Schaub T/th 5: 00 R09 Disclaimer

War is one of the most strenuous physical and emotional experiences a person can go through.  No matter how qualified or prepared a soldier is, chaotic warfare environments will undeniably place a great amount of stress on everyone.  This leaves a high percentage of soldiers at risk for developing Post Traumatic Stress Order (PTSD) once they return home.  Veterans with PTSD are often times hesitant to admit they have a problem, and they can also be reluctant to seek professional help.  Furthermore, those who do seek help often come to a sticking point with traditional therapy, leaving their symptoms uncured.  Due to the high percentage of soldiers experiencing PTSD, and the many problems with traditional therapy, engineers and clinicians have teamed up to start treating PTSD victims using Virtual Reality.  

A veteran straps on a Virtual Reality headset, and is instantly immersed inside a digital world.  The goal is to place the veteran inside an environment similar to that of where they experienced their trauma.  Although this may seem daunting at first, it is important to note that every aspect of the virtual world is controlled by a trained clinician who guides the veteran along through their experience.  The purpose is to allow veterans with PTSD to be more comfortable with their experiences at war, instead of trying to bury their horrifying memories deep inside.  

As an avid videogame player, I initially only saw virtual reality as a way for people to become more immersed into a video game.  However, once I researched the professional uses of virtual reality, I was amazed of how what I thought was just a tool for gamers, could also be a medical device used to treat a wide range of disorders and illnesses.  At the University of California, a team of engineers have designed a system just as I mentioned above to treat veterans with PTSD, called “Braveheart.” According to David Rizzo, the head clinical psychologist on the project, it has already shown positive results in numerous veterans, and it is providing new PTSD treatment methods for clinicians and therapists [1].

During a traumatic situation, it is natural for people to be afraid both during and after the event.  This fear causes your body to activate instinctive changes to help defend against or avoid danger.  This type of reaction is typically referred to as “fight or flight” and is intended to protect a person from harm [2].  Distressing events cause victims to experience a wide range of reactions.  However, most people will recover from the initial symptoms naturally over time.  Those whose symptoms are not resolved, and continue to experience the side effects of their traumatic experience, may be diagnosed with Post Traumatic Stress Disorder.  

Post Traumatic Stress Disorder, commonly referred to as PTSD, is a serious potential debilitating condition that occurs in people who have experienced life-threatening events or severely traumatizing experiences [2].  Whether someone was raped, witnessed a natural disaster, had a sudden death of a loved one, or fought in a war, PTSD will more or less have the same effect.  It can cause flashbacks, nightmares, and intrusive memories of when the terrible experience occurred.  
PTSD AND THE MILITARY
PTSD is perhaps most common amongst men and women who served in the military.  According to the PTSD Foundation of America, one in three returning troops experience Post-Traumatic Stress symptoms [3]. Fearing for their lives day in and day out on the battlefield takes a toll on the soldiers’ minds.  Constant exposure to death, gunfire, and many other gruesome aspects of war creates an atmosphere where soldiers are unable to mentally cope with their surroundings.  Once the soldiers return home, they are not the same person as they were before the war.  Certain sounds or sights may bring them right back to the horrifying moments on the battlefield.  A car backfiring, or loud construction noises, may trigger flashbacks to gunfire and combat for veterans.   Veterans with PTSD come home with some very dark problems.  They are unable to sleep, they have anger issues and can often be irritable.  This change in behavior not only causes severe issues with veterans themselves, but with their families and friends as well.  For troops suffering from combat trauma, two out of three of their marriages are failing.  In 2014, on average 20 troops died of suicide each day, and the risk for suicide is 21% higher for U.S. Veterans when compared to U.S. adult civilians [4].  The post traumatic stress these veterans are experiencing is preventing them from living a normal life in society.  The underlying issue with all these veterans is their inability to cope with their specific traumatizing experience.



TREATMENT BY EXPOSING VETERANS TO THEIR TRAUMATIC EXPERIENCE

Trying to bury or ignore what happened on the battlefield is making the symptoms of PTSD worse for veterans.  The solution for curing PTSD is for veterans to be more comfortable with the gruesome experiences they had at war.  In order to do this, researchers are putting the veterans back into the context in which they were traumatized, using virtual reality.

