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The new Empathy Machine - VR


Episode 3 - VR, the Empathy Machine



Earl: This episode of Philanthropology has been made possible by Advanced Micro Devices


Craig:  Philanthropology is the companion piece to our TV show on public television called The Good Road.


Earl:  I'm Earl Bridges


Craig:  and I'm Craig Martin and we capture stories of mercenaries missionaries and misfits.


Earl:  It's a raw look at the messy and complicated business of global philanthropy. And Craig and I set off around the world to places where people are doing good.


Craig:  Inner city ghettos border camps for refugees rural health clinics and fully armed anti poaching teams are some of the impossible situations we'll explore in Season 1.



Earl: In these half hour episodes we explore the messy cocktail of community culture and compassion with the “do-gooders” who see the world's greatest problems and say, "Hell I can fix that."


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Earl:  social impact renegades who risk it all and ask nothing in return.


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Craig:  Okay so what you just heard is a guy named Dave Eubank with an organization called Free Burma Rangers rescuing a little girl in Mosul, Iraq in the middle of a firefight. It's just crazy to think about it but you know one of the things that is a reality is that people, aid workers, charity workers, Philanthropologists, those people that do good in our world the “do-gooders” oftentimes face some serious trauma. And so later on in our podcast we're going to visit with a guy named Skip Rizzo who helps people get through those traumas in their moments of PTSD and stuff through a technology called virtual reality or VR


Earl:  So stick around till the end of our podcast for our version of what's Jon Stewart used to call the moment of Zen.


Craig:  Yep. Which is going to include some audio that you will be interested


Earl:  you don't want to miss.  Stick around to the end. This is basically two schools, one Nashville when it Kokoda outside of  Zanzibar in the archipelago. And you won't believe what you will hear.


Craig:  Meeting for the first time.


Craig:  All right. So one of the things that we want to do on The Good Road is to explore technology and the use of technology in philanthropy. So we're going to jump right in with some of that.


Earl:  We get to do cool stuff on this show. I'm just saying you know as part of the tribe we want our listeners and viewers to figure out a way to how to actually bring them out on location with us.


Craig: Yeah you are do gooders.  We just want you to join us kind of in some of the exploration of things like VR for instance virtual reality


Earl:  The reason why VR is important is because they call it the empathy engine or the empathy machine because it helps to evoke deep feelings for the people that you actually experience because you're doing it in this virtual experiences, virtual world.


Craig:  And honestly VR is like a perfect tool to allow you our viewers in this case on the TV show, The Good Road, to experience what the people in the world of philanthropy experience


Earl:  and the VR people that we've seen in the past that have gone with us are amazing.


Craig: Yeah.  So we're going to take a break here but then come back with an interview with Mark Lambert who is the founder of something called Vartisans here in Richmond Virginia. And Mark went with us on one of our big overseas productions he and a team of virtual reality producers so stay tuned for that



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Craig:  All right. This is exciting. We've got Mark here with us Mark. Just give us start with a little bit of background on your professional history.


Mark Lambert:  I started back in the early 80s actually starting up one of the first computer animation departments in the nation. And over the 80s I did a lot of groundbreaking work in computer animation that sort of caught the eye of some of the Hollywood crowd. And in the 90s I started working on feature films. I did over 14 feature films like Stuart Little, Castaway, a Kevin Bacon film called Hollow Man, Polar Express.  But probably the most popular one that everybody recognizes is when I was headed up the team that figured out what a Quidditch field looked like for the first Harry Potter.


Earl:  So Mark what made you get out of that animation business and decide to go into VR. What was the interest?


Mark:  I came back to Virginia really for some family reasons.  But also at the time, you know, the visual effects industry was starting to move out to Vancouver and other areas and I wanted to do something different. And I'd been playing around and in VR a little bit. When I first came back I did some work supervising a couple of TV series and some other projects but it really wasn't challenging and VR came along and it was a totally new opportunity to explore this whole new form of media.


