Speaking of Psychology - Bonus Episode: Driverless Cars and Body-less Therapy with Arnon Rolnick, PhD

Episode Date: October 21, 2019

Have you ever wondered why drivers don't get carsick? If you've ever been seasick, are you curious to know what causes it and what, if anything, can be done to stave it off? Dr. Arnon Rolnick is a clinical and experimental psychologist from Israel where he directs Rolnick's Institute for Advanced Psychotherapy and studies psychophysiology and the integration of technology and psychology. Rolnick spent 20 years as a psychologist in the Israeli Navy developing various methods to improve sailors' performance and well-being under conditions intended to make them seasick. He is also working on a book exploring how virtual psychotherapy can open new ways to study the roles of the body and brain in therapy. Join us online August 6-8 for APA 2020 Virtual.   Learn more about your ad choices. Visit megaphone.fm/adchoices

Hey everyone, it's Caitlin Luna, host of Speaking of Psychology. This episode was recorded during APA's Technology, Mind, and Society Conference, held in October 2019 in Washington, D.C. I was away on maternity leave during that time, so my colleague Kim Mills was a guest host. We hope you like this episode. Hello, and welcome to Speaking of Psychology, a biweekly podcast from the American Psychological Association

that explores the connections between psychological science and everyday life. I'm your host, Kim Mills, and I'm coming to you from APA's annual technology, mind, and society conference in Washington, D.C., a cross-disciplinary meeting to discuss psychology's role in developing and advancing everything from virtual reality to artificial intelligence to the Internet of Things. Have you ever wondered why drivers don't get car sick? And if you've ever been seasick, are you curious to know what causes it and what, if anything, can be done to stave at all? off. Joining me today is Dr. Arnnnnch, a clinical and experimental psychologist from Israel, where he directs Rollnick's Institute for Advanced Psychotherapy and Studies Psychophysiology and the Integration of Technology and Psychology. He spent 20 years as a psychologist in the Israeli Navy, developing various methods to improve sailors' performance and well-being under conditions that tended to make

them seasick. He is also working on a book exploring how virtual psychotherapy can open new ways to study the roles of the body and brain in therapy. Welcome, Dr. Rollnick. Thank you very much. Thank you for inviting me. One reason I wanted to talk to you today is to learn more about one of the papers you're presenting at APA's Technology Mind and Society Conference. It's called Technology Made Us Motion Sick.

Autonomous cars will make us vomit. It's a review of 40 years of research, which is a lot of time to study motion sickness. With the advent of self-driving cars, The idea that these vehicles might make people motion sick is one glitch that hasn't gotten a lot of coverage by the media. So I'm wondering, how much do scientists know at this point about the likelihood that this will be a widespread problem? And what can we do about it? Well, we studied this phenomenon for many years.

In fact, this is one of the ancient problem that technology made. you know, we were very happy that we could be moved by cars, ships, and horses, but we were not aware that it will produce such a debilating effect like motion sickness, and not only we found in my work in the Navy that people tend to be even helpless. They feel desperate. and I connected it to Martin Zelligman's theory of flound helplessness. The exposure to uncontrolled motion is producing some sickness. And not only sickness, it produced really some type of depression,

which I was able to show in my research. So that brought me to the question, how comes that there are certain people who are not sick, like drivers, and that came very nice with the theory that controllability. What learned helplessness theory predict, controllability prevents feeling bad. So I did this study almost 40 years ago, and I was not aware at that time

that in few years from now, everybody will be passenger. And not only they will be passenger, they will reading devices like phones or Kindle because they are free, they don't have to drive. So this autonomous car or driverless car is opening a real problem or producing a real problem

which we psychologists will have to deal with. And I'm going to present a few type of solution or possible solution, which I did in my work in the Navy. One of them was artificial horizon. We do know that the reason motion sickness developed, it has to do with some type of conflict between the information the eyes get and the information that the vestibular information

