Page 656 - Total War on PTSD

Similarly, PTSD PE treatment requires emotional processing of the fear structures to modify or extinguish their pathological elements so that the stimuli no longer invoke fear, any method capable of activating the fear structure and modifying it is predicted to improve symptoms of PTSD. The key to understanding why exposure therapy works so well in treating PTSD is recognizing the instinctive human response to experiencing trauma: avoidance. As with most psychological responses to stimuli, learned avoidance of threat evolved to protect us. It is the brain's way of making sure we do everything possible to avoid a similar incident. If the last time you awoke to the smell of smoke and your house was on fire, the smell of smoke in other situations is going to trigger an instinct to flee. There is no question that trauma-focused exposure is hard medicine for a hard problem. However, while avoidance is the biggest challenge to overcome in treating trauma, it is also the thing that VR therapy is arguably the most effective in preventing. Simply put, the use of VR is just another mechanism for delivering exposure based on the evidence-based trauma-focused approaches of prolonged exposure, cognitive processing therapy, or Eye Movement Desensitization and Reprocessing (EMDR), where people are encouraged to confront things that emotionally hurt them initially and process them in different ways. Thus, assisting a patient in the process of confronting and re-processing difficult emotional memories in VR has been shown to also be an effective approach in the treatment of PTSD.
In 2003, the University of Southern California Institute for Creative Technologies began the process of developing the BRAVEMIND system. The design vision was to
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