'Visitations': VR for Ketamine Infusion Therapy

[Music] visitations is a collection of meditative virtual reality vignettes they're designed to improve the setting as in set and setting for patients undergoing ketamine infusion therapy and was assembled for use in a study conducted by researchers at manhattan restorative health sciences in new york it is an artwork which employs design strategies tailored to support therapeutic outcomes these strategies include the use of artistic techniques which have measurable physiological effects and user experience design decisions which take into account the specific needs of incapacitated patients so send setting is a concept that timothy leary came up with he coined the term and it basically refers to the idea that your expectations and your own state of mind and the place that you're in have a huge impact on

the quality of the experience that you have when you're doing psychedelics so i am david loebser my background is in animation and visual effects i would also say applied design um i had a mid-career shift i went to itp at nyu in new york and i learned how to be a developer i fell in love with procedural design and around the same time i was also introduced to uh medicine ceremonies and and doing work in that space i developed an app called cosmic sugar which is sort of part of um kind of under the same umbrella and also even though it wasn't designed as a therapeutic experience initially it also has some therapeutic qualities i think i also worked on a project called luxury escapism with tyler pridgen who's here in the audience today and we set up a digital spa in new york uh just before the pandemic before the

pandemic and it was tailored to digital experiences designed to help you get into a more meditative state of mind and then visitations the app was released um actually i need to adjust that so it was really released in 2020 actually so this is an extra slide about luxury escapism we basically wanted to build an art experience that mirrored the experience of going to a spa so instead of steam rooms and cold dips and hot rooms and all of that stuff you went into these different experiences that were inspired by oddly satisfying content and asmr in the lower left that's an experience called rainbow therapy it's a vibrating waterbed with a very intense strobe light and binaural beats on the headphones that you're using and everything is adjustable this is a trailer for the experience

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uh the project was initially conceived of at the advent of this round of commercialized vr i had a lot of experiments that i was making for myself um as a way of self exploring self-hypnosis and exploring procedural graphics and i was seeking a way to package them together and share them with people because on their own each experience was not like was not going to work as a standalone experience so kind of wanted to make a festival or a gallery of these experiences for people they were influenced by the goals that filmmakers in the 70s had which had to do with exploring consciousness and creating films that kind of mirrored what consciousness is like on a moment-to-moment basis as opposed to making narrative films so stan brackage james benning michael snow i love all of them i had heard of jordan belson before but it was only when i came to san francisco recently that somebody reminded me of him so i

looked up his work a little bit and it's very much in line with this kind of work so he's san francisco based and basically invented planetarium laser light shows uh in in the 50s and 60s in san francisco so i was introduced to melissa sellinger who introduced me to tim canty who runs manhattan restorative health sciences and we collaborated on putting the study together so ketamine if you're not familiar with it is a it's similar to psychedelics but it's in its own class it would not be considered a classic psychedelic like lsd or mushrooms it is a dissociative anesthetic it creates a trance-like state providing pain relief sedation and amnesia experiences can differ some people are averse to it it can be strange and unusual but people report having visionary experiences of new perspectives and

emotions including hope optimism and a sense of meaning it's been around for a long time but interest has grown recently because of its anti-depressant effects and because of a growing psychedelic renaissance led by the works that maps is doing with mdma so the nice thing about ketamine is that it's been around for a long time it's been demonstrated to be safe it's legal any doctor can prescribe it it's schedule 3 so it can be prescribed off label so actually most people who get ketamine infusions are not being prescribed it in the proper way the only form of ketamine that is approved for depression right now as far as i know is johnson and johnson's s-ketamine which is a nasal spray and along with the substance you also need to they have a way of doing it so there's a protocol that's built into the approval of the drug which involves needing to sit with a therapist for two hours so it's a one hour experience and the sort of one hour after experience

very often so everybody who's prescribing infusions like everybody's kind of making up their own protocols but typically it would look like five or six infusions over two to three weeks um ketamine and vr have been combined before uh in 2011 i believe it was uh hunter hoffman did a um a study uh with a vr app called snow world uh there were um it was basically for burn patients who were having their skin debrided which is an incredibly painful experience and what he did was put people uh in vr and showed them an experience of uh snow people throwing snowballs at them so when the snowballs would hit them that's when their skin would be scrubbed to get rid of the dead tissue and part of the process was recontextualized that experience of pain you're getting hit by a snowball instead

of having your skin removed it becomes much more enjoyable so people actually rated this experience as being significantly more enjoyable than not being in vr so for this study we did with manhattan restorative health sciences there were three infusions in one week the first infusion was done without vr just on its own which is the standard way of doing it the second one was done with vr and the third time around patients could choose whether they wanted to be in vr or not and uh more than two-thirds actually preferred the experience with vr so it was well tolerated and people enjoyed it the alternative to being in vr was to either have an eye mask people could bring their own music but otherwise if they were not in vr they were in a fairly clinical space it's a nice clinic but it is a clinic um and the results are hopefully going to be published soon

