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Virtual Reality is a recognized tool for treating imbalances
One in four people experience some sort of mental health problem each year. The effectiveness of Virtual-reality programmes help to deal with the increased demand for treatment. Here's why.Share Tweet LinkedIn Embed pszr.co/KpjEM 256 views
|Health Technology > VR|
|Palo Alto, California|
|3 publishers interested|
"If we're going to radically increase the numbers of psychological treatments we're going to need technologies like VR." -clinical psychologist Dr. Daniel Freeman
Exploration of VR and anxiety treatments will lead the reader into a contemplation of the Gestalt of life and death. This book is a study which examines the use of Virtual Reality (VR) in therapeutic applications to remedy the negative side effects of fear of death (existential anxiety), neurosis and depression.
It is evident that VR can aid therapists, and more importantly aid so many more people to get the psychological advice they need.
In VR And Anxiety, Dorote Lucci, a therapeutic practitioner, researcher and meditation teacher, compares brainwave states of the individuals, or characters, in the book. A narrative is created based on interviews and personal observations, and then Lucci goes about analyzing patterns and personal action maps of the characters to give a larger view of social change in the age of high tech.
The intent of the study is to share these personal stories and insights through the lens of existential fears, their effect on lives, and the transformative potential that lies within every single personal journey of existential anxiety.
The story is that of a group of people who travel this road each in their own different ways. Their personal signatures, like fingerprints, will be their brainwave patterns collected with a muse headset. Their journey will be looked at through their experience of several juxtaposed experiences and brain states. There will be the comparison of the every day “normal’ state brain wave, the meditation state, StarflightVR (created by the author) to destress and relax, and a VR experience that duplicates the sympathetic brain response.
An interview-based on a set of questions that is part of a comparative study of diverse epistemologies on death and the afterlife (Schlitz, 2007). There will be a free flow format of story telling as well.
Ultimately a picture of personal and social transformation will emerge that will be analyzed in one chapter. The context of the transformation will be through the effects of new technologies like VR, and the finger print of brainwaves and the conversation around life/death and existential fears.
The conclusion will feature the comparison and integration between every character’s brainwaves, story, poem and photo collage.
Book format: There will be a chapter dedicated to all the major characters individually. There will also be 5 interpretive chapters in which the characters will be grouped together depending on their responses and their brain wave patterns. There will a poem for each character and a collage as well.
Ultimately a picture of personal and social transformation will emerge towards the end of the book, and this will be analyzed in two chapters. The context of the transformation will be examined through the effects of new technologies like VR, and the “finger print” of brainwaves relating to the conversation around life/death and the existential fears that arise.
The book is an amalgamation of personal stories seen through the lens of existential fears. It is deeply personal and yet reflective of the social movements and existential fears of our time. What are the personal stories around the fear of death, how are they reflected in current social movements and how are innovative technologies equipped to be tools of personal and social transformation in this age of digital tech.
We interiorize the culture we are born in from the early age (intersubjective), and are ourselves exteriorized into the social and political system that is a predetermined (interobjective) context; we have to adjust to those or risk being marginalized. How does the relationship with the fear of death/existential anxieties relate to our culturally based social image? Do we change the societal framework by confronting or facing our deepest personal fears? Can tools like VR or AR help us to find peace? Can we use these digital tools to build intimacy with ourselves and with others? These are questions that are of fundamental interest at the present moment in time when political turmoil and polarization are a product of deep rooted transformative processes taking place.
Target reader(s), groups: men and women of all ages primarily since this work is targeted to integrate objective analysis with the more intuitive and personal flavors of life stories.
This book serves as a story board or a tool for patients or people with GAD, OCD, SAD, PDA, PTSD, and other anxiety-related disorders.
In addition to programmes being developed by clinical psychologist Dr Daniel Freeman, who says there's "something beautiful" about how VR works, findings show that patients report satisfaction with VR-based therapy and may find it more acceptable than traditional approaches.
