1994 VR Conference Proceedings

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Telepresence: Future Prosthetic Working Environments for Agoraphobic Professionals

By: John Lenarcic
Department of Software Development
Monash University, Victoria, Australia


The crippling psychological disorder known as agoraphobia is profiled and the palliative application of telepresence systems is suggested as a means by which sufferers of the condition could possibly lead more productive working lives. Telepresence systems, such as shared media spaces, are a manifestation of Virtual Reality in which users in remote locations can collaborate on shared tasks via human-computer interfaces. A brief overview of these systems is provided.


Research initiatives aimed at developing enabling technologies to extend the latent talents of the physically disabled in the workplace are indeed worthy ventures, one example being Virtual Reality or VR. In its most advanced form VR can be regarded as being a computer-generated three-dimensional environment (referred to as either a cyberspace, a virtual world or a virtual environment) in which users when appropriately interfaced, appear to be totally immersed and can interact with simulated physical elements or other users sharing the system (Rheingold, 1992).

VR users generally wear miniature video display units mounted either in goggles or a helmet that provide 3-D stereoscopic viewing of virtual worlds. Users may navigate through such virtual environments and are empowered with the ability to manipulate simulated physical objects using special glove input devices. The latter input devices can also be used for gesture-based communication with other inhabitants of the virtual world. Various subcategories of VR exist at different levels of sophistication that do not necessarily require the full complement of exotic input/output apparatus, an illustration of this being the so-called "Desktop VR" systems (Arthur, 1992). Telepresence is a computer-based system in which users can experience real, often group-based, working environments in geographically remote locations via specialised interfaces that are appropriately networked. As a technology it is often placed under the VR umbrella and the term itself was originally coined by Artificial Intelligence pioneer Marvin Minsky, as stated in Rheingold (1992).

Scott (1992) speculates that VR has the potential to greatly benefit individuals with physical disabilities, listing educational aids, environmental navigation devices and augmentative communication systems as being suitable projects for future investigation. However, the suggested palliative VR systems so far have not been directed to any great extent toward those afflicted with debilitating psychological disorders, perhaps due to the subjective nature of mental ailments in general.

Arthur (1992) proposes that VR-based behaviour modification techniques could be employed to relieve the symptoms of phobias and other anxiety disorders. The idea is that a virtual world could be created that gradually confronts a phobic individual with their particular set of fears. The individual would hopefully learn to maintain control of the situation whilst the severity of the phobic stimulus was adjusted under the supervision of a psychotherapist. VR systems of this kind are already being developed for clinical psychologists by the commercial sector - in particular, Force Four Learning Systems based in Michigan USA - according to Aukstakalnis and Blatner (1992). Sherman and Judkins (1992) report that a similar VR system is also under development at the British-based Advanced Robotics Research Centre attached to the University of Salford, in collaboration with the Universities of Edinburgh and Leeds. It is claimed that this project's goal is to create "virtual spiders" as an aid in the cure of arachnophobia! None of these VR systems would appear to be in use at this time, no doubt due to the stringent evaluation procedures that such a system would have to undergo. With this in mind, Whalley (1993) offers some trenchant comments on the ethical issues raised in the application of VR to the treatment of mental disorders, warning against the blind acceptance of any "pseudo-scientific" therapies that may be deceptively packaged in new technological media.

Following a brief overview of the anxiety disorder known as agoraphobia, this paper will examine ideas on how telepresence technologies could empower agoraphobic professionals by providing them with active "prostheses for the mind" to foster more productive working lives. One particular focus will be on the possible uses of shared media spaces by graphic designers with this phobic condition.

What is Agoraphobia?

Agoraphobia is a poorly understood psychological disorder with the capacity to induce genuinely traumatic and handicapping emotional states (Gournay, 1989). It is a surprisingly common phobic syndrome characterised by fearful sensations and subsequent panic attacks - often triggering each other in varying degrees of severity. Although the exact incidence is difficult to assess, one typical estimate of the frequency of the condition is cited in Vines (1987), namely a 1985 National Institute of Mental Health survey in the USA indicating that more than 25 million Americans suffer from some kind of phobia (i.e. 10 per cent of the population) with about 15 million of these being agoraphobic (i.e. 6 per cent of the population).

Agoraphobia is often misunderstood by laypeople as merely being a fear of open spaces. A more accurate definition would be a fear of being in places or situations from which it is perceived that a quick exit might be physically difficult or socially embarrassing. Sufferers experience a sense that they lack control over self, resulting in a loss of self-confidence. Feelings of alienation are common, as well as a strong sensation of "unreality" in the environment being perceived. Physical complaints induced by the anxiety of a panic attack are often noted. An alternative, albeit recursive, view of agoraphobia is that of being a fear of fear or panic attacks, thus implying that it is a kind of "meta-phobia" (Vines, 1987; Emmelkamp, Bouman and Scholing, 1992). While many researchers believe that the environment plays only a symbolic role in phobic conditions, McNab (1993) argues that certain configurations of structures, objects or events in surroundings could act as anxiety-provoking stimuli via perceptual interactions that are as yet undefined.