so this is some of the feedback that we got not every subject had a preference for vr but those that did were effusive the feedback suggests that vr the vr experience didn't just provide a nicer place to be but assisted in the therapeutic work so this is just a little of the feedback we got which um uh my intuition was that we were gonna get good feedback but we got some very very good feedback so the goal of therapeutic art is not you know to to make an artistic statement it's to create a space for other people to have experiences it's also it should be designed in a way to elicit the body's natural healing responses you know the placebo effect is an incredibly powerful thing when they're designing antidepressants they have to demonstrate that antidepressants are more effective than placebo but it turns out the placebos are actually very effective antidepressants and effective

for all kinds of other things too so there is a quality of vr that can help lend to the placebo effect in addition to other things so the patients that were involved in the study were a population that suffered from pain and depression it's a it's an orthopedic surgery clinic so people you know were often there initially to have some kind of surgery done and these follow-up appointments were to deal with not just the pain but also the depression that came along with it they generally didn't have any experience with vr or very little experience with vr and we didn't want to give them complicated tasks to do we didn't want to give them controllers we didn't want to make a game we didn't want to do anything that was remotely complicated so it's so it's a very passive experience all the scenes are really meant to be settings um the patients are set up in recliners so they can recline as much as they want a lot of vr experiences are you know can can reorient with um in the y-axis

um but most vr experiences don't let you recline necessarily so that was an important part of the design for visitations is no matter which way you look it will reorient in that direction so you can be inverted you can be lying down reclining they're all designed to reorient so you're looking at the thing that we want you to be looking at so i already mentioned there's there's hardly any interaction people are given a controller so they can pick scenes but there's no menu they click on the controller button and they can switch to the next scene until they find one that they like there are 12 scenes total for the app that was released there is a gaze-based menu so you can design your own set of experiences and choose from them and it's you know made for people who aren't in in that state so these are um this is a non-exhaustive list of modalities we were thinking about when

we were designing these experiences the authors of the paper designing awe and virtual reality and experimental study describe ah as a complex emotion encompassing the two main appraisal themes of vastness the perception of being in front of either perceptually or conceptually grand and vast stimuli and need for accommodation the urge to adjust mental frames according to new incoming information so there's something called the overview effect which you might have heard of that astronauts experience when they blast off into space and see earth like all of earth for the first time um you know they have this experience of just like awe and wonder because they have to it's it's just like a completely new way of of looking at the world and that creates this sense of awe i think that part of the joy of looking at fractals uh is comes from a similar place i would say that the feeling of ah arises because the mind's eye is drawn into nested infinities effortlessly and

playfully accommodating the unique role of each particular recursive form the breath is the most commonly used object of meditation but it can be hard to focus on in unpleasant or confusing situations scenes and visitations are designed to act as immersive and all-encompassing objects of meditation that grab attention for people with less meditation experience catharsis is a purging of negative emotions resulting in beneficial outcomes not all of the moods explored in visitations are exactly uplifting some are actually fairly heavy which i believe allows people to immerse in more difficult emotions with the benefit of the distance of an aesthetic experience i'm also very inspired by a musician named phil niblock who creates like meditative tone compositions that are almost the same like like one tone for 30 minutes but they're incredibly textural and they explore a lot of different ranges of emotions

they're not all the kinds of uplifting music that you might hear uh sort of you know with new age sound baths or that kind of thing i think there's a range of emotions that can be explored and focusing on less positive emotions uh also has an important place so with distraction therapy vr draws a patient's focus away from wherever they are and leaves less concentration available to process incoming pain signals so the idea is you have a certain amount of attention and if you draw the attention away from the thing that's unpleasant then you'll have less of that experience so this is actually a really powerful thing about vr and you know vr on its own actually has analgesic effects if you're in a painful situation it's been shown again and again in a variety of studies that vr actually helps reduce the experience of pain so entrainment refers to the frequency following effect that comes from exposure to auditory or visual beats and

i'll talk a little bit more about that uh so the framing and context kind of gets to this idea of what they were doing with snow world where you're having an unpleasant experience or a challenging experience and the idea is to create a space where you can look at it in a different way recontextualize it it helps immensely psychologically so something i've been really curious about and somebody just forwarded me some information about a fairly new study that came out of helsinki it's titled restoration in a virtual reality forest environment and they found that virtual a virtual forest was perceived as more or equally restorative as an experience in a real forest which i think is really fascinating because it's been shown that being out in nature makes you feel better and it's kind of obvious in a way but the question is what aspects of that are the thing that makes you feel better and it turns out just looking at a forest and being in a virtual forest pretty much works just as well so it's not necessarily the exercise or the air

