‘Hi-tech headset finally beat my terror of heights’: How an NHS trial is using virtual reality to tackle patients’ worst phobias

• New approach of virtual reality therapy run as part of a trial by Oxford University
• Therapy being rolled out on NHS, including in Oxfordshire and Buckinghamshire 
• Uses a computer program to create environment that mimics a real-life situation

There’s only a handrail between me and a 120 ft drop on to massive granite rocks and crashing ocean waves below.

I can see the churning, thundering water clearly through gaps in the decking of the quivering platform I’m standing on — yet, miraculously, I’m not terrified.

This is a revelation. I’ve been scared of heights for as long as I can remember — and it has got worse as the years have gone by. 

Indeed, just two years ago, wild horses would not have dragged me on to this swaying platform over the ocean at Torndirrup National Park, Western Australia, where I recently holidayed with my family.

The virtual reality therapy, which was run as part of a trial by Oxford University in 2018, is now being rolled out on the NHS. (Stock image)

Yet here I was. The transformation, I believe, is thanks to a new approach of virtual reality therapy, which I tried as part of a trial run by Oxford University in 2018. 

This therapy is now being rolled out on the NHS, including in Oxfordshire, Buckinghamshire, Berkshire, Cambridge and Peterborough.

Some experts are hailing virtual reality therapy as an important new treatment for mental health conditions, from phobias to depression, schizophrenia and even pain — and trials are ongoing.

It uses a specially-designed computer program to create an environment that mimics a real-life situation. This is relayed through tiny projectors that patients see through a headset.

The idea is that by gradually exposing patients to the thing that’s causing their symptoms — for example, standing on a ladder for people like me with a fear of heights — in a safe and controlled manner, they become desensitised to it.

Fear of heights — acrophobia — affects around one in three people in the UK and, as was my experience, there is some evidence that it can worsen as we get older.

One theory, says Kevin Gournay, an emeritus professor at the Institute of Psychiatry at King’s College London, is that ‘as you get older, the balance system in the brain tends to deteriorate and you’re more likely to feel physically vulnerable’.

Daniel Freeman, a professor of clinical psychology at Oxford University, who led the virtual reality trial, says: ‘Phobias, such as a fear of heights, have a negative effect on many people’s lives. 

Virtual reality puts someone in a situation that would normally scare them but which is tolerable because it is not real.

‘This gives a vital element of detachment. The user learns that, although heights may feel unpleasant, they do not come to any harm. Over time, this new learning overrides old fearful memories.’

Virtual reality puts a patient  in a situation that would normally scare them but which is tolerable because it is not real. (Stock image)

For me, it seemed like a no-brainer when I heard about the Oxford trial on local radio. I wanted to tackle my fear, which was becoming a real nuisance on family outings, preventing me from joining in activities such as climbing castle towers or walks along cliffs.

My legs would turn to jelly, I’d feel breathless, my palms would sweat. I would be terrified of the thought that if I were to slip — just slightly — I would career over the edge.

I had nothing to lose by giving the virtual reality program a go. For four 30-minute sessions, I wore a headset strapped over my eyes and held controllers in each hand to enable me to ‘touch’ items in the virtual reality world.

Once I had put on the headset, I was dropped into a different world: a large multi-storey shopping mall but one with trees and fruit growing — a clear sign to me that this was a fantasy world and not real, which reduced my anxiety.

I was asked to do tasks through an earpiece. I used the hand controls to pick up virtual items such as fruit or, in the later sessions, a cat stuck in the branches.

By the final session I progressed to walking along a rope walkway suspended some 70 ft over the central void.

It felt very strange throughout: I knew that the mall was artificial, yet still felt that familiar lurching sensation in my stomach, shallow breathing and tingling palms as I found myself standing on the third-floor balcony with only a low barrier between me and the drop. 

The worst part was when the barrier was removed before my first task — I couldn’t help physically leaping backwards several steps.

I felt more confident as the sessions progressed but remained sceptical about whether it would have any long-lasting effect on me.

But for the Oxford researchers, there was good news overall. The two-week trial, which involved 100 adults with a fear of heights randomly assigned to have virtual reality therapy, or nothing, was a success.

Participants were given questionnaires before and after the trial to assess their phobias. We were given scenarios that would usually trigger our phobia — such as imagining standing on a 15th-floor balcony looking down — and asked to rate how scared we felt.

Results published in the journal The Lancet Psychiatry in June 2018 showed all those who received virtual reality therapy reported a significant reduction in their fear of heights — by an average of 68 per cent.

Traditional treatment for phobias involves talking therapies and ‘habituation’ — putting the person in the situation that scares gradually, so they get accustomed to it. Both involve encouraging the person to confront situations that trouble them.

There are potential advantages of virtual reality over traditional techniques as patients are exposed to situations that would be too terrifying or too risky in real life, says Professor Freeman. 

‘A virtual reality gives them time to live with the situation and learn new ways of dealing with it.’

Dr Warren Mansell, a clinical psychologist at Manchester University, says: ‘Virtual reality is also effective because it puts the patient in the driving seat — they can choose the level of discomfort and challenge they feel is appropriate.’

He adds that virtual reality has been shown to help other mental health problems such as paranoia, an irrational belief that others are out to harm you, where the program can introduce people to spending time in public places and they can adjust the level of human contact they experience to one they are comfortable with.

Research is also being undertaken into the possibility of using virtual reality to treat schizophrenia and social anxiety by facilitating people to confront the situation they fear in a controlled, safe environment and to change their thought processes towards it.

When the trial ended, I wasn’t convinced I would see a permanent benefit, yet a few months later I found myself climbing up a high ladder at home without a second thought, to the amazement of my family — and me!

As time goes by, I find I’m surprisingly open to giving heights a try — including standing on the ocean platform in Australia. So how did I really feel?

Vulnerable, yes, but — crucially — not scared. I am quietly jubilant and yet I have got so used to being frightened of heights that it’s more like something is missing than anything else. Which, indeed, it is.

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