Episode 1: Our Past, Present and Future

Psychiatry XR’s hosts provide their background in medical XR, how they currently work in the space, and what they hope you, our listener, gains from this podcast.

The following is a transcript of Episode 1:

Kim Bullock, M.D. :

Hi there! Welcome to Psychiatry XR where we are on a mission to inspire world-wide conversations and innovation around the use of extended reality XR in psychiatric care. I’m your host Kim Bullock, and I’m also a clinical Professor and XR researcher in Stanford’s School of Medicine. I am triple boarded in Psychiatry, Behavioral Neurology & Neuropsychiatry, as well as Lifesytle medicine. I along with my co-creators Jessica Hagen and Faaizah Arshad have created Psychiatry XR which is a monthly podcast for all stakeholders including; clinicians, researchers, mental health providers, XR developers, investors, patients, and anyone fascinated by the ways in which evidence-based medicine and technologies can be used in mental and behavioral health. In each episode we invite a new guest to shine light and insight into the potential benefits, challenges, and questions around immersive technology in mental healthcare. You can join us monthly on Apple Podcasts, Twitter, Spotify or wherever you get your podcast.

Please note that this Podcast is distinct from my own clinical, teaching and research roles at Stanford.  The information provided is not medical advice, and should not be considered or taken as a replacement for medical advice. We are here to learn together and be humble and to explore an emerging field.  We are seeking conversations to support those that are creating solutions for some of the hardest problems in our communities.

So today, since this is our first podcast we thought it was important to give you some context about who we are, how we became involved in the XR space and what our intentions and vision for this podcast. 

So I will start with my own story, give you a little primer and background.

I’ve always been interested in the nervous system and understanding why and how people behave the way they do.  I was an undergraduate in psychology and physiology at UC San Diego in the 80’s when the field of neuroscience was really having some tremendous breakthroughs especially in the La Jolla area. And one of my favorite classes was perceptual psychology taught by professors a neurologist Dr. V.S. Ramachandran.  He was one of the first to report on the use of mirror therapy, which is basically an augmented reality illusion to amputate phantom limbs of those suffering with distressing and painful sensations after amputations of a limb. His class actually inspired me to go to medical school where I wanted to pursue neurology like him, but by the end of medical school I had switched my interest to psychiatry because of my involvement with the homeless mentally ill in Washington DC  area where I was in school— where there was an epidemic. Psychiatric illness seemed much more complexed and mysterious and a place to explore and make breakthroughs to me.  So after doing an internship in Internal Medicine, I did my Psychiatry residency at Stanford and specialized in Neuropsychiatry and Cognitive Behavior therapy.  And while exploring physiotherapy for people with psychosomatic illness I happened to visit Jeremy Bailenson’s Virtual Human Interaction Lab on campus where he and his graduate students were experimenting with mirror therapy for chronic pain. I returned back to my roots and fascination with perceptual psychology and began collaborating with the Virtual Human Interaction Lab in the Communication department with different psychiatric populations and eventually I opened the Virtual Reality & Immersive Technology Clinic specializing in  XR enhanced cognitive behavior therapy about 7 years ago.  Kind of felt like serendipity. I’d come full circle from 20 years previously. Since then I’ve been exploring, researching, and innovating XR in psychiatric practice but to be honest I still feel like a newbie with so much about this area that I still need to learn.  In part of that journey, I realized that no one can accomplish anything alone. We can’t work in silos. You need support, community, networks and many times we are cut off from these for all sorts of reasons. Everyone has their own reasons,  but that all support occurs through a series of conversations.  So I decided to create a place for conversations through the Stanford Psychiatry Immersive Technology Consortium (SPIT-C) to facilitate cross disciplinary relationships innovation in this space. This podcast is in a sense an outgrowth of those conversations and relationships and an attempt to share this network with a broader audience.

 My vision and intent for the podcast is to foster non-hierachical, collaborative education without creating experts or gurus but focusing on facts and providing support for innovation in all its forms and possibilities. Selfishly this podcast serves as my own ideal education. We are creating the dream curriculum taught by the most talented and experienced teachers on a variety of topics in many fields— an egalitarian environment that promotes diversity which I believe is the key to excellence and required if we are going to make significant innovation and change in this space.

But that is enough about me. Let’s move on to our other co-hosts and founders, starting with Jessica Hagen.  Jessica could you tell us who you are and how you ended up in the XR space and what your intentions are for this podcast.

Jessica Hagen :

Thank you, Kim.

I'm Jessica Hagen. I'm a healthcare reporter and editor. I've covered the pharmaceutical and biotechnology industries as well as general happenings within healthcare globally, including the expansion of digital health and the evolution of the medical XR industry.

I was first introduced to VR about five or six years ago, and I thought it was a very compelling technology, but I wasn't immediately fascinated by it. It wasn't until I started to really explore how it was being used in healthcare, and I began to learn how providers were treating patients that it became very intriguing to me.

I started to learn about the various platforms, the research being done by universities and pharmaceutical companies and I would research the industry and the people within the industry. I began attending conferences to really get to know these people and better comprehend how healthcare providers and other healthcare stakeholders used immersive technology. I wanted to introduce the potential of XR to providers who may not have been privy to the methods through my reporting.

