Posts Tagged PTSD

[NEWS] ‘Mind-blowing’: Virtual reality PTSD treatment central to launch of consortium

Col. Rakesh Jetly, chief pyschiatrist, Canadian Armed Forces, demonstrates the 3MDR system with Capt. Anna Harpe at the Glenrose Rehabilitation Hospital in Edmonton on Wednesday, Feb. 13, 2019. HiMARC’s Motion-Assisted Multi-Modal Memory Desensitization and Reconsolidation (3MDR) uses virtual reality to treat post traumatic stress syndrome. LARRY WONG / POSTMEDIA

Virtual reality to help more military and other public safety workers cope with PTSD is central to the work of a new group launched in Edmonton.

Heroes in Mind, Advocacy & Research Consortium (HiMARC) is made up of those who want “to serve the men and women in uniform who have served us and continue to serve us daily,” Bob Haennel, dean of the University of Alberta’s Faculty of Rehabilitation Medicine, said in a Wednesday news release.

HiMARC’s Motion-Assisted, Multi-Modal Memory Desensitization and Reconsolidation (3MDR) research study — the largest of its kind in Canada with 40 Armed Forces participants — allows PTSD patients to use the Computer-Assisted Rehabilitation Environment (CAREN) system at the Glenrose Rehabilitation Hospital.

“It was incredible. I don’t know how else to describe it. My senses were heightened. I was even sensitive to the clanging sound of the carabiner on my harness,” said Capt. Anna Harpe, a social worker at CFB Edmonton, after experiencing the 3MDR system.

Patients who step into the CAREN unit walk on a treadmill toward a stimulus, sounds and images that may remind them of events that trigger traumatic memories. A therapist is with them through the process, guiding the patient confronting the memories.

While Harpe does not have PTSD, she said testing the 3MDR brought back vivid recollections of a mission in Afghanistan when she was in the infantry.

“I have worked with some clients who have been diagnosed with PTSD, and I have to say, the 3MDR is mind-blowing. My whole body was activated. You just cannot get the same thing through talk therapy in an office,” she said.

Study participants are receiving the therapy once a week for six weeks.

“By walking towards the fear, there is a shift in the brain,” said Suzette Brémault-Phillips, director of HiMARC in the Faculty of Rehabilitation Medicine and co-principal investigator for the study in Canada.

The 3MDR system — developed by Col. Eric Vermetten, head of research at the Military Mental Health unit of the Dutch ministry of defence in the Netherlands — has been effective in the Netherlands where it’s been used to treat the rise in PTSD cases there after its mission to Afghanistan.

Vermetten traveled to Edmonton to train Brémault-Phillips and her team to use the system.

HiMARC’s founding members also include the Royal Canadian Legion Alberta-NWT Command, NAIT, the Department of National Defence, Veteran Affairs Canada and Covenant Health.

“HiMARC is creating hope and I am so grateful for this group. I really believe this is just the beginning,” added Harpe.

Source:
https://edmontonjournal.com/news/local-news/mind-blowing-virtual-reality-ptsd-treatment-central-to-launch-of-consortium

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[TED Talk] Rebecca Brachman: A new class of drug that could prevent depression and PTSD – TED Talk

Current treatments for depression and PTSD only suppress symptoms, if they work at all. What if we could prevent these diseases from developing altogether? Neuroscientist and TED Fellow Rebecca Brachman shares the story of her team’s accidental discovery of a new class of drug that, for the first time ever, could prevent the negative effects of stress — and boost a person’s ability to recover and grow. Learn how these resilience-enhancing drugs could change the way we treat mental illness.

This talk was presented at an official TED conference, and was featured by our editors on the home page.

via Rebecca Brachman: A new class of drug that could prevent depression and PTSD | TED Talk

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[BLOG] Lash & Associates’ Award-Winning Blog site

TBI, ABI, PTSD, Stroke, Concussion Blog Posts!

Lash & Associates’
Award-Winning Blog Site
Is Well Worth A Look

Our large variety of blog articles are keyword searchable, and offer help & encouragement.

Click here to go the our blog site!

No matter what your situation – as a survivor, a clinician, a caregiver, or a family member, our blog site provides a great reference point. Check it out – we’ve got something for most any situation regarding the greater TBI Community!

via Lash & Associates’ Award-Winning Blog site

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[WEB SITE] How Virtual Reality Will Transform Medicine – Scientific American

Anxiety disorders, addiction, acute pain and stroke rehabilitation are just a few of the areas where VR therapy is already in use

How Virtual Reality Will Transform Medicine

Credit: Celia Krampien

If you still think of virtual reality as the province of dystopian science fiction and geeky gamers, you had better think again. Faster than you can say “Ready Player One,” VR is starting to transform our world, and medicine may well be the first sector where the impact is profound. Behavioral neuroscientist Walter Greenleaf of Stanford University has been watching this field develop since the days when VR headsets cost $75,000 and were so heavy, he remembers counterbalancing them with a brick. Today some weigh about a pound and cost less than $200. Gaming and entertainment are driving current sales, but Greenleaf predicts that “the deepest and most significant market will be in clinical care and in improving health and wellness.”

