The VR Experience That Might Make You Less Afraid to Die

This article originally appeared on Tonic

You’re sitting in a chair, looking down. As you might expect, you see your body below you: arms, lap, and bent legs. But it’s not “your” body, it’s a virtual one created by Mel Slater, a professor of virtual environments at the University of Barcelona, and his lab.

As you move, the virtual body you see through the VR headset moves with you. A large mirror faces you and if you wave, your reflection waves back. Blue bouncing balls appear and hit your wrists and ankles. You can feel their impact on your body—but which body? The line has become blurred between the “you” that’s wearing a virtual reality headset, and the digital “you” interacting with the balls.

As it turns out, it doesn’t take long for your consciousness to abandon your physical body and inhabit another one. It’s called a full body ownership illusion, and Slater says he and others are seeing that “this ownership of a virtual body is pretty strong, and it happens pretty fast.”

It’s a neat trick, but it goes well beyond just that. Slater is finding that what happens to your virtual body could have effects on the real you afterwards. He’s shown that when white people inhabit a black virtual body, their implicit bias scores—which measure unconscious preferences of race—go down. He’s taken adults and put them in the virtual body of a four-year-old. After, people identify themselves as more childlike, and think the world around them looks larger. He’s put men into women’s bodies, and turned people into their own virtual therapists (and if they embodied a Sigmund Freud lookalike, they had better results).

But what if “you” started to rise up out of the virtual body—if, suddenly, you’re departing the body you so recently became attached to, and hovering somewhere up near the ceiling, looking down at it? In his recent work, Slater uses this exact experience to probe a new question: Can VR reduce the fear of death?

It’s been sporadically reported that after a person has a near-death experience (NDE), they can gain a new outlook on life: They’re more charitable, more concerned about others, and they are less scared of dying.

NDEs are still controversial in the medical community, because we’re not sure what’s going on in the brain when they take place. Whether or not they are products of the brain, or true experiences, people consistently report similar sensations. They see bright lights, tunnels, deceased family members, and very commonly, they have an out-of-body experience (OBE), where they float above their body and look down on it from above. It was this part of the near-death experience that Slater wanted to capture using VR, and hopefully along with it, the associated reduced fear of death.

So how to simulate an OBE, without nearly dying? Rubber hand studies have already shown us that our idea of body ownership is more fluid than you might think. In numerous experiments, researchers have shown that if you position a rubber hand near your body–and hide your real hand out of sight–you can trick your brain into believing the rubber hand is your own. It’s usually done by touching or stroking your real hand and touching the rubber hand in the same way at the same time. The same studies have shown that if someone threatens your rubber hand, with say, a hammer, your brain elicits the same cortical anxiety as if it was your own—and the anxiety increases with the severity of the threat.

Olaf Blanke, the director of the Laboratory of Cognitive Neuroscience at EPFL and professor of neurology the University Hospital of Geneva, co-authored a 2007 Science paper that showed you could successfully create a full body ownership illusion, and a subsequent out-of-body experience, using virtual reality.

Lab-based OBEs can offer an insight into the interaction between the brain and body and how it affects our self-consciousness, says Hyeongdong Park, a postdoctoral student in Blanke’s lab. They’ve since been using OBEs to try to influence pain perception, to potentially treat chronic pain. Down the line, OBEs could help us learn more about the neural mechanisms for self-identification, self-location, and first-person perspectives.

These are fundamental features of the mind that we take for granted—but there are examples of what happens when that machinery breaks down. In 1942, neurologist Josef Gerstmann saw two patients with damage to the right temporoparietal cortex who experienced loss of ownership for their left arm and hand, a condition called somatoparaphrenia. Even though their arm and hand were connected to their bodies, they just didn’t think it was theirs. In some people this can manifest in the opposite direction: They will claim ownership of the hands or limbs of other people.

Similar neurological issues can lead to what’s called autoscopic phenomena, in which a person can’t see their bodies, their locations, or their identities correctly. People with heautoscopy, as it’s called, say they see a second copy of their body somewhere else, and “experience a close affinity with this autoscopic body,” Blanke wrote in a review paper on OBE research. We don’t yet know yet what precise brain abnormalities lead to heautoscopy.

