Monday, November 13, 2006
Reliving The Trauma of War
I was engaged in a spirited conversation with a producer as I left CNN for Emory University to check out new technology designed to help our returning warriors through Post Traumatic Stress Disorder. We were discussing what we would do if the researchers put me through the virtual reality therapy and nothing happened. After all, I had been in the Iraq war zone for only a few weeks back in 2003, nothing like the extended tours of duty of our service men and women. This, paired with the usual journalist's approach of "prove it" when it comes to new therapies, led us both to question whether we would have any video to put on the air after this trip to see Dr. Gerardi at Emory.

I wasn't ready for what would happen to my mind and body. Through this technology, which is like a video game and experienced by the patient wearing a wired-up helmet, I truly relived some of the most terrifying moments of my life, those moments when I really thought I was going to die. I could feel my heart pound and my hands shake as the therapist continued to remind me that the purpose of the simulation is to let me experience those moments as realistically as possible, but in a safe place.

I was overwhelmed by my response to this experimental treatment. I felt so out of control with real feelings of helplessness and despair at first. I felt more in control after going through the simulation a couple more times. And that's the goal - to help the military men and women, whose lives are on the line, come home and be in control of their memories and fears.

My experience gave me a new respect for the mental enemies faced by our troops and a new appreciation for the work of those trying to help them.

Tune into Anderson Cooper 360 tonight at 11 PM Eastern to see more about the experience of soliders who return from the war, only to fight equally challenging battles at home.
I remember when you were wired up for the dream segment and how it played back, so this will be quite interesting. I'm curious to know if any of this ever plays back in real time "flashes" as deja vu.
How effective do you think this kind of therapy would be to someone who has been dealing with PSTD for a longer period of time before the diagnoses. Say, 5, 10, 20 years down the line?
How absolutely sure are you that reliving those experiences won't renew the trauma rather than make it more manageable?
Your story about homeless vets. from Iraq is very disturbing. This message goes to all who support our troops in Iraq. Where are you when they come home? You can do the talk,but you cant do the walk. This country and its President should hold its head in shame.
I am diagnosed with chronic PTSD, agoraphobia, anxiety, and depression. I am a OIF III vet. After dealing with how I felt for eight months, I got tired of the pressure in my chest when I wake up, sleeping only a few hours a night, extreme hyper-vigilance (severe road rage) and depressed for reasons I couldn't explain (hours of crying, helplesness). I also felt detached from what was once "normal," almost surrealistic. If I have to go somewhere during the day alone, I get a big ball in my stomach and count the number of pieces of trash and small advertising signs along the roadsides (it's an I.E.D. thing they used to blow up) and feel vulnerable without my weapon (I don't own any, relax). I dislike wide open spaces too I feel like a target. I used to be so tense and clinch my jaw so much I knocked the cap off my tooth. The memories that stick with me the most are the loss of a fellow troop/brother we lost to an I.E.D. and I've had dreams of putting him on the plane for his funeral back home, the aftermath of a suicide bomber that killed 30 men, women and children in a market place. It's very vivid in my mind watching the medics collecting scattered human body parts while I was pulling security of the scene, and my vehicle was hit by an I.E.D. thinking my HUMMV blew a tire (which they don't). I lost my hearing at that time but it restored. I dislike the day, because that's when we conducted our business. Night is much more comfortable, unless a backfire, sky rocket, or bolt of lightening blows. That's was a time when the Paladins would fire for our night mission guys. Finding someone to listen to you helps, but they are only part of the puzzle. The meds I am on (Paxil, Clonopin) are allowing me to be more manageable within my enclosed space, and the 12 to 16 hours of sleep helps and no more chest pressure. I still have no need to go outside though. After reading your website of PTSD I thought it was strange that the day I walked off my job in a blithering rage was the same day my fellow soldier/ brother was killed and sent home, I didn't realize that until now.

I wrote all of this to help my other brothers in arms that they are not alone (like I used to feel). Get some help, you won't regret it. When I sleep now, I actually have some good dreams too. IT IS well worth the effort. You may be a soldier or a marine, but you are still human and a very important part of society. Find your Vet Center and get over there even if you need mom or dad to give you a ride. My best friend threatened me he was going to get me a police escort to the VA, I sucked it up and got there as fast as I could legally drive. If you are unable to work there's always family support at your base or post. They are a blessing! They are there for us, and have resources that are unbelieveable!