or something magical it might have something to do with associations or possibly the experience of seeing fractal-like shapes like trees or fractals so i think that's a really interesting question like what is it about that experience that is therapeutic on its own so these are some of the techniques that i use in visitations now visual strobing is a big topic you know easily worth its own long presentation on its own uh our our brains sort of work at different frequencies based on our mental state for instance 10 hertz is alpha waves 10 hertz ish and alpha waves are purported to bring about a sense of relaxed attention whereas 3 hertz delta waves are more associated with deep sleep the artists brian guyson and william burrows created a machine called a dream machine

i think that was in the 50s they took a cylinder with slits cut in it and put it on a turntable and as it was spinning around the lights would flicker in their eyes creating yantra like visual patterns there's an app that you can get for your phone right now called luminate or luminate and it actually uses the led on the back of your phone to strobe lights in your eyes and they mix that with voice over meditations and the idea is that by strobing lights or auditory beats you can train your brain waves in a way to elicit these desirable states of mind so if you think about you know drumming putting you in a state like a trance-like state you know that's a positive outcome potentially of these techniques a negative outcome of course is epileptic seizures so cyberpunk 2077 for instance had this issue where it's like some streamers were having having seizures on camera

this sort of came into popular consciousness in the 90s when an episode of pokemon had very intense strobing and children were falling over and frothing at the mouth and so there are actually a lot of regulations about um what kind of strobing you can have in media how to avoid giving people seizures that kind of thing so with the visitations that is released on the store there is strobing but it's pretty subtle i didn't i didn't want to like push that envelope too much but there are a couple scenes that have more intense strobing but it is a powerful technique and it's also sort of questionable um you know if it needs to be very intense so even less intense strobing could have an interesting effect so part of what you will let's see to that go to the next one so part of what you didn't switch

okay um part of uh so something that you'll see when you're looking at strobing lights are these patterns on the upper left that were described by a psychologist named heinrich clover there he called them form constants he was experimenting with masculine sort of in in a much earlier renaissance of psychedelics in the in the 20s or the 30s i believe so he was taking mescaline and basically describing these visual patterns that he saw and his suggestion was that these cobweb shapes and these spirals were constituent parts of the structure of our brains basically not just of our eyes and he surmised that because based on where he was looking the structures were actually part of the space and not just overlaid on his vision so i would suggest that sort of making use of these shapes kind of taps into

some pre-existing structures in our brains and sort of part of doing that with spirals with fractals when you kind of tap into things that are already there um it can be it can be easy to fall into the trap of making things that are a little kitschy or schmalty that's like sort of almost too easy on the eyes sometimes so i did try to avoid that um i may or may not have succeeded in some places in avoiding the kitsch trap um but it is it is a powerful technique i believe symmetry is another one so this is radial symmetry so you know kind of feels like a tunnel but our bodies are symmetrical natural things are symmetrical healthy things are symmetrical we're drawn to them they're easy carl jung famously used mandalas in order to gain psychological insight and self-understanding in the same way that spirals just feel right symmetrical forms do as well oops sorry um

visual artists usually avoid symmetry because it's too easy but if you're looking to create a comfortable environment it's pretty perfect a lot of 360 experiences are designed in such a way that you're invited to look all around in every direction in front behind for myself i find that to be a little bit stressful not knowing where to look at because i always feel like i'm missing something so and that's true even more narrative experiences that i create but in particular with this study and with patients who are incapacitated in this way it would be very difficult for them to sit up and and turn around behind them to see something that they're missing so i wanted to not just you know create a sense that they're seeing everything that there is to see and not invite them to look around in any way and i also just wanted to invite them to be very still and to keep their head still and to keep their eyes still and to accomplish that all the compositions

are very centrally focused which you know if you're working in visual art it's generally considered to be a big no-no it's like you want to have more interesting compositions and like kind of a flow of where you're looking but for if your effort is to create a meditative experience i believe that giving people a very obvious place to look and keeping it fairly still is a good technique uh scenes and visitations breathe uh there are variations in a way that mirrors the shifting sensations and biorhythms of the user so when you're doing a meditation that involves paying attention to your breath it's kind of the same it's like it comes in it goes out but the sensations are also changing constantly so you know i made an effort to do things like you know change the color of the sky in rhythmic ways where it's like changing back and forth but also you know it included some randomness so

you kind of notice things changing and it gives a feeling of the experience deepening or unfolding in a way that's different than just scenes that are strictly looping so if you look at a looping animation at least for myself i always notice the loop and i think the fact that these experiences are always changing a little bit creates them makes for an experience that's a little deeper so part of the reason that works is because all the scenes are procedurally generated or procedurally modified to to some extent some more than others uh some are very procedural uh and some just have uh you know subtle effects that are procedural so you know typical video game thing you know it's like randomizing the cave uh same idea that's always similar but a little bit different fractals i talked about a bit

