Me, Meet Virtual Me
Working with an avatar in virtual reality can help you overcome mental health setbacks
You’re standing completely still in what you know is a nearly empty room, with an awkward headset covering your eyes and pressing down on your forehead. In front of you: an animated version of yourself. You lift one arm and the other-you lifts its arm. You turn your head and other-you does the same. It seems like a party trick at first, a simple source of entertainment, this other-you. But the longer the illusion continues, the more you start to forget that it’s an illusion at all. You become that bit-coded hominoid. If a hand reaches out and pokes other-you, you’ll swear you feel it on your arm.
“Two minutes of simulation can override an entire lifelong experience when it comes to what your body is and where it is,” says neurologist Olaf Blanke of the École polytechnique fédérale de Lausanne in Switzerland.
What happens next, as you’re immersed in a virtual reality, could change your behavior for hours, days or even months to come. Researchers like Blanke have started to pull back the curtain on how the brain responds to simulated realities, and they’re finding that taking off the headset, or flicking off a screen, doesn’t end the effects of the technology.
Watching an avatar of yourself exercise makes you more confident in your ability to work out — and more likely to exercise in the days to come. Likewise, watching your own avatar comfort a child lifts your mood, seeing your avatar quickly gain weight after overeating can temper your appetite, and meeting an old-you avatar can inspire you to save more money for the future.
As the observations pile up, they’re becoming clinically relevant: working with
an avatar of yourself can help you overcome phobias of giving a speech or
flying on a plane.
Your digital self can also lessen physical pain or treat post-traumatic stress disorder. As gadget makers have pushed forward the technical capabilities of VR headsets, scientists have been identifying the ways in which the devices can change our behavior, for good or ill.
They’re finding that when it comes to psychological impact, VR therapy probably won’t hinge on the advanced capabilities of the upcoming Oculus Rift, Sony’s Project Morpheus or Microsoft’s HoloLens. Just hopping into a simple, ’90s-era virtual environment is often enough to trick your brain into new patterns of thought.
Yet as the price and bulkiness of these devices drop, a visit to VR will likely become a more commonplace tool for soothing bruised psyches or improving well-being. “These technologies could start to merge with what is already becoming another big field: wearable health,” Blanke says.
When researchers first started asking how virtual settings might affect our offline lives, they turned to rudimentary studies on video gaming rather than high-tech immersive VR. Today that line of research continues to inform VR work as it remains easier and cheaper to set up. True VR requires headsets to surround a subject with an alternate reality, sensors to track their motions, and speedy software to translate their gestures to the behavior of an avatar with no noticeable time lag.
A well-done video game can partially immerse someone in another world with just a monitor and a handheld controller. And research on video game play has hinted that you don’t have to be aware that a technology has its tentacles around you for it to have an effect.
In fact, many studies on both video games and true virtual realities have found that it’s more common for subjects to not notice the influence outright.
When Gunwoo Yoon, a doctoral student at the University of Illinois at Urbana-Champaign, asked undergraduates to play either superman or Voldemort in a computer game, the students later said that they didn’t particularly identify with either character. But their behavior showed otherwise. After five minutes of gameplay, Yoon and his colleagues asked the students to stop playing and help them instead with what they claimed was an unrelated experiment: doling out portions of chocolate and hot chili sauce for the next volunteer to eat. The participants who had played superman generously served up more chocolate than did either those people who had played Voldemort or a control group; the former Voldemorts doled out the most hot sauce. The research was published in 2014 in the journal Psychological Science.
“The biggest surprise was that even though most students didn’t perceive themselves as identifying with superman or Voldemort, they continued to behave in ways consistent with their avatars,” says Yoon.
It’s not every day that someone must decide how much chili sauce to feed an unsuspecting victim, but Yoon’s initial findings—that just five minutes of playing a stereotyped character can guide a person’s behavior—are leading him to pursue more practical applications of virtual reality and gaming. He’s planning virtual realities that let patients with autism or social anxieties interact with avatars in everyday settings, for instance. And he’s curious about how to use virtual realities to boost healthy habits. In 2010, researchers at Stanford showed that watching an avatar of themselves run on a treadmill made people more likely to work out. Yoon wants to see whether that effect can be caused by an even more subtle immersion — controlling a healthy-looking avatar in a game that’s unrelated to exercise
“Today people have the option of living in their everyday reality, or living in all sorts of virtual realities,” Yoon says. Because they are growing more ubiquitous, it has become all the more important, he says, to understand the covert effects of simulated settings.