or vestibular system. Which is in your ear? In our inner ear, yes. Right, right. Yes. and in the study I did with the TNO in the Netherlands, we were able to show that using artificial horizon, we could dramatically reduce the amount of motion sickness

and increase performance, that performance is becoming better as compared to people who did not have this artificial horizon which was kind of projected on the walls of the tilting room that we use. But this is some technical details. But what I really want to emphasize in this lecture that I'm going to give, which will be one of another two lectures,

but one of my talk will speak not so much on technical solution, but that we as psychologist has to examine the process of adaptation, because people do adapt to motion sickness, but we don't know enough about this process. And apparently it's not enough just to be exposed to the motion. We have to help them using various cognitive behavioral therapy approaches. And there is an interesting correlation now

between what I do in my clinical practice with people who are afraid from being sick, or afraid from vomiting, I'm doing gradual exposure to motion sickness. And it is possible that with this driverless car, we will need to do the same. So this is one of the area I'm going to talk in this conference, but then I will jump, if it's okay, with you, to another area which related to my main practice as a clinical psychologist. Okay, but before we get too far into that, a couple of questions about motion sickness. So you talked about an artificial horizon.

So I'm in an autonomous car. There's a real horizon out there. So why does that not prevent me from getting motion sick? What's happening? Or if you just gave me a steering wheel and I thought I was in control, would I feel better? Well, that's a very interesting. You have two points here. Both of them are good.

But let's go to the second one, which I was just trying in my, clinic in Israel, I wonder what happened if you have a wheel but you don't really control, you just play with it, like what I did with my child when he was some years ago. And apparently, we don't have a good research about it yet, but apparently it does help. So, you know, in this autonomous car, there's going to be some stages. At the beginning, we will still need the will, although it would not. really control the car. So I do suggest that people will kind of play with a useless will just to feel that they have perceived control. Regarding your previous question, it is true.

The main focus is that we need to give them a good visual reference. If the car manufacturer will be wise enough, they will do a big windows and that will be the best. But if you will notice in the diagram of how they prepare or plan those car. They are going to be like a room with many chairs facing each other, not facing the movement and a lot of screens. So people might not see the visual surrounding. And this is why I'm kind of, I think, that they will have to hear us,

We psychologists, our voice must be heard in these issues. Is that a problem so far with the cars that they're designing? Are you hearing that car sickness is an issue? Well, you see, everybody is now obsessed with the issue, shall they do accident or not? Right. And not enough about this issue. Well, there is, I should be more concrete.

Or a Mercedes-Benz is doing some research, and other companies are doing research. So it's not that they ignore. that they ignore it, but still the main focus is not exactly on this issue, I think. There is another issue I should mention. It's again important for psychologists. The issue of trust, we have to trust this computer that will drive us. Right. And it will be interesting to see what type of people will be kind of trusting it. No problem. And the other will sit anxious and anxiety. might produce even more sickness.

So there are interesting questions here. So why is it that some people get seasick or car sick and others don't? That's again a good question. Some people thought it's related to the function of their vestibular system in the inner area. And apparently not. Everybody that has a functional vestibular system might get sick. in our Navy, my data show that 70% of the people get seasick if the sea is high enough. In the car, it might be a little bit less, it might be less,

but again, if they will be reading and looking on certain devices, they will be apparently either not sick or they will have what they call sopite syndrome. Soapid syndrome is related to what I said about some type of lethargy, apathy, depression that we did show that emotion sickness does produce even without nausea. So that's produced. It's not something that you have before you get motion sick. It's when, after you become motion sick, you have this soapite syndrome. That's an interesting question. I studied with three of the leading people in this field. One is J.T. Reason from England. The other is Heston Grabeil from Florida. And the third is

James Lackner in Brandeis University. They were all studying this soapite syndrome, and they say that sometimes it develops even without the symptoms of motion sickness. Like we can see it as a phenomena that might be developed without nausea and without vomiting. Interesting. So you talked a little bit about cognitive behavioral therapy as one way to counteract motion sickness. How exactly would that work?

