A virtual reality game could help clinicians at the Manhattan VA Medical Center treat Iraq veterans suffering from posttraumatic stress disorder.

The system incorporates graphic components that were initially built for an American Army simulation titled Full Spectrum Command, which inspired the creation of the Xbox game “Full Spectrum Warrior.”

The Manhattan VA secured financing for a single console through a mental health fund administered by the Department of Veterans Affairs. Including updates and training for clinicians, the system costs $70,000, or roughly the same price as 175 Xbox 360s.

With the lights off and the headset on, the patient becomes an active participant in a computer-generated three-dimensional replica of an Iraqi city or a desert road convoy.

The machine includes a Nintendo-like controller, goggles and headphones, and a vibrating footpad.

In the city scenario, the patient sees desolate streets and ramshackle buildings. Helicopters fly overhead. The convoy scenario consists of a paved roadway with battle wreckage. From behind the wheel of a Humvee, the patient dodges debris. Sharpshooters appear on overpasses, and children run across the road.

Using a computer interface, the therapist can activate the sounds of gunshots or other stimuli such as vibrations that replicate explosions.

“Virtual Iraq” can also reproduce the smells of war: garbage, diesel fuel, Middle Eastern spices, and body odor. A clinical psychologist at the VA’s PTSD clinic, Dr. Michael Kramer, said scents help patients reimagine themselves at the site of a trauma.

“I treat veterans who say, ‘Right before the accident I smelled diesel’ or who were trapped for days in trucks reeking of sweat. Now I can replicate the smell of diesel fuel or sweat to bring the patient back to an important moment,” Dr. Kramer said.

The combat veteran coordinator for the New York Harbor Health Care System, Robert Greene, estimates that at least 8,000 veterans from Iraq and Afghanistan reside in New York. According to Dr. Kramer, between 15% and 20% of them will ultimately develop some form of PTSD. Symptoms include flashbacks, irritability, recurrent nightmares, and depression.

Dr. Kramer likened the therapy to swimming in cold water: “Your first impulse is to get out, but that’s the worst thing to do because you’ll be scared of the cold and you won’t go back in. You need to stay in the cold until your brain recognizes that the temperature is only uncomfortable, not dangerous. Then, suddenly, you feel warm.”

Before undergoing virtual reality treatment, a patient must achieve relative emotional stability. In the next few months, Dr. Kramer plans to treat a pilot group of about 20 veterans.

Traditionally, veterans with PTSD undergo “prolonged imaginal exposure.” The veterans must visualize a feared object or situation and then tell the story of their trauma in extreme, painstaking detail. “The problem with imaginal therapy,” Dr. Kramer said, “is that the patient must have excellent visualization abilities.”

The video game-like treatment could also help reduce the stigma attached to mental health care. Mr. Greene thinks the “coolness factor” will resonate with younger veterans and make them more willing to undergo treatment. A Vietnam veteran, Mr. Greene said: “I wasn’t treated that well when I came home, so I’m trying to do better. I tell the veterans, ‘This is not your father’s VA.'”

Previous studies have demonstrated the effectiveness of virtual reality technology in the treatment of psychological disorders. Most notably, clinicians at New York-Presbyterian Hospital/Weill Cornell Medical Center exposed survivors of the September 11, 2001, terror attacks with PTSD to simulations of the attacks. The clinician who led the pilot program, Dr. JoAnn Difede, said her staff screened several thousand survivors and treated a small subset, with promising results.