Future Forward

Harnessing Resilience and Mental Health Through Gaming

• Teresa Spangler

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Coping with the relentless challenges of ALS, I know all too well the importance of resilience, hope, and the importance of mental health, which is why I'm excited to invite back @Ryan Douglas, CEO of @DeepWell DTx, to talk about the latest product release, #Zengence. 


 Explore the innovative frontier of mental health care through the prism of video games. From my beginnings in media and animation to founding Next Turn, we chart a course through the intersection of technology and therapy. Discover how groundbreaking Stanford studies are revolutionizing our understanding of video games, debunking myths, and uncovering unexpected benefits for mental health. Learn about the transformative potential of gaming design when coupled with behavioral science, offering new pathways for therapeutic practices.
 
 Experience the cutting edge of stress relief and resilience training through immersive game mechanics and virtual reality (VR). We unveil a new video game that uses motion constructs and biofeedback mechanisms, featuring a unique breath-control system that provides both in-game advantages and real-life stress management benefits. Get excited about a VR game currently being tested with 500 players, designed to build resilience and promote mental wellness. This episode celebrates the power of innovation, the crucial role of community support, and the endless possibilities at the intersection of technology and mental health.



Facebook Community: https://www.facebook.com/groups/deepwellcommunity
Discord Community: https://discord.gg/pwNAdNNE

Facebook: https://www.facebook.com/gaming/DeepWellDTx
Instagram: https://www.instagram.com/deepwelldtx
LinkedIn: https://www.linkedin.com/company/deepwelldtx

Website: https://www.deepwelldtx.com/zengence
Meta Store: https://www.meta.com/experiences/7982150971811780

#mentalhealth #VR #videogames 

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Speaker 1:

Hello.

Speaker 2:

Hey Ryan.

Speaker 1:

Hey, it is good to see you.

Speaker 2:

I can't see you.

Speaker 1:

Oh well, let me see. If I can't fix it, How's that?

Speaker 2:

Very good. It's good to see you.

Speaker 1:

Oh, it's so good to see you too. How are you feeling?

Speaker 2:

Well, I'm good, I've lost my hands and my. I mean, it's been fast Ryan.

Speaker 1:

Oh, teresa, that is, very fast.

Speaker 2:

It's unfathomable, but I'm yeah, I'm still hopeful.

Speaker 1:

I love that you are and I love that you haven't stopped doing the things that make you you, teresa. I think, I think that is a really important part in it. Certainly it it's. It does me good to see you, you know, pushing through. And oh man, was I alarmed when I got that message. You know, I, I'm, I'm, I'm glad you're, you're taking this path. It must be. The best way to cope is to move through and move on.

Speaker 2:

And to you know, you know I have my days. Yeah, that might have been your product might help me, but you know, honestly, I have to help others. You know, I have to get the word out and bring more awareness. Sure, you know, and this is something that we can use, maybe you want to help others. I have to get the word out and be more aware of it.

Speaker 1:

Sure, and this is something that we can use. Maybe you want to edit it, but before we get into this too much, I did a post today on LinkedIn and I re-shared some work by Dr Jazz Gill. I love him, we've been connected for a period of time and he was always just coming with these very complex, um, emotional, mental health type situations and bringing them down into infographics and ways for people to really understand it, and he did one yesterday on grief oh my god, and it caught me.

Speaker 1:

He, he has this diagram and it's perfect. You know, I, I think you know, I lost, lost my wife sometime ago now to cancer, about five years ago, but it was a, it was a 10 year battle that we had, you know, and our family had. And in this thing about grief, you hit this point perfectly, which is that, you know, grief doesn't really diminish and loss doesn't really diminish over time. It is this, let's say this thing within your life. What you need to do is expand your life around it so it becomes a portion of who and what you are. But that really helps people understand why, when you don't do some moving on, people can get really stuck, because that grief is all of their, their being, and it also helps us understand, you know, after that, everybody's. It also helps us understand, you know, after that everybody's well-meaning people have shown up but the casseroles are gone and the visits are are reduced. And you know, the people closest to you have heard all about your emotions and your stories yeah the expectation is that that really starts to fade.

Speaker 1:

That's how you become socially reintegrated back into the world. You talk about this too much. You know it. It's just uncomfortable and but the truth of it is the only way for people to really do that is to give them some more. Things are, and they have to be ready for that life to expand. The expectation that the grief is shrinking is is just not how it works.

Speaker 2:

We carry loss with us I think that, I love that. I think that's actually accurate yeah.

Speaker 1:

So what you're doing here is you're expanding that bubble right and and I I love that I love that.

Speaker 2:

Yeah, you know, and it's the same thing. And then we'll get started. I am a musician. I can't play any of my instruments anymore.

Speaker 1:

What did you play?

Speaker 2:

I have 12 guitars. I have a grand piano and I wrote and sang.

Speaker 1:

Can I show you something?