Even in the early days, when the user entered a laughably low-resolution world, VR showed great promise. By the mid-1990s research had shown it could distract patients from painful medical procedures and ease anxiety disorders. One initial success was SnowWorld, which immersed burn patients in a cool, frozen landscape where they could lob snowballs at cartoon penguins and snowmen, temporarily blocking out the real world where nurses were scrubbing wounds, stretching scar tissue and gingerly changing dressings. A 2011 study with 54 children in burn units found an up to 44 percent reduction in pain during VR sessions—with the bonus that these injured kids said they had “fun.”

Another success came in the wake of 9/11. Psychologist JoAnn Difede of NewYork-Presbyterian/Weill Cornell Medical Center began using VR with World Trade Center survivors suffering from post-traumatic stress disorder (PTSD) and later with soldiers returning from Afghanistan and Iraq.

In Difede’s laboratory, I saw the original 9/11 VR program with its scenes of lower Manhattan and the newer Bravemind system, which depicts Iraqi and Afghan locales. Developed with Department of Defense funding by Albert “Skip” Rizzo and Arno Hartholt, both at the University of Southern California, Bravemind is used to treat PTSD at about 100 U.S. sites. The approach is based on exposure therapy, in which patients mentally revisit the source of their trauma guided by a therapist who helps them form a more coherent, less intrusive memory. In VR, patients do not merely reimagine the scene, they are immersed in it.

Difede showed me how therapists can customize scenes in Bravemind to match a patient’s experience. A keystroke can change the weather, add the sound of gunfire or the call to prayers. It can detonate a car bomb or ominously empty a marketplace. An optional menu of odors enables the patient to sniff gunpowder or spices through a metal tube. “What you do with exposure therapy is systematically go over the trauma,” Difede explains. “We’re teaching the brain to process and organize the memory so that it can be filed away and no longer intrudes constantly in the patient’s life.” The results, after nine to 12 gradually intensifying sessions, can be dramatic. One 2010 study with 20 patients found that 16 no longer met the criteria for PTSD after VR treatment.

Until recently, large-scale studies of VR have been missing in action. This is changing fast with the advent of cheaper, portable systems. Difede, Rizzo and three others just completed a randomized controlled trial with nearly 200 PTSD patients. Expected to be published this year, it may shed light on which patients do best with this high-tech therapy and which do not. In a study with her colleague, burn surgeon Abraham Houng, Difede is aiming to quantify the pain-distraction effects of a successor to SnowWorld called Bear Blast, a charming VR game in which patients toss balls at giggly cartoon bears. They will measure whether burn patients need lower doses of intravenous painkillers while playing.

Greenleaf counts at least 20 clinical arenas, ranging from surgical training to stroke rehabilitation to substance abuse where VR is being applied. It can, for example, help recovering addicts avoid relapses by practicing “refusal skills”—turning down drinks at a virtual bar or heroin at a virtual party. Brain imaging suggests that such scenes can evoke very real cravings, just as Bravemind can evoke the heart-racing panic of a PTSD episode. Researchers foresee a day when VR will help make mental health care cheaper and more accessible, including in rural areas.

In a compelling 2017 paper that reviews 25 years of work, Rizzo and co-author Sebastian Koenig ask whether clinical VR is finally “ready for primetime.” If today’s larger studies bear out previous findings, the answer seems to be an obvious “yes.”

via How Virtual Reality Will Transform Medicine – Scientific American

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[BOOK] Person Centered Approach to Recovery in Medicine – Luigi Grassi – Google Books

Bibliographic information

via Person Centered Approach to Recovery in Medicine – Luigi Grassi – Google Books

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[TEDx Talks] Can Virtual Reality Ease Post-traumatic Stress Disorder? | Dr. Brenda Wiederhold | TEDxChapmanU – YouTube

