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Virtual reality vs. PTSD: Helping combat vets heal

Researchers at USC's Institute for Creative Technologies are using virtual reality systems to help combat post-traumatic stress disorder. CNET Road Trip 2012 stopped by to learn more.

Paul Debevec, who heads up the graphics lab at USC's Institute for Creative Technologies, holds a mirror ball inside the lab's Light Stage dome. The dome is used to create extremely realistic virtual or animated human faces that can be used in Hollywood films, or to make virtual humans for military therapy purposes.
Daniel Terdiman/CNET

LOS ANGELES--I'm sitting across from a soldier named Garza, trying to get him to open up about why he got caught drinking and driving.

This is a serious offense in the military, and Garza could lose his rank, if not get kicked out of the Army altogether. And it's my job as his superior officer to try to understand that Garza -- who used to be among the best in his unit -- may be struggling with the effects of post-traumatic stress disorder.

This, of course, is a simulation. I'm not in the military, and Garza doesn't even exist. But the idea is very real: training young officers to deal with subordinates who are struggling with undiagnosed issues that might be related to PTSD -- something that has become an epidemic among Iraq and Afghanistan combat veterans.

As part of Road Trip 2012, I've stopped in at the University of Southern California's Institute for Creative Technologies, a series of labs that together create compelling "stories, characters and special effects [and apply] this winning Hollywood formula to benefit service members, students and society at large."

During the course of a whirlwind tour of ICT -- which was founded in 1999 with multiple-year contract from the U.S. Army -- I've gotten a primer in a number of different technologies, many of which either are already, or could soon be, used to help combat veterans or their families handle the growing problem that is PTSD in the military. As has been well chronicled, PTSD is the likely culprit behind an increasing amount of violence, bad behavior, and suicide among veterans. Yet despite a great deal of discussion on the matter, there is still a sense in the military that talking about having PTSD is a sign of weakness. As a result, many service members suffering its effects aren't getting help.

That's where a lot of research is coming into play, and at ICT, much of it is employing virtual reality as a means of developing systems that could eventually inspire veterans to open up about what's plaguing them. At the same time, ICT researchers are also working on technologies that could help those suffering with other serious combat-related maladies, such as traumatic brain injury.

The system that tasks young officers with learning how to handle struggling subordinates is called ELITE, or the Emergent Leader Immersion Training Environment. The idea is that new officers may not yet have the trust of their squad, yet must deal with disciplining them when they get in trouble.

ELITE utilizes a virtual human and a system that runs trainees through a series of scenarios where they have to question a subordinate who has gotten in some kind of trouble that may well stem from an undiagnosed case of PTSD. The goal is for the young officers to learn how to steer their charges in the right direction when trouble like this arises. And the system utilizes virtual reality because it's an ideal way for the young leaders to practice scenarios over and over again -- each time trying to get a little better at handling a difficult situation with a level of sensitivity that someone struggling with a serious, but untreated, ailment deserves.

Virtual Iraq/Afghanistan
ICT researcher Skip Rizzo knows that PTSD is a serious problem in the military, and he knows that one of the keys to helping sufferers is to get them to confront the events or issues at the root of the malady.

With Virtual Iraq/Afghanistan, combat veterans can gradually relive the events that led to their PTSD, such as experiencing a road-side bombing. Daniel Terdiman/CNET

That's the idea behind Rizzo's Virtual Iraq/Afghanistan system. Designed to be used in conjunction with slow and methodical therapy, the technology gives therapists a way to take combat veterans through actual events. To be sure, there's no way to go back in time, but if the patient is able to open up enough to the therapist about what helped lead to the PTSD, the therapist can use the software to develop a virtual run-through that re-creates -- often with a great deal of specificity -- what happened.

And to make the system even more helpful, Rizzo's team has seeded it with tools that can add certain kinds of triggers -- such as the smell of rotting garbage, burning cordite, or diesel fuel -- that might get the troubled service member to open up.