Craig:  So tell us a little bit about the kind of stuff you do at VR artisans. What kind of projects do you typically work on.


Mark Lambert: Well actually you know one of the things is it might be interesting to for your listeners a lot of them haven't heard about what VR is.  Or may not have actually been in the headsets. And that's one of the things I did want to touch on was basically the difference in VR is that typically when you're watching TV or watching something on a on a flat screen. But the thing about VR is you put on this headset and you're completely immersed in a world and you can look left and you can look right and all around you.  So it's very different from conventional TV. When I first got into it I was starting to do a lot of historical pieces. You know we did a civil war project where you were in a hospital and it was a soldier writing a letter home. I did a piece on a Holocaust camp over in Lithuania retrieval of a b 52 bomber off of Croatia. A lot of those type of things where you can take someone to a location and immerse them. I also did a big conservation series that's over at the Dubai aquarium where I take you to Uganda and you can you can sit with mountain gorillas and over the Maldives and swim with manta rays.   Basically we've done a lot also of travel related videos I'm taking people to places like Paris and Rome Tokyo flying them over the Swiss Alps. A lot of different locations that we can basically take people to and they can be there, look around, and sort of experience it as if they were on a tour. I think to date we've filmed in some like 24 countries including places like Thailand and Myanmar for The Good Road.


Craig:  Yeah exactly so. And then I want to jump into that real quickly. So Earl you and I were with Mark and his team. It was a little it was a little weird wasn't it.


Earl:  Well the first time you put on the headsets. I mean if you've ever seen VR you know and you haven't seen it in the last year or two it's changed completely! It absolutely takes you into a new area.  And what I was really interested as we did our first episode for The Good Road which is in our TV show that comes out in April on PBS. The interesting thing about that is that you've got the ability to take, for example, your parents and my parents back to Thailand right. Sit in a tuk tuk. Yeah driving around Bangkok.


Craig:  And I think though from kind of a technical side it was weird though wasn't it. We do all these interviews for the regular to the you know TV show and then we had to go back in to.


Earl: Right. Yeah yeah. All right. Clear out all the cameras and let's go ahead put the VR thing and get everyone out of the picture because like Mark says you can look up you can look down you look behind you in front of you and there's. And you know there's some camera guy hiding on a corner you can see their feet sticking out underneath the table as they try to get out of the shot.


Craig:  So Mark, talk about that specific project. I think we had some. Well first of all was it was it different from your other projects. I mean we're kind of. What were you hoping to accomplish. And how was it different?


Mark:  Yeah it's different I mean you know when you guys first told me about the The Good Road series this host base that I had to Philanthropology series.


Earl:  It's easier to say over time


Mark:  I hope so. But you know I was just amazed.  It just sounded like a great project. And I also had a vision of what it could be in VR and how it could be different. I mean it is it is unique. I hadn't done the those type of interviews before and I wanted to see how that could be done. You know how you would approach it in this in this VR space because we don't have the same tools the same language as is 2D film. People are used to a certain way of seeing in every interview a wide shot over the shoulder some close ups you know and we just pretty much plop you down next to the people and you know I want to see how that would work.  You know how to approach that how it would be a different experience. You know it's similar stories but it's a different treatment of it. And so it's a great opportunity to sort of explore building this new language that that nobody has you know has been has done. You know there's some documentary work going on but we're still at the early days of how to do this thing in VR. And we can't rely on the language of 2D.


Craig:  Well I mean as a as a filmmaker for me I had to wrap my whole brain around this idea of like you say not being able to direct the audience to a specific thing that they watch in that moment.


Earl:   technically Mark you were explaining.  I mean you use these audio cues sometimes to let you know that hey something's coming up behind you or look over to your right or left or whatever I mean there's different ways that you have to you know tap the viewer on the shoulder and say hey you know here's something going on over here.


