Virtual Reality and Psychotherapy

Pygmalion's Spectacles
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While the idea of virtual reality (VR) was described in Stanley G. Weinbaum’s short story “Pygmalion’s Spectacles” in the 1930s, researchers over the following decades sought real-world applications for VR. The technology took off during a research boom in the 1990s and has gained momentum in recent years. From Sega announcing its own VR headset for arcade games to Google creating Street View perspectives for Google Maps, companies and institutions all over the world are incorporating virtual reality into their products and services. The possibilities of VR tech are nearly limitless across multiple arenas such as education, video game development, military training, medicine, the visual arts, and more.

Unlike augmented reality (AR), which provides a live view of the real world, virtual reality replaces the real world with a simulated one. Virtual reality generates an environment that can simulate real world places or an imagined world. Computer screens and 3D imaging are used to display virtual reality environments, while speakers or headphones add real sound. More advanced virtual reality environments include haptic feedback—vibrations or motions— and input devices like a keyboard and mouse or wired gloves to enhance the experience. Ultimately, the aim of virtual reality is to immerse users into a realistic experience, one in which all five senses can be stimulated.

One particularly exciting field in which virtual reality is emerging is psychotherapy. VR technology is being used to treat people with anxiety disorders and phobias such as acrophobia—a fear of heights. Often called virtual reality exposure therapy, a user is guided by a trained therapist through the retelling of a traumatic experience related to the user’s disorder or phobia. During virtual reality exposure therapy, the therapist can also see and hear everything that the user can. The user not only reports when they are feeling anxious during the therapy, but the user’s physiology is monitored to gauge physical response. The user is exposed to virtual reality environments that are designed to elicit higher levels of anxiety as the user goes through different stages. Each stage can be repeated until the user feels comfortable with that stage and satisfied with the results. Virtual reality exposure therapy has proven to be so effective that it is now one of the primary treatments for PTSD and addiction rehabilitation.

The Virtual Reality Medical Center (VRMC) has offices in different parts of California that specialize in treating patients with anxiety disorders, training for both military and civilian populations, and enhancing various educational programs. VRMC continues to apply virtual reality technology in a number of emerging applications and operations as well as develop its own virtual reality systems. Virtual reality exposure therapy sessions at VRMC involve a head-mounted display, TV monitor, and stereo earphones so that users can receive both visual and auditory cues. VRMC also advertises the 20th anniversary of the CyberPsychology, CyberTherapy and Social Networking Conference, or CYPSY20, at the University of California San Diego from June 29 to July 2, 2015.

Not only are there specific institutions for virtual reality exposure therapy, but colleges such as the University of Southern California (USC) are conducting research and testing prototypes of their own virtual reality technology to use for therapy. USC’s Institute for Creative Technologies project funded by the U.S. Office of Naval Research brings together the technical, clinical and creative forces of ICT, Virtually Better, Inc. and the Virtual Reality Medical Center into a virtual reality exposure therapy known as “ Virtual Iraq/Afghanistan” aimed at treating combat-related PTSD. This VR psychotherapy technology utilizes virtual artwork and other components originally created for the commercially successful X-Box game and combat tactical simulation scenario, Full Spectrum Warrior and is uniquely suited to this generation of video game players.

The VR exposure therapy approach is now found at over 50 sites, including VA hospitals, military bases, and other universities. “Virtual Iraq/Afghanistan” uses relevant simulations for PTSD treatment, including Middle-Eastern themed city and desert road environments. Users of the program put on a head-mounted display and earphones, similar to the users at VRMC. However, “Virtual Iraq/Afghanistan” delivers vibrations and smells to users in the simulation, too. By gradually reintroducing patients to the experience(s) that triggered the trauma in a safe and controlled environment using VR, the memory becomes less intrusive into daily life and more tolerable.

As the opportunities for VR continue to expand in scope, the technology will likely be used other kinds of therapy as well, particularly art therapy. Traditionally, art therapy is the use of creative mediums such as painting, and sculpting, as well as others, to treat people with both physical and mental disorders. With the use of virtual reality, though, art therapy has the potential to grow exponentially with upcoming new technologies. Dr. Cathy Malchiodi wrote a book called Art Therapy and Computer Technology: A Virtual Studio of Possibilities that explores the idea of digital art therapy, which has emerged with the advancements in virtual reality. Additionally, the American Art Therapy Association (AATA) has a technology community that promotes the safe and ethical use of virtual reality in art therapy. Developers from the University of Pennsylvania have already implemented VR tech and art therapy into a virtual reality art therapy app called Cardboard Artboard that allows users with quadriplegic paralysis, neurodegenerative diseases, and amputations to create art with the motion of their heads.

CardboardArtboard by Veronica Wharton

Possibilities in VR and its implementation into psychotherapy are boundless. Along with virtual reality style immersive and gaming therapies, VR has opened an entirely new world for expressive arts treatments. Though virtual reality technology is still in its infancy, we are excited to see what future advances VR tech brings to mental health as well as to therapeutic and creative forms of self-expression, helping us live happier, more satisfying lives in the process.

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