Category: Mental health

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Scary monsters: how virtual reality could help people cope with anxiety

Guardian science correspondent is put to the test in the panic-inducing VR world of a game that teaches breathing technique

Tethered to a chair, in a gloomy basement, I’m doing my best not to panic – by breathing in for four seconds, holding for seven, and slowly releasing for eight. But when a bloodthirsty monster appears at my feet and starts crawling towards me, I don’t need a dial to tell me that my heart is pounding, and I’m in imminent mortal danger.

Welcome to the future of anxiety treatment: a virtual reality (VR) game that teaches you a breathing technique to help calm your nerves, and then pits you against a monstrous humanoid that wants to eat you, to practise deploying it in genuinely panic-inducing situations.

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Greenery and bright colours in cities can boost morale – study

Researchers in France used virtual reality to test the impact of tweaks made to urban settings

Having bright colours and greenery in our cities can make people happier and calmer, according to an unusual experiment involving virtual reality headsets.

A team of researchers at the University of Lille, in France, used VR to test how volunteers reacted to variations of a minimalist concrete, glass and metal urban landscape. The 36 participants walked on the spot in a laboratory wearing a VR headset with eye trackers, and researchers tweaked their surroundings, adding combinations of vegetation, as well as bright yellow and pink colours, and contrasting, angular patterns on the path.

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The technical tunes getting elderly Nigerians up and digitally dancing

People living in a Lagos care home are enjoying a break in routine with a virtual mix of therapy and entertainment delivered via headset

In the living room of the Regina Mundi care home in Lagos, 70-year-old Baba Raphael hauls himself up from his chair and puts on a virtual reality headset. For nine minutes, Raphael dances to the folksy tones of his favourite singer, the late Ayinla Omowura, while watching a music video.

“Are you enjoying it?” one of the staff asks Raphael. He doesn’t answer, oblivious as he sings along.

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Releasing the Grip of Grief with Games

I don’t like the hyperbole of saying that videogames saved my life, but it tracks true. Nowadays so many people say similar; ‘this song saved my life’, ‘this book rescued me from the edge’. Videogames did a lot for keeping me alive in a very dark period of my life. If it wasn’t for games, and to a lesser extent, writing about them, there’s a strong chance I wouldn’t be sitting here now, telling this story about how I used gaming to deal with the grief of bereavement. 

In 2007, my three-year old daughter Amelia was a passenger in a road traffic accident. The car was T-Boned on her side of the vehicle. Amelia suffered severe brain damage, was rushed from Essex to London’s Great Ormond Street Hospital, where she spent five days in intensive care, had two bouts of brain surgery and several blood transfusions. She died on February 8th 2007 after it was revealed she was brain dead. We removed life support. My world collapsed. Everything went dark.

The following months, probably years, were spent in a trance. I wasn’t sure what I needed to do, or even what I wanted to do. I reached out to my gaming buddies I’d met online, looking for a distraction; we played Crackdown and Rainbow Six: Las Vegas on Xbox 360. I wasn’t finding joy anymore though. Perfect runs through Terrorist mode of Rainbow Six didn’t please me, the beta of Halo 3 brought a small amount of fun to my post-tragedy life, but I was struggling to connect with the hobby I started twenty years previously on an Atari 2600.

The Grip of Grief

Grief feels different for everyone; for some it can feel like the loneliness of being the last person at a party; for others, it’s an overwhelming sadness that washes over them like waves of a frigid ocean. However it’s experienced, grief is relentless, it never seems to let go. It does occasionally relax its grip, allowing for some light to get through, as fleeting as it might be. In those moments I felt an overwhelming guilt that I could feel hope, which triggered another spiral.

I spent several years in this state, lacking any form of motivation or ‘want’, drifting from game to game, finishing them and feeling no sense of accomplishment. My days were spent in a mire of tiredness, guilt, shame and mostly, anger. My world felt empty despite having my wife and second daughter at my side. 

The death of Amelia gave me a sensation of lost control. As a parent, we feel we must protect our children from anything and everything. I couldn’t prevent the accident that took her life, I couldn’t save her in the moment she needed me the most, I couldn’t control my emotions any longer. The only control I had was in removing her life support and I didn’t want that. Loss of control is part of being human, but I needed, desperately, to reinstate my grip on it.