Speaker 2:

quick yeah.

Speaker 1:

You got to come with me for a second, all right. This is my favorite little room in the lodge, yeah.

Speaker 2:

Oh, my God you see all those guys.

Speaker 1:

Oh, that is awesome 74, les Paul oh I love it.

Speaker 2:

Yeah, yeah, yeah.

Speaker 1:

And a 73, Telly. Oh, wow, beautiful 62, 62 Ovation oh, that's beautiful 62 Gretsch the Joe Pass. First I ever played on stage and then a lot of acoustics all the way down to my dad's oh, I have a guild oh yeah.

Speaker 2:

I have a 50 year old Brazilian road board guild. Oh yeah, nice, I have a 50-year-old Brazilian rosewood skill.

Speaker 1:

Oh yeah.

Speaker 2:

And I have a Gretsch, a white, beautiful Gretsch guitar.

Speaker 1:

So great.

Speaker 2:

I can't play any of them.

Speaker 1:

Yeah, I imagine that would be.

Speaker 2:

The funny thing is I sent Dan Doctoroff. He's the founder of Target ALS.

Speaker 1:

Okay, yeah.

Speaker 2:

He has ALS, okay, and he and I have gotten very close. He's in New York. I sent him a song because he's in the hospital right now from Paul Simon, called Seven Songs. It's a beautiful song. He sent me a note right back saying Paul Simon lives on the floor above him. Really, yeah, I like that. I'm laughing. So it brings joy in different ways, you know.

Speaker 1:

Oh for sure. I mean absolutely there's listening. I mean, as a musician, what I find I can do is I can listen for things in the song that I don't think you would know about if you hadn't taken the time I agree you know, to get to know it yeah, but I know your time is short today, so well, I did get a little extra bumped on the end, so I don't have to leave right at noon.

Speaker 2:

So well, let me um. Let me start by saying I'm thrilled to have you again, ryan Douglas, our third discussion together.

Speaker 1:

Yeah.

Speaker 2:

And what you're doing for mental health is astounding. Thank you, and if you don't mind, because I am ALS and I do have to take in air and it's hard for me to breathe, I'll let you do a reintroduction of yourself, okay.

Speaker 1:

Thank you. I mean it's great to be back with you Every time we do this. I love it. So my name is Ryan Douglas. I am a medical device professional. Got my start though all the way back in media, so started working in software and with Mac. So Flash was the beginning, really, of animation on the web, but the audio just streamed in. We figured out how to time it with the visuals, and that's really where animations could occur If you couldn't time the audio and the visual.

Speaker 1:

You know you really couldn't hit the feel, so I had that time in media, then moved on. I ended up pretty involved with robotics, big data and then robotics robotics for the military but it finally progressed to this idea of when I looked at the things I did, health, wellness and safety was what resonated with me. I wanted to do things that help people, so was part of putting together a company called Next Turn. There was about 20 of us that really made that go and we commercialized a lot of medical devices over 17 years, including some in the mental health space everything from light therapy to some neurostimulation and management for pain and various things like that all of which, of course, were tied very much back to people's mental health state and then retired from that in 2020 and really took a little bit of a breather, but not very long after that. We, you know, we were headed into the pandemic and could see a lot was going on and from the mental health perspective, I felt like there was still a lot more to do and I think generally, as someone who's made a lot of medical devices or a lot of therapies or treatments or design therapies and treatments, I felt like we always had an adherence problem as well. We were having a hard time getting people to do the things we know, many things that are good for us. But even if you you know, it's kind of like when you see the doctor at the cancer clinic smoking outside the doors. You know, we we just aren't really well wired to take good logic and take care of ourselves.

Speaker 1:

But I had some friends that were in the video game space and at the beginning of the pandemic they released a game. It outsold Taylor Swift 10 to 1. Like this game just went crazy. It went out the same week that Taylor Swift had an album go out and but the big feedback coming in was about how it was impacting people's mental health. And this was right around that time 2019, 2020.

Speaker 1:

The World Health Organization, you know, pushes towards this idea that maybe video games are themselves a source of pathology, not just a symptom but a source. Others and in the United States that wasn't really adopted or the DSM-5, the manual that's used to determine, you know what is a diagnosable mental health condition, did not adopt it. But there was this back and forth, this push and pull, and we'd seen so many years of information that games were so bad for you that we dug in deep. You know, we had to understand the difference, because what we were looking at in a video game, what it hit me about this was the accessibility to care Everything we had built. You know, you couldn't just download it onto your phone and do it. You had to get prescriptions and you had to. You know, which meant you had to have a doctor and you had to have healthcare.

Speaker 1:

And you know in the United States that was a considerable challenge and you know you had to be able to afford all of these things. But these games you know were just available. They were fairly readily available. Clearly you have to still have a device. This is not going to solve for everybody there's still thresholds of financial need.