uh so oral techniques in addition to strobe lights uh affecting your brain waves um binaural beats is this idea that you can play one tone in one ear and another tone in the other ear and your brain will actually find a middle tone that creates a kind of wawa like beats between them so if you have a 440 tone and a 450 tone you're going to wind up with a 10 hertz beat and that again corresponds to alpha brain waves so there are so isochronic beats are similar but instead of having two pure tones in each ear each ear can hear both of those tones and the rhythms are a little bit more obvious so i worked with east forest who's an amazing musician he's idaho based and utah based we just did a performance together in las vegas and he specializes in creating musical experiences for people who are doing mushroom ceremonies

so he creates five hour long albums the music that he releases as albums like tend to be very pleasing the music that he does for ceremonies tend to have a little bit more complexity in their emotions and sometimes there's a little awkwardness and sometimes there's you know like sort of heavier emotions you know in part because it's um more experimental but he's also sort of exploring the range of emotions that come up over the course of uh of an experience like that i also worked with dr deirdre barrett who's a researcher at harvard and we are actually collaborating right now on a project with htc about dreams and she does a dream induction uh in visitations and this is not part of the study this is the the app that we released and then there's also a body scan meditation so again that was more for the uh the home user the body scan meditation is also

procedurally modified we pre-recorded prompts and then we randomly play them back in different orders and then uh rada is a partner of east forest and she provided a progressive muscle relaxation meditation and a body scan um and both of so uh for that um we put that together for healthy mind solutions which is a clinic in australia and they're interested in seeing what kind of meditation works better to reduce people's anxiety whether it's the pmr or the body scan it seems like studies outside of vr suggest that body scan meditations are more effective and then a lot of audio is connected to things that you see in space so diegetic audio so as lights are strobing the audio is strobing as well so it kind of you know enhances your sense of actually being in a place um and uh they amplify the effects of

each other so the visuals amplify the sound sound amplifies the visuals vr is amazing on its own just as a medium something that i have found a little challenging as an artist with vr as a medium is that people are so amazed by the medium it can be hard for them to provide useful feedback so you have to work a little harder with people to get the kind of feedback that you want to see if the thing that you're making is actually good and enjoyable or if they just think vr is amazing so that's just an ongoing issue because still most people have not used vr or have barely used vr some people you know really don't tolerate vr that well but for the most part if you design things properly the vast majority of people won't get sick and can at least enjoy the experience for the 30 minutes to one hour that they are

that they're in the experience at the clinic so vr completely captures your attention if you're watching a screen there's always going to be things in the periphery maybe people in front of you other things happening your phone is there etc issues like that so when you're in vr everything you're in a completely different place as far as your brain is concerned you've left the room and gone somewhere else and of course you know vr isn't just vision you can connect things to scent and vibro acoustics temperature wind all of that stuff uh there is um adam gazelli is a is working on a project right now called sense inc that actually combines all of these things together and there are a variety of efforts toward creating these fully sensory encompassing pods that include all of these senses as well so that was one thing that we tried to do with rainbow therapy at the spa was

basically overload all of your senses at once and by overloading all of your senses you have an experience that's similar to sensory deprivation so there's a book called vrx that i would recommend if you're interested in the space it's a broad overview and it's very entertaining it covers a lot of research into the therapeutic use of vr um so vr requires onboarding so this is a big blocker when it comes to getting vr headsets into therapeutic spaces there's a lot going on at a clinic you know the time of nurses and doctors are pretty precious they don't necessarily have a lot of time to be troubleshooting headsets you really need to be able to create something where they can just like grab it and give it to somebody and have everything be extremely obvious and easy and that's tricky i enjoyed using the oculus go i'm sad that they've been discontinued because they were so easy to work with and this experience was designed to be strictly a

three degree of freedom experience it works on the quest and it works on other headsets but it doesn't make much use of that six degree of freedom and that six staff headset has a lot more going on in terms of setup and tracking and all of that stuff so um yeah for for this kind of experience where it's made for people who are lying down three off headsets have a huge advantage so as doctors and clinicians are interested in getting in the space they need to work with artists artists are people that know how to work with narrative color sound you know it's like we know how to begin an experience and end an experience uh you know all of that kind of stuff it's like we also have intuitions like we know how to use ourselves as our first research subject um you know in medicine and in therapy it's like ideally you're getting feedback from dozens or hundreds of

people but as an artist you know the first person that you have to tap into is yourself and that's something that that we've learned how to do and trained ourselves to do and it's not necessarily as easy as um you know people who don't have as much experience creating things think that it is so it's super important that the uh the doctors and the scientists that are the best in the world are also working with artists that are the best in the world in this space ideally so these are my main collaborators right now i i mentioned them this is east forest dr barrett so in addition to uh use in ketamine assisted therapy um i am uh working with another team right now on bringing similar experiences into a space with other medicines like actually tbd other medicines it's for a a big pharmaceutical company that's developing other kinds of

