Virtual Reality for Treating Fears and Prepping troops for combat.
For my first podcast interview, I scored a meeting with Dr. Mark Wiederhold of the Virtual Reality Medical Center in San Diego. Before I researched him, I knew only a small bit of what they did and who they helped. I learned so much about their work talking with him. I showed up for what I thought was going to be a 20-minute interview, and got an experience that spanned almost 3 hours. Unfortunately, I could only present about 20 minutes of the interview in the podcast, so I wanted to bring you a more full description of what they do. Dr. Wiederhold was so welcoming and open to provide me with information. You can tell he is truly dedicated not only continue to provide beneficial service to his clients, but also to continue to develop cutting-edge modes of treating not only their phobic clients, but our country’s Wounded Warriors. I’m already looking forward to returning in the future to hear what they are doing then!
What is the Virtual Reality Medical Center?
Dr. Mark Wiederhold is the President of the Virtual Reality Medical Center (VRMC). The VRMC has locations in San Diego, Los Angeles, Coronado and internationally Qing Dao, China and Brussels, Belgium. Dr. Wiederhold and his team, co-headed by his wife, Dr. Brenda Wiederhold, originally developed Virtual Reality (VR) protocols to treat phobias, specifically fear of driving, fear of flying and fear of public speaking. Many of us can relate to the fear of public speaking, right? No matter how good at it one is now, there was probably a time when they had to psych themselves up in order to go confidently in front of their audience. Well, Drs. Wiederhold and team have technology that can immerse a person in a 360 degree experience to better aid them in overcoming their fears. Their work in the anxiety and phobia arena has expanded over the last 20 years to also include treatment for fear of closed spaces, heights, needles and blood, open spaces, spiders, thunderstorms, school phobia, social phobia, ADHD, panic disorder, flying anticipatory anxiety, general anxiety disorders and for pain distraction. They are now even using VR therapy to treat Wounded Warriors with combat-related Post Traumatic Stress Disorder. How you may ask? Let’s find out!
What is Virtual Reality Therapy and how is it Delivered?
Drs. Wiederhold and their team at The VRMC have been around for about 20 years. Computers were very different back then, which is a pretty interesting bit of information pertaining to virtual reality therapy. Although the virtual reality treatment protocols have advanced with our technical capabilities, surprisingly, the mode of the experience delivery is still very similar to what it was back then. So, what is virtual reality technology? It is essentially a headset comprised of glasses which house a computer screen in its lenses and a set of headphones. A client will wear the headset, watching a scene indicative of a 360 degree experience they fear (i.e. the taking off of an airplane) on the computer screen, while also wearing the headphones which deliver the sound of the actual feared experience. When a client presents for therapy at the VRMC, they will initially go through a 90-minute to 2-hour initial assessment with a licensed therapist. There will be no VR used in that session and it will probably feel like most any other initial assessment at a therapist’s office. What happens next is where it veers from traditional therapy. Since the treatment is to get a person exposed to their feared situation, the first few sessions are comprised of stress-response skill building. Examples of this are relaxation strategies and deep breathing techniques. The client will be encouraged to practice this in between sessions in order to prep them for their 360 degree immersive sessions. After that, the Virtual Reality fun really begins! The VR sessions are 20-minutes of exposure to the feared stimulus wearing the VR headset. While the client is in their immersive experience, the clinician in the room is monitoring the client’s physiological responses through heart and breathing monitors. The session does not seek to “flood” the client with fear (as some phobia treatment protocols do), but rather, the supervising clinician will provide the client with “just enough” stimulation each time to raise their anxiety little by little until they can handle a full immersive experience from start to finish.
This is a Virtual Reality system that uses a smart phone as a display
Virtual Reality Re-Training of Combat Veterans
The Virtual Reality Medical Center has very high rates of success- upwards of over 90% for certain phobias. This is a tremendous number in the world of treatment statistics. After focusing on treating phobias for so many years, Drs. Wiederhold and their team have branched out over the past 10 years to expanding their treatment protocols to treating combat veterans/Wounded Warriors with Post traumatic Stress Disorder (PTSD).
The VRMC’s work with combat trauma clients was born out of their work with survivors of Motor Vehicle Accidents (MVAs) with PTSD. When they realized they were effective with treating the trauma of the MVA survivors, they began to run research trials on developing initial protocols and treating combat trauma survivors. Combat trauma survivors have high rates of what’s called co-morbid, or co-occurring struggles. Most commonly, the co-morbid problems are traumatic brain injuries, substance use disorders (drugs or alcohol), and domestic violence/anger management problems. Treating the PTSD successfully can vastly decrease or even eliminate the incidents of these very serious co-morbid problems. The well-known problem with treating the veteran population from the civilian world has consistently been retention in treatment. The unique nature of the military experience and the combat-centered life has traditionally posed struggles in trusting the civilian therapist. The thinking has been that the civilian therapists “don’t know what it’s like” and the experience of being in theater is not an experience that’s even close to being easy to relate to. The nature of the structure of the VRMC’s protocol is such that the presenting Veteran doesn’t have to worry about having to “re-tell” his war stories. He/she knows that after the initial assessment session, they will be taught skills, and then be exposed to the stimulus scene. Dr. Wiederhold pointed out that since the current veterans are predominantly of the age of the video game generation, for as much as VR re-training is not a video game, it is helpful that the method of re-training delivery is similar to that of a video game. The retention rate has been over 90% and the “re-training” success rate has been about 80%. This is an outstanding statistic no matter what population one is treating, but to have it as the statistic for treating a population that has had such a historically difficult time staying engaged in treatment is really something to take notice of!
