive interview with Dr. Todd Adamson. Dr. Adamson provides VR training and consultation for mental health providers and also offers low-fee VR therapy for OIF/OEF service members.
Thanks, as ever, for reading War, U.S.A.