An early study on VRE for patients with posttraumatic stress disorder (PTSD) due to motor vehicle crashes demonstrated that patients reported very high satisfaction with VRE.16 In a sample of 150 patients with specific phobias, the refusal rate for VR exposure (3%) was lower than for in vivo exposure (27%),17 providing preliminary evidence that VR-based exposure may be more acceptable to patients.
One study in a PTSD sample found equivalent satisfaction between VRE and imaginal exposure,18 while another found increased satisfaction for VRE.19 In a sample of 352 post-9/11 US soldiers, the majority reported that they would be willing to use most of the technology-based approaches for mental health care included in the survey (e.g., VR). Additionally, 19% of those who reported that they would not be willing to talk to a counselor in person reported being willing to use VR approaches to access mental health care, suggesting VR may potentially address some barriers to treatment.
Generalized anxiety disorder (GAD) is a condition in which the patient experiences persistent, excessive, and intrusive worrying to the extent that daily functioning becomes difficult.
Small-scale RCT (n = 20) studies using VR in conjunction with biofeedback for patients to practice relaxation exercises during treatment. Patients were randomly assigned to VR with biofeedback, VR without biofeedback, or wait-list control condition. Although the study did not have enough power to examine between group differences, it provides preliminary support for the feasibility of using VR for patients with GAD. Thus far, this study has been the only one to examine the use of VR in treating GAD.
The dearth of studies may be due to the difficulty associated with creating standardized VR scenarios that are able to capture the numerous, varying, individualized worries of patients with GAD. Given this complication, VR-based treatment programs could focus on some of the more common worries among patients with GAD (e.g., health anxiety, something happening to a loved one). Alternatively, or if a patient’s worries are not readily addressable with such scenarios, VR-based treatment could serve as a visual guide for breathing exercises and for practicing relaxation or mindfulness-based approaches. https://www.e-mence.org/sites/...
Dorote Lucci is a researcher in the field of psychology. She has a private practice where she teaches meditation, and uses other psychophysical and psychospiritual methodologies to help clients manage and heal their anxiety, depression and chronic stress symptoms. She utilizes the mobile VR apps that she creates as therapeutic tools to facilitate mental health and balance. She also facilitates workshops, gives presentations and talks. Having noticed a need in her clients for gentle support in addition to therapy and healing work she had co founded Embodied Inc in 2014.
The first app for reprogramming habit patterns was called Worry Bubble (Apple app store) and was born in the same year. In 2015 she created Corereboot and brought out StarflightVR, a mobile Virtual Reality experience to support deep and lasting habit change. FlowforbreathVR the next VR experience she created supports meditative breath training and its benefits fro stress relief and mental health. Both apps focus on a gentle, non invasive and intuitive approach to transformation and habit change.
Her background includes complementary medicine practices, interpersonal neurobiology, a Master of Clinical Hypnosis, spiritual practices and psychology as well as a Master in International Management. She currently is doing her PhD in Psychology and researches the most efficacious links for holistic transformation and habit change. She loves the connection between neuroplasticity, human behavior and the possibilities available for us to permanently change our patterning and habits through somatic and visual experiences. She is fluent in English, German, French and Spanish. She believes in the healing rhythms of poetry and the power of neuroaesthetics. She blogs for the Huffington Post.
In addition to a Masters in International Management she has a Bachelor’s degree in history and world literature. This provides her with an understanding of basic human behavior patterns and an eye for technology for good. Additionally she has studied more than a dozen different complementary healing modalities, receiving certifications. She applies the knowledge from these certifications such as complementary concepts of neuroplasticity and Body Psychology, with coaching and envisioning therapy to improve personal and relationship integration.
