Among the many uses of virtual reality when it comes to therapy, using it to treat anxiety and phobias has shown some of the most promising results in both utility and degree of successful treatments.

Virtual reality therapy for Anxiety and Phobias

When talking about anxiety we must realize that it is a very broad spectrum which also includes conditions such as Phobias and PTSD for example. Also there are many types of anxiety from mild ones akin to stress to the severe types that can even cause panic attacks. But no matter how you define anxiety a lot of people still don't know if they have it or not. Feeling anxious about your work day or your paper at school is not exactly the same thing as having anxiety although it is closely related. Maybe the best way to describe how anxiety works and effects you is to relate a personal experience.

A personal experience

A decade ago I was working as a croupier at a casino. Now immediately people that have worked in the same industry or in any industry which deals with potentially very disgruntled customers might already know where I'm going with this. A lot of people working in customer service or similar jobs where you deal with people's anger might have had similar experiences. Now, having trouble and being annoyed with difficult customers is not the same thing as having anxiety over dealing with them. In my case, as I am sure in most other cases in similar jobs, we were thought how to deal with these situations and deescalate the problem as soon as it appears.

It all worked fine until I started to have to deal with a customer who would spontaneously go from 0 to 100 in his anger and reactions. One minute you are dealing the cards to him and the next second he slams the table and throws the chips in your face. If it happens once or twice, there is no problem but it started to happen regularly and it was always unexpected. This had a very bad effect on me and my colleagues. In my case in particular I kept trying to brace myself for the moment that customer would start going crazy; so much so that I was having palpitations whenever I was his assigned croupier. I was sweating like crazy, had trouble speaking properly and was overall a mess. At that time I had no idea that what I was experiencing was a pretty serious case of anxiety, almost on the brink of having a panic attack, which I eventually did experience one.

You can also experience similar anxiety problems even over the phone. Just the unbearable anticipation of when the customer will eventually lash out is so stressful for some people that it can give them severe anxiety. In these cases it might be better for your mental health to try and change jobs as I did. But what if I had a way of treating my anxiety in a safe and accessible way? When treating any type of anxiety, the most effective treatment method has been shown to be exposure therapy. In other words the patient needs to be exposed to what causes the anxiety in order to try and treat it. But recreating similar experiences is not easy. It is time and resources consuming, not to mention also potentially dangerous depending on what anxiety or phobia you are dealing with. This is where virtual reality exposure therapy comes into play. It is better in every way than the real life alternative. It is not only more affordable compared to traditional therapy but also a lot more accessible. You can undergo treatment in the comfort of your own home. This also means that everything is anonymous.

There is no more need for face-to-face interactions, thus removing the awkwardness many experience when dealing with a mental health professional. In my case I could have experienced a similar scenario of dealing with a unpredictable rowdy customer, but in a safe and controlled environment which can gradually ump the realism and difficulty depending on how I would handle it. With advanced A.I. programs you would not even need a therapist to assist you. This would make it possible to receive therapy treatment anywhere and at any time you feel comfortable doing so. And considering how the success of a treatment is highly impacted by how comfortable you are with it, being able to undergo therapy in a relaxed environment is already half the battle won.

How to deal with phobias using virtual reality

A subset of anxiety is known as phobias and it refers to an irrational fear of an object, animal, insect or even the environment around us. Phobias are usually comparable with more severe cases of anxiety since getting in contact with the object of your fears will trigger fight or flight responses. Phobias, just like anxiety, can be acquired because of certain situations. In fact humans are born with only two innate fears and those are the fear of falling and the fear of loud noises. These are not only found in humans but in a lot of other animals as well basic survival mechanisms. So in the vast majority of cases unless it is the fear of heights, phobias are a product of our environment and experiences.

Some of the most common phobias are the ones surrounding heights and flying followed by certain inspects, enclosed spaces and dogs. To give a concrete example of how a phobia can originate, I will tell you the experience which led to one of my friends developing a phobia of dogs. Now some may look at the next picture depicting a bunch of dogs having fun in a park and think it is cute. But for my friend it would be a horrible reenactment of what happened to him in a park.