Isaac’s Eternal Journey

In 2011, a game came along that stole me away from my grief. A game played in bitesize chunks, it didn’t require too much of me.  It’s a game that has now been in my (almost) daily rotation for those eleven years, I’ve grown with it, it made me fall in love with the roguelike genre, it gave me back my sense of control. That game is The Binding of Isaac.

Edmund McMillen’s The Binding of Isaac is a roguelike played from a top-down view. With a slight edge of Robotron, players can shoot in cardinal directions while exploring separated rooms where groups of enemies await. Edmund’s major inspiration for Isaac was The Legend of Zelda, though his masterpiece is not at all family friendly.

I think I discovered The Binding of Isaac through YouTube. It first appealed for juvenile reasons, the game is filled with gore, scatological imagery and debased toilet humour. Beneath this is a deep and resonant story of religious indoctrination and the control religions have over people, as well as the human struggle with our minds. Over the years, McMillen has expanded The Binding of Isaac several times, but Isaac’s story has remained the same; to escape his murderous mother who believes Isaac is a danger, an evil.

In order to escape, Isaac must traverse several ‘worlds’ battling enemies and large bosses who resemble religious and parental tropes. In order to do this, Isaac collects items to change his base stats, attacks and abilities. Items synergise with each other creating powerful combinations. Over time you learn which combos bestow the most damage, you learn which items effectively ‘break the game’ open by min-maxing every room, every enemy, every item drop. It rewards the player by handing them full control over their fate.

Controlling Destiny

This aspect of control appears in all roguelikes, the majority of titles require the player craft their character builds, paying attention to the smallest upgrades and details to gain enough strength to battle demons and monsters. Ultimately, over the years, these games – Enter the Gungeon, Dead Cells, Spelunky, Hades, Nuclear Throne – have given me a psuedo-control over death.

To some extent, all videogames give us this control. Even playing Mario as a kid we were controlling the life and death of our hero and the enemies around them. But with a roguelike, there is rarely a safety net of ‘lives and continues’, there’s always a sense of finality, because often death relinquishes all progress made on that attempt at the game. Besting death in a roguelike is about more than success, it’s about retaining our growth, our abilities and our progression.

For me, during a time of desperate fragility, I needed to find solace and rediscover my sense of self. I could do that via these games, by crafting a character, slowing my play style and taking my time. They each allowed me to take calculated risks and create controlled situations because the finality of death had visited me, leaving me empty – progress could be lost with one missed shot, one wrong move, one blindsided action.

If we look at Spelunky, a game about discovering treasures untold in a series of worlds, we find a game hell-bent on killing us. Sure, the hero can take a certain amount of hits from middling enemies before dying, but that one bad jump could land you on spikes which kill you instantly. All that time, that care, robbed from you. Mastering this, taking control of the character’s fate, is in some ways empowering.

This sensation stepped up once I started dabbling with FromSoftware’s SoulsBorne games, arguably the pinnacle of roguelikes, though they’re often classed as adventure games. These titles, when broken down into their constituent parts, asked more of me as a player. My demons were bigger, more dangerous, my life more fragile. There was more on the line. A SoulsBorne game feels more like Spelunky; you can get peppered with small hits, but a one-hit kill is always around the next corner.

Repeat After Me

Roguelike games offer more than an adjustment of control. After devoting thousands of hours to these games, repetition becomes a large factor in the gameplay loop. Every journey starts out the same way, each try becomes another attempt at beating the same situation. Repetition is a powerful tool to those in desperate need when struggling with grief and anxiety. A recent study by Tel Aviv University states this on repetition, “people often act in these ways because they help increase a person’s belief that they are managing a situation that is otherwise out of their hands.”

Discussing the power of repetition, Dr. Jill Owen, a chartered psychologist from The British Psychological Society, says this, “repetitive behaviour and rituals can be very effective in increasing focus and reducing stress”. Over the years, the discussion points of videogames and their impact on mental health has begun to change. In the 2000s we saw many up in arms on the damage these games did, now we realise these were knee-jerk reactions to an emerging technology becoming mainstream.