substances and we are working together right now to figure out how to pair these uh right now our approach is actually to create experiences for pre and prose post trip experiences um so there's a question of you know whether it's whether you should whether it's dangerous uh you know like what issues could arise from actually having people inside of a vr experience while they're tripping on mushrooms let's say so um there are there's you know different people have different feelings about that but in general uh there's a sense that it's probably best to try to avoid that at least for now and sort of ease into that space by giving people pre and post trip experiences so to get them prepared with the meditation and then to kind of like bring them bring them back down at the end with another experience in addition to that i've brought my headset to the dentist and it makes it so much better um you know just like being another space instead of looking

at that dentist light and like you know paying attention to like whatever horrible sounds are happening it reduces pain and it makes the whole thing more enjoyable so dentistry is a huge and amazing use for for vr other kinds of infusions chemotherapy like whatever so any any place where you're sort of forced to be in a place and you'd rather not be there vr is super helpful for that and then of course painful procedures teletherapy i think could be really interesting just like improving a sense of presence with therapists that you're working with meditation training wheels again not everybody um meditating is hard and it's boring and you know there's this a word that i'm kind of getting into called mindfulness so it's kind of like entertaining meditations or meditative experiences uh and sort of having an experience like that could make it easier to get to the place where you are meditating and sort of you know

orienting the my your mind the way that you would like to so i think that that is an interesting use for this kind of experience and then of course in addition to having the in clinic experience being able to take the headset home and eat and revisit that and reinforce it i think can also potentially as the potential hasn't been studied yet but i think that that could extend the usefulness of ketamine and other things one thing about ketamine compared to other psychedelics is that the positive benefits tend to only last a week or two or maybe a month with mushrooms with acid people have experiences that change them forever it's not as much the case with ketamine so yeah maybe having the sense memory of being back in vr could help with that too so this is very much a work in progress slide and kind of you know just like a work in progress uh activity of mine so it's like creating visitations for the clinic was

very it was a constrained process there was not much interaction people were just switching scenes all of the audio was you know ambient and diegetic people could bring their own music if they wanted to but creating an app for home users who have lots of different goals and want to do lots of different things is a different thing so my efforts in that space are a little experimental right now i have a game that works in visitation so it's just a very simple game to just like help you focus on something very simple so it's basically just like guiding a ball through rings and the rings get faster and faster so you are forced to pay enough attention to where you can keep the ball going through the rings it's very easy but it does sort of force you to focus in some ways one thing about meditation or hypnosis is that a lot of this relies on your own internal mental

imagery i tried a vr meditation the other day that was beautiful lots of interesting things were happening in it but the voice over was telling me to visualize things so it said it was a chakra meditation and it was asking me to visualize you know it's like a bright warm red light in my chest and i'm like but i'm looking at a blue light right now so you know there was a bit of a disconnect so if you're doing um voice over meditations and you're asking people to imagine things you also have to be respectful of the fact that they are looking at something too so that's kind of the difference between meditative meditation mental imagery things you're actually seeing so if you're in a situation that's difficult or challenging being distracted and being forced to look at something is pretty powerful but if you're trying to learn how to meditate at some point closed eye meditation or or whatever like focusing on a piece of lint in the corner i think is probably just as powerful as looking at anything that you could see in vr really

um so some other things i'm interested in is this idea that you could conjure sense memories so making trippy graphics that look trippy is that like really what you need to meditate not necessarily but if you use those graphics in a way to conjure up experiences in people that they've had before is that desirable is that helpful i'm not sure um but interesting subject something that i try to avoid is um any kind of cultural appropriation and that includes like new age cultural appropriation so i don't use any um what's the word i'm looking for sacred geometry let's say but that's kind of a question if somebody responds to sacred geometry and they love sacred geometry is looking at sacred geometry gonna get them to a different place than if they're not looking at it so that's that's a question um so flow is something i'm also you

know it's like if you're a game designer flow is a really important thing to consider so my other experience cosmic sugar is much more in line with the kind of experience that can conjure a sense of flow visitations is more of a kind of lean back um and pay attention to things and notice things and be open to things flows a little different and that it's asking you for engagement and like getting into something and and and sort of succeeding at something and gaining a skill and that kind of thing so which of those is going to be more useful and i would say probably flow is a little bit more helpful for people who are sober and don't necessarily need to be distracted but are interested in having an experience to kind of get them to a different place so novelty is another issue like if you're meditating novelty is uh undesirable it's like if you're meditating you have your shrine or you have your closed eyes or

whatever you're paying attention to what is um if you are creating a mindfulness experience then uh the ex like the experience of seeing something new regularly like new content is probably going to be the thing that you're going to want to kind of get people into that space of being open to getting into a meditative state of mind so this so you know more questions than answers and you know like we're figuring all of this stuff out right now um all of this stuff is brand new and that's part of why i'm really attracted to this space is we have this opportunity to create a new kind of visual culture and a new approach to digital shamanism um which uh i think is really interesting uh so some other considerations uh 360 video versus real time graphics like is looking at a 360 video of a beach that somebody shot is that as good or is it better than real-time graphics

