Using Deepfakes In The Treatment of PTSD and Chronic Grief

Overview

Over the past few decades, the incidence and prevalence of mental disorders have skyrocketed, which is attributed by some experts to the stressful lifestyle of modern society. (1)  According to the Canadian Mental Health Association (CMHA), one in five Canadian will go through a mental health issue in any given year. (2)

The CMHA also reports that by the age of 40, approximately 50% of the population would have dealt with some form of mental illness. (2)  By far, conditions such as major depressive disorder (MDD) and generalized anxiety disorder (GAD) are the most prevalent; however, other mental illnesses are also a major source of concern, including post-traumatic stress disorder (PTSD), bipolar disorder, and to a lesser extent, pathological grief. (3)

When it comes to PTSD, veterans are especially vulnerable to this condition due to the major exposure to traumatic events. According to reports, 23,792 Canadian veterans were diagnosed with PTSD in 2019 alone. (4)  However, PTSD is not an exclusive ailment to soldiers, as being part of any traumatic incidence can trigger this disorder, including car accidents, history of abuse, work-related injuries, and more. (5)  Despite the relative advances made in the field of mental healthcare, researchers are still looking for innovative approaches to manage patients and avoid the use of pharmacological drugs due to their heavy side effect profile. (6)

In this article, we will discuss the potential use of a cutting-edge technology known as Deepfakes in the treatment of PTSD and grief.

What are Deepfakes?

Deepfake technology focuses on manipulating existing videos or images to produce synthetic media content. (7)  The idea behind this technique is to utilize machine learning and artificial intelligence to synthetically create and edit a video of a real person talking or performing a certain act, which is astonishingly advanced relative to conventional editing technology (e.g., Photoshop, video-editing software). (8)

Unfortunately, Deepfakes have gained a bad reputation due to its illicit use in wrongful acts by rogue individuals. (9)  In reality, the technology of Deepfakes is quite impressive and can be used in the field of psychotherapy to help patients with mental disease, which we will discuss in the next sections.

Post - Traumatic Stress Disorder (PTSD) and Grief

Post-traumatic stress disorder, or PTSD, is included in a new category called ‘Trauma- and Stressor-Related Disorders’ in the Diagnostic and Statistical Manual of Mental Disorder V (DSM-V). (10)

As the name implies, PTSD gets triggered after going through a traumatic event that significantly ranges in severity.  Experts have been able to pinpoint some common risk factors for PTSD (11), which include:

• Stressful careers (e.g., police officers, medical professionals)
• Childhood abuse
• Sexual assault (e.g., harassment, rape)
• Domestic abuse
• Violent assault
• Substance abuse
• Disasters (e.g., earthquakes, tsunamis, flooding, hurricanes)
• Medical history of other mental illnesses (e.g., MDD, GAD)
• Family history of PTSD

The management of PTSD focuses on pharmacological drugs (e.g., anxiolytics, mood stabilizers, antipsychotic medications) and psychotherapy (e.g., cognitive behavioral therapy, exposure therapy). (12)  Unfortunately, many patients relapse after a while, which is why PTSD is considered problematic in the field of psychiatry. (13)

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Oftentimes, grief is conveyed as a natural process that most humans go through during a certain phase of their lives when they lose a loved one.
While this statement is true, not all people experience grief the same.  According to DSM-V, persistent complex bereavement disorder (i.e., prolonged grief disorder) is defined as the yearning/longing for the loved one and getting preoccupied with the deceased and its circumstances for at least 12 months. (14)  Unlike normal grief, these patients are in a constant state of emotional suffering that may precipitate suicidal ideations and death.

In one study published by JAMA (15), researchers evaluated the complexity and available treatment options for persistent complex bereavement disorder and concluded that “Individuals with complicated grief have greater risk of adverse health outcomes, should be diagnosed and assessed for suicide risk and comorbid conditions such as depression and posttraumatic stress disorder, and should be considered for treatment.”

In other words, this condition could lead to debilitating complications if not treated promptly.

How Will Deepfake Technology Help?

In psychiatry, patients with PTSD and persistent complex bereavement disorder are treated with a combination of pharmacotherapy and psychotherapy. (16)
Oftentimes, this entails exposure therapy, where the patient goes back to the site of the accident or imagines him/herself in the presence of the abuser to gain back control over the situation.

Combining pharmacotherapy and psychotherapy is now the gold standard approach.