“Human adults experience a ‘real me’ that ‘resides’ in ‘my’ body and is the subject (or ‘I’) of experience and thought,” Blanke wrote. “This aspect of self-consciousness, namely the feeling that conscious experiences are bound to the self and are experiences of a unitary entity (‘I’), is often considered to be one of the most astonishing features of the human mind.”

In his recent research, Slater tested two versions of OBEs using virtual reality, based on Blanke’s work and another similar OBE study design published ten years ago. The setup for both scenarios is the same: You are in a virtual body, the body emulates your movement, and when the bouncing balls appear you can feel them touching you (through the use of stimulation on your real body). Once you achieve the body ownership illusion and feel like the virtual body is yours, your perspective begins to float up towards the ceiling.

In a first version, Slater will keep the bouncing balls near the ground with the body. You can still feel them touching you, and if you move your arms, the arms of the virtual body still mimic you. But your visual point of view is from high up on the ceiling. “What this speaks to is a kind of confusion, or a strange feeling, of being in two places at once,” Slater says. “My viewpoint is here from the ceiling, but somehow I’m still related to that body that’s down there below. It leads to this kind of split feeling of: I’m in two places at once.”

In a second version, Slater moves the balls up too, so they’re floating with you. You can “feel” them up near the ceiling, rather than below. When you move your limbs, the virtual body underneath you does nothing; you’ve completely separated from it. “What this can do is produce a feeling of disassociation with the body down below,” Slater says. “I’m now completely out of this body.”

In his 16 healthy participants, he found that an exposure to second scenario led to a self-reported reduced fear of death, but not the first. He thinks the OBE can lead to a psychological shift regarding death, but only with total separation from the body, not partial.

“What we think is happening is that somehow your brain is learning implicitly that it’s possible to separate consciousness from the body,” he says. “That was my body, I’m out of it, and I still have my full consciousness. Therefore, implicitly, consciousness can be separable from the body. And if consciousness is separable from the body, then it’s possible to have survival beyond the physical body.”

Slater’s work has inspired others outside of the science community, like Dutch designer Frank Kolkman. Kolkman has dreamed up medical designs before, like his DIY Surgery Robot, which promotes the idea of surgical access for all.

Kolkman tells me that when he read about the current state of end-of-life care, he was struck by how focused it was on extending life at all costs, rather than accepting death. “Right now it’s a very limited, linear way of treating the end of life, or dealing with terminal patients,” he says. “It’s almost about winning and losing sometimes. You hear that in the language when we talk about it.”

In Kolkman’s setup, you stand in front of a robotic head mounted on a moving trolley. The head has cameras in its eye sockets and when you put on the VR headset, you see what the robot head sees: yourself from behind.

Through speakers in the robot’s ears, you hear noise from the robot head’s location, not your own. When you move your head, the robot head moves with you. When the robot head starts to move slowly on the track away from your body, you feel that you go with it.

“Most people by that point are fairly connected to the robotic head,” Kolkman says. “They feel as if they are present in the location of the robot instead of where their body is.”

As you pull away from your real body, you can continue to look around from the robot’s perspective. When you reach the end of the track, Kolkman has a rude awakening set up for you: a mirror. When you turn to face the mirror, only the cold white robotic face stares back at you—which Kolkman says brings about the out-of-body experience in an extreme way.

Then, the head slowly moves back towards your body, a kind of return. In this phase, people “experience a drifting sense of presence,” he says. “They can either be inside the robot or inside their own body, or somewhere in between. Which is quite a strange feeling.”

More than 2,000 people have tried Kolkman’s machine at events like the Embassy of Health exhibition at Dutch Design Week, and he says nearly all of them have described some kind of out-of-body experience. As for a reduction of death anxiety? That’s what he hopes to explore next, hopefully with collaboration with researchers. He specifically designed his setup to possibly fit into a clinical setting: The experience happens quickly, as fast as a CT scan.