as a content creator i would tend to say that real-time graphics are definitely better but hasn't been studied so you know is a bad video better than um really good real-time graphics or vice versa and what is good uh so there's like kind of a lot of questions there about like what what's really gonna work um uh i like this term the uncanny valley of photo realism so it's kind of if you're familiar with the uncanny valley it's like the more realistic uh an industrial robot gets as an industrial robot goes from you know a chunk of metal to a fully accurate human there's a place where they get into the spot of being kind of corpse-like and it's disturbing to us to see something that's almost human but not quite so i think the same thing is true with graphics where it's like it's almost a beautiful nature scene but not quite you know i wonder how much i mean as a creator i see that and i'm resistant to

graphics that aren't quite good but i wonder if that's also true of people who don't have as much experience actually creating things you know should it be something that's like very easy or challenging so if it's challenging it might be more prone to creating a state of flow if it's easy going it might make it easier to meditate so understanding what your audience wants is a really important part of this trying to be realistic again kind of goes back to the uncanny valley is it better to try to be realistic and maybe fail or is it better to lean into a more illustrative approach which you know just you know from the perspective of animating and budgets creating something that is illustrative and beautiful is can require less production resources than trying to do something that's amazing and photo real that top image is from supernatural it's a game from within if you haven't tried it they have far and away the best photo realistic vr environments that

i've seen in part because they actually use real photos and do an amazing job of photogrammetry but the scenes are not very dynamic and they're very much locked to being in a single position so to create an experience that's as good as that that you can actually move around in and that changes gets very expensive very fast um so budgets are always a part of you know considerations with all of this stuff uh so abstract versus figurative what like what are people going to like more my intuition initially was that abstract imagery was the thing uh turns out that people like natural spaces just as much it's like kind of 50 50 in my experience which visitations people like the most right now i have six natural landscapes and visitations and six abstract scenes i started off making abstract scenes and wanted to test to see if people would like natural scenes more

and i wound up bringing some of the lessons that i learned from the abstract scenes into the natural scenes so that's like the tunnel-like compositions the single point of focus you know kind of similar techniques can be used to create natural scenes and they're very illustrative i did not try to do anything photorealistic again 360 versus 180 do you want people looking around or not do you want to be exploring more or do you want to be situated in a spot more questions so this is some of the stuff i want to do in the future i want to keep collaborating with people i want to collaborate with therapists i want to study the effectiveness or i want somebody else to study the effectiveness because it turns out that studying effectiveness is actually incredibly expensive at a minimum if you if you want to take a vr experience and see if it really works and if it actually improves people's mental health it's like a hundred thousand dollars to five hundred thousand dollars to do a study like that um so hopefully somebody will do that i know that they're they're in the works um and they also take a long time so the

study that we did is actually not about effectiveness uh the study that we did is about preference which is much easier so we just wanted to do a survey and show that people tolerated it and liked it we didn't like we we did do a pre and post depression scale survey but given the small sample size and the fact that ketamine is such a powerful antidepressant there's no way that we could really see from that study if it was actually effective just the people liked it i want to work with different artists i want to make a way for people to record their intentions and record their reflections so that they can visit those things after the fact i'd like to create networked experiences so that therapists can actually create custom experiences for people and share those that would also allow for let's say more junior therapists to guide sessions with material that is made by more experienced therapists so that's

something that east forest is actually working on right now he has a startup company called journeyspace and they're doing networked teletherapy ceremonies and the idea is to eventually have a lot of music and a lot of materials and resources uh so that it's easier for people who haven't had all that time to create all of their own content to hop in and lead groups of people through these experiences um interested in working with uh different kinds of inputs uh so i recently got a hp reverb omnisept which has a heart rate monitor and also can track your eye and that includes pupil dilation and from pupil dilation you can kind of see how activated people are so i think it's sort of similar to the way galvanic skin response would work and that's all built right into the headset so sort of using that to feed back into people's experience i will say one

thing that we tried at the spa just before it shut down one of the activations that we did was connecting a gong to your heartbeat and so every time your heart beat the gong would ring and it was actually surprisingly stressful so i'm like very curious to see how like these different um you know feedback devices uh can work because right now i'm not sure and i need to do some experimenting myself um so pressure sensing i've been wanting to you know it's like if you if you think about painful experiences you're going through you might want to like grip something tightly so having some kind of grip affect what you're seeing in vr i think could be really interesting um sort of you know like bring in the voice there's uh a company called um entheo digital uh was started by robin arno and they're doing really interesting work they have an app called sound self where you can kind of it feeds back your own voice