Well, in my studies, again, some earlier studies and some later, we trained a soldier or sailors with some simple cognitive behavioral techniques, or it could be either relaxation, either changing their cognition. And we show that people that did it and that people that had high self-control where by far they perform better than their counterparts or their other sailors that did not have self-control ability. We use the classical method of measuring self-control, and we were able to show that cognitive ability of self-control might be very useful. Now, I should mention here a very important.

figure is named Dobby, James Dobby, who worked in the Naval Biodynamic Lab here in this country, and he just published a book about his, I am speaking about 40 years, I think he's working 50 years in the field, and he's not psychologist, but what he found, that in order to help pilots, sailors, and people that suffer for motion sickness, he uses cognitive behavior therapies. And there is another study that people did it in the sea just some years ago with very good results. So yes, we, you know, people in the field of cognitive behavioral therapy usually think that their job is to prevent drivers' rage or drivers' anger or, you know, anxiety or depression, I invite our colleague in the CBT to begin to prepare themselves to a new arena

that they should work, and this is how to help people at the cars. And more important, motion sickness is very much conditioned. Like if I'm driving in a car and in this car there is a smell. some type of smell that usually wouldn't bother me. This smell is kind of conditioned with the nausea. This is a phenomena we all know in psychology. We call condition taste aversion and conditioned smell aversion. So it is possible again that we might also test the role of odors

and maybe we can prevent this conditioning by using different odors at the first drive or the first voyage that people are doing. So you'd associate a good odor with feeling well. Exactly, exactly. But may I go to other field at the time? Like I began with the old ancient problem, but now I'm dealing a lot with the role of the Internet

in helping people. And in fact, in psychology, there is two directions that the Internet took. One is to do what they call Skype therapy or online video conference. And this is mainly the relational people or the psychodynamic people that were said, hey, it's interesting to see what we can learn about therapy when we do it online. Is it the same therapy? Is it the same alliance that is produced in this online therapy?

and I just published a book with Chaim Weinberg, a friend of mine, about online therapy. There is some books in this area, but our book is dealing with cases that we are doing it not only one-on-one, like classical psychotherapy, we are doing it with couples, with families, with groups, and with organizations. So this is the uniqueness of our book that we are dealing with. it, doing online therapy, and it produces very interesting questions. For example, now there's two people sitting in front of me, you and our technician, and suppose I want to see the interaction between the two of you. Now, the classical people just put the guy or the couple before the camera, before the computer, and we just see two faces. It's not what we want.

we want to see the full body we want to see the interaction between the couple what happens when the wife says something that bothers the male or vice versa we want to see their bodily

behavior so we did develop some new way that with the new cameras that can go from one to the other and the couple then

can also see where I'm looking, although I'm in Israel. And the couple, let's say, in the United States, we found the cameras that could represent my head. And now my head is showing, the camera is looking on you, and now the camera is looking on our nice technician here. So I'm speaking about a lot of things that we are testing now regarding this online therapy.

So is the therapist controlling the cameras? Exactly. And then the people who are the patients, they're able to see themselves at the same time or afterwards? How exactly does that work? Well, people can see themselves. That's another interesting question in this Skype and Zoom and all of the other programs. People can see themselves. And sometimes it's produced some too much people are too much self-aware.

Right. But your question is very important. Yes, we found a way that the therapist from a distance can control the camera which exists in the couple's room. And in this way, it makes it somewhat more like a real therapy. You know, in couple therapy, we usually need to kind of approach the male and tell him, hey, please, count down. We might approach the female and tell her, could you? invite him in more. So we are like a conductor of orchestra and we cannot do it.

Well, we couldn't do it till we developed this technique where we can really give the couple the feeling that we are either looking on one of them or the other. So that's one direction that we are doing with online therapy. But that's not enough. I think that we need not to, it's not enough to be happy that we are doing a good online therapy. What happens between one session to the other session? Usually in psychotherapy, psychotherapy is a wonderful experience. People love it.

If we are a good psychotherapist, the patient feels that you understand him. The patient feels that you are helping him to accept himself. The patient might feel some hope. It's a wonderful thing. But it's a fantasy that we can think that in one session a week or two sessions a week, we can really do a significant change. So we developed an application that is kind of accompanying the subject or the patient, all the week.

Suppose we were talking about, let's say, my arousal now, speaking in this conference, and I will come to my therapist and I say, I was a little bit too, I don't know, exhausted. And suppose the therapist say, listen, now and it's okay, you can take breath and you can kind of think differently, you know, cognitive.

But that's not enough. What will happen when I'm going to be interviewed tomorrow to the CBS? It might happen again. Right. So our point is that we will, between session, we produced an application that remind me to do what we discussed. It could be some types of what we call in CBT homework, but it could also be some type of, some type of, hey, Arnon, why want you, this program kind of accompanies,

I would say, why won't you share with me some of your dreams or some of the thoughts that you had in the middle of the week? So our idea is to produce, we produced application that is accompanying the subject between sessions. It also measures our, anxiety, our depression. So there is a constant measure of the patient's situation, patients' well-being, and that helps the therapist to be aware what's happening and if the

therapy is going well or not. So how is it measuring these things? Is it like testing your skin conductance or your heart rate? or, I mean, what exactly is it doing? And you said it so that every day at 3 o'clock it reminds you, like now's the time for you to be mindful and deep, deep breathe and all those good things? Yes, reminder is, of course, one very important aspect.

We came from the biofeedback field. All of our, it's not only me, it's Dr. Yuvalodadad, and Dr. Gorinich, who is kind of developing this system. So we are very much aware of the psychophysiology and the sensor. But at this stage, we are more focusing really on some interaction between the patient and the therapist. And it's going automatically. The therapist does not have to be aware, hey, what happens to my patient who now in Tel Aviv? the system send him a message, a message that is designed with the therapist and the patient.

Let's say this week we are going to focus on your ability to think differently, on your ability to initiate more social activities. So coming back to your question, it's not mainly censors, although we have developed some ideas about sensors, but at this stage it is more verbal. So you think that's where psychotherapy is going, or is this going to be just an adjunct to traditional therapy? I think we psychologists are now divided to two companies, or no, two camps.

There is the camp to say, this is not psychotherapy. We are not allowed to do it. The main issue in psychotherapy is the human interaction. And they say, completely don't do that. There is the other camp who say,

if it works, why won't we do it? In my clinic, we decided to combine the two camps and what we are doing is really, we are doing a lot of online therapy and coming back to your question, we are going there. No, the genie is out of the battle. Now, we could use it in a positive way or in negative way.

I've just been in New York and I've seen Aladdin. And we could see that there was happy end there, and I do hope that in our case, there will also be some happy end, namely that psychotherapy can really advance using both online video conference and online applications that can enhance the therapy. Well, it sounds like you're doing a lot of really interesting work in your clinic. I'm very happy that you were able to join us today and appreciate you're taking the time

and we'll keep an eye on your work. I'm sure people who experience things like sea sickness and car sickness are going to be very concerned as we have more and more of these autonomous cars out there. So I hope that your work is able to save those of us who get a little queasy from experiencing that. Well, thank you. And if people are interested, our work will be published in a site called Internet Psychology. Sorry, internetpsychotherapy.competreeperop.com.com. Great. That's good to know. We can include that in our notes.

Before we go, I just wanted to remind our listeners that we at Speaking of Psychology want to hear from you. You can email your comments and ideas to speaking of psychology at APA.org. That's speaking of psychology, all one word, dot org. And please give us a rating in iTunes. It really helps. Speaking of Psychology is part of the APA podcast network, which includes other informative podcasts such as APA Journal's dialogue about new psychological research and progress notes. about the practice of psychology.

You can find all our podcasts on Apple, Stitcher, Spotify, or wherever you get your podcasts. You can also go to our website, www.sperengofpsychology.org, and listen to more episodes. I'm Kim Mills with the American Psychological Association. Thank you.