How Can We Leverage Virtual Reality to Solve Behavioral Health Problems?

By Steven Plappert

(Special Guest: Aaron Gani, CEO of BehaVR)

It’s no secret that behavior change is one of the trickiest and most impactful puzzles we can solve as a human race. If we can figure out how to drive behavior change, almost anything becomes possible. Nowhere is it more impactful than in healthcare, as behavior change can directly drive improvements in quality of living, life expectancy, disease, etc.

The use of new technology has been a driving force in our ability to enact behavior change, and one of the technologies moving the needle right now is Virtual Reality (VR).

To learn more about this problem, and the potential that VR has for solving it, we interviewed Aaron Gani, Founder & CEO of BehaVR, a growth-stage VR-based behavioral health company based here in Kentucky.

Steven:“Okay Aaron, give us the Introduction to Behavioral Health & the power of this discipline. What does behavioral health mean to you, and why should we care?”

Aaron: “You can think about behavioral health as both promoting well-being, by preventing or intervening in mental unease or illness such as depression or anxiety, or as preventing or intervening in substance abuse or other addictions.

Data suggests that we’re at a critical point, nearly one (1) million people globally take their lives each year; 40 million American adults and 25% of children suffer from anxiety disorders, and 20 million American adults are battling a substance use disorder*. And that’s likely just scratching the surface; we should assume there are millions more who aren’t represented in those numbers because they don’t seek care.

The Gallup World Emotions Report shows that adults in the U.S. are more worried, stressed, and angry – 20 points higher than the global average. Anger (22%) is at its highest level since 2006, and stress and worry – 45% – are at a 12-year high.

These numbers are extremely concerning and demonstrate the need for new ways to address behavioral health. With the rates of stress, worry, anxiety, and anger on the rise, it’s critical that we identify better ways to teach and activate stress resilience. We need better ways of coping and managing the stressors that are causing these dramatic increases that directly correlate to rising healthcare costs, addiction-related deaths, and life-threatening medical problems like heart disease and diabetes.”


Steven:“Okay wow, those numbers are concerning, and I hate to see trends going in the wrong direction. What’s your hypothesis as to WHY things are getting worse? Why are we more stressed and angry these days?”

Aaron: Well I’m not sure if we know exactly, but we see the ever-accelerating pace of change in our global society, and we know that change is stressful.  We also are surrounded now with technologies such as social media that draw our attention increasingly away from being in the moment, just living our best lives, towards constant comparisons with others, which is not healthy.  We put so much pressure on ourselves these days – whether it’s young people comparing themselves to peers and unrealistic standards on Instagram, or pushing ourselves to achieve more and succeed at all costs, or simply being on the treadmill of materialism… none of these things are good.  Our health is also declining generally, while our health security, knowing that we’ve got the resources to care for ourselves and our families, is decreasing. I could go on, but modern society changes so fast, and we struggle to evolve fast enough as a species to keep up and thrive in it.  We need to get back to things that ground us – being mindful, being in touch with our bodies and how we need to care for them, and being in touch with our neighbors, across the street or around the world. We have a lot of work to do! But technology isn’t all bad. With the power of new technologies like Virtual Reality, there is actually hope for it to help us accomplish those things.

Steven:“Fascinating. Well, let’s switch gears to positive. Virtual Reality is a groundbreaking technology and has the power to transcend our standard experiences. Tell us about Virtual Reality and its power to enact behavioral change”

Aaron: “Well, when you say “virtual reality / VR”, most people imagine a game where, through the integration of a computer and a headset, a person gets “transported” into another realm experiencing the thrills, e.g. the psychological and emotional responses, of swimming with sharks, piloting a spacecraft or driving a race car. It’s as if they were really there.  The brain receives the multi-sensory input (generally at least visual and auditory input) in the same way, and through the same organs that it experiences the “real” world, and so there is very little difference between an actual experience and a fully immersed, multi-sensory virtual one.