Videogames offer us solace, they offer us peace when it feels like the world is against us. More than that, they offer us a different view, through first-hand experience or playing a role. They allow us failure at little to no cost; they can help build an emotional resilience; games create a sense of community and they can aid in rebuilding a life slowly, step by step, item by item.

Nowadays gaming is celebrated for having a positive effect on our mental health. Once society began to look past the violence which dominated the 2000s and developers began exploring our own psyches, games took on a new role. Psychologist Roy Sugarman explores the aid of videogames in those dealing with grief with Wired where he says, “Games put you in a metaphoric world where you can express a range of stuff honestly, where you can express grief.”

This is it, but What if?

I still gravitate towards roguelikes above all genres. Mostly because I still feel lost a lot of the time. My world is still fragile, the cracks still show. Sometimes I still need that sensation of organised chaos; that possible control over the game. The Binding of Isaac is still the answer I give when someone asks “what’s your favourite game?” I give this answer because it did save me in some way. It turned the lights back on, helped me rebuild my shattered world. Plus, it’s simply a masterpiece of game design.

Of course, over the years, my passion for gaming came back. I rediscovered what it was that made me fall in love with games in the first place – a sense of belonging and escapism. Whether it’s in a cyberpunk strategy, a World War shooter, a colourful battle royale, a mobile idle clicker or a roguelike, my enjoyment returned, along with some of that lost control.

In the same year I discovered Isaac, I also played Minecraft for the first time and used the creative side of the game to express myself, to be more mindful and to relax the thoughts of my busy and broken brain. Minecraft also offers that aspect of control; the deliberate placing of blocks, building shelter from the darkness, equipping your character with the means to survive.

Now I revel in the lack of control some games give, because it reminds me that life is not designed to be controlled. That fate, if you believe in it, cannot be changed or altered. In some ways, failing in videogames has begun to have more impact, because it reconnects me with the fact that life is filled with ‘what if?’ – that life can change in an instant and while that may be out of our control, it doesn’t mean we can’t wrestle it back.

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Is Metaverse Technology Improving Mental Health Treatment?

It’s been a wild past two years for us all. After experiencing the tumults of the pandemic, unforeseen market instability and a seemingly endless chain of global and civil unrest, the prevalence of anxiety, depression and other mental health conditions has reached a staggering high. Even the World Health Organisation (WHO) has weighed in on the dangers of our mounting mental health crisis, with one scientific brief reporting a 25% increase in mental health issues since COVID-19 first hit the world.

The social isolation resulting from the pandemic was one of the biggest challenges our modern society has faced in the last century — causing unprecedented constraints on people’s relationships, work lives, communities and overall mental wellbeing. As a result, many people turned to virtual resources for work, regular communication and even medical care. It’s also for this very reason that 92% of businesses reportedly believe the pandemic has accelerated the development of metaverse technologies.

As we exit the final stages of the pandemic and look towards our first normal summer of the decade, it seems fitting that this year’s theme for Mental Health Awareness Week would be loneliness. In honour of this year’s event, let’s take a look at how developing technologies are looking to improve mental health treatment, decrease the effects of loneliness and provide greater access to care — especially as we see metaverse technologies increase in popularisation.

Using XR technology to combat loneliness

When we couldn’t physically meet with our colleagues, friends or family members during the pandemic, video conferencing helped us stay connected — even if it didn’t exactly replace the sensation of real-life interactions. In keeping with this year’s theme for Mental Health Awareness Week, more immersive technologies have already been suggested by experts as an even better remedy for those experiencing social isolation and loneliness. The spatial nature of VR means that interactions inside more immersive games and metaverse platforms feel much more like being around people in the real world. 

During the pandemic, VR even found an unexpected new group of users — seniors. MyndVR has already worked with hundreds of senior living communities across the United States, seeing a significant surge in popularity within the last two years. Chris Brickler, co-founder of MyndVR, has remarked on the company’s reimagining from a youth-based gaming culture to a “very safe, secure and senior-friendly platform”. Moreover, he commented on the platform’s success during COVID: “We’re just super excited about providing this service to so many older people that are, you know, sometimes lonely, combating isolation.”

