Overcoming Phobias Using Virtual Reality

Nov. 20, 2003 -- Miss Muffet no longer fears that spider that sat down beside her in that famous nursery rhyme. In fact, she's become downright fond of it.

That's because Miss Muffet, in this case, is a real person with a real phobia of spiders, and she's learned how to conquer that fear with one of the newest gadgets in the psychologist's toolbox — virtual reality.

But this isn't your grandfather's virtual reality. This one comes equipped with a fuzzy, creepy replica of a beast called a Guyana bird-eating tarantula in the University of Washington's Human Interface Technology Laboratory.

In addition to the three-dimensional helmets worn in your run-of-the-mill virtual reality lab, the Washington experimenters have added tactile effects in the form of a fuzzy object that feels just like a spider, and even scary music straight from the movie Psycho.

The point of all that, says psychologist Hunter Hoffman, leader of the project, is to make the simulated experience as real as possible.

Just simply adding the hand-held fuzzy object to the visuals seen through the 3-D goggles worn by the participants made virtual reality far more effective than it had been with just the visual effects, he says.

"It was dramatically significant," Hoffman says. "It doubled the effectiveness."

The proof, he says, lies in participants like Miss Muffet, which, of course is not her real name. She had been so frightened of spiders that she couldn't even approach a cage with a spider sealed inside, and past clinical efforts to help her had failed.

But by the time she completed the experiment in Hoffman's lab, she could hold a live tarantula in her hand, and she did that for more than 30 minutes.

Furthermore, her fear has not returned, Hoffman says, supporting a growing conviction in the clinical community that virtual reality can be a very helpful tool in fighting phobias.

The research also supports Hoffman's contention that the more real the encounter is, the more effective the treatment. That's because in order for the treatment to work it has to evoke the anxiety and fear that would be expected in the real world, and adding additional sensory experiences, like touch, makes the experience more intense.

Hoffman thinks the music also helps, because it adds auditory sensations, but so far that theory hasn't been tested.

The technique holds the promise of expanding clinical treatment to people who won't seek help because they are afraid of being seen as being afraid, which is a common inhibition among people with phobias. With virtual reality, there's no reason to be afraid because the entire situation is under control at all times.

It also makes treatment for such things as fear of flying more feasible because it isn't necessary to charter an airliner several times to help someone get over that fear.

And that, Hoffman says, may be extremely important because people who have avoided treatment in the past might begin to seek out help if virtual reality becomes a more commonly used tool.

The researchers, who published their findings in the November issue of The International Journal of Human-Computer Interaction, selected 36 students from a pool of 400 who expressed an above-average fear of spiders. Eight, including Miss Muffet, were classified as clinically phobic.

All of the participants feared spiders enough that they couldn't remove the lid from a cage with a tarantula in it. During the series of experiments, some of the participants received only the visual part of virtual reality, and others received both the visuals along with the creepy replica of the real spider.

Later, while one of the clinicians waited just outside the door, each participant was told to go into the lab and walk up to the cage containing the spider. Prior to the treatment, the participants didn't want to get within five feet of the cage.

But the participants who had received just the visual treatment were able to cut that distance in half. And those who had also felt the fuzzy replica during the experiment were able to get within six inches of the real thing.

And after it was all over, Miss Muffet was able to reach inside the cage and pick the spider up.

The point of all of this is not to suggest that people should have no fear of spiders, or flying, because a few spiders bite, although usually in self defense, and some airplanes crash, so some anxiety should be expected. But in many cases, the fear far exceeds the danger. At that point it becomes a phobia, defined as an irrational or excessive level of fear.

In the past, psychologists dealt with that by "in vivo" techniques in which they gradually exposed the patient to real spiders, or real airplanes, but that won't work for all kinds of traumas. Hoffman's lab earlier used virtual reality to help people suffering with post-traumatic stress disorder after the terrorist attack of 9/11.

It wasn't possible to destroy the twin towers again, nor would any sane person want to, so virtual reality was used to recreate the scene, over and over, for patients ranging from a housewife to a New York City firefighter.

One woman who was reduced to sobs whenever she saw a replay of the tragedy was eventually able to talk about her emotions and finally remembered that she thought she was going to die, part of the reason she was so stressed. The treatment proved very effective, Hoffman says.

By adding additional and supportive sensual experiences, as in the experiments on spider phobia, Hoffman believes the treatment can become even more effective.

Lee Dye’s column appears weekly on ABCNEWS.com. A former science writer for the Los Angeles Times, he now lives in Juneau, Alaska.