Virtual reality is an illusory environment, engineered to give users the impression of being somewhere other than where they actually are [5].  As you sit safely in a room, strapping on a Virtual Reality headset can transport you to a submarine in the middle of the ocean, a crowded rock concert, or for the purpose of treating veterans with PTSD, a battlefield in Iraq.  Virtual Reality fully immerses its users to re-create the actual experience by combining vision, sounds, touch, and feelings of motion engineered to give the brain a realistic set of sensations [5]. It is relatively easy to trick the brain, and studies have shown that people experiencing virtual reality react the same as they would in an actual real life situation.  For example, someone immersed in a virtual reality scene standing at the edge of a cliff will have an increase in heart rate, and their brain will resist commands to step over the edge [6].

At the University of Southern California, Dr. Albert Rizzo developed a project called Bravemind, a “clinical, interactive, virtual reality based exposure therapy tool being used to assess and treat post traumatic stress disorder” [7].  Veterans with PTSD are reluctant to be reminded of their traumatic experience.  This project’s aim is to provide a means in which the veterans can overcome their avoidance tendency.  The virtual reality equipment was engineered in a way to where a clinician is able to control every aspect of the patient’s environment.  For example, the clinician can control simple things in the virtual world like the location, time of day, weather, etc.  More importantly, they also control the elements that are relevant to that specific veteran’s traumatizing experience, like the sounds of gunshots, explosions in the distance, and enemy helicopters shooting down on the user.  This allows for a controlled, step by step process, where the patients’ stress responses and reactions are monitored via advanced brain imaging and psychological assessment techniques [7]. This in depth analysis offers professionals a better way to research, diagnose, and treat veterans with PTSD that was not possible with traditional therapeutic methods.

Stressful war-fighting experiences are leaving a shocking number of troops at risk of developing PTSD.  With relationships between troops and their loved ones being ruined, and on average 20 troops committing suicide each day, PTSD is an ever increasing problem.  The core to this problem involves veterans being incapable to deal with their harrowing experiences.  Virtual reality offers a new tool for clinicians to expose patients to an environment similar to that of the event which caused their PTSD.  It is known that the virtual world will not be an exact replica of that environment, but that is not important.  What is important is that being in such an environment will evoke emotions and reactions that are necessary to overcome the trauma veterans experienced.  Patients will bring in their own memories and experiences to the virtual world, which will fill in the gaps between the virtual world and their past.  

United States veterans risked their lives for our freedom.  The fact that they have a high chance of coming back from war with PTSD is a shame.  It is only fair that we as a society do everything we can to make sure veterans can live their lives as comfortable as possible upon returning home.  An engineer’s overall job is to apply their scientific and mathematical skills to improve society as a whole.  Veterans plan a crucial role in our society, so engineering a way to improve their lives is important to me.  Engineering a virtual reality simulation has provided clinicians with a new, more efficient way to treat troops with PTSD, enabling them return to their normal lives.  This technology will allow for troops to have an easier transition back into society.  It will protect the strong relationships these troops had with their family and friends, and put an end to the sleepless nights and erratic behavior associated with PTSD.  In addition, it can potentially put an end to the 20 veteran suicides every day.
SOURCES
[1] “Treating PTSD with Virtual Reality Therapy” ABC news. Accessed 10.29.16. http://abcnews.go.com/Technology/treating-ptsd-virtual-reality-therapy-heal-trauma/story?id=38742665

[2] “Post-Traumatic Stress Disorder” National Institute of Mental Health. Accessed 10.30.16. https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

[4] “Suicide Among Veterans and Other Americans” Mental Health VA. Accessed 10.29.16. http://www.mentalhealth.va.gov/docs/2016suicidedatareport.pdf

[5] “Enhance Virtual Reality” NAE Grand Challenges for Engineering. Accessed 10.28.16. http://www.engineeringchallenges.org/9140.aspx

[6] “Virtual Reality is about to completely transform psychological therapy” Business Insider. Accessed 10.30.16.

http://www.businessinsider.com/how-virtual-reality-is-used-for-ptsd-and-anxiety-therapy-2016-1

[7] “Bravemind” USC Institute for Creative Technologies. Accessed 10.29.16. http://medvr.ict.usc.edu/projects/bravemind/

I would like to thank my old boss for allowing me to use his virtual reality headset which sparked my interest in this topic. Thank you to Kyle on my floor for allowing me to test out his Samsung Virtual Realty headset. Also, thank you to my roommate Ryan who help me stay motivated during this assignment.