May is Mental Health Awareness Month. It’s a time to deepen our understanding of mental health and behavioral issues, to acknowledge that many of us struggle at times, and to reduce the stigma so those who have difficulties can seek help and come out of the shadows. These last years have been tough. With the COVID-19 pandemic forcing isolation, and other worldwide tensions causing suffering and grief, people have recently struggled to manage their mental health.
According to the Colorado Health Access Survey, which was conducted in 2021 by the Colorado Health Institute, 38.3% of people (1.6M people) in Colorado had a decline in mental health, such as anxiety, depression, or loneliness since the pandemic started.
At Cognitive Behavior Therapy Associates of Denver, virtual reality therapy is used to treat anxiety, phobias, and post-traumatic stress disorder. Additionally, it can help to enhance relaxation and mindfulness. VR treatments also called virtual reality exposure therapy (VRET), allow patients to be fitted with a headset and headphones, enabling therapists to coach them through fearful or uncomfortable situations such as fear of needles, fear of flying, fear of driving, insomnia, and mood disorders.
“Virtual reality is an immersive 3-D experience,’ said Mary Heekin, co-founder of CBT Denver which is located at 600 S Cherry St. “The patient, when wearing the goggles, is having a first-person experience. So, if they are sitting on an airplane they can look right and left and see whoever is sitting next to them. They can look above them and below them.”
Heekin has over 17 years of experience and has worked at the University of Colorado within the Department of Psychiatry and at the University of Denver as an adjunct professor in their School of Social Work. She is focused on evidenced-based practice for a several mood and anxiety disorders. Those include depression, bipolar disorder, trauma, generalized anxiety, perinatal and postpartum depression/anxiety and panic disorder.
Heekin said that she initially began to get into virtual reality treatment when she worked at Emory University in Atlanta, Georgia. She said they did studies with returning combat veterans from Operation Iraqi Freedom and Operation Enduring Freedom.
“The combat veterans were diagnosed with Post Traumatic Stress Disorder. And the study was on the use of virtual reality exposure therapy for combat PTSD. So that was my first experience and understanding of what virtual reality was,” Heekin said. “The human brain does not need the experience to be identical to real life in order for habituation to take place,” she adds.. “Our brains can basically fill in the gaps between the computer world and the real world. We tend to generate the same level, or close to the same level, of anxiety when immersed in a virtual world as we do in the real world.”
Patients can see and hear in a virtual, three-dimensional world during these treatments which are similar to video games. This technology gives therapists the ability to manipulate and titrate the experience to gradually help their patients alleviate their mental health challenges.
Heekin said that virtual reality exposure therapy is different than EMDR treatments which have been widely used for PTSD and trauma intervention.
“EMDR does use technology in a way, but it is not an immersive three-dimensional computer world. It’s simply the use of a light bar or sound or hand buzzers to create a bilateral stimulus across the body,” Heekin said. “VR is, is an exposure tool.
Heekin said that VR therapy is under the large cognitive behavioral therapy umbrella, as many forms of exposure therapy are used to treat different mental health challenges.
“So, if you imagine a big umbrella, the big part of the umbrella is cognitive behavioral therapy. And under that umbrella, you have exposure therapy. And as part of exposure therapy, you have virtual reality exposure therapy,” Heekin said. “The premise behind exposure therapy is that you are therapeutically having patients confront what they fear in increments that help them habituate to their fear over time, and then hopefully, they can function much better in their life because the fear is not as big of a deal.”
She said that this type of exposure therapy allows therapists to create levels to help improve their patients’ fears. For example, if someone is afraid of heights, Heekin said they would create lists that would allow their patients to start by experiencing a height of one floor above the ground and work up to a height of a Manhattan skyscraper.
With improvements to the technology and more accessibility, they have been able to start using it at CBT Denver.
“The technology was pretty expensive, and hard to come by. But in the last decade, VR has become much more clinically available to practices like ours, which aren’t giant, robust research centers,” she said. “So, it’s more available. And cost effective. And you know, we license the software, and we offer it to our patients.”
Now, what about the results? Heekin said that she has seen significant improvements in her patients after using VR treatments, but the progress does take time.
“They improve dramatically. The results aren’t immediate, but they are profound, and you just feel a little worse before you feel better,” she said. “We have seen patients overcome a wide variety of struggles. I would say the most common thing we treat is probably a fear of flying. But we have also treated our fair share of needle phobia, claustrophobia, fear of driving, and fear of public speaking.”
Heekin did say that if you have access to a virtual reality system, using it on your own could help to alleviate some day-to-day stress.
“Mindfulness components for sure,” she said. “I mean, I think that I think that it doesn’t take a therapeutic intervention to figure out how to get a hold of the VR headset and do something like diaphragmatic breathing or body scan.”
Several VR platforms and applications can help alleviate more mild mental health challenges. For example, the Oculus Go headset can use the Liminal and Happy Place applications to improve mood and anxiety and reduce stress. The Oculus Go headset can be purchased for under $300.
Mental health challenges do not heal overnight. It takes time and energy to get your mind to a place where you feel happy and confident. If you are struggling with your mental health, instead of living with your fears, consider conquering them with the help of VR therapy.