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Virtual Cures for Real-World Phobias
by: Patricia Edmonds
Adapted from: Reader’s Digest, January 2005
1.
Charlice Noble-Jones was on a fast track. At 25, she managed a team at Deutsche
Bank that processed billions of dollars in currency transfers every day. Her office was
next to the South Tower of the World Trade Center. Then came September 11, 2001.
That morning, Noble-Jones emerged from the subway to see the North Tower with a
hole in it. “I remember the sound of the fire,” she says, “and the people jumping out of
the windows.” She ran through showering debris, past “a lady with beautiful red
hair…lying on the ground bleeding.” For months afterward, Noble-Jones says, she was
“a zombie.” She felt no grief, no joy, just “days of anger.”
2.
Her mother finally got her an appointment with JoAnn Difede, a post-traumatic stress
disorder expert at Cornell University’s Weill Medical College, who suggested virtual
reality (VR) therapy. Noble-Jones remembers scoffing, “I stopped playing video games
years ago.” But she went, and a few minutes into her first session, she was in tears. The
VR program took Noble-Jones into a virtual world that made her feel she was reliving the
events of 9/11. Where it showed her simulated buildings, she saw her bookstore and dry
cleaner; where it used humans, she saw a man and woman falling, holding hands. After
six sessions of successively more detailed scenes, a remarkable thing happened. NobleJones no longer showed symptoms of severe post-traumatic stress or depression.
3.
Welcome to a new kind of therapy, where cures are computer-generated. From New
York to Milan, virtual reality is being used to treat crippling phobias and soothe physical
and mental anguish. The therapy has even showed promise as a treatment for stubborn
conditions like eating disorders and addictions.
4.
In a typical VR experience, a helmet blocks out the real world and immerses the patient
in the sights and sounds of a computer-generated 3-D world. The helmet positions
goggle-size television screens close to each eye, enabling the patient to see a single
image with realism and depth. Headphones supply the sound; joysticks and gloves let
the patient manipulate the scene. This combined sensory input creates the illusion of
being in the virtual world.
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5.
The technology is so promising that the National Institute on drug abuse (NIDA) supports
16 VR research projects. “People are coming up with more and more clever ways of
using this,” says Dave Thomas, co-chair of NIDA’s virtual reality working group. “But
we’re just scratching the surface.”
6.
The visionary
behind this new therapy tool was a computer scientist from Georgia
Tech. In the early 1990s, Larry Hodges had an idea. He knew that the military had used
VR for years – introducing flight simulators, for instance, to help pilots nail a landing.
Maybe riding a simulated elevator could help acrophobics conquer their fear of heights.
7.
In 1993 Hodges teamed with Emory University’s Barbara Rothbaum, an expert in anxiety
disorders, to develop a VR program that made fear-of-heights patients feel they were
ascending in an open elevator or crossing a rope-and-ladder bridge over a canyon. The
pair weren’t sure whether they were “on the cutting edge or the lunatic fringe,” Rothbaum
says. But when their test subjects showed dramatically reduced fear of heights in the
real world, VR therapy was born.
8.
Researchers are still learning how VR works, but the basic principle is this: Experiences
in the virtual world allow patients to develop coping responses, which then serve them in
real life. With phobias, for instance, VR exposes patients to what they fear – like spiders
– until they learn to manage their anxiety.
9.
Jenny Moore was an Illinois high school senior in 1990 when, after years of jetting to
family vacations, she suddenly found herself panicked on a flight. “I promised myself I’d
never get on another plane,” she recalls. And for ten years, she didn’t. To avoid flying,
she chose a college close to home, and even insisted on a honeymoon within driving
distance when she married in 1997. After she and her husband moved to the
Washington, D.C., area, car trips with their baby to see Illinois relatives were nightmares.
Moore feared she’d never be able to take her daughter to Disney World.
10.
When standard counseling failed, Moore visited Maryland psychologist and VR
practitioner Keith Saylor in August 2000. At one time, Saylor would have taken Moore on
real airplanes to confront her fear directly. But airline flights are costly and inconvenient.
With VR therapy, though, Moore could be “on a jet” while sitting in Saylor’s office. The
digital simulation was of a familiar cabin view: aisle, overhead compartments, seats. To
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her left was a window view of the tarmac. Headphones delivered the hum of engines, a
flight attendant’s patter and the ka-chunk of cargo doors closing.
11.
The VR flight felt so real that Moore, weeping, asked to stop. But over the next month
and a half, her tolerance grew, until she “flew” calmly even through simulated storms. By
November, she was ready for the graduation flight – a real plane trip. Moore was
nervous as the jet door closed. But in-flight, she was fine. “I’m flying! I can’t believe it!”
she exclaimed. In the four years since, Moore has flown repeatedly – including that trip
to Disney World with her daughter.
12.
Moore’s success is backed by research. In a study comparing 14 fear-of-flying patients
who did VR therapy with 13 treated on real planes, VR did as well as the traditional
method: Within six months, all but one from each group were able to fly. Phobias like
fear of flying are fanned by environmental cues, says NIDA’s Dave Thomas. VR lets you
“control the cues in extremely slight ways.”
13.
This feature
makes VR a potential tool against addiction as well. Emory’s Rothbaum
has developed a “virtual crack house” that she hopes will help addicts practice resisting
people or things that make them want to use drugs. Similar programs might help
alcoholics and smokers.
14.
It’s not always realism that makes VR effective. There’s more fantasy than reality in
SnowWorld, a program developed by University of Washington psychologist Hunter
Hoffman. Visitors fly through an ice canyon of bluish crags, over an iceberg-dotted river
and past a frigid waterfall. They shoot snowballs at comic-book snowmen and feel the
thud of impact when the snowballs land.
15.
And sojourns in SnowWorld have provided relief for patients who are undergoing painful
medical procedures. Tacoma, Washington, plumber Mike Robinson, 37, was working on
a car in 2003 when its gas tank exploded, causing second-degree burns on his arms.
Despite doses of morphine, the daily wound cleansings “hurt like hell.” But when he used
SnowWorld during the treatment, he says, “I didn’t even feel it.” When patients are
engrossed in VR simulations, explains pain researcher Dave Patterson, they have “less
attention available to process pain signals.”
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16.
As Virtual Reality therapy begins its second decade, innovations crowd the horizon.
To assess students with ADHD, University of Southern California researcher Skip Rizzo
uses a “virtual classroom” that lets him manipulate distractions and gauge students’
reactions. VR may also help autistic kids improve social skills. One day patients may
have VR gear at home, for 24-7 access to cyber support groups that help them resist
alcohol or overeating.
17.
Few know better than Charlice Noble-Jones the promise that VR therapy holds. Once
her treatment for the shock of 9/11 ended, Noble-Jones’s life turned around in other
ways. She reconciled with the fiancé she had pushed away, married him and moved to
Georgia, where they’re running family businesses and raising a one-year-old son. NobleJones grants that there may always be “things that will draw me back” to 9/11 – a lowflying plane, perhaps, or an explosion in a movie. But thanks to VR therapy, she says, “I
don’t have to stay there.”
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Virtual Cures for Real-World Phobias