Scared of heights? How virtual reality can help people overcome their phobias

Fay Nugent's fear of escalators had become so debilitating it was starting to interfere with her day-to-day life. 

The U.K.-based project manager, 52, can remember the phobia starting as a fear of heights. She recalls being in her early 30s and on a weekend getaway with some friends. 

"We decided as part of this weekend to do some adventure activities, which involved climbing up a pole and then walking out across ropes at different heights," she told CBC Radio's Tapestry. 

When it came time to walk across the rope, however, Nugent couldn't do it. She froze in fear. After that, whenever she was in a situation involving heights, she'd start to feel dizzy and this "overwhelming sense of concern" would wash over her. 

For the next 20 years, she avoided heights as much as possible, especially escalators. Her breaking point came in 2018 when she was at an airport in the Netherlands with some colleagues. 

"[They] were heading toward an escalator with luggage to go down and check-in," she said. Nugent had to follow them but was terrified. 

Not long after, she heard an ad on the radio from Oxford University. Researchers were looking for people who had a fear of heights to participate in a new clinical trial. The trial involved testing out a new virtual reality technology as a therapeutic tool.

"I thought, 'Well this is it,'" said Nugent. "This is something that I can try and get back to some sort of normality in my day-to-day life." 

Virtual reality-based (VR) therapy combines other forms of therapy, including talk, with technology, allowing patients to immerse themselves in their fears in a groundbreaking way. It's been used to treat post-traumatic stress disorder, anxiety and other mental health diagnoses.

In Nugent's case, a form of virtual exposure therapy presented her with challenging situations in a controlled setting. 

With a VR headset, a patient can pause an experience or step away from it if it feels too overwhelming, said John Francis Leader, a psychologist and cognitive scientist who specializes in psychology and technology at University College, Dublin.

The researcher describes the approach as "theme park meets therapy." He said that VR therapy is still an emerging field, and at its core is a combination of the physical, the virtual and the imaginary. 

The imagination can be a very powerful driver of anxiety on its own, said Leader. 

"Very often, somebody's doing a form of mental rehearsal using imagination," he said.