Vir­tual re­al­ity ther­apy tar­gets com­mon pho­bias

Tech­nol­ogy fi­nally go­ing main­stream af­ter 20 years of re­search.

Austin American-Statesman Sunday - - TECH SUNDAY - By Carla John­son

Dick Tracey didn’t have to visit a tall build­ing to get over his fear of heights. He put on a vir­tual re­al­ity head­set.

Through VR, he rode an el­e­va­tor to a high-rise atrium that looked so real he fell to his knees.

“I needed to search with my hand for some­thing solid around me,” he said.

He told him­self, “I must look stupid. Let’s just stand up. Noth­ing’s go­ing to hap­pen.”

Vir­tual re­al­ity ther­apy can help peo­ple like Tracey by ex­pos­ing them grad­u­ally to their great­est ter­rors. The tech­nol­ogy is just now reach­ing the main­stream af­ter 20 years of re­search. Equip­ment is lighter and more af­ford­able, with tech ad­vances spilling over from the gam­ing in­dus­try to help peo­ple fight dis­abling fears of fly­ing, heights, spi­ders or dogs.

And the surge in prod­ucts is bring­ing VR to more ther­a­pists’ of­fices. Ex­perts pre­dict peo­ple with mild pho­bias will treat them­selves suc­cess­fully at home.

Re­search shows VR ther­apy can lead to real-world gains for peo­ple with pho­bias, and works as well as tra­di­tional ex­po­sure ther­apy, which slowly sub­jects pa­tients to what causes anx­i­ety for them.

For Den­ver li­brar­ian Nick Har­rell, VR was a booster shot af­ter tra­di­tional ther­apy for fear of fly­ing. Panic drove him off a flight to Paris two years ago, forc­ing him to aban­don a va­ca­tion with his girlfriend.

“I don’t like be­ing locked in the metal tube,” Har­rell said. “I couldn’t breathe. My chest was pound­ing.”

With help from a ther­a­pist, Har­rell first faced his fears through ex­po­sure ther­apy. El­e­va­tors, buses and trains were good prac­tice for air­planes.

“Within a mat­ter of months, I was fly­ing again,” Har­rell said.

With VR re­cently added to his ther­apy, Har­rell keeps fears in check. His health in­surance cov­ers the cost with a small co­pay.

But few peo­ple with pho­bias seek treat­ment. Too em­bar­rassed to get help, many plan their lives around avoiding their fears.

Tracey of Ox­ford­shire, Eng­land, avoided heights, from lad­ders to breath­tak­ing vis­tas. Es­ca­la­tors gave the 62-year-old re­tiree heart pal­pi­ta­tions. His wife walked be­tween him and steep slopes.

Tracey’s VR ther­apy was part of a study. He was one of the first to try a VR world with an an­i­mated vir­tual coach. Univer­sity of

Ox­ford psy­chol­ogy pro­fes­sor Daniel Free­man de­vel­oped the pro­gram for an Ox­ford spinoff with sup­port from the Na­tional Health Ser­vice.

Free­man’s team is now at work on a VR world where peo­ple with schizophre­nia can prac­tice be­ing in a cafe, el­e­va­tor or store.

“Many of our pa­tients are with­drawn from the world,” Free­man said. The fear-of-heights VR pro­gram shows you can au­to­mate treat­ment.

What is VR? Put on a head­set and look around. You’ll see a sim­u­la­tion of an in­ter­ac­tive, three-di­men­sional en­vi­ron­ment. Look up and you’ll see the sky; look down and your own hands and feet may come into view.

With ex­po­sure ther­apy, a ther­a­pist can ac­com­pany a per­son who’s afraid of heights to a tall build­ing. With VR, a pa­tient learns to feel safe on a vir­tual high-rise bal­cony, with­out leav­ing the ther­a­pist’s of­fice.

Ex­po­sure works by grad­u­ally tak­ing the oomph out of panic. Sweaty palms and pound­ing hearts ease. Fears shrink to man­age­able lev­els. By rid­ing it out, a per­son learns the feel­ings are sur­viv­able.

The best stud­ies on VR ex­po­sure ther­apy have been small with fewer than 100 pa­tients.

In­creas­ingly VR ther­apy will be de­liv­ered at home via the in­ter­net, a still largely un­stud­ied area, said Katha­rina Meyer­bro­ker, a re­searcher at Utrecht Univer­sity in the Nether­lands, who has pub­lished re­views of re­search done in the field.

Har­rell’s ther­a­pist is help­ing field-test VR con­tent for a com­pany called Lim­bix, an ar­range­ment be­tween the com­pany and the Na­tional Men­tal Health In­no­va­tion Cen­ter at Univer­sity of Colorado’s med­i­cal school.

Such ties are im­por­tant for VR com­pa­nies, which need sci­en­tific cred­i­bil­ity to sell their prod­ucts to ther­a­pists. Re­searchers gain too. “We’ve all been pig­gy­back­ing on this tech­nol­ogy that was ini­tially de­vel­oped for video gam­ing,” said Hunter Hoff­man, a re­search sci­en­tist at the Univer­sity of Wash­ing­ton in Seat­tle who de­vel­oped an early VR ther­apy called Spi­der World two decades ago. He didn’t li­cense his arachno­pho­bia project like other early re­searchers who’ve teamed up with com­pa­nies to sell VR plat­forms and con­tent.

Chil­dren may some­day use VR to learn to cope with anx­i­ety, said Stephen White­side, di­rec­tor of the Mayo Clinic Pe­di­atric Anx­i­ety Dis­or­ders Clinic, where a study tar­gets kids with school­work anx­i­eties.

In the VR sce­nario, a class­room teacher hands back a school pa­per with a bad grade.

“You hear the voices of other kids laugh­ing and say­ing you didn’t do so well,” White­side said. “When I first watched it, I had a vis­ceral re­sponse my­self. It made you ner­vous.”

The Mayo re­searchers say chil­dren pre­fer the VR ex­pe­ri­ence to tra­di­tional ex­po­sure ther­apy. Next they’ll test whether it works as well.

White­side said VR re­searchers ev­ery­where must demon­strate ben­e­fits that out­weigh treat­ment costs, which can reach $200 per ses­sion in some spe­cialty clin­ics.

“The cheaper and more ac­ces­si­ble it gets,” White­side said, “the eas­ier that will be.”

VR ther­apy made life sim­pler for Tracey. Af­ter seven VR ses­sions, he now eas­ily parks his car atop a mul­ti­story garage. He stood on the flat roof of his house to clean his car­port.

“I would never have dreamed of do­ing that be­fore,” he said. “I now know how much the fear of heights re­stricted my ev­ery­day life.”

P. SOLOMON BANDA / AS­SO­CI­ATED PRESS

Nick Har­rell holds VR gog­gles used in ther­apy to treat his fear of fly­ing amid an Au­gust demon­stra­tion of the tech­nol­ogy to treat pho­bias at the Na­tional Men­tal Health In­no­va­tion Cen­ter in Aurora, Colo. Be­hav­ioral health sci­en­tist Sam Hub­ley is at right.

OX­FORD VR

An im­age pro­vided by Ox­ford VR shows a vir­tual re­al­ity viewpoint from a sim­u­la­tion de­signed to help peo­ple with a fear of heights. VR ther­apy can help pa­tients by ex­pos­ing them grad­u­ally to their great­est ter­rors.

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