Psychotherapy on a pixel beach and endurance tests in a virtual airplane: US scientists are successfully curing alcoholics in the online world of Second Life. They will soon publish the first results of their research. SPIEGEL ONLINE accompanied a patient to therapy.
In her first life, Shelly (not her real name) was often drunk. On the day of her niece's wedding, she downed half a bottle of vodka and took a strong painkiller. Just before the ceremony, while sitting in a white pavillion with a baby in her lap and in a complete daze, she suddenly slipped from her chair and the baby fell to the ground. Someone grabbed her by the arm and put her in a taxi. Shelly looked up and saw her mother, who she then pushed away. She says that she would have preferred to keep on drinking herself into oblivion.
In her second life, Shelly often sits on the beach, almost at the water's edge, as the surf tickles her toes. She has an eternally young body. A lone seagull circles in the distance as a bonfire flickers in a fire pit nearby. The wind carries sparks to the sea. Shelly holds a glass of lemonade in her pixel hand. She could sit there and keep on drinking forever. The cup is always full.
Shelly has been dependent on alcohol since she was 16. Now 44, she has been undergoing a unique form of therapy for the past year. She is a patient at the Accelerated Recovery Centers, the first treatment program for the alcohol dependent and alcoholics that integrates the online world Second Life into the therapy concept. Patients are treated in Atlanta and on Identity Island, a place that only exists in the virtual world. In Second Life, patients engage in individual and group conversations and undergo special training programs that teach them to resist alcohol, even in stressful situations.
For the past nine months, roughly 100 alcoholics and a dozen psychologists have met for conversations on Identity Island. The company plans to publish the results of the test phase soon. According to Accelerated Recovery, the study strongly suggests that the incorporation of virtual worlds can significantly improve addiction treatments.
Shelly slips into her flip-flops and leaves the pixel beach. She heads up a stone path, walking past streetlights, birch trees and yellow bushes, and then enters a large house. In one of the rooms, there are two brown leather sofas placed at right angles to one another. In front of the sofas is a wooden table with a strange bronze statue standing on it. A slim and darkly tanned avatar, as the pixel denizens of Second Life are known, with long black hair sits on one of the couches. "Hello Shelly," says the real person behind the avatar. "Welcome to therapy."
'Like Going to Confession'
The room with the bronze statue in it actually exists in real life. What Shelly sees on Identity Island is an exact replica of a room in Atlanta where therapy sessions are held. The man behind the avatar is David Stone, the founder and managing director of Accelerated Recovery, and a practicing psychologist for the last 20 years. The resemblance between Stone and his avatar -- and between Shelly and hers -- is striking.
This similarity creates tension between proximity and distance. On the one hand, the patient and the therapist are close to each other in the virtual world, conversing in a familiar environment and looking at familiar faces. On the other hand, they are physically separated, which makes it easier to talk about more intimate matters. "It's almost like going to confession," says Stone. "The clients tell their problems through their avatars like the Catholic tells his sins through a curtain."
Just as in a confession or a real-life session with a therapist, the meetings in Second Life are completely confidential. The only way a patient, or anyone else, can reach Identity Island is through Accelerated Recovery. In fact, the area is even off-limits for Linden Lab, the creators of Second Life.
Shelly is now sitting on the brown sofa, diagonally across from her therapist. Stone leans back and his avatar's upper body seems to disappear into the virtual leather of the couch. Shelly, her back hunched and her hands resting on her thighs, talks about what happened at the wedding.
Finding Courage in Second Life
Shelly tells the therapist about how she started drinking again the day before the wedding after she found out that her brother would be there. She talks about how she reproached her brother for cheating on his wife, and how he threatened her with physical violence. She felt terrible after the wedding, she says, and she continued drinking out of shame, and then felt even worse afterwards. The family, she tells Stone's avatar, blamed Shelly for everything until she believed that it was all her fault, even though much of it wasn't.
Shelly stopped drinking half a dozen times and started up again just as often -- a common pattern among alcoholics. The National Institute on Alcohol Abuse and Alcoholism in the United States estimates that 65 percent of American alcoholics will fall off the wagon at some point, most of them in the first year after alcoholism treatment. The estimated relapse rate in Germany is about 50 percent.
Volker Weissinger, the head of Fachverband Sucht, a German professional association for addiction treatment programs, concedes that virtual therapy has the potential to reduce the recidivism rate. Nevertheless, he is largely critical of the Second Life platform. "Most alcoholics relapse as soon as they try to get back into their daily routines," he explains. "It is important that they receive quick help in stressful situations. A virtual contact point where patients can get help at any time, no matter where they are, would be a valuable, additional component."
Shock Therapy in a Virtual Airplane
Although Shelly is only involved in discussion therapy on Identity Island, the virtual world offers other treatment options. For instance, there is a airplane simulator on Identity Island that Shelly could board. Inside the plane, passengers can hear the roar of the engines and see the lights flickering in the cabin as the virtual flight passes through turbulence and passengers are pushed roughly against their seats. A smiling flight attendant stands in front of the cockpit. Those who click on the flight attendant and press the right mouse button receive a drink to calm their nerves: whisky, beer, vodka and soft drinks hidden between alcoholic beverages.
While their avatars fly through virtual turbulence, the patients are reclining in heavily vibrating leather armchairs. They wear special goggles that project the virtual world directly onto the retina. "The outcome is shockingly real," says psychologist Stone. "And it has a great deal of therapeutic value. We can have patients experience the kinds of extreme situations in which many would reach for the bottle once again. This helps them learn to resist alcohol, even at difficult moments."
Shelly hasn't had an alcoholic drink in two years. Some time ago, she and Bob, another patient, were walking up a stone path together. They could hear the sound of the ocean softly in the distance. Shelly and Bob placed their avatars into a fountain. After a while, they realized that they couldn't get out again. They laughed about their misadventure and talked for an hour about therapy, children and the possibility of finding a way out of their wet pixel prison. Then Bob discovered the way out. He pressed a key and his avatar took off. Shelly did the same thing and her avatar began to hover above the ground. Then the two flew away together.
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