Fear factor: Study shows virtual reality can cure phobias

Patients repeatedly exposed to images of things like spiders, airplanes and needles were able to overcome their fears.

A clinical trial has found virtual reality technology – or VR – can be a very effective treatment for some of the world's worst phobias.

The study at the University of Otago campus in Christchurch repeatedly exposed patients to images associated with their worst fears, including spiders, dogs, needles, heights and flying. Many were able to overcome their phobias for the first time.

Participants wore a VR headset designed to fully immerse the user in another world, and were gradually exposed to what they were afraid of.

The trial was led by Associate Professor Cameron Lacey, who described the results as “really heart-warming”. They recorded a 75% decrease in phobia symptoms across the 129 participants.

“We deliberately selected people with [the] severity of fear that could be classified as a specific phobia, and these are conditions that profoundly affect people's lives,” he said.

VR image of spider.

“I was thrilled and to some degree surprised at just how significant the effect was for a group of people.”

The technology has been devolved by Christchurch entrepreneur Adam Hutchinson and operates under the name oVRcome. The company uses a low-cost headset that runs from a smartphone and offers an app to go alongside.

Hutchinson hoped the trial results would encourage others to tackle their phobias.

“It just means that people know that when they go down this pathway, of using oVRcome, that there's going to be a really good chance at success for them,” he said.

“Recently there was a report that came out in the US, and it shows that 86% of mental health apps have no form of clinical evidence behind them, and we really didn't want to be in that.”

The key to the success was the “immersiveness” of the technology, he said. The VR made the experience far more compelling than watching a video or looking at a picture online.

“For the treatment to work, your brain has to know that it's in this environment, and over time you become desensitised,” he said.

“By looking at images or by watching a video, your brain understands that you're not in that environment. So, by using virtual reality, we're able to trick and manipulate the brain into thinking that it is in this environment and therefore the treatment is effective.”

VR image of needles.

‘After watching it, my brain rationalised it’

One of the participants of the trial was Auckland woman Julie Raine, who had an extreme phobia of needles.

She decided to take part after years of difficulty with procedures like blood tests and injections.

“I'd have the injection, but I'd just burst into tears, I'd have a full day off work just to get over the whole anxiety of it,” she said.

“Even talking about giving blood, even if I saw a sign that there was a blood donor, I just couldn’t go near the building.”

The VR was very overwhelming at first, with Raine facing her worst fear.

“I remember the first one just being a VR with the doctor unwrapping [things]. Not even a needle inside, just unwrapping all the bits and pieces, and I could not watch it. It took me 15 goes to try and watch it,” she said.

“I really had to say to myself, ‘you're okay, I'm at home, I'm on my sofa, so no harm can be done’, and eventually once I got over the first hurdle of watching, then it was fine afterwards.”

The impact was significant and, after a few weeks, she had a mindset change.

“I suddenly realised I'd never watched anybody have a needle before until I'd watched the VR,” she said.

“I realised that actually the nurses and the doctors are there to help, actually, oh, ‘it didn't hurt’, oh, ‘it didn't look that bad’. The whole procedure - after watching it - my brain rationalised it.”

Her symptoms were now nearly non-existent, and she even was able to get the Covid-19 vaccination.

“I didn't think about it the night before, I just slept as normal, I got up in the morning, I was quite excited,” Raine said.

“I think back now how I was, and I can't imagine being like that now, it's really made a huge difference.”

VR image of flying.

New trial underway for social anxiety

With this trial complete, the University of Otago in Christchurch is now considering the wider implications of the technology.

Associate Professor Lacey says it could be used as part of formalised treatment by psychologists and therapists as they treat phobias.

“In future, I hope it will be picked up by health services, and be used as the first step in a stepped care model of service delivery,” he said.

“It's done in the comfort of your own home, it's much easier to access than the wait list we're currently experiencing in mental health services to see therapists, so I would encourage everyone to give it a go.”

oVRcome Founder Adam Hutchinson says there will now be a second trial, through their research partners at the University of Otago, to assess whether VR can help other kinds of anxiety.

“We're actually now starting a clinical trial for social anxiety, so this is where people struggle going out into social environments,” he said.

“We're now moving into a programme for depression, substance abuse, eating disorder, panic disorder and performance anxiety as well.”

Participants can sign up on the oVRcome website by clicking here.

The possibilities are enormous, for the brave new world ahead.

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