Speaker 2:

But it changes the accessibility curve so much that we dug in well, I think you might have a really good point right there the whole accessibility. Not just the whole accessibility, not just mental health.

Speaker 1:

It's not just mental health, I mean no, across the board. Affordability of care, accessibility of care and compliance. These are the three major you know if you will circles in the Venn diagram that allow us to bring accessibility of care, allow us to bring care to people on the greatest level and to get adoption of that care. And in the States affordability and accessibility are complicated dance because it may be affordable to you if it is cleared by insurance but it still may not be accessible to you, if you can't get to a doctor that knows about it and brings it into you.

Speaker 1:

And then if you get it and you bring it know where I've really done a lot of my work, which is the home-based environment, outside of the surgical robotic stuff like that. We did a lot of getting medicine into the home with white therapy treatments, compression therapy treatments, all these sorts of things. Um, you know, compliance becomes a really big part of what, what you need. You need people to do it.

Speaker 2:

Yeah.

Speaker 1:

Yeah, we have the best intentions but we're just not neurologically wired, from what I can see, to longitudinally take care of ourselves. Yeah, short term, if something happens right in the moment, you have a reaction, a fight or flight mechanism. You know a choice to be made of a fight or flight mechanism. You know a choice to be made of am I going to fight my way through this? Am I going to? You know, and I got to run in the other direction of it and then you pretty much settle back in. You know, once the threat is gone, you settle back into. You know normal.

Speaker 1:

But when you're looking at a longer term challenge or problem or issue, whether it's your weight or it's your mental health or you know any one of these, these things that we, we deal with, we tend to actually sort of suppress it, put it on the back burner more than we tend to. Oh, it's so, this compelling nature of games, this way, that you could be drawn in. You know, at the beginning of this journey for me, I was like this is an amazing therapy delivery mechanism if you can get people to want to do things they otherwise didn't want to do. What a win.

Speaker 1:

And you try to get a team to actually really focus on this right oh my god, I mean yeah, I mean the, the folks that showed up, I mean from the medical side of things, dr sam brown, a world-renowned pediatric neurosurgeon scientist. Dr Lisa Marin, a psychologist who, like, built the psychology program at OHSU Austin Peck, one of the physiologists who was one of the first doctors to ever commercialize a device. This, in this case, would have been like a treadmill with big screens around you, that kind of yeah getting work on this.

Speaker 1:

You know dr amory porter, who's her whole career has been writing on and measuring video games capability to help us. Uh, dr justin sitsma, with a philosophy of science, who was really our, he was our um foil. He was always pushing back in the other direction, having us push the research further. Yeah, dr Julia Scott, who you know she's just known for she'sa. You know all about brain science and it takes all of these people to kind of like.

Speaker 1:

And then Dr Len Hadlad was, is an MD and he worked on the front lines of having clinics and he did it in Canada where he had to start up mental health clinics because he was just seeing so much need from the general practitioner that he you know. So all of these folks and others as well. But this, that core team came in so hard and strong from that perspective and the video game world showed up as well. I mean, if you look at, you know who's designed on this game. And I mean, if you look at, you know who's designed on this game. And I mean, if you look at our chief product officer right, it's Jeffrey saying he is legendary 50 mobile titles out there.

Speaker 1:

He's, you know from, did some of the original great titles like man, but he also was really well known for learning how to build games for a new audience, so his big thing was that he figured out how to do mobile gaming for women. So Covet Fashion Design Home, which is now a multi-billion dollar franchise that belongs to EA. That's all him, and so you know. These amazing people showed up to bring their craft to what we were talking about, and in the midst of doing this work, we found this amazing thing Amazing.

Speaker 2:

And doesn't it speak to the collaboration of diversity of talent that takes oh yeah it always has.

Speaker 1:

You know, even you look all the way back to light therapy. People are like, well, it's a light bulb in a box. What did it take? Oh my goodness. It took people that understood the eyes. It took people that back then we were using, uh, fluorescence, so ballasts which are very complicated to design so amazing electrical engineers. And then it took people that understood the eyes. It took people that back then we were using fluorescent, so ballasts which are very complicated to design, so amazing electrical engineers. And then you've got folks that understand the brain. You got, you know, folks that understand mental health, and we all had the room. That was really maybe the special part of what I liked about making these devices is that it is about assembling a group of experts.

Speaker 2:

You know I'm trying to do that with ALS.

Speaker 1:

I bet. I bet, I mean I'm certain that's required. I mean that's very complicated.

Speaker 2:

It's very complicated.

Speaker 1:

Yeah, keep going, because that's where you're going From the collaboration side. The thing I was saying is that this amazing thing. So we all got together and we're like what a therapy delivery mechanism. And then we dug deep into the research and we even we did a bunch of like questioning of what was good and bad for you about games and we got really deep into you know what it was that that was working in these games already, in commercially viable video games, right. And that's when we discovered a couple major things.

