Virtual Reality Therapy Plunges Patients Back Into Trauma. Here Is Why Some Swear by It.

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“V.R. is not going to be the solution,” said Jonathan Rogers, a researcher at University College London who has studied rates of anxiety disorders during the pandemic. “It may be part of the solution, but it’s not going to make medications and formal therapies obsolete.”

Virtual reality treatments aren’t necessarily more effective than traditional prolonged exposure therapy, said Dr. Sherrill. But for some patients, V.R. offers convenience and can immerse a patient in scenes that would be hard to replicate in real life. For some people, the treatment can mimic video game systems they’re already familiar with. There’s also a dual awareness in patients who use virtual reality — the images on the screen are almost lifelike, but the headset itself functions as proof that they’re not real.

Months after the Sept. 11 terrorist attacks, Dr. Difede and Dr. Hunter Hoffman, who is the director of the Virtual Reality Research Center at the University of Washington, tested virtual reality treatments in one survivor with acute PTSD, one of the first reported applications of the therapy. Dr. Difede said that the first time the patient put on the headset, she started crying. “I never thought I’d see the World Trade Center again,” she told Dr. Difede. After six hourlong sessions, the patient experienced a 90 percent decrease in PTSD symptoms. Dr. Difede later tested V.R. exposure therapy in Iraq War veterans; 16 out of the first 20 patients no longer met the diagnostic criteria for PTSD after completing treatment.

At the University of Central Florida, a team called U.C.F. Restores has been building trauma therapies using V.R. that allows clinicians to control the level of detail in a simulation, down to the color of a bedspread or a TV that can be clicked on or off, in order to more easily trigger traumatic memories. The program offers free trauma therapy, often using V.R., to Florida residents and focuses on treating PTSD.

Dr. Deborah Beidel, a professor of psychology and executive director of U.C.F. Restores, has broadened the treatments beyond visuals, customizing sounds and even smells to create an augmented reality for patients.

Jonathan Tissue, 35, a former Marine, sought treatment at U.C.F. Restores in early 2020 after talk therapy and medication failed to alleviate his PTSD symptoms, which included flashbacks, anxiety and mood swings. In the end, it was the smells pumped into the room while he described his military service to a clinician that helped unlock his memories. There was the stench of burning tires, diesel fumes, the smell of decaying bodies. He heard the sounds of munitions firing. His chair rumbled, thanks to the center’s simulated vibrations.

“It unlocked certain doors that I could start speaking about,” he said. He talked through his newly uncovered memories with a therapist and a support group, processing the terror that had built in his body for years.