Δημοσιεύτηκε στις 2 Σεπ 2015
A licensed clinical psychologist in the U.S. and Europe, a visiting professor at the Catholic University in Milan, and an entrepreneur, Dr. Brenda Wiederhold completed the first randomized, controlled clinical trial to provide virtual reality medical therapy for war veterans suffering from post-traumatic stress disorder (PTSD).
Her most recent achievement is working with coalition troops to provide stress inoculation training prior to deployment. She is further exploring the use of VR in treating patients of all ages suffering from ailments such as claustrophobia to stress disorders. In the spirit of ideas worth spreading, TEDx is a program of local, self-organized events that bring people together to share a TED-like experience. These local, self-organized events are branded TEDx, where x = independently organized TED event. The TED Conference provides general guidance for the TEDx program, but individual TEDx events are self-organized. Dr. Wiederhold is CEO of the Virtual Reality Medical Institute in Belgium and the Executive Vice President of the Virtual Reality Medical Center in California.
She completed the first randomized, controlled clinical trial to provide virtual reality medical therapy for war veterans suffering from post-traumatic stress disorder (PTSD). Her most recent achievement is working with coalition troops to provide stress inoculation training prior to deployment. She is further exploring the use of VR in treating patients of all ages suffering from ailments such as claustrophobia to stress disorders.
This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at http://ted.com/tedx

 

via  Can Virtual Reality Ease Post-traumatic Stress Disorder? | Dr. Brenda Wiederhold | TEDxChapmanU – YouTube

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[Abstract] Combined transcranial direct current stimulation with virtual reality exposure for posttraumatic stress disorder: Feasibility and pilot results

Abstract

Background

Facilitating neural activity using non-invasive brain stimulation may improve extinction-based treatments for posttraumatic stress disorder (PTSD).

Objective/hypothesis

Here, we examined the feasibility of simultaneous transcranial direct current stimulation (tDCS) application during virtual reality (VR) to reduce psychophysiological arousal and symptoms in Veterans with PTSD.

Methods

Twelve Veterans with PTSD received six combat-related VR exposure sessions during sham-controlled tDCS targeting ventromedial prefrontal cortex. Primary outcome measures were changes in skin conductance-based arousal and self-reported PTSD symptom severity.

Results

tDCS + VR components were combined without technical difficulty. We observed a significant interaction between reduction in arousal across sessions and tDCS group (p = .03), indicating that the decrease in physiological arousal was greater in the tDCS + VR versus sham group. We additionally observed a clinically meaningful reduction in PTSD symptom severity.

Conclusions

This study demonstrates feasibility of applying tDCS during VR. Preliminary data suggest a reduction in psychophysiological arousal and PTSD symptomatology, supporting future studies.

via Combined transcranial direct current stimulation with virtual reality exposure for posttraumatic stress disorder: Feasibility and pilot results – Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation

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[BLOG POST] Sleep Disorders After Brain Injury, PTSD, TBI

Why Do So Many Survivors Have Sleep Disorders After Brain Injury?

January 2018,  Written by Bill Herrin

Click Here to sign up to receive a BULLETIN monthly!!!

January’s Brain Injury Journey Bulletin dives into the new year with a topic that often keeps people up at night…sleep disorders after TBI.

Sleep. It can be elusive, and one of the most frustrating things to accomplish after brain injury – especially on a consistent basis. Quite often, sleep disorders can take hold after brain injury – and cause everything from anxiousness to feeling depressed, tired, irritable, and more. In this issue of the Brain Injury Journey Bulletin, we’re going to take a look at all the things that sleep can affect, and some ways to conquer a sleep disorder after TBI.

Tossing and Turning

When your quality of life is being affected by lack of sleep, the desperation of wanting to rest can actually hinder you from getting the rest you need. Here are some changes in sleep patterns after TBI that are quite common:

  • difficulty falling asleep easily
  • trouble staying asleep throughout the night
  • waking up very early in the morning and not falling back to sleep
  • falling asleep and awakening far later than desired
  • purposely staying up late at night to get things done

Examples are:

  • You get into bed around 10 but it takes you several hours to fall asleep.
  • You wake up frequently during the night for no major reason.
  • You wake up at 4 in the morning and cannot fall back to sleep.
  • You’re up late every night working on the computer and your partner keeps asking
    you to come to bed.

Sleep Disorders and Other Factors

There are lots of different sleep disorders, and they can involve many different parts of the brain. Here are some of the more well-known sleep disorders that people encounter: Insomnia, extreme drowsiness, altered sleep patterns and Narcolepsy. Other disorders that can directly contribute to lack of sleep are Restless Leg Syndrome, teeth grinding or clenching, involuntary movements of your arms/legs during sleep, sleepwalking, sleep apnea, etc. Other factors that can deprive you from sleep are pain, alcohol, caffeine and nicotine, depression…and naps. A poorly timed nap (late in the day) obviously can end up backfiring on you later that night! It’s best to limit the length of naps so they help you get through the day, but don’t keep you up at night.

When PTSD is involved, especially in military veterans, sleep disorders can disturb sleep to the point of a person dreading bedtime, and efforts to quiet the symptoms with drugs or alcohol can make symptoms worse in the long run. Hyper-alertness, flashbacks, or nightmares can play a big part in keeping PTSD survivors up at night.

