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UNREALITY




VIRTUAL UNREALITY

The latest virtual reality (VR) technology can produce worlds so absorbing, you
could almost believe you were there. For many people who experience psychosis
however, their sometimes fantastical and frequently distressing worlds cannot be
switched off at the touch of a button. Psychosis typically includes
hallucinations ('hearing voices' is not uncommon), distortions of perception and
meaning, and the scattering of thought and behaviour into fragmented or
eccentric threads. Excited by the increasingly realistic environments available
to the would-be creator of VR worlds, researchers have recently begun to make
the conceptual leap, from trying to simulate reality, to simulating the
unreality of psychosis.

One such project is the brainchild of psychiatrist Peter Yellowlees and computer
scientist Jasmine Banks. Aiming to produce an interactive learning environment
for students of psychology and psychiatry, they worked closely with Sandy, a
patient who experienced intense psychotic episodes. Using descriptions of her
experiences, work began on creating a prototype environment, including a
simulation of the intrusive hallucinations that were described to the research
team. These included a cacophony of abusive and derogatory voices, the
experience of receiving threatening messages from the newspaper and radio, and
even an image of the Virgin Mary, who transformed from a comforting vision to a
vindictive and insulting apparition without warning.

Despite the limitations of using computer software to simulate what is often a
complex Jasminlive experience, Sandy was generally positive when she saw the
finished version, recounting to the researchers that the simulation was a good
approximation that captured the essence of her own psychotic episodes. So
accurate in places, that having her hallucinations available to others caused an
initial pang of anxiety: "This is such private stuff in a way", she remarked,
"your hallucinations are things only you see; no one else sees them. It's
exposing a part of me that no one else has ever seen before".

However, Banks' and Yellowlees VR simulation was written for the high power
computers and wall to wall screens of the University of Queensland's Advanced
Visualisation and Computing Laboratory. As it was intended as a public education
tool, it became clear that their project would need to run on nothing more than
a desktop PC if it was to move beyond the confines of academia.

By this time, Yellowlees had moved to California to continue his work at the
University of California, Davis and by chance met James Cook, an employee of
Linden Lab. Linden Lab had designed and created Second Life, an online community
designed partly as an updated version of the text-based MOOs, a form of
interactive adventure game popular during the internet's early years. Like many
of the MOOs of times past, Second Life is designed mostly for social activity
and gives users significant leeway in building their own corner of an online
world for others to enjoy. Unlike a MOO, Second Life is represented as a 3D
graphical environment that takes advantage of the latest developments in desktop
hardware to produce a feature-rich multimedia experience. Cook, a qualified
doctor, joined Linden Lab after becoming jaded with the relentless pace of
primary care medicine, and became intrigued about the possibilities of using
Second Life as a platform to bring Yellowlees' psychosis-simulation project to a
wider audience.

Although technically accomplished, Second Life was not designed to be a
graphically realistic representation of reality and the building tools are
designed for flights of fancy rather than serious medical simulation. Despite
these challenges, Cook set about creating Second Life's first psychiatric ward,
where visitors could experience what it might be like for someone experiencing
acute psychosis. "I built most of the objects myself and I'm not much of an
artist" Cook admits. Despite this, exploring Cook's psychotic corner of the
Second Life world can be an unsettling experience. While wandering the
corridors, the casual explorer is assaulted by derogatory voices ("You're
nothing. Kill yourself. Do it now"). Pictures and reflections warp and change as
you examine them, and the seemingly-solid changes unpredictably. In one instance
the floor falls away to reveal nothing but sky below, and in another a
spotlighted handgun appears menacingly on a table.

Disquieting it may be, but some might ask how accurately virtual reality can
simulate such a convoluted and confusing state-of-mind. Both Jo and Abbey have
experienced psychosis and both have an interest in this developing field.

