Virtual reality (VR) is on the rise again. While its initial peak occurred in the mid-1990s, today our society mentionsvirtual reality‘ more than ever. Is this resurgence another trend, or are we officially opening the doors to alternate worlds for mass public access? 
 
The term ‘metaverse’ was coined by science fiction author Neal Stephenson in the 1992 book “Snow Crash” to describe the invention of virtual reality worlds that people would immerse themselves into. Today, the term means more or less the same thing, representing the transition from human infatuation with the natural world, and towards immersion in augmented and virtual worlds. It’s not Orwellian, but equally as prescient: considering that the latest VR headsets cost less than the omnipresent smartphone, it’s a safe bet that we’ve crossed the threshold of the virtual door sill and into the odd future of the metaverse. Fair warning for those planning to throw caution to the (virtual) wind: too much time spent in immersion can lead to nausea, fainting, and even seizures in epileptic patients. 
 
Prosthetic Imagination 
 
Who said that imagining is easy? John Lennon’s cerebral lyrics [“Imagine…it’s easy if you try”] still echo in the minds of many. However, due to neurodiversity — a term that means we are all unique to the core –, some of us lack the gifted third eye that cultural mavens like the Beatles’ late frontman developed. For those of us with an imagination that needs a good kickstart to get going, there’s good news: you might no longer need to close your eyes to imagine. Instead, a virtual reality can serve as a type of prosthetic imagination. 
 
Dr. Kim Bullock, MD, founder and Director of Stanford’s Neurobehavioral Clinic and Virtual Reality & Immersive Technologies (VRIT) program and laboratory, reported that virtual reality works because for the majority of people, vision is the most influential sensation for perception. This tendency for vision to dominate our senses, coined visual capture in psychology, allows VR experiences to immerse their users. VR leverages visual capture to hijack and guide attention to prevent it from drifting away. In modern devices, it only takes 5 to 7 seconds to trigger an immersive state. “Immersion in perceptual psychology refers to the robustness of a device to create a sense of presence of really being somewhere else or being someone else,” reported Bullock. Several factors — quality of the scene display, responsiveness of the virtual environment, tracking and rotation of head/body movement — stimulate the brain in such a way that we actually believe we’ve been transported somewhere else. “This very customized visual guidance can help people stay focused as well as relieve the burden/cognitive load of generating their own mental imagery,” said Bullock. However, you don’t want the experience to look “too real”, which seems eerie and leaves people with an uncomfortable feeling. Rather than being a direct replication of the real world, effective virtual realities stay on the unreal side of the uncanny valley and are more cartoonish. 
  
The trademark of a virtual world is the ability to transport people into environments that extend the ideas and boundaries of the self and location. On the consumer end, the potential for creating more immersive versions of online social/gaming worlds like Second Life are limitless. However, VR has the potential to be more than postmodern forms of social media and gaming in the recreational sector. 
 
Applications 
 
Medical professionals, researchers, and technologists are exploring the implications of these new perceptual environments because they see the potential for therapeutic benefits and soft skills development. To date, VR has been tested to assist in treating conditions like depression, anxietysubstance abusepalliative care, and even has the potential to reduce implicit bias, and improve social skills training. 

For example, TRIPP, a company that produces VR software, has partnered with the Nathan S. Kline Institute for Psychiatric Research (NKI), The National Institute of Drug Abuse, and others to explore its potential uses. TRIPP’s immersive wellness platform uses prior research in mindfulness structures, targeted sound frequencies, visuals and interactions that are delivered through a psychedelic virtual reality experience. The trippy visuals aren’t just for looks, they synchronize with breathing exercises that promote relaxation and focus to provide non-chemical, digital alternatives. TRIPP is in the middle of several clinical trials to determine how VR experiences may: help reduce anxiety and pain, which could reduce the need for opiods, enhancement of perioperative well-being and quality of life, support recovery from alcohol and stimulants, and ease the transition for patients who require a form of psychedelic intervention. 
 
One of VR’s promising uses, according to Dr. Bullock, is by modifying how people act, feel, and think during challenging situations. If you have a fear of flying, experience anxiety in public places, or even wish to be more effective in social settings, VR could provide a safe playground to face those fears, even from home! In the middle of the pandemic, VR is quickly becoming a frontrunner technology for telepsychiatry. For example, Bullock uses VR exposure therapy in order to help patients overcome their fears, by rewiring their brains. “We don’t know exactly how VR changes the brain in behavioral health but we can assume it works similar to other psychotherapies: 1) enhancing normalization of the amygdala habituation thought extinction / desensitization in exposure therapy and 2) helping improve executive functioning through skill acquisition,” said Bullock. This type of state-dependent learning allows people to expose themselves to virtual situations that go beyond typical scenario building and immerse users in a life-like experience. The virtual simulations lie somewhere in between a full-on natural moment and the attempt to imagine what it would actually feel like. This virtual middle ground serves as an ideal (and safe) space for users to stimulate their minds and nervous systems while limiting any physical threats. But these types of modified behavioral training are not just for psychotherapy and telepsychiatry, they also are being used in the workplace to promote skill acquisition through virtual coaching.
 
For most people, learning how to manage their conduct at work happens on the job. VR training modules can enable employees to practice essential skills before they actually encounter them in the workplace. Medical schools are currently using this especially in surgical training, added Bullock. Virtual coaching could be an HR manager’s dream playground for simulating hiring interviews, difficult conversations, and even basic training for employees, managers, and leadership. For example, a VR program encouraging employee voice could place users in a virtual meeting where presenters and viewers take turns speaking. The user — who is normally too shy or scared to speak up during a meeting — would be prompted to express their thoughts during suggested, optimal breaks in the presentation to avoid interruption or speaking out of turn. At the same time, people who typically present at meetings could take a similar training where they learn how to create more safe space and opportunities for employees to express themselves, while also learning how to deliver encouraging and positive feedback. Additionally, VR is being used in the workplace for diversity training and to decrease implicit bias.  
 
Believe It or Not 

The possible applications for VR are as limitless as the metaverse itself, and the momentum behind its second hype train is very real. But can you really find a healthier version of yourself in a virtual world? Some of the brightest minds in medicine and technology are on the road to determine the effects of VR on health and wellness, but the outcomes are just beginning to be understood. For now, VR remains yet another breakthrough technology for wellness, but mass adoption will rely on trusted results. 

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Nicklas Balboa

They say it, I write it. This journalist from the Bay Area is known for covering psychology, neuroscience, and tech…but occasionally dabbles in grittier topics.