Research has found that sleep disorders are 3 times more common in persons with TBI than the general population, that about 60% of TBI survivors have ongoing problems with sleeping, that women are more affected than men…and that aging increases the likelihood of sleep problems.

This group has been researching how people sleep, and they have collected some great information about how drug addiction and recovery can affect a person’s ability to have healthy, restorative sleep….along with addressing other sleep disorders. You can read the full guide at this link.

Better sleep?

Sleep, when achieved regularly, brings a bevy of positive side-effects, and is an essential component of mental and physical well-being. It can affect healing of the brain and body, improve short-term memory and attention, improvement of your mood, and it can even reduce physical pain. The main thing that sleep obviously provides is that you feel rested and more alert!

How You Sleep Also Matters

Being uncomfortable can affect your sleep more than you realize, too. Here’s a link to an article on WebMD.com that covers different sleep positions, and how they can help (or hinder) sleep, or even cause pain in your back, neck, etc.  Here’s the link.

Talk It Over With Your Doctor

There are plenty of over-the-counter and off-the-shelf medications specifically made to help you “catch some ZZZZZ’s” – but it’s very important that persons with brain injury talk to their doctor about the side effects of sleep medications before using any of them.

Brain injury presents a variety of issues that can cause stress, and the stress can easily parlay itself into loss of sleep. If loss of sleep is wearing you down, or slowing your recovery after TBI, you should speak with a physician right away. Once you seek medical advice, the doctor can help you discover the causes and effects of your sleep issues, and discuss all possibilities of easing the loss of sleep. From sleep labs to prescription medications, to discussing techniques for easing your mind before bedtime, your doctor will hopefully help you resolve the sleep deprivation to some degree.

Suggested Reading

The person you are with little or no sleep, versus the one you are when well rested can be like the difference in…well, like night and day! Tips for managing your sleep schedule, and how to improve it, are available in this easy-to-read tip card – available on our website. It’s titled “Sleep after brain injury”, and if you go to this link, you can get a free tip card and catalog.  Here’s the link. for the catalog & tip card. Here’s more info on the SLEEP tip card.

New Year, New Sleep Habits?

With a new year started, you can reference any issues imaginable that relate to PTSD, TBI, ABI, brain injury, concussion, and more, on Lash & Associates’ blog page. Specifically relating to the new year, realistic resolutions after TBI, here is a blog article by Donna O’Donnell Figurski that talks all about it. Here’s the link.

Knowing that stress and anxiety (after TBI) can take its toll, this blog post by Marilyn Lash and Taryn Stejskal, discusses managing stress, and the symptoms of stress that become evident when they’re taking their toll on your health and well-being. Here’s the link.

Blog Posts Galore On A Wide Range of TBI Issues

Feel free to keyword search our entire collection of blog posts, many written by well-known experts, clinicians in the field of brain injury, and also people who have survived brain injury, had family members that have a TBI, and much more. It’s a treasure trove of information that is available for FREE, 24/7/365. It’s all for you at this link!

Resolution of sleeping issues is a “2018 Resolution” for the new year that many have added to their lists to  achieve. We hope that you have a great new year, and that you rest assured…and sleep well!

 

 

 

 

via Sleep Disorders After Brain Injury, PTSD, TBI

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[WEB SITE] ‘After, I feel ecstatic and emotional’: could virtual reality replace therapy? – The Guardian

If you’ve got acrophobia, paranoia, fear of flying, PTSD, even depression, software could soon be the solution

Virtual reality is the great hope for many mental health professionals.

 Illustration: Leonard Beard for the Guardian

Leslie Channell admits he’s not a typical case for treatment. Channell, known to everybody as Chann, is a registered pilot who served 24 years in the army working on Apache helicopters. Chann also happens to be scared of heights. He doesn’t mind flying planes or sitting on the side of the Apache with the door open; he’s just terrified of going up two or three floors of a building or driving over a bridge.

Chann is nervous; his speech is fast. He says he’s sweating. We meet at a trendy startup in Oxford, where he is about to undergo virtual-reality therapy for his phobia (although the term “virtual-reality” therapy is controversial: some say the VR is just a tool for the therapy; others argue that the virtual reality is the therapy itself). Psychologists are now trialling VR for all kinds of conditions, from phobias to pain management to post-traumatic stress disorder (PTSD).

There are two other people in the room. Cognitive-behavioural therapist Polly Haselton sits behind a curved computer screen watching Chann, occasionally asking questions. Daniel Freeman, professor of clinical psychology at the University of Oxford and one of the world’s pioneers in this field, watches Chann’s every movement. Freeman explains there are three common fears of heights: that you will fall; that what you are standing on will give way; or that you will jump, which is known as “the call of the void”. Chann’s fear is of falling.

