Greg Reger turned on a computer, put on some headphones, and then sat on a chair on a wooden platform.

The computer screen in front of him showed an Army Humvee driving through a small town.  Explosives blew up all around him as the vehicle crawled through the streets.  Suddenly an explosion stopped the Humvee in its tracks.

"For a soldier suffering from PTSD, this therapy allows them to relive the event down to the smallest detail," said Reger, a clinical psychologist and the acting division chief of Innovative Technologies Applications Division at Joint Base Lewis-McChord.  "Instead of the soldier having to remember the sounds and the feel of the Humvee, they can actually feel the rattling and movement of the Humvee in their seat."

Reger is alluding to Virtual Reality Exposure Therapy, which uses interactive computer-generated environments to help reduce anxiety and post-traumatic stress disorder.

The basic premise of VRET is based on the idea that avoiding harmless people, places and situations because of anxiety doesn't help the person; rather, it leads to significant interference in functioning and actually increases anxiety.

Some of the most common issues treated with VRET include PTSD and fears of flying, driving and heights and social anxiety.  However, at JBLM, it is used predominantly with soldiers with PTSD.

The therapy program is offered under the auspices of the National Center of Telehealth & Technology, which is known as T2.  Serving as a central coordinating agency for Department of Defense research, development, and implementation of technologies, T2 provides diagnostic, treatment, and rehabilitative services for warriors and their families with psychological health or traumatic brain injuries.

The goal of the standard treatment of exposure therapy is to ask the patient to revisit his or her fear or anxiety provoking events, Reger said.

"It is a natural thing to want to avoid it, because it is too painful," Reger said. "Most people don't want to talk about it or think about it. For folks with PTSD, they cut out chunks of their life to avoid dealing with these situations, which, despite these efforts, still invade their thoughts and often their sleep.  Exposure therapy turns avoidance on its head."

To participate, persons receiving the traditional therapy are asked to close their eyes and think about the situation in first person as it occurs, he said.  They tell their story for 45 to 60 minutes during 10 sessions.

"A lot of times when they start they tell us they have never told their story in this much detail," he said. "To be successful, they must revisit the memory in therapy.  They need to be emotionally engaged in it.  This can be difficult because everyone who deploys unplugs emotionally to get through the deployment."

To improve emotional engagement,  servicemembers are presented with multi-sensory stimuli.  The virtual environment is customized to resemble the patient's trauma.

"We get specific details from the soldier," Reger explained. "Things like their location in a vehicle, their location in a convoy, the weapons used ... as they tell us their story, we are customizing Virtual Iraq software to match the trauma."

Although they deal with soldiers from every Army career area, there are some common scenarios, he said.  The most common scenario involves IED explosions.

"Their buddy is hit, and several people attempt to render aid," Reger said.  "They move the buddy to an air evacuation area, and the chopper takes them away.  They are immediately put back in the truck on the road where the explosion occurred."

The therapy is designed to work like a virtual computer game.  Equipment includes a rubber replica of an M4 rifle. Then using the software program, the traumatic event is reenacted.  To add to the experience, they have the ability to release scent modules including smells of garbage, body odor, diesel fuel, weapon fire, and burning rubber into the air.

After the servicemembers have completed 10 therapy sessions, the hope is that the PTSD symptoms will be reduced and their quality of life will be improved, Reger said.