VR & The Mind: Anxiety – Can VR Stop Us All Worrying So Much?

In a new series Alex Handy asks what VR can do for your mental health.

One month ago as I pulled off my virtual reality (VR) headset I felt a drop in my stomach as the motion sickness overwhelmed me. I’d had motion sickness from VR before, but this was worse. I experienced intense headaches, light-headedness and the symptoms persisted. I’m still recovering to this day. This experience gave me a salient reminder of just how powerful VR is as a technology.

Reality is ultimately a product of our minds, a translation of the sensory perceptions it is continuously provided. As Jeremy Bailenson puts it, Director of Stanford’s Virtual Human Interaction Lab and author of “Infinite Reality”, “virtual reality is just an exercise in manipulating these perceptions”. “Manipulating” implies negative intent but VR can evoke equally intense feelings of pleasure, relief and insight.

In this series, I will explore how VR can harness this power over our minds to influence the fundamental thoughts, feelings and emotions that underpin our everyday lives. How we deal with fears, anxiety and pain, how we interact and empathize with other people, and even how we can learn to reshape our own memories.

Sherry Turkle, Director of MIT’s Initiative on Technology and Self, has it right, “When we are at our best, thinking about technology brings us back to questions about what really matters”.

So, can Virtual Reality stop us all worrying so much?

TL;DR – VR can have a huge impact as a targeted tool primarily in therapeutic settings. In general use, we need to be mindful of immersion evolving into escapism.

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“Anxiety is part of the new connectivity” – Sherry Turkle

We’re all worrying more. A lot more.

Almost 20% of people are now believed to suffer from an anxiety disorder in the US. In the UK, around 40 per cent of new claimants for disability benefits are suffering from mental illnesses, of which anxiety and depression are the most common.

Right now, technology seems to be making this worse.

We are overwhelmed by a paradox of choice when attempting to make even the simplest decision, constantly comparing ourselves to glamorized representations of others on social media and attempting to achieve a Herculean number of tasks in parallel.

As Rachel Dove expresses in her own excellent article on rising anxiety, Like most Millennials I feel naked without my phone and am rarely without it. It gives me a window to the world that not only provides a constant stream of news (which in itself can be a cause of anxiety) but also enables me to keep up with anyone from friends to Kim Kardashian.”

It’s even been shown that this is all having a chemical impact on the brain. According to psychologist Daniel Levitin, when we’re juggling email, Whatsapp, Snapchat (if you’re younger than me) we’re actually just burning up the very oxygenated glucose we need to stay on task and boosting production of the stress hormone cortisol.

Most concerning, despite more people reporting symptoms and the high treatability of many anxiety disorders, less than a third of people actually seek help. We have on-demand transport, food and even dogs at our fingertips but continue to suffer in silence, anxiously glued to our devices.

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So how could VR help? Is this not just another technology for us to become consumed in? Perhaps providing the ultimate escape from reality?Before we can fairly assess the role VR can play, we need to (very) briefly look at how anxiety works and how it is currently treated.

 

“Anxiety is a normal and necessary emotion that is there to protect us. The key is to identify ‘unnecessary anxiety’” – Roger S. Gil, MAMFT, clinical psychologist

Anxiety is rooted in our evolutionary development. We have an in-built fight or flight mechanism, which is constantly assessing the environment around us for potential dangers.When anxiety is triggered, it creates a heightened sense of awareness, improves our reflexes and  basically gives our bodies the best chance to fight for our survival.

The problem is, anxiety can be triggered by a range of psychological and behavioural factors based on imagined as well as real threats. Under this assault of triggers, we develop habitual thought patterns that reinforce these as “threats”. Our bodies then become constantly “wired” for anxiety, which forms the basis for many anxiety disorders.

There are a wide range of anxiety disorders each with their own recommended treatments. To oversimplify and leave room for where others cover more comprehensively, for generalised cases of anxiety there are three main approaches, often employed in tandem. The things you can do yourself – Meditation, relaxation and exercise (this is a broader topic which we won’t touch on further here).

The things you can do with a therapist (or trained professional) – Cognitive Behavioural Therapy and Exposure Therapy are two of the most common treatments, as well as medication – in increasing numbers. Many of these treatments can be highly effective, but with rates of anxiety continuing to grow and resources already stretched, we need more.

So what could VR actually do? Let’s look at each of these areas in turn.

 

The things you can do yourself

There are already a plethora of meditation and relaxation apps like Headspace available online and on mobile. The problem is, these apps don’t automatically provide you a calming environment to practice in and risk providing more distraction equalling more anxiety. VR can totally occlude a user from the physical environment.

