2024-03-17 18:00:00
An Ifop/Fit-bit study from June 2021* indicates that in 2021, a particularly stressful year between Covid and confinements, 54% of French people said they had been stressed. What solutions are proposed to get out of this?
There are multiple applications of virtual reality in medicine. It can be used in eating disorders, schizophrenia, addictions and anxiety disorders. TERV, virtual reality exposure therapy, constitutes a real revolution in the treatment of anxiety. Meeting with Dr Éric Malbos, specialist in therapies by exposure to virtual reality (TERV) within the psychiatry center of the Sainte-Marguerite hospital of Public Assistance – Marseille Hospitals.
How can exposure to virtual reality treat people who suffer from anxiety disorders?
It makes it possible to gradually confront patients with situations that distress them by immersing them in a 3D virtual environment, created by computer, giving the illusion of reality. The goal is for them to feel the same emotions as in a real situation and to learn to manage them. The computer allows you to create any type of environment, such as the interior of a supermarket, a subway or an underground car park for an agoraphobic person. The patient is not passive: in the virtual reality, he can choose to approach the edge of a cliff, pet a dog, press an elevator button, etc. The first clinical studies date back to 1992 – we therefore have more than thirty years of experience – and they attest to its effectiveness in the treatment of numerous anxiety disorders (phobias, obsessive-compulsive disorders, generalized anxiety, etc.). The patient is more serene, he regains his independence even though he no longer dared to leave the house, take a plane or drive.
Is virtual reality exposure therapy (VERT) beneficial in the treatment of post-traumatic stress?
Absolutely. We conducted a study on its effectiveness in the field of evaluation among French soldiers veterans of the Afghan war, with the Sainte-Anne army hospital, in Toulon. The protocol includes around sixty patients; around fifteen were treated. A virtual Afghanistan has been recreated, with shock events such as skirmishes and injuries. Virtual reality helps the patient to relive the traumatic event and to perceive it in a peaceful manner as if they were a spectator. Around ten sessions are necessary. In the United States, civilian victims of the World Trade Center attacks successfully experimented with this method.
Is there not a risk in exposing the patient to what terrifies him?
We don’t expose it straight away. The treatment begins with learning the techniques necessary to manage anxiety: relaxation, stress management, mental imagery, restructuration cognitive… Four to five sessions which can be carried out in a group are necessary. The patient then uses these techniques to manage your anxiety when immersed in the corresponding virtual reality environments. A session lasts thirty to forty minutes, and it takes between eight and fifteen. Which represents two to three months of treatment.
What are the advantages of this technique compared to traditional therapies?
Behavioral and cognitive therapies for anxiety disorders rely on exposure to real-life situations. Many people give up consulting because this exposure seems too brutal, anxiety-provoking and trying. With la PLAN, the situations to which the patient is exposed are gradual in their nature and intensity. We can thus modulate take-off procedures, the duration of a flight, weather conditions and passenger behavior. Furthermore, this exposure can be repeated as often as necessary without problem. Finally, with this treatment, we have the possibility of measuring the patient’s heart rate by placing them under monitoring, asking them questions, etc.
Does TERV have side effects?
Yes. This is what we call “cybersickness” syndrome. It affects 5 to 10% of people and is similar to travel sickness. If patients move their heads too quickly, they may experience nausea, sudations. These symptoms generally occur during the first sessions. This is why we ask patients to turn their heads slowly and take breaks. This recommendation also applies to users who have their head-mounted display at home.
How many practitioners use this therapy today?
A thousand psychiatrists and psychologists listed on the site phobie.com use this method. Exposure to virtual reality can be used as part of behavioral and cognitive therapy but also during psychoanalysis, as Rodolphe Oppenheimer offers in his office on the outskirts of Paris. And patients can now carry out their therapeutic training entirely at home, using a head-mounted display and a computer. Several companies, such as C2Care or In Virtuo, offer virtual environments for paid download for professionals and the general public. 21% of French people have had at least one anxiety disorder during their life. Specific phobia is the most common. Women are significantly more affected than men, and young people more than older people.
Which head-mounted display to buy?
Opt for one of the models popular with gamers. He can…
- Be autonomous, that is to say without the need to be connected to a computer.
- Be lightweight (less than 700 g) and adjustable according to head size.
- Have a high resolution, at least 2160 x 2160.
- Provide as large an open visual field as possible (at least 100°).
- Have a high sweep frequency (at least 90 Hz).
- Have adjustable lenses.
- Be compatible with therapy software sold turnkey.
*Ifop/Fit-bit @The French and stress, June 2021
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