Past speaking engagements: Science and Nonduality Conference, Augmented World Expo, Digital Reign society @ ESALEN, The Association for Contemplative Mind in Higher Education Conference, VR Arcade Conference
Future speaking engagements so far: International Symposium for Contemplative Research (ISCR), Science and Nonduality Conference
Social media following:
FB- 794 and 391
Twitter- 369 and 144
Huffington Post articles
Books and papers that have inspired me-
An inquiry into the impact of VR on intimacy “Future Presence” by Peter Rubin
The background story to VR by “Experience on Demand” by Jeremy Bailenson
The Trauma of Everyday Life by Mark Epstein MD
Research study, book and movie on death and existential fears- Death makes Life possible by Dr. Marilyn Schlitz -Schlitz, M. (2015). Death makes life possible: Revolutionary insights on living, dying, and the continuation of consciousness. Boulder, CO: Sounds True.
Josipovic, Z. (2016). Love and compassion meditation: A nondual perspective. Annals of the New York Academy of Sciences.
Damasio, Antonio (2010-11-08T22:58:59). Self Comes to Mind: Constructing the Conscious Brain (Kindle Locations 470-473). Knopf Doubleday Publishing Group. Kindle Edition.
Barrett, Lisa Feldman (2017-03-06T22:58:59). How Emotions Are Made: The Secret Life of the Brain (Kindle Locations 540-542). Houghton Mifflin Harcourt. Kindle Edition.
Almaas, A. H. (1986). The Void: Inner Spaciousness and Ego Structure. Boulder, Colorado: Shambhala Publishing.
Schlitz, M, Vieten, C. and Amorok, T. (2007). Living Deeply: The Art and Science of Transformation in Everyday Life. Berkeley: New Harbinger.
Since Virtual Relaity has been a recognized tool in treating certain mental health imbalances such as PTSD, this study examines its further potential as a supportive tool for existential anxiety and fear of death. Within existential psychotherapy, CBT and Terror Management Theory fear of death or existential anxiety is deemed to be at the root of neuroses and fears. Long term anxiety is correlated with a tendency towards depression as well (Jacobson and Newman, 2017, Sapolsky, 2001). In the study different psychophysiological states were examined. Two were induced by Virtual Reality and one by meditation. From the results it seems that VR could be useful to address existential anxieties and depression, but further research needs to be conducted.
A. Virtual Reality is a recognized tool for treating imbalances
Virtual Reality has been used in a myriad of psychotherapeutic applications successfully. It also has a long history of use for Post Traumatic Stress Disorder (PTSD) as a tool within exposure therapy (Cukor J. et al., 2015).
The elements that make VR so compelling in the mental health arena are:
The ability to generate a relaxing experience that stimulates the senses while it integrates with the polyvagal system (Porges, 2011). Therefore, it can help to provide a deep sense of muscle relaxation. This in turn facilitates autonomous stress regulation. Integrating aspects of phenomenology may well provide a myriad of additional psychophysiological possibilities that need to be further researched.
A. Fear of death/existential anxiety is considered to be a basis for anxiety and depression in existential psychotherapy, CBT and Terror Management Theory.
At its core, the existential perspective has the belief that dread is the basis of human emotional life. It proposes that it is the fear of death that motivates our reality, and is the core of human experience, which results in existential anxiety. This in turn sets up a filter to create a specific experience of reality. However, these processes are typically nonconscious.
Nonconscious fear processes cannot not be approached in the same manner as conscious fear processes (LeDoux, 2014) and may need a different approach to uncontrolled fear states. Existential Psychotherapy focuses specifically on this area (Yalom, 2009). Fear of death is considered to be at the basis of nonconscious, uncontrolled fear states (Lewis, 2014, Beck & Weisshaar, 1995, Ottens & Hanna, 1998).
A. Existential Perspective
The existential psychotherapist and writer Yalom (1980) outlines what he considers to be the ultimate concerns of humankind: 1) Death, 2) Isolation, 3) Meaninglessness, and 4) Freedom. As a psychotherapist, Yalom is primarily interested in how these existential concerns inform the therapeutic process. He believes that our psychological difficulties stem from an inability to reconcile ourselves with these existential concerns. Thus, his sessions include a thorough examination of the way every individual accommodates these concerns. Yalom believes that the liberation of suffering and sorrow would occur once the client has made peace with their circumstances.