i think that you know having the ability to use your voice as a controller could also be really interesting and helpful in the space if that would lead to more intuitive controls that kind of thing so also really interested in other output devices so working with dome spaces there's a place in new york called frequency that has a dome and they do sort of live healing sessions in a space like that so you know vr is just a display technology you can display this content anywhere else as well it's a little more than just a display technology but it is a display technology custom displays as well something i'm interested in experimenting with so you know ways to take leds and do interesting things with those the rainbow therapy again was a set of strobing leds that were designed for closed eyes but i i'm very interested in exploring like low resolution led displays that can incorporate you know some of these strobing effects

strobing effects work a lot better and are much more controllable with leds with a display you're sort of locked into whatever the display rate of the screen is so you can have frequencies that are aligned with whatever your display is but nothing really outside of that um and then i would love to i'd love to push a narrative in a way but i think that with narratives that would unfold over the course of a series of medicine ceremonies really the user has to bring their own narrative to it so there's a question of like how do you create a narrative that's open enough but also guided and that's something else i'm interested in exploring uh so i i added this slide recently everybody wants to talk about the metaverse these days um i had a slightly snarkier slide before but toned it down a bit um so the good like you know if you're if you spend your life in minecraft or roblox and that's a comfortable space for you it could also be a very comfortable

space to get therapy if you're a kid and you meet up with your therapist and you're like doing minecraft together that could be a really positive thing it could also potentially you know increase access in the same way that video conferencing does but you know could potentially embody things a little bit better so i think there are some interesting potentials with going from your life in the metaverse to getting your therapy in the metaverse and obviously the biggest bad thing about it is it's your mental health it's very sensitive and having big companies have any kind of access to that stuff could be very dangerous so that's um that's an important thing to consider right now um light clinic is working with htc on a project called vive dreaming and chapter 1 will hopefully be getting released soon i'm also working with a company called cyber which is a healthcare gaming studio and they're now part of a thai which is a very large company that is developing a lot of novel psychedelic compounds

rocket vr um we're working together to create experiences to help people calm down when they're getting radiation therapy for cancer and i'm working with johns hopkins on experiences for people who are um having mushroom trips uh so visitations is currently in use in a few places it's it's going to be in use at penn and i expect to keep working with it for a long time this is the studio um i chose the name light clinic in part because uh the dot like light that was available as a website and i was like this sounds cool the problem is i didn't think about at the time it's like i can't tell people like if i just write light.clinic it's not obviously a website so i don't know if other people know how to deal with that stuff with their uh with their domains but light.clinic is the website um i'll be adding more projects in there as they become available one downside of working with

startups and in the healthcare space the healthcare space is very slow startups don't want to sort of share their stuff so there's actually other startups that are so like stealth that they don't even want me mentioning that i'm working with them so as soon as i can i'll be sharing other work from those projects but they're all you know kind of informed by what i learned from doing visitations so that um yeah i think time wise there's eight minutes for questions if anybody has any questions [Applause] i'm just going to go right forward that was great thank you um what from your experience and your own understanding of how folks interpret virtual reality do you think is good for people just in the current marketplace i'm talking anything from a fully blown action game to the weirdest just straight up 180 degree video just anything that's currently out there that you would look

at and go based on my understanding of how people respond to vr in a therapeutic way that they could get something out of it if they for example structured it differently like beat saber as a therapeutic exercise if you put on a custom song or anything of the sort i was just curious your take on yeah i think that's a great question because i i tend to think that almost anything can be therapeutic i was i was going to mention tetris and tetris effect let's say you know it's kind of like whatever is therapeutic for you is therapeutic right so if you find it relaxing to be in a first person shooter environment and shooting people then that's what's therapeutic for you so i think that um different things are just going to work in different ways so it kind of depends on what are your therapeutic goals and needs and then i think a lot of it's just a matter of framing you know it's like you slow down beat saber and it's a tai chi experience but you know maybe what you need for your therapy right then is just to distract yourself from like whatever is annoying you at the time so i think yeah i mean i guess the short answer is almost anything can be

therapeutic for sure hello i have two questions first one how can i help this project and is it open for i mean like experiment with it by myself and with friends uh so you can you get the app and try it yourself is that the question and yeah but also like tinker with it as a developer and try it and and someone and then myself oh so like take take the code and make some modifications to it yeah yeah well yeah okay come come talk to me later it's not open source so the code isn't out there but if there are sort of uh techniques or tools that you're interested in working with there are uh you know things that i could possibly connect you to okay that's awesome and the second question uh you have a lot of experience with this so how can i learn how to make fractals in 3d

um also a big question and there's a lot of answers to that i actually am um have been working on a fractal making library for a long time and it's it's in kind of a halfway state but i am hoping to continue developing that and that would be an open source way to actually this image right here was developed with with that tool and it's actually like very flexible and i'm hoping to continue developing that so that would be one way to do it but again if you want to chat later okay thank you thank you hello um i'm wondering if you can spend a bit more on the burn victims specifically you mentioned that the patient reported reduced pain during procedure however do you have any information about how much pain was produced at the you know did the surgeons doing the surgery report that they were it was easier to work with the patient did the surgery take less time i know you don't have all the information and this wasn't a huge clinical trial but can you expand