Thanks Dr Gupta, things are making more sense.
I am very glad that they are trying to come up with new ways to treat PTSD rather than just treat the symptoms. It's great that the soldiers are getting some help. However, I hope they don't forget about the families who are going through PTSD also. Sitting and waiting for phone calls, after an incident has happened over there is very difficult. Especially for the families who have soldiers on the front lines. Speaking as a spouse whose husband has PTSD. I am seeing improvment with him having to relive the memories. Unfotunately there are not nearly enough trained Professionals to help the soliders in need.
Wonderful segment. I am a psychiatric nurse and currently obtaining my masters degree with my focus on PTSD in combat vets. I just happened to turn CNN on and was captivated by your segment this morning. Thanks so much! Sometimes SSRIs "just ain't enough" PS Lets all try to remember Sgt. Matt Maupin from Ohio, he is till missing and that poses PTSD for his family and friends!
You news about PTSD was good but I think it's missleading. As Viet Nam vet, I' m still waiting for help. I'm now 62 years of age and have been turned down. VA gives me deperssion pills. I truely think you were misled.
The fact that we have professional soldiers,with the best trainning in the world,does't mean that they are not human.
Nothing prepares you to survive a war without psychological and/or physical damage.
I urge our goverment to take good care of the people who are ready to give their lfe for this nation without questioning.Without them we wouldn't have the liberties that we enjoy today.
PTSD is very real gentlemen,it is not only our soldiers who suffer from the consecuences of PTSD,but also their loved ones.They also need help.
PLese don't let our soldiers alone when the time of need comes;They are always ready when the call is made.
"Semper fi"
Dr. Gupta, About ten years ago I had an auto collision. A car was at the stop street on my right and pulled in front of me. he did not see me, the sun was in his eyes. The physical damage is mostly healed but the post traumatic stress is still there. It has lessened with time but I still get an anxiety reaction when a car stopped on the right moves even a liitle . I did my own virtual reality by going by that same corner over and over again until I could pass it without major anxiety. For the first time, last month, and nearly 10 years later I went by the corner without a thought or anxiety caused by the collision. It has taken me ten years for this mental issue to heal and the mental anguish of war wounds is much more serious so I am not sure there is hope for many or our soldiers.
I am sorry that the Bush administration gave no thought to the terrible mental and physical trauma to our young men and women before they started this terrible war with a country that was no threat to America.
The notion of trivializing someone's most self-threatening memories and feelings by turning them into a video game to be relived over and over may lead to a flashy NIH research grant, but it probably won't do much to help the most psychologically wounded GI's, or worse, may actually cause more damage. However, it does make for great PR to give the impression that PTSD is actually being treated.
As a Vietnam veteran, I was very disappointed in that it seems that my generation's experiences with PTSD are not being drawn upon to help this generation. I had hoped that we learned that just as each individual is unique, so is their PTSD, and their immune system healing response to traumatic stress injury. The best we can offer is "life support" until the mind heals itself. There is no magic "video", or quick trendy fix. It takes time, and resources, and most of all, acceptance by their peers, and understanding and care from all of us.
why hasnt the VA used this procedure on other vets from other conflicts, there are many more of us than the american consiousness can grasp.
I am impressed with your courage and commitment to finding better ways to help those who have PTSD. It was clear that reliving those experiences was difficult for you. Thank you for showing us what it is like be triggered and the impact that it can have even when you are in a safe room with people who care. I am concerned that most treatments focus only on helping people manage symptoms better.

We all owe a debt to those we ask to go in harm's way for us. Thank you keeping the American public aware and searching for the answers.
I am so sorry that Mr Pagliolo feels that using video game technology trivializes the PSTD problems. It couldn't be further from the truth. Please don't equate "game technology" with "childish" or "frivolous." This isn't Mario or Pong we are talking about here! We would never disrespect the sacrifices he and others like him have made!

I'm a long time game developer who is currently doing what we call 'serious games' work and am VERY gratified with the success we are seeing. The technologies in video games are now being used to help patients overcome cancer, help doctors make fewer mistakes in surgery, even help keep our country safer via game style training simulations.

