Copy of an article by Gorini e al on role played by three-dimensional (3-D) virtual worlds in eHealth applications. Below, the abstract, and at the bottom of the page, the link to the complete PDF article.

Abstract

The aim of the present paper is to describe the role played by three-dimensional (3-D) virtual worlds in eHealth applications, addressing some potential advantages and issues related to the use of this emerging medium in clinical practice. Due to the enormous diffusion of the World Wide Web (WWW), telepsychology, and telehealth in general, have become accepted and validated methods for the treatment of many different health care concerns. The introduction of the Web 2.0 has facilitated the development of new forms of collaborative interaction between multiple users based on 3-D virtual worlds. This paper describes the development and implementation of a form of tailored immersive e-therapy called p-health whose key factor is interreality, that is, the creation of a hybrid augmented experience merging physical and virtual worlds. We suggest that compared with conventional telehealth applications such as emails, chat, and videoconferences, the interaction between real and 3-D virtual worlds may convey greater feelings of presence, facilitate the clinical communication process, positively influence group processes and cohesiveness in group-based therapies, and foster higher levels of interpersonal trust between therapists and patients. However, challenges related to the potentially addictive nature of such virtual worlds and questions related to privacy and personal safety will also be discussed.

To read more: Article in PDF.

Published in Journal of Medical Internet Research, 2008 • www.jmir.org

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Psychotherapy on a pixel beach and endurance tests in a virtual airplane: US scientists are successfully curing alcoholics in the online world of Second Life. They will soon publish the first results of their research. SPIEGEL ONLINE accompanied a patient to therapy.

In her first life, Shelly (not her real name) was often drunk. On the day of her niece's wedding, she downed half a bottle of vodka and took a strong painkiller. Just before the ceremony, while sitting in a white pavillion with a baby in her lap and in a complete daze, she suddenly slipped from her chair and the baby fell to the ground. Someone grabbed her by the arm and put her in a taxi. Shelly looked up and saw her mother, who she then pushed away. She says that she would have preferred to keep on drinking herself into oblivion.

Shelly has been dependent on alcohol since she was 16. Now 44, she has been undergoing a unique form of therapy for the past year. She is a patient at the Accelerated Recovery Centers, the first treatment program for the alcohol dependent and alcoholics that integrates the online world Second Life into the therapy concept. Patients are treated in Atlanta and on Identity Island, a place that only exists in the virtual world. In Second Life, patients engage in individual and group conversations and undergo special training programs that teach them to resist alcohol, even in stressful situations.

For the past nine months, roughly 100 alcoholics and a dozen psychologists have met for conversations on Identity Island. The company plans to publish the results of the test phase soon. According to Accelerated Recovery, the study strongly suggests that the incorporation of virtual worlds can significantly improve addiction treatments.

Shelly slips into her flip-flops and leaves the pixel beach. She heads up a stone path, walking past streetlights, birch trees and yellow bushes, and then enters a large house. In one of the rooms, there are two brown leather sofas placed at right angles to one another. In front of the sofas is a wooden table with a strange bronze statue standing on it. A slim and darkly tanned avatar, as the pixel denizens of Second Life are known, with long black hair sits on one of the couches. "Hello Shelly," says the real person behind the avatar. "Welcome to therapy."

'Like Going to Confession'

The room with the bronze statue in it actually exists in real life. What Shelly sees on Identity Island is an exact replica of a room in Atlanta where therapy sessions are held. The man behind the avatar is David Stone, the founder and managing director of Accelerated Recovery, and a practicing psychologist for the last 20 years. The resemblance between Stone and his avatar -- and between Shelly and hers -- is striking.

This similarity creates tension between proximity and distance. On the one hand, the patient and the therapist are close to each other in the virtual world, conversing in a familiar environment and looking at familiar faces. On the other hand, they are physically separated, which makes it easier to talk about more intimate matters. "It's almost like going to confession," says Stone. "The clients tell their problems through their avatars like the Catholic tells his sins through a curtain."

Just as in a confession or a real-life session with a therapist, the meetings in Second Life are completely confidential. The only way a patient, or anyone else, can reach Identity Island is through Accelerated Recovery. In fact, the area is even off-limits for Linden Lab, the creators of Second Life.

Shelly is now sitting on the brown sofa, diagonally across from her therapist. Stone leans back and his avatar's upper body seems to disappear into the virtual leather of the couch. Shelly, her back hunched and her hands resting on her thighs, talks about what happened at the wedding.

Finding Courage in Second Life

Shelly tells the therapist about how she started drinking again the day before the wedding after she found out that her brother would be there. She talks about how she reproached her brother for cheating on his wife, and how he threatened her with physical violence. She felt terrible after the wedding, she says, and she continued drinking out of shame, and then felt even worse afterwards. The family, she tells Stone's avatar, blamed Shelly for everything until she believed that it was all her fault, even though much of it wasn't.

