Management of Psychological Stress in Nurses and Teachers

The recent convergence between technology and medicine is offering innovative methods and tools for behavioral health care. Among these, an emerging approach is the use of virtual reality (VR) within exposure-based protocols for anxiety disorders, and in particular posttraumatic stress disorder. In a randomised controlled clinical trial funded by the European Commission, our team was able to show that Virtual Reality enhanced treatment is able to significantly reduce stress, while increasing coping skills.

interstress-rct

Virtual Reality for the Attenuation of Pain and Anxiety

The Virtual Reality Medical Center and nonprofit affiliate, Interactive Media Institute, recently published the article, “Using Virtual Reality to Mobilize Health Care: Mobile Virtual Reality Technology for Attenuation of Anxiety and Pain” in the January Issue of IEEE Consumer Electronics Magazine. The article summarizes the use of virtual reality as a tool for pain distraction and stress reduction in patients. This tool has been used to treat phobias, stress disorders, distract from surgical pain, and help overcome chronic pain. As a mobile healthcare platform, virtual reality and related technologies are changing the face of healthcare services by increasing access, efficiency, and effectiveness.

For the full text, please visit: http://ieeexplore.ieee.org/document/8197481/

Please direct any questions regarding this article to Dr. Brenda K. Wiederhold at frontoffice@vrphobia.com

 

 

Wiederhold BK, Miller IT, Wiederhold MD. Using Virtual Reality to Mobilize Health Care: Mobile Virtual Reality Technology for Attenuation of Anxiety and Pain. IEEE Consumer Electronics Magazine. 2018 Jan;7(1):106-9.

Kathy Feldman

By the time I decided to do Virtual Reality Therapy I had done most everything else I could possibly do that was offered. I had done:

  • Cognitive Therapy
  • Biofeedback
  • Hypnosis
  • EMDR
  • A Fear of Flying Clinic

At the time, the closest Virtual Reality Medical Office to my home was in San Diego, an eleven-hour car ride away. I had never had a problem flying until 1994, when my family and I boarded a small, general aviation plane for a tour over the Grand Canyon. While the plane was built for a fewer amount of people, we were packed into it like sardines. The plane ride was an hour’s worth of bumps, hits and jolts. It felt like the plane wanted to drop out of the sky under the weight of its many passengers and I was in a blind panic the entire time. It was this experience that imprinted a bad belief system and distorted view of flying in my head.

When the plane finally touched down, I got out of the plane and kissed the ground. Literally, the first words that came out of my mouth were “My life has been changed forever” and for seven years, that statement was true. While I continued to fly after that incident, it was never the same. For instance, when I had travel plans that involved flying, I would begin having anticipatory anxiety about three weeks before the scheduled flight. I would lose sleep. I would have nightmares. I would obsess about the flight.
My mind couldn’t think about anything else BUT the flight. My thought process would be filled with “what if’s.” It was so bad that by the time the day of travel came around, I emotionally didn’t have anything left over for the actual flight. My desire and drive and inner-strength for flying were completely zapped and spent. There was nothing emotionally left over for me to push through the actual flight. I felt paralyzed by the fear.

On one occasion, after I had boarded a plane with my two children and just before the Flight Attendant closed the door to the aircraft, I bolted off the plane leaving my children behind to fly on without me. I will never forget the tears and look of disappointment on their faces. At that point, I stopped flying all together for a number of years. I was exhausted and I was tired of putting my family through this unforgiving process each and every time we wanted to fly someplace.

Then, I found Virtual Reality Therapy. For me, because of the nature of the feedback I received during the VRT sessions, I was able to identify my “flying rough spots” easier. Virtual Reality Therapy gave me more concrete feedback about what I, as a nervous flyer, needed to work through to begin flying again. Because the “fear” had this “invisible hold” on me, Virtual Reality Therapy gave me a realistic and physiological perspective about myself that I could grasp and wrap my mind around so that I could actually understand what it was I needed to do to progress. Working yourself out of fear to the point where you can fly without anxiety or panic is a process that is unique to each person. Whatever you do, don’t stop trying – even if it seems nothing is working. In the long run, it will all pay off.

First, you need to be committed to finding a “cure” for yourself. Fear of flying is the type of thing that will creep back into your life if you don’t keep it in check. Therefore, don’t fly less because of the fear, FLY MORE! Fly as often as you possibly can. By flying more, you will be giving yourself a chance to purge your old belief system. By flying more, you will be giving yourself the chance to put your new belief system into place. By flying more, you will be able to prove to yourself that the old belief system simply doesn’t work any longer.

