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See Inside October/November 2007

Fantasy Therapy

Steeping patients in computer-created virtual worlds can help heal a multitude of psychiatric ills, including phobias, eating disorders and implacable pain

Jonah is inching upward in the glass-walled exterior elevator of a 70-story skyscraper. For each story he ascends, he rates his fear on a 100-point scale. At the top, he peers out over a microcosm of office towers, streets and gas stations--that are not really there. While donning a headset that produces three-dimensional images, Jonah is receiving an experimental therapy for a debilitating fear of heights.

The goal of the treatment is habituation, a form of learning in which a response to a stimulus diminishes with repeated exposure. Traditionally this exposure is done in real-world settings--in an actual skyscraper, on an airplane (for fear of flying) or with a spider (for spider phobia). But in a new twist, clinicians are increasingly replacing reality with 3-D computer simulations.

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