A view of the virtual-reality therapy programme that guides patients through their fear of heights.

 The virtual reality therapy programme that guides patients through their fear of heights

A view of the virtual-reality therapy programme that guides patients through their fear of heights.

Photographs: Nowican/Oxford VR

He straps on his virtual-reality headset (also known as a head-mounted display, or HMD). Inside the headset, he will find himself fully immersed in a three-dimensional world. Today, he is going to level four of a 10-storey building in New York to rescue a kitten stranded on a branch of an indoor tree.

Chann has to use a lever to push himself on to a small platform towards the cat. He is a stocky, tough-looking man in his late 50s. But he’s not looking tough any more. His voice is rising, and he’s shaking. He edges forward along the virtual branch. In real life, his feet also move gingerly – then come to a sudden stop. His breathing becomes louder and more staccato.

“You’re doing really well,” Haselton says.

“You don’t know how difficult this is,” Chann pants. “Come here, cat.” Then he stops. “Nah, can’t get it. Aaaagh. No! Gotta come back.”

He starts again, cautiously edging forward. “Yes. Yes. Yes! No, stop Chann. Yes! Yes!” His yeses are urgent, desperate. He makes a grab for the kitten, and returns it to virtual safety.

Task complete. He takes his headset off, talking even faster. “My anxiety levels were way high. Super high.”

“We’re talking nine out of 10, 10 out of 10?” Freeman asks calmly.

“Yeah. I really didn’t want to be there. I had to think I was in a room in Oxford. ‘You’re not here, it’s all OK, do it.’”

Chann is one of a dozen people currently testing this software. (Next month, the trial is being extended to 100 people.) Already, he says, it has made a difference to his life. “Yesterday, I went on a rollercoaster with my daughter. I had never gone on one before. Not the big ones, the smaller ones, but still…” He’s spent only around 20 minutes in the virtual world today, but he is exhausted. “I was worried about coming here, and I’ve done it, and I’m buzzing. Elated.” He pauses, trying to catch his breath. “But I know in my heart of hearts, if there was a real cat on level four, I would not be going out and getting it. Polly asked me, what if it was a little baby? That would change the dynamics.”

Freeman has been working with VR for 16 years. What he loves about this therapy is its simplicity. “There are very few conditions VR can’t help,” he says, “because, in the end, every mental health problem is about dealing with a problem in the real world, and VR can produce that troubling situation for you. It gives you a chance to coach people in other ways of responding. The people I see are anxious or depressed, or worried about people attacking them, and what they’ve done in their life is retreat from the world. With VR, you can get people to try stuff they haven’t done for years – go in lifts, to shopping malls, then they realise they can do it out in the real world.”

Acrophobia, or the fear of heights, is just the start, Freeman says. He has already developed VR programs that treat people with paranoia – for example, placing them in virtual libraries, lifts or on tube trains with strangers eyeballing them. In a Medical Research Council-funded study, he used VR with 30 patients to help them re-learn that they are safe around other people.

“The results were remarkable. From just 30 minutes in VR, there were large reductions in paranoia. Immediately afterwards, more than half the patients no longer had severe paranoia. Importantly, the benefits transferred to the real world. It wasn’t a definitive study. It was small and short-term, but the results do show great potential.” The program will initially be used in NHS mental health services with a staff member present, but Freeman believes that, ultimately, it could be available commercially.

Nearly two million people sought advice for mental health issues in 2015, according to the Health and Social Care Information Centre – up from 1.2 million in 2010. Meanwhile, the number of mental health nurses fell by nearly 15% from 45,384 in 2010 to 38,774 in July 2016, according to a written parliamentary answer from Philip Dunne, the health minister. The British Medical Association recently revealed that in 2016-17, 5,876 adult patients with mental health conditions were referred to another health trust for treatment, with some patients being sent 600 miles away to Scotland. Against this backdrop, virtual reality is the great hope for many mental health professionals. Some psychologists believe they are on the brink of a VR revolution. Then again, they were saying the same thing a quarter of a century ago.

Barbara Rothbaum’s office in Atlanta, Georgia, is closed due to the impending arrival of Hurricane Irma. In between electricity cuts, I manage to speak to her at her home. Rothbaum is a professor in psychiatry, a clinical psychologist at Emory University, and the founding mother of exposure therapy using virtual reality. “We published the very first study using VR to treat a psychological and psychiatric disorder back in 1995,” she tells me. Again, it was to treat acrophobia, and the results amazed Rothbaum. “Seven out of 10 people who got the virtual reality reported putting themselves in real-life height situations afterwards.” That was when they thought they were on to something big. “We used to say: ‘We’re on the cutting edge of the lunatic fringe.’ That was our line at the time.” She laughs.