It’s difficult to appreciate just how remarkable virtual reality is until you’ve tried it. VR’s ability to “trick” the brain has human relevance way beyond fun and games. There are more than 300 peer-reviewed studies proving VR as an effective clinical modality for treating stress-related anxiety and depression, chronic pain and addiction. It’s a new frontier in medicine, with multiple applications in behavioral health that will continue to evolve.”

Steven: “That makes a lot of sense, and as you said, VR really is something you have to “see to believe” and once you see it, there’s no going back. I remember the first time I played a VR game, and my hands were sweating, my heart was beating, unlike any other game experience. It’s clear to me how that tech could be leveraged “for good” so to speak, to help us rise above some of the biological/natural issues we face day-to-day as humans. So let me ask you this, is this why you started the company? To save us from ourselves?

Aaron: “I started BehaVR because I believe it’s essential that we turn the tide against chronic disease, which is the cause of 85% of our unsustainable $3.5T annual spending on healthcare in the United States. I identified the crucial gap between knowledge, tools, and activation of healthy behavior, and believe Virtual Reality experiences can close that gap.

Our mission is to educate, motivate and activate people to achieve their best health via the unmatched psychological power of VR. Our platforms are rooted firmly in neuroscience, which is why we understand it’s critical to not only educate and motivate, but activate; that is, build stress resilience and emotional regulation skills by positively activating brain circuits involved in reward, stress, and self-control. Doing so over time equips individuals to more reflexively make healthier choices.  

Steven:“ So cool. What about the history of this field, meaning VR in Behavioral Health. Is this something brand new?”

Aaron: “VR as a clinical modality, aka. clinical VR, actually emerged in the mid-1990s. Early programs and research focused on VR to deliver exposure therapy for people suffering from phobias (fear of heights, flying, public speaking, etc.). Over the last two decades, the clinical use of VR has expanded; particularly noteworthy is the military’s investment in and use of VR in the successful treatment of veterans suffering from PTSD.

Today, VR is increasingly recognized as an indispensable neuroscience-based psychological tool for treating behavioral health issues. As I mentioned before, there is an urgent need to do something different – something that works and improves access to care.”

Steven: “Interesting, I would have never guessed we’ve been working on this for almost two decades. So now I have to ask, if this has been going on so long, how is what BehaVR doing differently? What’s novel about your approach?

Aaron: “Good question. Our platform is designed to help people with their long-term behavioral health. Our neuroscience foundation and mission of education, motivate and activate differentiates BehaVR from other VR solutions on the market.

The way we collect, store and analyze data also sets us apart. Our experiences are powered by a cloud platform that enables partner customization, agility, and efficiency. Care providers remain in control of the BehaVR experience at all times, initiating and monitoring patient experiences from a physician administrative app. For patients, the experiences we create guide them through a change journey that is personalized, engaging, and effective.”

Steven:“Very cool. Okay, you’ve already touched on this a little, but I want to know more, What makes VR so powerful when it comes to enacting behavior change?”

Aaron: “Well, VR works because over time and with repetition and practice, it changes brain circuitry.  Many behavioral health challenges root from faulty reward and self-control circuits. VR has the potential to change behavior at a neurological level by rewiring unhealthy stress responses and cravings. For instance, addiction is now widely recognized as a chronic and treatable medical condition, rather than a moral failing. Addiction dysregulates neural circuitry involving reward, stress, and self-control.   

Our platform is immersive, meaning it is multi-sensory, so patients’ brains experience each VR program almost as if it were “real”. By systematically providing mindfulness-based experiences designed to re-build stress resilience and emotional regulation skills, BehaVR’s programs begin to activate new neural circuitry which can help patients’ brains repattern and function in healthier ways.”

Steven:“Talk more about the multitude of applications.  How is it being used today beyond what you have already told us?”

Aaron: “They range from distraction-based therapies to relieve pain and discomfort, to exposure-based therapies for overcoming phobias and building refusal skills, to experiences that engage, motivate and measure interaction with digital stimuli and virtual worlds. The applications are broad, from encouraging movement, overcoming fear, eliciting emotion, and changing perspectives of aspects of our own personas and how we are embodied.”