A recent study from Frontiers in Psychology has also concluded that XR technology and more immersive gaming experiences have positively affected users — particularly by “modelling the relationships between involvement, wellbeing, depression, self-esteem and social connectedness”. The study determined that, while there is a risk that VR can supplant in-person involvement, healthy social interactions within a VR environment still “benefit players by satisfying essential needs of belonging and connecting with others.”

Anna Bailie, a PhD candidate at the University of York, specialises in researching mental health cultures on social media — and she believes the future of how the metaverse will impact our mental health will improve, rather than harm our ability to connect with others. According to Bailie: “The metaverse has been sold as a place for community, sociality, making friends and maintaining relationships.” Furthermore, she believes that: “there’s no reason that can’t happen when we already see it on social media platforms like Instagram and Reddit, where people find communities which they wouldn’t have access to otherwise.”

Improvements through immersive care

As we’ve previously covered, a recent peer-reviewed study from Oxford University concluded that patients who tried VR-based therapy saw a 38% reduction in anxiety or avoidant symptoms over the course of a six-week treatment period. According to another study, patients suffering from paranoia saw a decrease in their phobias — even after undergoing just one VR session. The immersive nature of VR is now understood as a way for us to trick our brain into thinking it is reacting to a more realistic encounter — an advent that can see patients develop healthier and more effective coping strategies.

Dr. Daria Kuss, lead of the Cyberpsychology Research Group at Nottingham Trent University, has touted VR technology as an effective therapy tool: “We know that particular psychology formats, notably virtual reality exposure therapy, can be fantastic tools to help individuals affected by a variety of phobias, depression, psychosis, addiction, eating disorders — as well as post-traumatic stress disorder — by gradually exposing them to the triggering, feared, or trauma-producing stimulus in a safe space (like the virtual environment).”

University College London (UCL) has been behind a series of clinical trials using VR to treat mental health conditions. The university has partnered with Tend VR to bring mindfulness-based cognitive therapy (MBCT) — a type of face-to-face therapy that has been proven highly effective — into a virtual setting. According to Rebecca Gould, Honorary Clinical Psychologist in the Division of Psychiatry at UCL, “virtual reality-based mindfulness represents an innovative and novel approach to addressing this challenge.”

UCL also revealed a specialised VR intervention program that would substitute face-to-face therapy for depression, with the objective of helping patients increase their ability to exhibit self-compassion. Using a virtual room, patients are shown two virtual avatars — both a child and an adult. In the first segment, they enter the room as the adult — with the task of comforting the child until their stress is decreased. In the next segment, they get to play as the child — this time being comforted by the script of the adult. The compassionate script inside the module zeroes in on three key themes: validating experience, redirecting attention and activating a positive memory.

A growing body of scientific research now also supports the idea that certain psychedelics, when administered by a therapist, can support a range of mental health conditions — including depression, PTSD, addiction and various types of anxiety. Now, health experts are even looking to replicate the benefits of psychedelic-assisted therapy in the metaverse. Emotional Intelligence (EI) Ventures, a growing startup, is harnessing the power of VR to overcome geographical and economic barriers that have previously hindered people from accessing psychedelic therapies. 

After receiving a dose of a medically-prescribed psychedelic, EI users will embark on a virtual journey using their VR headsets. According to founder David Nikzad, each user’s vision will be specifically tailored to suit their unique background, personality and medical history — with the goal of delivering a “zone of comfortability”. He continues: Not everybody’s going to have the same comfort zone. I might like beaches and waterfalls, somebody else might want to be in the Swiss Alps. We can fine-tune that experience.”

Even current gaming tycoon Roblox, which has been praised for bringing users together through shared experiences, has recently launched greater initiatives to raise awareness around the importance of mental health and personal wellness. Sponsored by Alo Yoga, Roblox recently unveiled the ‘Alo Sanctuary’ in February — a metaverse island with a picturesque landscape, encompassing “three earthly elements of the brand name Alo — an acronym for ‘Air Land Ocean’.” Danny Harris, co-founder of Alo, has called “this first-of-a-kind partnership” a “longstanding commitment to supporting the mental and overall health of the global community at large.”