After acrophobia, Rothbaum developed a VR program for fear of flying. This was even more effective, because traditional exposure therapy (paying for yourself and a therapist to travel on a plane) is time-consuming and expensive. “I can do all that in my 45- to 50-minute therapy session, with ultimate control. So if I know they’re not ready for turbulence, I can guarantee there won’t be turbulence.”

Rothbaum then went on to do pioneering work with Iraq and Afghanistan war veterans suffering from PTSD. Before VR, veterans were confined to imaginal therapy – basically, shutting your eyes and thinking yourself back to the original situation. But now Rothbaum could recreate it for them in a controlled environment. “With PTSD, especially in military folk, they are very avoidant emotionally. With VR, it’s harder to avoid, because it is such a potent stimulus.”

Early on in her VR career, a public-private partnership between Emory University and the Georgia Institute of Technology insisted Rothbaum and her colleagues form a corporation and patent their software. The result was a company, Virtually Better, that designs environments for fellow clinicians to use. “That is my conflict of interest,” Rothbaum says. Whoever she speaks to, she instantly declares it. Does it worry her that she is responsible for the research showing how effective her own VR products are? “It has done, over the years,” she says. “One of the ways I manage it is, I disclose, disclose, disclose.”

Rothbaum is not alone. VR therapy is a small, niche world. Read the scientific papers, and the same names crop up again and again. And most of these academics are now also running commercial companies. As traditional funds dry up for universities, people such as Rothbaum are increasingly reliant on business – often their own business – for support in their research.

As it happens, Rothbaum says, she lacked the cut-throat instincts to be a good businesswoman. “A criticism of Virtually Better was that it was run more like an academic department than a business. We knew how to write grants so we’d write small business grants and enjoy collaborating rather than competing. I thought it was an interesting way to do exposure therapy and wasn’t very mercenary about it.”

Has she ever used VR to treat her own fears? “No. My fear early on was that somebody was going to make a lot of money, and it wasn’t going to be us. Actually, that is probably still going to come true. But I’ve adapted to that; it’s all right.” She’s still not rich? “Oh no, not by a long shot, no.”

Despite research showing its efficacy, the VR therapy revolution did not take off in the 1990s or the noughties. This time around, though, it looks as if it might. Mel Slater, a professor of virtual environments, shows me why. We meet in the London HQ of Digital Catapult, a government initiative to promote the digital economy. Slater hands me the headset used in the virtual psychotherapy sessions he is developing. “The VR world burst open in 2013 when this Oculus Rift was released for a few hundred dollars, compared with the next credible headset of $50,000, and now all the big companies have gone into it.”

Slater talks quietly and, facially, has a touch of Woody Allen about him. Although primarily a computer scientist, he is now largely based in the psychology faculty at the University of Barcelona. Slater is one of the most-in-demand academics in the virtual world, with an endless list of titles, including professor of virtual environments at University College London, co-founder of the company Virtual Bodyworks, and immersive fellow at Digital Catapult. He also works with Daniel Freeman on treatments for persecutory delusions and acrophobia.

Like Rothbaum, Slater is one of the early 1990s pioneers. “Nobody told me virtual reality died, so I stayed with it.” He smiles.

And had it died? “No, but for a long time people said, ‘It’s not going anywhere because it’s too expensive.’ The equipment we used at UCL cost £1m. The equipment I have in Barcelona, when I set up there 10 years ago, was £100,000. Now I can do the same thing with £3,000.”

Slater says the human reaction still surprises him. “There is some level of the brain that doesn’t distinguish between reality and virtual reality. A typical example is, you see a precipice and you jump back and your heart starts racing. You react very fast because it’s the safe thing for the brain to do. All your autonomic system starts functioning, you get a very strong level of arousal, then you go, ‘I know it’s not real’. But it doesn’t matter, because you still can’t step forward near that precipice.”

Virtual reality therapy session

Simon Hattenstone explains his problems to Sigmund Freud…

 

Virtual reality therapy session

 …then analyses himself as Freud. Photographs: Event Lab, University of Barcelona, Spain

In some ways, he says, virtual reality beats reality because it enables you to experiment in ways you can’t, physically, in real life (for example, putting people in different bodies to experience what it is like to be a different gender or ethnicity) or in situations you would avoid.

“I was in one session where the guy had such a fear of public speaking that he told us about speaking at his daughter’s wedding, and we said, ‘How old is your daughter?’ and he said, ‘Three!’ So he spoke to a virtual audience. He said: ‘I can’t do this, I’m turning bright red, my voice is an octave higher.’ The psychologist later played it back to him and said: ‘Is your face red? No. Are you speaking an octave higher than normal? No.’ The psychologist did in one afternoon what would normally take 12 weeks.”

