How Designers Can Build Experiences That Reduce Anxiety and Stress

A VR designer at Oculus explains how virtual experiences can ease the stress of the data deluge during the pandemic and beyond

Illustrations courtesy of the author

From my Brooklyn apartment in New York City, I watch Gov. Andrew Cuomo share the daily Covid-19 death toll with the nation. I watch his broadcast every day, around 11 a.m. I dubbed Cuomo America’s #crisisdaddy and have posted so many Instagram Stories of these dispatches that people have begun to send me photos of his potentially pierced nipples. I’m not a #CuomoCrusher*, but I am fully addicted to the daily broadcasts — they’re a glimmer of hope in otherwise droning and difficult days. *(Required anti-bias reading.)

Benign thoughts in a crisis.

And with that, I’ve spent the last three weeks wondering why I can’t stop watching these broadcasts: Is it the data dumps? The descent into dadaist strings of fatherly adages that reliably occur at the 25-minute mark? Do I just find his Italian American mean-guy combination of stern chides and emotional outbursts familiarly reassuring? Is it just the ritual of it all?

The answer was closest to the latter: the ritual. If I watched the Cuomo-cast (my coinage, not theirs) every day, I was less likely to spend subsequent hours of my day falling into a news vortex. It worked by providing me with the information I needed, in a digestible format, at a set time; somehow permitting me to limit my news time. When I wondered why this felt so novel, the UX designer in me awoke to explain: News, in recent years, had become a deluge. Long dead are the days of the morning newspaper and the nightly news. Information updates have permeated every second and square inch of our lives, shrouding us in more chaos than we ever thought possible.

Pandemics aside, there arguably isn’t more news to report, just more opportunities to do so — 24-hour news networks, mobile push notifications, and the endless window into the world that our phones provide — they all contribute to the deluge and to the anxiety that comes with it.

Information is a battlefield and the prize is your sanity

In a 2010 New York Times article, author Chuck Klosterman compares the modern digital information flood to a zombie hoard. “When we think critically about monsters, we tend to classify them as personifications of what we fear […] zombie killing is philosophically similar to reading and deleting 400 work emails on a Monday morning, […] following Twitter gossip out of obligation, or performing tedious tasks in which the only true risk is being consumed by the avalanche.”

Shaun of the Dead, 2004. Photo: Rogue Pictures/Courtesy Everett Collection/The New York Times.

That was 10 years ago, and in the interim, the digital deluge has become the status quo. But it doesn’t have to be. This is the perfect time to reflect on all things wrong with our previous “normal” and posit new paradigms.

But how do we remedy modern information overload anxiety? First, we have to understand what information trauma does to our brains. With that knowledge, we can look to psychological treatments that have proven successful at alleviating such trauma. Then we translate those treatments into viable interactions we can apply to future information mediums and digital platforms.

The latest user interface on the Oculus from Facebook VR platform.

I’m particularly interested in this attention economy because as an AR/VR designer▲, I build experiences for future platforms — platforms that, by virtue of the fact that they sit on your face, can commandeer your entire visible spectrum. Imagine wearing AR glasses all day and being inundated with updates, ads, and social notifications. This experience is, in my opinion, un-fucking-acceptable.

▲ (I’m a VR Design Lead on Facebook’s AR/VR Social Experiences Team).

This is your brain on trauma

The body responds to overwhelming stimuli by releasing stress hormones, and, according to Bessel van der Kolk, MD in the book The Body Keeps Score, “in order to return to proper functioning, this persistent emergency response must come to an end.” When the stimulus doesn’t end, the response continues, causing prolonged anxiety and stress.

The Body Keeps the Score has quickly become part of my must-read list.

Usually, when confronted with a troubling experience, people with nontraumatic histories will experience a spike in stress hormones, followed by a drop when the threat abates. But in stressful events of extended duration — like a pandemic, for example — or for those with a history of trauma, the threat never recedes. That means the stress hormones never receive signals to pull back. Instead, they remain present in full force, causing the body to remain tense and distracted. This is anxiety.

When viewed through this lens, it’s easy to see why the modern news firehose is so problematic: A constant influx of traumatizing information never grants us the reprieve needed for our bodies to reset. We live in a digitally induced state of fight or flight, constantly threatened by digital danger.

Our phones have permeated our lives in a way that is both magical and terrifying. We can access all the world’s information on demand, but it comes at a cost: The world can whip an unpredictable blast of painful information at you at any time. I worry about this deluge deeply as we near the corner to consumer AR/VR products. I have nightmares made of violent notification swarms splayed across immersive interfaces, physically overwhelming our POV and our sanity.