Speaker 1:

One a lot of the research that suggested that video gaming was bad for you had been sponsored in various ways by people that were looking to position it in certain ways. Now, that doesn't mean that there aren't things about video games that could be very bad, but they weren't the traditional things that people thought. It wasn't the violence in the games, necessarily the content delivery stuff. It was actually more tied to the socialization and monetization of those games where, you know, skinner box loops were used in a way to compel especially vulnerable populations to overspend, over, engage in their time and certainly if you had an addictive personality or you were in a state in your life where you could be overly drawn to something, some of those games especially in the free-to-play world that use those mechanics could be a problem, but the game content itself.

Speaker 1:

There was nothing in the play that was actually, you know, bad for you. First-person shooters were not going to turn you into a first-person shooter. Matter of fact. Interestingly enough, the data was showing us that when one of these drops, one of these big new uh games drops, you know, sometimes the trends show that violence actually goes down in society during that time. Now, I'm not saying a shooter video game makes the world a safer place, but it doesn't make it a more dangerous place.

Speaker 2:

I think MIT came out with the study years recently, didn't they? On that?

Speaker 1:

Yeah, so one of the best studies came out of Stanford recently. Within the last year, Stanford looked at the 82 studies that had been previously used to kind of point video games and violence together, and they arrived at this idea. They completely debunked it. They're just like it's not fair Now, and sometimes it was how they had measured violence too. Like they would say look, while you're playing this video game, did your brain look more aggressive? Maybe because you're playing this video game did your brain look more aggressive? Maybe because you're doing something?

Speaker 1:

but, that doesn't translate into you being a more violent person, right? And so when they studied more deeply about what does it mean to translate from this fantasy world where you, you play, um, you know, in in this first person shooter environment, does that translate into you becoming one, or wanting to be one, or thinking that it's okay, or even becoming more numb to the idea of harming? No, not at all.

Speaker 1:

When they redesigned the studies and and gave people like the actual ability to you know, to give someone a little electric shock, or after they played a game, or to put their arm in ice or something, and the guy that just played the game or the woman that just played the game they got to choose. They didn't see any diminished, but we did see something amazing. We saw two amazing things. The first thing is we saw that these action video games were some of the most therapeutic, totally accidentally right, and so that was something we had to look at, you know, and go. What is what we got here? What's happening here? And then the big thing revealed ourselves. The games weren't just a therapy delivery mechanism yeah, therapeutic. And so it turned out that these game designers that have been working on this for the last 50 years were some of the best behavioral scientists observational behavioral scientists we had.

Speaker 1:

They had figured us out in ways, as doctors and as therapy designers and device designers and stuff and pharmaceutical folks, we maybe didn't understand because we weren't good at compelling you and they really were and so that's where it started to converge with the learning sciences silo as well, and we started to understand that when you're playing these games, you look like you can accelerate the adoption of new ideas. Right? So this becomes a hack, for many of the things that we have to do for ourselves that are good for ourselves are hard. People say it's like, hey, just meditate. I've been formally trained to meditate by some of the best. It's not easy. My brain won't shut down right, just breathe, breathe through these things, learn to get. If that was easy, you wouldn't see, you know, tibetan monks sitting on mountaintops for 25 years trying to figure this out. Right, like this is, you know, or you know? Just suppress this emotion or just think different about this. None of these are just. They're very hard, and so if we can accelerate that learning environment for you and the adoption of a new response to a stimulus, then we're really onto something, and that's what those games were already doing all the way back from the tetris effect you know where, and and the data like the tetris study was.

Speaker 1:

Teresa was really amazing. We're talking about this particular case. They took folks that had been in a car accident and while they they weren't particularly harmed, but they were in the hospital and they had to fill out the forms about what happened. The control group just filled out the forms. Is what happened. The uh experimental group played 20 minutes of tetris and then filled out forms. And is what happened. The uh experimental group played 20 minutes of tetris and then filled out forms and while they played the tetris they thought about that accident they'd been in and they had a 62 less incidence rate of post-traumatic stress disorder 62, that's amazing yeah and you know this in health across war.

Speaker 1:

This is whether you're talking cancer care, but mental health is really true. Nothing happens at the 62 percent rate. Drugs get cleared if they make a 10 15 improvement in population. Devices do as well, if we can get you know.

Speaker 1:

Talk therapies work and maybe the 15 to 30 range on yeah it's not to say that you you don't have some folks that can take that to a real high form of art. But when you talk about the generalized delivery of cognitive behavioral therapy, 15 to 30% success rates. So some of these success rates were just out of this world and that really drove the team forward. And this idea of you talk about collaboration. We had to redefine how we worked together, what we did. We knew how to make medical devices. We had certain words for it, processes for managing it, the fda, the agencies that we had to deal with, ways of doing it.

