Exploring the Link Between Self-Esteem and Delusions: Oxford University's VR Experiments Shed Light

The last beep of the metro doors closing echoed, and just as I stepped in, the doors shut behind me—I had barely made it. My anxious heart settled for a moment, but only for a moment.

After catching my breath, I realized how disheveled I must look. My hair, hastily gathered, probably resembled an Angry Bird from my sprint; my shoulder bag had skewed around to my stomach, resembling a fanny pack; and sweat was seeping through my clothes. I felt like an unwelcome guest intruding into the personal space of the other passengers (although this space belonged to no one in particular, or perhaps to everyone).

I began to suspect that the smiling student on her phone in front of me was amused by my appearance; the man leaning against the door was giving me a once-over; and someone behind me chuckled, possibly at my Angry Bird hairstyle...

Paranoid Delusions Are Common and Closely Linked to Schizotypal Disorders

Experiences like mine—overinterpreting or being overly concerned with the gaze of others—are not uncommon. According to a survey by Professor Daniel Freeman, a clinical psychologist at Oxford University, one-third of 1,200 students had experienced paranoid delusions, and more than half were suspicious enough to feel the need to be constantly on guard against others, impacting their mental health.

While most paranoid delusions are harmless, they can be a sign of schizotypal disorders. Professor Freeman's research at Oxford University indicates that paranoid delusions are widespread in contemporary society, especially in the context of the COVID-19 pandemic and the prevalence of conspiracy theories.

Traditionally, psychiatrists have relied on questionnaires and interviews to diagnose paranoid delusions, which not only test the patient's expressive and linguistic abilities but also cannot rule out the possibility that their delusions might have a basis in reality (perhaps the neighbor who the patient believes is constantly watching them is indeed a voyeur or another paranoid individual). Consequently, researchers at Oxford University have turned to virtual reality (VR) for answers.

VR Experiment: Simulating the Experience of Being Watched

In an experiment led by Daniel Freeman, 100 men and women were equipped with VR headsets and entered a simulated subway environment with virtual passengers designed to breathe and react randomly. If the participants looked at them, the virtual passengers would respond with a smile, enhancing their self-awareness.

After the four-minute experiment (equivalent to the duration between two subway stops), the team asked participants about their impressions of the virtual passengers. Some perceived the smiles as friendly, akin to those of ordinary people they might encounter in real life, while many others thought the virtual passengers were unfriendly or even hostile:

"One person was aggressive, as if they wanted to intimidate me."

"A woman laughed when I walked by."

"Someone looked sneaky, as if they were preparing to do something, like attack someone."

Subway passengers in the experiment. But it seems like there’s a bit of an uncanny valley effect? (Source: OXFORD UNIVERSITY)

Freeman then pondered whether paranoid delusions are related to negative feelings about self-esteem. He designed another VR experiment with a manipulated variable—reducing the participants' height. Studies show that we tend to overestimate our height, and the more powerful people are, the more they overestimate it.

In the experiment, participants took two virtual subway trips: one at normal height and another with a changed perspective to simulate being shorter (participants were unaware they had been "shrunk"). The results showed that when "shrunk," people felt more inferior, weaker, and were more likely to develop paranoid delusions, such as believing someone in the carriage was staring at them, affecting their self-esteem.

The research team thus confirmed that paranoid delusions are related to negative self-perceptions and mental health.

The headset used by Freeman’s team for their experiments (it feels very heavy). (Source: OXFORD UNIVERSITY)

Beyond Paranoid Delusions, VR Can Also Be Applied to Anorexia and Hoarding Disorders

This study was completed as early as 2008, but Daniel Freeman, sensing an increase in public paranoid delusions post-pandemic, continues to invest in related research. He has published a book and hosts the BBC podcast "A History of Delusions," which discusses mental health.

With VR, the research team has obtained the clearest experimental evidence of paranoid delusions to date. VR also allows researchers to recreate problematic situations repeatedly, extending to anxiety disorders, schizotypal disorders, eating disorders (such as anorexia), and substance addiction (like alcoholism).

Freeman has used his research findings to establish Oxford VR, a spin-off company from Oxford University, which uses VR to simulate scenarios related to mental health, helping patients build confidence and self-awareness. There is already a Social Engagement™ program for patients with anxiety-related social avoidance. Coupled with previous introductions of VR applications in treating anorexia and hoarding disorders, as well as using VR horror games to alleviate anxiety, it seems that VR has boundless prospects in cognitive psychology and related treatments.

The Oxford University VR experiments offer a glimpse into the subtle and profound connection between paranoid delusions and self-esteem. This research not only challenges traditional understandings of mental health but also opens a new chapter in exploring the mind through technology. As for me, reflecting on my subway moment of delusion and scrolling through my Instagram stories, I realized that I might have been adjusting to a new haircut at the time—well, in regret.

In reality, most people on the subway are probably too preoccupied with their own phones to pay me any attention.