Please understand you have my sympathy and deepest gratitude for your sacrifice. Know that we, in serious games development, are doing everything we can to use what we've learned about entertainment technologies to address very serious subjects and have had amazing success. I am certain that the same success will be realized in the PTDS work being done and we will help soldiers live lives free of the burden of this terrible disorder!
Yeah, like what I WANT to do is fully relive my war experiences. Thanks, but no thanks. I'd rather shoot myself first.
Hi, Skip Rizzo, Ph.D. here from the Univ. of Southern California and I am one of the developers of the Virtual Iraq PTSD treatment tool that Dr Gupta demonstrated in his piece on November 12th. It should be stated right now that Exposure Therapy has the best documented track record in the scientific literature for Anxiety Disorders such as PTSD.
Not having personally experienced the physical and emotional horrors associated with actual combat, I can only try to weakly extrapolate from other traumas in life, which, I suspect, don't even come close to this 'reality'. I have the greatest respect and admiration for all of our troops that put their life on the line for our Country.

I do, however, have a great deal of experience in utilizing what is often referred to as 'virtual reality' (I hate that term) in addressing real world problems. Generally speaking, this involves using such technology to supply information to the mind in manner that the mind can absorb far faster and more effectively than is normal for 'data'. Used properly, the technology permits the brain to process and understand complex non-real world information at amazing speeds.

I assure you that to many of us this is a very serious effort and definitely neither trivial nor a game. There have already been remarkable successes in applying this technology both to learning and to the treatment of phobias or fear.

First, the purpose of the VR Therapy is absolutely NOT to make people relive the situation/fear. This would be cruel indeed! What appears to be happening (and we don't completely understand the mental process) is that you can present what amounts to a cartoon version of a fearful situation which a non-cognitive part of the mind reacts to BUT the conscious mind does not, and therefore retains a degree of control.

Take, for example, arachnophobia, the fear of spiders. If you present the conscious mind with a cartoonish, not very realistic, spider crawling out of a virtual drawer, the mind realizes this isn't a real spider, that isn't a real drawer, I'm in absolutely no danger and the whole scenario is almost funny. The fear pathways in the brain, however, start signaling danger and fear and try to provoke a pre-patterned response.

The therapy appears to provide the conscious mind with the ability to detach and examine it's own involuntary response and begin to assert control over these responses. We further speculate that when this happens, the conscious mind is able to affect a re-programming or re-categorization of situation (and the automatic responses) into a non-threatening, no-response-required area of memory.

While this is a simplification of a process we do not fully understand, there is a high treatment success rate. Often within a few weeks of periodic treatment the phobia will permanently disappear. This doesn't mean the memory is gone or that you won't avoid spiders in the future. But the fear is usually greatly diminished and often eliminated.

PTSD and related conditions are obviously more complex than simple arachnophobia or agoraphobia. However there is great potential here and enough successes to be encouraging. My advice is that if it is available, consider trying it. It doesn't hurt (a shot is worse) it won't take long (weeks not months or years) to find out if works for you, it doesn't involve any medications, and it could put you back in charge of your life (at least this aspect). If it doesn't work, it only wasted a relatively small amount of time. Who knows, you might even have fun!
Why did the report leave out that the researchers combine D-cycloserine with the VR treatment?
Lately I am reading everything that says red meat isn't good for us. My doctor recently told me to avoid red meat, especially those high in iron. I have been diagnosed with Polycythemia Vera and really want my syptoms to go away or be relieved. I really dont need another worry right now so if avoiding red meat will help keep breast cancer away I say that is even more reason to eat Turkey.
I'm glad that more and more attention is being payed to mitigating the effects of PTSD, but I have had great success helping all kinds of traumatized clients using EFT (emotional freedom technique), which has no side effects, can be learned by anyone and is 85% effective in almost all cases. I worked with a famous author, who was deep in the middle of Vietnam atrocities and carried that trauma for 40 years. I was able to clear almost all of it in a singlem 4-hour session, using nothing but this technique and my fingertips! Activating the acupuncture meridian systems, gently, without needles is highly effective and guided sessions can be done on the phone! There are many paths of healing the mind/body/spirit and I have found EFT to be the most effective, to date.
Please continue your excellant work. I look forward to your spot each week and have benefited greatly from the information and insight you provide.
Thank You.
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