by Corey Mead
Pennington spent the next year in a haze of medication and rehabilitation at Walter Reed Army Hospital in Washington, D.C. His only concern was his physical recovery: he wanted out of his wheelchair. He had been diagnosed with post-traumatic stress disorder, but his doctors had placed him on such a strong cocktail of opiates that he had little sense of any emotional distress. When he was released, he and his wife returned to central Maine, where Pennington, with his doctor’s permission, stopped taking his medications, because he was tired of how groggy and apathetic they made him feel.
In the weeks after moving home with his wife, Pennington fell into a deep depression. He had planned on spending his life in the army, and now that option was gone. He hated his carbon-fiber leg and the cysts it raised on his stump. He hated that whenever he went out in public, people approached to thank him for his service or to share their opinions on the war. “A lot of [soldiers] just want a break” after being at war, he says, “and it’s really hard to get one.” He began heading to stores later and later in the day; eventually he tried to avoid going out in public at all.
At the same time, his relationships with his wife and friends were rapidly deteriorating. “I was acting like a prick and on real high alert,” he recalls. “A lot of people told me this, but I refused to listen.” No matter how many times people informed him that he was acting different from his old self, Pennington did not believe them. Self-medicating with alcohol to dull his depression, he seemed on the verge of becoming a full-blown alcoholic. From his perspective, every time he opened his mouth to speak it only made things worse, so he just kept quiet. He had never been one for sharing his feelings anyway; now he simply stopped communicating. With their marriage on the brink of collapse, he and his wife separated three times. One night, drunk and at the end of his rope, Pennington drove his car directly into a brick wall.
This would be the rest of his life, he thought: anger, isolation, alcoholism. But one day, in 2009, a friend forwarded him a casting call from an undergraduate filmmaker at New York University. The filmmaker, Nicholas Brennan, needed someone to play a veteran from Maine who had lost his leg and was suffering from PTSD. Though he had never thought about acting, Pennington was struck by how closely the character’s life mirrored his own. As low as his confidence was at that point, he thought acting in a film might “be so out of the normal that it would force me to deal with things.” Pennington’s desperation overcame his apprehension, and he typed out a moving e-mail to Brennan: “I was injured in 2006. It resulted in a personality change for the far worse.”
Pennington wanted to heal, yes, but part of him was also searching for a reason to give up. A conservative, he thought spending time with liberal NYU undergrads was likely to confirm his impression that America wasn’t accepting of veterans. Point proved, Pennington could then spend his life sitting angrily alone in his house, convinced of his own righteousness.
Instead, the three days he spent working on the film showed him that even if people were opposed to the conflicts in Iraq and Afghanistan, they were not against the veterans themselves. More important, the process of playing Connor, the film’s protagonist, illuminated his own struggle with PTSD. For the first time Pennington began to grasp how serious the issue was.
The next step in Pennington’s healing came after the fifteen-minute film, A Marine’s Guide to Fishing, was completed. Following an initial screening in Portland, Maine, Brennan and Pennington traveled to the 2011 GI Film Festival in Washington, D.C., to present their work. There, on the third night of the festival, in a movie theater inside the U.S. Capitol, Pennington encountered the work of WILL Interactive.
Sharon Sloane began WILL’s presentation that night with an overview of the VEILS learning system. She then screened The War Inside, the game about veterans’ reintegration into civil society following deployment. The audience members that night were given handheld devices so they could play along with the game on the big screen.
As Pennington played through the various characters in the game—an army specialist suffering from PTSD; an officer who no longer relates to his wife and child; a spouse trying to come to terms with her husband’s negative behavior—he felt that he was encountering his own life from striking new perspectives. Playing the spouse, for example, he says, “was like watching my wife.” The surge of recognition was like a slap in the face: “I thought, ‘Wow, okay! This makes so much more sense to me now.’ I was able to go back [home] and talk about things more effectively.”
A key reason that Pennington responded to WILL’s work is that it steers away from what he calls a “direct, confrontational” approach. The War Inside, he says, doesn’t accost veterans with cries of “Hey, what’s wrong with you?” Instead, it enables them to identify with the characters. In doing so, veterans “can turn the light on for themselves. [That approach] makes everything much more effective . . . It’s able to open your eyes to see how you may be going about things and why it has proven ineffective for you.”
Pennington says that when veterans return home from war, “confrontation is just a quarter-second away—with combat stress, one of the symptoms is that you’re on an adrenaline high, and almost anything can trigger it. It could be a car driving past you too fast, and six months ago, a car couldn’t come within a hundred and fifty meters of you because it’s considered a threat. Little things like that.”
Too often, he says, people take an overly forceful approach to treating veterans. This method has it all wrong, he believes: “With veterans who are undergoing withdrawal symptoms, or are maybe even delusional and not seeing their own symptoms, [a confrontational approach is] just going to push them further away.” With a digital game–based approach like WILL’s, he says, “there’s no human-to-human interaction, so [veterans are] able to go through the thought process themselves instead of feeling like they’re being told what’s wrong with them . . . They’re able to come to their own conclusions about it.”