Providing greater access to mental health care

Many metaverse-related complaints we’ve heard within the past year have circulated around the idea that a more immersive internet will be more addictive than the one we live in now, thereby preventing us from embarking on healthy, socially-engaging lifestyles. However, the practicalities and flexibilities of VR are already proving that the metaverse will also make mental health treatment more accessible and even more plausible for people to access — giving it a very positive use case.

XR technology now makes mental health care accessible to anyone across the globe, regardless of their location or social standing. Users who have historically encountered physical barriers to mental health care can now see more affordable treatment options, all while receiving it through more immersive, lifelike and interactive channels.

Daniel Freeman, a clinical psychologist at the University of Oxford, has highlighted one problem he sees in the field of clinical psychology — that many patients are unable to attend therapy sessions due to lack of accessibility (including lack of transportation, rigid work schedules or fear of stigmatisation). As an alternative, his team has revealed gameChange — a programme entailing a six-week course, where participants can meet with a virtual coach from anywhere in the world to conquer phobias and other forms of paranoia.

Joy Ventures, a growing VC firm that is seeking the support of science-backed consumer products for wellbeing, has also pointed out the potential for VR treatment to be more personalised and adjusted to meet the personal needs of patients. Additionally, they’ve also stressed the scalability and flexibility of these technologies: “Even before the pandemic, social isolation, stress and anxiety were worsening problems — but with greater use of behavioural health technologies, people will have better and more accessible options for receiving the care they need.”

Final thoughts

While mounting research makes several clear arguments for why the metaverse will be a great therapy tool, it’s still important to note the number of potential health risks that are present. Several experts in the fields of both technology and mental health have already expressed concerns about how the immersive and potentially addictive nature of the metaverse can lead to a decline in mental health.

However, other experts argue that this issue is much more nuanced — asserting that factors like genetics, physical activity, diet or socioeconomic standing play a much bigger role in identifying mental health conditions. Nick Allen, a professor of psychology at the University of Oregon, stresses the importance of context when referring to metaverse use: “[For example], a young person who may be LGBT and who finds an online context where they can feel a sense of social support — we would predict that that would be a benefit for their mental health,” he says. “On the other hand, if using metaverse technologies replaces non-online behaviours that are healthy and supportive to mental health, like appropriate exercise, engagement in relationships in real life, healthy sleep, time spent in natural environments, then they can be harmful.”

It’s critical that both the pros and cons of emerging metaverse technologies be highlighted. Clinical psychologist Barbara Rothbaum, whose efforts in the VR space date back as far as 1995, can vouch for the timeline in which we’ve seen immersive technologies develop and transition from academia to society. We are now at a stage where we can see the efficacy of VR technology from a clinical point of view, but she still insists that there are “some barriers” to overcome.

Overall, studies seem to be trending in the right direction. XR technology appears to have reached us at a pertinent time — when mental health and the effects of isolation have never been a greater concern. As such, we should expect to see the benefits of more innovative, flexible and accessible mental health care become more commonplace over time.

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VR role-play therapy helps people with agoraphobia, finds study

Sessions with virtual-reality headset helped people overcome anxiety and complete everyday tasks

It’s a sunny day on a city street as a green bus pulls up by the kerb. Onboard, a handful of passengers sit stony-faced as you step up to present your pass. But you cannot see your body – only a floating pair of blue hands.

It might sound like a bizarre dream, but the scenario is part of a virtual reality (VR) system designed to help people with agoraphobia – those for whom certain environments, situations and interactions can cause intense fear and distress.

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Is that really me? The ugly truth about beauty filters

Smoother skin, slimmer faces, plumper lips … how unattainable ideals are harming young users

Popping a beautifying filter on the TikTok video she was filming seemed harmless to Mia. It made it look as though she had done her makeup, took away the hint of a double chin that always bothered her, and gently altered her bone structure to make her just that bit closer to perfect.

After a while, using filters on videos became second nature – until she caught a glimpse of herself in the mirror one day and realised, to her horror, she no longer recognised her own face.

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