Virtual Reality Combat Simulations as a Treatment for PTSD

PTSD Virtual Reality War Games

Recently we at Veterans Today have been getting a lot of feedback both positive and negative on the Pentagon’s experimentation with Virtual Reality War Simulations as a treatment for PTSD.

First let me say that I personally want to approach this with an open mind, heck I’m a strong, passionate supporter of Assistance, Service, and Companion Dogs for Vets and Troops as a treatment for PTSD but not as a exclusive approach. That said, not even the Pentagon is advocating the use of virtual reality combat simulations as the answer for PTSD, combat stress, or combat trauma but as a weapon in their arsenal for dealing with and helping troops cope with PTSD. After all the MISSION of military medicine is Force Readiness.

What I do caution are (1) Sally Satel has advocated this approach from the early stages of its development and that alone turns my radar of suspicion on, and (2) virtual reality is based on a commercial war game that is sold in Wal-Mart, K-Mart, even on Base and Post Exchanges, so why spend tax payer bucks on a defense contract when military psychologist can just pay a few bucks to pick up a similar war simulation at the Bx or Px and tailor it to the patient’s PTSD symptoms?

Veterans Today Editorial Comment and Revision: Although Sally Satel is not a direct participant in the development of this effort called Virtual Iraq, she has promoted the alternative treatment on several occasions. Dr. Albert “Skip” Rizzo the founder and developer of Virtual Iraq has no official ties with either Dr. Sally Satel or the American Enterprise Institute (AEI) that we know of.

Anyway, we at Veterans Today have decided to do a series of articles focusing on this latest development in state of the art technology to treat PTSD. I am going to do best I can to paint a balanced picture of the pros and cons, because as I said we should approach this open minded, fiscally prudent (is is cost effective per patient treated), exactly how does it differ from the War Games psychologist can buy or prescribe for their patients at the BX/PX, but most important how many active duty troops can they get to step forward and admit they have a problem using this attention getter?

Lastly, what are the implications, if any, for expansion of this treatment into the Department of Veterans Affairs? If PTSD is caught, treated, and troops even taught to cope with PTSD and stay on active duty, then eventually PTSD could become a thing of the past within the VA system. Are we talking cure here? Maybe, maybe not.

Robert L. Hanafin, Major, U.S. Air Force-Retired, Veterans Today News Network

Dr. Sally Satel Promotes Virtual Reality War Games as a Treatment for PTSD

During testimony on post-traumatic stress disorder (PTSD) and other personality disorders affecting U.S. military veterans before the House Committee on Veterans’ Affairs way back on July 25, 2007, Dr. Sally Satel of the conservative think tank American Enterprise Institute (AEI) noted that VA disability determinations for PTSD needed to be tightened up to a take the emphasis off monetary compensation, in the same breath, she promoted ‘virtual reality war simulations’ mentioning Virtual Iraq, as state of the art treatment for PTSD. That was 2007 during the Bush administration, and in just three years during the Obama administration the Pentagon is now promoting it as state of the art treatment for PTSD!

Her intent was commendable, for she promotes catching PTSD in its early stages while still on active duty could prevent Veterans from a lifetime of dependency on VA compensation for PTSD. She also noted that, “A point worth raising here is the importance of qualified staffing at VA mental health facilities. Anecdotal reports suggest that many [VA] facilities do not have adequate numbers of clinicians who can perform cognitive-behavioral therapies. This is a deficit that must be addressed.[12]”

Footnote 12 in her testimony to Congress on the treatment of PTSD was that “A specific form of exposure-desensitization therapy under development is called “Virtual Iraq.” Studies are in progress. The therapy was developed with funding from the Naval Research Office and is considered promising. The veteran [really active duty Soldier or Marine] wears a virtual-reality helmet and goggles and headphones. A therapist manipulates virtual situations via a keyboard to best suit the individual patient during 45-50 minute sessions. By gradually re-introducing the patients to the experiences that triggered the trauma, the memory becomes tolerable and feelings of panic no longer accompany once-feared situations (such a driving on city streets, being in crowds)., accessed July 21, 2007.

Veterans Today Editorial Revision: Of note I have spoken to a young Air Force Mental Health Clinician who has told me that at least for him the treatment has had a positive impact. He was a ground troop in the Army in Iraq prior to getting his commission as a Psychologist in the Air Force. We have discussed his situation as being traumatized when he returned by feelings of panic as he drove the streets back home fearing IEDs. He once avoided being in a crowd for fear of suicide bombers. His experience with Virtual Iraq took away some of his feelings of anxiety and panic. Thus, we are not totally ignoring the positive effect virtual reality may be for a few of our troops coming forth to admit PTSD. This approach does have the positive aspect of trying to break down the stigma associated with going to the Mental Health clinics on Army and Marine base.

The contract between a video game production company, college research centers, and virtual technology companies that specializes in Iraq War simulations seeking defense contracts for games already sold at BXs and PXs around the world is one thing, but suggesting that the “VA must be equipped with mental health staff trained in [Virtual Reality] state of the art PTSD treatment. Treatment should be delivered at early as possible to avert development of chronic syndromes” is quite another.

Any serious Veteran’s advocate who doesn’t know Dr. Satel’s reputation for cost savings on the backs of America’s Veterans and views influenced by the book Stolen Valor knows that when Sally says “to avert development of chronic syndromes” she IS NOT just talking psychology, but she shares a belief that Veterans are motivated by monetary gain to seek treatment for PTSD and far too many are fakes.

However, it was not Dr. Satel’s link to the 2007 Defense Department update on Virtual Reality therapy that caught our eye at Veterans Today; it was the link to the Video Game and virtual reality developers and scientists getting the defense contract, their motivations, their logic, and the role played by military medical and mental health personnel.

Before this approach be promoted within the Veterans Community or VA, closer scrutiny needs to be played to all the players behind this approach to PTSD treatment. Why?

There are beaucoup bucks to be made in video games that promote and glorify war. Just walk into any computer or video game store, or section of a Base or Post Exchange, or your local Wal-Mart. The militarization of the video game entertainment industry is a well known, and successful, retail sales fact – WAR SELLS!

Should the same attraction youngsters have for violent video games that even the military uses to recruit for combat be seriously considered as a treatment or cure for PTSD? Maybe, maybe not.

Games for Health Day – the Birth of Virtual Reality as a Treatment for PTSD

I’d like to note first off that I myself have been through cognitive therapy for Neurological difficulties (memory problems), so I am well aware of the benefit that on-line video game therapy can provide folks with mental or cognitive problems. Thus, I am not down on the concept itself nor the intent but only the motivation behind the concept and intent.

I am also a fan of strategic war games, like Rome Total War, Shogun Total War, Medieval Total War, the Crusades, and various American Civil War ‘GAMES,’ heck I’m into violent war games, so I’m not totally down of the entertainment or therapeutic use of strategy war games. If I want to exercise my mind by conquering a nation, the world, and kill thousands in the process IT AIN’T REAL! I can hit the delete key and start over, hell I can even cheat and play God. HOWEVER!

Games For Health 2006: Addressing PTSD, Psychotherapy & Stroke Rehabilitation with Games & Game Technologies

We ran across this expose on Serious Games promoting an entertainment video game convention called Games For Health 2006: Addressing PTSD, Psychotherapy & Stroke Rehabilitation with Games & Game Technologies as part of the Games For Health day held at the University of Southern California [USC] on May 9th, USC’s Dr. Albert “Skip” Rizzo, the founder of ‘Virtual Iraq’ presented his study on psychotherapy and stroke rehabilitation using video games and related technologies, such as virtual reality (VR).

Dr. Albert “Skip” Rizzo – Virtual Reality Treatment for PTSD

Dr. Rizzo presented three therapeutic areas he was working in at the time.

Expose, Distract, and Motivate

The three main strategies Dr. Rizzo was using, he abbreviated as Expose, Distract and Motivate. To develop the therapeutic Virtual Reality (VR) systems he talked about, Dr. Rizzo worked with a host of other collaborators from different departments at USC, including among others Computer Science, Neuroscience, Annenberg School of Communication and Journalism, Department of Biokinesiology and Physical Therapy, Department of Occupational Sciences, USC Keck School of Medicine, Department of Psychology, School of Gerontology & Neurology, Department of Cell and Neurobiology and also the Children’s Hospital of Los Angeles.

University of Haifa in Israel contributes a War on Terror input

In addition to the USC departments, Dr. Rizzo mentioned nearly a dozen clinical partners at universities and hospitals around the U.S., as well as at the University of Haifa in Israel.

The ‘Expose’ Strategy For PTSD

For Post Traumatic Stress Disorder (PTSD), Dr. Rizzo dealt with the strategy referred to as “Expose”. In order to create simulations for treating soldiers suffering from PTSD, including soldiers currently [2006] serving in Iraq, Dr. Rizzo worked closely with Jarrell Pair of the Institute for Creative Studies at USC. Quoting from the New England Journal of Medicine, Time Magazine and other sources, Dr. Rizzo established that symptoms of PTSD are increasing with soldiers involved in the war in Iraq, compared, for instance, with soldiers who fought in Afghanistan.

VETERANS TODAY EDITORIAL COMMENT: Dr. Rizzo’s findings at the time may have been valid due to the Pentagon’s emphasis on military operations in Iraq as opposed to Afghanistan, but the contrary may be true today with the switch in focus to military operations in Afghanistan.

