Treating body dysmorphia in a virtual world

Computer gaming technology straight out of Second Life and World of Warcraft is now being used to help treat a variety of mental illnesses. Scientific American did a nice write up on the use of virtual worlds in treating children and teens at risk for violence and trouble with the law. The computer program, known as Simulated Environment for Counseling, Training, Evaluation and Rehabilitation (SECTER), allows children and therapists to interact virtually and choose avatars and display emotion, like high fives and a swaggering walk.

In the case featured in the article, the therapist (Heather Foley) acts as the patient's (13-year-old Joe, in a residential mental health treatment facility) adoptive mom and tries to interact with Joe in the virtual world. The breakthrough occurred "when she used SECTER's "after action review" feature, which replays role-playing sessions from any avatar's point of view. In this case, she wanted Joe to see the interaction from Foley's—or his adoptive mom's—perspective. She says the feature helped Joe recognize that his behavior in the virtual world—and by virtue of that in the real world, too—"was inappropriate and hurtful." "

While this is certainly interesting, virtual treatments are now being used to help treat eating disorders and specifically the body dysmorphia that frequently accompanies them. The idea is that these virtual treatments will give sufferers a better idea of how to experience their bodies in the real world. Other researchers have attempted to modify body sensation through sensory stimulation using a neoprene suit (okay, it's not exactly VR treatment, but it seems like a similar idea to me). The Frontal Cortex blog had a good write up of the last bit of research here. (h/t Cammy)

I think all of this is very exciting, but Laura brings up a good point in her comment on the Frontal Cortex blog: many times, the severe body image distortion that accompanies eating disorders does retreat after someone returns to normal body weight and eating habits. Many times, but not always. I fall into the "not always" category. Perhaps it's a function of having an ED for longer. Perhaps I have sub-clinical BDD. Perhaps there's no real explanation for it. Research shows that people with the restricting subtype of anorexia didn't show any significant improvement in body perceptions at the end of treatment, although those with other ED diagnoses did.

I think these treatments can have great utility in treating the symptoms that remain after restoration of weight and normal eating habits, though more study is clearly needed. What do you think? Would you like to try virtual reality treatment? Do you think it would work?


Brwneyedgrl08 said...

I don't know that treating body dysmorphia with virtual reality will work necessarily. Personally I believe that standard treatment programs or centers are the best way to help those who have eating disorders. I know that depending on the person different treatment options work better than others, but overall I think the best success comes from treatment programs such as this one here.

Sad Mom said...

I would give it a try. He doesn't see himself as he is at all. He doesn't see the scapulae standing out like knives under his sweat shirt. He doesn't see the vessels in his arms and legs standing out like a Rand-McNally relief map. He doesn't see his hair is dull and thinning.

He sees his tummy bulge after a dry salad and thinks he's fat.

There's a painting in the MFA of an old man, shirtless and spare after an evidently hard life of toil and meager menus. It looks just like him. He's seen it but doesn't make the connection with his own physique (that's a generous word for what's left of his body).

If he saw himself as others do he might get the message. In conjunction with traditional therapy and support it might spur a reality breakthough. I've been considering medical hypnosis but this sounds better.

I'll try anything at this point.

Carrie Arnold said...

You're right- CBT is the gold standard for treating BDD. And I don't know that these would be a replacement for CBT but a good add-on, if further research shows efficacy.

Sad Mom,

I realize your son is probably an adult, but restoring his nutritional status is the most important step you can take. I get that it's easier said than done, but therapy doesn't work as well (if at all) on very malnourished brains. Starvation is keeping your son from seeing himself as he actually is. He literally can't do it. Even the healthy men in the Minnesota Starvation study began to see themselves as fat when they were starving.

Let me know if/how I can help.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


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