Mark:  Yeah and that's interesting I can do that in my sort of more 2D scripted things when I'm doing a civil war piece of a you know a Civil War hospital or something like that. You know I it's finely directed but doing documentary it's a little bit of craziness that you really don't have that opportunity to fine tune “screen direction” and stuff and so you have to let things breathe a little bit more you know. But also I mean one of the powers of it I remember being over in a village in Myanmar and you know you can finely direct people in 2D to look at this and look at that.  But we're sort of setting you down and in the viewer can decide you know hey I want to explore this space. So before you actually get to the action you let them look around a little bit and they can look over and see somebody you know dipping buckets into water and sort of taken the whole space before you know they get to the actual action.


Earl: One of the funny things about this whole behind the scenes what goes on into production may not be interesting to everyone, is super interesting to me was you'll set up this camera I think we did it in Ayutthaya we walk away. And then people see this like glow thing looking at the middle. They walk up they don't know what it is they're tapping on it. I think you actually had that same experience mark with some of the animals you know as you're leaving the 3D camera and they're curious as to what is this thing. It's like  the Gods Must Be Crazy, it's a coke bottle in the middle of the Amboseli, a National Park in Kenya.


Mark:  Yeah I've got a baby elephant that comes up and reaches up and touches a camera then goes running away you know same thing with a lion it's it's a story you know we try to remove the scent from the from the camera and all kinds of things but it's still a strange piece of machinery you know in the middle of the Maasai Mara right. Yeah. So yeah they're gonna come up to it.


Earl:  Well speaking of removing scents maybe you need to add scent. And that's the next thing it's gonna be 3D plus smell cues.


Craig:  So Mark this is kind of you know part of the podcast is meant to be a bit of a companion piece to the good road and so what we want to do is let our viewers or invite our viewers to kind of know some of the nerdy things that happened on our on our productions as well. Were there any challenges working you know with a 2D crew and you're trying to do your VR thing. What were some of those challenges?


Mark:  Yeah. Well that was one of things I was looking forward to was doing a co-production with the 2D crew. Everything that we had done before it tended to be more isolated. You know I was I was just doing my 360 production. So this was an opportunity to actually be part of a traditional production that I've been on plenty of those. So I knew sort of how to stay out of the way of the of the 2D production. And I think that's what the biggest thing we learned was you know the 2D production not necessarily understands that we see everything.  So you know there are people are used to being able to sort of walk around behind the camera and you know have gear laying out everywhere you know and we pretty much had to clean up everything. But there's a lot of advantages. You know we can essentially form two pieces of content two different pieces of media you know at the same time with somewhat of a minimal additional cost and time effort. I mean you guys do have to interview somebody twice or something. But you're still mic’ed up locations or are already scouted and you know everything's set up so to have that opportunity to sort of take a different take on it was it was challenging but it was I think really worked out pretty well.


Earl:  You know Mark what we're interested in on our television show is not just the fact that we get to drag people around the world and help them to see some of these areas but really try to make a difference in the world through the storytelling and through the interviews and the people that we introduce our viewers to. But VR has this kind of unique ability. They call it the "empathy machine" to evoke an emotional response I think much more strongly.  What's your experience? I mean, how far along are we with this concept of the empathy machine and its full potential?



Mark:  Well I think it's definitely being proven that the emotional response is higher. And part of that is because you are immersed in an environment when you're watching something on TV. One thing is you've got still a room around you. You've got your phone sitting by you know so you're a little distracted. But the other thing is you're not totally immersed in that world. And in TV we use cuts and you know all these great things the close up you know to evoke emotion.  But in VR when you're there you know it's really an honest portrayal of you know a location and environment a storyline. And it also gives people an opportunity to see other aspects that you know we may not even have recognized in the scene. But to them sort of makes a difference.  I think that I think the biggest thing about the "empathy" is just that your brain connects better with that story or the character or the location that you're in when you're totally immersed in it.


Craig:  Well Mark thank you so much for joining us on our new podcast Philanthropology. 


