Sci + Society,

#087: Virtual Reality Therapy

July 30, 2015

“If you think about this kind of treatment, there’s one important component you have to consider: there’s a difference between wanting and liking” says Dr. Robert Reiner.

The topic under discussion is Virtual Reality Therapy, a method for treating phobias and anxiety that Reiner has been on the forefront of for nearly three decades.  He and Jesse discuss the evolution of the treatment modality and its use in modern psychology.

Also in this episode, Jesse reveals his own personal phobia — something that’s been haunting him since he was a barefoot four-year-old in a soggy Oregonian garden patch…

PS:  Coming soon… Some interesting developments on Smart Drug Smarts. Keep your eyes peeled.  And while you’re waiting, don’t forget to check out our recently-launched stacks at AxonLabs.

Show Notes
  • 00:00:45

    An introduction to Virtual Reality therapy.

  • 00:01:44

    This Week In Neuroscience: Linking emotions to memories.

  • 00:05:38

    A great week in listener interaction.

  • 00:07:32

    Check out our recently launched stacks at Axon Labs.

  • 00:08:23

    Jesse introduces Dr. Robert Reiner.

  • 00:09:06

    A primer on Virtual Reality therapy by Dr. Reiner.

  • 00:10:28

    Treating different kinds of phobias.

  • 00:12:03

    Fear of flying vs fear of public speaking.

  • 00:13:26

    The evolution of some common phobias.

  • 00:14:24

    Inducing phobias artificially and bio-feedback.

  • 00:16:15

    Prediction error and abdominal breathing.

  • 00:19:25

    How phobias, addictions and OCD build up over time.

  • 00:20:39

    The technology of Virtual Reality therapy.

  • 00:21:48

    Systematic de-sensitization.

  • 00:23:44

    Addiction vs phobia.

  • 00:27:04

    Jesse reveals his one and only phobia.

  • 00:27:54

    Ruthless Listener Retention Gimmick: A significant and salacious finding.


  1. Grey says:

    Around the 17-18 minute mark, Dr R talks about 5 second breathing leading to synchronisation between heart & breath, which he refers to as Coherence (which I use the Inner Balance app to train). He says that finding the coherence ‘sweetspot’ leads to the shutting down of the flight-or-flight system, inducing relaxation. I always thought it was the opposite …

    Could someone comment on their understanding?

    If someone is in fight-or-flight (i.e. stress) then their heart will be unable to become coherent because the beat has stress-induced regularity. I was under the impression that coherence appears one you can turn off that stress response, and not the other way around … that getting coherence turns off fight-or-flight.

    Anyone know which is the cause and which is the effect?

  2. Brandon says:

    Hey anyone know the different breathing phone apps Dr. Reiner mentioned in the podcast?

  3. Greg says:

    I use the ‘Inner Balance’ app – measures heart rate (live heart rate, not just averaged over the last minute), HRV, includes a breath pacer, lots of graphs, etc.

  4. After several minutes of slow diaphragmatic breathing, heart rate will soon sync up with respiration. In other words, as you inhale, HR begins to rise and as you exhale, it begins to drop, with both looking like sine waves. How quickly a person goes into coherence depends on health of their cardiovascular system. This response, known as Heart rate variability (HRV) and/or Respiratory Sinus Arrhythmia (RSA), is stimulated by baro-receptors in the vascular system. They have the effect of making a person sleepy and relaxed; we use a modified version of it to treat insomnia. Naturally, people are told to NEVER do it while driving a car. When I was referring to “sweet spot” I was talking about the particular rate of respiration that generates the biggest swing in heart rate. For example, if resting pulse is 70 and when you breath in for five seconds and out for five seconds (6 breaths a minute) and it rises to 82 beats per minute during peak exhalation and drops to 60 during peak exhalation the total is 22 (82 – 60 = 22). Lets say that 5.5 breaths per minute generate a swing of 28 heart beats per minute, and that appears to be the largest swing (after sampling several different respiration rates). That particular rate will be given to the patient to practice as this produces the biggest drop in sympathetic arousal/fight or flight). In the Android world, the best app is called “paced breathing”

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