It might seem that making a combat veteran relive, say, a roadside bombing, or friends getting killed in front of them, is cruel. But in fact, if done properly, and repeated carefully, it can be a key to helping a veteran process what is plaguing him or her, and potentially escape the constant anxiety that comes with PTSD. Rizzo has stats that back up the assertion. Of the first 20 veterans who went through the system, he said, 16 no longer met the definition of having PTSD after the treatment.

Sim Coach
While the combat veterans are the ones struggling most directly with the effects of PTSD -- or in some cases, traumatic brain injury -- their families and friends are right there with them. Families, once a cornerstone of military life, are falling apart at record levels. So researchers at ICT have come up with another system that aims to help loved ones get some of the help they need, all without jeopardizing the veteran's privacy.

One system is called Sim Coach. Utilizing a Web-based virtual human programmed to ask a number of questions that can help loved ones understand how to navigate what's happening to their family.

One key component is that the virtual therapist makes it clear he -- or she -- doesn't represent the military. Instead, he or she is there to act as an advocate for the loved one, and to potentially guide them to more in-depth local assistance. In order to achieve that, the Sim Coach asks a number of questions to try to figure out the right approach for getting help. And ultimately, one powerful result is that these people often start to get used to confiding in someone else about what's happening to them -- even if it's just a virtual character.

Daniel Terdiman

More from Road Trip 2012: Tech out West

Check out the latest from Daniel's tour of all things geeky in the Golden State, with jaunts into Nevada, Arizona, and Oregon, as well.

Light Stage and Digital Emily
Given that ICT is in Los Angeles, it shouldn't surprise you that there is a fair bit of Hollywood in the lab. That's true nowhere more than in the graphics lab, home to the Light Stage. This full sphere contains dozens of special cameras, as well as a unique LED lighting system that, put together, is capable of creating a facial scan that can give animators or virtual reality programmers access to a virtual face far more realistic than what has come before.

The system has been used in several Hollywood films -- including "Avatar" -- but it is also useful at creating faces that can be used by virtual humans for therapeutic purposes. Researchers have concluded that the more realistic the face is, the more likely a service member will respond as desired, especially when the face is joined by realistic scenario programming.

A showpiece for Light Stage is the Digital Emily project. For this, researchers scanned actress Emily O'Brien and using the special lighting system inside Light Stage, were able to generate 32 specific animated facial expressions of hers. Those expressions, it turns out, are enough to give an animator all they need to make a realistic animated Emily.

Mixed reality lab
Though not clearly related to helping the military tackle PTSD, the work being done in ICT's Mixed Reality Lab is no less impressive. There, researcher Mark Bolas is working on virtual reality tools that could soon give the military ways to train service members in combat scenarios with higher fidelity than ever before.

The showpiece of this research is a system called Redirected Walking. By putting a head-mounted display on someone, the researchers can then usher that person through what they think is a long walk down a gravel path hundreds of feet long, all the while looking out into a desert scene with a 140-degree view that changes in real time, and with the wearer's movements and turns of his or her head, far more than anything else available, Bolas claimed.

The trick is making the wearer believe they're going into a room and walking around inside looking for something. What really happens is that the wearer returns to the original starting point on the lab's 30-foot-long gravel path. But they don't know that. Instead, they return to what they believe is the same spot on the path that they left to go into the room, and pick right up where they left off. The point is to get service members comfortable with running scenarios with a head-mounted virtual display.

That was very cool, of course: I had definitely never experienced anything like it. But I wanted to know when there were be a version that utilized a more realistic sized set of goggles or the like. Bolas said "I could hug you," and walked me over to a table with some, yes, goggles. Here, he showed me a set of smartphone apps that he and his team designed to approximate the larger work they've done on an every day device. It's not the same, of course, but when I put on my goggles, wrapped around my iPhone, I was inside a virtual space, and wherever I moved my head or my eyes, my view in the virtual room reflected the move.

It was one of the coolest things I've ever seen done with an iPhone. And coming before too long, I'm sure, the real technology Bolas and his team created will be reduced in size from a giant, unwieldy helmet to something as stealthy as a pair of glasses. I can't wait.

Correction (Tuesday, 9:24 p.m. PT): This article originally mistakenly called ICT part of the University of California.