Using Deepfakes to treat these conditions will take exposure therapy to the next level by creating synthetic media content that’s generated using a computer and controlled by an operator to allow patients to have therapeutic conversations with their abuser, a friend who died in a car crash while they were driving, a deceased loved one where the last conversation ended on bad terms, and more.

The use of this technology in the field of psychotherapy has never been tested, but we believe that implementing Deepfakes in advanced exposure therapy could be The Next Breakthrough in Psychotherapy.

This innovative technique has no side effects and helps create virtual situations in a controlled, safe environment.  Similar techniques have been used before to treat anxiety and PTSD, including virtual reality exposure therapy (VRET). (17)  In one meta-analysis, researchers analyzed the results of 10 studies to review the efficacy of VRET in the treatment of PTSD. (18)  They concluded that “VRET proved to be as efficacious as exposure therapy. VRET can be particularly useful in the treatment of PTSD that is resistant to traditional exposure because it allows for greater engagement by the patient and, consequently, greater activation of the traumatic memory, which is necessary for the extinction of the conditioned fear.”

The last sentence of this conclusion is crucial to understand the potential of Deepfake therapy, as it significantly increases the engagement of the patient with the traumatic event to help alleviate the associated memory.

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Deepfakes have a massive potential in the field of psychotherapy to assist patients with mental illnesses and accelerate recovery.  Hopefully, this article managed to shed some light on the uses of Deepfakes in mental health, but if you want to learn more or if you have any questions and/or concerns, please do not hesitate to reach out to us and learn how Delsec Human Security can help you and your community.

References
1- https://apps.who.int/iris/bitstream/handle/10665/272735/9789241514019-eng.pdf?ua=1
2-https://cmha.ca/fast-facts-about-mental-illness
3- https://www.uptodate.com/contents/posttraumatic-stress-disorder-in-adults-epidemiology-pathophysiology-clinical-manifestations-course-assessment-and-diagnosis
4-https://www.veterans.gc.ca/eng/about-vac/news-media/facts-figures/8-0
5- Bryant, R. A. (2019). Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges. World psychiatry, 18(3), 259-269.
6- Harvey, A. G., & Gumport, N. B. (2015). Evidence-based psychological treatments for mental disorders: Modifiable barriers to access and possible solutions. Behaviour research and therapy, 68, 1-12.
7- https://lab.witness.org/projects/synthetic-media-and-deep-fakes/
8- Kietzmann, J., Lee, L. W., McCarthy, I. P., & Kietzmann, T. C. (2020). Deepfakes: Trick or treat?. Business Horizons, 63(2), 135-146.9- https://theoutline.com/post/3179/deepfake-videos-are-freaking-experts-out
10- Santiago, P. N., Ursano, R. J., Gray, C. L., Pynoos, R. S., Spiegel, D., Lewis-Fernandez, R., ... & Fullerton, C. S. (2013). A systematic review of PTSD prevalence and trajectories in DSM-5 defined trauma exposed populations: intentional and non-intentional traumatic events. PloS one, 8(4), e59236.
11- Tang, B., Deng, Q., Glik, D., Dong, J., & Zhang, L. (2017). A meta-analysis of risk factors for post-traumatic stress disorder (PTSD) in adults and children after earthquakes. International journal of environmental research and public health, 14(12), 1537.
12-Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258.
13-Martenyi, F., Brown, E. B., Zhang, H., Koke, S. C., & Prakash, A. (2002). Fluoxetine v. placebo in prevention of relapse in post-traumatic stress disorder. The British Journal of Psychiatry, 181(4), 315-320.
14-Boelen, P. A., Spuij, M., & Lenferink, L. I. (2019). Comparison of DSM-5 criteria for persistent complex bereavement disorder and ICD-11 criteria for prolonged grief disorder in help-seeking bereaved children. Journal of affective disorders, 250, 71-78.
15-Simon, N. M. (2013). Treating complicated grief. Jama, 310(4), 416-423.
16-Huhn, M., Tardy, M., Spineli, L. M., Kissling, W., Förstl, H., Pitschel-Walz, G., ... & Leucht, S. (2014). Efficacy of pharmacotherapy and psychotherapy for adult psychiatric disorders: a systematic overview of meta-analyses. JAMA psychiatry, 71(6), 706-715.
17-Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258.
18-Gonçalves, R., Pedrozo, A. L., Coutinho, E. S. F., Figueira, I., & Ventura, P. (2012). Efficacy of virtual reality exposure therapy in the treatment of PTSD: a systematic review. PloS one, 7(12), e48469.