Valeria Balashova, a 28-year-old woman from the southern Ukrainian city of Odessa, fled to Bucharest in March of last year to escape the war. She has since been back only in virtual reality. In October, she was contacted by a Romanian colleague’s psychologist and asked if she would be interested in taking part in a new program designed to provide therapeutic support for Ukrainians, both at home and abroad, who were being affected by the war. This program, she was told, would take place not in a therapist’s office but in VR. “I told him that it's a very great idea, and of course I would be glad to take part in it,” she told me on a Zoom call.
The program is set within a virtual rendering of Kiev’s House with Chimaeras, a squat fortress bristling with ornate statues of animals, which sits just across the street from Zelensky’s office in the Ukrainian capital. The virtual environment is serene: a blue sky, plenty of greenery, and graceful buildings cloaked in the shade of a summer afternoon. In the middle of the square sits a dark circular area, ringed by blue couches—the type you might see in a therapist’s office. This virtual House with Chimaeras has been designed as a space where Ukrainians, many of them displaced from their home country since the start of the war, can meet in VR, share stories, and hopefully recover from their individual and shared traumas.
The VR program is oriented around talk therapy and peer support, two of psychiatry’s traditional frontline defenses against PTSD. Developed by an international team of psychologists in partnership with the VR platform 8agora, each participant—including a therapist, who guides each session—appears as a customizable avatar. In a pilot session which was recorded and posted to YouTube, Balashova and two other Ukrainian refugees currently living in Bucharest discussed some of the more mundane challenges they’ve encountered since relocating to a new country.
“I moved to Romania with my [two] daughters,” a Ukrainian woman says through her avatar, which has pink hair and symmetrical face tattoos. “[We] faced the problem of the language barrier… The first time was hard, but I signed up for a course.” Another woman lamented the difficulties of adapting to the transit system in Bucharest. And so on.
The subject matter of the conversation was easygoing by design. “People with PTSD sometimes don't react well when other people mention a traumatic event that they themselves went through,” says Dr. Cezar Giosan, Associate Professor of Psychology, University of Bucharest, who helped design the virtual peer support group. “They may have a panic attack during the session… we don't want that.” Better to have the participants start slow, discussing everyday frustrations, before delving deeper into the traumas they've experienced.
The psychologists leading the project hope that VR will help to cut through some of the stigma surrounding PTSD. One study published last year in the European Journal of Psychotraumatology assessed 194 adults with PTSD in the UK and found that close to half (41.2 percent) were affected by “self-stigma,” which the authors of the study defined as “the internalization of negative societal views and stereotypes.” That study also found that the participants who reported feeling self-stigma were also experiencing “lower income and higher levels of anxiety, depression, and traumatic stress symptoms.”
In VR, however, it appears that some of that stigma can be ameliorated: “There's really no shame in it, but [sexual assault is] not an easy thing to talk about,” Dr. Albert ”Skip” Rizzo, a clinical psychologist, the director of medical virtual reality at the Institute for Creative Studies (ICT) at the University of Southern California (USC), and one of the experts developing the project, said about one specific type of trauma that VR therapy has shown promise in treating. “You should be able to talk about it and get support, but a lot of people [feel] stigma about it. By doing it behind the face of an avatar it becomes a little easier, and for the first time, maybe people start to feel more comfortable talking about the pain that they went through, and that becomes the first step towards healing.”
According to Balashova, Ukrainians tend to feel their own, culturally unique form of stigma. “We’re not used to asking for help, because we know that nobody will help us,” she told me. “Our government will not help us— usually, everybody is on his [or her] own.” But within VR, she says that she and the other participants felt more relaxed, more at ease with their vulnerability. “It gives you freedom of thinking, freedom of speech. It opens you more … I hope that they will continue developing [the program], so it will really start working and helping people daily.”
The peer support VR program also has the added benefit of being accessible across platforms; no expensive VR headset required. “You can [access the program] from any device that's connected to the internet,” Giosan says. “You want to make these things as simple as possible — point and click, basically.”
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