Posts Tagged ‘PTSD’

Lara CroftFor a few years now, I’ve been raving about Crystal Dynamics’ reboot of Tomb Raider and their reimagining of its protagonist, Lara Croft, from a scantily clad, hypersexualized, adolescent male fantasy to a more realistic, appropriately dressed and anatomically restrained, tough, gritty survivor (see my earlier post here). I applauded their depiction of her as an imperfect woman forced by circumstance to make difficult choices and carry out some fairly gruesome acts in order to stay alive and save her friends. Lara’s not proud of what she does, nor does she take pleasure in it. She does it because she has to, because her only other option is to give up.

That both gamers and critics praised Tomb Raider came as no surprise. At long last, the franchise had a game that looked stunning, played beautifully, and featured a tough, intelligent heroine that both men and women cared about and could believe in. Here, at last, was the Lara Croft we’d all been waiting for.

And now, Crystal Dynamics has done it again. At Microsoft’s E3 press conference this past Monday, they revealed a teaser trailer for Rise of the Tomb Raider, slated for a late 2015 release. The trailer features all the energy and excitement of the first game, including a few very tense moments of Lara in peril—no surprise there. But it features something else, something unprecedented in the history of gaming.

Rise of the Tomb RaiderThe video begins, not with Lara escaping death or brutally overcoming an attacker, but with her in therapy. You read that right: therapy. We see her on the edge of a chair, cloaked in a hoodie, head downcast. As the therapist talks, Lara digs her fingers into the upholstery, clenches her fist, bounces her leg. She can’t sit still. She’s clearly anxious and uncomfortable. This is not the bulletproof heroine we’ve come to expect, casually shaking off the death she’s dealt. Lara has experienced horrors the likes of which most of us can’t imagine, and she’s been deeply affected by them. But neither is she a broken woman. Battered and scarred yet alive, she’s found away to exist in between. Her therapist continues:

For many people, these traumas become a mental trap. They get stuck, like a ship frozen in ice.”

Lara HoodiePTSD. That’s what he’s talking about. This is classic Post-Traumatic Stress Disorder. Lara is suffering from something that affects nearly eight million American adults, that’s all too common among veterans of war and survivors of abuse, that can strike at any age, and that can tear families and communities apart. She has PTSD, and she’s dealing with it. That a video game is so directly dealing with this is extraordinary. And that Lara is working through and recovering from the trauma of her ordeal may provide hope to those facing traumas of their own. I’ll leave you with the experience of a young woman suffering from PTSD who, while playing Tomb Raider, discovered just that:

It didn’t hold any punches, but it didn’t need to… it affected me in a way years of therapy never did. It healed me in a way that no one’s physical comfort, words, and condolences could ever do. It made me realize that, much like Lara Croft, I survived as well—and that I had my own path to walk. That my experiences were real and tangible and yes, they defined me, but that I’d have it no other way. I am a survivor and I am alive.”

After years of buried trauma and hidden pain, this young woman had found solace and salvation by her own hand, through Lara Croft and the game. By reimagining Lara, Crystal Dynamics has done the impossible: from a game heroine, they’ve created a human being.

Picture this: you’re behind the wheel of a military Humvee on the road to Fallujah, your unit’s team leader in the seat next to you and half a squad of Marines in the back. Tensions are high: Iraq is still a hotbed of violence, you’re traveling a dangerous road, and everyone knows the risks. Still, nothing’s happened yet. You’re just beginning to relax when a roadside bomb—one of the infamous IEDs—rips through the truck with a deafening roar. Your team leader dies instantly, but you barely have time to notice because the Humvee’s now on its back. Screams sound from behind you. Looking back, you can see your team through the billowing smoke—and it’s not pretty. A Hollywood makeup artist with an unlimited budget and a taste for the macabre would have a hard time duplicating the scene. Some of the men are dead, the rest horribly wounded. There’s something burning in the back, noise and smoke are overwhelming. You need to do something, but what?

Try taking off the VR headset.

Fortunately for you, this was only a simulation. But for many US servicemen and women, variations on the above scene are all too real. And for those who survive, healing from the physical wounds may be the easy part.

Post-traumatic stress disorder, or PTSD, has always been a serious problem, and it’s getting worse: Iraq and Afghanistan are unique in the history of US military conflict (length of deployments, faster than usual redeployment, etc.), and seem to be contributing to growing mental health problems. According to Steven Huberman, PhD, dean of Touro College’s School of Social Work, in New York City,

Since the deployment to Iraq and Afghanistan started… we’re seeing a significant difference from other military involvements, in the number and types of injuries, the types of deployments, the nature of the military force, and the impact on families and kids.”