The definition of PTSD (from Dr. Rizzo’s Power Point slide) was as follows: “Post Traumatic Stress Disorder (DSM-4) is caused by traumatic events that are outside the range of usual human experiences such as military combat, violent personal assault, being kidnapped or taken hostage, terrorist attack, torture, incarceration as a prisoner of war, natural or man-made disasters, automobile accidents, or being diagnosed with a life-threatening illness.

Veterans Today Editorial Comment: Note Dr. Rizzo’s use of the terminology “violent personal attacks” instead of calling it what it is RAPE. Although the inference is there, the actual focus on female troops is glaringly missing as if rules prevention women from combat positions make them immune to PTSD or RAPE.

Dr. Rizzo also notes that “The [PTSD] disorder also appears to be more severe and longer lasting when the event is caused by human means and design (bombings, shootings, combat, etc.).”

Once again we at Veterans Today would view caused by human means to mean RAPE.

Dr. Rizzo described some of the symptoms of PTSD, such as flashbacks, reoccurring nightmares, avoidance, emotional numbing, hyper arousal, and drug abuse and relationship problems. These are just some of the symptoms, however, which can extend into many areas of a person’s life. He said that over time, some people adapt or habituate to the effects of their experiences, and can return to baseline levels. However, people with PTSD may begin to suffer symptoms after 30 days and, though some symptoms appear to lessen at first, the effects tend to flatten out without getting any better over time.

Preparing our Warrior of the Future – Gradual Exposure to Trauma in a Manageable Way

This is most preposterous coming from an academic community and society in which less than one percent of the population is EXPECTED to serve the nation and protect the other 99%.

What we at Veterans Today see is an academic attempt to brainwash a future generation of Warriors to be killing machines without conscious, simply put ROBOTS. Why not simply use robots or better yet mercenaries to serve the other 99% of us?

The therapeutic approach Dr. Rizzo’s project took used gradual exposure to trauma in a manageable way, which eventually led to habituation and extinction of the PTSD syndrome. Does this mean that Dr. Rizzo has stumbled upon a cure for PTSD?

Normally, about 75% of soldiers will begin to display PTSD symptoms within about six months. With traditional [VIETNAM ERA] therapy, this is reduced to about 67%. But with exposure therapy, this can be reduced to only 27%.

“We normally rely on a patient’s imagination – what is called ‘imaginal therapy’, but we know we can provide the exposure to them through game environments,” said Rizzo.

Though the Pentagon is touting the success of Virtual Reality this is what Congress is not being told – there are vulnerabilities and limitations:

Problems with imaginal therapy include patients being unwilling or unable to visualize effectively or avoidance of the reminders of the trauma. When a patient can’t emotionally engage through imagination, it is unlikely that imaginal therapy will be effective.

Tools For Gradually Exposing Sufferers To Trauma – Virtual Vietnam, World Trade Center, Virtual Iraq?

Dr. Rizzo then mentioned several virtual tools, such as Virtual Vietnam from Emory University, as well as several others including a World Trade Center simulation from Cornell. Showing images from the Virtual Vietnam simulation, which depicts realistic scenes typical of that conflict; Dr. Rizzo cited a 1998 study that found, even 20 years after the events, that symptoms of sufferers of PTSD were reduced by 34 percent, while patients engaged in self-assessment though their symptoms saw reductions of 45 percent.

Veterans Today Editorial Comment: This means that yes the use of Virtual Reality could and should be extended to patients from the Vietnam and Gulf War generations claiming PTSD to reduce their symptoms if it is being promoted as a treatment for younger Veterans and Troops. However, only about 20 Vietnam veterans have been through VRE therapy, with positive results.

The emphasis on Terrorism (Virtual Terrorist Bombing of a Bus) vs other forms of PTSD such as Rape?

Dr. Rizzo skipped over the World Trade Center simulation, saying we didn’t need to see that again, but he did show a video clip of a virtual terrorist bus bombing from an Israeli perspective in collaboration between Israel’s University of Haifa and the University of Washington, demonstrating how the severity and realism of the simulation could be adjusted for therapeutic purposes. Other examples shown during the presentation of VR employed in treating PTSD included Motor Vehicle Accidents, a simulation from the University of Buffalo and Virtual Angola, which was created in Portugal.

Once again, we note that obvious virtual reality cannot be applied to some very emotional traumatic experiences like rape, or child abuse, but it can be applied to humans placed in a combat situation over and over and over again.

The focus on Virtual Iraq and Defense Contract with the DoD Office of Naval Research

Dr. Rizzo then discussed his project at USC, Virtual Iraq, which is based on the popular commercial Xbox game, Full Spectrum Warrior, using assets from the popular video war game on top of others that have been added. This of course saved both time and money, as Dr. Rizzo and his team worked with the Office of Naval Research (ONR) as well as USC Institute for Creative Technologies (ICT), Virtually Better, Inc. and the Virtual Reality Medical Center (VRMC).

Veterans Today Editorial Comment: Above alone we Veterans have three or four separate defense contracts, but each virtual reality research center IS NOT going to do this collaboration free of charge.

Full Spectrum Warrior-Game Description

The U.S. Army is the most powerful ground force in the entire world. The backbone of a ground invasion is the U.S. Army Infantry, and in the midst of combat, their skills, courage, and teamwork are put to the test. Full Spectrum Warrior is based on a game commissioned by the U.S. Army to train light Infantry troops in urban combat situations. Soldiers are placed in a tense, hostile, and claustrophobic environment where they must complete a variety of military objectives. Players act as the Squad Leader, providing direction to Alpha and Bravo fire teams. The successful Squad Leader effectively uses cover in the environment and moves his fire teams in a coordinated fashion so they can protect themselves from possible attacks that could come from any direction. Full Spectrum Warrior puts you in the dirt with your men, where danger lurks around every corner.


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50 Responses to "Virtual Reality Combat Simulations as a Treatment for PTSD"

  1. indythinker  May 19, 2010 at 10:18 pm


    After consultation with Dr. Skip Rizzo, we have decided to revise some of the wording in this article for clarification a balance.However this is not a retraction due to that many factual links the story is based on.

    However, we wish to make it clear that to our knowledge Skip Rizzo and his project Virtual Iraq have only been promoted by Dr. Sally Satel of the American Enterprise Institute.(AEWI). Dr. Rizzo and his project Virtual Iraq have had no input or collaboration with either Dr. Satel or the AEI. Skip Rizzo is not a staff member, professor, or fellow at AEI.

    Skip also appears to be genuinely interested in an innovative approach to treatments for PTSD that many readers of Veterans Today may not agree with, but we need to keep the discussion as civil as possible.

    We extend a welcome for Skip to contribute and post a positive image of Virtual Reality and Virtual Iraq from his perspective. He may do this as a rebutttal or simply remain positive in his message, and the collective we should and must render him the same courtesy and dignity.

    I intended presenting the pros or positives of this approach being promoted by the Pentagon anyway without comment.

    Robert L. Hanafin
    Major, U.S. Air Force-Retired
    Editorial Board Member
    Veterans Today News Network

    • Skip Rizzo  May 20, 2010 at 2:28 am

      Thank you very much for this opportunity Robert! I intend to write up a description of the VR PTSD approach, its history and rationale, summarize some of the data and pose some questions at the end that some of your readers may choose to respond to in order help our group be more aware of the issues that they feel are important for us to keep in mind as this work continues to move forward. I will also make myself available to answer more specific questions as your readers may see fit.
      Skip Rizzo

    • vet613  May 23, 2010 at 12:58 am

      Skip I have an idea for you (ya no just so your “research” is up to date).

      Sign up, put on the uniform, get yourself assigned to a combat position, put in some time down range.

      You may even hit the jackpot and develop a “for real” case of severe PTSD for yourself, then you could go play some video games…you will then know what you are talking about. Till then you are just another talking head…nothing more.



      First off we know where you are coming from and believe you are partly right. However, it would be naive to believe that Veterans, especially withing the Armed Forces, would have or could have been in a position historically to have anything to do with the study or recognition of PTSD.

      Most of us tend to believe that PTSD was born during the Vietnam War when it became both defined (not founded) and highly politicized to what the collective we recognize today.

      However, any deep fact check into PTSD research shows that it went back way before the first troops landed in Vietnam. Not only that but most, if not all, research with the objective of helping us Veterans was done by YOU GOT IT – non-Veteran scientists and academic, some with a liberal political agenda and some not having any political views per se.

      Brother go to this 1995 Short History of PTSD written in the VVA Veteran Magazine in the March/April 1995 Edition and begin reading from “Robert J. Lifton is a psychiatrist based at Yale University, and he is renowned for his work with trauma patients, including Vietnam veterans.” [on down the article].

      Was Dr. Lifton anti-Vietnam War (yes), was Dr. Lifton a liberal (quite possibly) was his goal to help Vietnam Veterans or end the Vietnam War? Given his focus and concentration of Lifton’s work we’d have to say ending the war came secondary and only meant less people with PTSD – DAH.

      We at Veterans Today have some real problems with Dr. Skip’s video game approach but not so much because he is not a Veteran or combat Veteran. Hell Bro if we waited for Psychologist or Scientists who just happen to be combat Veterans to find treatments for PTSD, we would still be at the level of 19th century research. Simply put at least Skip is willing to recognize PTSD exists, talk about it, and debate the approach even if we think it is bullshit.