But What Does Virtual Reality Therapy Feel Like?
After the formal recorded interview was over, Dr. Wiederhold let me explore the clinic and the equipment. I got to experience an introduction virtual reality experiential session. I was led into an office that looked like a regular generic office – lots of computers on the table top, but nothing that screamed, “You are about to enter a combat zone!” But that’s exactly what I did. I was strapped into the head piece. It was rather comfortable – it felt like what I imagine watching a movie on the lenses of my sunglasses would feel like with the surround sound coming through the headphones. Dr. Wiederhold set up my scene and adjusted my lens for me. Next thing I knew, I was a passenger in a Humvee with my driver and my gunner standing behind me. I didn’t know what to expect as we drove through the village. About 7 or 8 minutes in, I felt my anxiety rise and said to Dr. Wiederhold, “I’m worried that I’m going to miss the blast if I look away”. I was concerned I was watching a potential “real combat” scene. The good doctor assured me he didn’t set me up in a trauma scene – I would not be blown up or shot at. He explained that the voyage I was on was part of a 20-minute Stress Inoculation Scene. This is one of the scenes they are now just beginning to use to get soldiers ready for going to a war zone (I’ll explain more about that in the next section). What I witnessed was driving through an Iraqi town outskirts, and then through a small village. There were people milling about and if I turned my head in any direction, I got a full 360 degree experience- even saw what my feet would look like all geared-up! I really can say that I could see the benefit of getting used to the new scenery before someone is sent there. It is anxiety provoking due to all the unknowns. Getting desensitized to the environment would allow a soldier to possibly be able to more effectively stay present and focused on the potential threats in the area versus having to be aware of every little bit of new stimuli. I was definitely sold on the experience!
I’d love on a return visit to try out a phobia scene – I’ve pretty much conquered a long-time fear of heights, but I’d love to experience that scene. Reason #10 to definitely convince Dr. Wiederhold to let me interview him some more!
I’m getting ready for my VR experience
The Future Possibilities for Virtual Reality Re-Training of other Veteran Populations
The Virtual Reality Medical Center seems to be constantly engaging in research to expand their treatment capabilities. As I mentioned in my experience with the goggles on, they are now doing research in the area of what’s called Stress Inoculation Therapy. According to MentalHelp.net, Stress Inoculation Therapy (SIT) is “a psychotherapy method intended to help patients prepare themselves in advance to handle stressful events successfully and with a minimum of upset. The use of the term “inoculation” in SIT is based on the idea that a therapist is inoculating or preparing patients to become resistant to the effects of stressors in a manner similar to how a vaccination works to make patients resistant to the effects of particular diseases”. The VRMC is not only utilizing this therapy to prepare active-duty troops, but they are also using it to prepare the combat-zone medical professionals. The medics going to our war zones may be used to seeing blood and bodily trauma, but because of potential sheer volume and severity of the traumas they could be subjected to on a regular basis, they have implemented SIT training for the medic staff. (I’ve posted a couple of pics of the training materials). They use fake wounds and blood to desensitize these doctors and better prepare them to stay focused on their tasks at hand.
This is one of the Medic Training Kits.
The VRMC is utilizing the Stress Inoculation Therapy protocol to prepare troops for entering the combat zones. The work the VRMC is doing is focused on coming up with strategies that seek to decrease the risk of PTSD even happening. Wouldn’t that be amazing!
But wait! They’re not stopping there! They have already had the opportunity to send VR equipment to Fallujah and treat troops on base. Established research on treating trauma-related symptoms has demonstrated that the earlier a trauma survivor receives treatment, the better the results of that treatment. With the VRMC being able to equip the war-zone medical centers with the virtual reality technology, there’s no telling how many troops could be spared some really intrusive emotional repercussions. I’ll look forward to finding out at our next meeting what they’ve been able to implement as far as protocols in combat-zone bases.
And there’s more!! When I was prepping for this interview, someone asked me if the VRMC treats Vietnam War veterans. I asked that question to Dr Wiederhold. They are, in fact, beginning to design those protocols. Treating this population would pose different obstacles to overcome: the time removed from the trauma incident, their possible lack of comfort with using the technology, and, of course, getting funding form the Department of Veteran’s Affairs to provide such treatment. In order to get that sort of finding, they will need to conduct research, which also means having access to that population, which certainly is not as readily available as our current veterans. However, after learning about all that they do, I’m sure if the Drs. Wiederhold and their team believe they have a protocol that can help heal this population, they will do everything possible to find a way to deliver it to them.
It was a pleasure and a privilege to spend this time at the Virtual Reality Medical Center and with Dr. Wiederhold. Thank you!
