Virtual reality can help treat severe paranoia by helping people face their fears and "re-learn" that situations they worry about are actually safe, an Oxford University study claims. In the study published in the British Journal of Psychiatry, researchers have found that virtual reality simulation could be used to alleviate the symptoms of severe paranoia.

Funded by the Medical Research Council, the study combined "psychological treatment techniques with state-of-the-art virtual reality social situations to reduce paranoid fear."

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According to the study, people with severe paranoia often display symptoms of extreme mistrust of other people and believe that others are deliberately trying to harm them. As a result, they often use coping mechanisms such as avoiding social situations, reducing eye contact or cutting short any social interaction with others. These tactics, however, possibly worsen the condition because patients believe they can avoid harm by using these "defence behaviours."

Led by professor Daniel Freeman from Oxford University's Department of Psychiatry, the study included 30 people who were placed into two virtual reality simulations — a train ride and an elevator scene — with increasing numbers of computer avatars, which normally make patients quite anxious.

They were told that by staying in the situations, they could relearn that they are safe. The patients were randomly given different instructions on how to deal with the situation. While one group was encouraged to use their normal defence behaviours, the other was encouraged to drop their defences and try to fully learn that they were safe in the virtual realm. The latter group were told to approach the computer avatars and hold long stares or stand toe-to-toe with them.

Patients who fully tested out their fears in the virtual realm by lowering their defence mechanisms showed a significant reduction in their paranoid delusions. Researchers also reported that more than 50% of these patients did not have severe paranoia at the end of the testing day. The patients appeared much less distressed in real world situations, such as going to a store, later as well.

"Paranoia all too often leads to isolation, unhappiness, and profound distress. But the exceptionally positive immediate results for the patients in this study show a new route forward in treatment," Freeman said. "In just a 30-minute session, those who used the right psychological techniques showed major reductions in paranoia."

The second group who faced their fears in virtual reality while still using their defences also showed some promise. About 20% of the group no longer had severe paranoia by the end of the testing day.

"It's not easy work for patients, since lowering defences takes courage," Freeman said. "But as they relearned that being around other people was safe we saw their paranoia begin to melt away. They were then able to go into real social situations and cope far better. This has the potential to be transformative."

Going beyond the gaming realm, VR has been making its way into healthcare as a means to diagnose and even treat a number of psychological disorders including depression, phobias, pain, autism and PTSD.

Professor Clark, a member of the team, said, "Virtual reality assisted treatment has great potential because, as the price of the equipment makes it more accessible, much treatment could be delivered in people's homes."

Since patients know and understand that VR is not real, the technology has been observed to help patients avoid developing a full panic attack.

"Virtual reality is proving extremely effective in the assessment and treatment of mental health problems," said Dr Kathryn Adcock, Head of Neurosciences and Mental Health at the Medical Research Council. "This study shows the potential of its application to a major psychiatric problem. There is a lot of work to do be done in testing the approach in treating delusions but this study shows a new way forward."

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