Speaker 1:

Video games developed really kind of on the back of the entertainment industry and they look a lot more I think I figured out by being there long enough looks a lot like sort of uses, the terminology of making a movie, right, and so I mean we had different words for what a project manager even means. You know, and yeah, we're calling them line producers, like we need a line producer, we're so we need a project manager. They're like well, how many projects do you have? And like no, the whole thing is a project. We didn't even have the same words, we didn't have the same cultural, um, sort of start points, functional points. So the building of this team was the greatest evolution of deepwell.

Speaker 1:

Really like it so you've innovated on your intel absolutely and did it from a cultural perspective, really worked first at the belief level. We didn't know exactly what we were going to do, what we were going to be or what we're going to make, until we knew who we were, because it wasn't about one person driving a vision. It was about this collective of folks taking their individual passions yeah driving them towards a purpose.

Speaker 1:

So we had to do that work. While we were doing some of the underlying work of, you know, defining how these games could reach us, what they could potentially do were we willing to take the research for what we'd seen and push forward with the promotion of something very, very different from mental health.

Speaker 1:

And you know, and that in itself is is scary. I remember when Dr Norman Rosenthal and I worked on white therapy together, I mean both of us, I think, for a while wondered if our career was going in the wrong direction as a net result, that when we first brought that out, there was a lot of skepticism, there was a lot of pushback. And you know, and I, and I think we've experienced and you kind of watch that on, you know on LinkedIn when that there's a lot of people that when we put these things out there, they're revelations for what they've already experienced they played a commercial video game.

Speaker 1:

They feel great and they're really gratified to see it legitimized yeah, but then there's a whole other side of folks that just you know there's big blowback, everything from really legitimate parent fear where you know, I mean as a parent myself trying to keep the world of the internet and social media and everything in some sort of scope and control.

Speaker 1:

It's like you know you thought the one thing you know just say no to call of duty turned out to maybe, you know, not do that, or some parents can't even really identify the difference between a call of duty and, and you know, a roadblocks and and minecraft. And you know, you know so there's fear out there and understandable, but the blowback, you know to change is big.

Speaker 2:

And you guys have doubled down.

Speaker 1:

We did. Yeah. So I'm very proud to say that sorry.

Speaker 2:

Working on getting a product out there right.

Speaker 1:

Yeah, so I'm very proud to say that on June 13th, on the Meta platform, we will launch the first ever action shooter video game for mental health. Meta has been an amazing-.

Speaker 2:

Amazing. I think that's amazing.

Speaker 1:

Meta has been an amazing partner on this. This is the first think. That's that's amazing. Well, meta has been an amazing partner in this. Like this is the first thing that's ever gone into the meta game is an approval process. You don't just upload it like mobile. This is a back and forth. This is the first thing that's ever gone.

Speaker 2:

Think about an action shoot. It seems like it would be the opposite, but it's not.

Speaker 1:

No, it's very counterintuitive, right? And so Meta has been amazing, you know, because there's never been anything that was for your health. They have health apps, they have an app store and an app lab, but the game tab is about play, true play, and so we have this, you know, integrative approach. It has a very brand new mechanic in it that utilizes toning, but that's not the only thing. It's got these extrinsic um sort of things, like the breath mechanic that's built into it, a bunch of intrinsic um uh, game mechanics that you may not know why they're working or they're working.

Speaker 1:

But you know we've got motion constructs and we really have, um, those are tied to a set of visual spatial interference kind of things. And that's what, where the action games are really important, we gotta get you having a good time and playing, you know, and having fun. You might go into that thing knowing that you've got mental health concerns, but 30 seconds in, if you're not engaged in playing, then we can't kick the mechanisms in place okay, yeah you know, and so and that's what's really interesting about an action shooter or these games is it's the attention economy that you can demand.

Speaker 1:

If I want your attention right now, you and I are together. Right I, if I was to throw something towards you that's going to get your attention, much more than I hand you a puzzle and say solve this. I want you in the here and now and I want to bring you into the present and I want to get that dopaminergic state up and running to the place that you might then be more open to adopting and learning from new ideas that are tied back to your achievement or tied back to the physical work that you're doing in that moment. Yeah, you can't beat something that has that level of motion to it.

Speaker 2:

So does the product have a name?

Speaker 1:

it does. It's called zengeance what's that called? Zengeance, so it's this idea of you know, bringing your, your zen together yeah with your intelligence and even really with your vengeance in some way, and it's got these very clever intrinsic things as well, like for instance I mean the game design just, which I have very little to do with, but it just blows my mind to.

Speaker 1:

To access the bad guys in this world, which you're really actually freeing more with your magic than you are taking out, you have to call them into being. You use your magic to get them to come towards you and that's like an invitation to take a look at, you know, the challenges in your world and it's built in a way, um, maybe how we look at our multiple personalities interesting.

Speaker 1:

You know that's not I. I think that's an interesting way of looking at because we do have I don't think you mean the pathological idea but the idea that there's a lot of different voices that I had that's right. Yeah, I mean absolutely that. You know the game really looks at these things, that we know video games are very good at. So motion constructs, you know getting you moving is really important when you're in a, in a stressful situation.