I have seen headlines suggesting that VR can cure depression. Surely that is an exaggeration? “Cure, I don’t know,” Slater says. “But we published a study last year where we reduced the level of depression among a cohort of people through a VR intervention not that dissimilar from what I’m going to show you today. Part of having depression is that you are overly self-critical and cannot give compassionate thoughts to yourself. So in the VR, you see a crying child. Beforehand, the therapist has given you a structure of things you should say to other people in order to give them compassion. So you say these things to the child who starts looking at you and stops crying. Then, in the next phase, you are that child, so you then see and hear your previous self giving you the compassionate speech. When we gave this to a group of moderately depressed people three times, the level of depression decreased.”

I put on my headset and sit in front of a screen. The program I’m trying, called VReflect-Me, is still being developed for people with anxiety issues and depression. It is based on the notion that, when advising friends, we are often kinder and more objective than when analysing ourselves.

First of all, an avatar is created of me. Then I embody that avatar. I am in a therapy session with a psychiatrist (in this case, Sigmund Freud) and I tell him my problems. In the next stage, I embody Freud. When my head moves, Freud’s head moves; when my hands move, his move; and when I’m ready, I advise myself in the form of Freud. (Slater says that Freud is a useful avatar, because you tend to adopt characteristics of your avatar; so, if he is wise, you become more wise.)

I tell Freud I have paranoid tendencies; generally, I think I’m incredibly boring with nothing to say and hate formal social situations (not the pub), because I fear my stupidity will be exposed. More specifically, I tell Freud, I have just read comments on social media about an interview I just wrote saying that I gave my subject an easy ride. I am full of self-loathing, and feel useless at my job.

Now I switch roles, and am Freud advising me. The first time I do it, I’m too self-conscious. Slater gently suggests that I was not fully immersed. I ask if I can do it again. This time, I go for it. It might not be the way Freud would have responded, but I listen to my problems and then tear into myself – rightly or wrongly, I make a good case for not being boring, stupid and a rubbish journalist. I verbalise everything and dismiss it as solipsistic nonsense. I then return to my own avatar. “Good points. Well made,” I say to Freud. And I mean it.

When I take off my headset and leave the virtual world, my breathing is fast and shallow – not unlike Chann’s after he’d been to the heights. I feel both ecstatic and emotional. Tearful, almost. Even if it doesn’t last, it’s been a useful exercise. I might say this kind of stuff to myself in my head, but it feels different when you say it out loud.

Slater is pleased with me. “Wow! You did amazing. You said, ‘You, you, you!’ which is great.” What he means is, I successfully got out of my head and into Freud’s. It strikes me as a powerful tool for therapists. There is no way I would have said what I said, as Freud, if I was simply talking to a real person.

But I can’t help thinking I’m a relatively safe case. What if I were more vulnerable? What, for example, if I suffered from the acrophobic’s call of the void, did the VR program, convinced myself I’d overcome my phobia, went to the nearest high-rise and jumped?

Dr Kate Anthony, an expert on the use of technology in therapy and a fellow of the British Association for Counselling & Psychotherapy, stresses that technology is there to be used alongside therapy, rather than instead of. “VR is a good opportunity for helping psychotherapists,” she says, “but we’re not at a stage yet where virtual reality is going to be able to replicate a human therapist.”

It’s all very well, she adds, having software to encourage you to talk and tackle your fears, but that will take you only so far. “The VR therapist can’t respond in any meaningful way, and without that meaningful response, I don’t think the client is going to progress.”

Once VR treatments have been proven to be effective, she says, she would like to see them available on prescription. What about making them commercially available? No, she says, it’s too risky. “If we’re talking about paranoia, for example, any of these situations can trigger the client. The trouble with something like that is it could bring up all sorts of issues. I would want to see it closely managed.”

Dr Michael Madary, a philosopher and technology ethicist, and his colleague Thomas Metzinger, have drawn up a code of conduct for the use of VR, some of which addresses its use in therapy. He thinks VR can have a positive impact, but that therapists must not blind themselves to the dangers. One particularly sensitive issue, Madary says, is data. Participants in studies know their data is confidential, but that could be very different if commercial companies invest in VR therapy purely for profit. “With motion tracking, particularly facial tracking, users are going to reveal a lot about themselves – about their mental state, about how they react to various stimuli – and that data can be collected and then used as a powerful bargaining tool.”

He envisages a scenario where there is an advertisement flashed, or product placed, in the virtual world and the content creators collect the response of users to that ad based on the faces they make. “You can imagine seeing your avatar in a new jacket, for example. There will be a lot of powerful techniques that emerge in marketing, with widespread use of motion capture.”

