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VRET Dissertation UNIVERSITY OF CALIFORNIA, SAN DIEGO War, Trauma, and Technologies of the Self: The Making of Virtual Reality Exposure Therapy A dissertation submitted in partial satisfaction of the requirements for the degree Doctor of Philosophy in Communication and Science Studies by Marisa Renee Brandt Committee in charge: Professor Chandra Mukerji, Chair Professor David Serlin Professor Kelly A. Gates Professor Charles Thorpe Professor Joseph Dumit 2013 Copyright Marisa Renee Brandt, 2013 All rights reserved SIGNATURE PAGE The Dissertation of Marisa Renee Brandt is approved, and is acceptable in quality and form for publication in microfilm and electronically: Chair University of California, San Diego 2013 iii DEDICATION I dedicate this dissertation to all of the people around the world have suffered trauma as a result of the Global War on Terrorism. May we never give up on peace. iv TABLE OF CONTENTS Signature Page ................................................................................................................... iii Dedication ........................................................................................................................... iv List Of Figures ................................................................................................................. viii Abbreviations ..................................................................................................................... ix Acknowledgements ............................................................................................................. x Vita ................................................................................................................................... xii Abstract Of The Dissertation ........................................................................................... xiii Introduction: The Cultural Work of Making VR The Right Tool for Treating Military PTSD ................................................................................................................................... 1 A Cultural Biography of a Technology-in-the-Making ........................................... 6 Impersonal Trauma and the Media Environment ...................................... 11 What is Virtual Iraq? The Technology According to Its Maker ............................ 13 Literature Review: Medical Miracle or Militarized Therapy? .............................. 21 Research Methodology .......................................................................................... 26 Three Orienting Ethnographic Vignettes ............................................................... 30 Vignette 1: Playing Therapeutic Technology: Visiting Virtual Iraq ......... 30 Vignette 2: When Does Therapy Require Technological Enhancement? Virtual Iraq’s Therapeutic Milieu .............................................................. 41 Vignette 3: Media Attention to VRET Preceeds Scientific Evidence ....... 45 Coda: A Real World for a Virtual Environment ....................................... 50 Overview of Chapters ............................................................................................ 54 References ............................................................................................................. 58 Chapter 1: If the answer is PTSD, is the question “What is VR?”: Public Representations of Virtual Iraq .................................................................................................................... 65 The Problem: Emasculating Therapy .................................................................... 70 The Solution: Masculine Technology ................................................................... 73 v VRET-Mediated Remasculinization Narratives ........................................ 74 Spectacularization of Therapy: Machine Agency and Intense Memories . 78 Soldier 2.0 Does Not Want to Talk About His Mother ............................. 85 Traditional Prolonged Exposure ............................................................................ 94 Restoring Memory & Masculinity: VRET in Crime Dramas ............................... 97 Conclusion ........................................................................................................... 107 References ........................................................................................................... 108 Chapter 2: Therapy For Cool Dudes: Masculine Performance And Virtual Iraq ........... 112 Seeing Like an Innovator: Virtual Iraq’s Origin Story ........................................ 115 Video Game Origin Story as Promotional Resource ............................... 119 Video Game Drag and Destigmatizing Therapy ................................................. 123 Public Talks as Therapeutic Technovangelism ................................................... 130 Live Demos and Treatment Technologies as Toys ............................................. 132 Presentations for the Media: Making “Virtual” Demos ...................................... 136 A Crisis of Representation: Veterans Today ....................................................... 141 Conclusion ........................................................................................................... 153 References ........................................................................................................... 154 Chapter 3: From the ‘Ultimate Display’ to the ‘Ultimate Skinner Box’: The History of Virtual Reality Exposure Therapy ................................................................................... 158 A Brief History of VR: Hammers and Nails ....................................................... 163 Origins of the Clinical VR Field ......................................................................... 169 The Origins of VRET for Phobias in Atlanta ...................................................... 175 From Intuitive Observation to Clinical Trial ....................................................... 177 Alternative Paradigms: The Case of “Virtual Therapy” ...................................... 188 VRET for PTSD: Virtual Vietnam ...................................................................... 194 Conclusion ........................................................................................................... 199 References ........................................................................................................... 200 Chapter 4: How to Represent War Trauma Without Killing: The Virtual Iraq Design Process ............................................................................................................................. 205 vi Full Spectrum Warrior PTSD: Next Generation VRET ...................................... 209 Research as a Design Problem ............................................................................ 213 User-Testing Realism .......................................................................................... 219 “It Has to Look Good”: Production Values and Realism .................................... 223 BRAVEMIND: Re-Designing Virtual Iraq ......................................................... 230 Scenarios .................................................................................................. 233 Clinician Controller ................................................................................. 235 Case Studies: Representing War, Trauma, or Therapy? ...................................... 238 Case 1: Is Killing a Virtual Arab Therapeutic? ....................................... 238 Case 2: Is Representing Violence Against Bodies Therapeutic? ............ 241 Case 3: Are the Sounds of War Therapeutic? ......................................... 247 Conclusion ........................................................................................................... 255 References ........................................................................................................... 256 Conclusion: Mediation, Imagination, and Machine agency ............................................ 259 Impersonal Therapy, Depoliticized Trauma, and Behaviorism ........................... 269 Future research: Users’ Perspectives ................................................................... 275 Conclusion: Beyond Critique .............................................................................. 277 References: .......................................................................................................... 280 vii LIST OF FIGURES AND TABLES Figure 1: A typical Virtual Iraq clinical set-up………………………………………….14 Figure 2: The top inches of a characteristic online article about Virtual Iraq…………..80 Figure 3: Masahiro Mori’s graph of the uncanny valley………………………………225 Table 1: Forms of Mediation of Virtual Iraq………………………………………......268 viii ABBREVIATIONS DSM Diagnostic and Statistical Manual of Mental Health Disorders HITlab University of Washington Human Interface Technology Laboratory HMD Head-mounted display, also known as VR goggles ICT Institute for Creative Technologies IED Improvised exploding device MedVR The Medical Virtual Reality Laboratory at ICT NMCSD Balboa Naval Medical Center San Diego PE Prolonged exposure PTSD Post-traumatic stress disorder RPG Rocket-propelled grenade STS Science and technology studies USC University of Southern California VA Veterans Administration VR Virtual reality VRE-AC Virtual reality exposure with arousal control VRET Virtual reality exposure therapy VRMC Virtual
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