A2 Friday, November 26, 2010 • THE BULLETIN
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Virtual healing for the real world Simulations allow patients to confront phobias in controlled and safe settings
their area, depending on what it has learned.”
My avatar, myself
By Benedict Carey New York Times News Service
OTTAWA — His talk was going just fine until some members of the audience became noticeably restless. A ripple of impatience passed through the several dozen seated listeners, and a few seemed suddenly annoyed; then two men started to talk to each other, ignoring him altogether. “When I saw that, I slowed down and then stopped what I was saying,” said the speaker, a 47-year-old public servant named Gary, who last year took part in an unusual study of social anxiety treatment at the University of Quebec. The anxiety rose in his throat but subsided as his therapist, observing in the background, reminded him that the audience’s reaction might have nothing to do with him. And if a question stumped him, he could just say so: No one knows everything. He relaxed and finished the talk, and the audience seemed to settle down. Then he removed a headset that had helped create an illusion that the audience was actually there, not just figures on a screen. For more than a decade, a handful of therapists have been using virtual environments to help people to work through phobias, like a fear of heights or of public spaces. But now advances in artificial intelligence and computer modeling are allowing them to take on a wider array of complex social challenges and to gain insight into how people are affected by interactions with virtual humans — or by inhabiting avatars of themselves. Researchers are populating digital worlds with autonomous, virtual humans that can evoke the same tensions as in real-life encounters. People with social anxiety are struck dumb when asked questions by a virtual stranger. Heavy drinkers feel strong urges to order something from a virtual bartender, while gamblers are drawn to sit down and join a group playing on virtual slot machines. And therapists can advise patients at the very moment those sensations are felt. In a series of experiments, researchers have shown that people internalize these virtual experiences and their responses to them — with effects that carry over into real life. The emerging field, called cybertherapy, now has annual conferences and a growing international following of therapists, researchers and others interested in improving behavior through the use of simulations. The Canadian military has invested heavily in virtual-reality research; so has the U.S. Army, which has been spending about $4 million annually on programs with computergenerated agents, for training officers and treating post-traumatic stress reactions. The trend has already generated a few critics, who see a possible downside along with benefits. “Even if this approach works, there will be side effects that we can’t anticipate,” said Jaron Lanier, a computer scientist and author of “You Are Not a Gadget: A Manifesto” (Knopf, 2010). “And in some scenarios I would worry about defining humans down: defining what’s normal based on what we can model in virtual environments.” But most researchers say that virtual therapy is, and will remain, no more than a therapist’s tool, to be used only when it appears effective. “There’s a real and understandable distrust of technology as a shortcut for good clinical skills,” said Albert Rizzo, a psychologist at the University of Southern California, “but I think, deep down, most therapists will want any tool that can help them do their work, and they’ll be open to using virtual approaches.”
Virtual humans, real therapy “My abilities are somewhat limited,” says a female voice. “For example, I can speak and listen to what you say, but I can’t do any physical activity.” In an office at the Institute for
Photos by Michal Czerwonka / New York Times News Service
Sin-Hwa Kang, co-author of the Angelina study, a virtual interaction therapy program, demonstrates the software at the Institute for Creative Technologies at the University of Southern California in Los Angeles, on Oct. 20.
The face in the mirror does not look familiar; it has a generic, computer-generated look. Yet it does appear to be staring out from a mirror. Lift a hand and up goes its hand. Nod, wave, smile, and it does the same, simultaneously. Now, look down at your own body: And there, through the virtual reality headset, are a torso, legs, clothes identical to those in the mirror. In a matter of minutes, people placed in front of this virtual mirror identify strongly with their “body” and psychologically inhabit it, researchers at Stanford University have found. And by subtly altering elements of that embodied figure, the scientists have established a principle that is fundamental to therapy — that an experience in a virtual world can alter behavior in the real one.
‘Mini-Me’ in action
Josh Williams, left, and Andrew Smith demonstrate a new therapy program designed to help veterans with post-traumatic stress disorder, at the Institute for Creative Technologies. Creative Technologies at the University of Southern California, a virtual woman named Angelina is addressing a college student from a computer screen. Angelina looks to be about 30 or so, a pretty, athletic figure with an open, intelligent face framed by short black hair. Her eyes and expression, guided by video cameras and microphones, stay in sync with the student’s, as an empathetic therapist’s would. “What are some of the things you hate about yourself?” asks the voice. The student stalls for a moment. “Well,” she says, in a video of the exchange, “I don’t like that I can be really quiet in social situations. Sometimes people take that as me being rude, but it’s just me being quiet.” Angelina nods sympathetically and then asks another question, about what the student fears most. The figures are clearly not human; some are balky with language, others mute. Many have a 2-D graphic-arts quality. But the faces are mobile, blinking, alive, the body language and
Williams demonstrates a new therapy program designed to help veterans with post-traumatic stress disorder, at the Institute for Creative Technologies.
“There’s a real and understandable distrust of technology as a shortcut for good clinical skills. But I think, deep down, most therapists will want any tool that can help them do their work, and they’ll be open to using virtual approaches.” — Albert Rizzo, psychologist, University of Southern California gestures seemingly natural; in some cases, the voice recognition and choice of replies are good enough to conduct a stiff but convincing conversation. The result is a living presence that is responsive but not judgmental. In a recent study using this virtual confidant, researchers at USC have found that Angelina elicits
Arno Hartholt interacts with two virtual characters inside a simulated Old West saloon at the Institute for Creative Technologies.
from people the crucial first element in any therapy: self-disclosure. People with social anxiety confessed more of their personal flaws, fears and fantasies to virtual figures than to live therapists conducting video interviews, the study found. The researchers are incorporating the techniques learned from Angelina into a virtual agent being developed for the Army, called SimCoach. Guided by languagerecognition software, SimCoach appears on a computer screen and can conduct a rudimentary interview, gently probing for possible mental troubles. Using SimCoach on a laptop, veterans and family members would anonymously ask about difficulties they’re having, whether due to post-traumatic stress or other strains of service. “It does not give a diagnosis,” said Jonathan Gratch, a co-author of the Angelina study with SinHwa Kang, also of USC. “But the idea is that the SimCoach would ask people if they would like to see a therapist; and if so, could then guide them to someone in
In the virtual studio at the University of Quebec, patients wearing a headset can have a short conversation with a diminutive, attentive virtual therapist. Except for slight stature, it is a ringer for Bouchard: the same open face, the same smile, the same pelt of dark hair around a bald pate. “Mini-Me, we call it,” Bouchard said. The hologramlike figure seems at first to be minding its own business, looking around, biding time. Then it approaches slowly, introduces itself and kindly asks a question, like some digital-age Socrates: “What is the best experience you’ve ever had?” For now, Mini-Me cannot do much more than cock its head at the answer and nod, before programmers begin to guide the conversation; the scientists are adding more language-recognition software, to extend interactions. Yet Mini-Me offers a glimpse of where virtual humans are headed: three-dimensional forms that can be designed to resemble people in the real world. “You could scan in a picture of your mother or your boss or someone else significant and, with some voice recording samples, use a system that would automatically and quickly re-create a virtual facsimile of that person,” said Rizzo of USC, where programmers have set up an Old West bar scene, complete with a life-size, autonomous virtual bartender, a waitress and a bad guy. “Then, perhaps, we’d be able to stage interactions that might closely resemble those in a patient’s life to help work through challenging issues.”
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