An experimental treatment using virtual reality technology seems poised to address a dire mental health crisis. Here is why some swear by it.

Iran PressSci & Tech: When a Veterans Affairs therapist first suggested that Chris Merkle try a virtual reality simulation that would mimic his days in combat, he was horrified. “I was like, you want to put me in a virtual world, reliving my worst days, my worst nightmares?” he said.

It was the winter of 2013, and after three tours in Iraq and four in Afghanistan, Merkle had spent years struggling with the invasive symptoms of post-traumatic stress disorder. He felt constantly on edge, bracing for an attack. He got angry easily. He avoided thinking or talking about his time as a Marine; he tried traditional talk therapy, but didn’t feel ready to discuss his past, The New York Times reported.

Months later, after his symptoms intensified and he felt desperate for a salve, he decided to give virtual reality exposure therapy a try at a Department of Veterans Affairs hospital in Long Beach, Calif. The treatment uses VR technology to immerse a patient in a three-dimensional environment that mimics a traumatic memory. He strapped into a headset and sank into the past.

The details in the simulation were extremely precise, Merkle said: The military-issue truck, the weight of the model gun in his hand, the dark swath of sand in the night. He narrated one particularly troubling incident out loud to a clinician, who adjusted the simulation as he spoke. “I was seeing that person shooting at me, that I hadn’t thought about in 10-plus years,” he said. His muscles tensed. His heart raced. He was terrified.

“My body was physically reacting, because my mind was saying, this is happening to us.” But when he took the goggles off, he said, the sense of accomplishment became its own form of comfort. For years, his memories had terrified him. Confronting the past in VR proved to him that he could survive revisiting his memories. “That was the biggest leap,” he said.

After about seven runs through the simulation, Merkle started uncovering fragments of memory his mind had blacked out, which is a common response to trauma. He remembered the name of the soldier who had been next to him in a truck during combat. He remembered the clear feeling that he was going to die. Merkle walked out in the hall after he was done, grappling with what his brain had revealed.

He felt like he was in a fantasy novel, he said. As he left the session, he imagined that “there was this black smoke pouring out of my mouth, oozing out of me. Like this evil, for lack of a better word for it, was slipping out” of his body. He got to the parking lot and sat in his car for an hour. The treatment was working, he thought. He was less scared of his memories, less scared of himself. He was getting better.

Why VR? Why Now?
The most significant disorders that virtual reality therapy has shown success in treating — PTSD, anxiety, phobias — are on the rise. An April survey by the Centers for Disease Control and Prevention cited significant increases in respondents showing symptoms of anxiety disorders. Health care workers have reported high rates of PTSD during the pandemic — a February study of 1,000 frontline workers reported that nearly one-quarter showed likely signs of the disorder. In contrast, only 6.8 percent of the general population ever experiences PTSD in their lifetime, according to National Institute of Mental Health estimates.

“Covid has been traumatizing to so many people in so many ways,” said Nomi Levy-Carrick, a psychiatrist who leads outpatient psychiatric services at Brigham and Women’s Hospital in Boston. Grief, isolation, economic upheaval, housing and food insecurity, the “toxic stress” of lockdown and the surge in domestic violence during the pandemic can all be traumatic stressors, she said. And the constant uncertainty of the past pandemic year created conditions for widespread anxiety.

Recreational VR headset sales to the general public have grown during the pandemic, but the technology has yet to fully enter the mainstream. Experts who study the therapy argue that’s about to change for the medical establishment, as clinicians look for effective and accessible ways to treat anxiety disorders.

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