TStrapped to a chair, in a gloomy basement, I do my best not to panic—breathing in for four seconds, holding for seven, and slowly releasing for eight seconds. But when a bloodthirsty monster appears at my feet and begins to crawl toward me, I don’t need a dial to tell me that my heart is pounding and that I am in imminent mortal danger.
Welcome to the future of anxiety treatment: a virtual reality (VR) game that teaches you a breathing technique to calm your nerves, then pits you against a monstrous humanoid that wants to eat you, to practice using it in real panic causative situations.
The game was developed by researchers at the University of Cambridge, with help from a local video game company, Ninja Theory, and is being tested as a means of teaching people a strategy for coping with everyday anxiety. For me, this could mean filing a story for the Guardian at extremely short notice, or trying to get out the door with two kids and already running late.
“We view anxiety as something most people experience, as opposed to a specific anxiety disorder, and try to teach emotion regulation techniques that can be useful for most people at some point in their lives,” says Lucie Daniel-Watanabe, a PhD student who leads the research.
“Therapists often ask people to teach techniques, such as breathing techniques, in totally static and disconnected ways, then say, ‘Try this while you’re stressed.’ But there’s no way to get people to try it if they’re stressed in that therapeutic situation. With VR you can completely manipulate the environment people are in, which can be very useful for that.”
With the VR headset in place and a heart rate monitor on my finger, I’m transported to a rowboat, on a calm lake at sunset. A soothing voice encourages me to inhale, hold my breath and exhale at the appropriate times, and as I feel more and more relaxed and my heart rate slows, the boat gently moves forward.
After about five minutes, I’m ready to begin the next phase of my training: the dungeon. While I know it’s just a game, the immersive nature of VR helps suspend my disbelief, and I’m surprised to hear my heartbeat pounding in my ears. In the upper corner of my vision, a small dial tells me that my heart is beating significantly faster than it was when I was on the boat, reminding me what I’m here for. I begin to slow my breathing and the dial also gradually creeps down – even hearing a fellow inmate scream, and when I look to my left I see a body being dragged back out of sight.
Then, suddenly, the monster stands before me, emaciated, gray-skinned and blindfolded with a terrible smile on his mouth. I’m told it can’t see me, but it can use my heart rate to sense my location; the only way to avoid death is to use the relaxation technique to lower my heart rate.
I’m doing my best, but the monster is too close and too hideous. Afterwards – after the monster jumps on me and the screen goes black – Daniel-Watanabe tells me that she deliberately put me on a harder level because many of the subjects she’s tested it on so far have been too good at avoiding death.
Striking the right balance, not to mention validating the approach with larger and more diverse groups of individuals, can take time. But other VR-based approaches are already being trialled within the NHS, for example helping people suffering from social anxiety or agoraphobia practice everyday scenarios, such as being on the street or in a shop, under the guidance of a virtual coach.
Partnering with a gaming company can take such experiences to a new level. Gamifying the process can also motivate people to practice helpful techniques, such as breathing exercises, rather than relying on internal motivation — “which, when you’re in a difficult situation, can be difficult,” Daniel-Watanabe said.
While she would never want to see VR in place of therapy, “it could be a tool people could use if they were on a cognitive behavioral therapy waiting list, to learn some basic techniques in the meantime,” she said.
As for me, while I’d be reluctant to go back to that dungeon, the encounter has reminded me to breathe slowly when I’m stressed. Even an approaching deadline is no match for that monster.