Atlanta Clinic Battles Phobias Using Virtual Reality | WABE 90.1 FM

Atlanta Clinic Battles Phobias Using Virtual Reality

Nov 3, 2015

When you think of virtual reality, maybe you think of video games that immerse you in fantastical worlds where you might fly, fight bad guys or do other things you’d — probably — never do in real life.

But tech experts tell us that expanded technology may mean that activities from online shoe shopping to attending conferences could soon involve an element of VR. In fact, the technology has already moved beyond sci-fi and into the world of mental health ... taking us into those dark corners that scare us most.

'That’s When I Knew I Had A Real Problem'

When Michael Rosenzweig first donned a VR headset, it was to enter a setting that many people would consider pretty mundane: a passenger plane. But for him, airplanes meant a rapid heart rate, shakiness, light-headedness and dizziness. “It was a feeling of a loss of control,” he says, “mostly centered on concerns about turbulence.”

His phobia emerged seemingly from nowhere, and soon, his colleagues were kidding him about being the guy who’d do anything to avoid boarding a plane. He’d schedule endless phone meetings and drive to distant cities to meet with clients. Eventually, he says, “I got to a point where sometimes, I’d get on a plane and the feeling wasn’t quite right, and I’d get off the plane. That’s when I knew that I had a real problem.”

And it was about then that a friend urged him to take part in a new study trial treating phobias like his with the technology of virtual reality. He agreed on the spot. At that point, he says, “I would try anything.”

Teaching Minds And Bodies

The approach used, both by that study and in VR therapy today, is based on something called exposure therapy. It treats phobias by helping people directly confront the scenarios that scare them.

This might mean riding up glass elevators to counter a fear of heights or driving through Spaghetti Junction to counter a fear of driving — the latter of which can be scary enough to any driver on a bad day.

Emory University clinical psychologist Barbara Rothbaum is one of the nation’s authorities on exposure therapy. She says, “It helps teach in their minds, heads and bodies, ‘I don’t need to be scared of this. I can stay in this situation, and my anxiety will come down.’”

Rothbaum was one of the people who helped pioneer bringing exposure therapy into the virtual world.

Because, as it turns out, not everyone’s phobia can be treated by a spin on Spaghetti Junction.

Fears like flying, heights or post-traumatic stress disorder often involve scenarios that are difficult — or even impossible — to revisit in real life.

And that’s where virtual reality exposure therapy comes in. Patients with a fear of heights can don VR goggles and walk across a swinging bridge over a vast chasm. Or, if you’re afraid of public speaking, another scenario will take you before an auditorium full of expectant listeners. Scenarios in Afghanistan and Iraq treat PTSD.

The virtual setups are as sensorily complete as possible. Patients hear sounds recorded onsite, feel vibrating platforms under chairs to represent the hum of an airplane, elevator or tank, and even smell scents like coffee, perfume or fuel.

Less Is More

Better realism is something Michael Rosenzweig says he wishes had been around back in 2000, when he enrolled in that trial study for his fear of flying. “I found that to be disappointing and highly unrealistic because what you saw when you looked through the goggles [were] cartoon figures!”

Sure, his chair vibrated, and he recalls the airplane sounds as lifelike, too. But at the end of the study, “I thought, “Very interesting. Really glad I did this. This has been of no benefit to me whatsoever.”

And that would have been the end of the story, except that a few weeks after that, he boarded a real airplane.

“We got up in the air, and sure enough, there was pretty significant turbulence. And I was fine,” he says.

He’s been fine ever since. He doesn’t love flying, but his crippling phobia? That’s gone.

And here’s where things get really interesting.

Because it could be that the low degree of detail that made Rosenzweig's virtual reality experience feel flimsy was actually what made it effective. That’s because, according to Rothbaum, when really specific details are missing from a fear scenario, our brains fill them in, using our own personal memory bank of fear-provoking experiences.

Rothbaum tells this story. “The first time that we used the virtual reality to treat PTSD was in the '90s. We created a virtual Vietnam. A number of the folks who went through that reported, for example, tanks. We didn’t have tanks in it. They reported seeing the enemy. We didn’t have the enemy represented.”

And so on, with water buffalo and other sights. If you trigger enough of the memory, people fill in the rest themselves. The treatment is working. Studies show that VR exposure therapy yields results just as effective as its traditional counterpart.

And even though he’s not sure what exactly worked about his own experience, Rosenzweig recommends it to others today. “I’m always reminded that there was that moment in time where I got on a plane and should’ve been a basket case, and I wasn’t.”

A New Technology, New Questions

All of this raises a question.

There’s new virtual reality technology on the horizon that experts say will change everything. Oculus Rift is an advanced new headset set to be released to the public in 2016. And it’s got tech types very excited.

Andrew Currie leads the team that designs VR scenarios at a treatment clinic in Atlanta called Virtually Better. He’s really excited about the unprecedented lifelike detail and fidelity of motion offered by Oculus Rift. “It’s kind of scary how immersive it can be,” he says. The headset’s quick response time means users report less motion sickness, which is actually a major problem with most virtual reality simulations these days.

To Currie and other techies, these improvements mean Oculus Rift is the future, not just of video games, and not just of exposure therapy, but of … well, everything. Predicted applications for the new technology range from social media, to doctor’s visits, to the ability to virtually attend conferences in far-away locales — meaning that if Michael Rosenzweig had just waited long enough, he might not have needed to get his flying phobia treated at all.

He could have just popped on a headset to find himself in the same room with his faraway clients. No airplane required.

As for Oculus’s effect on exposure therapy, that’ll likely mean striking a balance between the new technology’s touted realism and the low level of detail that’s already proved to work so well.