Experimental PTSD therapy gets traumatized soldiers walking toward relief

Canada's military says it will soon begin testing a new treatment that combines virtual reality, physical exercise and conventional psychotherapy to help patients overcome Post Traumatic Stress Disorder. The experimental Dutch treatment is also being examined by the U.S., Britain and Israel.

Canadian Forces experiments with new virtual-reality therapy developed in the Netherlands

A test subject tries out the experimental 3MDR system at the Ottawa Hospital. (CBC )

The virtual reality lab at the Ottawa Hospital looks like the bridge of a spaceship or the world's biggest video game.

A treadmill sits on a platform in the middle of a darkened room in front of a huge wraparound video screen. Patients are tethered in a harness to the treadmill as they walk through a series of computer-generated virtual environments, all controlled by a technician at a nearby command station.

The high-tech machine called CAREN, short for Computer-Assisted Rehabilitation Environment, is normally used to help patients with severe physical injuries learn to walk again. But in the next few weeks, the Canadian Forces hopes to use this technology to test an experimental form of psychotherapy to treat soldiers suffering Post Traumatic Stress Disorder.

"I think this can be a game changer," says Col. Rakesh Jetly, chief psychiatrist for the Canadian Forces.

Jetly has high hopes for a new system known as Motion-Assisted, Multi-Modal Memory Desensitization and Reconsolidation, or 3MDR.

Patients step into the CAREN unit, where they listen to music and view photographs on the big screen. The sound and images, chosen by the patient, are meant to remind them of the events that brought on their traumatic memories. For a soldier, it could be images of combat or songs they listened to during their deployment.

With their therapist present to guide and direct them, the patient is asked a series of questions as they walk on the treadmill, steadily and continuously toward the images that bring back their trauma, forcing them to confront their painful memories.

Col. Rakesh Jetly, chief psychiatrist for the Canadian Forces, sees potential in the virtual reality therapy that combines exercise and audio-visual elements. (CBC)

"From a psychological point of view, it's confronting your feared memory by walking towards it. So, the idea is you're walking toward something that you're avoiding," Jetly says.

The 3MDR system was developed by military doctors in the Netherlands. Like Canada, the Dutch military is dealing with a rise in PTSD cases after its mission to Afghanistan. The Dutch military spent four years in the country. Twenty-five Dutch soldiers died and another 140 were injured.

Col. Eric Vermetten is head of research at the Military Mental Health unit of the Dutch ministry of defence. He was in Canada recently to brief doctors here on studies the Dutch military have been carrying out on 3MDR.

"We've walked through, now, maybe 20, 25 patients through the system. And what we see is patients do get better," Vermetten said in an interview.

Walking exercise seen as a 'breakthrough'

Vermetten says 3MDR has been especially effective with patients who have dropped out of other more conventional therapies for their PTSD.

Col. Eric Vermetten, head of research for the mental health unit of the Netherlands' defence ministry, (CBC)

"By putting them on a treadmill, by engaging them in this walking exercise….really was a breakthrough. They felt sort of victorious, that they were proud of the way that they had been able to engage and to sort of reconnect with images of their past that they were afraid to look to."

Both Vermetten and Jetly say 3MDR requires more study. Canada will begin its own testing soon. The U.S., Britain and Israel are also looking at the system.

It's not the first military has experimented with virtual-reality systems to treat PTSD. Advocates for soldiers and veterans don't want to raise unreasonable hope for the new treatment, but say it's vital mental health professionals keep exploring new ways of treating PTSD.

"This is super important," says retired Lt.-Col. Chris Linford, national ambassador for Wounded Warriors Canada, a group that helped injured Canadian soldiers and veterans.

"We need to always be pushing forward and always looking at new ways of treating this injury," Linford says.

"Let's face it, one treatment might work great for me but not work that great for the next 10 guys through the door. So, it's important that we keep expanding, keep the research going, keep the money going into this problem."

A 2013 survey by Statistics Canada showed roughly one in six full-time members of the Canadian Forces reported experiencing mental health or alcohol-related disorders. Roughly one in 20 reported suffering PTSD, nearly double the rate reported in 2002.

The federal government has been sharply criticized for failing to provide adequate services for military personnel and veterans struggling with the disorder. But even one of the government's most outspoken critics says he's encouraged the military is trying out new therapies. 

Michael Blais, founder and director of the group Canadian Veterans Advocacy, sees it as a positive step.

"Programs like this may seem a little out of the box," Blais said. "But they may be effective."