At the thought of addressing a classroom or a larger auditorium packed to its capacity some people break out into a sweat, their legs turn to jelly, and their hearts begin to pound wildly or go light-headed.
Glassophobia, or the fear of public speaking is one of the many phobias that are associated with a medical condition called Social Anxiety Disorder of SAD, the third largest mental health care problem in the world, that affects roughly around 200 million people in India according to estimates by the WHO.
Now a US-based company called Illumenta has introduced a Virtual Reality Exposure Therapy (VRET) that will recreate situations, which are most feared and use a combination of desensitisation techniques that would if used over a prolonged period of time gradually help people tide over any type of phobia, fear or addiction.
Creating atmosphere
In VRET those who are afraid of speaking up in front of a large audience, are made to stand on a makeshift podium and given the necessary paraphernalia of goggles, headset and earphones to wear and all lights are dimmed. "A typical classroom with noisy students and blaring music comes up before the client and he or she feels as if they are really standing inside a classroom," says Manish Bhan President and CEO of Illumenta.
Anxiety is developed due to the conditioning that a person receives, says Dr Tulika Mehta Aggarwal, clinical psychologist, who has worked with a select small group of clients on a trial basis for the VRET technique.
"For example if a child speaking in front of a relative or a group of family friends is chided or mocked then there is a tendency for the situation to be carried forward in future and develop into a phobia," says Mehta.
From teenagers who find it difficult to stand up and speak in front of their classmates in school or college to young adults who are petrified of facing a job interview or even elderly people who are unable to initiate or hold conversations with strangers at social functions, there is quite a sizeable number of people in the country (roughly estimated to be around 200 million) who are affected by this condition. According to WHO, about 25 per cent of the Indian population are admittedly shy in which around 80 per cent of those are privately shy and the remaining 20 per cent fit the publicly-shy stereotype.
Compared with control subjects, individuals with social anxiety disorder are  8.4 per cent less likely to graduate from college, 14.5 per cent less likely to secure a professional, technical, or managerial job, and will earn wages that are 14 per cent lower.
Those suffering have generally have low average education levels and the peaks of incidence of SAD is found between the years 11 to 15 and between 18 to 25 years and is sometimes preceded by a history of social inhibition or shyness.
"We expose them repeatedly to stimulus they fear. Maybe they will have to speak in an auditorium or face interview sessions or be in a conference room" says Dr Mehta.
Classroom situation
So in a classroom situation a person is forced to deal with students who interrupt his speech by going out of the room and banging the door shut, by throwing pieces of paper at him or whispering and giggling, all those situations that would be terribly unnerving for those who suffer from a social anxiety disorder.
The VR therapy uses the technique of exposure, after immersion, that is a controlled display of the fear stimuli and so if a person is afraid of speaking in front of a group of people he is progressively introduced to a small audience and then to a large audience and eventually to a large auditorium," says Bhan.
The whole session is recorded on video and shown to patients to help them gauge the level of treatment.
“People whom we have worked on are very average people ranging from college-going students to young adults who have developed wrong responses to particular situations. We try to teach people in virtual environments not to fear," says Mehta. Virtual reality corrects the wrong responses to situations, she adds. The VRET has been used worldwide to help treat people with with Post Traumatic Stress Disorder, addiction and substance abuse to distract people with extreme pain and other such phobias.
Bhan says most people just think that they have a social anxiety but often when they are tested it is found that they do not have any such disorder.  "We screen patients to gauge the level of disorder and only then proceed with the treatment," he says. In the desensitisation process an anxiety arousing situation is paired with a anxiety management one. "Th client progressively realises that the situation which used to be once out of control can now be handled easily. Also, repeated exposure to the feared situation and audio video feedback help clients in a realistic self evaluation," Bhan explains. Before these sessions we give them anxiety management techniques," he says. The therapy, will be officially released in India in August in collaboration with the New Delhi-based BD Chandiwala Centre for Psychological Research.