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At War with PTSD

Battling Post Traumatic Stress Disorder with Virtual Reality

The Spartans called it The Trembler; recent history has seen it termed shell shock, combat fatigue, soldier’s heart, and Vietnam Syndrome. Whatever the name, post traumatic stress disorder (PTSD) has always been with us. With 20 percent of the Veterans of the wars in Afghanistan and Iraq exhibiting PTSD symptoms, the United States military has a strong interest in combating the condition. Navy psychiatrist Robert N. McLay has been at the forefront of these efforts. This is his story of using virtual reality to treat Service Members and Veterans with PTSD.

As a practicing psychiatrist who works with Veterans and civilians coping with PTSD, McLay had known for years before the September 11, 2001, attacks that effective treatments for the condition were elusive. When active duty called, he met the challenge, becoming the primary investigator on PTSD treatment projects that had Service Members face the ghosts of war in a computer simulator. After using this new form of exposure therapy on the home front, McLay and his team believed they had found a promising way to work with warriors broken by combat, so in 2008 they took it to the front line in Fallujah, Iraq, with the First Marine Expeditionary Force.

Several years into the project, McLay recounts openly and with bleak honesty the successes, failures, and limits of virtual reality treatment for PTSD. Filled with poignant firsthand accounts of war and its psychological aftermath, At War with PTSD explains the difficulties of using this specialized technology in the field and discusses such challenges as helping people who refuse to believe in PTSD, including those diagnosed with it. So far, the virtual reality program shows more promise than traditional therapies. And although McLay remains unsure why or how, his experiences hold out hope for those suffering from this devastating disorder.

About the Author

Robert N. McLay, M.D., Ph.D., is a psychiatrist and research director with the Naval Medical Center San Diego. He came on active duty in the United States Navy in 2001 and shortly after the start of the war in Afghanistan became Primary Investigator on two Navy programs involving Virtual Reality treatment for PTSD.


Dr. McLay’s account of combat PTSD is both intensely personal and realistically scientific. The story of how he worked to perfect virtual reality therapy—which has helped many Service Members overcome PTSD—is a must read for anyone who has to deal with combat PTSD—Veterans, loved ones, and those who seek to help them.

- Paul S. Hammer, CAPT MC USN, Director, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury


Highly recommended for military and psychology holdings alike.

- Midwest Book Review

Thoroughly recommended as a humane, insightful, and very readable book.

- Chris R. Brewin - European Journal of Psychotraumatology

Recommended to the general reader interested in the effects of war and the importance of finding new and better ways to treat those effects.

- Choice

Accessible, informative and compelling.

- Taylor Poor - National Alliance on Mental Illness

Though useful for mental health professionals from different backgrounds (i.e. psychologists, social workers, psychiatrists, patient care technicians, etc.), this work is also intended for those who have experienced symptoms of PTSD or know someone who has... There are many books that discuss virtually every aspect of PTSD... few offer such a personal, frontline glimpse into the challenges mental health professionals face in providing accurate assessment and treatment services for military personnel.

- Steven T. Herron, MD - Doody's Review Service
Johns Hopkins University Press
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