So what’s happening in the brain when you unintentionally start to act like an assigned character in a virtual reality, or when you wince in pain when your avatar gets poked? That’s what Olaf Blanke is working to understand.
I ask Blanke what the difference is between seeing a character that you identify as another person, and seeing an avatar that you view as your own body. “The temporo-parietal cortex,” Blanke answers. This area of the brain, where the temporal and parietal lobes meet, is thought to integrate all sorts of information from different sources: what we see, hear and feel.
Blanke was a practicing neurologist, working with stroke and epilepsy patients, when he became interested in what it meant to have a physical sense of self. Some of his patients reported out-of-body experiences after their strokes or seizures, and he didn’t have a scientific explanation for what was happening.
“The patients’ experiences were really like biological avatars,” Blanke says. The patients would feel that their body was located a few feet away from their vantage point; they’d see themselves in the third person.
Blanke started studying the brains of these patients, as well as the brains of people immersed in virtual realities that displaced their physical identity. When you look at an avatar that’s meant to be someone other than you, the temporo-parietal cortex stays quiet. But when the avatar starts mimicking your movements, showing your heart rate or speaking your words — all tricking your brain into thinking the avatar is your own body — the temporo-parietal cortex lights up, just as it does when you watch yourself in a mirror. Similarly, Blanke found that patients with out-of-body experiences often had strokes or seizures that affected this area of the brain. “The initial surprise was just how easy it is to trick the brain,” he says.
As Blanke carried out studies that required healthy volunteers to interact with an avatar of themselves, he started to notice something else uncanny. “The more you embody the avatar, the less you embody your physical body from your brain’s point of view,” he explains. When someone is truly absorbed in a virtual world, living as their avatar, they’re less likely to notice if you poke their real, physical body. Blanke immediately thought of the implications for treating chronic pain.
Since this initial observation, he’s gone on to show that, indeed, he can decrease the amount of pain someone feels by redirecting their attention to a virtual body. In addition to having an avatar imitate someone’s movements, Blanke has found that a trick involving physical touch really convinces the brain that an avatar is one’s own body. So Blanke’s setup involves simultaneously stroking a person’s back with a stick, and showing their avatar’s back being touched in exactly the same way (it’s a high-tech version of the classic rubber hand illusion).
Now, Blanke is testing the technique in spinal cord injury patients and amputees who have phantom limb pain. By first stroking an amputee’s back, followed by the avatar’s back, and then showing the subject the avatar’s leg being touched in a virtual setting, Blanke hopes he can induce feelings other than pain in their limbs. “We’re working on different cases now where patients could use this technology for acute flare-ups of pain,” Blanke says.
The plummeting price of VR technologies is spurring more clinical studies using virtual environments, Blanke points out. But what that means for consumers isn’t clear — his studies require extra sensors to exactly match up an avatar’s motions with one’s own. “The tracking needs to be ultrafast and robust,” he says. “If you use a VR that’s not perfectly fine-tuned, you get motion-sick.” Though commercial VR devices like the Oculus Rift completely surround your vision with a virtual reality, and track the motions of your head to align what you see, they don’t allow you to, say, see your own hands and coordinate your real-life hand motion with those on-screen hands (at least not yet— companies like Sixense are working on it).
Where avatar-based virtual realities are already being put to use is in psychiatric clinics that specialize in the treatment of phobias and anxieties. They use virtual realities to expose people to their fears in a safe manner. Scared of flying? Spend increasing amounts of time on a virtual plane to teach your brain to stay calm in the air.
Deathly afraid of spiders? A virtual room with some small creepy-crawlies might slowly help you become less terrified.
At the Virtual Reality Medical Center in San Diego, these kinds of therapies aren’t just theoretical; they’re carried out on patients every day. Executive director Brenda Wiederhold, also a researcher at UC San Diego, says she’s been using the technology on patients since the mid-1990s. Before that, clinicians working to calm phobias could either ask patients to visualize their fear, or use the real thing. Both have drawbacks, as only about 15 percent of the population is any good at imagining, Wiederhold says. But the virtual realities are incredibly effective.
“Our brain really doesn’t know the difference between reality and a virtual reality in a lot of cases,” she says. “If I expose you to a spider in a virtual setting, your limbic system will light up just as if you see a spider in real life.”
And once again, the participant isn’t always aware of the effect, or even what’s real or not. After experiencing a virtual airplane, Wiederhold says, she’s had patients comment that the smell of coffee as the flight attendant came down the aisle really helped immerse them in the scenario. Only there was no smell of coffee.