The first immersive tech conference I attended was actually Oculus 5 and though the event didn't focus much on healthcare, from what I did see in the realm, it really hooked me, and the next conference I went to was the International Virtual Reality Healthcare Association Conference in Tucson, Arizona, and there were no reporters in attendance. I thought, how is this field that has so many original innovators putting this unique spin on healthcare have no media coverage?

And what's really interesting is I attended and covered a resident in Nashville earlier this year in 2022, and though there still are not many reporters, the presence of these giant tech companies and healthcare organizations was palpable — Microsoft, Meta-affiliated companies, the National Institute of Health, Johnson & Johnson, and HDMS of CVS Health. They all attended, and you could see their enthusiasm for the potential that VR has to offer in healthcare, and it's quite fascinating and great to watch and report on.

So, I've seen medical XR change dramatically over the years with advancing technology and new and innovative ways of using that tech that really impacts healthcare, and it's a very exciting time to cover the industry.

I'm thrilled to be part of this podcast because I think it's vital to have these conversations about how medical XR writ large has and will change the healthcare landscape and to showcase the companies, organizations, and individuals really pioneering these pretty fascinating innovations.

As the technology progresses, which it's doing at such a fast pace as technology does new platforms are emerging. And through our conversations, it's my hope that we as hosts and our listeners can simultaneously discover the different ways the healthcare ecosystem is using it and share those best practices for the benefit of both healthcare providers and patients. So, I'm really excited to learn more as we move through this journey and explore how medical XR is being used to treat patients how it's affecting the healthcare ecosystem directly and indirectly, and how patients are reacting to this tech.

I think even learning about and discussing various concerns often expressed about immersive technology by those inside and outside of the industry, and then solutions people have found to specific problems will be incredibly valuable as medical XR moves forward and progresses.

It's an exciting time for the industry. And I'm really thrilled to be able to dive further into the nuances and really converse with the people and companies affecting these changes within the healthcare ecosystem.

So on that note, I will hand it over to Faaizah.

Faaizah, if you would like to take it away. That would be awesome.

Faaizah Arshad :

Thanks Kim and Jessica.

I’m Faaizah Arshad, and I am an undergraduate student at UCLA. Early on, in my high school and college coursework, I cemented an interest in science. In college, I decided to pursue a psychology major because it aligned with my deep enthusiasm for understanding the mind and behavior. I’m really fascinated by the way in which clinicians diagnose and treat cognitive and behavioral diseases and disorders. 

I’m interested in how we can generate interdisciplinary, reliable evidence to create clinically useful resources that improve psychiatric patient care. In particular, to learn more about quality of evidence and care, I’ve spent the last two years conducting observational research using real-world data, such as electronic health records and administrative claims to characterize population-level diseases and understand methodologies that are being used by healthcare systems and government agencies. I believe one underlying goal in medicine is using quality research to establish and apply the best clinical practices that individualize patient care. And psychiatry is a field that will benefit greatly from fresh and emerging technologies (like extended reality) that are reinforced by research. In general, extended reality and immersive technologies excite me because they are versatile and can be individualized. In fact, I actually met Kim and Jessica through the Stanford Psychiatry Immersive Technology Consorsium (SPIT-C), and it’s been a phenomenal way to educate myself in this space and get involved in a network and community of people who are specialized at a variety of topics.

I’m also a Director and writer for a Los Angeles organization that partners with nonprofits to bring free and long term health care services to underserved communities. I think it’s crucial to push for health equity and accessibility in medicine, and extended reality really holds the potential to do that. For example in the future, I think it is possible that extended reality can be used more frequently for remote psychiatric care, which can perhaps bring innovative treatments to rural areas and directly to the patient’s location. It is also possible that more options for extended reality treatments will be made available at cost-effective prices that are accessible to all patients. The way in which immersive technologies can enhance equity is promising to me.

And finally, while I am still early on in my academic career, I aspire to pursue medicine. This podcast will be an invaluable way to stay up-to-date on the latest digital revolutions in psychiatric and behavioral health which will likely have evolved in many ways by the time I am a practicing physician years from now. There’s just so much to learn and also so many ways to contribute to this field, and I’m hoping everyone who listens to our podcast feels the same excitement for the future of immersive medicine.

Kim Bullock, M.D. :

So that’s us and this is the Psychiatry XR podcast. Thanks for getting to know your co-hosts. We hope to provide you with even more realistic and conversational deep dives into the wide-range of current and emerging XR enhanced solutions for psychiatric care. Thanks for listening! This episode was brought to you by Psychiatry XR: The Psychiatry Podcast About Immersive Technology in mental health. For more information about Psychiatry XR, visit our website at www.psychiatryxr.com. Make sure to subscribe to the podcast. Tune in again next month where we will walk you through a primer on the very basics of XR in psychiatry.

Kim Bullock produced this podcast with the help of Faaizah Arshad and Jessica Hagen. We credit and are grateful to Austin Hagen for music and audio production. See you next time!