Speaker 1:

Um, it can really just those endorphins can really lower you down so there was parts of the game that were really built on relief of the moment, and then there's parts of the game that are built on resilience and really changing. You know where you would go over time outside of the game with, with a, you know, in a very realistic, stressful situation. So you know, I and and we look at that through motion constructs, we look at that through social constructs. So there's going to be a community that we've been working on that. There's a place for you to come and talk about your reality and better understand the game. And you know we've got this visual spatial interference. This is the idea that something's coming at you in a way that we can cut that chatter, that secondary talk down in your head so we get you in a very pure, in a very pure state.

Speaker 1:

Then we got a biofeedback mechanism in there. That that brings a really cool part of it. It it takes getting used to it. People are calling this a very novel mechanic, because you don't have to do it this way in the game, but you can use your breath to control your magic and to become more powerful. You do that through this really cool mechanism that we came up with, which is toning. So the toning what the big revelation we had that it's not a super revelation, but ended up making this really accessible is that you can only make a humming tone, or most tones, on the breath out.

Speaker 1:

If you try to do that on the breath in, you can't make the sound, and so we didn't have to put in a complicated piece of hardware, something like that. We just had to ask you to make noises in certain patterns and we could start to set your breath rate. That triggers this amazing thing that's being called intrinsic haptic. So what happens is, if you think of this storyline of this game, you're a mage and you're in this dark realm and you're trying to free um your realm from these mages that are coming out as well to attack you. These dark mages are attacking you.

Speaker 1:

As a mage, you have these powers, but if you think realistically, if you actually were a mage, would you not need to channel deep with inside of yourself? And that's what you start to feel as you make these sounds. But you're dodging and you're weaving and you're doing these things. At the same time, you can intrinsically feel the work that it takes to draw power from you, and I've never had a more immersive experience. It takes some getting used to, but it also then made me feel much, much more like wow, this is really happening, I really am controlling this world. And that hits on another really important part of games. Simulation has been shown to be a very powerful way for us to deal with reality, so the more real something feels, the more your brain is likely to adopt that behavior as a newer behavior.

Speaker 1:

Yeah, you know as, again, you don't have to do it that way. You can just do the motion constructs and the other things that are in the game and and it's going to work for you, you're going to feel the relief, but as you. If you to feel the relief, but as you, if you draw on to the the breath mechanic, over time you become much more powerful in the game and you also have a much higher likelihood of that same mechanism action being triggered outside the game. And there's nothing wrong with when you take a piece of stress stimuli if the next thing you feel like doing is a deep breath in humming or low tone. I mean that is vagal nerve stimulation and we know that's exactly where we want to get you in moments of stress.

Speaker 1:

And if you do that, you're from an intrinsic motivational point, precognition. Now you've learned it in a very different way. It's not like a talk therapy where a therapist has said to you hey, the next time you feel X, you should think Y. So then I feel X, then I'm like, then I feel probably my initial emotion. Then I remember that the therapist said oh, I should really be here. And I try to build a new construct around an intrinsic precognitive response to stimuli as the stimuli comes in and you just do it and this was built up.

Speaker 1:

If you don't mind, I'll explain kind of the backstory I might've explained we studied so many things on biofeedback, but this one anecdotal story was almost more powerful for the med advisory team than a lot of the studies that we looked at, which you know.

Speaker 1:

We did a massive meta study over 800 breathing studies alone were hyperanalyzed to figure out how to put this all together. But this one story was a was a Marine and I believe he was in Iraq or Iran, but it was around the 2008 timeframe and he was leading his troop Iran, but it was around the 2008 timeframe and he was leading his troop and he made a couple of mistakes. First of all, he had the radio and the leaders and leaders not supposed to have the radio, and he was in the front of the whole group and apparently they're not supposed to be in front of the whole group with the radio. Be that as it may, he was attacked and either stepped on a line in my, but he lost his leg, it was blown off, and in that moment, you know, he was also flooded with this idea. He's done it all wrong and you could see that his troops were about to get into trouble.

Speaker 1:

So he started to take these deep breaths. He calmed himself down, he tourniqueted his leg, he called it in on the radio and then he passed out. When he woke up everybody else was safe and he was alive. Of course he lost his leg, but he's alive. For years people use that story to prove the power of vagal nerve stimulation. We don't really need to talk about the power of vagal nerve stimulation anymore. We're very aware there's a lot of mysteries to how it all works and exactly what's going on, but deep breaths are shown over and over again to be a very calming mechanism. What I love? That our team asked this question. How did he choose to make that?

Speaker 1:

breath, choose to start breathing in a high panic situation and the truth was. He's a Marine, he's been conditioned, he's done the hard work. They've shot live fire over this man and he's been trained and all. But we can't do that to everybody, but in simulation we can put you in a place where we drive your stress level up while you're having a good time. And we've got you with this visual spatial interference so you have not a lot of self-talk and we can promote a learning environment where you learn that that breath absolutely that is what's been compartmentalized.

Speaker 2:

I never made this connection until now.

Speaker 1:

Oh.

Speaker 2:

We work with the army on virtual reality and that training scenario.

Speaker 1:

Oh, interesting For resilience. Yeah, yeah.

Speaker 2:

Think about it, absolutely mental health.

Speaker 1:

Yeah, so I mean, that's exactly, I mean, and so that's where, and here's where I think jeffrey saying is absolutely amazing. So he looks at this whole thing and, as a pro who's done so many new game mechanics, he says this is so new I don't exactly know how people are going to respond to it, so he shadow launches the game. It's actually floating out there already. You know. He's got 500 people in there playing it and he's not kind of tweaking it. He is actively changing a live game, getting ready for what will be the bigger release, based on the feedback that is coming in at the moment. Because this is such a new mechanic, you know, and it's really, really interesting. I, I, I mean this is not something you get to do typically in a medical device environment.

Speaker 1:

You have to do all your clinicals, you have to do all your studies, but this first one, going out as a wellness device for stress, gives us all this flexibility while we work on the back end of the agency for, you know, greater implications for uses down the road, you know, and this to have this, the bravery of this guy because I mean when you know, when you make video games, your titles it's again a lot like making movies your titles and your releases.

Speaker 1:

They are tied to your. You know how you're perceived and what job you're going to be asked to do next and all these kind of things and who are these bad students for?

Speaker 2:

this are there people that shouldn't participate?

Speaker 1:

I mean, if you've got, if you've got deep respiratory concerns, this is, I mean it's it's an active game, you're moving and stuff like that, so a deep respiratory concern is going to be somebody that this wouldn't be for. I mean you can play if you're sort of if you're asthmatic. You can play without the breath mechanic and it's still going to. It's got all of those other great game mechanics in it that are going to run endorphins through you. You're going to feel good, you're going to, you're going to see stress relief. You may not see the same level of resilience as if you were to pull in the biofeedback mechanism over time, but you know, and folks, that if you've dealt with those sort of things that just don't allow you to exercise a lot, this is probably not your, your place. Now we we do have a mobile version that we're looking at releasing at some point that would be much more.

Speaker 1:

Sit down, you just put your headset on again. The beauty of it is. The only piece of equipment you need other than your phone is a headphones with a microphone, you know, and so, and there is, within the game as well, something called the zen garden, and the zen garden doesn't have all the action constructs. It's a place to just go and kind of chill down a little bit. So people could use that portion as well. Yeah, but how?

Speaker 2:

do they get this game?

Speaker 1:

so, unfortunately, you have to have a quest or quest two, so you have to, and that was a tough choice for us. We really wanted to be out in the mobile world where everybody has a phone but honestly, we needed to start in a place where we could drive the most immersive content we possibly could to do the learning we needed to do.

Speaker 1:

We also needed an environment where we could do tweaking and stuff like that. Mobile is not a place to play around. It's a very expensive world to be in. It takes a lot of advertising and promotion.

Speaker 1:

So, starting in a smaller world and with a super supportive group you know that we had with Meta as well. I mean Meta also had to nod to letting this thing into their world. You know, and they've been very careful about their content. You know they're trying to curate the right content in the right place. So all of those reasons led to us starting in vr um also, we wanted to start our platform there and and I mean the agency work that we were doing behind some of the mechanics that are in this game and other games that we're trying to submit and get the the fda to approve a software development kit which would allow developers to make games like this. So we're not just like trying to make a thing, we're trying to make an ecosystem where people can do this, because it's going to take a lot of games yeah I mean, you're going to need to stay actively engaged, so this one will take you somewhere, but maybe after a while you're like I don't want to do that anymore.

Speaker 1:

We have to have another option. So you know that also allowed us to work on a software development kit in a very you know closed environment early on, which was important for testing and those sorts of things, and it looks like VR is going to be the first reimbursable gaming platform as well. There's they're very close to close to the reimbursement code now. So that's huge to accessibility as well.

Speaker 2:

Do people go to your website to sign up, or do they?

Speaker 1:

Yeah, I mean if you have a quest, it's right there in the game tab called Zengence. There's no other word like Zengence. You'll find it very quickly.

Speaker 2:

Remind them of your website.

Speaker 1:

Yeah, it's deepwelldtxcom, so that's another place you can look at these on the intro as well yeah, and I mean I'm very findable on linkedin, I'm.

Speaker 1:

I put one post out every day to share how all this works, share all the data. We've open sourced all of this. So, uh, we're just now all those posts, risa are being being organized into a website and we're realizing that I've put out between five to 600 different articles. So there's, I mean, as it came up to us, like during the development process, if I was deeply into the biofeedback mechanism and vagal nerve stimulation, I was talking about that. If I was, you know, deeply into the, the visual spatial interference, I was pointing back to those. If I was deeply into the violence portion of the situation, I was pointing to those articles. So there's a whole it's probably a textbook's worth of, you know, but it all has crib notes, everything we've posted. You know.

