The treatment of personality disorders and phobias:

Larry Hodges and Exposure Therapy:

One individual working with virtual reality technology to treat some personality disorders and phobias is LARRY HODGES. He works out of Georgia Tech, his current projects include software and system support for building virtual environments, development and evaluation of three-dimensional human-computer interaction techniques, and building and studying applications of virtual reality to clinical psychology, education and visualization.

Hodges has also dealt with psychological disorder through controlled studies of virtual reality exposure therapy. His work was shown to be very effective in reducing acrophobic subjects with anxiety and avoidance of heights, and in improving attiutdes towards heights. Patients begin with less threatening situations and gradually work their way up a hierarchy of more anxiety producing situations. For example, if one patient is afraid of heights, therapy sessions might begin by looking through a third-floor window with therapist present...

Example of Hodges' work dealing with a fear of heights. The patient goes through a virtual elevator ride to condition him/her to the adjustment and sensations of the actual experience...Exposure therapy involves exposing the subject to anxiety producing stimuli while allowing the anxiety to attenuate. These stimuli are generated through a variety of modalities including imaginal (subject generates stimulus via imagination) and in vivo (subject is exposed to real situations).

Type of VR setup used: Immersion VR

Georgia Tech VR Page

Larry Hodges

In a similar fashion, if a patient suffering from depression discovers, through counseling, that his depression is rooted in a deep-seated lack of self-esteem, exercises and scenarios could be conducted by a therapist in the VR space, creating a sense of value and worth within the patient.VR therapy can provide for patients suffering from depression and who cannot possibly imagine their lives getting better...

*The only problem was that Hodges wasn't too impressed with my ideas for VR technology. In his reply by email, he writes...

"My major concern is that it is not clear what VR offers for this type of therapy that you could not do without VR. Since the technology is still costly, it must have a clear win in terms of time, convenience, effectiveness or safety before anyone would really use it."

*Despite having my battleship sunk, by a foremost authority on the subject, I decided to carry on with my research and proposal...

Dr. Max North

I also managed to contact another indivdual, working with patients from personality disorders, using VR technology as a tool. The main man working at this was Dr. Max North, and I had asked him if he felt that VR technology could be used to treat clinical depression...

Dr. North's Web Site

His reply was: "Yes! Virtual Reality can be used to treat almost all the psychological disorders!" Dr. North's approach to phobias and personality disorders makes an exact match for this proposal (No! I didn't copy off his ideas!). Use IMMERSION TYPE VR along with behavorial therapy in order to treat their patients...

Max and Sarah North, with Joseph Coble from Clarks Atlanta Virtual Technology Laboratory, have done a follow-up, in depth case study. A subject was asked to rank a list of acrophobic situations according to the degree of anxiety arousal. The subject was placed near a virtual bridge that crossed a river in the middle of a simulated town. The study consisted of one pre-test exposure and eight 15 to 28-minute sessions. The subject started at the least threatening situation and then progessed, under his own control, to the next level of arousal. An anxiety measurement was taken every two to five minutes. At one month post-treat, the subject was asked to complete an 11 point rating scale to measure the degree of phobic situations after the VR treatment...

How VR Technology Can Treat Depression:

* The issue with this proposal is what exactly causes depression? The answer can vary, the purpose of this proposal is not to have everyone come to a single agreement...

This proposal assumes that if the depression is caused by behavior or form of faulty thinking, then the VR technology could be used..

Example 1:

Behavior Therapy and Cognitive Approaches

Aaron T. Beck

Recently, some behavior therapists have begun to give more attention to the influence of thought on behavior. One American psychologist, AARON T. BECK, believed that depressed people tend to have negative conceptions of themselves, to interpret their experiences negatively, and to view the future with hopelessness. He sees these tendencies as basically a problem of faulty thinking. His treatment techniques, like strictly behaviorist approaches, are aimed at correcting the problem directly. Cognitive behavior therapy uses the behavioral approach to change beliefs and habits of thought that appear to be the source of the client's distress.

If the patient , for example suffers from a sense of low self-esteem and internalized shame. He or She feels "defective" as human being.

The feelings are often intensified because the patient feels "lonely" or is saddened by the lack of girlfriend/boyfriend. A patient can't seem to find someone to be intimate with. They feel flawed and undesirable, become depressed and find no answers for themselves.

The VR Technology can train them, learning to open up to people and form intimate relationships. Any exercise, interacting with a "virtual significant other" could remove the binding shame, and the patient gains a sense of self-worth thereby no longer feeling depressed...

Example 2:

Alfred Adler and Social Interest

An Excellent Use For VR Space

A patient doesn't know how to express his/her emotions, feeling lonely and depressed. A loss of ease with oneself, a feeling of inner emptiness, a state of not being at home with oneself, could be corrected with some VR tech exercises and scenarios. ALFRED ADLER, one of Sigmund Freud's students, believed that patients must find power and significance in their lives, and that is the quality called social interest. Social interest is the empathy and identification with other people. According to Adler, psychological disorders result from a faulty way of living, including mistaken opinions and goals and underdeveloped social interest. With the VR technology, the therapist's goal is to reeducate patients--to convince them of their errors and to encourage them to develop more social interest...

*Not just social interest only, but any personal interest as well. It may sound silly, yet if a patient enjoys taking walks in nature, then why shouldn't the technology be used to get the patient excited about doing something??

Example 3:

The Lessons from Child Psychotherapy

What talk is to adult therapy, play is to child therapy. The actual technique used is likely to involve play with clay, dolls, and other toys. The use of play as a means of communicating with a child...

A child plays with a dollhouse as the psychiatrist listens for clues that may reveal her difficulties in getting along with people among whom she lives. Likewise, the same concept can be performed for any patient suffering from depression by identifying life issues or problems in the VR space. Behavior therapists such as B.F. SKINNER, believed that these same learning principles can be used to correct troublesome behavior, so why can't VR technology be of any use?

If the source of the distress comes from an individual's job, a scenario in the vr space can be conducted to root out faulty thinking, changing habits and thought life. The patient can even design a scene from work showing the therapist the nature of his or her experiences at work or wherever...


Eric Fromm, Karen Horney, and Erik Erikson:

Same Goals And Objectives As VR Proposal:

Eric Fromm believed that the fundamental problem confronted by everyone is a sense of isolation deriving from separation. The goal of therapy and life, according to Fromm, is to orient oneself, establish roots, and find security by uniting with other people while remaining a separate individual. Horney believed that neurotic behavior blocks a person's inherent capacity for health and growth The job of the therapist was to disillusion the patient of such defense blockages, that is, to identify and clarify them. Helping the patient to mobilize innate constructive forces for change. Erikson was convinced that human beings are capable of growth throughout their lifetime. Guiding such chang is the patient's ego, which can acquire through therapy the basic trust and confidence needed for a healthy ego. The bottom line is that these ideas are used when treating patients for depression today. The secnarios and exercises designed to help, can be played out in the VR space. In the end, patients not needing medications can have their entire outlook on themselves and life reevaluated for the better...