The intense anxiety connected with the disabling mental condition of acute agoraphobia often imposes travel restrictions upon the afflicted, thus hindering their professional lives. Some agoraphobic individuals need a companion for peace of mind when venturing away from home, while others are sentenced to virtual self-imprisonment within the confines of their own home.

How can Telepresence benefit the Agoraphobic Professional?

The opportunity to fulfil one's career objectives by working from home has long been a cherished dream by some, especially for those with family commitments that would make daily commuting to a geographically remote office difficult. Tazelaar (1986) notes that working at home with computers is often the only option available for many physically disabled persons who wish to lead productive lives. For agoraphobic professionals the ability to work from home may be both a necessity and a means by which self-esteem can be raised.

A panoply of essentially synonymous terms exist to define the technical concept of systems permitting multimodal, group-based interaction at a distance: Telepresence, Groupware, Shared Media Spaces, Cooperative Hypertext, Computer Augmented Teamwork and Computer-Supported Cooperative Work or CSCW, to name but a few (Baecker, 1993; Bostrom, Watson and Kinney, 1992; Grantham and Nicholls, 1993; Greenberg, 1991; Johansen, 1988; Marca and Bock, 1992).

Telecommuting, or teleworking, is the "plain vanilla" personal computer-based version of working at home using the existing (or soon-to-be-improved) telecommunications network infrastructure. (To confuse matters further, Sherman and Judkins (1992) use the term "virtucommuting" when referring to telecommuting with the aid of VR paraphernalia.) Telecommuting is at present a growth industry both in the USA (Arthur, 1994; Rheingold, 1994) and in Australia (Lynch, 1994). In 1994 the local prominence of teleworking was made apparent by the negotiation of a landmark industrial relations award that protects the rights of teleworkers in the Australian Public Service.

According to Gold (1985), figures attributed to the US Department of Labor indicate that there are an estimated 133,000 graphic designers in the USA, with almost half of them being self-employed. In the early stages of their careers, most freelance designers work from a home office which can be subject to the problems of being remotely located. Shared media spaces are an example of telepresence systems that could be of benefit to graphic designers suffering from agoraphobia. These systems are computer-controlled multimedia spaces in which writing or drawing tasks can be shared along with human communication signals.

Krueger (1991) recounts pioneering efforts in the development of computer-controlled responsive environments that can create an "artificial reality" in which a working space can be shared by participating users without the need for cumbersome personal VR input/output devices. One prototype system covered in the latter expose is VIDEODESK, an environment dedicated for sophisticated teleconferencing sessions involving gesture-based interactions that are tracked via video cameras. More useful for the graphic designer would be a shared media space incorporating multimodal interaction (e.g. speech and gestures) integrated with drawing tools for real-time creation of preliminary sketches and/or rough layouts suitable for display in meetings with geographically remote clients. Such a system should also permit clients to interactively annotate or alter the embryonic design materials shown to them.

Lakin (1986) observes that the visual communication exemplified in the structured doodling of blackboard activity constitutes an informal kind of conversational graphics that acts as an important information conduit in certain group-based tasks. Extensive research, particularly at Xerox PARC, has been undertaken to develop variations of electronic whiteboards (or blackboards) on which remote collaborators can draw or write, often in conjunction with an audiovisual system that also allows the integration of speech and body language into the communication channel (Elrod, Bruce, Gold, Goldberg, Halasz, Janssen, Lee, McCall, Pederson, Pier, Tang and Welch, 1992; Ishii and Kobayashi, 1992; Minneman and Bly, 1991; Tang and Minneman, 1991). Whittaker, Geelhoed and Robinson (1993) describe an empirical evaluation of a shared media space used for text-based and graphic design tasks, observing that greater communication efficiency is achieved for a workgroup in such an environment.


The time is ripe for experimentation with existing telepresence technologies, in the guise of shared media spaces, to determine their potential as a partial panacea for the agoraphobic professional. Any such experimental activity would no doubt have to address complex ethical issues first. (e.g. If telepresence systems for agoraphobics are designed merely as "safe havens", are they not cruel substitutes for reality if no ultimate cure for the malady exists? Would such systems actually make agoraphobics feel more alienated and increase their feelings of unreality?)

However, before any of these exotic telepresence systems gain mass acceptance many technical problems have to be overcome to improve their effectiveness. For example, Whittaker, Geelhoed and Robinson (1993) claim that better integration of synchronous and asynchronous communication technologies would be advantageous. Current prototype systems are also too cumbersome in the apparatus that is required for use. "Nonchalant" interfaces are needed that are intuitive, unobtrusive and commonplace, such as those proposed in the ubiquitous computing research agenda (Weiser, 1993a; Weiser, 1993b).


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