      Frankly, Bro the issues surrounding PTSD are so complex, controversial, and inflammatory, and they are today just as much as during and after Vietnam.


      Some of the earliest 20th-century research was done by Abram Kardiner,
      M.D. He involved himself with traumas of war and began to emphasize
      the importance of studying traumatic neuroses? He defined PTSD and
      revised the diagnostic criteria for the DSM-III and DSM-IV. His
      initial research was applied by other psychiatrists during World War
      II, and laid the groundwork for other researchers around the time of
      the Vietnam War.

      When Vietnam War veterans began returning from the conflict, they
      started experiencing intense symptoms of shell shock? Psychiatrists
      Chaim Shatan and Robert J. Lifton were antiwar activists who became
      involved in rap groups?

      These rap groups would become what many in the Vietnam Vets activists community would come to know as Vet Centers and still exists today for Iraq and Afghanistan Vets.

      With returning veterans in the New York City area. Vietnam Veterans Against the War (VVAW), a large organization of antiwar veterans, was headquartered there and received Congressional lobbying assistance from Shatan and Lifton.

      They argued that psychiatric symptoms that the Vietnam veterans were experiencing differed significantly from those of past wars. They felt that a distinct and new diagnosis was necessary to bring these issues to light so the
      veterans could be adequately treated.

      The Social Demands of PTSD

      Bessel A. van der Kolk, M.D. in a chapter from Traumatic Stress has
      this to say about the development of PTSD:

      PTSD as a diagnosis was constructed in response to a social demand to
      delineate a syndrome that captured the psychological suffering
      experienced by many Vietnam combat veterans at a time that the U.S.
      was coping with millions of soldiers that had just returned from the
      war. . . .

      If this doesn’t sound familiar, it will before the lifetime of many Vietnam Vets is over. The debate over approaches for treating PTSD is about to begin as once again many Iraq and Afghanistan combat veterans are and will be continuing to return from the current war(s) without end. Skip is but a very small part of that debate, but at least he and the Pentagon admit there is a problem instead of hiding it. That’s not to say the Puzzle Palace will not try to downplay or detract from the force readiness implications of PTSD, they will more so during a time when our nation will not accept THE DRAFT.

      The DSM III definition of PTSD, guided by Kardiner’s description of the traumatic war neuroses . . . highlighted the physiological alterations that follow traumatization, and the co-existing traumatic intrusions and emotional numbing and avoidance.

      Mardi J. Horowitz was another researcher that played a major role in
      the formal definition of PTSD in the 1970s. In his major work, Stress
      Response Syndromes, he outlined a predictable sequence of symptoms
      following stressful life events. These symptoms are now recognized as
      the primary symptoms of PTSD as defined in the DSM-III. Other
      important works include Psychological Aspects of Stress, edited by
      Harry S. Abram in 1969; and John Henry Krystal? Massive Psychic
      Trauma, investigating trauma psychology in World War II concentration
      camp survivors.

      THE POINT WE ARE MAKING HERE BRO IS THAT MOST OF THOSE INVOLVED IN RECOGNITION AND TREATMENT OF PTSD WERE NOT VETERANS AT ALL. Members of the military medical profession and psychological profession were in no better position then or now to take the lead on such research given the Pentagon’s prime directive of Force Readiness meaning sending troops back into combat unquestioningly is the order of the day, all other things, family, future lives, mental health, you name it comes second, third, or last.

      CAUTION: that said we caution anyone Veteran or not that when their research interacts or connects with the Pentagon’s prime directive of Force Readiness, their PTSD research is going to come into question. Are they war profiteers, how much control does the Pentagon have over their research, what is their hidden agenda (if any), and so on AND Bro that is the problem we have with Skip, not so much that Skip is a Veteran or not.


      From a purely financial standpoint, then and to some degree today in 2010, it was difficult for veterans suffering from PTSD to receive government benefits for treatment because there was no diagnostic code for combat stress in the DSM-II. And, under the DSM-I, symptoms persisting beyond 2 years after discharge was not considered service-related by the U.S. government,
      excluding veterans from receiving benefits. PTSD was often misdiagnosed as depression, paranoid schizophrenia, or character or behavior disorders.

      VETERANS TODAY COMMENT: Have we not seen the exact same financial resistance to PTSD over the past decade of the Bush administration spear headed by ultra-conservative right-wing Veterans? That Bro is the problem we have with Stolen Valor.

      During the time that Drs. Shatan and Lifton were conducting their rap
      groups, Shatan learned that he was under surveillance. FBI agents
      even masqueraded as veterans and would attended these groups in an
      attempt to get closer to Shatan and entrap him. He remained vocal in
      advocating for veterans and against the war, despite friends and
      colleagues warning him about potential danger.

      When he and Lifton estimated the prevalence of PTSD among Vietnam veterans to be about 20% (much higher than the government figure of 5%), the Veterans Affairs central office highly criticized them in the press, and they
      were described as being too hung up on the war, and accused of dishonoring brave men. The established Veterans Service Organizations back in the day (the American Legion and VFW) who controlled upper and middle management of the Veterans Administration were recruited to join in this government fervor to attack Lifton and Shatan as liberal mad scientists collaborating with the VA to make those serving in the Vietnam War look bad thus Stolen Valor’s real meaning, and is so today – a political slogan having nothing to do with PTSD.

      Readers all Stolen Valor by B.G. Burkett was is a vain attempt to distract from the real problems of PTSD, divert attention to a few (very few) people faking their Veteran status, all of whom to be Democrat BTW or left of center leaning so much for an unbiased assessment by someone who yes was a Vet, a REMF, but who was not an MD, nor was Burkett a psychologist, nor did Burkett get any prominent medical or psychiatric folks to buy off on his partisan politcal attacks on both PTSD and Agent Orange which he and other Vets for Nixon claimed to be a conspiracy between YOU GOT IT liberal doctors at the VA, Vietnam Victims of American (VVA) against Dow Chemical Company.

      Senator Alan Cranston, a World War II veteran and member of the Senate’s Committee on Veterans Affairs, felt that the psychological problems that faced Vietnam veterans were different from the older veterans. He introduced a number of bills to improve counseling and funding for the treatment of these psychological problems. His bill passed the Senate in 1973 and 1975, but never passed the House.

      The House was dominated by World War II veterans, and their allies in the American Legion and VFW running the VA, who refused to believe that there were different problems produced by the Vietnam War from those of other past conflicts.

      This obstacle to the formal definition of PTSD as a distinct diagnosis was overcome slowly as a result.

      For a completely fascinating account of controversy surrounding PTSD
      and war-related trauma read this article in its entirety.


      Eventually, through Cranston’s efforts, specialized counseling centers
      sponsored by the Veterans Affairs office appeared, [the still exists today, as I mentioned] providing a place for veterans suffering from PTSD and other emotional disorders to receive the counseling and other services they so desperately needed.

      The official entry of PTSD into the DSM-III also made is such that
      veterans could receive treatment for this newly defined service-connected diagnosis

      The focus today of the right-wing Vets, and politicians, is to try focusing on the Stolen Valor arguments of 30 years ago. We’ve heard them, too many Vets faking PTSD, too many Vets elaborating their combat service. Too many Vets scamming the VA system. How in the hell could too many Veterans scam a system controlled by right-wing fiscal conservatives (well conservatives) over the past 10 years or since 2000. Congressman Steve Buyer from Indiana, the Vet we Veterans love to hate was the epitome of COST SAVINGS over VET SAVING, and he still would be despite photo ops with VVA leaders.

      Research continued beyond the formal inclusion of PTSD in the DSM-III
      in 1980. A study commissioned in 1983 by Congress was the National
      Vietnam Veterans’ Readjustment Study (NVVRS). Its primary goal was to
      investigate PTSD and other postwar psychological problems among
      Vietnam veterans. It sought accurate data regarding its prevalence in
      order to better provide for the needs of veterans. For a complete
      description of the study, as well as a summary of its findings see:

      Just like Agent Orange, Vietnam Veterans of America (VVA) is still fighting the battles of AO and PTSD what 30 years after Drs. Lifton and Shatan championed the cause.

      Yes, vet613, more Veterans have joined in the fight who happen to have PhD or are medical or psychiatric professionals, but precious few, and none come from the Pentagon or military medicine as such, and therein is our concern about who Skip gets in bed with.

      The Pentagon has the same, if not more so given NO DRAFT, drive to put troops into combat over and over and over again as it did during Vietnam and in that respect very little has changed except the number of bodies in the pool available to send back into combat over and over and over again, thus in that respect we must caution and advise Skip to divert his attention to Veterans not active duty troops, doctors, psychiatrists, or psychologists under Pentagon command and control.