Earl:  We'll put a link up to your stuff. We'd love for people to see some of the amazing things that you've done.


Mark:  The easiest way is to go to the And from there they can they can see a link to some shots from The Good Road. You can go and visit some of the animals you can visit a civil war hospital. You know a lot of the projects that we've worked on our viewers are going to love it.


Earl: I mean again the stuff you've done is amazing.


Craig:  Thank you so much Mark. And we'll see you back on the good road on the good road.


Mark: Looking forward to it guys. Thanks a lot.


Craig:  So Skip Rizzo is a well renowned researcher in the field of virtual reality and its application to human mental health studying things like VR therapy for PTSD


Earl:  and a big deal men are sponsors AMD.  They put us in touch with him early on. He works out in California rides a Harley has long hair. He's super bad ass.


Craig:  He is a bad ass. He's a very cool guy.  And so we just sat down with him and talked to him about his work that he's been doing since the early 90s really


Earl:  and really specifically around the work and research around the U.S. war victims people that are coming back from PTSD, what's the role of virtual reality in that?


Craig:  Yeah. You know I'm combat veterans and how he's getting them through that with the technology with VR.


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Craig: So we talked about before the break that where we interviewed a guy named Skip Rizzo a researcher and his work with combat veterans. Skip’s were pretty amazing guy. I hung out with him in Austin over a few beers and got a lot of other insight into his life.


Earl:  Wasn't that South By.


Craig:  Yeah I was at South by Southwest exactly


Earl: Lucky


Craig:  and yeah that was a lot of fun and Skip and his wife are really cool. So just as one more kind of emphatic statement.  What Skip is doing as a "do-gooder" is really important work and helping not just combat veterans but others who deal with the topic of PTSD.


Earl:  That could be anyone, first responders, people that you know school violence.


Craig:  rape victims that's the projects that they're talking about doing.


Earl:  We've got a lot of crap in the world left to deal with and VR has a role in making this you know some kind of therapy.


Skip Rizzo:  My name is Skip Rizzo. I'm the director of medical virtual reality at the University of Southern California Institute for Creative Technologies. I also have faculty appointments in psychiatry and in gerontology.  My work since 1996, when we formally started the VR psych lab, has focused primarily on the application of virtual reality for clinical purposes.


Craig:  Okay so Skip has this focus on exposure therapy and and in the world of you know clinical mental health work.  Exposure therapy is a really important part of helping people with PTSD get through their trauma and their stress. But virtual reality really adds a more complex and in-depth element to this idea of exposure therapy.


Skip:  And so with exposure therapy which I'll talk about more detail in a minute input people and environments are that they're fearful of. And help them to overcome their fears or overcome their negative memories of their traumatic experience. You can use distraction to distract people from painful medical procedures. This is a very big area right now in pain management. You can motivate people to do things that they might not do in the real world like say physical or occupational therapy after a stroke or traumatic brain injury introducing game-like elements into a very boring, repetitive and frustrating activities of posts central nervous system dysfunction rehab.  You can measure performance you're when you look at aircraft simulators they can certify precisely how well somebody reacted and behaved and operated the equipment under a range of control conditions.  And finally engage. And this is a more murky, but definitely a magical potent element and that is you know we can engage people in types of treatment that you know that traditionally people don't get engaged with so much in the traditional talk therapy format.


Earl:  Skip is identified the power of virtual reality because the technology's unique ability to kind of create these worlds outside the real world.  I mean you put on the headsets and it really does alter your reality, transports you to places that might be stressful, put you into or out of situations that you know you need to confront within this PTSD you know kind of world


Skip:  you know we can engage them in novel interactions in spaces that that even our imagination can't conjure.  Or, we can engage them in very boring tasks or in activities that they would never do with a real person like in the use of humans for social skill training with people with autism or for job interview training and so forth.  So there are a tremendous number of opportunities out there that make it so these five core elements really can drive how we do clinical work in the future. You know you always start with something you know works in the real world or that there's some theoretical basis for that there's some research for and then starting with that start point you can say all right what does VR do.  And how can I amplify or extend that process in the virtual world.


