I envision a time when you go to boot camp and the first day you get requisitioned your equipment and you get “Here’s your helmet Private Rizzo, here’s your gun, here’s your backpack. Here’s your Gear VR.”

“Here’s your helmet Private Rizzo, here’s your gun, here’s your backpack. Here’s your Gear VR.”

In that Gear VR, it’ll contain 75 lessons that you will be expected to interact with during the course of the next 10 weeks. And it doesn’t have to be just resilience training, it can be everything from squad tactics and visualization and line of fire training. All things that leverage what VR is good at. That 3D visualization, that ability to put you in situations that are hard to create in any systematic fashion.

So that is where some of the PTSD work is moving towards, not just treating PTSD but maybe building emotional resilience, cognitive resilience in ways that make it easier for people to better cope. My analogy is like you’re taking a 19-year old whose biggest trauma up to that point was Mary-Sue breaking up with him the day before the senior ball. And now you’re putting him in a combat zone where he can see his best friend’s head get blown off. How do you deal with that shit?

So that’s what we’re aiming to do with that. So in that zone of PTSD and military trauma advancing the technology, advancing the application area to sexual trauma and combat medic trauma now, and doing the research, and documenting all this, and then expanding it now to reliance training at a low-cost format. Leveraging the recent advances in mobile phone delivered VR.

Exposure therapy is an endorsed treatment for PTSD, what other treatments are now available using VR?

SR: Exposure therapy is the area where VR has had the biggest impact because it perfectly matches the requirements for doing exposure. The ability to help to confront and process difficult emotional memories in the context in which they occurred. Even if it’s not an exact replica of what they experienced, it’s close enough to activate those memories and help them to go back and to confront them, and it falls into the category we call Trauma Focused Therapy.

Some people think “Oh no! once somebody has PTSD, we want to help them forget.” You don’t want me to be dwelling on it, you what to focus on the future, but the only way they can do that adequately is to get right with the past. And so this is where the trauma focus comes in with the prolonged exposure.

There are other methodologies that are trauma-focused like cognitive processing therapy where the user or the client writes down a narrative of their traumatic experiences and then the clinician uses that written narrative for the processing that goes on in therapy. But it’s still trauma-focused and you’re asking the person to construct and write their experience in VR where they’re in the simulation and they’re narrating their experience while the clinician in real time adjusts everything in the environment to match what they’re saying, and the clinician has a Wizard of Oz control panel to do that.

So what about EMDR? (Eye movement desensitization and reprocessing, an effective technique used by therapists for treating trauma).

SR: It’s applied VR for that even though EMDR is a trauma-focused therapy. You’re asking a person to imagine the trauma while they’re doing the eye movement. But no one has applied it in that area. People will in the future but our software is really generic. It’s really a set of 14 different worlds that have a lot of diversity whether it’s an Afghan village, a remote mountain outpost , a populated Iraqi city, or an industrial zone. You can put people in anyone of those places and systematically manipulate the time of day, the lighting, weather, ambient sounds, distance of explosions, the number of people. So theoretically, our system could be applied beyond just Bravemind to EMDR because you can help the patient reconstruct their trauma narrative and become engaged in it, and that’s the key thing.

If people aren’t emotionally engaged in retrieving their traumatic memories, if they’re just repeating back a cognitive rendition of it with no emotion, they don’t usually show good outcomes, and that is typically measured with things like galvanic skin responses or talking. If you don’t see any bumps, you see poor outcomes.

VR is simply a tool to enhance the engagement of the patient with their traumatic memory and to give the clinician a more accurate vision of what the patient has gone through for constructing this. Patients actually feel that a trauma therapist using Bravemind actually has a better idea because they were a partner in the reconstruction of it in VR.

I know you’re veteran-focused. That you work with the VA a lot, are you working on any other types of trauma?

SR: Yeah, I’m working with a buddy here who has a fear of public speaking application. And people have been doing this for a long time. That’s not novel but we’re trying to bring a novel technology into the mix. With better sending of the user’s state looking at their vocal parameters. How they’re taking. Giving them feedback on that. And that fits in the same category as the job interview training stuff that we’re doing with high functioning autism where we build virtual job interviewers that are systematically controllable. We can make them nice interviewers or we can make them son-of-a-bitch interviewers. And that represents different age, gender, and ethnic backgrounds. We put them in different backdrops. So it could be for a job interview for a restaurant or a warehouse or an office.

We’ve built out these kinds of interactive things for civilian applications. With PTSD, you could say, if the clinical trial is successful which is looking like it will be. Then the content we build, which is primarily civilian content, will then be available for civilian uses like those relating to sexual trauma.

The anxiety for job interview training is also a big one. We want to also extend the autism work beyond job interviewing to make it more applicable for practicing social skills on the job, practicing with virtual people. Because we know that high functioning autism folks have great talent sometimes and great abilities and they can do the job. But if they run into trouble with social interaction on the job, that puts them at risk of losing it. So we want to start working in that direction. We’re working on using the Gear VR to deliver the virtual classroom for testing kids with ADD and other attention and cognitive functions.

Of course, we have all our physical therapy and occupational therapy work which is civilian focused towards people after a stroke or traumatic brain injury from a car accident or a spinal cord injury. They all have military roots but the funding the military gave us allowed us to build out an architecture and authoring kit that we can now apply to patients following cancer treatments and help them to maintain their contact with their doctor or learn information about their treatment, or to do clinical interviews at any hospital.

We can train any doctor with virtual patients on how to best conduct a clinical interview, taking various types of patients with the clinical conditions. Essentially, giving a novice clinician the chance to screw up a bunch with a virtual patient before they ever get their hands on a live one.

We’ve got a lot of guiding principles but two of them are important. We don’t build one-offs, we try to build systems that evolve and that we can apply to other areas and address other needs. So our mission really is to take what we get funded in the military context and build strong architecture so that for similar problems in the civilian sector, it’s just a matter of changing the content and doing the clinical trials with a civilian population, and document that it adds value to existing treatment. And the second principle is to build things that we can translate to a wider range of clinical conditions. To build an infrastructure of VR so to speak.

That’s perfect, and goes right to my next question. How are VR programs going to become available to clinics or even private clinicians?

SR: I think that probably the most exciting thing we’re seeing is with some of the phobia applications. The capacity to do that on a low-cost display like the Gear VR or similar types of technologies.

There is a company out of Spain called Psious. They’ve marketed a product that runs on the Gear VR that addresses the fear of flying and social phobia and a number of other phobias. Virtually Better, a company that has been around for 20 years is now transitioning much of their stuff to mobile devices.