“I hope that machines like this, or this way of thinking, could add this little bit of grey to the end-of-life discussion,” he says. “Maybe if we could take away a little bit of fear, and then replace it with acceptance, then it might mean that people decide differently. They might opt against doing a treatment that might give them another month, but would come at a cost both in quality of life and economically. I hope that this could relax that system.”

But can these experience really be applied to end-of-life care? I ask Craig Blinderman, the director of the Adult Palliative Medicine Service at Columbia University Medical Center, who says he doesn’t think anyone can claim this without testing it on people who have a serious illness, and whose death anxiety is not an abstract existential dread, but a looming reality.

Slater agrees, and says that his experiment was to answer a specific question on the impact a body illusions could have. “The rest of it is just opinion,” he says. “I don’t know if this will be useful for patients who are very ill. My guess is it will be more suitable not for patients who are very ill, but for people who are healthy but who have an anxiety about death.” Slater is pursuing current research on the out-of-body experience and its effects, and they have another paper in review.

Blinderman tells me that death anxieties aren’t systematically documented in patients with serious illnesses. But he knows from experience that a significant number of patients with cancer have existential distress, most commonly in the three months following their diagnosis, and that it seems to dissipate over time. He also says that the most common reasons given for using death with dignity laws are existential ones, like fear of the future, fear of being a burden on others, loss of autonomy.

But he feels that something about the VR experience is false, and if it did work, it might be promoting or creating belief systems that weren’t there before. “There is something manipulative about ‘creating’ a psychological belief that there may be ‘life after death’ or that ‘my body is the only thing that dies, but some non-corporeal entity may live on,’” he says. “It all feels a little bit like “escaping from reality.”

Instead he suggests that individuals be mindful of, or present to, what’s happening in their bodies, rather than turn away from it, through practices like mindfulness or meditation. He says that traditional interventions like psychotherapy focused on meaning-making and dignity, or chaplain interventions should be turned to first, before attempting to create OBEs with VR.

At the same time, he also nods to the use of psilocybin, the psychedelic compound from specific species of “magic” mushrooms, as a more promising nontraditional therapeutic option. Anthony Bossis, a clinical assistant profess of psychiatry at NYU Langone Health, recently published a double-blind, placebo-controlled study on its effects when he and his collaborators administered it in a safe, controlled setting to terminal cancer patients.

Bossis thinks that we all think about and fear death, even if we’re young and healthy. “We try very hard to push it out and deny it,” he says. “But we can’t. For some people it affects them more than others. If you’re a human being, you can’t not think about how you’re going to die.” But for how much death is on everyone’s mind, he agrees with Kolkman: our culture, especially our medical culture, is bad at having conversations about death and dying. We need to find better ways to talk about it.

Bossis says in his study, the psilocybin triggered a kind of mystical experience for his patients that led to huge behavioral and attitude shifts about death and life. “Their anxiety around death was dramatically reduced,” he tells me. “We found anxiety, depression, hopelessness and demoralization, and a host of other measures dramatically reduced in a matter of days following the session.”

In the mystical experiences that Bossis’s psilocybin participants experienced, they reported feeling a sense of unity with all living things, a sense of transcendence, a sense of meaning, a sense of sacredness. The feeling of transcendence, Bossis thinks, is especially important. “In our study, some people come to this insight that we’re not only these bodies, not only this cancer, but something else that’s more enduring.”

Is that so different from what Slater’s virtual reality setup is attempting to achieve? Bossis says he actually thinks the goals sound extremely similar, even if its execution needs to be studied further. “Maybe we can generate transcendence with this technology,” Bossis says. He doesn’t think it’s out of the question, because he believes that humans are “wired” to have this kind of transcendent experience, whether through a virtual reality headset, magic mushroom, a near-death experience, or, like Blinderman proposed, meditation and mindfulness.

And if it is just an escape from reality? A way to trick the brain?

“Well, what does it mean if it’s an illusion?” Bossis says. “People in my study still arrived at insights like, love is important, and connectivity is important. But the insight that they could transcend the body and continue on, if that’s a delusion? Well, that’s a pretty wonderful illusion to have for a few hours.”