      Bobby Hanafin, Major, U.S. Air Force-Retired, Veterans Today News

    • Tom Dillman  May 24, 2010 at 2:08 am

      The problem is, Bobby, that Rizzo is trying to simulate PTSD causing EVENTS using Virtual Reality. You, I and all the other respondees on this post KNOW the very same battle is DIFFERENT for each contestant (if you will let me use a game term). I’m not sure of the exact mathematical algorithm unless I really think deep about it, but if 500 people are fighting, some percent will get PTSD at some point later in their lives. Let’s assume 20% for convenience. That says 100 soldiers will suffer PTSD at some level. Then we have to have to add the chopper crew, the medics, the nurses, the doctors at the field hospitals, etc. etc. Each will have a completely different view of that one battle, depending on their task and emotional makeups. Which view are you going to simulate? How many views are close enough to be able to be grouped in one approximate simulation to do any good?
      I think Duff has stated that of the 2.6 million combat troops in Viet Nam alone (forgetting the support staff of roughly 8 times that), all but 800,000 have already died. That’s 1.8 million Vets that have died, many with self-inflicted wounds. Most of these guys (and gals) died MUCH younger than their stay at home, “military skipping” friends (i.e., a LOT of draft dodgers). 20% of 2.6 million = 520,000 PTSD sufferers. That’s 520,000 seperate simulations. The good news for you is, only 160,000 are still alive. You can see why Congress and the VA want us to be “denied until we die”.
      I say screw Congress, the Draft Dodgers (many the same) and the B-Crats. Some of us onery ones like Duff, vet613, barrie, Jeff, Major Bobby, Mike L., B.A., Bill, Fran, Byron, Pappy, oldleatherneck, Texas Grunt, that crazy Thomas Paine liberal, and others are going to hang around and see them in their graves. Giving them shit all along the way. Oh, we might even let Johnny Punish join us. And Skip Rizzo? We might let you hang around so we can watch you going crazy with 2.6 million X 10 to the ninth, different combos of your VR game. Then you can start on the First Gulf War. 🙁
      Have fun and thanks for trying. Tom Texas Vet Gary Owen!

  2. Tom Dillman  May 18, 2010 at 7:51 pm

    Gary Owen vet613!

    Thank you for your service man.

    Tom First Cav Vet — the original boondoggleers for what at the time was the original fantasy dream called the Air Cav. The common response at the VA as I limp by is” “oh, there’s the guy with one too many jumps.” 🙁


    • vet613  May 19, 2010 at 11:23 am

      Hey Tom,

      I guess I’m not the only “limper” then huh? The VA treatment itself (the whole rigged system) would be funny…if it wasn’t so sad.

      Gary Owen Brother

  3. ROBERT VNvet 11th armoredcav  May 18, 2010 at 5:47 pm

    It must be nice to make money doing these bullshit reseraches… Who the hell are these fools, and why do they get to stand up in front of Congress shooting their mouths off… In the first place they have not see any kind of combat, dodged bullets, or mortors, or had body parts and the blood of fellow soldiers covering them… So how in the hell can they say that PTSD is just a bullshit way for a combat Veteran to gain compansation.. It’s not like it pays that much by todays standards anyway, but the drugs are good…. I know myself that the drugs I get turn me into a jomby, so I don’t take them… And I tried the group sessions for a couple of months, but that soon got old because it was the same guys week after week doing the same crying about how hard their life has been… So the VA gave them more drugs to take…

    If the Smartasses really wanted to help, and wern’t so worried about just the troops in Iraq as much… They’s stand up in front of Congress and tell them to STOP starting WARS in the first f–king place…. But there’s no money in that…

    It blows my mind with all the energy and money that is spent on PTSD.. I guess if you get a degree and you want your name seen, and can’t do anything else with it, PTSD is a good place to do your research… I don’t care what you do there is no way in hell you can replace the real experiences of combat with any games, and all the drugs do is cover up the real feelings for a while.. Everyone went through their own personal hell and experiences and it a broad spectrum… So to all these so called Doctors and researchers, I have to say, go to Iraq and live the life before shooting your mouths off… We took the Oath and we did the jobs we were suppost to , and we lived the life, so if it bothers you that we are getting a few lousey bucks now afterwards, than you you have bigger problems than do us Veterans.. Ih that’s right , your already getting PAID to do all this research…

    • Texas Grunt  May 18, 2010 at 9:03 pm

      Thank you brother. Right on track!

      Texas Grunt First Cav

    • Fran Lawrence  May 19, 2010 at 3:31 am

      Right on.

    • vet613  May 19, 2010 at 11:28 am


      You are on the MONEY. That’s what it is all about…MONEY. Sadly it is not about making us safer. Read Duff’s posts to get the REAL picture of this shit.

      Best to ya!

  4. Jim Starowicz  May 18, 2010 at 4:10 pm

    I would say “Why is this woman still getting press as well as bei9ng mentioned as an authority on Anything!” but one only needs to look around not only now but these last 30 or 40 years and seen what passes as ‘experts’!! She should have been drummed out, and has by many, of ever mentioning anything to do with PTSD years ago, shunned as the kook she is, and if with a license stripped of that and not allowed near Anyone!!

    • vet613  May 18, 2010 at 5:20 pm

      Roger that Jim…

    • Texas Grunt  May 18, 2010 at 7:59 pm

      Roger, roger, guys! Over and out.

  5. Byron Skinner  May 18, 2010 at 3:50 pm

    Good Afternoon Folks,

    Of course this is all bull sh**. Just another crack pot theory for a problem that has been around since the Persian wars, if you don’t believe me read Herodotus or Thucydides. The bottom line is those who fight their countries and are the soldiers beyond the tip of the spear are going to have their minds screwed up.

    Every war since the US Civil War the US government has done studies on this and has come to the same conclusion. It is a life long condition, in WW II a study of the US 3ed. ID showed that any more then 180 days of combat will have a permanent effect on the mental being of the soldier. As long as countries are going to send their young men and now women to kill other is the rather dubious name of defending their country this will be a problem. It is the cost of folly and national vanity.

    The default to this of course since the US Civil War has been drugs. Then it was Opium now it is Morphine. My own personal experience with VA prescription pain killers to treat PTSD, is they do lessen the effects of PTSD. They help, but the patient must be careful on their use.

    Right now the VA is handing out morphine like trick or treat candy, many PTSD patients see a VA Doctor only every six months for a prescription refill order. Many patients have excess weds, far more then what they need and it sold to the street dealers.

    For Duff. Something to think about the nine member Supreme Court will soon be six catholics and three Zionists. The Pope and Tel-Aviv will have effective control over a third of the United States Government.

    Byron Skinner

    • Tom Dillman  May 18, 2010 at 7:57 pm

      Thanks for your service and comments Byron. You are right on the money about several things, including your last sentence. I’m Jesuit trained and I am concerned. 51% of America is Protestant, with noone to represent their views on the Supreme Court. 40% of America is Catholic and 1.7% is Jewish. Hmmmmm.

      Tom Texas Vet

    • Byron Skinner  May 18, 2010 at 10:12 pm

      Good Evening Tom,

      I’m an agnostic so I’m kinda use to it but looking back the past 20 years of court decisions one can see a definite bias toward the Catholic point of in cases decided and cases not taken. Without any Protestant representation on the court as you suggest 51% of the population are not represented.

      I justice is suppose to be blind, but I also know human nature. We just had a President that claimed that if the President does it, it is legal, and the courts didn’t object, the same court that put him in office.

      Byron Skinner

  6. George  May 18, 2010 at 2:23 pm

    My son has had two tours of Iraq, he plans on making the Army a career. Before he joined up, fresh out of High School in 2005. He was playing Virtual Reality War Games on his xbox 360 before entering into military service. He feels it prepared him for the real thing. He shows no signs of PTSD. He dosen’t smoke or do illicte drugs. He might have a few cocktails, but thats all. On the other hand I am a Vietnam Vet, who has nightmares of combat in nam. But the VA say that since I don’t use Alcohol are drugs, I don’t qualifie for a PTSD claim.

    • Tom Dillman  May 18, 2010 at 7:47 pm

      Thank you for your service, George. I wish your son the best of luck and I hope he gets to remain a remf. Keep an eye on him though. When his denial runs out — as is bound to happen if he has combat experience — he could end up in a pile of hurt in a hurry. Of course, like you, the VA bureaucracy will deny him everything unless he runs over a hill tomorrow, acting crazier than a loon. Meanwhile, send him my best.

      Tom Texas Vet, First Cav

    • Fran Lawrence  May 18, 2010 at 11:42 pm

      we did finally get my husband’s claim through… they tried to say he never served in combat, and that his dad beat him and that’s why he had problems, then a liar and a faker and then mentally ill AND faking! My husband does not abuse acohol or drugs. The VA will do anything to escape any responsibility that it can… However it can.

      I am concerned that young soldiers may now… when they show signs of PTSD … That they may be told that they are faking because they have already gone through a program like this!

      Take Care.

    • Rob Jackson  May 26, 2010 at 11:38 am

      Good luck and God bless your son George. I am sorry to hear that you are also being ignored by the VA because you don’t fit in their mold of a PTSD patient. I suppose if they couldn’t have said I didn’t qualify for PTSD benefits because I wasn’t wounded in action, they would have said since I’m not an alcoholic or drug abuser that I would still not qualify.

      It sounds as if you have found a way over the years to cope with your nightmares/memories. I hope that I do too. Good luck and God bless you as well.