Craig:  So Skip's work with combat veterans is really interesting.


Earl:  Who knows exactly what's going on?  As many wars as we've had. I still feel like we're learning what happens to these kids when they come back.


Craig:  I just can't imagine like you know being right next to your best friend in an IED blows them apart. I mean what is that like.


Earl: Right. And so in a clinical setting I mean it feels clinical. You've been in hospital all right. But in a VR you put on the headset and it really does kind of transports you into these areas and it forces them to be in an environment that is helpful to their therapy.


Craig:  And the more they do it and kind of the scenes are mimicked in there in virtual reality the less stressful that happens over time it's just repetitive. So I think that's what the clinician helps them deal with.


Earl:  But like I said I mean I still feel like we're super early. And the upside potential for this is who knows where it goes.


Skip:  It's typically imagination only where the client comes into the office and after a number of sessions getting to know the therapists and mapping out what their trauma was in the conditions and so on then the patient closes her eyes session 4 and the therapist says, “OK let's take it one of the easy events from your combat deployment I want you to narrate your experience as you went into that village where you saw a number of wounded civilians…” that first thing that you told me about is the person closes her eyes and they would narrate you know as if it's happening right now I'm driving a vehicle we pull and I'm deploying into a village now I'm walking out of the vehicle and by doing that repeatedly you're actually inducing some level of anxiety because these are these are the types of events and emotions that people with PTSD typically avoid thinking about or going to places that remind them of it.  And that avoidance in the real world actually propagates continued PTSD symptoms because when you avoid something you're fearful over it makes you anxious or brings up bad memories. You get a sense of relief when you avoid it. You know you got away from it and that reinforces continued avoidance. And it begins to generalize to a lot of areas not specific to the trauma. So they're in the traditional format you're helping a patient in imagination to go through this. Well one of the problems with that and even though it is one of the best evidence-based approaches where the problems is first off it's not 100 percent.  Second off, we know that people that don't engage in imagination in a deep emotional way as measured by safe physiological markers like skin conductance or heart rate changes. We find they have poor outcomes so the solution is build VR simulations that represent a wide range of generic contexts of the combat environment. This is you know we're talking specifically about combat really PTSD certainly there's a number of applications and supported data for terrorist attacks and now sexual trauma and motor vehicle accidents and so on but they're going back to the combat related stuff.


Craig:  It's really interesting to hear how Skip drills down into the experiences and then applies those in clinical settings you build out we are in our application. 


Skip:  We have 14 different worlds that we can put people in that are diverse enough that you know, anybody that comes in the door pretty much we can put them in an environment similar to what they were with where they experienced their trauma.  And then, the clinician, following exactly the same protocol of the traditional format of prolonged exposure and imagination can then work from a “Wizard of Oz” type interface and recreate the events so they can start off with where you in a Humvee where you in an MRAP where you on a foot patrol.  How many people were with you?  What was time of day? What were some of the sounds you heard? What did it smell like? Because we have a small machine that we also use.  And now the patient does the exact same thing. They recount their trauma narrative. And the clinician is mimicking it in VR.  And you're finding that you really raise the emotional valence of patients in these simulations and you know one of the criticisms has been, oh what if you re-traumatized the patient. What if you make it worse. Well this is where having a well-trained clinician is essential because good clinicians know how far they can push a patient in this process of confronting and reprocessing the emotional experience as you do it more and more the anxiety doesn't go to the same level.  It dissipates quicker and eventually now you get to a tipping point where the client now starts to feel empowered that now they're facing and talking about things they never talked about and they're getting through it and they're not hurt because they're in a safe environment.  And then you move through the hierarchy. You pick on the next most traumatic experience or you define it based on the client's need.  But it is hard medicine for a hard problem because you are asking people to confront the things that they have spent months or sometimes years avoiding thinking about because it's so painful. What do you do in a safe environment. You do it with the support of a trusted clinician that's really competent and you see the reductions.  And we've shown this and in clinical trials.  We've got a new clinical trial that just completed a randomized control trial with a lot of folks in it and you know we're showing good at the very least equivalent to the existing format but in many cases better and in some cases people that had gone through the traditional format with no benefit they come into VR and they do show benefits