According to psychodynamic theory, Yalom’s view represents the specific tension of dual instincts of ego and libidinal instincts (Greenberg, 1983, Kindle location 98). The demands of the external and internal environments are the birthplace of the superego. This is the force that manages interpersonal demands and the need of the child for approval from their security-providing adults. Failure to find balance may freeze life enhancing movement forward that resides in the libido. It seems that the character structure rests in part on the role of the super ego. The super ego manages the safekeeping of its owner. According to Greenberg (1983), “Growth is always compromised for the sake of security” (Kindle Location 107). Therefore freezing, whether it be muscles themselves or the lack of movement that comes from a suppressed libido, could easily lead to frozen expressions, frozen muscles, and frozen facial traits. In other words, the frozenness itself becomes a “being”, blocking movement forward as growth is compromised for security. Greenberg (1983) says, “In Freud’s revised view, meaning is determined by the ebbs and flows and, a complex interplay of life and death instincts” (Kindle Locations 552-553).
In the end, Yalom (2009) provides a solution to the existential psychologists’ dilemma: “A denial of death at any level is a denial of one’s basic nature and begets an increasingly pervasive restriction of awareness and experience. The integration of the idea of death saves us; rather than sentence us to existences of terror or bleak pessimism, it acts as a catalyst to plunge us into more authentic life modes, and it enhances our pleasure in the living of life.” (Kindle Locations 89-91).
This causes stress, anxiety and possibly depression in the individuals experiencing “death denial”. The physiological effects of this should become measurable because stress stimulates the sympathetic nervous system while inhibiting the Vagus Nerve (Porges, 1995; Sahar et al., 2001). Therefore, typical stress related brain wave patterns could be analyzed to understand the effects of the fear of death, relaxation and VR as a psychotherapeutic tool.
A. VR may provide an compelling modality to treat anxiety and depression based on existential fears/fear of death
VR may well prove to be a major mental health tool in the future. Immersive virtual environments technology has already been used in therapy for phobias (Côté and Bouchard, 2008, Wiederhold, Jang, Gevirtz, Kim, Kim, and Wiederhold MD, 2002), stress (Bouchard, Baus, Bernier, and McCreary, 2010, Riva, Raspelli , Algeri, Pallavicini, Gorini, Wiederhold and Gaggioli 2006, Villani, Preziosa, and Riva, 2006), anxiety (Harris, Kemmerling, and North, 2002, Repetto and Riva, 2011), exercising (Bryanton, Bossé, Brien, Mclean, McCormick, & Sveistrup, 2006), and memory problems (Brooks BM and Rose FD, 2003, Klinger, Chemin, Lebreton and Marié, 2006). Additionally, the effects of VR on anxiety symptoms has been examined as well. In their study Gorini, Pallavicini, Algeri, Repetto, Gaggioli, and Riva (2010) reached the conclusion that VR for relaxation represents a promising approach in the treatment of General Anxiety Disorder (GAD). This is because VR enhances the quality of the relaxation experience through the elicitation of the sense of the sense of presence generated within the immersive experiences. These types of studies underline the fact that clinical cases such as GAD can also benefit from the VR treatments.
The elements that make VR so compelling in the mental health arena are the ability to generate a relaxing experience that stimulates the senses while it integrates with the polyvagal system (Porges, 2011). Therefore, it can help to provide a deep sense of relaxation and give patients the ability to build their vagal muscle. This in turn facilitates autonomous stress regulation. Integrating aspects of phenomenology may well provide additional psychophysiological possibilities that need to be further researched in this context.
The use of VR to facilitate the relaxation process, in this case the visual presentation of a virtual calm, helps facilitate patients' practice and their proficiency in relaxation. VR facilitates a more vivid relaxation experience than the one most subjects can create using their own imagination and memory. VR triggers a broad empowerment process, especially if used daily, although daily use is not part of this study.