Pennington was so impressed by WILL’s work that he wanted to spread the word to other veterans. To do so, he enlisted the help of the Coalition to Salute American Heroes, a nonprofit organization where his wife works. The organization holds a monthly training seminar called “Hands of Hope,” where a licensed clinical psychologist meets with veterans to talk about their issues. Pennington knew the program director personally; he told her about WILL Interactive and the GI Film Festival and then connected her with Sharon Sloane. Ultimately, “the coalition was able to show The War Inside to a lot of its associates and families,” Pennington says, “and they’re all wounded combat veterans from the current conflict. And they all just ended up falling right in love with it. And they were able to take a lot out of the experience as well, because like me, they were able to see things for themselves” and come to their own conclusions.
“We all have self-awareness,” Pennington reflects now. “We all know how we sit with ourselves. And we have our self-identity as well, how we see ourselves. And that’s why I [like WILL’s games], because through the process, you understand that you have to step out of yourself. And when you’re doing that, you’re dropping your own self-awareness and self-identity to look at [other points of view]. And then you’re able to feel like, ‘Wow, okay, I see where I’ve been doing this and this. Now it makes some more sense to me.’ . . . [That process] changed my attitude toward my behavior, and it made me more receptive to listening.”
Whack-A-Mole
Despite the positive testimony of soldiers like Pennington, Sharon Sloane acknowledges that there is no silver bullet for combating the wear and tear on the armed forces after more than a decade of war. A game may provide a temporary solution to a problem, but soon enough a new, and perhaps more severe, version of that problem will crop up elsewhere. This is the military’s own continuous version of Whack-A-Mole—new issues keep springing up and extending themselves faster than the military can (or will) deal with them.
Playing a game like The War Inside obviously doesn’t cure anyon
e; nor is it intended to. It is intended, like many of WILL’s games, as a bridge toward treatment, or toward a change in personal behavior or treatment. The idea that games can play a role in convincing someone to seek treatment, or to recognize his or her own behaviors as unhealthy, is slowly gaining traction throughout the military health-care community at large.
The military is also turning to games for treatment of mental health issues, however. As we are about to see, one of the most promising therapeutic tools for treating veterans’ PTSD comes, perhaps surprisingly, in the form of a modified first-person shooter game. But its purpose could not be further from the commercial entertainment of its blockbuster brethren.
Spacewar! being played on a PDP-1 at the Massachusetts Institute of Technology. Arguably the first digital game, Spacewar! was invented in 1962 by twenty-three-year-old math major Steve Russell and his cohorts in the fictitious Hingham Institute Study Group on Space Warfare, a collection of like-minded, Pentagon-funded engineering graduate students at MIT.Courtesy of the Computer History Museum
Part of the IBM AN/FSQ-7 computer that was the backbone of the U.S. Air Force’s Semi Automatic Ground Environment (SAGE). The SAGE project led to significant advances in core memory, keyboard input, graphic displays, and digital communication over telephone lines.Scott Beale / Laughing Squid
DARPA (Defense Advanced Research Projects Agency) headquarters, Alexandria, Virginia. DARPA is the Pentagon’s technology research lab; along with funding the creation of numerous weapons systems, DARPA is responsible for the invention of computer networking, as well as ARPANET, an early version of the Internet. It has also been a primary sponsor of research in computer science and artificial intelligence over the past several decades.Arlington News / ARLnow.com
FlatWorld, shown here at the Institute for Creative Technologies. One of the ICT’s earliest projects, FlatWorld was conceived of and designed by a combination of video game designers, special effects artists, research scientists, and Pentagon personnel working together to create the army version of Star Trek’s fictional “holodeck,” a virtual space that can be programmed to mimic a wide array of three-dimensional settings.USC Institute for Creative Technologies
Colonel Casey Wardynski at West Point. For more than a decade, Wardynski ran the U.S. Army’s Office of Economic and Manpower Analysis; while in this position, he created America’s Army, the world’s first-ever military-developed video game. He is now superintendent of schools in Huntsville, Alabama.Courtesy of the author
A screenshot from America’s Army. From 2002 to 2008, America’s Army was one of the top ten online games in the world. Originally designed as a recruiting tool, the game has since been repurposed as a training tool for the military and numerous government agencies.U.S. Army Office of Economic and Manpower Analysis
Tactical Iraqi, released in 2005, trained soldiers in Baghdad Arabic and Iraqi culture. The game’s emphasis on training even junior personnel in intercultural difference represented a new phase for the military; in the past, understanding the culture in which one was fighting would have been seen as the purview of the State Department, not the armed forces.© Alelo Inc. Used by permission
A soldier training on VBS2. Currently the military’s most widely used video game, VBS2 is designed to plan mission training and mission rehearsal, and also to provide education—hence the inclusion of language training, cultural training, and medical training in the hardware, along with a captains’ career course focused on leadership.Catrina Francis (USAG Fort Knox)
