FAIT Phobia Therapies

"VR For Your Own Good --Whether You Like It Or Not"

Phobic disorders can interfere with a person's ability to work, socialize and go about a daily routine. They may focus on something as common as germs and may prevent many daily activities. Phobias may arise whenever the person ventures from home, preventing work, social life or even grocery shopping.

Symptoms of a phobia include the following:

Behavior modification therapy is a successful treatment for simple phobias. Techniques include systematic desensitization to the idea of the stimulus that causes phobia and graduated direct exposure to the stimulus in the company of the psychotherapist, whose presence represents a safe environment.

One behavioral technique that has been adopted relatively recently involves intensive exposure to the phobic stimulus either through imagery or in vivo. In imaginal flooding (implosion therapy), patients are exposed to phobic anxiety produced by images of the phobic stimulus for as long as they can tolerate the fear until they reach a point at which they can no longer feel the fear. In vivo flooding requires patients to experience similar anxiety through an exposure to the actual phobic stimulus itself.

Exposure therapies have proven effective for a variety of phobic conditions. However, traditional exposure therapies are also costly, in terms of therapist time and logistics. A patient's confidentiality, hesitancy and potential for embarassment are additional limiting factors for final-stage in-vivo exposure therapies.

Virtual Reality exposure therapy has provided an effective alternative to costly traditional exposure therapies, for several reasons:

  1. Many patients are willing to try VR therapy who are unwilling to undergo exposure therapy in real-world environments.
  2. Confidentiality is afforded the patient, since treatment occurs in the therapist's office.
  3. The risks associated with travelling to an airport, navigating security and pamphleteers, and the possibility of a bumpy ride (and subsequent validation of the patient's fears) are eliminated -- VR offers total environmental control.
  4. The therapist's time in virtual therapy is reduced to a minimum, as tried-and-true therapy regimens are developed.

FAIT-Style Exposure Therapy

Since our Volunteers are picked more or less randomly and their immersion in virtual environments is more or less constant during their stay at our facility, anonymity and confidentiality are guaranteed. Upon arrival at the lab, the subject is suited up and subjected to three hours of rigorous psychological testing in our Leviatron system, which pinpoints fears, phobias, anxieties and aggressive tendencies within a +-5% accuracy range. Upon completion of Leviatron analysis, our top-level therapists determine necessary areas of psychological focus for each subject (based on Leviatron output data), and prescribe an appropriate virtual therapy regimen. Patients are kept isolated to guarantee their confidentiality, and after showering and a routine defumigation, proceed directly to their treatment.

In Fear-of-Flying therapy, the patient is strapped into a typical airline seat (augmented with hydraulics and vibration transducers to simulate realistic flight sensations) and fitted with a head-mounted display with omni-directional headphones. The resulting combination of interfaces enables a convincing air-travel simulation.

Lumbar support is provided where none is indicated, and temperature and humidity deprivation levels are regulated to add realism to the in-flight experience. Dry-roasted peanuts are served with a minimal amount of corresponding beverage. The "Fasten Seat Belts" sign is flashed intermittently throughout the flight, and occasionally oxygen masks drop from overhead panels, with accompanying alarm klaxons sounding from the forward section. Autonomous stewardess agents are programmed with realistic behaviors, simulating a range from "sticky sweetness" to "total indifference". An "abject horror" behavior algorithm has been added for additional realism during "rocky-flight" simulations. The combination of the above simulation parameters slows subjective exposure time, resulting in real-time treatment sessions lasting only 2/3 of apparent elapsed time.

The Flight Sequence

As in real-flight scenarios, a prescribed sequence of events occur in our virtual airplane. Subjects spend up to an hour waiting for takeoff. During this pre-flight period, surly virtual passengers are crammed into all available seats, while the whirring of fans accompanies the ever-increasing scent of diesel oil and spilled jet fuel in the cabin. Just before the flight gets underway, an announcement crackles over the loudspeaker system notifying passengers that the flight has been overbooked and anyone desiring future free passage to Hawaii should come to the front of the cabin, resulting in a mad rush and one or two serious tramplings. Within a short time, the virtual plane taxies for takeoff across the tarmac.

Physical sensations during taxiing and accompanying takeoff are efficiently simulated by the viration transducers mounted to the subject's seat, faithfully reproducing every little patch of asphalt, every pebble and stray bolt on the runway. After a few false starts, the plane lifts off the ground at a steep angle, forcing the patient back in his seat with the aid of the hydraulics. The climbing phase lasts for ten minutes or so, then the seat once again resumes a more or less level attitude. Turbulence simulations often occur randomly during this early stage of flight, triggering a realistic "worried" look on the faces of the cabin crew automatons.

In mid-flight, ball lightning travels from the wingtips through the fuselage as the sound of pelting hailstones fills the cabin. Passengers groan and become ill as crew members collect "air discomfort" bags at an alarming rate. Finally, the "Fasten Seat Belts" sign is lit one last time, and the plane begins its descent. After announcing an ETA of ten minutes, the pilot guides the plane into a holding pattern over a massive cloud bank, where it remains for approximately forty-five minutes.

Finally, the plane is in position for its final descent. Just as the wheels screech into contact with the runway, the hydraulics in the chair begin a violent side-to-side motion which is not reinforced in the visual cue system. This motion slows and recedes as the plane nears the terminal building. When the call comes over the loudspeaker to remove seatbelts and disembark, all the other passengers rise and clog the aisles immediately, forcing the subject to wait for an exasperating period before being removed from the simulation.

Negative Reinforcement:

Character-Building Through VR

If the subject shows signs of impatience during the pre-flight delay, virtual infants are seated on all sides. If, during the post-flight disembarking, the subject shows signs of aggression, panic or frustration, an announcement comes over the loudspeakers reminding all remaining passengers to stay in their seats for the continuing flight to Saskatchewan, and the simulation is resumed.

Positive Reinforcement:

"Have Another Oreo, Sir..."

Since the goal of FPT is to loosen the subject's grip on habitual phobic behaviors, positive inducements are offered during the virtual flight to encourage the subject to relax in the face of what may otherwise seem to be impending doom. Muscle tension sensors are mounted in the armrests of the passenger seat, pupil-dilation is metered in the HMD by infrared detectors, and capillary pulse measurement is obtained via optics in the headphones, giving feedback to the Sadometrically-based monitoring system about the subject's discomfort levels. The system compares incoming values to those stored during earlier Leviatron analysis, removing the need for subjective evaluations by human therapists during the session.

When desireable emotional states are maintained by the subject, the simulation engine responds favorably. The system offers rewards such as allowing the subject to actually listen to the sound of the in-flight movie, reclining the seat, or raising the humidity to near-normal levels when the subject demonstrates sustained conscious control over the phobic behaviors.

On The Horizon

FAIT's Fear-of-Flying phobia treatment procedures are showing extremely positive results, and Dr. Flaxon expects to see long-term potentials for other FAIT phobia treatments, such as: