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Is a person is need of therapy if his imaginary friends are computer generated?

As the lines blur between the real and virtual, we may find ourselves making friends with some very odd characters
Robots in the 'standard platform' division compete at the RoboCup championships in Eindhoven, Netherlands, on June 27, 2013.  (photo credit: AP/Toby Sterling)
Robots in the 'standard platform' division compete at the RoboCup championships in Eindhoven, Netherlands, on June 27, 2013. (photo credit: AP/Toby Sterling)

In the movie “A Beautiful Mind”, the director succeeds in creating a moment of surprise and even shock amongst the viewers. There is a point in the movie when the main character, a super brilliant mathematician who suffers from psychotic delusions, recognizes that he has  been in communication with pure figments of his imagination. This motif has been repeated in other movies and TV shows. There is a television program by the name of “Perception” which deals with the same issue – how can a schizophrenic ever really know if he or she is interacting with reality or altered brain chemistry.

In the movie “Her”, the protagonist is fully aware of the fact that his new friend is a computer simulation. Nevertheless, he develops a close and even intimate relationship with the virtual character. At any moment during the movie, the main character realizes that he is dealing with silicon. Nevertheless, there definitely seems to be something pathological about his relationship with the simulation.

The lines between reality and software are so blurred in this movie, that a human surrogate offers herself to be the physical persona of the computer [female] character. Were the main character to allow himself, one could easily see a progression happening towards even marriage and children with the surrogate. But all of this would be taking place with a person who has willingly exchanged her own personality with that of a computer program. I am sure that someone will write their Master’s project or even a PhD in psychology on this specific topic. I personally believe that we will be dealing with the real version of this movie’s premise within the next few decades.

Microsoft introduced a dramatic new technology that I referred to in a previous blog post. Called “HoloLens”, this technology which requires the user to wear specialized glasses, creates a 3-D holographic virtual overlay on top of the reality around us. So imagine walking into a restaurant and seeing every food item labeled with the amount of sugar in it. Furthermore, imagine that all of these labels are clickable [in mid air] so that the user can select the items he or she wants for dinner, and have the nutritional details recorded in a personal database. As graphic engines become more and more powerful, and thus can simulate reality far more effectively, such a 3-D experience will be for all intents and purposes, real to the user.

No one knows what this will mean. I have no doubt that some people will become lost in this augmented reality version of life, and then struggle to deal with a real world where street signs and even people are not clickable. Someone will come up with a new psychiatric term for people with this condition. And then, there will be a most interesting discussion where people will argue that this is not a problem.

If someone chooses to walk through life wearing rose-colored [computerized] glasses, then that is the person’s choice. In a case like this, people might rely on an old adage about how to distinguish between madness and eccentricity. Simply put, the eccentric pays his or her taxes. In other words, as long as a person fulfills their basic responsibilities to society and to family, it is their right to believe in aliens, ghosts and goblins and anything 3-D glasses can make real.

From a medical standpoint, the potential is difficult to quantify. With a system like HoloLens, a patient who is depressed could be wrapped up in a virtual paradise, where all of the negative triggers simply do not exist. In this world, the sun would always be shining,  people would always be smiling, and the depressed patient would find a new friend every day. All of the people in this virtual world would be nonjudgmental and more so, totally supportive of helping the patient to find a way back out of his or her depression. No real environment or person would ever be as understanding or patient as the 3-D avatars that would always accompany the depressed individual.  The key question will be if there ever should be a point when the depressed person exits this 3-D world and reenters “normal” life.

The key difference between this 3-D alternate reality and a true psychotic episode will be the individual’s ability to press an exit key at any moment in time. Within the field of vision of the patient, there will always be  a small red button that  simply says “goodbye”. This button will be a constant reminder that this is in fact a simulation and that there is a real world out there. With such a button in place, the whole experience will not be much different than someone who sits in their basement, surrounded by comic books, and who gets truly lost in the fantastical stories. Of course, I am talking about someone else, not me.

With HoloLens, whole concepts of desk space, personal space, a keyboard and screen and yes, privacy will melt away. In the work space, virtual meetings will occur at the snap of a finger, and all participants will truly feel as if they are sitting on some beautiful island beachfront, while discussing the new user interface for the company’s main software system.

Human beings are primarily visual creatures. With HoloLens, everything that you now read for business and perhaps even for pleasure, will have a visual front-end. Most likely, this will improve understanding and retention of the material. At least in the medical world, this will be a tremendous step forward in education and day-to-day practice.

Time will quickly tell if the HoloLens experience is welcomed  by users, or if it is too realistic and thus causes anxiety, confusion and straight out fear amongst its users. Some brilliant developers will create tools which take maximum advantage of this new tool. I can guess as to what types of products will be created, but I suspect that I will be totally surprised by the thinking-out-of-the-box systems that these HoloLens developers come up with.

Perhaps the catch line for a HoloLens-based company will be something akin to “reality is just a matter of opinion”.

Thanks for listening

My website is at http://mtc.expert

About the Author
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology.
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