A pilot project at Montreal's Philippe-Pinel Institute has patients with schizophrenia confronting voices that torment them by way of a virtual reality experience.
The project, developed by psychiatrist and researcher Alexandre Dumais, allows patients to create computer-generated avatars that look and talk like the demons they face inside their heads.
Richard Breton, 52, has been struggling with hallucinations and paranoia since he was diagnosed with schizophrenia in his early 20s. (Radio-Canada)
Richard Breton, a 52-year-old father of two, has struggled with schizophrenia since his early 20s. He told CBC's French-language service that his episodes of psychosis and paranoia at times put his life at risk.
Tormented by voices and hallucinations despite medication and traditional therapy, Breton turned to Pinel's pilot project.
He was the first participant in the project, inspired by a U.K. study conducted in 2010.
Breton described the appearance of his internal tormentor to a design technician, and with the help of a virtual reality headset, came face to face with that tormentor projected before his eyes.
"The patient can't avoid it," said Dumas. "It allows patients to manage their emotions while they're being persecuted and learn to confront [the avatar]."
Patients describe their demons to a design technician and provide a list of phrases for the avatar to say. (Radio-Canada)
Dumas stays closely connected to the patient during the interaction, reading off a list of phrases submitted by the patient — the kinds of things the person hears the tormentor say.
"You're not a good father. Nobody loves you," the avatar tells Breton, in a satanic voice.
Learning to fight back
In the beginning, patients find the interaction very difficult. But over six sessions, the psychiatrist helps them to respond to the insults they're hearing and to develop defence mechanisms.
"I'm a good person," Breton has learned to respond. "Give me any trouble, and I'll make you go back inside."
For Breton, wrestling with a projection of his inner demon has worked.
"I'm able to fight it," said Breton. "The voices have diminished from 80 to 90 per cent."
He credits the project with helping him return to work and engage in more social activities.
"The voices were too invasive," he said of his life before this experiment. "I isolated myself because every time I went out, the devil caught up with me."
Richard Breton says the voices he hears have diminished 80 to 90 per cent since he participated in the pilot project. (Radio-Canada)
Nineteen patients at Pinel have taken part in the pilot project since it was launched in September 2015. Fifteen have reported seeing a significant improvement.
"The numbers speak for themselves," said Dumas. "It worked in Britain, it works here."
Some patients have found the lack of realism of the animated avatar distracting, which limited the effectiveness of the therapy.
For that reason, a second phase of the project is being launched — a collaboration between Montreal virtual reality company Ova and the Pinel Institute, to create more vivid iterations of the patients' descriptions of their inner demons.