Speaker 2:

I give a nice short summary if you don't want to read I think any research you can provide, well, we'll provide the links to it yeah, once that's up, I'll get that it's it's quite of a turns out.

Speaker 1:

Getting stuff off of linkedin and, like your old content is not very easy, so they're, they're kind of scraping it all back through, uh, so we but, yeah, we'll have it out there as a developer's resource, also as a clinician's resource, to better understand this thing that I believe will end up being called immersive medicine. I think we're standing on the precipice of media being used, and specifically, gaming is a great aspect as a companion to many other medical devices and even pharmaceuticals as well. I think you're going to see that dosages of drugs. In certain cases, this is already happening. Deepwell's not doing this, but there are other companies right now that are working on. If you play this game, you might need less of this drug or these allow.

Speaker 1:

They balance you out one another, and I certainly think we're going to see that more in other medical devices as well. Deepwell's been approached several times already to look at other folks that have digital therapeutics or other medical devices that are having maybe challenges with compliance or aren't getting all of the therapeutic response they were looking for or the adherence they want, and so I think you're going to see this become a very intrinsic part of medicine over time.

Speaker 2:

Are you still inviting collaborators?

Speaker 1:

medicine over time. Are you still inviting um collaborators? Absolutely, um, right now, I mean, what? What? Uh, jeffrey's really doing this right now. Check this out. I think this is amazing.

Speaker 1:

We've had some people that have come, they've got into the game, they're playing and they're helping evolving it so much that our players are going to end up some of them listed in the credits of the game because they are that involved with the, the, the evolution of this mechanic. You know. So we're always always looking for people to help. We can't always. Sometimes we get a lot of inquiries even in a week and we can't funnel everybody into a meaningful place right at one time. But but absolutely, you know, and we certainly keep track of everybody who wants to collaborate too.

Speaker 1:

You know the thing about getting a product out and you know this is is you got to get kind of hyper-focused for a period of time too. So we really are in that get this one out. So right now, the collaboration we need is we need people to play and give us the feedback positive, negative just be part of this evolution of these new mechanics so we can get them as right as possible for people we're going to try to bring as many people to you as we can thank you very much our time is on myself.

Speaker 2:

Is there anything else you want to share before we end?

Speaker 1:

I want to share how happy I am to see you again, how much I love to be here with you. I love our discussion you know, I just uh, you know I, I think all the way back to our first talk and, and you know, I just read your book and you know I was inspired by that one. Uh, I mean, this has been a very difficult journey.

Speaker 1:

You're on theresa and the way that you're approaching to tell people at that point in time I had just finished hiking the camino to santiago yeah, you had no vision for this coming how fast our world can change yeah, and that's what in that mental resilience that you've brought to it this is what I was talking about is you know you've changed with it instead of pushed against it. You know you push against your disease. I see that and you're you're you've got hope it instead of pushed against it. You know you push against your disease. I see that and you're you're you've got hope, and I think that's amazing and you're pushing towards getting better, and that's you know. But you're also not waiting to be better to. You're still doing.

Speaker 1:

I can't write yeah and I, I uh, wow, I just I'm I'm pretty amazed by it and pretty honored to be with you here, thank, you.

Speaker 2:

The feeling is mutual, Ryan. I love your work and we're going to keep up with you.

Speaker 1:

Thank you so much for that.

Speaker 2:

So let me know how it goes For all of our followers. Thank you for joining us. All of our followers, thank you for joining us. We will have all the links in the bio and you can reach out to me, but we'll also have Ryan to contact info. Thank you, ryan, and we'll conclude our session.

Speaker 1:

Thank you very much, and I want to end by thanking everybody that's contributed to Deep Well. There's been I mean, it's an amazing amount of people that have shown up, the vast majority of which have volunteered their time and energy to put this whole thing together.

Speaker 2:

Don't people want to help? I'm finding that I have an outpouring of support. They want the help.

Speaker 1:

If we would have had to pay for all the expertise that we have, we couldn't have pulled this off the way we have. I mean, we've raised small money. I mean it's not a big market yet. I believe it's going to be an amazingly huge market. But folks, you know, they have felt this, whether it's the connection to mental health, the connection to gaming, the connection to accessibility to care, um, you know, so we've we've had just an amazing outpouring of help and, uh, you know, we're so lucky to work with the people we work with, so, and they have not stopped. It's been three plus. We thought we're going to get this done in a year. Three plus years of banging through it and and um, and now here, you know, we're going to have this first thing out on the 13th and and I'm so excited for the team and for us to to have this in the world and have it be the stepping stone to what, what comes next keep up the wonderful work and thank you again.

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Teresa Spangler

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