A screenshot from VBS2.Bohemia Interactive Simulations
Filming a scene for a WILL Interactive learning game. Founded in 1994 by former secondary school teacher Sharon Sloane, WILL differs from its competitors in that it utilizes what it calls Virtual Experience Immersive Learning Simulations, or VEILS—live-action, interactive movies in which users become the lead characters. The games are based on real events, use real actors, are shot on location, and last between two and three hours. Similar to the old Choose Your Own Adventure book series, each game offers users more than eighty “moments of decision,” with every decision affecting the story line and the outcome.Courtesy of WILL Interactive
Matthew Pennington at home in Maine. After being injured in battle, Pennington found that playing a WILL Interactive learning game helped guide him toward treatment for his PTSD.Todd Heisler / New York Times / Redux
Skip Rizzo in his office at the Institute for Creative Technologies. Rizzo is one of a small but increasingly influential group of psychology researchers working in the discipline of virtual-reality exposure therapy (VRET). Since its origins in the early 1990s, VRET has proven remarkably effective at treating anxiety disorders; initial studies indicate a “cure” rate of between 70% and 90%.Courtesy of the author
Soldiers in Iraq demonstrating Virtual Iraq. The brainchild of Skip Rizzo, Virtual Iraq—and its more recent counterpart, Virtual Afghanistan—are the most widely used virtual-reality exposure therapy treatment programs in America. Wearing a head-mounted display, VRET patients are placed in immersive, interactive environments designed to represent their traumatic memories, ensuring that they can confront their experiences without having to conjure up the memories themselves.Courtesy of Greg Reger
SimCoach’s Bill Ford. In SimCoach, virtual humans act as advisers and sounding boards for members of the military community who may be suffering from such issues as depression, stress, substance abuse, suicidal ideation, brain injuries, and relationship difficulties. One of the primary goals of the application is to break down the barriers to care that have traditionally dogged the military—most prominently, the belief among soldiers that they will be judged negatively if they admit to needing help.USC Institute for Creative Technologies
Students at New York City’s Quest2Learn, the nation’s first public school to feature a curriculum based entirely on the principles of good game design. According to the school’s mission statement, “Games work as rule-based learning systems, creating worlds in which players actively participate, use strategic thinking to make choices, solve complex problems, seek content knowledge, receive constant feedback, and consider the point of view of others.”Photo by Gillian Laub
U.S. Cyber Command, which is charged with centralizing and coordinating the various cyberspace resources that exist throughout the military. Headed by National Security Agency director General Keith Alexander, Cyber Command is responsible both for protecting the Defense Department’s information infrastructure and for developing new offensive and defensive cyberwar capacities across the services as a whole.U.S. Air Force / AGE / F1online.de
The Chinese army’s Glorious Mission. Reportedly modeled on America’s Army, the game requires players to complete basic training before advancing to online team combat. After players complete training and combat, they move into a third stage, which re-creates what a Chinese news report calls “the fiery political atmosphere of camp life.”Giant Interactive Group
CHAPTER 7
The Aftermath: Medical Virtual Reality and the Treatment of Trauma
ON SEPTEMBER 11, 2001, Jerry Della Salla was a thirty-one-year-old struggling actor who had spent the past decade working in independent films, offering private acting lessons, and living what he calls the “romantic New York artist life.” But on the morning of September 12, devastated by the attacks on the city where he’d lived since his freshman year at NYU, he put all that aside. Seized by a desire to become a fireman, he began traveling to firehouses all over Manhattan to find out if anyone would take him. The officials he met all told him the same thing: he was too old. For pension-related reasons, the city wouldn’t let anyone older than thirty take the test to join the department.
Della Salla soon decided that the military represented his best option for serving his country. After repeated discussions with a recruiter in Harlem, he signed his papers, entered basic training, and was attached to the army’s 306th Military Police Battalion out of Uniondale, New Jersey. There he spent the next two y
ears awaiting orders to deploy. In April 2004, as news broke of the prisoner abuse scandal at Abu Ghraib in Iraq, his unit finally received notice: they would be heading to the military base where the prison was located to relieve the scandal-plagued units and help “restore the integrity” of the U.S. Army in Iraq.
After spending the winter months at Fort Dix—Della Salla and his unit couldn’t understand how training in frigid weather in the woods of New Jersey would prepare them for desert warfare in Iraq—the troops of the 306th MP arrived at their destination, the now notorious Forward Operating Base Abu Ghraib, twenty miles west of downtown Baghdad. The soldiers realized immediately that they had walked into what Della Salla calls “a nightmare.” “We had entered a hornet’s nest of media hype, military shame, and a new motivation for the insurgency,” he says. In the aftermath of the revelations of abuse, the base had become a focus of the Iraqi resistance, subjected to almost daily attacks. The pace was relentless. “Everything and everyone outside the wire was trying to come in and take us out,” Della Salla says.
