Friday, November 7, 2008

What Is Reality, I: Virtual Reality as Part of the Solution

Phobias are excessive fears that interferes with life. People with phobias typically try to avoid the feared stimulus because of the uncomfortable physical sensations that arise—often those of a panic attack: rapid heart rate, irregular breathing or the sensation of difficulty breathing, sweating, a sense of dread. If you avoid flying because of a fear of flying, it can limit your professional life and vacation activities. If you have a spider phobia, you may refuse to enter basements or wooded areas.

There's a very effective treatment for phobias: exposure. Exposure involves allowing yourself to confront the feared stimulus in a planned way for a sustained period of time (about 23-30 minutes) and noticing that nothing catastrophic happened. When you sustain attention to the feared stimulus, the uncomfortable physical sensation dissipate, and you confront head-on any irrational beliefs you may have about the feared stimulus. For instance, when someone with a spider phobia is exposed to a spider, he or she learns that, in fact, nothing awful happens beyond the physical discomfort of the anxiety symptoms, which pass with time. Ditto for fear of flying—beyond the physical discomfort of the anxiety, nothing catastrophic happens because of flying per se. (Of course, any method of transportation has risks: people get hit walking down the street, riding their bikes, in their cars.)

In learning that no harm befalls them other than their own physical anxiety, they can rethink their fears: "Hm…so I didn't go crazy from being around the spider, and it didn't bite me and turn me into some type of freakish creature…maybe I don't need to be so afraid of it" or "Hm…maybe my fear and worry wasn't actually keeping the plane in the air…maybe I can relax a bit and not view the plane ride as a death sentence." With repeated exposure to the feared stimulus--more time around spiders, more plane flights—the anxiety and physical reactions lessen even more.

There are several different ways exposure can be undertaken:

  • imaginal exposure—using your imagination to form mental images of the feared stimulus
  • in vivo exposure—being exposed to the actual feared stimulus. A percentage of people seeking treatment for phobias hestitate to use this method because they feel it will be "too much" for them.
  • virtual exposure—being exposed to a "virtual" stimulus, such as virtual reality of the feared stimulus (on the high-tech end) to photographs or recordings of sounds of the feared stimulus (on the low-tech end). For more about virtual exposure, click here,

Here's an example of virtual exposure to an airplane.

Click here for a video about virtual reality therapy

Recent research suggests that as a treatment for some phobias, such as fear of flying and fear of heights, virtual exposure is as good as in vivo exposure. Even thought the virtual world is a bit cartoonish, users are able to confront the feared stimulus and learn that their almost automatic fear reaction is out of proportion to the situation. People were able allow the virtual reality to simulate reality to the point where there was no difference in people's responses to the two different types of reality.

To me, the fact that people respond to exposure with virtual reality as well as if it was "real" is remarkable. In the next blog posting, I'll talk more about virtual reality as is relates to gaming.