The calm in the storm

When people are overwhelmed — as with notifications or trauma — they find calm in rhythm, repetition, and synchrony. Predictable patterns make people feel safe, as though the waters of the world are calm. “Our sense of agency, how much we feel in control, is defined by our relationship with the body and its rhythms: Our waking and sleeping and how we eat, sit, and walk define the contours of our days,” Van Der Kolk says. Historically, we’ve used this to make sense of heavy flows of information — the newspaper that lands on a doorstep at the same time every day brings order and sense to the world’s events. In William H. McNeill’s Keeping Together In Time, he describes collective, rhythmic experiences as the key to instilling greater context in our lives.

In my “Virtual_ Healing” article, I mention being a survivor of chronic abuse and physical assault. After years of reconciling this trauma and investigating its effects on my day-to-day life, I noticed that my lifelong anxiety was a result of an unpredictable history. There are no reliable rhythms to life for an abused person; assault can come at any moment, without reason. I associated people I loved with explosive risks of betrayal, and therefore, couldn’t feel comfort in my life. My way around this mechanism was to foster rhythm and predictability — and therefore, agency — into my behaviors.

Specifically, I built a system of control around my stress-drinking. For nearly seven years I have followed the same self-made program: I am never allowed more than seven drinks in a week, no more than three in a day, and no more than two in one sitting. This system was custom-built for my body to prevent me from becoming intoxicated. The strange side effect of it was that it generated a rhythm that brought calm to the former chaos of my stress-drinking. While I once threw endless intoxicants into a sea of overwhelming anxiety, I suddenly had to stop daily to consider whether I would drink, how much I would drink, and how I could mediate the week’s remaining drinks to accommodate.

This rhythm allowed not only for pause and reflection but, most importantly (and unexpectedly), it prevented me from thinking about drinking for the rest of the day. Predictable patterns coupled with agency and play empower people to feel in control of the uncontrollable.

Building better information delivery systems

So now we understand how it all works. Stimulus overflow induces anxiety and feelings of helplessness that cannot subside because the input is constant. Introducing rhythm and pattern provides windows for stress to abate, building perceptual agency; and feelings of relief and control allow us to enjoy life in real-time. But how do we apply this understanding to the design of everyday things?

Psychiatric therapies for trauma and post-traumatic stress disorder (PTSD) aim to help patients resolve their sustained stress through mindfulness, predictability, repetition, rhythm, and control. Many calming therapies are based on pattern building: yoga, eye movement desensitization and reprocessing (EMDR), meditative breaths, musical therapy, and qigong have all proven successful at managing over-stimulus, according to Van Der Kolk. Familiar cadence keeps us in tune with our circadian rhythms, breath patterns, digestive cycles, and other parts of our biology.

To apply the tenets of mindfulness, predictability, repetition, rhythm, and control to experience design, let’s look at proven psychiatric therapies for each and offer analogous (AR/VR-friendly) design solutions that you can employ.

Mindfulness

The Oxford English Dictionary defines mindfulness as “a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations, used as a therapeutic technique.” Yoga, meditation, and Qigong have become common ways to treat anxiety and PTSD because they engage in momentary presence by allowing traumatized patients to safely experience their mental and bodily sensations. Neuroimaging studies of the brain done before and after regular yoga practice have proven that areas involving self-awareness are activated by yoga — areas often made frozen by trauma, according to Van Der Kolk.

Yoga allows for presence because of its meditative and cyclical nature. It introduces periods of time to engage with specific sensations, pleasant or otherwise. Ever noticed that good yoga teachers will help you anticipate the end of discomfort by telling you how many breaths a difficult pose will last? By understanding the cycles, we can submit fully to them, allowing time for momentary presence.

We can bring comparable mindfulness to our devices by limiting information flow to facilitate periods of focus. Not all notifications should flow through in real time. Designers should consider grouping, categorization, and timed-release when constructing information flow.

We’ve all seen these features — in our devices and apps — that allow for notification batching and customization. But, my favorite example of app-driven mindfulness is actually unintentional: When I’m in VR, I can’t receive my usual push notifications at all. If I want to engage with social applications or news updates, I have to open a browser in VR and explicitly choose to do so — or peer at my phone through my nose gap.

Predictability

Exposure to traumatic experiences can build skepticism in life’s structures of safety, predictability, or meaning. Reintroducing longer-term predictable patterns, cycles, and behaviors can help resolve trauma by reinforcing faith in these structures. Alcoholics Anonymous’s (AA) 12 Steps program has exhibited incredible success at helping people traumatized by alcohol addiction to reach long-term emotional healing and alcohol abstinence, according to The Bronfenbrenner Center for Translational Research. AA fosters commitment and trust by adding structure to experience. As psychologist Clifford N. Lazarus writes in Does Alcoholics Anonymous Work Because it’s a Form of Cognitive Behavioral Therapy?, “If we look closely at AA, we see that despite its spiritual underpinnings and focus on working the 12 Steps, it is a very behaviorally oriented process. […] One of the core recommendations [is] to change one’s routines, repertoires, and actions.”

