At first glance, everything seems normal in this apartment with a neat design. But observing well, we see in a corner of the entrance long legs that move on a dark ball: a big spider. As one goes around, black creatures multiply. Nightmarish for phobic, this visit is an illusion, created by a virtual reality headset and joysticks. Guided by the voice of a therapist, the arachnophobe learns to tame his anguish. At the end of a care protocol, he is even invited to catch – virtually – the critter.
This particular video game is one of the applications developed by the Canadian team of Stéphane Bouchard, one of the leading laboratories in the use of virtual reality for mental health. In his laboratory in Gatineau (the city facing Ottawa), at the University of Quebec in the Outaouais, the effectiveness of a cure for arachnophobia is very concretely measured by measuring how many centimeters a patient accepts to get closer to a real tarantula, placed in a vivarium.
Virtual reality to cure phobias? The treatments are based on the same principles as conventional cognitive therapies, that is to say on exposure to objects creating panic. “The therapist helps the patient to change the interpretation of the signals that trigger panic,” explains Stéphane Bouchard. It's about reeducating the brain, dominated by the automatic response of the amygdala, which sends an alarm signal to the sight of a spider, a dirty bathroom, a compact crowd …
A safe and fun approach, which dramatizes the care
While a classic therapy appeals to the imagination, virtual reality brings an immersive experience that creates an “illusion of presence”. And it has two advantages that traditional behavioral therapies do not offer: first, security. It allows, for example, to reproduce the environment of a plane taking off safely for the phobic. At any time, the patient can leave the game: no risk of panic attack. “The virtual makes it possible to induce the emotions to the rhythm which the professional needs it”, adds Stéphane Bouchard. Secondly, “the game-based treatments can dramatize the therapy and attract patients who were reluctant to consult in a traditional way,” says Pierre Gadea, founder of C2Care, French leader of serious games used in psychiatry.
“A scientific literature provided, the first study of which dates back to 1995 and which includes some 900 articles and thirty very serious studies, proves the non-inferiority of virtual reality treatments compared to conventional treatments,” says Karim Ndiaye, the manager of the PRISM platform of the Brain and Spinal Cord Institute (ICM). In other words, treatment with a virtual reality headset is no less effective than conventional treatment, it is proven. Dedicated to the functional exploration of human behavior, the cognitive science laboratory piloted by Karim Ndiaye allows Pitié Salpêtrière practitioners to test the effectiveness of new treatment protocols. “Virtual reality also opens up very interesting perspectives in neurology, for example for the rehabilitation of patients who have had a stroke or, more recently, to treat pain,” adds Karim Ndiaye.
Developed jointly with the psychiatric teams of major hospitals, the serious games using virtual reality headphones covers a spectrum that continues to grow: fear of the plane, agoraphobia, fear of emptiness, obsessive-compulsive disorder (OCD), addiction to games, drugs, alcohol, sex , eating disorders, fear of social intermediation, post-traumatic stress disorder, cognitive disorders in geriatrics …
Virtual reality headphones cover a spectrum that continues to expand. Credit: C2Care
Each application launched by C2Care – which sells its software by subscription to health professionals – is done in collaboration with the laying of a reference hospital service in a particular pathology. “For the post-attack stress syndrome, we are working with Professor Benoît in Nice, for pathological games, with Professor Cottencin's team in Lille, for addiction to cocaine, with Professor Georges Brousse, in Clermont-Ferrand … “details Pierre Gadea.
The boom in treatment slowed by the lack of care in the city
“France is one of the countries most open to these new treatments.In three years, we have equipped more than 600 liberal and clinical doctors,” says Pierre Gadea. C2Care, the company it launched in 2016, today dominates the French market. Its competitors are InVirtuo, the company that markets Stéphane Bouchard's research, as well as the Spanish publisher Psious.
The rise of these innovative treatments, however, faces a significant economic drag: psychotherapies in the city are not reimbursed by the Social Security, which only supports treatment at the hospital.