Basically on evening night when he was returning from his piano lessons he wanted to cut trough a park since it was very dark due to being cloudy and was also started to rain. The weather that day may have prevented his next ordeal from being even worse since he did bring an umbrella with him. Now, this is also a product of the country I live in, where there are way to many dogs and packs of dogs roaming free with no masters. So my friend, while walking through that park was surrounded by one such pack of dogs, all of them barking aggressively and trying to get closer to him. Because it was 9 PM and very dark with almost no lighting since it was a park, my friend was also having difficulty assessing how many dogs were around him and how close. His only means of escaping his predicament was to hold the umbrella in front of him at ground level and rotating his way out of the park. He did this for only a couple of minutes but for him it felt like an eternity. From that moment forward he started to have an aversion to dogs which gradually got worse until he would cross the street if there was someone walking their dog on his side.

Similar to this story, other people have their own experiences which led them to have a phobia regarding an object, animal or situation. Maybe they had an airplane flight in which the plane experienced severe turbulences. One experience is enough for that person to then start developing a fear of flights, thinking that any plane they are on could come crashing down at any time, this despite flying being the safest way to travel statistically.

So how to you deal with the fear of flying? You would need to get some sort of exposure to the traumatic event but in this case it would probably be too much for the patient. You can't jump straight into the fire when you fear the heat. But if we were to use virtual reality, then it is an entirely different story. First of all, the patient will know at all times that no matter what he experiences and how scared they will be, their safety is guaranteed. You might be asking yourself: doesn't this defeat the purpose of exposure therapy? Don't you need to feel danger in order to get over it? And you would be right to ask that question. But this is were the way our brains come into play. Even if we know we are completely safe and nothing can happen to us, we can still get really scared at the same time. Have you ever been to a cinema and watched a scary movie? Or maybe you played a horror game on your computer. In both of those instances you know that you are safe but you can still get scared. This is why virtual reality exposure therapy works so great. You get to treat your condition by knowing you are completely safe but still experiencing the fear you normally feel when dealing with the situation that gave you the anxiety or phobias you are currently experiencing.

The future of therapy

But as we said at the beginning, virtual reality has a lot more versatility than just being used to treat anxiety and phobias. The more we lean about the brain and how strongly it can effect our bodies the more benefits we can extract from tricking it with the use of virtual reality. Studies and trials have show for example virtual reality to be very useful in severe pain management as it can distract the brain better than any other tool out there. Not to mention the very important role it has in treating PTSD. Maybe not many know about this but virtual reality was in its earlier stages meant for soldiers, either as a tool to practice combat simulations or a treatment method for those affected by PTSD. It was deemed extremely effected since it could recreate traumatic events but tweak them gradually to be more severe or realistic and all of it in the safety of a virtual world.

And this may be one of the biggest advantages that virtual reality has over traditional methods of treatment. The ability to gradually increase the difficulty of a treatment whilst also keeping it very safe for the patient and making the patient a lot more comfortable while receiving the treatment. This is a very important part since the level of comfort the patient feels in regards to a treatment can and often times dictates how effective the treatment will be. For example, going back to the anonymity advantage of virtual reality. You may not know this but a lot of people refuse to start therapy just because of having to be talk face-to-face with a therapist. The very idea of spilling their inner most darkest fears to a stranger is traumatizing in itself to a lot of people. So much so that they would prefer not to receive treatment in the first place.

But if you didn't have to meet someone face-to-face? In fact what if you could just stay at home in your comfy couch and undergo treatment from there in a virtual world. And in that virtual world the scary therapist is just a silly avatar which no longer triggers your anxiety. Mental health professionals can also benefit a lot from using virtual reality since with it they can earn the trust of the patient a lot faster and get to the important stuff, the treatment as where in traditional therapy a lot of time is wasted in earning the trust of the patient and trying to make them feel as comfortable as possible as to open up. Survey among people that refused to undergo therapy because they would have to meet a doctor face-to-face has show that up to 40% of them would actually try to partake in the treatment if the meetings were done in virtual reality.

As for other advantages I don't think we need to mention accessibility again. It is the ultimate tool when it comes to that. There will be no more geographical limitations with the help of virtual reality. No more time spent in traffic, no more strict schedules and access to a lot more mental health professionals from the entire country or even international specialists. Also virtual reality therapy will be a lot more affordable as well since besides not spending money on gas, especially with the prices now, and wasting time in traffic (not everyone lives near a therapy center), the therapy sessions with virtual reality will be a lot less expensive, at least with Neurotops, since they will be available on a subscription model. This way it will be affordable for a lot more people than ever before.

These are the reasons why we believe virtual reality will be the future of therapy; it has the AAA necessary to do so: accessibility, affordability and anonymity. And maybe with enough enthusiasm from regular people like yourself, we will all live to see this vision of a brighter future achieved sooner rather than later.

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Julian Sanda
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