As a freelance programmer, Jo has worked on a number of notable free-software
and commercial projects. During a time of intense activity her mind began racing
with thoughts and revelations that initially seemed beautiful and significant,
but eventually turned into an intense paranoid psychosis. Although intrigued by
VR projects like James Cook's, she remains a little sceptical about how
successfully it could represent an experience like her own. "What seems
problematic", she says, "is the experience [of psychosis] has a deeply
subjective content which I don't think VR would be able to replicate without
access to my subconscious. Perhaps it is evasive to say that this is not
communicable to anyone who hasn't experienced the same thing, but perhaps it is
not communicable at all". "It does seem to risk reducing the whole thing to a
novelty", she worries, although she is not totally dismissive and sees promise
in being able to relate visual sensations like the "hyper-patternedness" she
experienced, or the "snatches of familiar voices muttering things I'm not
conscious of thinking".

Abbey (not her real name) experienced a similarly unusual version of reality
during a severe bout of clinical depression. Now a research psychologist
studying mental illness, she has a particular interest in novel ways of
understanding psychosis. She feels that her own hallucinatory experiences could
be accurately portrayed by virtual reality, but like Jo, thinks some of the core
features would be poorly represented. "During the early stages", she remembers,
"I had an intense feeling of perplexity. I knew something strange was happening,
but I could not work out what, and later, during the intense psychosis, I was
often unaware that my beliefs and perceptions were unrealistic". Although she
thinks such complex mental states could never be simulated by computer, she
feels the educational aspects of VR simulation may still be valuable, but not as
they presently stand. "Without context, or if presented as a mish-mash of
several people's experiences, I think the waters are being muddied too much. But
presented in the context of someone's background, situation and wider mental
state, there is potential for a richer understanding of their experience".

As a clinician himself, Cook is happy to acknowledge some of the shortcomings,
admitting that some people "may have difficulty believing this sort of
environment can be used for serious education". Although even with the potential
drawbacks, feedback from his Second Life project has generally been very
positive. The majority of visitors said that although they found the experience
disturbing, they also found it educational and would recommend it to a friend.

Hoping to overcome some of the conceptual difficulties, an alternative approach
has been tried by researchers from London's Institute of Psychiatry. They
recently created a VR simulation of a library, where simulated people mill
around or sit reading. Instead of trying to replicate radical changes in
perception, their environment is designed to be as stable as possible.
Crucially, they ask participants in the project what they thought of the other,
virtual library users. They are interested in a certain subset of their
participants who experience the people in the library as suspicious or
malevolent, despite them being designed to act in an entirely neutral manner. By
creating a controlled environment, and assessing how some people interpret a
non-threatening situation as menacing, researchers aim to get a handle on the
psychology of paranoia, one of the aspects that other 'virtual psychosis'
projects have not been able to successfully tackle.

Ultimately however, it may be impossible to simulate the full experience of
psychosis whichever technique is used. Yet prototypes such as the Cook's Second
Life simulation may be having a positive effect none-the-less. Education is an
ongoing process and can be accomplished with tools much simpler than high-end
computer hardware. In this case, virtual reality is perhaps better considered as
a complement, rather than a replacement, for traditional methods of education.
"It may not be perfect", Cook says, "but if it raises awareness about mental
illness and makes people a little more understanding, the technology has been
well used".


VIRTUAL HALLUCINATIONS IS NOT FOR TREATMENT

I'm the James Cook mentioned in the article. Dr. Yellowlees and I built the
virtual hallucinations site in Second Life.

Just to clarify something that has come up in the comments: the virtual
hallucinations site is intended as an educational tool for people who are not
mentally ill. We've only put two people with schizophrenia in the environment,
and they were not sick at the time. We showed them the environment because it
was based on their descriptions of their own hallucinations and we wanted to
validate that it was a reasonable reconstruction.

We really don't have any idea if this is useful for treatment. My guess would be
that it isn't helpful in general, particularly showing patient A's
hallucinations to patient B. It might be helpful if you could show a patient his
own hallucinations and try to do some sort of desensitization, like in treating
phobias. But that's a big open question.

My primary hope is that this will be useful in ways like the movie "A Beautiful
Mind". That movie does a poor job of accurately depicting hallucinations. But
it's a great film, and a great benefit to the mental health community.

I'd hope that giving people an approximation of what it's like to hear voices
and see illusions increases their sympathy for people with schizophrenia, and
teaches them something about the disease.