Steven:“Are there certain types of disorders or behavioral conditions is VR best suited to serve?”

Aaron: “Honestly, VR has application for any disorder where the brains’ healthy neurocircuitry has been disrupted and improved stress resilience and emotional regulation are desired.  Currently, VR has traction in treatment for addiction, chronic pain management, PTSD, anxiety, and depression. In one year with BehaVR, we’ve had great success in pain management serving over 1,200 patients in close to 100 physical therapy clinics and pain management centers. We launched our Addiction Platform in March.

Going forward, we anticipate a broader utilization of VR in addressing stress as a root cause of many chronic diseases. 2019 data released by the Mayo clinic lists the following as health risks associated with long-term stress:

  •  Digestive problems
  • Heart disease
  • Sleep problems
  • Weight gain
  • Memory and concentration impairment
  •  Sexual dysfunction”

Steven:“Those are huge problems. And so foundational to our experience as humans. If we can live a more stress-free life, we’re happier people. But it’s not all about avoiding stress you say, it’s about DEALING with it. Why is Stress Resilience so important?”

Aaron: “To successfully make a change to a habit or element of our lifestyle, we must first understand how to change, and we must be motivated to change. That’s why BehaVR’s experiences start by providing educational and motivational elements related to a particular behavior change goal. But knowing what to do, and wanting to do it are not enough. It’s relatively easy to stay on track when we’re motivated and focused. What’s hard is staying on track when the stresses of everyday life try to knock us off our path.  

It might be an angry boss, a fight with a family member, financial pressure, troubling news, or rude and disrespectful people crossing our path that cause us to emotionally react and possibly lose touch with what matters most to us.

At BehaVR, we believe building and practicing new skills of stress resilience and emotional regulation are critical to sustained behavior change, and we believe VR is the ideal medium in which to practice our skills of stress resilience. With VR, we can engineer experiences that are deliberately designed to elicit an emotional response, so that we can practice our skills of detecting and then managing our own state of emotional arousal.

As we look at the mental health crisis we’re currently facing, it’s critical to not only educate people about the anatomy of their conditions, but arm them with the tools needed to better manage their environments when the headset comes off. That’s why we’re committed to designing programs that focus on long-term resilience, not a one-off distraction.”

Steven:“Okay, let’s talk about the future. Where do you see VR in 10, 20, 50 years?”

Aaron: “Due to advances in optics, computing power, graphics capabilities, 5G networks, biometrics and analytics, VR will continue to rapidly improve, and the fidelity of the virtual experience will continue to increase. In the not-too-distant future, we will be socially interacting and engaging in highly personalized and persistent virtual environments for long stretches, while the multi-sensory input expands from today’s primarily sight & sound based simulations to include and engage our other senses of touch, smell, and the kinesthetic sense of movement.”

Steven:“That sounds like something out of a movie, but at the pace we are advancing, I have no doubt that it’s true. How far can this go?  Is it asymptotic? Is there an upper bound to VR’s influence?”

Aaron:  Well, this is where things can get a bit geeky.  If the technology keeps getting cheaper, lighter, better, faster, and more immersive, as it almost certainly will, and we keep increasing the computing power and with technologies like Artificial Intelligence we can make the virtual environments ever more personalized and naturally responsive, it’s not a big leap to imagine people preferring VR to the real world.  If you can do anything, be anything, and go anywhere in VR by just donning a headset and haptic suit, why mess around with the real world? This is the premise underlying the really entertaining book by Ernest Cline, “Ready Player One”, or more darkly, The Matrix films. It’s fun, or scary, to think about that world, but I think if there’s any risk of that at all, it’s way out in our future, and there is SO much good we can do with VR between now and then, we should just get on with it.  I do believe that we will transform behavioral health, how we treat and undo trauma, and how we educate ourselves, at a minimum, in VR over the next several decades.

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