Done well, you can literally feel like you’re sat on a beach. Guided Meditation VR created by Josh Farkas’ Cubicle Ninjas is the most talked about, providing a range of environments that can be matched to your mood along with audio guidance. I’ve tried it and it’s impressive. The smartest feature is that the app lets you track your heart rate before and after the experience.

Quantifiable evidence of reducing physiological effects of anxiety is gold dust.

Other notable early movers include ShapeSpace VR and Deepak Chopra who are combining abstract art, interactive features and storytelling to offer a similar experience. Whilst Joe Donnelly also wrote an interesting article on how the game “Deep” helped him with his anxiety.

As we’ve seen, getting people from recognising symptoms, to diagnosis and then treatment is a huge problem. Personally, I’d love to see developers exploring how we could use VR to make diagnoses more effective and more user friendly. If you have ever seen a mental health form at the doctors you will immediately understand how broken and intimidating this is to people suffering.

 

The things you can do with a therapist (or trained professional)

Virtual based therapies are not new to professional treatments for psychological disorders. Research institutes such as USC’s Institute for Creative Technologies and Stanford’s Virtual Human Interaction Lab have been pioneering the use of VR as a therapeutic tool for decades.

Exposure based therapies, where patients are exposed to their fear or anxiety in a controlled environment, are particularly transferable to VR. Patients can be put into highly realistic virtual environments, which can be entirely controlled and tweaked by therapists at, comparatively low cost. Compare this to trying to run this type of therapy physically for someone trying to overcome a phobia of flying or spiders.

Dr “Skip” Rizzo, Director of Medical Virtual Reality at USC, has applied this to Post Traumatic Stress Disorder (PSTD) by developing an application called Bravemind for use with military personnel. More recently, Professor Daniel Freeman and his team at Oxford created a trial using VR to help treat social paranoia and recorded encouraging results.

Similarly, pain relief has received a lot of focus with AppliedVR and DeepStreamVR developing applications aiming to reduce pain for patients. Research has shown that virtual therapy can be so effective that it reduces pain by 50% to 90% in clinical trials (according to Infinite Reality). There are many more examples and this is the most promising area for VR as a tool in conquering our growing anxiety.

 

Medication

VR obviously isn’t a drug in its own right. Theoretically as we continue to make advances in tracking chemical and circuitry in the brain, you could be prescribed a specific experience to trigger a re-balancing of your brain chemistry.

In a less targeted way, this is broadly what is happening at the biological level when people are plugged into meditative experiences or experiences designed to relieve pain. Its very early days here, so VR will likely remain an ancillary treatment tool rather than something to fully replace medication.

 

What could go wrong?

Amidst all the positive applications for anxiety, we must be mindful that, right now, VR is a pretty unregulated field. That means VR could just as easily make you more anxious as well as calming your nerves. As with any new medium, content creators have a high degree of free reign to experiment with the types of experiences they are creating. These aren’t always full of calming meditative visualisations and abstract worlds designed to give you a metaphorical cuddle.

Breaking Forth, recently ran a well-received, sold-out showing of their new ground-breaking film CTRL. It’s one of the first extended narrative VR pieces open to the public but covers some sensitive topics, unexpectedly, which could have a very lasting impact given the enhanced immersion. More overtly and easier to avoid are the vast array of horror experiences hitting the market but as you can see here – this can create pretty visceral reactions.

Lastly, there is the more philosophical concern that as VR becomes more mainstream and realistic, people will become addicted and permanently detached from reality. This is a problem already, particularly in Asian cultures where e-gaming is even more prolific. This was demonstrated most dramatically by the man who collapsed and died in an internet cafe after playing an online game for 3 days straight.

We know from extensive scientific research, that isolation and a lack of physical, human interaction enhances anxiety and depression.

Proponents would argue as VR becomes more social it can actually help connect more people but it’s a precarious balance and one that needs to be traversed with care.

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So what does this all mean?

The best place for VR to start tackling our anxiety is as a targeted therapeutic tool. Delivered in a controlled clinical setting, with carefully produced experiences the incredible benefits are already being demonstrated. These are only likely to improve as the tech gets better.

For everyday use, VR could provide new ways to grab that moment of relief from anxiety. A sort of virtual hot bubble bath. Perhaps it could also make it easier for people to develop improved habits and practice activities such as meditation more regularly. But as with all of VR right now, we need to recognise the consequences of where this new technology could take us. When moments of immersion become sustained escapism we have to start talking in terms of addiction rather than treatment.

And then we’ll have another anxiety disorder to add to the list.

Alex will be back next month on VRFocus  with another ‘VR & The Mind’, if you’d like to discuss the topics raised here further with him he can be contacted via email or Twitter and would be interested in hearing your thoughts.

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