Abstract

Presence, or the feeling of “being there” in a virtual environment, has long been studied as a key feature for determining whether a virtual reality (VR) system can be effective in eliciting a strong response from its user. The same applies to the concept of immersion, which can refer directly to the technology that enables the user to experience the virtual world (e.g., a head-mounted display or a mobile screen) or can be related to the user's internal experience and willingness to suspend disbelief and feel invested in the virtual world. 1
In truth, both presence and immersion are necessary for a VR experience to be effective, and research has found that users will not feel immersed if they cannot connect with the story of the environment. 1 It is only once a connection is made—once the line between reality and imagination is crossed—that VR can be used as an effective treatment modality.
Recently, researchers have begun to explore a third concept related to how users connect to a virtual world: embodiment. Embodiment is especially relevant to a user's empathic response, which is crucial to creating a beneficial therapeutic environment.
What Is Embodiment?
Embodiment is defined as a person's sense of having a body. 2 More specifically, the human brain, in order to regulate and control the human body, creates its own simulation of the body in the world. 3 This concept, drawn from cognitive neuroscience, is about how we experience ourselves inside a body as it interacts continuously with our environment. 4
Embodiment is a construct through which we can understand how we see ourselves as people and how our minds interface with our bodies. Many models of embodiment describe the self as “an integration of a social or conceptual self along with our physical self.” 5 In other words, humans understand themselves through both their interactions with others and their interactions with the environment.
Scientists have found that this sense of self can be manipulated by creating conflicts in visual and tactile cues, creating a “body illusion.” 5 These illusions can either arise organically through an issue with a person's sense of embodiment created by their own mind, or they can be created artificially, such as during therapy in an effort to encourage the brain to reassess and update sensory organization to correct the induced conflict, 5 essentially “rebooting” a person's embodiment.
Embodiment and VR
VR, itself an embodied simulation, 3 is a form of technology that is perhaps perfectly suited to the study of embodiment. Until recently, VR had been used, for the most part, to provide the opportunity to explore a world or environment that didn't actually exist. However, scientists are now exploring the use of VR to create new ways of structuring, augmenting, and/or replacing the experience of the body to enhance clinical goals further. 3
VR creates a world that individuals can manipulate and explore, just like the real world. And like the human mind, VR technology creates a simulation of a body in space; it's just that in VR, physical bodies are replaced with virtual bodies.
VR enables users to inhabit virtual avatars which can be crafted independent of physical reality, removing the tethers to one's personal identity. 1 With VR, a person can temporarily become someone else. It is even possible to induce the perception of a limb or even an entire body. 4 This ability to shed the limitations of the real world while at the same time manipulating a person's embodiment provides the opportunity for a wide range of therapeutic interventions, especially as it relates to empathy.
What Is Empathy?
Empathy is the ability to understand how someone else is feeling in a particular situation. In essence, when we can “see through another's eyes,” we can more fully experience empathy. The concept of empathy can be divided into two subtypes: cognitive empathy and emotional (or affective) empathy. 6 The first—cognitive empathy—is defined as an intellectual understanding of another person's emotions and mental state while remaining an objective observer. 7 In other words, the other person's motivations and reactions are understood, but the observer is not affected by the other person's emotions. In contrast, emotional empathy refers to being affected by and sharing another's emotions and matching or corresponding one's emotional reaction to the emotions of another individual. 7
Both types of empathy are important for social interaction. Empathy is the foundation for positive relationships and well-being within a community. It discourages aggressive behavior, essentially acting as an internal peace-keeping force in complex social interactions.8,9 It is a key construct for social relationships, and it plays an essential function in medical and psychological treatments and caregiving relationships. 7
Empathy is also part of what gives meaning to many art forms. Empathy is why we care about characters in books, movies, plays, and video games. As with those art forms, VR is a more powerful experience when it draws out a stronger empathic response.
How Does VR Embodiment Enhance Empathy?
If empathy is a matter of understanding another person's situation, VR is uniquely suited to help a user “walk a mile in someone else's shoes.” When a user connects with, or “embodies,” an avatar in a virtual environment, the elements that would otherwise ground them in their own sense of self are disrupted. That displacement can foster empathic connections. 1
Because VR is able to immerse a user so fully in an experience, providing a range of sensory stimuli, it is an ideal platform for recreating embodied situations. For example, if a person without a particular condition, such as panic disorder, has the opportunity to experience the symptoms of a panic attack in a virtual world, they will likely come away from the experience better able to understand those with panic disorder and to feel more empathy toward them. 10
VR is so effective at generating and enhancing empathy in these situations precisely because it allows users to have an embodied experience, without having to rely on imagination.
Instead of asking an individual to visualize or create another person's perspective from scratch, VR technology provides that input directly for the user. 11
Likewise, the empathy that a user feels for his/her own virtual form (even if it is an intentional facsimile of the individual user) is crucial for reinforcing the other elements of an effective VR experience: presence and immersion.
If more than three decades of VR-related research has proven anything, it is that technology can have a profound impact on one's sense of self and concept of reality. From presence, to immersion, and now to embodiment, VR has revealed itself to be a complex, multilayered tool that is invaluable for its contributions to behavioral healthcare.