DEFINITELY NOT PERFECT, BUT MIGHT STILL BE USEFUL

It's hardly perfect. I mean if your brain is not working properly, everything
else could be normal but you could feel scared/paranoid/angry for no particular
reason other than your brain is not working properly. This even happens in
dreams.

But I suppose it could be helpful for some people. Developing the ability to
have "lucid dreams" apparently helps some people deal with nightmares. So if
they get their minds used to being in a different state in a virtual psychotic
environment it might help them control their mental state when they experience
the real thing.

Also with the mind, belief/faith alone is sometimes good enough to get things
fixed. So if it helps them believe that it fixes things, and it does.

That said I wonder if one might also break minds that way if you're not careful!
The proverbial last straw on the camel's back.


THE BEST WAY TO EXPLAIN PSYCHOLOGICAL

Problems to people is by explaining to them that people with psychological
problems don't have something we don't have, but that people with psychoogical
problems have a little more of or a little less of something we all have

for example: manic depression. we all have moods and cycles, but manic
depression is simply this taken to new heights and lows

or obsessive compulsive disorder. we are a little obsessive, this even helps us
in some ways. but not all of us need to wash our hands with a new bar of soap
25x a day

even schizophrenia: hearing voices, seeing things that aren't there. we mislabel
stimuli all the time... i thought i heard... i thought i saw... the chaturbate
rooms sensation doesn't persist or manifest itself for very long, not even past
a split second as some sort of corrective feature dampens the impulses... but we
all have false impressions that fade away very quickly every day

so i think when communicating psychological problems to "normal" people, i think
the thing to do is not focus on what a person with a psychological problem has
that we don't have, but that they merely have a deficit or magnfication of what
we all have going on in our skulls

and i think this is an important point, because it demystifies and
demarginalizes people with psychological problems and makes them less exotic and
more accessible


THIS IS NOT SOLVING THE PROBLEM

i would propose a metaphor in this case to capture your key take-away points

basically you're saying that if your daughter's hand hurts you should cut it off
instead of treating the infection

you claim that virtual reality is helpful because it can put subjects into
different environments that may not exist or be available to them directly

i claim therefore that this is nothing better or worse than drug abuse; drugs
simply numb us to reality and give us an alternative reality

if this VR can be put to good use for good end results that benefit mankind,
then fine

but i doubt it strongly and instead feel that it will waste tax payers' money
and sink morale for the handicapped


I TRIED SECOND LIFE ONCE

It was ugly. That's really the first thing that you notice. It would be damn
good-looking if this was five years ago, but let's face it, it's not.

The second thing you notice is the sheer detail you can apply to creating a
Jasminelive character. Male models have a slider for "package size". I kid you
not. I spent about an hour examining my face in the mirror and trying to
duplicate it perfectly, just for the challenge of it.

The third thing you notice is that it's *really* ugly. I'd like to say
otherwise, but the fact is that it's a real dog of a game, visually.

The fourth thing you notice is that it doesn't really matter.

See, anyone can build something. They can build, really, anything. So I spent
some time wandering. I bought a cheap motorcycle and spent half an hour driving
it around and discovering how bad the physics model was. I went to the
construction zone and played around with moving polygons. And then I browsed
things other people had done.

One person had built a giant crystal sculpture. That was impressive.

Another person had built what looked like the demonic crossbreed of a tricycle,
a hovercraft, and a preying mantis. That was pretty cool also.

Yet another person had built a six-person flying behemoth. Apparently it was
buggy, he hadn't gotten all the kinks worked out of the scripting, but it was
still pretty cool-looking.

I took a look at the scripting. It was pain. Like, distilled pain.

In the end, I decided it wasn't for me. But I sent them ten bucks anyway. It's a
severely impressive concept, and it feels to me like the only reason it's not
yet implemented well is because nobody has a fucking clue how to implement it
well. It's a devilishly complicated problem, and they're the only ones seriously
working on it.

If it can accomplish things like this, it's worthwhile, and it will only get
better. I can hardly wait to see what it looks like once they have a lot more
bandwidth and CPU to play with. I have the feeling nobody here has seen the last
of Linden.


SCIENCE PATH

 * The Science of Hiding in Plain Sight
 * StegPng
 * Half the loss of data
 * Efficient electric pallet jacks
 * Kosher food?

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