To bring comparably predictable, trust-honing patterns into our interactive designs, we must strive to be transparent and informative when asking for attention from our users. Whether it’s a new-user onboarding experience or a social notification, the more we disclose about the time commitment or steps involved in an interaction, the more agency that person has — and the more able they are to opt out if that interaction doesn’t serve them.

Repetition

Our next tenet of trauma treatment, repetition, sheds light on another commonly used treatment for PTSD: EMDR — a psychotherapy treatment designed to “alleviate the distress associated with traumatic memories,” according to The EMDR Institute. During EMDR, a patient is asked to recall a painful thought while a therapist moves their hand back and forth across the patient’s field of view. When the patient follows the therapist’s repetitive hand, they activate a state comparable to rapid eye movement (REM) sleep. In this state, one can interface with painful thoughts on a safe and primal level, allowing deep associations to be made and troublesome experience loops to be closed. Unlike talk therapy’s reliance on clinical interpretation, EMDR insight is gained from boosted emotional processes.

To translate this sort of pattern awareness into AR/VR experience design, data becomes our best friend. Piles of user behavior data are collected from the tiniest interactions. If we process this data and give users transparent access to their own behavior loops, allowing them awareness and, subsequently, agency over their own activity. Rather than hoarding this data to fortify addictive patterns, we can help users build an ideal experience by empowering them to see and understand their own interactions. Apple’s Screen Time touches on the beginning of what’s possible here: exposing personal patterns and allowing users to modify and limit phone use.

Apple’s Screen Time on iOS.

Rhythm

According to a study by the U.S. Department of Veterans Affairs, rhythm is commonly manifested in PTSD treatment as musical therapy, an option known to address emotion dysregulation stemming from intrusive and triggering thoughts. Musical therapy can include listening to, thinking about, playing, and creating music. It stimulates the brain on a primal level, allowing a person to engage in a rhythmic, communal experience, according to Van Der Kolk. In “Music, Rhythm, and Trauma: A Critical Interpretive Synthesis of Research Literature,” researchers suggest that “rhythm-based activities are beneficial for people who have had adverse experiences because it bypasses higher cognitive functioning and allows connections to form via more primitive, undamaged regions of the brain.” As our content-consumption patterns have become more customized, algorithmic, and user-behavior driven, we’ve lost one of the most satisfying aspects of being human: collective experience. While the always-on aspects of our digital behaviors satisfy immediate needs, they rob us of the benefits of simultaneous, communal experiences — particularly their proven potential to subdue anxious, intrusive thoughts. This is especially important during times of social isolation. Communal experiences, whether they be Zoom raves or live broadcasts, remind us of our place in a broader community of support.

Designers and platform creators should provide opportunities for communal, synchronous activity to our users. Scheduled collective experiences (like a news broadcast at a specific time), give people opportunities to feel experientially united with telepresent humans, while also allowing them to separate their digital engagement time (via preplanning) from their IRL presence time. Many platforms are exploring opportunities for synchronous experience (Instagram Live, Facebook Live, and Zoom parties come to mind here), but VR offers truly incredible possibilities for embodied, real-time digital presence — and the positive sensation of community that comes along with it. Venues is one of my favorite examples that we’ve created at Oculus: Telepresent users can stand right next to each other in VR to attend live concerts, sporting events, and conferences.

Control

In PTSD treatment, clinicians may use cognitive behavioral therapy (CBT) to realize and, ultimately, take control of their own actions. CBT, as described by Psychology Today, is a form of talk therapy that focuses on, “modifying dysfunctional emotions, behaviors, and thoughts by interrogating and uprooting negative or irrational beliefs,” with the goal of confronting and changing negative behavior loops. The intent is to reveal problematic patterns, by talking through circumstance and emotions in real time, allowing for correction of one’s missteps and biases in future experiences.

Rec Room’s Personal Space and Ignore Bubble settings.

The designer’s answer to this means of building agency lies within the most oft-neglected zone: settings. If we provide granular settings that allow users to define their ideal experience, we allow them to cut out negative or triggering behaviors. One of my favorite examples of this is VR dialogs that allow people to define how close other users can get to them by setting the parameters of their personal safety bubble. You can learn more about this in “Designing Safe Spaces for Virtual Reality” and “Designing Safer Social VR” by Andrea Zeller and me.

Design and “the new normal”

My ultimate goal is to inspire more UX designers to reconsider information anxiety through the profound lens of PTSD. As we use this “quarantime” to reprocess all the things that were accepted but harmful about our “old normal,” we should seize this chance to change the way we design as well. We have a responsibility — as the people who imagine our digital interfaces and interactions — to confront the patterns that built our old economy of information and push for newer, better paradigms.

It’s easy to excuse ourselves from building a better future when we’re not on the front lines, but every discipline can offer a mechanism for change.

XR Design @ Facebook Reality Labs + NYU Adjunct — concerned with: design-ethics / social-VR / trash-hardware / virtual-inclusion / dada-futurism / glitch

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