Virtual Reality Exposure Therapy for World Trade Center Post-traumatic Stress Disorder: A Case Report

TLDR

Re-exposure to traumatic memories via imaginal exposure therapy can reduce PTSD symptoms, but many patients cannot self-generate painful images. This case study reports on a World Trade Center 9‑11 survivor who developed acute PTSD. The patient underwent six one‑hour virtual‑reality exposure sessions that gradually simulated planes over the WTC, jet crashes, explosions, people falling, tower collapse, and dust clouds. After completing VR exposure therapy, depression scores fell 83 % and PTSD symptoms fell 90 %, indicating a strong preliminary benefit. The study is available for further review at www.vrpain.com.

Abstract

Done properly by experienced therapists, re-exposure to memories of traumatic events via imaginal exposure therapy can lead to a reduction of Post-traumatic Stress Disorder (PTSD) symptoms. Exposure helps the patient process and habituate to memories and strong emotions associated with the traumatic event: memories and emotions they have been carefully avoiding. But many patients are unwilling or unable to self-generate and re-experience painful emotional images. The present case study describes the treatment of a survivor of the World Trade Center (WTC) attack of 9-11-01 who had developed acute PTSD. After she failed to improve with traditional imaginal exposure therapy, we sought to increase emotional engagement and treatment success using virtual reality (VR) exposure therapy. Over the course of six 1-h VR exposure therapy sessions, we gradually and systematically exposed the PTSD patient to virtual planes flying over the World Trade Center, jets crashing into the World Trade Center with animated explosions and sound effects, virtual people jumping to their deaths from the burning buildings, towers collapsing, and dust clouds. VR graded exposure therapy was successful for reducing acute PTSD symptoms. Depression and PTSD symptoms as measured by the Beck Depression Inventory and the Clinician Administered PTSD Scale indicated a large (83%) reduction in depression, and large (90%) reduction in PTSD symptoms after completing VR exposure therapy. Although case reports are scientifically inconclusive by nature, these strong preliminary results suggest that VR exposure therapy is a promising new medium for treating acute PTSD. This study may be examined in more detail at www.vrpain.com.