With Virtual Reality against fear
A spider dangles from the door frame. Football-sized. Hairy. Disgusting. “Take a look down at your feet,” says psychotherapist Andreas Mühlberger. Ahhh. Another brown monster. Menacingly, it lifts its front legs, lets its mouth tool open and snap. “Take a step towards the animal,” the professor asks. For people with spider phobia, the purest horror. Even if you know that the eight-legged friends do not really exist, but were developed on the computer.
One in ten suffers from an anxiety disorder
Professor Andreas Mühlberger from the University of Regensburg helps patients overcome their phobias with high-tech. With a gamepad in his hands and the head-mounted display, a kind of 3D glasses, on his head, he sends them into virtual reality to confront them with their worst fears: the view into the depths, the start of the plane or a lecture in front of an audience.
“Those who manage to get into this situation and endure it will find that the fear subsides by itself and the feared catastrophe does not occur,” explains the leading scientist in this field. The success is amazing. After a few sessions, most patients are cured.
Research is under way worldwide on the use of VR technology in psychotherapy. So far, the so-called exposure therapy with Virtual Reality (VR) in Germany is only available to the general public in Bavaria: at the university outpatient clinics in Würzburg and Regensburg.
Too expensive the technology, too small still the offer of specific software. But in five years, the researcher is sure, it will find its way into practices across the board-and help millions of people. Because the need is enormous. Phobias are widespread, almost a common disease. According to the Robert Koch Institute, more than ten percent of the population suffers from a specific anxiety disorder.
Here you have a panic fear of a certain situation or object. “This can lead to people no longer using rooms in their house for fear of a spider or no longer going to the beer garden – so they are massively restricted in their lifestyle,” says Mühlberger.
Phobias can generally be overcome well. However, this often means great effort. With classical exposure therapy, the psychologist becomes a spider-catcher, has to climb narrow elevators with the patient or visit full department stores. “That’s why this happens far too rarely in everyday practice, purely for logistical reasons,” says Mühlberger.
According to him, this is exactly where the advantages of VR therapy lie. “It is much more effective and easier to carry out.”With technical progress, the scenario could not only be better adapted to the specific fear – for example, before the start of the aircraft turbines – in the future, but also repeated as often as desired. “In real life, however, it is difficult to climb seven different towers with the therapist,” says the professor, who is currently researching social phobias in particular.
Equally important is the acceptance of the advanced form of therapy. “Almost 80 percent would prefer them to the classic confrontation.”The idea of entering a virtual situation in a protected setting is easier and less stressful for many. Mühlberger is certain that if there were comprehensive options for VR therapy, more patients would decide on treatment much earlier.
And the areas of application of cyber glasses are not limited to fears. Addicts could go to a virtual bar and learn to withstand the pressure of alcohol, drugs or nicotine, people with social phobias in coffee house situations practice to approach others. Even pain is reduced with VR. At the School of Medicine at the University of Washington, patients with burns are sent to a kind of snow world. “This has a comparable effect as a treatment with morphine,” says Mühlberger, who is internationally networked. A great deal will still be done in the coming years.
Sensors of the VR glasses react to head movement
Nicole Vehring was treated in Regensburg. Trembling, shortness of breath, palpitations and the feeling of falling right into the depths: the fear of heights had the mother firmly under control for years. “I couldn’t even clean the windows in the attic of our house,” says the 40-year-old in retrospect. When her husband and the two sons climbed a viewing platform, the mother remained downright panicked. Until she made a virtual trip to the Bottroper Tetrahedron near her home with Andreas Mühlberg. And came back cured after just under two hours. Gondolas, suspension bridges, glass floors? “Are no longer a problem today,” says the woman from the Ruhr area.
She had great doubts in advance. “When I put the glasses on, it looked like a PC game. I was wondering if that would do any good.”However, when she approached the railing of the observation deck, fear sets in.
“The brain processes the situation exactly as it does in reality. Patients show behavioral inhibitions and physiological reactions. Even if the scenario does not seem completely deceptive,“ knows Mühlberger, who has been researching in this field for 20 years. This is made possible by the screen in the darkened headset. “Each eye sees a different image. Thus, depth perception is generated. The so-called stereoscopic vision.“
The sensors of the cyber glasses respond to any head movement, the patient has a 360-degree view and the feeling of moving freely in virtual space. This sometimes leads to side effects. “If the image is not tracked quickly enough, cybersickness occurs – it’s like a kind of motion sickness, but it can be managed well.”In order to trigger the emotional networks even better, the professor and his team try to appeal to all the senses. By a gust of wind, birdsong, smells.
It is important to choose a situation that the patient can cope with. “My task is to make sure that the patient stays there, consciously experiences the fear and notices how it goes away again-without me doing anything.”The worst fears do not occur-that is the decisive experience.
But how does panic fear occur in the first place? Mühlberger and his colleagues are trying to find out in preliminary discussions. “There are various theories for the causes,” says Mühlberger. Often phobias would develop early. Through model learning, for example, if the mother has a problem with tight spaces, the child watches this. An unpleasant experience with a dog or at the dentist can also be a trigger,“ explains the professor.
In the case of height and water, an innate fear is suspected, which must be unlearned in the course of development. “Children who have fallen from the tree are more likely to have no phobias,” says the 47-year-old. By the way, the fact that many are afraid of spiders or snakes is due to evolutionary biology. “It’s still stored in our brains that they could be toxic. That’s why hardly anyone is afraid of sockets, although you can get an electric shock there.“
At the end is the reality test
Even if the patients are struggling in virtual reality-no one can avoid the reality test. “Most of them are totally motivated to implement what they have learned. Confronting yourself again and again is important, otherwise the fear can become stronger again,“ Mühlberger knows.
Nicole Vehring has only one wish after her therapy: “I wanted to go to the real viewing platform.”She did it. “I had a tingling sensation in my stomach, but not from fear, but from happiness,” she says.