Anxiety disorders: this peculiarity of the brain could revolutionize psychotherapy
The lecture hall is full. The patient’s pulse rises. Speaking in front of people scares her, she suffers from social phobia. But the audience is watching so kindly right now that the situation for the patient is stressful, but feasible. Because actually there is no lecture hall at all. The patient is standing in a room of only twelve square meters. On a screen, a therapist monitors your stress levels, he controls the situation. Virtual reality glasses put the patient in the dreaded situation.
The Paderborn-based start-up Psycurio develops such virtual worlds in which patients face their fears. “For our brain, it makes no difference whether I do something in the real or virtual world,” says founder Daniela Schumacher. When avatars move and behave like humans, the scenery feels real to patients, explains Thies Pfeiffer, who researches virtual reality and human-machine interaction at the Bielefeld Cluster of Excellence Cognitive Interaction Technology. The quality of the presentation is not so decisive. This peculiarity of the human brain could revolutionize psychotherapy.
Virtual reality is particularly suitable for the therapy of anxiety disorders. Therapists work classically with the so-called exposure therapy: the patient is gradually confronted with the dreaded situation and endures the fear until it subsides. At some point, the brain learns to cope with the situation.
Anxiety disorders are among the most common mental illnesses. “For the therapy of phobias, a therapist needs well-manageable, anxiety-provoking situations,” says Mathias Müller, Managing Director of VTplus, a virtual reality company based in Würzburg. Climbing a tower or experiencing a turbulent flight – this can also be done in the virtual world.
The specialist for psychiatry and psychotherapy, Peter Zwanzger, is researching these possibilities at the kbo-Inn-Salzlach-Klinikum in Wasserburg am Inn. Virtual reality therapy is not only more cost-effective and time-saving to implement than analog exposure therapy, but also more accessible for patients, says Zwanzger. The prospect of actually getting on a plane, touching a spider or speaking in front of a hundred people as part of a therapy deters many patients. These inhibition thresholds are lower in virtual reality therapy, Zwanzger has found in his studies.
Nevertheless, the breakthrough of the new method is long in coming. Both VTplus and Psycurio are currently negotiating with health insurance companies. Müller and Schumacher are convinced that if they were to cover the costs for the virtual reality therapy, the VR glasses could soon move into many practices. Peter Zwanzger is a little more reserved with forecasts: “Especially in medicine, desire and reality often diverge.” Technically, a lot is possible – what is therapeutically useful and practically applicable is another question. Although pilot studies would suggest the effectiveness of virtual reality therapy, there is still a lack of proper basic research with several hundred subjects.
As a member of a panel of experts, Zwanzger is working on the new guidelines for the therapy of anxiety disorders. Therapists can orient themselves on these so-called S3 guidelines – they give an overview of recognized medical procedures. The current version from 2014 advises virtual reality therapy for certain phobias, but only if a real confrontation is not feasible.
Mathias Müller would like to go further. According to his idea, experiencing the real situation is only the icing on the cake at the end of the therapy. Psycurio even relies on purely virtual therapy, always with human accompaniment. Founder Schumacher is convinced: “Virtual reality therapy enables a modern, very effective therapy that is less unpleasant for the patient.“
Peter Zwanzger agrees with her. But many things are still a dream of the future for him. “I believe that patients have a right to have the effectiveness of a therapy proven.“ That is why the new S3 guidelines will not contain an unlimited recommendation for this type of therapy – but at least an indication of a promising new technology.