Safe Space: How Virtual Experiences Help Patients Conquer Paranoia

by Isha Salian
VR train car for paranoia therapy
VR can help people with severe paranoia overcome dread of confined spaces.

Imagine stepping alone into a high-rise elevator. It’s just you at first, but every few floors more people get on. By the time you reach the upper floors, the small, windowless space is packed tight.

For most people, this is a scenario of temporary discomfort. But these cramped quarters can cause feelings of imminent danger to people suffering from severe paranoia.

Virtual reality could serve as a safe space for these patients to face their fears, according to recent work by researchers at Oxford University.

The team created two VR simulations powered by NVIDIA GPUs: a crowded elevator and a train car on the London Underground. With just half an hour to explore the virtual world, their subjects felt a dramatic reduction in their feelings of paranoia.

A New Kind of VR Therapy

VR has been used a therapy tool for various phobias, physical injuries and post-traumatic stress disorder because it’s a realistic way to transport subjects anywhere, anytime and for as long or short as is comfortable. But the best part: figures in the virtual world can’t hurt the user.

“VR, we thought, was a brilliant way to help people re-learn that they are safe, to counteract the feelings of danger so the paranoia melts away,” says researcher and clinical psychologist Daniel Freeman. He says this is the first time VR has been used directly to treat a psychotic experience.

The team’s study put 30 patients with persecutory delusions into a virtual experience in the London Underground or an elevator. Each subject entered the virtual world seven times for up to five minutes. With each trial, more virtual people were added to the virtual space, gradually exposing the patients to more intimidating situations with up to 28 avatars.

VR is computationally intensive, even more so with many avatars. “Without a GPU, it definitely wouldn’t run fast enough,” says Angus Antley, the project’s computer scientist. “You can’t have VR without it.”

Researchers conducted the Oxford study with a GeForce GTX GPUs and an NVIS nVisor SX111 head-mounted display. The team is upgrading to a TITAN X GPU and Oculus headset so they can include more avatars in their virtual world and achieve higher frame rates.

Dramatic Results

Half the patients were instructed to use defense mechanisms such as avoiding eye contact, while the other half were told to explore the space by looking at and approaching the avatars. Both groups felt reductions in their paranoia, with the second group experiencing a 33 percent reduction in delusional feelings.

When surveyed a week later, the patients still had significant reductions in their feelings of threat. But the Oxford team isn’t stopping there. They’re planning a longer-term trial with more subjects, says Freeman. “We think the patient benefits can be incredibly strong, with effect sizes you do not normally see for the treatment of such a severe mental health condition.”

In the long term, the team would like to incorporate more realistic facial animations and up to 50 avatars in a virtual scene. They also hope to build more personal avatars that look and dress like the subjects.

VR helps paranoia patients
Riding virtual train cars filled with people can help patients with paranoia reduce feeling under threat.

With time, they see VR therapy becoming mainstream in mental health clinics, hospitals and the home.

“One thing we want in the future is a phone that can work as well as a TITAN X,” says Antley. Taking powerful VR experiences portable makes treatment easier and much more accessible, he explains. “For us, it’s crucial that we get home delivery in the future.”