Craig:  Yeah and it is very serious business because so many of the combat veterans and other people dealing with PTSD commit suicide and have a really horrible ending to their lives.  It strikes me to that back to the comments about the exposing veterans for instance to the trauma nobody would bat an eye at all with a physical therapist doing physical work on somebody and having them go through a certain amount of pain. As day in and day out go through that process and yet it seems like you're doing a similar thing with the mind. And yet people push back that's just interesting to me.


Skip:  It's an excellent metaphor there. You're so correct here. And you know just to throw one more metaphor into the mix. What amazes me is people will live years if not lifetimes suffering with this kind of emotional result of a traumatic experience and not seek help. You know you think about last time you had a bad toothache. Nobody likes to go to the dentist but you go because you want that pain to end.  So I think you'll see more of this whether it's for treating PTSD not just with police officers but victims of terrorist attacks we're negotiating with a corporate foundation to help us build a Las Vegas shooting scenario for victims of that attack since there were 22,000 people there. If you just do a conservative estimate of that number you're going to see 2,200 people with severe PTSD from that.  And maybe this is an area where we can actually build something out that would be available to those people for free. You know with a good clinician to really make a difference for those folks or for police firefighters first responders you know people whose occupations are necessarily engaged with traumatic events on a daily basis. These folks have a lot of needs. And I think you know we're gonna see movement in that area for this kind of support. We just completed a feasibility trial with a sexual trauma application for military sexual trauma and got great results and now going to be looking to fund a clinical trial with civilians for the same issues.


Craig:  That's great. Amazing stuff from Skip. You know his work is so critical in solving some of the major issues related to the victims of trauma and PTSD.  So thank you so much for listening to this episode of our podcast about VR and


Earl:  Technology has a role in doing good. And we'll have a lot more on our Web site. We'll have some of the extended interviews. We'll have a link out to the artisans and Mark's work some of Skip's stuff as well. So check out the Web site. The Web site is going to be


Craig:  And don't forget to stick around for the exciting road trip section.


Craig: You might think that the issue of poaching and the legal consequences for poachers is cut and dry. They are the bad guys and we throw them in jail or fine them.


Earl:  But like most things in life it isn't that simple at all. I mean there's a lot of issues at play like was there a television show. Charity is a messy business.


Craig:  In our next episode of Philanthropology we explore that topic and in some of our findings I think will surprise you.


Earl:  Check out episode of Philanthropology as we delve into this issue of the killing of exotic animal species and what motivates the people to hunt and harvest these majestic animals.


Earl:  The Philanthropology podcast is recorded at In Your Ear studio in Richmond, Virginia.  With direction from producer Carlos Chafin. Engineering help from Andrea Stefl.


Craig:  Earl and I also get creative direction from Andy Duensing, The Good Road, public television show.


Earl:  We also want to thank all our "do-gooders" who gave us their time support in grey matter.


Craig:  And finally we want to thank our original investors in all of this.  Our wives and kids.  Specifically our wives, who put up with us. Pam Bridges and Erika Martin.


Earl:  ...And to all the girls I've loved before...


Craig: Ali, Can you tell them what they're seeing on the video right now is in America.


Ali:  (In Kiswahili....)


Craig:  As you can tell Dr. Kessler the kids here are just a little bit excited.


Dr. Kessler:  Hello from Hunters Lane High School in Nashville Tennessee. In the United States


Ali:  (speaking in Kiswahili)

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