A high sense of presence induces an embodied relaxation response. In this study we use of the VR mobile application StarflightVR, which provides the relaxation experience. In a past research project, 20 subjects who were suffering from anxiety symptoms were asked to use the application daily for six weeks. The response was positive. The study showed a significant change in immediate anxiety and a significant change in depression patterns over the long term. Daily usage showed this VR methodology to effective. Although there is also evidence of this positive use of VR Rizzo (2010) for example, further research needs to be done in this area.
Anxiety and depression seem to be correlated (Jacobson and Newman, 2017). Influencing one appears to influence the other. According to Sapolsky (2001), there is a correlation between chronic stress and anxiety that has been shown to contribute to patterns that lead to depression. In turn the affective and cognitive symptoms of depression influence the physiology of the brain. Sapolsky (2001) points to a change in the hippocampus that is both morphological and functional. The Hippocampus is crucial to memory and learning. As Rizzo (2017) explains, “Regardless of the technical approach, the key aim of these immersive systems is to perceptually replace the outside world with the virtual world to psychologically engage users with simulated digital content designed to create a specific user experience.”
A. Description of Experiment
The purpose of this research is to assess the degree to which there is an impact on brain activity on the sensory awareness of death and the effect of mobile VR to remedy possible mental imbalances resulting from death awareness/existential anxiety. All participants will be exposed to the experience of meditation, DeathVR (Jurassic Park), and RelaxVR (StarflightVR).
A. Group 1)
Participants will have their brainwaves measured, this will be used as a baseline.
Participants will be introduced to a brief meditation session while measuring brainwaves.
A. Group 2)
Participants will have their brainwaves measured, this will be used as a baseline.
Participants will be exposed to a calming mobile Virtual Reality experience (StarflightVR) and brain activity will be measured.
A. Group 3)
Participants will have their brainwaves measured, this will be used as a baseline.
Participants will be exposed to the VR experience Jurassic Park, which is an experience that is meant to stimulate the fear of death.
These experiments will be conducted using a GEARVR headset VR system and the VR mobile application StarflightVR and Jurassic Park VR. Participants wear a lightweight headset that displays a stereoscopic (3D), immersive environment provided by StarflightVR.
A. Subjects’ selection
In this research project, we propose to record the brain activity of 9 participants to establish brainwave differences for a meditative state, a VR fear of death experience, and a VR induced meditative state. We will randomly select subjects by asking possible participants. The subjects will at least be 18 years of age.
A. Experimental protocol
EEG data will be collected for a baseline measurement as subjects are in a natural state of attention looking straight ahead. EEG data will be collected during the meditation, which consists of focusing on the breath while eyes are closed. EEG data will be collected during both the DeathVR (Jurassic Park) and the RelaxVR (StarflightVR). The order is as follows: Baseline, Meditation, DeathVR and RelaxVR.
A. Psychometric measures
Brainwave changes will be measured for the meditation, the VR relaxation experience state and the VR death fear state.
DeathVR measurements were inconclusive using EEG analysis due to the nature of the sympathetic NS response which includes vast physiological fluctuations that are then removed in the filtering process of the data. Further investigation is necessary to understand the nature of the response to a perceived threat, maybe using HRV or breath analysis through sensors (eg. Spire, Heartmath, etc)
The response to meditation was in range with already existing research in the field (Brabosz,et al, 2010). It showed a significant increase of brainwave activity in the lower ranges, from theta to beta. Since most participants were subjects with a meditation practice, it is also necessary to collect further data from non-meditators. There was only one subject who was a non-meditator.
Fig. 1. Baseline vs. meditation
The response to the RelaxVR category was ranked significant for several lower brainwaves. From theta to beta and alpha as well. This is in line with the data collected for the meditation category. The meditation category showed more significance in the lower ranges, again possibly due to the fact that the subjects could attain a meditative state on their own. When compared the state of meditation vs RelaxVR showed no significant statistical difference.
