When I ask Hawker if he believes that playing military games has helped him, he answers, "In some respects yes, in some respects no." He's seen an improvement since he began facing his trauma in virtual space; he's become better at coping with triggers, which still occur, but are less intense. He has fewer nightmares. He doesn't solely attribute his recovery to his activities in-game, but feels that it plays an important role along with talk therapy and medication. "It's gonna be a long process," he says, "I still can't get myself to be that suicide bomber in the truck, I just can't do it, but I can sit and watch it and laugh about it now-the more I saw it, the more I processed it, the more I played, the more it just became part of the game. It allows me to talk about it, which is what I really need to be able to do."
For those that complete the program, Virtual Iraq has around an 80% success rate.
His counselor has been urging him to try Virtual Iraq, but he remains skeptical. "I've been balking at it because the things I saw over there I don't want to relive, but I relive them every day. I like Battlefield, since I can do it on my own terms."
This reluctance is something Dr. Rizzo has struggled with. Getting patients to agree to the treatment and consistently show up for appointments has been an ongoing challenge, but for those that complete the program, Virtual Iraq has around an 80% success rate for eliminating all symptoms of PTSD within six weeks. Regardless, mental health disorders are still heavily stigmatized in the military community, and dropout rates remain high. However, the program has been successful enough that the government has provided pilot funding so that Virtual Iraq can be rebuilt on the Unity Engine, in order to add customizable elements that make it relevant to veterans of Afghanistan, as well as members of the Air Force. Dr. Rizzo is also in the planning stages of retooling the simulator to create a training program troops experience before they deploy overseas. The idea is to use the program as both a standard introduction to coping strategies before combat, and a normal part of debriefing after returning from deployment, rather than something troops are assigned to after being diagnosed-hopefully removing the stigma. "The mission here is to do this on the front end," says Dr. Rizzo. "Then perhaps we can lower the PTSD rate in the first place. This is one area where we can say with a straight face that it really does work. People achieve benefit if they stick with the exposure approach."
Thankfully his message seems to be getting through to a military establishment increasingly alarmed by the psychological toll asymmetrical warfare and multiple deployments are taking on its troops. It is difficult to obtain hard data about PTSD rates due to underreportage and delayed affects, but ten years after September 11th, some studies indicate that up to 35% of veterans may be fighting a personal war on terror.
Hawker plans to continue going it alone in the virtual warzone, "I can honestly say that playing videogames has helped, it's not going to work for everybody, but it's worked for me. It allows me to express my sorrow, and my pain, and my guilt. If there's veterans out there that haven't gotten help in some way, they need to deal with it. Drinking and doing drugs is not going to make this go away. Whether they realize it or not, everybody that's been there has some form of PTSD. They need to reach out to the VA, or a counselor, IAVA, VFW, American Legion, they have people that understand. You'll always be able to understand a vet before you understand a civilian."
Robert Rath is a freelance writer living in Austin, Texas. The Iraq and Afghanistan Veterans of America (www.iava.org), a nonpartisan nonprofit group, provided veteran interviews for this article. If you are a veteran of the wars in Iraq and Afghanistan, the IAVA can provide resources and advocacy to assist you and your family.