Virtual reality at the service of psychiatry
Meeting with Dr. Eric Malbos, speaker at the Virtuality exhibition: he uses virtual reality to treat his patients and their phobias. A success.
How did you fall into the VR as a psychiatrist / psychologist?
Dr. Eric Malbos: 2002, I was finishing my medical studies and I was looking for a subject for my thesis: I did not want to fall into the old cliches, but to present something original; Something related to my passions, video games and science fiction. I then realized that in the world, laboratories used virtual reality in medicine, and more specifically in psychiatry. I started to take an interest in it and now I use it in consultation.
What mental disorders do you treat with this technology?
Dr E. M .: At the University Hospital of Design, we use RV to treat several mental disorders, the first concerns anxiety disorders, a family that includes phobias of all types. For each of them, I create myself a suitable virtual environment. I designed many for frequent phobias types, fear of the plane, claustrophobia, phobia of the subway, acrophobia, driving on highway phobia ...; And also for scarce phobias, such as phobia of dogs, water phobia, or generalized anxiety disorders (chronic worries). For the latter, the RV will serve to optimize the relaxation. The patient is virtually transposed on a beach, with palm trees, he watches a sunset. We also treat addictions such as tobacco, and above all we do prevention to avoid recovery: in this case we expose the patient to high risks of relapse: a virtual cafe in town, a virtual restaurant on the beach with a sunset, a coffee break at work, a bus waiting. We can do everything with the RV, get a patient to swim, confront him on the highway.
What is the environment you have created and which you are mostly proud of?
Dr. E. M .: The plane scenario is the most classic but works best. I created the Launch and recovery systems, turbulences, I even had to create airport, plane, armchairs, based on photos because I am not an engineer basically. The benefit of this type of experience in psychiatry is that the patient can be exposed progressively. It is an open environment, the patient does not follow a corridor. He can walk in the airport, he is not obliged to enter the plane; Or if he wishes to enter, he can experience the experiment without taking off. The psychiatrist must go slowly, not to rush him, especially since he is able to control in real time the environment: closure of airlock, number of people on the plane ( The patient more likely prefers to start with an empty plane, then passengers are added gradually), presence of turbulences, duration of flight ... this capacity of modulated progression is important in the interest of the therapy.
Can side effects be a problem?
Obviously we have some fears from time to time of cyber discomfort (nausea caused by wearing the helmet), apart from that there are no psychological side effects. We are working with Afghanistan veterans with post-traumatic stress disorder: we are recreating a virtual Afghanistan where the person is recovering from trauma and can manage it better by reviving it. Here too we have enough perspective on the method, it has already proved itself on the veterans of the war of Vietnam. It is of course important to understand that the patient is never immersed right away in virtual environments, it would be traumatic and far too brutal. The patient is treated in 10 to 12 sessions, the first 4 to 5 sessions are dedicated to the management of emotions, relaxation, cognitive therapy, autosuggestion. Afterwards he is immersed in the RV to apply the methods he has been taught. We even plan to create virtual environments to treat schizophrenia and help patients to better manage their hallucinations.
What is the added value of RV compared to conventional medicine?
Dr. E. M .: The RV gives the possibility of gradual exposure and the control of random events in reality. The second benefit is confidentiality: the patient can train without fear of being watched by others. Finally: the cost. In a classical treatment, the patient must be accompanied by his psychiatrist in situation (subway, train, plane ...). The latter must generally take an entire day, which is time-consuming and extremely expensive.
I have planned with Dr. Bouchard, a professor in the Department of Medicine at the Faculty of Medicine at Laval University and a neurologist at the Center hospitalier universitaire de Québec, to form a scholarly society around the RV in the Francophonie and his Mental health: INFIRA (French and international institute of virtual reality or augmented in mental health). It will serve in particular to train psychiatrists and psychologists in this technology. This institution will also be used to issue quality labels for the companies that will be doing this type of program. These quality labels will assure both professionals and patients that the virtual environments they use have a real therapeutic effect.
How do you see the future of RV?
Dr E. M .: As a psychiatrist I think this will upset our society, the children who will grow with this material will be more intelligent than their ancestors: this will develop, amplify, considerably their intelligence. Intelligence is based on the use of abstract concepts: RV will allow the children to have access to abstract worlds, geometry in space, the world of the infinitely large, the infinitely small, All that is not in sight of our senses but that our brain can conceptualize. They will be able to handle gamma rays, solar systems, have access to atoms, molecules and understand their functioning. All this will greatly expand their abilities at an early stage ...
Dr. Eric Malbos works in the psychiatry department of Prof. Lançon, CHU Conception APHM in Marseille. He is a psychiatrist confirmed in virtual reality treatment, a former doctor at the French Embassy.