  7. Skip Rizzo  May 18, 2010 at 1:49 pm

    Thanks for you interest in reporting on this important topic. However, I really have to question why for this reporting, that you did not contact me directly to get the story straight. While we are all entitled to our own opinions, we are not entitled to our own facts! And there are many facts that are incorrect in your reporting of this story. This particularly relates to the funding for this project (we are a university lab and not a traditional for profit military contractor), the difference between the use of an off the shelf video game and a tool designed for clinical practice, your assessment of why I do not advocate the use of this technology as a tool for exposure therapy for rape (and my acknowledgement of the additional and unique needs of those patients), and your complete exclusive and inaccurate, context-devoid reliance on a talk given at a venue for “Games for Health”. I have presented the PTSD work in many more relevant situations where that work was the focus of the talk, that you could have drawn from. Instead you choose to characterize the whole area in a fashion that trivializes the research, the success of the treatment, and the actual way that the treatment is conducted. Telling a person to go to the PX and buy a War game to treat their PTSD would be misinformed and unethical. Rather than rant further here on the mischaracterization of how you have portrayed this (and recognizing that you did get some of the content correct and are trying to do a good job by the vets here!), I will be glad to be interviewed on this, publically or privately, I will answer all questions that you ask, and perhaps we can work together to set the record straight and put this form of therapy in a context where someone can make an honest judgement about its value. You have my email and I will make myself available around your schedule to do this. Also, I recommend to you and your readers, expecially some of the folks that left comments, that you go to the PBS Frontline link here to watch actual video of how the therapy is done, the reports of people who have gone through it, and some of my explanation of the process:
    I am open to all questions you may have in order to honestly explain the approach and context for this effort. So it is your turn now.

    • Texas Grunt  May 18, 2010 at 7:39 pm

      Thank you, Skip — You sound halfway intelligent, but don’t forget, you have the other half that may have serious flaws.
      1) SR => This particularly relates to the funding for this project (we are a university lab and not a traditional for profit military contractor),

      TG => This lets you off the hook? Where do university labs get most of their funding? Right, from the taxpayers’ taxes. Own up that you wouldn’t have crap if it weren’t for taxpayers. NO employees, no salary, no equipment and no space.

      2) SR => “that you go to the PBS Frontline link”

      TG => once again, PBS is a taxpayer funded entity that spouts bullshit and helps your Congress Thief appropriate money for you.

      Keep trying Rizzo, and be honest with yourself about where your bread is buttered. Once you do that, you’ll be able to be open minded about the reality male and female (yes, B.A.) veterans are REALLY coming from. Don’t just talk to what Gordon Duff at VT calls accurately, REMF’s (rear-echelon mother-f–kers) who talk a good game while they’re drinking beer and shooting pool. The remf’s are perfect candidates for virtual reality. They’d jump and run at a popcorn fart.

    • Skip Rizzo  May 18, 2010 at 9:59 pm

      Dear Texas Grunt,
      You seem to keep hanging onto this funding issue. Please let me clarify this. No one denies that taxpayers fund research, and it is typically research where large corporations do not see a profit margin and will not invest in! I fought tooth and nail with govt. to get funding for this project to make a difference in the right direction. I made the case that if we even only help out 10 folks with this approach, it will pay back the cost to the taxpayers in the reduction of human suffering and the costs for the continued application of medical and pharmacological approaches that continue to be used, with no evidence of their success. I am sure from what I have read on this and other Vet sites, that everyone seems to have a horror story about the medicational approach that was hammered down their throats that only made matters worse! So getting government funding to try to do the right thing and make a positive difference in peoples’ lives, when no corporation would even give this a look, in my mind is no sin! It was the really the first success, getting the govt to admit there was a problem and to explore new ways to treat it rather then just dishin out the same old crap that wasn’t working (but that the pharma corporations wanted you to buy into!).

      I initially began work on this project with a computer science colleague, Jarrell Pair, in our spare time with NO govt. funding because we cared enough to put the effort in on our own time to make a difference in the future care for all active duty and Veterans who might benefit from this. And this was in 2003 when no one was talking about OEF/OIF PTSD, we were still in the bullshit “Mission Accomplished” lovefest error…or era. We anticipated problems at that time and began a proactive effort to get ahead of this and try to prevent the screw-ups that occurred with Vietnam Vets. This was motivated by a positive view of how we might provide an option for care that could make a difference. And I might note, when I told some of my academic colleagues about my intentions, many laughed and said that I would be wasting my time and that I should worry about doing work that would get me tenure. I said “bullshit, this is the right thing to be doing”. And, I also still do NOT have academic tenure. The characterization in this article that the VR approach is based on “a commercial war game that is sold in Wal-Mart, K-Mart, even on Base and Post Exchanges, so why spend millions of tax payer bucks on a defense contract when military psychologist can just pay a few bucks to pick up a similar war game at the Bx or Px and tailor it to the patient’s PTSD symptoms?”, is a gross oversimplification and inaccurate depiction of what we have created with Virtual Iraq/Afghanistan. The real story is that when I had NO funding to do this work, I acquired the art assets from the Full Spectrum Warrior videogame as part of a cheap and dirty effort to create a prototype VR world in order to show a proof of concept to get funding to build the real thing, informed by the feedback of active duty military personnel and Vets. This prototype was NOT a game, but a setting in which exposure therapy could theoretically be conducted in, NOT A WAR GAME!! We finally were able to get funding to build a treatment tool for PTSD that leveraged the best empirically supported treatment of PTSD (exposure therapy), from this free effort. And since that time when we got a small grant from ONR, we started over from scratch to build the tool creating our own VR assets and building it as a therapy tool rather than as a friggin’ “War Game”. Thus, the characterization of this as a “Virtual Reality War Game”, although the author states that it is his opinion, is not based on fact and is deceptive in its characterization.

      I am not here to pick fights with anyone, but when you put your heart and soul into a project and have to fight tooth and nail for every resource to create and apply it for a good rightful human purpose, you tend to not sit back on your hands, when someone misrepresents it as evil. What got my hackles up early on in the piece, was another point where the author states: “What I do caution are (1) Sally Satel has advocated this approach from the early stages of its development and that alone turns my radar of suspicion on, and…” Immediately out of the gate the author cites this Sally Satel character as some authority that has endorsed this work. I have never met her, she has never engaged in any dialog with us on this project, and she has NOTHING to do with this project. I don’t care if she was talking to Congress or to God, she was talking out of her ass, since she has NEVER had any input or affiliation with our group! However, the impression that this creates with this inferred connection to her of our work is classic “guilt by association” with no actual factual argument. Sort of like “Hitler likes milk, so all dairy farmers that produce milk are evil”. And he actually did this with the TITLE of the article–can you honestly say that that is really fair–to set up the expectations of the reader with such a negative association. That was not reporting, it was a persuasive ploy to get the attention of readers!

      I hope the author of this piece agrees to my repeated requests that he interview me about this project in either a public or private format, where I will address any question posed to me with NO BULLSHIT, or linguistic gymnastics. The straight word. That is what Vets deserve more than anything, straight answers to hard questions and I stand ready any time, any place to do this! So in the end, I am willing to put myself in the hot seat for this, because I believe we have something that will make a positive difference for the well being of Service Members and Veterans as the primary beneficiaries of our efforts. I think we are on the same side here in wanting to prevent of repeat of the bullshit that occurred with the Vietnam Era, but I believe that we need to have an honest discussion of where those efforts intersect. To cast a negative light on a positive project like this and stir up bitterness that is better directed at the culprits that have cast a blind eye to the plight of those who unselfishly gave all for their country, would be very sad indeed. And that is why I am taking the time to reach out in response to this article. So I hope that folks who take the time to read this consider this project in a way that doesn’t demonize it with rhetoric that is better directed elsewhere. Thank you for your service, time and attention.
      Skip Rizzo

    • Fran Lawrence  May 18, 2010 at 11:27 pm


      My husband was 1st Cav (airmobile) in the Vietnam War as well. I am not buying it.
      I have firsthand seen the VA tell my husband that he never served in combat, that he was a liar… then a faker and then mentally ill AND faking. My husband was truamatized by THAT! My family has been truamatized by believing this country cared about our veterans and then seeing how
      one gets treated. DISCARDED. So while you may be sinciere about your work… I don’t trust the VA to not use your work to just relieve itself of any responsibility of any PTSD cases from combat, to trivialize PTSD as it had in the past and Continues to do while Trivializing WAR and the effects. The VA will spend more on training and paying specialized staff and research than actually helping veterans… Because they Don’t respect combat veyerans for the most part when they are done using them. All they want is to use your research to get as much as they can out of each soldier as they redeploy them over and over And then Deny a veteran who may end up having PTSD after multiple tour due to that they have already received your PTSD treatment… and say they are faking or mentally ill AND faking And their dad beat them up when they were growing up… That’s why they joined the ARMY and has problems.

      Please if you do care about people… hear what I am saying. You are being used. I can prove everything I am saying here and More of the hideousness of the VA against disabled combat veterans.

      Are you in this for the money from the side?
      Or because you really care about people?
      If you do care about people… you should really know what the VA is really like.

      Do you need proof? Let me know… and I’ll seek
      advise from the people I trust on the best way to

    • Fran Lawrence  May 18, 2010 at 11:33 pm

      Please don’t be decieved by my typos, I am not ignorant and have complete validity of what I am saying here as well as for the validity of my husband’s tour.

    • Skip Rizzo  May 19, 2010 at 1:07 am

      Hi Fran, This all sounds horrible, but do you advocate that no one attempt to create a PTS treatment because it would only be used as a corrupt tool by the VA to deny rightful claims?

