Mind games: VR therapy is helping people navigate phobias

New virtual-reality (VR) worlds are aiming to help those with psychological disorders such as agoraphobia (a fear of social interactions and crowded places), acrophobia (fear of heights), aquaphobia (fear of water) and claustrophobia (fear of enclosed spaces), by letting them inch towards a feared experience, and begin to gradually navigate that fear.

The aim, says Daniel Freeman, professor of clinical psychology at Oxford, is for participants to relearn safe boundaries through practice, without the use of exposure therapy, where a patient is asked to remain in distressing situations until their anxiety levels drop.

Freeman headed a recent study on the impact of gameChange, a VR program designed to help those with agoraphobia. For 26 weeks, 174 patients spent time in this simulated world, walking down a street, ordering a meal at a restaurant, making eye contact with virtual characters. As they worked their way through five levels of difficulty, the number of virtual characters or proximity to them increased.

At the end of six weeks, these participants showed significant reductions in agoraphobic avoidance compared to a control group of 172 patients with similar symptoms who received similar care but no access to the VR program. At the end of 26 weeks, researchers found that those with severe agoraphobia had benefited the most and were able to attempt at least two new activities, such as walking down a street or going shopping alone. Findings of the study, conducted between May and September 2021 by researchers at Oxford, was published in the journal Lancet Psychiatry in April.

“In the VR sessions, a virtual guide ushers people through simulations of everyday situations that trouble them. The beauty is that the conscious awareness that these are simulations allows people to try things that they would be wary of trying in real life. We found that the learning leads to major benefits,” Freeman told Wknd.

There are two caveats, he added: The patient’s regular care must continue; VR programs can only be part of a treatment plan. And the VR content must be carefully curated and calibrated.

In India, the content has been a stumbling block for Kolkata clinic Sahayta (Hindi for Help). The closest thing they could find to local context was content from Spain, and it does not feel relatable, says Dr Tathagata Chatterjee, a psychiatrist and founder-director of Sahayta. “Most of the virtual avatars are white, and scenarios include chatting with a stranger at a bar. The lack of regional language options also limits user experience.”

Still, the novelty of the technology has drawn about 20 takers since the clinic began offering it in January 2021. Patients with acrophobia can inch forward on a plank extending from the 20th floor of a virtual building; those with aquaphobia can go on a ride in a water park; people with agoraphobia can address a crowd from a podium. In his experience, Dr Chatterjee says, even experiences that aren’t perfectly crafted to suit the audience “do give people the confidence that if they can get over something in VR, they can get over it in the real world as well, through slow, sustained effort.”