Fig. 2. Baseline vs RelaxVR
Fig. 3. baseline vs RelaxVR - AF8
Fig. 4. Baseline vs RelaxVR - TP10
Fig. 5. Meditation vs RelaxVR
When comparing all categories: meditation, RelaxVR and DeathVR there was significant difference across the board. Possibly showing that the states were vastly different in all brainwave ranges.
Further research needs to be undertaken in the area of Virtual Reality’s possibilities for alleviating symptoms from fear of death, anxiety and neurosis. However, it was noticed that the subject with no meditation experience reacted very positively to the VR option and that the brainwaves showed a picture of relaxation, vs the data gathered from the meditation portion were there was a significant increase in higher range brainwave activity. Two further subjects with less meditation experience also showed this same picture, albeit not as drastic. This suggests that, in this case, VR may be more interesting as a mental health tool for the fear of death with non-meditators.
Meditators it seems will still benefit from the VR application but can reach deeper levels of meditation without the VR. Additional research needs to be conducted to determine how the level of meditation practice affects the effectiveness of VR as a mental health tool for fear of death/existential fears and depression.
Bouchard S, Baus O, Bernier F, & McCreary R (2010) Selection of Key Stressors to Develop Virtual Environments for Practicing Stress Management Skills with Military Personnel Prior to Deplyoment. Cyberpsychology and Behavior. 13(1): 83-94.
Beck, A.T., Weishaar M.E. (1995). Cognitive therapy. R.J. Corsini, D. Wedding (Eds.), Current psychotherapies, Peacock, Itasca, IL, pp. 229-261
Braboszcz, C., Hahusseau, S., Delorme, A. (2010) Meditation and Neuroscience: from basic research to clinical practice. In “Integrative Clinical Psychology, Psychiatry and Behavioral Medicine: Perspectives, Practices and Research”. Editor: R. Carlstedt. Springer Publishing.
Brooks BM & Rose FD (2003) The use of virtual reality in memory rehabilitation: Current findings and future directions. NeuroRehabilitation. 18(2): 147-157.
Bryanton C, Bossé J, Brien M, Mclean J, McCormick A, & Sveistrup H (2006) Feasibility, Motivation, and Selective Motor Control: Virtual Reality Compared to Conventional Home Exercise in Children with Cerebral Palsy. CyberPsychology & Behavior. 9(2): 123- 128.
Côté S & Bouchard S (2008) Virtual Reality Exposure for Phobias: A Critical Review. Journalof CyberTherapy and Rehabilitation. 1(1): 75-91.
Cukor J. et al. (2015) Virtual Reality Exposure Therapy for Combat-Related PTSD. In: Ritchie E. (eds) Posttraumatic Stress Disorder and Related Diseases in Combat Veterans. Springer Publishing.
Dryman, M. T., McTeague, L. M., Olino, T. M., & Heimberg, R. G. (2017). Evaluation of an Open-Access CBT-Based Internet Program for Social Anxiety: Patterns of Use, Retention, and Outcomes. Journal of Consulting and Clinical Psychology. Advance online publication. http://dx.doi.org/10.1037/ccp0...
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Rizzo, A., Difede, J., Rothbaum, B. O., Reger, G., Spitalnick,J., Cukor, J., & Mclay, R. (2010). Development and early evaluation of the Virtual Iraq/Afghanistan exposure therapy system for combat-related PTSD. Annals of theNew York Academy of Sciences (NYAS) 1208, 114–125.doi:10.1111/j.)1749-6632.2010.05755.x
Rizzo A.A. & Shilling R. (2017). Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD. European Journal of Psychotraumatology, 8:sup5, 1414560, DOI: 10.1080/20008198.2017.1414560. Published by InformaUK Limited.
Sapolsky, R. M. (2001). Depression, antidepressants, and the shrinking hippocampus. Proceedings of the National Academy of Sciences of the United States of America, 98(22), 12320–12322. http://doi.org/10.1073/pnas.231475998
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Villani D, Preziosa A, & Riva G (2006). Coping with stress using Virtual Reality: a new perspective. Annual Review of Cybertherapy and telemedicine. 4: 25-32.
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