    • Fran Lawrence  May 19, 2010 at 2:32 am

      Skip Rizzo-
      Your research will be misused by the VA and the government.
      Sounds horrible? It WAS pretty damn bad. I am STILL truamatized by what we went through. And I am not a Pansy. I am a strong woman.

      HOW does a video simulation reached into the very fibers of one’s being and takes from each cell of a person which is saturated with the trauma and purges and cleanses the mind, body and spirit of entrenched horror, shock, numbness and helplessness?

      How does a video simulate a little known battle where tens of thousands died and the corspes and pieces of corspses lay endlessly with the unavoidable smell of death on the hot, humid air as your helicopter flies over and in your dreams you find yourself floating over too many bodies?

      Look up ‘Second Battle of Quang Tri’ and ‘Highway of Horror’ under Google of ‘Untold Stories’. Most Americans were home then and this was not an American battle… but you are a newly turned eighteen year old and unknowingly… ‘an advisor’. No one knows of this battle when you come home and say “yeah, 1972… The war was winding down then.”.

      What if you didn’t even know yourself where you were… you were just doing your job… you didn’t ask where you were going.

      What if you didn’t even remember yourself… and never remembered much until 37 years later, your wife gets concerned because you are wondering if you were ever even in Vietnam… so she took all the notes of all the thongs you said about Vietnam over the years… that you would tell her and later forget… and she took statements of your family members of the things you were telling them when you came home and never remembered and it took her ten months to reconstruct your tour with very little records to go on?

      What if that is when you found out that you were in combat during the Easter Offensive and that fragment of the memory you had of finding the ARVN soldier screaming with his leg blown off during a medevac that you were grabbed for on a dustoff because the 571st medical evac compnay along with just about everyone else went home… You realize later that he was walking to you amid the mortars and machine gun fire and people dying all around you And that was when a mortar went off near you and threw you and when you regained your senses Then you found him screaming and holding his blown leg with bone sticking out where his leg use to be. And then you realize that it was Days that you and the two other Hueys went back and forth into hell and picked up the too many burnt people with one, two, three missing limbs?

      What if you forgot about the pilot who you were sitting back to back with, on ceasefire and no weapons and it shot the pilot in the head right after you felt the bullet go by your head and you saw it and how he clutched the controls so tightly that the helicopter did a crash landing in a rice paddy and took off again all shot up and someone screaming in the back who was shot?

      What if you forgot about the CH-47 that went down by your base and all 17 men died and you had to go with your buddy and picked up their arms, legs, bodies and heads and there was blood everywhere and everyone was getting sick?

      What about the time you went on a mission and picked up a downed cobra and while flying front seat in the recently downed Cobra which you have to fly high in to auto-rotate if it fails nut that
      puts you in risk of a surface to air missle and you hear
      your buddies in the other helicopter get shot up over the shot up radio and feel so helpless?

      What about seeing a Mohawk taking off right on front of you and you see them get hit by a sniper and the plane rolls over 25 feet over the runway and you see both pilot eject right into the runnway and you can’t fire at the sniper because there are barracks right bejind them?

      And the mortar that came through your hooch right after you left it and your buddy flew over you and you grabbed him while running towards the barracks?

      What if you completely blocked out all the Night Hawk missions that went on? The very aggressive missions that were neccesary because you and everyone were in grave danger of being overran every night by the enemy? Missions I will not go into details. The missions you completely forgot until 38 years later, you meet the crewchief of the Night Hawk helicopter and talks to you of the missions you, he and the others on the Night Hawk birdvwent on and how no one knows how all of you lived… especially that night it came in with over 60 bullet holes (and how wonderful duct tape worked with paint over it.)?

      There’s a whole lot more… But I am running out of room here…

      So Skip Rizzo… do you have THAT program?

      How does someone live through something so unbelivable and expect others to believe it?
      In fact… you came home in shock and don’t even remember what you told your family when you were a mess… But your wife found every single thing 37 years later… Things Vietnam War history professors and historians still don’t know… She found them because you told your family almost 40 years earlier and they really happened. And your country called you a liar and mentally ill and made up grand stories you could not prove…

      Do you have that program?

      Please do not put war in a one size fits all box.

      You are dealing with something that you have no clue of…
      A fire that every one of these men here talking to you have been through..
      And every fire is different…

      This attempt to fit horror into a box is insulting to
      me and, I believe, most of these men here.

      War, rape and all horror should never be trivialized…

      War shouldn’t be looked at as something ‘to learn to deal with.
      That takes away from the good and decency of being human.

      You are building a Frankenstein to be misused by the enemy…
      People who have never been in war who try to make it ‘easier’ for those they send…
      So they can send them again and again and again and then tell them they are liar and fakers and mentally ill when they become ‘battle fatigued’.

    • Fran Lawrence  May 19, 2010 at 2:34 am

      Where is the program to deal with the guilt of living after seeing so many die… and you have no idea how you did come out alive?

    • Fran Lawrence  May 19, 2010 at 3:12 am

      Skip Rizzo-

      I sense that you do mean well. Because of that… I ask you to consider carefully How you proceed… Wisely and with caution, if your true goal is for healing.

      Skip Rizzo- medicine used wrongly- kills.

      I have no answers at this time to the paradox of your reasearch… If it is feasible.
      I do ask you to meditate and search yourself about considering safety holds and possible resrictions that only you and your peers can put into place before you hand over the keys to this possible pandora’s box.

    • Fran Lawrence  May 19, 2010 at 1:05 pm


    • Skip Rizzo  May 19, 2010 at 2:07 pm

      Fran, I am still digesting all you have detailed here. There is no “one size fits all” “cure” for all ills. Of course the primary problem here is war and the way that the folks that serve in these wars are treated when they return home with a life that has been ravaged by these experiences. While all experiences cannot be replicated in a simulation, the use of VR to begin help a person process their experiences in a way that will lead to a more healthy life after war is the ultimate aim. Early work with a VR simulation of Vietnam, while certainly not replicating the visible detail that you describe, served to provide enough of a context that Vets were able, when in the simulation, to be able to talk about their experiences in a way that they hadnt in the past, and most found this beneficial. The key here is that the VR simulation is not the cure, it is simply a tool in the hands of a well trained and thoughtful clinician who can work with the person in how they process and later think about their own real experiences. Many wartime events are so horrific, that it would be naive to believe we can make the pain just go away. But we can make a start on the process of moving ahead to the future, by addressing this pain in the past. Lets face it, drugs that further numb a person to the pain is a symptom solution that doesnt address the root cause of the pain and becomes an endless cycle of further hurting a persons efforts to move ahead in peace. Basically there is no one answer here, but we are making some gains here. I have had an excellent dialog with the author of this piece, Bobby Hanafin, over the last day and there will be a follow up to this article that I hope will add clarity to this positive effort to make a differenc in clinical care, while acknowledging the challenges and mistakes of the past. One outcome I aspire to, is to help make this work better aligned with the needs of ALL Vets and prevent the tools that we create from being used in a way in which they were not intended–to deny the valid claims of those who have served their country and gave all. I went into this work essentially to make a better “tool”, and I will fight to the death to make sure that the tool is used to make a positive difference in addressing the PTS challenge rather than to cause more pain. You have had more than your share of that already.

      I will likely not be able to respond further to the comments here for awhile, and will instead work with Bobby to help with a Part 2 to the article and attempt to move our work in a direction that will better integrate the needs of Vets rather than to add another problem to the pile.

    • Fran Lawrence  May 19, 2010 at 4:40 pm

      Dr. Rizzo,

      Thank you for listening and thank you for caring.

      Fran Lawrence

    • Tom Dillman  May 22, 2010 at 1:28 am

      Fran — Here’s Skip’s problem as I see it. I too can describe the horrors. Virtual Reality can paint vague pictures of horrors. A well designed VR system can even provide smells and semi-tastes to the evironment.
      But what VR can’t do, and probably won’t be able to do for the 50-100 years, is mimic the FEELINGS of fear, despair, elation, disappointment, terror, joy at surviving, guilt at surviving, etc., in the right context. And that context varies for EACH individual in a battle scenario.
      And like your husband, Fran, much of this stuff gets buried out of a need for survival. And then a trigger happens, 35-40 years later and it’s as if one is thrown backwards in time — as real as it was 35-40 years or more earlier.
      Now, Skip, I appreciate what you are trying to do. Your responses to Fran are well said. Since you have your Phd—I assume—take what Fran and others of us have been trying to say and figure out how to integrate that into your system. Smells, sounds, emotions, feelings, none of these are easy things. But they are fundamental to humans — no, to all living creatures. They are built into our DNA programs and the software is modified by individual experiences. The body moves and reacts in 3D and 3D space. I’m getting to be an old, damaged coot soon. My lifeline is getting shorter by the hour. I can only point you at what you need to do. You can listen or ignore. That’s up to you.

      Tom — Texas Vet First Cav

    • Skip Rizzo  May 19, 2010 at 8:04 pm

      My pleasure Fran. I stand ready to continue listening and learning from you and all Vets with the primary aim to make a positive difference in our work. It is never too late to learn and make a contribution that may serve to relieve the horrible suffering of those who deserve our best efforts. I know I am taking a chance here by doing this–but here is my email in case you want to share advice and observations with me in this regard. [email protected]

    • Rob Jackson  May 26, 2010 at 11:32 am

      Dr Rizzo,

      Thanks for working on this project, and I think you have the best interests of Vets in mind.

