“On a scale of 1 to 10, how anxious are you?” This is the question that Pierre Gadea regularly asks our journalist Laure. With a virtual reality (VR) headset on her eyes, she agreed to participate in a small experiment during which her nerves will be tested. Pierre Gadea is responsible for business development at C2Care, a French company that provides a digital solution for patients with anxiety disorders, including phobias. And for the occasion, Laure decided to act as a guinea pig.
One of C2Care’s specialties is C2Phobia: therefore the patient wears a virtual reality headset and is immersed in a world that looks like a video game. The different universes developed by the company allow the patient to deal with his phobia: fear of flying, driving or even fear of heights. For this test, Pierre Gadea puts himself in the shoes of a health professional, whose presence is always mandatory at each session.
Laure has a real fear of heights. Although the equipment is not installed yet, she begins to get stressed. She puts on the virtual reality headset, the supervisor tells her that her priority is to “go at your own pace.” The idea of C2Care is to personalize the patient’s experience as much as possible by selecting different parameters such as the type of environment desired, the level of difficulty or even the size… At first, Laure takes a while to get used to the environment, she is surrounded by buildings, in the middle of a crowd. Then comes the dreaded step: gaining altitude.
Address the 15th floor of a building. Laure moves in the game using controllers. Pierre Gadea continues to personalize the experience: concrete or glass walkway? With or without railing on the sides?
He also tells her that she can stop at any time. Laure must now move towards the catwalk, but this step turns out to be more complicated than expected: “Oh, I can’t!”
Despite some rather rudimentary graphics, its sensations are therefore very realistic. The head of development deciphers his physical behavior: “You see there his legs stiffen, his face closes, his hands are clenched, his arms along his body, his body reacts, he is in a situation of real discomfort.”
To avoid a panic attack, Laure is asked to breathe easy and descends several floors. In the fifth, she abandons the controllers and is now physically moving. She must cross a concrete walkway. So far everything is going well. But when ropes appear instead of the railing and she has to get closer to the void, it becomes more difficult.
A Gradual Exposure
Although the virtual reality headset is considered primarily for entertainment, it is a medical device. All this implies a very specific protocol.
Until now the exercise was done in real life, but certain situations such as fear of heights can be dangerous. “So VR headsets can be a good solution.”
Launched six years ago by an engineer, a doctor, and a business development manager, C2Care deals with software development and the various environments offered. A team of about ten therapists affiliated with the company accompanies the patients during the sessions.
“If the patient follows one session per week for three months and the autonomous training made possible by the helmet, the phobia can disappear,” says Pierre Gadea. All patients must be accompanied by a face-to-face or remote therapist to guide them.
And the company is far from doing what it wants in terms of developing its solutions. “Between a study and the concrete implementation, about four years pass,” he specifies. “It is a matter of responding to a call for projects, going through a scientific validation, the Committee for the Protection of People validates whether or not the project is ethically viable, then we gather cohorts of patients.”
Dr. Eric Malbos is a psychiatrist at the CHU Conception in Marseille and a specialist in virtual reality treatments. “It is also because of my skills in this area that the CHU came looking for me,” he wishes to specify. He is one of those doctors who help C2Care develop their software by providing medical advice when developing new environments.
For him, the interest of VR is the possibility of being able to gradually expose himself to a situation of phobia.
With his patients he performs 11 sessions. “It’s average for VR therapy. I do 5 group sessions to learn how to manage their emotions, then 6 sessions with the headset. The therapist really accompanies the patient and can see his progress.” According to tests carried out by C2Care after sessions with patients, the success rate of the device is estimated at 85%.
“Use less medication”
The virtual reality headset has also found its place in operating rooms for virtual medical hypnosis. The Strasbourg company Hypno VR “aims to treat pain and anxiety in a non-pharmacological way by combining medical hypnosis with VR,” explains Nicolas Schaettel, co-founder of the company, who has worked for Microsoft and Paypal, to Tech&Co.
Hypno VR was born at the end of 2016 from the idea of two doctors who presented their project at the Hacking Health Camp in Strasbourg. On this basis the company was created.
The helmet can be used before, during or after an operation or for example for chemotherapy or dialysis sessions. “Before to reduce stress, during in addition to local or general anesthesia, after to treat pain,” adds the co-founder.
Tech&Co was able to test drive the helmet to get an idea of the experience. Like C2Care, the goal is to provide the most personalized experience possible. The patient chooses a place in which he wishes to immerse himself (a beach, the mountains, an Asian garden…), a visual universe, a voice… The doctor will also choose them according to the type of operation. Hypno VR also mixes music therapy and hypnotic suggestions.
For the test we chose a snowy forest, with a female voice that invites us to observe her breathing. The formulations are similar to those in yoga classes. In the hull, a door in the middle of a sky similar to a universe, a somewhat magical, almost mystical door. Eventually it opens up and the snowy forest appears.
In the middle of the screen, there is a small white ball. Little by little, the patient advances in this forest, animals appear, snowflakes slowly fall. He feels like being in a cartoon.
Then, little by little, everything is done to get caught up in the decoration and the voice. In this forest the sun rises, the light warms, and the patient is invited to take advantage of this moment that has been granted to me, to relax all his muscles and become aware of his body.
After ten minutes, the session ends and the patient is taken to the end of the forest to a place where several fires are lit. Finally, the voice indicates that “this day is going to go perfectly well.”
“The most important thing is after”
But can everyone be suggestible and use it?
The Hypno VR tool is also a medical device that must meet a number of standards. “We have demonstrated the clinical efficacy of our device through more than 15 studies. We comply with current European standards to allow hospitals to use it safely”. Hypno VR is used in more than 350 healthcare facilities in five countries, including France.
All these virtual reality devices, be it Hypno VR or C2Care, arouse both curiosity and questions. Although the patient is always accompanied by a healthcare professional, these headsets are still intended to move practices towards full digitization.
Dr. Antoine Pelissolo, head of the psychiatry department at the Henri Mondor Hospital in Créteil, collaborates with C2Care to give his opinion on the medical aspect and raise the needs in the creation of new environments. Rather, he sees the virtual reality glasses as a complementary tool: “it cannot completely replace face-to-face sessions”, for example, the fact that a phobic person must also face reality.
VR headsets allow for a less anxiety-inducing approach to the most intensive sessions, but this device faces many limits. “Not all health professionals are inclined to include it in their professional practice because it requires availability, training and freeing up extra time.”
Even if the effectiveness is now proven by studies that have been published on the subject for 20 years, some patients are also reluctant. It is therefore a rather young audience that is tempted by the experience.
Source: BFM TV
