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Virtual reality and psychiatry: Together at last.

University psychiatry professor Chris Donahue uses virtual reality to treat anxiety disorders.

Eyeing a virtual cure for anxiety disorders

By Deane Morrison

February 6, 2006

As the turbulence grew worse, Carrie's seat began to rock. Looking out the window of the plane at the dark storm clouds, she fought nausea even as she heard somebody else being sick. Flying through such a storm and getting sick was her worst nightmare, and she wanted to jump up, run to the cockpit, and beg the pilot to land.

Except that there was no pilot, or plane either. Carrie, a teacher from St. Paul, was sitting in the virtual reality room of the Fairview-University Anxiety Disorders Clinic, experiencing the flight through a headset, woofers that simulated engine vibrations in the floor under her seat, and University assistant psychiatry professor Chris Donahue shaking her chair with his hand.

For nearly a year the clinic has been using virtual reality to desensitize patients to experiences that provoke fear and anxiety. The key is to repeat the exposure many times in a session, which can't be done for real when the anxiety involves things like flying and public speaking, the two major foci of current therapies. Other programs treat fear of storms, heights, closed spaces, and being interviewed.

"Immersion is everything for this to be a viable therapy," says clinic director Matt Kushner, a University associate professor of psychiatry. "We match the sights and sounds of the real experience." Afterward, patients tell the therapists what worked and what didn't. For example, fear-of-flying patients have said that the vibrations in the floor were important in making the experience realistic. Without realism, patients are unlikely to feel afraid and therefore cannot become desensitized to their fear. The therapists also teach other techniques to deal with anxiety, such as relaxation exercises.

In the virtual-reality flight program, patients experience sitting in a plane on the tarmac, taxiing, taking off, flying, and turbulence. Those who fear speaking in public endure standing in front of a bored or hostile virtual audience and hearing a cell phone go off in the middle of one's presentation. Also, lectern-leery patients may hear Donahue provoking their fears with comments like "Are you sure you're prepared?" or "Aren't you starting to sweat?" as they talk to their cyber-audiences.

So far, only a handful of patients have been evaluated. The therapy often works well, but it isn't for everyone. Even when successful, treatments can't erase memories of trauma, but they do give patients an alternative to old habits.

"We sort of lay down a new track beside the scary one," says Kushner. "This is like exercise--it's a discipline. You have to keep it up." For a person afraid of flying, that translates, ideally, to a trip every two months or so. It took Carrie only six or seven sessions to gain the skills to resume flying. Recently, she flew to Washington, D.C., and had a smooth flight. Maybe too smooth.

"I was almost hoping for something more challenging," she says.

Anyone wishing to be evaluated for anxiety treatment should call the Psychiatry Clinic at 612-273-8700 and ask for Donahue or Kushner.