Helpful Hints

Take all the “decision making” out of flying beforehand. Do whatever you can “pre-flight” to prepare so that on the day of your flight, all the choices and decisions surrounding flying are done. There’s nothing worse for a nervous flier than to have to make even the simplest decisions and/or choices on the day of travel. The nervous flier’s mind is simply too balled up in fear at that point. For example:

  1. The night before you travel, lay out the clothing you will be wearing on your flight.
  2. Be absolutely packed by the day before travel, including your Bag of Tricks, which may include: 
       
    • MP3 player packed with your favorite music
    • Bottled water
    • Battery powered fan
    • Inspiration index cards
    • Pictures of loved ones
    • Reading materials
       
  3. Allow yourself plenty of time to get to the airport and checked in at the gate.
  4. Once at the airport, take a more positive cue from fellow travelers. Look around and notice how everybody is just going about their own business, without fear. Being around other travelers can put your “distorted view of flying” back into perspective.
  5. Once you have boarded, let the Flight Attendant know you are a nervous
    flier and ask to be checked on from time to time.
  6. Now that most airplanes have sky phones on them, arrange for a family member or friend to stay by the telephone while you are in flight. If you feel restless or out-of-sorts, use the sky phone to call that person. It is a very calming thing to do.
  7. Ask the Flight Attendant if you can meet the pilots. Talk with the Pilots about anything that’s on your mind. Pilots and Flight Attendants are the nicest and most helpful people. Remember, the airline industry wants your business. To get it, though, they must first earn your trust and respect – and they do this by wanting to make your flight comfortable. It’s OK to lean on them.

 

For more information on Kathy’s story, click here.

Post-traumatic Stress Disorder Due to Motor Vehicle Accidents

It is nearly impossible to get anywhere in California without driving, even in major cities. Stephanie Wall, a 23-year-old resident of Southern California, knows this only too well. Just two days before she was scheduled to begin college in Colorado, Wall was involved in a traffic accident that caused her to stop driving for what she thought would be forever. On a hot summer day, a teenager slammed into Wall’s sport utility vehicle on a freeway in Denver, rolling it over. Wall was rushed to intensive care. As she recovered in the hospital, she thought about her future with driving. “I didn’t want to freak out and get into another accident,” she said.

Two months after her accident, Wall returned home to California to begin the long process of physical therapy. While her body recovered and improved, her fear did not. “I would be in the car with [my] Mom and would get really anxious, sweating, and I would jump,” Wall says. “I would even shut my eyes sometimes when I saw a car coming at me in the same sort of way as [in] the accident.”

After two years of enduring this fear, Wall was referred by her psychologist to Dr. Brenda Wiederhold at the Virtual Reality Medical Center (VRMC) in San Diego, California. At VRMC, Wiederhold uses a combination of cognitive-behavioral therapy and VR-enhanced cognitive-behavioral therapy (VR-CBT) to help patients with specific driving phobias, fear of driving related to panic disorder and agoraphobia, or PTSD due to motor vehicle accidents. Over the last decade, psychologists around the world, including Wiederhold, have been using VR therapy to treat a variety of phobias including fear of heights, public speaking, spiders, flying, medical procedures, and enclosed spaces. However, Wiederhold was one of the first to use VR to treat PTSD due to motor vehicle accidents.

At VRMC, Wall did not enter VR during her first two treatment sessions. Instead, Wiederhold taught her relaxation techniques (e.g. deep breathing, visual physiological feedback, etc.) and cognitive techniques that would help her cope with anxiety when she was confronted with her fear. In subsequent sessions, Wall was placed in the virtual driving environment that included a real automobile seat and seatbelt, steering wheel, gas and brake pedals, and a vibrating platform to simulate movement. The environment allowed Wiederhold to change what Wall was seeing with the press of a key. Situations included varying traffic and weather conditions, a bustling commercial center, a residential area, bridges, mountain roads, and a highway. Over time, Dr. Wiederhold adjusted the scenes, adding speeding cars, pedestrians, rainstorms, and lifelike sounds to make the exposure more realistic.”It was obviously a computerized environment,” said Wall, who now tackles Southern California’s freeways. “But still, it felt real. The drivers would even yell at me, sometimes in Spanish, and one time I started yelling back.” Wall’s final goal was to drive to school 20 miles away, on the freeway.

“When we started getting in traffic on the [virtual] freeway my heart would start racing like I was having a mild anxiety attack,” Wall recalled. “The noises bothered me, too. You could be at a stoplight and they’d have a fender bender next to you and that sound really got to me.”

With VR, “you can have an accident and not get hurt,” Dr. Wiederhold said. “People who are afraid fo the freeway say, ‘Oh my God, this is dangerous.’ I get them to stop the thought and think instead, ‘Yes, I’m sweating, but I’m still in control.'”

