On June 20th, I attended the day-long “Brain at War” conference in San Francisco presented by NCIRE – The Veterans Health Research Institute, in cooperation with the San Francisco VA Medical Center, UCSF, and the US Department of Defense. Annually hosted by the stately Marine’s Memorial Club & Hotel, “Brain at War” reports on the “ongoing examination of the physical and neurological consequences of military combat duty”. Experts in medicine and science present “the latest innovations and emerging technologies” in the understanding and treatment of PTSD, TBI, and other brain injuries associated with combat experiences.
Some of the presentations were of great value. Caroline Tanner, MD, PhD, the Director of Clinical Research at the Parkinson’s Institute, gave a fascinating overview of Parkinson’s disease and its possible relation to brain injury and exposure to toxic chemicals. My father died from complications of Parkinson’s, and while I was familiar with some of the information Dr. Tanner presented, some of her material was new to me.
Robert Obana, Executive Director of NCIRE, graciously included me at a lunch table where I was able to meet several presenters and other important conference attendees. We had a lively discussion on many topics, one of which included the day’s most thought-provoking presentation.
The presentation came courtesy of Dr. Albert “Skip” Rizzo, the Associate Director for Medical Virtual Reality at the Institute for Creative Technologies, USC. Skip, who obviously loves his job, gave a fascinating overview of his work developing virtual reality applications for military personnel training and treatment.
Briefly, Skip’s work involves four areas: first, an intense, customized version of the Xbox game “Full Spectrum Warrior” for PTSD exposure therapy; second, a video resilience training program modeled on a “Band of Brothers” format; and third, a somewhat folksy, virtual-online PTSD mentor-coach, dispensing information and coping skills from across the table on a porch.
The fourth application involved the creation of a virtual therapist who conducts a Skype-style counseling session from a comfortable chair. The program uses a fairly young, female image to probe for emotional dysfunction in her real patient by instantaneously tracking patient verbal responses while reading both vocal patterns of distress (by microphone) and visual body language (by web-cam). The virtual therapist is programmed to then respond verbally and physically in real-time to the issues shared by the military patient. “That sounds difficult”, she acknowledges when a veteran reveals a painful memory, and leans forward when her real-life patient leans back.
The therapists, social workers, and counselors in the room reacted strongly to this simulation. I felt a visceral dislike for what struck me as a removed and cold treatment approach to the complicated issues and deep wounds of many of our traumatized combat veterans. A “sensitive” machine is still a machine. Won’t troubled service members feel belittled and dismissed if they assume they don’t rate face-time with the empathetic, skilled professional help of a real, live therapist?
This chilling prospect was remedied, somewhat, by Lieutenant Colonel Steve Countouriotis, US Army (Ret.), NCIRE Board of Directors, and fellow resident of Petaluma, in his closing remarks. He brought humanity back into the day and touched me deeply.
So, on to the question of this blog post title: Would you talk to a virtual therapist? There’s a possibility, I admit, that feelings of intense embarrassment or shame could make confiding in a virtual, not-real therapist seem safer or easier. I would appreciate it if you’d weigh in on this one. Could you see yourself participating in virtual therapy? Or, do you see it more as I do, as an approach which could oversimplify and disrespect the complex nature of trauma and being human?