      It is unfortunate that your research will be misused by the agency that is supposed to be supportive of Vets to deny support.

      I have first had experience dealing with the VA and their methods of making Vets claims moot. They actually accepted a Dr report regarding my condition which I requested from him. I gave him a copy of the VA’s regulations regarding the particular problem and asked him to choose their definition that best described my case.

      Their reply was that they have reviewed his report and decided that I did not warrant an increase in benefits based on that letter. An increase would be warranted if – insert letter from doctor here -. That’s right their refusal said that an increase in benefits would be warranted if I were diagnosed word for word what my Dr said in his letter. They then claimed I could not use that report as evidence in my future filings as they had already considered it. It took me 2 years to get my benefits adjusted, and I was told that I was lucky it was done that quickly.

      Your research will end up being used as a prescribed treatment and when that treatment is over, the patient will be considered “cured” even if they are not. This kind of thing becomes fodder for the bean counters to reduce the benefits that Vets need and deserve.

      I am not saying your results are not valid however, I do not believe your treatment would be of help to someone like myself who has deeper issues than just having witnessed combat to deal with.



      The deeper you get into this as a young Iraq and Afghanistan War Vet the more you make sense, and you are articulate. Please consider writing or joining a Veterans writing groups as one of many weapons as a therapy for treating PTSD. Therein you, me or any Veteran can create our own virtual reality.

      We also feel that Skip means well HOWEVER.

      You focus on how it may be used to cut costs at the VA when the fiscal focus of the VA swings once again from VET SAVING to COST SAVING.

      We found evidence that one aspect used to pitch VR to the Pentagon (don’t know about the VA) was the cost savings involved in methods that have failed with Vietnam Vets. This pitch however focuses on the tax payer dollars spent on Gulf War Vets claiming PTSD. The inference tends to be how can Gulf War Vets have PTSD hell they won their war per se.

      As for you own VA Claim, sound to us as if you no shit have the grounds for Appeal. May we suggest you contacting either Veterans for Common Sense (VCS) which has recently been added to the VA listing of recognized Veterans Service Organizations able to sponsor VA Claims

      or Swords to Plowshares to file an Appeal.

      We do not know if Iraq and Afghanistan Veterans of America (IAVA) or Iraq Veterans Against the War (IVAW) yet has the in house capacity to assist with VA Claims or Appeal filings.

      You cannot get an attorney until your VA Appeal is denied, then we can point you to attorneys who do Pro-bono VA appeals.

      Bobby Hanafin

  8. Texas Grunt  May 18, 2010 at 12:20 pm

    Ah yes Dr. Dumb (Rizzo), I can see a virtual reality game really helping a young GI by simulating his post-battle existence. Let’s see, ah yes. Here’s one to simulate. How about lying in a military hospital bed for 4+ months, mostly comatose. We want the full effect of the event, right Rizzoz? How, Rizzo, are you going to simulate the total embarrassment of finally waking to bedpans? And then simulate the euphoria of finally getting up — the first trip to the shitter and finally being able to take a healthy crap on one’s own. Oh yes, don’t forget in your VR simulation Rizzo, the two orderlies standing by, holding their noses and trying to keep the damaged soldier from falling sidewise off the pot. It’s all part of PTSD Rizzo. One tiny sliver of my experience.
    That would be a great, real-time video Rizzo. A stack of DVD’s an inch thick. You could make a lot of loot off that fancy 5 month long game. Rizzo, you and your like are intellectual idiots who have no understanding of real reality.
    Sorry, Major Bobby. I shouldn’t vent in public. But post military, I managed to get college degrees in Electrical Engineering, Physics and Math. As a computer designer, I spent years working in virtual reality as a way to hide from reality. Rizzo and Satel are arrogant nutcakes. The positive? At least they want to try something, even if it’s motivated by greed and ego.

    Texas Grunt

    • B.A. Gilmore  May 18, 2010 at 2:24 pm

      Wow, Texas Grunt, you are so right. I don’t believe you can use virtual reality videos for PSTD unless you have the sights and smells and sounds of combat. And I’m not surprised that rape was left out. Women are always the forgotten warriors.

    • Pappy  May 18, 2010 at 2:55 pm

      Texas Vet. Without saying a lot you said a lot. What happened during Vietnam and after, and now in our present war, war has been trivialized.

      These people who are promoting this sort of PTSD treatment are using the old adage “If You Build a Better Mouse Trap The World Will Beat Down Your Door”.

      It is all very cynical, and about making money. The country does not courage have to gather around a wounded GI to support him or her.

      They can give wounded vet 1.9% increase in disability every year. In their mind that should satisfy us lowly bastards. Or the broad America can do it with a ribbon on their car. To me this is all very cynical.

    • Texas Grunt  May 18, 2010 at 7:23 pm

      Thank you Pappy. Thank you B.A. You both understand.

    • Fran Lawrence  May 18, 2010 at 10:59 pm

      Hey T,

      This is the place to vent… and especially on this subject and with all of your experiences, including professional. If You can’t here and on something you know so well… then where can you vent?

      You are still, as always, are being a gentleman.

      I’m sure you have, (I know you have), seen me ‘vent’. This was the only place that ‘got it’ for the most part when my family was going through hard times and going through a terrible time trying to get my husband’s claim through for PTSD. Almost every dirty trick that you may of read about that can happen to disabled VN veterans with PTSD… while trying to get a claim through… we experienced it… as my husband was ill (agent orange related) and could not work. It was so hard.

      Well, I hope all is well with you and those you love.

    • Rob Jackson  May 26, 2010 at 11:17 am


      Thank you for bringing it around to what is actually done with us. I was diagnosed by a VA Psychologist as having severe PTSD. The VA administrators decided I can’t have PTSD because I wasn’t wounded in action. They sent me to another Psychologist who decided that I have depression and a God complex. The VA a few years ago decided that it needed fewer PTSD cases because it cost so much to treat so they sent a memo around telling their Psychologists to stop diagnosing PTSD. Luckily my primary Psych decided that he didn’t care about costs and continues to both treat me and updates my records with the fact that I am a PTSD sufferer.

      Satel words her statements carefully to appear caring about vets, but all she cares about is how much it costs to care for them and how to reduce that spending. The VA routinely refuses claims, basically saying that if you are really in need of care you will reapply or ask for an appeal. The problem with that thought stream is of course that the appeals process has become a multi year affair with no guarantee of reversal, especially if the appeals dept decides the decision was valid based on their rules, regardless of your medical status.


      “[Sally] Satel words her statements carefully to appear caring about vets, but all she cares about is how much it costs to care for them and how to reduce that spending.”


      I for one did not intend to overplay the role certainly played by Satel for the Bush administration’s quest to cut cost at the VA. However, she is for now in the past that is until the ultra-conservatives once again gain control of Congress, the White House, and the VA. Hell they still control the Pentagon (wink).

      What the collective we need be careful of are people who may have been influenced by the views or teachings of Sally Satel and the American Enterprise Institute (AEI). Keep in mind the AEI is laying low FOR NOW waiting for the next far right wing government to come to power AGAIN, and it will it is only a matter of time, and THEY just might not be Republicans (wink).

      The collective we need to be concerned about those who really matter to us in the War at Home and Wars Against PTSD, Agent Orange, DU, Gulf War Illness, and whatever crud comes out of Iraq or Afghanistan that could be more devastating to America’s Veteran our families and children than the BP Oil spill will be to our environment and economy.

      He may not know her, even heard of her, but we must be cautious about has Dr. Skip Rizzo among other Psychiatrist, Psychologists, and Clinicians been infected by the cancer spread by Sally Satel and the AEI.

      We are willing to give Skip the benefit of the doubt thus far, and invite him to write an article expressing his views of how Virtual Reality will no shit help us Veterans and active duty troops. However, just the fact that his focus is on active duty troops, making them somewhat immune to combat trauma, and assisting the Pentagon in sending troops back into combat who have been diagnosed with PTSD makes us wonder just how close Skip’s views and intend are to the teachings of Sally Satel and the AEI.

      Ship claims we are nailing him with quilt by association. So we have tried to cautiously disassociate Skip from the Sally Satel who we rightfully demonize.
      However, if his own remarks, comments, and justification for his research parrallel Satel’s views we sure as hell will point it out.

      Bobby Hanafin

    • Rob Jackson  May 26, 2010 at 11:07 am

      I am not so sure that it was left out because women are forgotten warriors, and men can be the victim of rape too.
      I think it is more an issue of having a really hard time finding anyone willing to make a “game” with rape as the central theme. This kind of software would be viewed as offensive by most of the population and could be considered training for potential rapists.

      I for one play some war games and avoid others due to my PTSD. If I can see the content as too real, I don’t play with it. Maybe that’s making my PTSD last longer, but I find it more productive to try to find a way to integrate my memories into my past and move on. My doctors agree I have a positive attitude but we have not been able to overcome some of my issues and it has been five years. I would expect that most rape victims would want to avoid “reliving” the experience, whether there’s a doctor there or not.

  9. Archie Haase  May 18, 2010 at 10:57 am

    No way in hell I want to relive the horror of what I went through. There was a time maybe five to ten years after combat where I could relive almost every day of the 46 day siege of Con Thien. Subconsciously I think it had to do more if I could have done something different. I do not dream anymore every night about war.

