By Rachel Stern

There’s a strange but familiar mixture of exotic spices and body odor that saturates the desert streets. The soldier steps out of her rumbling Humvee, readies herself for combat, and feels the beads of sweat trickle down her neck.

She wishes this weren’t real. This time around, it isn’t.

In the immersion system of “Virtual Iraq,” realistic street scenes, sounds, and smells encourage Post Traumatic Stress Disorder (PTSD) sufferers to “re-live” Iraq in a controlled environment. In “exposure therapy,” the clinician determines the environment the patient is ready to see—ranging from driving a Humvee down a desert road to being immersed in a zone of rapid gunshots and explosions. For an extra dose of realism, participants can stand on a platform that recreates the vibration of a military vehicle or a concussion from a bomb blast.

“You can raise the level,” said Dr. Albert “Skip” Rizzo, who presented his research Sunday, Feb. 18 at the American Association for the Advancement of Science (AAAS) meeting in San Francisco, of what many would consider his unorthodox therapy.

Rizzo, a psychologist at the University of Southern California’s Institute for Creative Technologies (ICT), has helped create other virtual exposure therapies in conjunction with the Office of Naval Research. They range from placing arachnaphobes in homes crawling with spiders to helping stroke victims gain motor rehabilitation through ping-pong.

“[Exposure therapy] allows people to face their fears and feel more in control,” Rizzo said.

Virtual Iraq has been utilized in clinical trials in 10 locations around the United States, although only four soldiers—including a 21 year-old woman who witnessed multiple suicide bombing attacks—have successfully completed treatment.

Four soldiers have discontinued the treatment, but the dropout rate, according to Dr. Rizzo, is not any higher than that with other forms of therapy.

Success in virtual reality exposure therapy “translates into being able to leave the house, go to work, and carry on a relationship with your wife and loved ones,” Rizzo said.

The only negative effects of the therapy, he said, are too much initial exposure, noting how a Vietnam War veteran had a panic attack when virtually placed into the war zone he had not experienced for 25 years.

“The therapist has to be in close contact,” Dr. Rizzo told City on a Hill Press (CHP). “We’re not trying to eliminate the clinician; we’re just giving the clinician a tool.”

The “Virtual Iraq” participant wears a headset that can show virtual images of either a street scene or a desert. The system, which costs almost $10,000, includes a “smell machine,” a box that delivers eight different smells—cordite, diesel fuel, burning rubber, body odor, middle-eastern spices, and cooked lamb—by means of an aerosol spray. The typical PTSD treatment takes place in two one-hour sessions over the course of five weeks with an average cost of $160 an hour.

Being able to walk a patient through the senses and sounds of their trauma is what distinguishes virtual exposure from conventional forms of therapy, according to Jane Bogart, UC Santa Cruz Student Health Outreach and Promotion Coordinator.

“Sometimes fears come from not knowing what is happening,” said Bogart, who helped counsel PTSD sufferers after the 9/11 attacks as the Health Promotion Director at New York University.

Post-traumatic stress syndrome describes psychological after-effects of traumatic events. Victims often suffer from nightmares or flashbacks, increased irritability, and isolation.

A 2004 study by the Walter Reed Army Institute discovered that almost one in eight soldiers returning from Iraq and Afghanistan experienced some syndromes of PTSD.

In “real life” therapy for PTSD, sufferers have often been asked to imagine previous traumas. According to Dr. Rizzo, this method is difficult, as PTSD sufferers tend to block out the source of their fears.

Dr. Elana Zimand, Director of Clinical Services at the Georgia-based Virtually Better, agrees that virtual exposure therapy is a safe method for easing patients into difficult situations.

“Real life scenarios are really good ways of conquering fears, but sometimes they’re too scary,” Zimand said. “This is a good first step.”

Virtually Better pioneered virtual reality exposure therapy in 1996. In addition to treating PTSD, the clinic—whose groundbreaking footsteps Rizzo follows—aims to help patients conquer various anxiety disorders ranging from fear of flying to fear of heights.

“[Virtual reality exposure therapy] is equally effective to other treatments,” Zimand said. “But it can be better because of the ease of delivery.”