Blue Line

Virtual reality simulation and neurofeedback to help PTSD

One of the toughest battles fought by Canadian soldiers is the one fought within. Although things have come a long way in the past decade with the decreased stigma of mental health illnesses and with men and women increasingly seeking help, it can still be a challenge to share their feelings and experiences.

December 19, 2017  By Jennifer Madigan

Dr. Michelle Presniak is faced with helping them with that challenge regularly, as a clinical psychologist and the Psychology Lead within the Operational Trauma and Stress Support Centre (OTSSC) at CFB Petawawa, and finds her work particularly rewarding.

According to the Canadian Forces website, the Operational Trauma and Stress Support Program provides assessment, individual and group treatment for members suffering from an Operational Stress Injury as well as for serving members of the Canadian Armed Forces and their families dealing with stresses arising from military operations.

“There is something about the men and women who are trying to be tough but are struggling,” she said. “They are the ones that don’t freely seek services, so when they do it’s often critical. I like helping them find their way.”

Presniak has unique tools to help guide the soldiers along that path. While she offers traditional psychotherapy to help patients talk through their problems and find new ways to cope, she also uses two high-tech solutions: virtual reality simulation and neurofeedback.


Virtual reality simulators, available at all of the Department of National Defence’s OTSSCs, put the soldier back on the battlefield where they can look around and see the terrain, their comrades, and experience situations that may trigger anxiety. This form of treatment can help the individual to work through the anxiety or provide the key to a soldier opening up.  

“I had one member who had seen multiple service providers and no matter how much he wanted help he just could not open up and share his experiences. Something was blocking him,” said Presniak. “We put the goggles for the simulator on and suddenly everything came out. He was finally able to tell his story with great detail.”

Presniak also specializes in neurofeedback which is used to teach patients to regulate brain function. There are documented changes in the brain in individuals who are experiencing anxiety, depression and PTSD. Neurofeedback therapy allows  Presniak to monitor brain wave activity and to teach patients to regulate their brain activity through an advanced diagnostic system with a video game interface.  

“It’s a really nice option for members who don’t want to talk about what happened,” said  Presniak. “Some of them really like that they are regulating themselves in a concrete physical way.”

It also provides Presniak with further insight into what soldiers mean when they say they feel anxious, depressed or stressed.

She tells the story of one soldier who said he was experiencing high levels of anxiety, but when he was set up for neurofeedback, she wasn’t seeing the brain activity she expected. Instead, she could tell by his brain activity he was going into a hyper-vigilant planning mode – looking for danger around him and planning both defence and offence. Once she saw the brain activity he described as anxiety, she was better able to help him figure out how to manage what he was experiencing.

“I will always remember the session he came in where he actually said to me, ‘You know what happened to me this week, doc? I was doing my thing, I was planning and preparing for the worst, but I caught myself doing it and so I pretended I was in front of the [neurofeedback] machine, and it just stopped.’ From there he reached the end of his treatment really quickly,” said Presniak.

Neurofeedback is not currently offered on Canada’s military bases, but Presniak offers this service to military personnel from her practice in Kanata. She works part-time at the base in Petawawa and likes the flexibility of this work for Calian. Calian provides DND with health support services, essentially helping to avoid gaps in medical care, whether it be finding medical professionals for short-term openings or providing specialists to fill roles the government or DND cannot.

Presniak says there are some incredible benefits to working as part of the team on a military base, but she also enjoys the freedom to continue her own private practice and her work on neurofeedback.

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