After 15 sessions with Wiederhold, Wall is back behind the wheel, for the most part comfortably. “I still use the breathing techniques to this day,” she says. “I find comfort in that. Knowing that I can encounter any situation, anywhere, and I’ll be able to handle it. That makes me a better driver.” Though her original goal was 20 miles on the freeway, Wall now drives 20, 30, or even 40 miles away, allowing her to get to school and physical therapy on her own. She now says that she prefers driving herself. “It has become ‘me’ time,” she says. Walls is still in physical therapy for her injuries from the accident, but she has gone back tot school and recently bought a condo. Her new goal is to drive back to Colorado and finish her trip to Denver. “Someday I’ll accomplish that,” she says, “and it will be with the tools that Dr. Wiederhold taught me.”

Sourced from Dr. Brenda K Wiederhold’s book, Virtual Healing.

For more information on Stephanie’s story, click here.

Fear of Public Speaking

We all know how upsetting it can be to be scared of someone or something.  In fact, one La Jolla man says his fear was affecting his job and life.  So, he decided to take control and fought his fear in a way that very few people have done.

“I would become very anxious, light headed, lots of perspiration,” said Ronald Davidson.  “I thought I was going to pass out I was some nervous.  People are going to think i’m crazy.  How am I going to explain this?”

Fears of flying, spiders and heights.  Most of us are afraid of something, but when our fear becomes overwhelming it can paralyze us and change the way we live our everyday lives.

“I’ve been in the middle of a speech and was almost so disabled by anxiety.  I was almost not able to carry on.”

Davidson’s fear of public speaking affected his ability to do his job, and his confidence in life. 

“I’ve had a couple of times where I thought I was going to pass out.  I was so nervous it’s not a good feeling.”

“Phobias are the number one mental illness, even more common than depression.  But they’re also the most treatable mental illness,” Doctor Brenda Wiederhold.

Psychologists today treat phobia by having their patients imagine what they’re afraid of then they jump straight into real life situations.  But  a medical center in Sorrento Valley has virtually opened a door to a new world of therapy. 

“What we’re able to do with the VR is to take more systematic baby steps.  Because you don’t want the person to feel some anxiety… you don’t want to overwhelm them.  That can actually make them avoid even more.”

The therapist controls the environment and monitors the patient’s heart rate, breathing and mind activity.

“They’re actually feeling the vibrations, they’re hearing the sounds they’re seeing the visuals so all of their senses are stimulated.” said Wiederhold.

“I’m fairly skeptical so if it works with me it’ll work with anybody,” said Davidson.

The future of VR is virtually limitless.  Right now they are treating people with eating disorders, ADHD and anger management.  And some therapists are even experimenting with treating schizophrenia.

“You put them in the Virtual world to make them understand that those voices are just in the virtual world and you get them to slowly change their reality,” said Wiederhold.

Virtual therapy is in its beginning stages, but it has helped at least one patient with his fear of public speaking and changed his life.

“It helps you in so many other ways when you gain self confidence.  You faced something that you found very fearful and you know I probably could have gotten through the rest of my life with out doing this… I could have skated around it, I have in the past.  But it feels so good for a change to confront it and to over come it.”

 

For more information on Ron’s story, click here.

Virtual Reality Therapy for Fear of Spiders

If you are afraid of spiders, then you are not alone. In fact, approximately 55% of women and 18% of men in the United States suffer from arachnophobia, which is the fear of spiders. Virtual Reality Therapy may be able to help you overcome that fear!

Although not everyone who dislikes spiders has the actual phobia, there are some symptoms to watch out for. If you freeze or run away if you see a spider, refuse to go into a room that may have a spider, and if you will not go camping, hiking, or do any other outdoor activities you used to enjoy for fear of seeing a spider, you may have arachnophobia.

According to licensed clinical psychologist Dr. Brenda K. Wiederhold, PhD, MBA, President of the Virtual Reality Medical Center (VRMC) in La Jolla, California, “A phobia is a diagnosable disorder that impacts your life negatively.” But don’t worry, there are treatments that can help. Virtual Reality (VR) exposure therapy helps the sufferer desensitize to the stimuli that causes their phobia. For example, those who have arachnophobia may be exposed to VR scenarios of spiders in a non-threatening way to gradually decrease the fear at the patient’s own individual pace.

Virtual Reality therapy exposes you to the scenarios in the safety and comfort of the therapist’s office. Licensed clinical psychologist Dr. Brenda K. Wiederhold, PhD, MBA, has been practicing Virtual Reality (VR) therapy for over 2 decades. She completed the first randomized controlled clinical trial in 1996 using Virtual Reality and biofeedback to treat patients with phobias.  And the VRMC has been successfully performing VR therapy now for 23 years!   With a new set of skills on how to react differently and think differently about spiders, followed by gradual exposure through VR, you can be enjoying that camping trip in no time!

Most individuals with a specific phobia require on average one clinical intake session and 10 treatment sessions.  If you live in the San Diego area, you can choose to come once a week or twice a week.  If you are coming from out of the area, we can accommodate “condensed treatment” where you will experience one VR session per day, each day, Monday-Friday.