Before he went off to the Iraq War, Army veteran Victor Alcantar took driving for granted -- but not anymore.
"I notice that when I drive through neighborhoods, I'm always looking on rooftops and over bridges, and I don't think that will every go away; the hyper vigilance wherever I'm at," he said.
In Iraq, that hyper-vigilance was the difference between life and death. Humvee drivers were taught to scan for snipers and rocket propelled grenades and roadside bombs to avoid being boxed-in -- and if you feel threatened, don't stop.
Victor came back to San Jose with post traumatic stress syndrome and demands from his fiancé that he control his temper behind the wheel. That led him to this program at the VA Medical Center in Palo Alto.
"Most often, they're coming to see me because a loved one -- either they've been in an accident, in which case they're forced to see me, or family has reported they're driving aggressively," occupational therapist Marc Samuels said.
Marc's program at the VA Hospital is designed to get veterans safely back on the road. It starts with an evaluation of their behavior behind the wheel, and possible triggers that would force a soldier into a fight or flight reaction. Then there's time in the simulator, where Marc helps clients spot stressful scenarios.
"When is my anxiety getting up, when is my heart rate getting up. When am I scanning more. What caused that, oh there's a guy on a cell phone, there's a truck next to me, I feel boxed in," Alcantar said.
Once a baseline established then there's road time, on routes that get more complex and frustrating -- and coping strategies are taught.
"They teach me to calm down more, to just be able to relax when you drive," Alcantar said.
"If we can think of alternative options in our mind, then we can feel empathy instead of anger or aggression," Samuels said.
The driver's training is only one part of a mental health treatment program that includes therapy. Victor says he's getting fewer complaints from his girlfriend.