XR and Mental Health: In Conversation with a New World Enthusiast
Jeemoni Lahkar
Suriya Palaniswami
It was Dionysius of Sicily who first demonstrated to Damocles that with great fortune and power also comes great danger (and not Uncle Ben). Henceforth, the story was known as the sword of Damocles. However, in the tech world ‘Sword of Damocles’ has a completely different meaning. It is a mechanical tracking system created in 1968 and widely considered as the first Augmented Reality System. In 1935, Pygmalion’s Spectacles written by science fiction writer Stanley Weinbaum wrote about a character who explores the world wearing a pair of goggles – the first prediction of Virtual Reality as we know it today.
Extended Reality which is the term used to encompass Virtual Reality, Augmented Reality and Mixed Reality has come a long way since then. In recent years, the usefulness of these technologies in mental health has been extensively studied and a number of applications have also been made. There is a growing interest in extended reality environments to create experimental narratives in a user-controlled platform. Lindner et al discusses how traditional Cognitive Behavioral Therapy techniques can be converted into VR experiences. Previously, extended reality techniques have been used to treat phobias and anxiety issues. Other than olfactory and gustatory senses, VR experiences can stimulate all the other senses of sight, sound, and touch. Thus, Virtual Reality Exposure Therapy (VRET), as it is called, can provide a more personalized, gradual, and controlled immersive experience for the user that can be implemented by the therapist.
Various studies especially in the case of anxiety disorders and Post Traumatic Stress Disorder (PTSD) have confirmed that these technologies have immense potential to make an impact on treatment strategies and on public mental health. In one meta-analysis comparing VRET with that of classical evidence-based treatments, it was found that the post-treatment results show similar efficacy between the two but VRET does better in waitlist control. (1) In a meta-analysis done by Powers and Emmelkamp, it was found that in-vivo exposure was not significantly more effective than VR exposure therapy and there was even a small effect size favoring VRET over in vivo exposure. (2)
In this article, we talk with Suriya Palaniswami, XR Developer about the implications of these new technologies in clinical practices.
- In recent years XR is finally getting mainstream publicity and is also being used in a number of sectors including mental health. What are your thoughts on this?
In a lot of countries, XR has already started to make its mark in the healthcare space. One example is the VR based therapy for people in the autism spectrum and for people suffering from ADHD. Since VR can create virtual stimuli to mimic real world stimuli and recreate scenarios with a high level of realism, it can be used as a virtual environment for people on the autism spectrum. There is a US company called XRHealth which is providing VR based therapy for Depression, Anxiety, pain management, and post-covid rehab. Another major advantage is that treatment strategies are personalized for the patient. Then there is Floreo, co-founded by Vijay Ravindran who himself has a child who is autistic. Floreo aims to bring together Virtual Reality with therapeutic content designed for parents, teachers and health care specialists. Basically, we are looking towards combining treatment methods with these technologies to make them more patient-oriented.
- With one of the largest social media giants ‘Facebook’ announcing that they are aiming for a more ‘immersive’ experience, how do you think it will affect the user?
For the first time, I think technology has the capability to deliver empathy which is a very humane and personal quality. Whenever any product is being sold or presented to us with the promise that we empathize with the user, it is always as a byproduct. But in AR and VR, empathy is one of the core values of the experience as it is a simulation of reality. It is taking the expression ‘walk a mile in my shoes’ literally. In a study done a few months ago with more than 5000 participants, it was found that VR improves the user’s emotional empathy although not their cognitive empathy. (3)
Director of Stanford University’s Virtual Human Interaction Lab, Jeremy Bailenson has been working on a project called “Empathy at Scale” that develops ways to design, and test virtual reality projects to teach empathy. (4)
The technology, which can be described as being at an adolescent stage, is at a crossroad with respect to the effects it can have on the public and their mental health. Because it is a very new and unique development it makes it difficult to predict the effects it can have on the general population. Like any other thing in existence, there will surely be negative impacts. The accessibility and ease-of-use of technology will drastically increase in the next 5 to 10 years or maybe even less. Our screens will transition from our phones and our laptops to glasses which we wear all the time which will impact our already shortened attention spans. We will be bombarded with information from all around the world and about all things just in front of our eyes. More research will need to be done in the coming years for us to get a clearer image on how these all developments will affect our mental well-being.
- Anything more you would like to add.
There was a documentary ‘Meeting You’ that was aired on South Korean TV Broadcaster MBC in 2020 about a seven-year-old girl Nayeon’s final goodbye to her mother. The girl who suffered from a life-threatening disease and passed away in the hospital. South Korean startup Vive Studios recreated a virtual experience for the mother to meet her daughter one last time. We can’t really say whether such experiences are helpful for the bereaved family to cope with such a tremendous loss but it does raise a number of questions on the fundamental questions of life.
In conclusion, we are at an unprecedented era in the history of humanity with regards to new technological developments. XR technology also raises a host of ethical concerns that need to be addressed. Brey raised the concern of engaging in immoral acts (e.g., pedophilia) in a virtual environment which could cause psychological harm to other people who have been victim of abuse and trauma. (5) Then there are other ethical aspects which include data sharing, privacy, and misuse of personal data. These ethical issues may also aggravate as the technology continues to reach greater levels. VR implemented along with traditional treatment methods can help us create more effective and personalized treatment strategies.