Equipped with a virtual reality headset, the viewer sees the interior of a passenger plane as it gently starts to shake in response to turbulence. As the turbulence worsens, the viewer can see a thunderstorm outside the windows, rocking the plane even more. But this isn’t a VR game: It’s a therapeutic approach to treating a patient with a crippling fear of flying.

Researchers and therapists are increasingly applying technology usually associated with gaming — including VR headsets and lifelike 360-degree virtual worlds — to treat anxiety, phobias, post-traumatic stress disorder (PTSD) and other mental health issues. By exposing patients over time to the source of their fears virtually, their anxiety diminishes.

Using VR to treat mental health disorders is not brand new. Thanks to clinical studies dating back to VR’s use in the mid-90s to treat common phobias and research from “Virtual Iraq” — a set of VR environments developed to help Iraq War veterans recover from PTSD — the technology has become an accepted therapeutic approach, even if it isn’t commonplace in therapy offices yet.

“People still think it’s radically experimental, but that couldn’t be further from the truth,” says Thomas Overly, the founder of the VR Therapy and Counseling Center in Grand Rapids, Michigan. “We’re doing standard cognitive therapy and exposure therapy. But we’re now using a tool that allows us to approach treatment in a way that simply wasn’t possible before.”

Breaking through emotional numbness

Unlike real-world exposure, VR technology helps patients confront objects or environments that trigger anxiety with tools that both the therapist and the patient can control.

“Only about 15 percent of the population has a good enough imagination to conjure their fears,” says Dr. Brenda Wiederhold, executive director of Virtual Reality Medical Center in San Diego. Simply relying on a patient’s imagination can’t break through their defenses.

“Patients are often emotionally numb,” adds Hunter Hoffman, director of the VR Research Center at the University of Washington’s Human Photonics Lab. Hoffman says that most patients have learned to block their feelings of anxiety and avoid the source of their fear, but “with VR treatment, patients are emotional. It’s a powerful way to reinstate the content of the traumatic event.”

In other words, the patient needs to become anxious and frightened in order to learn how to tolerate the situation. These incredibly lifelike virtual worlds deliver that environment. Hoffman explains how this process worked with a patient suffering from a severe fear of spiders. Wearing a VR headset and watching “Spider World,” a virtual world created by University of Washington researchers, the patient saw a tarantula on the other side of a room. At first her anxiety spiked, but after 20 minutes or so of watching the spider, she became more comfortable about being in the same “room.”

In successive sessions, the patient virtually brought herself closer and closer to the spider. Thanks to the VR environment, she could back away from the spider if the anxiety became overwhelming, and approach it when she felt confident. “The beauty of VR is that you have control over how emotional the patient gets,” Hoffman says. “You want the patient to be uncomfortable, but up to a 7, not a 10, so you can back up when needed.” The VR treatment resulted in the patient actually being able to handle a live tarantula.

Wider adoption may depend on cost reduction

How well does VR therapy work, compared to traditional therapy methods that don’t use VR? Psychology professor and VR researcher JoAnne Difede conducted a study of people suffering from PTSD after the September 11 World Trade Center attacks and found that those who underwent VR therapy showed a significant decline in PTSD severity compared to people who did not have the treatment. In addition, Wiederhold and other researchers found that patients who suffer from agoraphobia and received VR treatment needed 33 percent fewer therapy sessions than those patients undergoing traditional behavioral therapy.

In tandem with research showing VR’s promise in treating health issues, improvements in VR technology and reduced costs may boost adoption by more doctors and therapists. Costs for a VR headset and a computer or laptop to run VR software can start at about $2,000; clinicians then need to either purchase existing software, or commission custom VR worlds from software programmers.

Therapists and researchers say the good news is that VR technology and accessibility is improving rapidly thanks to its gaming and industrial applications — so its potential as a mental health treatment is just beginning. “The younger generation has been exposed to so much realism” in video and gaming, Wiederhold says. That audience is likely to embrace VR as a way to address anxiety and phobias, since it’s technology they know well. “As VR becomes graphically rich, it will be much better for those coming in for treatment,” she adds.