This is not happening for real. It is just a situation in a virtual world, tailor-made for violent criminals to train them to control their aggression. Märta Wallinius, a researcher at LU and psychologist and head of unit at the Regional Forensic Psychiatric Clinic in Växjö, is now developing and evaluating the method in both the Swedish Prison and Probation Service and forensic psychiatry. Together with the convicted offender, she sets up the scenarios that most trigger aggression and what the person needs to practise. Märta Wallinius then controls the VR avatar’s reactions, voice and gestures in real time.
“In general, it’s often authority figures who provoke acting-out behaviour that can lead to acts of violence. Even if the person knows that it’s a computer-simulated human, they will have the same neurological and physiological responses as in a real situation. If I notice that the person is getting more triggered than I expected, we take a break and I can guide them with my own voice for a while. It’s important that they succeed.”
It was at the end of her training as a psychologist that Märta Wallinius began to think about what makes people hurt other people. This led her to apply for forensic psychiatry to see if it would suit her. It did.
“I felt I could reach out to these people and I wasn’t afraid. Even though there are long care processes involved, it was very meaningful. For me, it’s important to have a role where I can actively do something to help these people.”
Challenging problems
The vast majority of the people she works with have had a tough childhood and a lot of contact with psychiatry or other support initiatives in society. They have challenging problems with mental illness, addiction and criminality and are often difficult to manage in the healthcare system. But despite the fact that forensic psychiatry can be a scary place to work, Märta Wallinius has never felt threatened. She says that there is no need to be afraid, but to be aware of the risks and what these people are capable of.
Märta Wallinius’ research study on VR has attracted a lot of media attention and she has had a busy autumn with many interviews, TEDx talks, supervision of doctoral students and, not least, participation and first prize in the Swedish competition for submission to the European Crime Prevention Award.
“Yes, my mailbox has gone haywire due to all the incoming mail. It’s intense, but I’m so grateful and it’s great fun!”
Pioneering work
The study is small and the results are inconclusive, but compared with other aggression treatments it looks very promising. About half of the participants experienced a reduction in self-reported aggression that persisted for three months after completing treatment. Märta Wallinius is keen to emphasise that more and larger studies are needed and that the method must be combined with other treatments – VR alone is not a miracle solution. Much of what she does is pioneering work and the tool is being widely tested in both forensic contexts with people who have committed crimes and with psychotic patients suffering from paranoia.
“Seeing a person succeed in their journey towards a life free of crime, mental illness or addiction is something that drives me. Even a small change in aggressive behaviour can have a big impact both on the individual and on society.”
Research and clinic
Another driver is her role as a manager and trying to influence how care is delivered. In Sweden, there are as yet no national guidelines for forensic psychiatry and it is, to say the least, a challenge getting the healthcare system to pull together for the provision of more equitable care.
This year marks exactly ten years since Märta Wallinius was given the chance to build up a research environment from scratch in combination with clinical activities in Växjö.
“I am proud to exploit the synergies that arise between academia and the clinic and to introduce colleagues to new methods. When it comes to VR, I am convinced that there is great potential – inside the walls – to give criminals tools to manage their emotions outside the walls.”