Mel Slater accepts that virtual reality can be abused. But anything can, he says. “You can use a bread knife to cut bread or to stab someone, so any tool can be misused deliberately. This is why I think the applications in clinical psychology have to be led by people such as Daniel, who know the risks.”

Back in Oxford, Daniel Freeman is not so sure the programs need his presence to be effective. He is talking about his company Nowican, and anticipating the launch of its first product – Nowican Do Heights, the acrophobia program being trialled by Chann.

He hopes that the NHS and individual psychologists will invest in it, but believes its prime use will be for individuals seeking help. “We’re putting a virtual coach in there so you don’t need a therapist, and we’re also looking at better techniques than simple exposure.”

Is he in danger of doing himself out of a job? “No. We’re not saying it has to replace the therapist. Some people will want to talk to a therapist, and sometimes the complexity means you need a therapist. But the issue is, there aren’t enough therapists.” Freeman is hoping that, before long, we will be able to download this as an app on our smartphones.

In a world of diminishing NHS resources, Freeman regards it as a no-brainer: “I see people who have been waiting 20 years and not had a chance of seeing a therapist. The idea that we can give so many people the chance to access what the best therapists should be doing – that is really exciting.”

  • Watch the Guardian’s latest VR experience The Party, filmed from the perspective of a 16-year-old girl with autism, on our new Guardian VR app. You can download it from the Apple App Store and the Google Play Store, or watch it as a 360 video, along with other Guardian VR experiences, at theguardian.com/vr

via ‘After, I feel ecstatic and emotional’: could virtual reality replace therapy? | Technology | The Guardian

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[WEB SITE] Beyond VR Games – VR Techs Applied to Medical Treatment such Psychotherapy, Mock Surgery

The field to which VR is most actively applied is posttraumatic stress disorder (PTSD).

The field to which VR is most actively applied is posttraumatic stress disorder (PTSD).

Seoul, Korea – 22 November 2017 – 9:45am –Choi Mun-hee

Virtual reality (VR) is used in various areas in hospitals such as medical treatment, the education of medical staffs and the enhancement of the convenience and safety of those who visit hospitals.

According to the medical world on November 21, VR is touching various medical fields such as medical education through virtual surgery, virtual rehabilitation treatment and the like. Especially, the field of mental health medicine is garnering much attention and an exposure treatment method which treats various phobias and addictions by using VR is already in a clinical utilization stage.

An exposure therapy is a behavioral therapy that develops emotional tolerance in a deliberate and painful situation for patients suffering from psychological distress that occurs in certain situations. VR is receiving much attention from medical staffs in that it allows precise control over a situation that doctors want to expose patients to. The field to which VR is most actively applied is posttraumatic stress disorder (PTSD). VR is actively used to treat patients suffering from the avoidance and re-experiencing of traumatic situations such as war or traffic accidents and anxiety about such situations.

Gil Hospital of Gachon University will establish the ‘Virtual Reality Therapy Center’ in January of next year and treat PTSD and panic disorder patients in earnest. In the future, the hospital is planning to expand VR treatment areas to mild cognitive impairment or attention deficit hyperactivity disorder (ADHD). “In order to treat PTSD and panic disorder, patients and therapists must go to sites which trigger PTSD and panic disorder or be exposed to stimuli that spark off stress but it is practically or physically impossible,” said professor Cho Seong-jin, a professor of mental health medicine in Gil Hospital. “VR can enable patients to reach a treatment stage by repeatedly giving stimuli in accordance with patients’ conditions.”

Sejong Hospital recently launched a VR application to let patients take a tour of examination rooms, wards, the checkup center and surgery center before visiting the hospital in person. ‘Cancer Hospital VR’ App was released by Samsung Seoul Hospital. The application guides patients about the hospital’s major facilities. VR can help patients reduce their anxiety and stress by taking a look at places where they will be treated and their medical procedures. Bundang Hospital of Seoul National University came up with the results of the application of a VR video for child patients. That is to say, the hospital developed a VR video that allows children close to undergoing surgery to experience surgical procedures with “Pororo” Character popular among kids in a VR world. So the hospital could reduce children’s anxiety before anesthesia 40% in actual surgery.

Gangnam Severance Hospital which has operated a virtual reality clinic since 2005 is developing technology to manage mental health via VR in cooperation with Samsung Electronics. The hospital and the IT giant will jointly develop diagnostic kits and chairs to analyze psychological states with VR devices, a VR mental health program including psychological evaluation, education and training processes, and an artificial intelligence diagnosis system among others with the goal of commercializing them next year.

 

via Beyond VR Games: VR Techs Applied to Medical Treatment such Psychotherapy, Mock Surgery | BusinessKorea

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