NEW YORK (AP) -- For months after Sept. 11, 2001, Fire Chief Stephen King endured the same haunting dream: an endless wooden staircase spiraling into the clouds, his friends climbing ever skyward, always beyond his reach.
King was the battalion chief in charge of safety for the New York Fire Department on the morning when 343 firefighters died in the terrorist attack on the World Trade Center. King, who was friendly with nearly half the FDNY victims, barely escaped the north tower. His right knee was shattered.
The injured joint slowly healed. His shattered psyche took longer.
Despite more than 30 years as a firefighter, he could hardly bear to visit Manhattan, where he had worked for years.
''I didn't want to even stand next to any high rise building as long as I lived,'' said King, 57, of Long Island, a second-generation fireman with a son now working for the FDNY. ''I didn't even want to go over a bridge.''
King tried sleeping pills, anxiety medications and traditional therapy. But he didn't get better until he tried an experimental treatment: virtual reality.
For years, virtual reality has been used to treat common phobias such as a fear of airplanes, storms and speaking in front of crowds. Patients afraid of heights, for example, can put on a headset with a small screen in front of their eyes, and find themselves walking across a rope bridge nearly 200 feet above a canyon, with the wind howling and the bridge swaying. Claustrophobics can experience being stuck in an elevator; Vietnam veterans can return to jungle warfare.
It may sound like some kind of demonic amusement park ride, but since researchers at Emory University pioneered the therapy in the early 1990s, doctors and mental health experts across the country have begun using virtual reality as a treatment option.
Dr. JoAnn Difede, director of the Anxiety and Traumatic Stress Studies Program at Weill Cornell Medical College, found the practice extremely effective and, after 9/11, thought virtual reality therapy could be adapted to treat World Trade Center survivors.
Together with other researchers, she developed a new World Trade Center program for patients with post-traumatic stress disorder that incorporated animated 3-D images of the 9/11 attacks.
Difede began work on a pilot study of the program in 2002 and has been treating patients with it for more than a year with very promising results, she said.
Patients put on the headset and, by watching the screen, are transported to lower Manhattan, complete with honking traffic and sidewalk chatter.
Look left, and there's a row of skyscrapers. Look down, and there's the street. Look up, and there, looming twice as tall as everything else, are the twin towers.
The early sessions focus just on these peaceful images of the World Trade Center standing in a bright blue sky. Over a period of several months, the events of the day begin to unfold.
With a soundtrack of sirens and screams from news footage, the patient watches as the planes crash into the towers, as people jump from the highest floors, as fireballs burn, buildings buckle and, finally, a cloud of rubble covers all.
Difede said she has treated about two dozen 9/11 survivors with the virtual reality program and she is working to develop a new simulation that takes place inside the towers themselves.
Reliving the day in such vivid detail sounds like it could spark a new round of nightmares. But Difede says it allows patients to become comfortable with their own memories, thereby robbing the trauma of its power.
''This a way to introduce an element of control and to process it emotionally so they're no longer terrified,'' Difede said in her Upper East Side office. ''It can then be formed into a memory that's not associated with terror anymore. It's just something that's happened in the past.''
Most mental health experts agree that the therapy is promising and based on sound research, which has been published in medical journals, but some have reservations about its long-term effects.
''It could be disturbing or upsetting to a fair number of patients,'' said Dr. Spencer Eth, a professor of psychiatry at New York Medical College and an expert in post-traumatic stress.
''Some patients' symptoms could get worse rather than better,'' Eth said. ''They could find this very upsetting because it feels they're back in that situations and they have a hard time tolerating the treatment.''
For King, it was hard to imagine that horrible day as mere history.
He remembers hearing the thunder of the south tower's collapse while he was in the tower next door, and remembers believing that he was about to die
Those 10 seconds felt like 45 minutes. ''Oh my God, they're never even going to find my body,'' he remembered thinking. ''I'm going to be in that eighth subbasement.''
He remembers stumbling out of the building lobby, blinded by a thick fog of white dust. A thought struck the chief: Was he already dead, and walking through the clouds?
He remembers rolling down a subway entrance staircase to escape the debris from the second tower's collapse. And he remembers searching for his driver and aide, firefighter Robert Crawford, who had died.
Because of all this, and because he's ''a big, tough fire chief,'' he was skeptical of the virtual reality program.
''When I first saw it, I thought this is like a video game for my kids,'' he said in his home in Deer Park. ''It's like Cartoon Network. This is going to be a waste of time.''
Nevertheless, he decided to try it, reasoning: ''I can't be like this for the rest of my life.''
Within 10 minutes of putting on the headset and seeing the twin towers, King said, ''My heart was pounding, and I was sweating like I was there.''
The therapy helped him better understand his memories, and recall moments that he had buried, like when he crossed the Brooklyn Bridge minutes after the first plane hit, and saw the north tower on fire.
''The pieces that were missing started coming into place,'' he said. ''I was able to talk about it from beginning to end.''
After several months, King said he had overcome much of the pain and the terror, and he credits the therapy with freeing him from his nightmares.
''I can function and I couldn't have ever done that before this treatment,'' he said.
Due to his knee, King had to retire after the attacks, but he still works with groups that promote better safety equipment for firefighters. He lectures on terrorism and his experiences at the World Trade Center.
He says the virtual reality treatment saved him.
''I don't know if I'm exactly the same person as I was before 9/11,'' he said. ''It's always going to be part of your life and there's always going to be something there that makes you different than you were four years ago, but now I'm a functioning person.''
On the Net: Virtual Reality Therapy
Copyright 2005 Associated Press
