Virtual Reality as Psychological Therapy

Virtual reality has been around for a while, both as a staple for science fiction and a real world tool. Most people encounter it as part of a sophisticated game in which one is inserted into a virtual world for entertainment. On a more serious note, VR is being used as a simulations tool to help train people to do difficult and/or dangerous tasks, such as piloting an air plane or surviving a hazardous combat situation as a soldier or police officer.

Virtual reality is also being used by researchers to treat certain psychological disorders. These include various kinds of phobias and post traumatic stress disorder.

A phobia causes a person to be unusually anxious when confronted with the object or situation of his or her fear. These can include spiders, closed in spaces, cats, dogs, driving, flying, and numerous other things. These phobias can be debilitating and can cause years of misery. Someone afraid of being in closed in spaces have difficulty, for example, getting into an MRI.

The way Virtual Reality works in helping people overcome their phobias is by helping them confront the object or situation of their fears in a virtual reality world. For instance, a person with spider phobia would be inserted into a VR world in which spiders abound, allowing him to confront and face his or her fear under the supervision of a therapist. The person is thus conditioned to disassociate spiders with unreasoned fear of coming to harm, thus losing his or her phobia. Holding ones ground in the presence of spiders (for example) causes the person to actually experience a drop in anxiety.

Researchers have already gotten good results using this technique. In collaboration with others, Barbara Rothbaum, a clinical psychologist from Emory, and Larry Hodges, a computer science expert from George Tech, were the principle investigators in the first published Journal study on using VR exposure therapy for treating fear of heights. This was followed by a publication about using of VR for treating spider phobia by a research group at the Human Interfaces Technology Lab, including Albert Carlin and Hunter Hoffman at the University of Washington in Seattle, who have recently been working with Azucena Garcia and Christina Botella from Spain.

Rothbaum and Hodges have had great success using VR exposure therapy for treating fear of flying. Hodges and Rothbaum have also explored the use of VR for treating fear of public speaking.

Carlin and Hoffman pioneered the use of virtual reality to treat a woman suffering from spider phobia. Prior to treatment, the patient had been clinically phobic for nearly 20 years and had acquired a number of spider-related obsessive-compulsive behaviors. She routinely fumigated her car with pesticides and smoke to rid it of spiders. She sealed all bedroom windows with duct tape each night after scanning the room for spiders. She was hyper-vigilant, searching for spiders wherever she went, and avoiding walkways where she might find one. After washing her clothes, she immediately put her clothing inside a sealed plastic bag, to make sure it remained free of spiders. Over the years, her condition became worse. Eventually her fear made her afraid to leave her home.

Carlin and Hoffman created a virtual world called Spider World, which provided a virtual spider for the patient to confront, as well as a plush, toy spider for the patient to touch. Slowly but surely, the patient progressed from standing across the virtual room from the virtual spider to actually picking it up and handling it. After about nine of these VR sessions, the patient’s anxiety faded. She stopped engaging in obsessive-compulsive spider rituals, and can now interact with real spiders with moderate but manageable emotion. Her improvement is so profound that she has time for new hobbies such as camping outdoors, something she would never have dreamed of doing prior to therapy. Since then, about twenty people suffering from phobia have been given the VR treatment with an eighty five percent success rate.

Azucena Garcia and Christina Botella created a VR treatment for fear of enclosed spaces or claustrophobia. The patient enters a large, virtual room which slowly closes in on him or her. The patient can control the walls of the room, allowing him or her to slowly lose the claustrophobia.

Hunter Hoffman, along with Dr. JoAnn Difede, assistant professor of psychiatry New York-Presbyterian Hospital/Weill Cornell Medical Center, have created virtual reality therapies to treat post traumatic stress disorder. Post traumatic stress disorder afflicts many people who have survived a dangerous, life threatening experience, such as battle field combat.

The first patient to experience the VR therapy was a young, female executive who had survived the 9/11 attack on the World Trade Center. She suffered from flashbacks, avoidance (i.e., refusal to watch news reports or stay in tall buildings), sleep problems, hyper-vigilance to avoid disaster, and anger and irritability. Traditional therapies had proven ineffective.

However, after being inserted into a virtual lower Manhattan with the twin World Trade Center Towers, the patient was able to confront her anxiety for the first time. She was able to control her environment and proceed at her own pace. After six VR sessions, the woman showed a ninety percent reduction in symptoms of post traumatic stress disorder and an eighty three percent reduction in symptoms of depression. Since then, several other people, including a New York City firefighter, have completed the virtual therapy with positive results.

More research needs to be done before this kind of virtual reality treatment becomes widespread. But it is clear that this tool can be very useful in helping people overcome phobias and psychological trauma.

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