PTSD is often hard to identify, always difficult to treat, and has far-reaching impacts on sufferers and their families. In order to recover, victims have to confront the memories and emotions surrounding the traumatic event and eventually work through them. Ignoring them only creates more severe problems. The trick is confronting the memories safely.

Enter Virtual Iraq. Virtual Iraq is an immersive, 3-D virtual world that allows a PTSD patient to re-live a traumatic situation in a safe environment. Based on the videogame Full Spectrum Warrior, Virtual Iraq places the patient into a therapist-controlled combat scenario. During the scenario, the therapist exposes the veteran to the sights and sounds of battle at a level that he or she is emotionally capable of handling. As the patient progresses, the therapist can turn up the heat, enhancing the realism of the scene by delivering additional sounds and images—jets flying over, insurgents coming out of palm groves, IEDs, explosions—into the environment. The videogame provides a safe environment for the patient to confront their emotions and ultimately gain control over the PTSD.

Says Albert “Skip” Rizzo, a clinical psychologist at the University of Southern California—and Virtual Iraq’s developer,

VR puts a person back into the sights, sounds, smells, feelings of the scene… You know what the patient’s seeing, and you can help prompt them through the experience in a very safe and supportive fashion. As you go through the therapy, the patient may be invited to turn on the motor. Eventually, as they tell their story, you find out that it wasn’t just a vehicle in front, it was a vehicle with five other friends… The guy that died was going to be discharged in two months. You start to see a rich depth of story.”

This type of treatment—called virtual reality exposure therapy (VRET)—isn’t limited to combat vets, though. There are virtual environments for treating much more common fears, including flying, heights, storms and public speaking. Virtually Better—the company behind Virtual Iraq—also has other environments designed around specific traumatic events: Vietnam, Hurricane Katrina and the attacks on 9/11/2001.

Here’s Skip Rizzo again, this time in his roles as Associate Director – Institute for Creative Technologies, and Research Professor – Psychiatry and Gerontology, University of Southern California, Los Angeles:

Results from uncontrolled trials and case reports are difficult to generalize from and we are cautious not to make excessive claims based on these early results. However, using accepted diagnostic measures, 80% of the treatment completers in our initial VRET sample showed both statistically and clinically meaningful reductions in PTSD, anxiety and depression symptoms, and anecdotal evidence from patient reports suggested that they saw improvements in their everyday life situations. These improvements were also maintained at three-month post-treatment follow-up.”

Perhaps the best testament to the effectiveness of Virtual Iraq, though, comes from this 22-year-old Marine injured during combat operations in Iraq:

By the end of therapy I felt more like one person. Toward the end, it was pretty easy to talk about what had happened over there. We went over all the hot spots in succession. I could talk about it without breaking down. I wasn’t holding anything back. I felt like the weight of the world had been lifted.”

This young man—and there are many others—gained his life back in large part through the healing power of a videogame.

Maybe videogames do have something positive to offer after all.

A quick Google search for Virtual Iraq will give you more information than you ever wanted, but here’s a selection of the best links:

Here’s an article from the New York Times Health section.

The New Yorker magazine published an article on Virtual Iraq here.

Check out this article about Virtual Iraq from Veterans Today.

NPR has a similar story here.

The US Army’s official web page has a story on VRET and PTSD here.

Here’s Fast Company’s take.

A discussion of Videogames and PTSD is here.

And you can find Virtually Better’s website here.

Safe sex, clinical depression, PTSD, knee replacement rehab, Parkinson’s, acquired brain injury, nutrition, weight loss, diabetes, Cystic Fibrosis, nightmares, cancer, dancing, HIV, emergency response. What do these have in common? They’re all subjects of videogames, and are all featured topics at the seventh annual Games For Health conference in Boston next week.

The Games For Health conference is one of the largest gatherings of researchers, medical professionals and game developers interested in learning about and shaping the impact that videogames have on health and health care. For three days (5/16-5/19), several hundred people will hear how videogames and game technology are being used across a variety of disciplines—neuroscience, healthcare, defense, game development, pediatric medicine, and behavioral health among them. There are games for things like weight loss, smoking cessation, disease management, and pandemic preparedness, and game technology has been adapted to help soldiers recover from traumatic stress, train paramedics in emergency response, and speed up post-injury rehabilitation.

For more information about Games For Health, follow this link:

About Games For Health

And be sure to preview the conference schedule here:

G4H ’11 schedule

Check back here throughout the week, as I’ll be posting updates from the conference.