Oddly, Wiederhold says that though the technology is better today than it was in her first trials in 1996, her therapies are no more effective. “I got great results with a very antiquated, pixelated world back then,” she says. “Today we can use more photorealistic realities, but the success rates aren’t really any different.”
In fact, she says, she thinks that less realistic realities might sometimes be more effective because patients’ brains have to fill in the details. If she immerses a plane-phobic patient into a detailed virtual 757, the patient might say, “Well I’m not as scared of 757s as 767s,” or “this airline doesn’t fly 757s anymore, so I know this isn’t real.” But immerse them into a generic, slightly less realistic plane, and they won’t be picking apart the reality. (It’s just a theory, Weiderhold admits, adding that she’d “absolutely love for someone to do a study on this.”)
Since the early 2000s, many insurance companies have covered part or all of the immersion therapies at Virtual Reality Medical Center, since they’re billed as cognitive behavioral therapy, a widely accepted technique.
Many patients, Wiederhold says, come in for ten or 12 sessions and do great for years afterward. As word gets around, she says, she thinks more centers like hers will offer the virtual reality-based therapies. “It’s definitely starting to become more common, and I think it will continue to do so as the price of the hardware comes down and as clinicians get trained,” Wiederhold says.
Aside from using virtual realities for exposure, there’s another whole school of thought about how avatars can help people. Called the Proteus Effect by researchers, it’s the idea that someone’s behavior can be affected by the appearance of their avatar (rather than the environment) in a virtual setting. This is where Yoon’s ideas are rooted: identify with a villainous avatar and you’ll act slightly more nefariously, identify with a healthy avatar and you’ll want to be healthier. It has less do with the virtual environment and more to do with that other-you.
Last year, Laura Aymerich-Franch, then a Fulbright scholar at Stanford’s Virtual Human Interaction Lab, reported the results of a study on how someone’s avatar could lower anxiety about public speaking. Her experiments were based on the Proteus Effect, she says.
Previous studies that used avatars to affect public speaking anxiety had focused on manipulating the audience in a simulation: a cheering audience, say, might boost someone’s confidence more than a sleeping audience. Aymerich-Franch (who is now a Marie Curie fellow at the National Institute of Advanced Industrial Science and Technology Joint Robotics Laboratory in Japan) says she was surprised that studies hadn’t instead tried manipulating the appearance or behavior of the avatar itself.
In Aymerich-Franch’s first study, she asked 82 volunteers to give a speech in a virtual environment. Each participant was assigned an avatar that either looked similar to themselves, based on a photo, or an avatar based on someone else’s face.
The more someone looked like their avatar, Aymerich-Franch reported in 2014, the more anxious they were while giving the speech. “People who suffer from social anxiety tend to pay more attention and magnify the negative aspects of their selves,” she says. But when a participant’s avatar looked sufficiently distinct, that person could remove himself or herself more easily from the situation.
But in a second experiment, similar appearance mattered more. Rather than use avatars (which mimic a person’s movements), she turned to doppelgangers (which look just like you but act independently). When a person watched their doppelganger deliver a great speech, they became less anxious about public speaking.
“Since digital doppelgangers possess a strong resemblance to the physical self,” Aymerich-Franch says, “they have great potential to serve as powerful models.”
In a somewhat similar study published last month by researchers in Europe, when participants watched their own avatar comfort a child, they got a mood boost, rating themselves as less self-critical and more self-compassionate afterwards.
Because both the environment and the “self” can be so easily manipulated in a virtual reality, VR can be used to study the effects of numerous aspects of the world on our thoughts. A prominent Stanford lab, for instance, is exploring how virtual reality can alter people’s empathy or prejudices toward one another, their attention and learning abilities, and the resources they consume (if you see virtual trees being chopped down, you’ll use less paper, for example).
For Blanke, it’s more basic questions, such as how all this self-identity plays into the idea of consciousness.
“It goes back to Descartes,” he says. “Cogito ergo sum.” I think therefore I am. But if our brain adopts an avatar as a body, are we still?
“We seem to take for granted that our consciousness is in our body,” Blanke muses out loud. “But what if it’s not?”
Not every problem can be solved by immersing us all into an alternate reality. But for tweaking small behaviors, and pulling out the best, most confident and compassionate sides of ourselves, hanging out with a well-designed avatar might do the trick. “I think some people in the field have oversold virtual reality,” Wiederhold says. “It’s not the be-all and end-all, and it won’t cure everyone and everything. But it’s a nice starting point.”