a bit more on what your findings were um so i was not working with burn patients just to be clear about that that that was a study that hunter hoffman did at the university of washington um and it's very well documented so um yeah if you just google snow world uh hunter hoffman you can get all the information there and it's like i don't remember all the exact numbers of like you know percentage of people that responded really well to it or anything like that but it was like definitely like statistically very significant and people enjoyed the experience a lot more and tolerated very well thank you hi um so vr has like great ability to like make an immersive like environment for patients and players but one of the biggest downsides of it is obviously the the immersion breaking of the physical device i was wondering if you had any specific strategies you implemented to help combat that effect so when you say immersion breaking of the physical device you mean just having

a headset on your head yeah basically um yeah i mean it's like there's definitely some people just really don't like having a thing on their face and they and they find it sort of upsetting so i mean the the key really is is just about how how you introduce people to it and just kind of making making it a personal experience like that onboarding experience of that first moment of having a headset put on your head and getting adjusted if that if that experience is pleasant then i think people tolerate it better it's like they tolerate it less well if you just hand it to them and they put it on and it doesn't fit right it's like some people will just hold the headset up and they think to themselves like oh it's like vr just isn't good because it doesn't fit so i think that that personal connection of the person who's putting the headset on is is extremely important and then you know at some point you do just have a thing on your face so people who are on large amounts of ketamine don't really notice i think for the most part or nobody complained about that in particular but

um the the flow device that htc just came out with is uh is a little bit lighter weight and a little easier to get on so it's it's just going to get better and less of a concern but yeah there's only so much you can do about the fact that people just have a big thing on their face cool thank you great talk very interesting love it i'm pretty interested in there's a comment like learning more about the forest bathing in vr and like how that's going to how that's going to be equivalent to like real forests um so i'll have to find uh that article you talked about but that question made me think of the previous question maybe think of like are you thinking about ar and like how to do these types of experiences in ar rather than completely vrs that might be a little more comfortable in my experience people who work in the xr space are kind of like split in two camps it's like some people love ar and some people love vr i love vr because of all of these qualities of being able to

block the world out um and it's you know it's more about narrative and immersion and that kind of thing whereas people who are excited about ar are i think very interested in sort of practical uses and um uh and stuff like that so i have considered the idea of of working in ar but it's not a passion area and i would be more interested if an ar headset manufacturer like funded the development of something but like for for this application um the whole idea was to block out the fact that you're in this clinic so overlaying something on the clinic i don't think would be quite as powerful and for for this particular use case that's fair yeah thank you but actually so i guess one last point um to ar it's like i think with teletherapy that could be really interesting potentially but i think like the tech in general still has a little ways to go cool thank you thanks amazing presentation amazing products thank you um i was just reflecting on

how a lot of meditations aim to take you into the body and you know more the idea of the mind being fragmented outside of the body and then the body is a tool for various outcomes and you were talked about how vr as far as your brain is concerned you're basically not in your body so i was wondering if you could talk about maybe that tension or do you see it as a tension do you see vr's applying just to these other types of benefits or somehow are these compatible i definitely think it's a tension and i i think it's a really interesting um dynamic uh to explore so something some so my approach to sort of that tension between like focus on your body but you're in this space that's bringing you outside of your body was to present just very lightweight prompts like if you're doing a body scan it's like all about completely focusing on that part of your body um so the prompts that i have are more

about trying to combine focusing on a part of your body and tying that to something out in space so there's a kind of meditation called open focus meditation which is kind of it's kind of a body scan but it's a body scan that involves that involves imagining spaces between things so it's like in those meditations you'll be asked to like imagine the volume of your finger or the space between your hands and your throat or that kind of thing so i think there's a way to incorporate elements in the outside with elements in your body and i think it's really just a matter of fine-tuning that and i i have not fine-tuned that yet it's an it's an ongoing process but then there's also the question of is that a worthwhile or interesting thing to even pursue and uh like that's also something i'm not sure about either because like a body scan meditation is so powerful and you really don't need to be looking at anything for it so it might just not be a useful thing to have in vr at all

potentially thank you thanks hi um great presentation uh generally speaking i have a question about the people who suffer from you know post-traumatic syndrome or who went through war zones yeah bunny what is your opinion on it and how are you seeing this technology and helping those who's in need yeah with ptsd specifically there's um a scientist named skip rizzo who's done a lot of work with that um over a long period of time and the idea with ptsd and i think i'm actually two minutes over already um so with ptsd there is this idea called fear extinction and something you can do is actually recreate traumatic experiences for people and by putting them in a safe place and allowing them to re-experiencing something traumatic like let's say an ied exploding you know by your humvee when you're in iraq like that can actually sort of help

with reducing symptoms of ptsd so vr is really powerful for that and really interesting and and not something that i'm personally exploring at all right now thank you cool okay thanks everybody [Music] you