    I believed then in the 60’s 70’s and 80’s my life and dreams about war would have been better if my experiences would not have been such a socially isolating event in my life. In other words who is going to understand my situation? Most people in the US were interested in money, making money, sex, drugs and rock and roll.

    I could not even talk to other combat veterans because they had the same problem I did. In fact most I knew back then did not even want to admit they had problems. Let’s face it Americans do not have a clue about war.

    Why even talk about the trauma of combat because Americans would and did attach to you the stereotype the US media handed them. That is a crazy disturbed out of control Vietnam veteran.

    At least this game is an attempt to help. I hope the combat veterans today understand. The VA is at least set up to deal with their situation. Not so in the 60’s and later.

    • Tom Dillman  May 18, 2010 at 7:21 pm

      Right on Arch! => “Most people in the US were interested in money, making money, sex, drugs and rock and roll.”

      TD => The lazy, unprincipled bums around us are still that way! Excuse me, I had a BAD day at the VA today.


    • Michael Leon  May 19, 2010 at 8:44 am

      Just another scheme cooked up to deny veterans what they deserve.

      Don’t care what your politics are, everyone on this site is committed to fighting these pencil necks who continue to think of new and improved ways to screw veterans.

      Thanks for the piece, Robert!

    • Rob Jackson  May 26, 2010 at 10:59 am

      Right Arch,

      By taking up the role of Soldier we have made ourselves the “less than 1%” of a population that relies on us to keep their freedoms, but condemn us for the method which must be used to do so. I live in an apartment building with 320 units, and there are maybe 3 other vets here. The majority of my neighbors are insensitive to the vets here, and this is an Army town, I’d hate to see how things are out in the rest of the country.


      I’ll try to keep this one shorter than my last.

      Wo Rob, I hate to lay this on you Bro, but given your capacity TO THINK, despite having PTSD (wink), I can relate and believe that you Rob need to be involved in Iraq and Afghanistan Veteran advocacy and activism as a means Rob to channel any anger, resentment, disillusionment, or frustration you are feeling.

      You say my suggestions in my first response. Now let’s hit your point REALISTICALLY.

      Let me use an unsavory quote here from a Pentagon leader the collective we love to hate, Donald Rumsfeld, “We fight with the Army we are given not the Army we want.”

      A pun intended on Rumsfeld’s quote, “We fight with the 1% who volunteer not the 100% with no commitments to the war(s).”

      Therein Rob you will find the realistic reasons why:

      “By taking up the role of Soldier we have made ourselves the “less than 1%” of a population that relies on us to keep their freedoms, but condemn us for the method which must be used to do so.”

      We have made ourselves the less than 1%, very good point Rob, but think about it when the two words THE DRAFT is mentioned (a concept that no shit gets the other 99% involved like it or not and forces them to relate to us one percent, who is the first to cry foul or we don’t need it, or draftees make worse Soldiers than you and me – YOU GOT IT BRO, we do us who were or are recently on active duty – DAH!

      A population that relies on us to keep their freedoms. Another good point, problem is do you really believe that? If the other 99% no shit relied on us to well ‘keep their freedoms,’ how come they are no willing to ‘keep their freedoms’ by either joining us or accepting THE DRAFT? Here Bro we have another UNREALISTIC expectation that 99% of the population really cares about their freedoms enough to fight and die for them (RIGHT). Add to that Bro the reality that within that 99% is what percentage who could care less about ‘fighting them (whoever them is) over there, so we (when did the American people begin speaking French) don’t have to fight them over here.’ Who exactly would the WE be Bro? GET IT! Rob, the other 99% never really relied on us for anything – THEY USED US!

      However, do not get mad, don’t get angry, don’t check out, GET EVEN in realistic and humane ways.

      “The majority of my neighbors are insensitive to the vets here, and this is an Army town, I’d hate to see how things are out in the rest of the country.”

      Now you can relate to how my wife and I felt living in an apartment near the campus of the University of MD, College Park and there was no Veteran in the building, and most residents had opposed the Vietnam War. However, that had no impact on my opposition to that war – I questioned my role in it. At least we had one thing in common, but they still could not relate to me.

      I’d hate to see how things are out in the rest of the country.
      Report: The Community Service Desires, Civic Lives of Returning OEF/OIF Veterans – All Volunteer Force

      Flush with important skill sets and valuable experiences, military veterans can be counted among a community’s greatest assets. Unfortunately, one barrier they face when out of uniform and in a civilian capacity is a feeling of disconnection from the very people they wish to serve.

      So says a a 44-page report, All Volunteer Force: From Military to Civilian Service [pdf]. Published last November on Veterans Day by public policy firm Civic Enterprises, it presents the findings of a first ever nationally representative survey focusing on veterans’ homecoming transition and civic lives.

      The survey found that “only 13 percent of veterans strongly agree their transitions are going well. Yet those veterans who said they had volunteered since returning home had better transitions than those who had not.”
      It is estimated that almost 3,000 OIF/OEF veterans have sought assistance from the U.S.Department of Veterans Affairs or National Coalition for Homeless Veterans agencies for homelessness.

      Given the age of these current veterans, these early numbers do not bode well for the future.

      The unemployment rate for veterans who have served in the military since September 2001 outpaces the adult unemployment rate, jumping to 11.3 percent in August 2009, up from 9.8 percent the month before, according to the Bureau of Labor Statistics.

      Volunteering provides veterans with an opportunity to hone skills, or to develop new skills, as well as networking opportunities that can assist in finding paid employment.

      The National Alliance to End Homelessness estimates that among 1 million veterans who have served in the military since 9/11, nearly 72,000 are paying more than half of their incomes in rent, instead of building equity in homes.

      According to the Defense Commissary Agency, military members and their families redeemed food stamps last year [I believe 2008 or 2009] at nearly twice the civilian rate. More than $31 million worth of food stamps were used at commissaries nationwide in 2008 — an increase of more than 25 percent.

      After long absences from home, OIF/OEF veterans also face challenges with their families. One in five service members have filed for divorce since 2001. More than 27,000 service members filed for divorce in 2004, a 44 percent increase from 2001.

      In addition to being members of our active duty military, national guard, and reserve, these veterans are also husbands and wives, fathers and mothers, brothers and sisters, and neighbors and community members. Yet, almost no attention has been focused on their civic lives: how they re-integrate into their neighborhoods, what roles civic and religious institutions play in their transitions home, what their attitudes and interests are in continuing to serve on the home front, and what America can do to utilize their talents and skills as they move from military to civilian life.

      Neuroscience tells us that improving a person’s civic health can improve his physical and mental health. Studies have shown how participation in service efforts can boost job prospects. Civic connectedness also can provide additional support to families as they adjust to the transition of having their loved ones back home. Furthermore, veterans are untapped national assets, having acquired experiences and skills while serving in the military that have significant value in the workplace and in communities. They are beacons of hope that can encourage our next generation to serve their country in the military, in government service, in national service, or in traditional volunteering.

      As our country welcomes home this generation of veterans, we must pay close attention to, and act upon, OIF/OEF veterans’ perspectives on their civic lives. In doing so, we can improve the veteran’s transition home, engage them in meaningful work and service on the home front, and hold them up as the leaders that they have become to a grateful nation. …

      The primary purpose of this report is to spark a national effort around the civic engagement of our nation’s veterans. We hope this endeavor will promote that dialogue and action in earnest so that we as a nation can look back on this moment as when we truly rallied around veterans — not just with parades and yellow ribbons or job training and health care, but also by unleashing the civic talents of these extraordinary Americans for their own benefit and the benefit of the American people.

      Rob, sorry but once again this is maybe a long winded way to explain how you are feeling. However, once again, I do not endorse everything in this report. But there are insightful parts that need dealing with. My suggestion is to first organize and mix with crowds of folks who can relate to you and me.

      I get hammered for this, but I believe that the long traditional Veterans Service Organizations played a valued role for what they do. However, they too cannot no shit relate to your experience in Iraq and Afghanistan other than from our views of our war(s) and yes there is a political take on our wars that even divides us til the day we die. We must somehow get beyond that, and it is not too late for your generation to do that.

      You must hook up with an Iraq and Afghanistan group, state chapter, or the closest one to you in order to survive the War at Home.

      In fact, your War at Home has begun way before your war(s) have ended making the skirmishes, fire fights, battles, and war(s) far more difficult to deal with, but at least the War at Home is winnable in definitive ways.

      Bobby Hanafin
      The Mustang Major

  10. Basil White  May 18, 2010 at 10:28 am

    The effectiveness of exposure therapy suggests to me that PTSD may be a natural form of exposure therapy: reenacting a traumatic experience to rob it of its power.

    • Tom Dillman  May 18, 2010 at 7:18 pm

      Basil, that sounds like about as dumb as a brick! Clearly, like the authors Rizzo or Satel, you’ve never been there / done that. What they are trying is just another massive waste of taxpayers money.

      Tom Vet — First Cav — Gary Owen!

    • Fran Lawrence  May 18, 2010 at 10:40 pm

      Oh my goodness! I absolutely agree with you Tom!

    • Tom Dillman  May 22, 2010 at 12:56 am

      That must be a mistake Fran. I must have grown a liberal soft spot in my brain for you to agree with me on something. 🙂


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