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Stalked by Fears. Will Virtual Reality Be the Answer We Need?


Clink, clink, clink, the sound was relentless as the bullets hit the outer skin of the armored vehicle. Boom! A roadside bomb had exploded and everyone inside the vehicle was thrown out into a bloody pile of bodies and body parts.

Moans filled the air, and smoke rose as the flames began to envelop everything in sight. The terror and the fear that came with it drove the memory ever deeper into the brain of the person who had been at the wheel. All of it was a vivid memory that refused to be forgotten by anyone involved in the tragedy. Many would suffer from prolonged anxiety disorders as a result.

Sense memories are components of the anxiety disorder known as Posttraumatic Stress Disorder (PTSD). On their return home, military servicemen and women would have these persistent disruptions of reality and their emotions. Nightmares came in explosive succession and made the night a time of renewed fear; the horror never stopped.

Sudden flashbacks stopped them on the street where some fell to a crouching position, trying to avoid the AK-47 bullets being fired. Frantically, one might yell for help. “Medic, medic!” Everyone would stare, not knowing whether to run or call 911 for help. It was lifechanging and disabling. A return to their former life or self seemed impossible. Often, suicide was an answer.

Therapy and Virtual Reality

Virtual reality (VR) recreates the environment in a controlled therapeutic setting using a virtual set, eyewear, software and hand-held objects. The scene is “real” in every sense of the word except it’s not real.

Immersing an individual into a reconstructed virtual environment by computer programs and digital screens on a headset was first invented in 1968 by Ivan Sutherland at MIT. Sutherland explained how the term and the software came to be in a video. Since that time, the potential for this form of digital reality-based programming has blossomed from games to therapy as it found additional utility in mental health care. Anxiety was a prime target.

Virtual reality as a therapeutic intervention for anxiety disorders has incorporated influential techniques research has shown to be highly effective. The original technique, developed by Joseph Wolpe in 1958, is known as systematic desensitization or reciprocal inhibition and was effective in treating “war neurosis.”

The theory is that it isn’t possible to experience fear and relaxation at the same time and a three-step technique was developed based on this model. The steps include learning methods of relaxation, developing a hierarchy of fears, and then gradual exposure to the fear stimulus. In this way, both physical and mental abilities can be brought to bear during the therapeutic exercise.

As an innovative technique, virtual reality may be used in a number of fear-provoking situations. However, there are some individuals who may not be able to utilize it. Anyone who has experienced either feelings of dizziness, known as cybersickness, seizure disorder or some heart disorders, might not be candidates for the therapy. The cybersickness may be decreased by a gradual introduction to the virtual environment.

A few other individuals might also not be candidates and these include persons with migraine headache. Any individuals prone to psychosis or a personality disorder where they might confuse the virtual world with reality might also be excluded. The future is bright, however, and more individuals will be brought under the VR umbrella of therapies.

The Future Promise of VR

Clinicians and researchers see an optimistic future for the expansion of virtual reality programs for the treatment not only of anxiety disorders such as PTSD and specific phobias. Improvements in technology and initial cost for equipment make VR more readily available. It will be used to help persons with disabilities and autistic spectrum disorder to learn appropriate skills and to diminish their fears.

The programs can also be used in ways not intended specifically for disorders but for enhancing feelings of self-efficacy and cognitive enhancement to deal with dysfunctional beliefs. The experiences provided virtually can create opportunities for positive outcomes in other environments.

VR can also be used in a variety of ways to enhance learning or to integrate learning into new situations. The challenge lies in the programming and in the creativity of both the programmers and those who can envision new opportunities in which to involve this technology.

Medium: Twitter: @drpatfarrell

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