Shelly stopped drinking half a dozen times and started up again just as often -- a common pattern among alcoholics. The National Institute on Alcohol Abuse and Alcoholism in the United States estimates that 65 percent of American alcoholics will fall off the wagon at some point, most of them in the first year after alcoholism treatment. The estimated relapse rate in Germany is about 50 percent.

Volker Weissinger, the head of Fachverband Sucht, a German professional association for addiction treatment programs, concedes that virtual therapy has the potential to reduce the recidivism rate. Nevertheless, he is largely critical of the Second Life platform. "Most alcoholics relapse as soon as they try to get back into their daily routines," he explains. "It is important that they receive quick help in stressful situations. A virtual contact point where patients can get help at any time, no matter where they are, would be a valuable, additional component."

Shock Therapy in a Virtual Airplane

Although Shelly is only involved in discussion therapy on Identity Island, the virtual world offers other treatment options. For instance, there is a airplane simulator on Identity Island that Shelly could board. Inside the plane, passengers can hear the roar of the engines and see the lights flickering in the cabin as the virtual flight passes through turbulence and passengers are pushed roughly against their seats. A smiling flight attendant stands in front of the cockpit. Those who click on the flight attendant and press the right mouse button receive a drink to calm their nerves: whisky, beer, vodka and soft drinks hidden between alcoholic beverages.

Source: Spiegel Online

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From a spiritual perspective (at least mine...), we are eternal beings making vast array of physical experiences, in various time frames, dimensions, and parallel realities, all of this simultaneously. Some call that different lifetimes. The key point here is simultaneity: the various time frames (lifetimes) are like different areas of experience of the soul. They are connected, fundamentally interlaced. What happens in one scene affect all other scenes, in and out of time.

Our souls interact in various theaters of experience, physicality being one of these theaters. The more intense the experiences, the richest the learning for all aspects involved.

Biochemical nature of reality
When we create an image of an event in our mind, the brain does NOT make the difference between the image and the actual event. A good example is sexual fantasy. The body is flooded with the same endorphins if we imagine a sexual intercourse or if we do it physically. The same goes for any trauma, grief, joy, bliss. The key point is that we are spirit imagining a physical experience, and then manifesting it. Yet the manifestation is optional. The experience and its endocrinian effects are the same in imagination or in physicality. Same rush of adrenaline, seratonin or other endorphins, these catalysators of the feelings of being alive in a body...
Same experience, then, and ... it all happens in the mind.

Imagination never leaves the mind

In a world saturated with obligations, conditions and prohibition of all sorts (understand Real World, whatever that means...), in a society governed by penitentiary set of rules, it is difficult to really go through the experiences one needs to achieve in order to expand consciousness and become spiritually free. We are constantly inhibited, persecuted, brought back into the illusion of official normality. Hence the numerous life times needed to learn the simplest of things: being essentially all one and only one Mind, what you do to others you do to yourself...

So in our societies, we have several fuses to prevent the explosion of these unattended and socially unspeakable impulses and deep needs of freedom. The movies and video games hitting the market today are a good illustration of these fuses - kill-kill-fuck-fuck.... It does help to keep the global unattended emotions and impulses at a “reasonable” level, where they will not threaten the consensus of comfort and so-called respectability.

Yet these impulses, desires and fundamental needs of freedom - (our real nature we are trying to own back) are all images issued from the mind, experienced in the mind and remaining in the mind, until they are transcended and transformed into wisdom - awakening.

Could virtual environments have healing potentials?
The main reason for accepting social programmation - I should say castration of our creative and free nature – is simply survival, physical, emotional or social survival. If you don’t behave, you are left aside if you are lucky, banned or killed if you are not.
However, if there is no danger of loosing your life or your reputation, if the worse that can happen is having to create a new account, opportunities emerge to experience new, outrageous or undreamed aspects of yourself with much, much more freedom and easiness. Nothing new here, you will say... and I agree.
However, the implication of this new medium of relationships and experiences may be underestimated... Nothing leaves the mind, right? All experiences are of the mind, by the mind, between aspects of the mind... So the experiences made in virtual environments are as valuable as the physical ones...
Virtual environments provide fields of experimentation, just like any other framework of incarnation... These virtual frameworks are as valid as any other for solving issues, testing behaviors, sharing love...
It produces the same rewards than any other framework.
In this sense, virtual environments or what they will become in the future may be a unsuspected booster for our collective evolution, not to mention the obvious business potential that is gradually being recognized.

New synaptic connections in the global brain
One more aspect of these new virtual environments must be mentioned. The rapid development of the technologies of information - that started to explode in the early 20st century - has had a tremendous impact in our societies. It is just the beginning. The telephone and the airplane have transformed our our world profoundly. Then internet has boosted even more this transformation, adding a layer of immediacy and freedom to human interactions. This alone has transformed our world irremediably.

With Second Life and the other emerging 3D environments, a medium emerges that can carry emotions, feelings and yes - intuitions, in an even more immediate way. People are in presence of each other. It is real. This new mode of interaction may transform human interactions profoundly.

There is a striking analogy between the development of intelligence in the human brain and the development of the global intelligence of mankind: it amounts to the number of synaptic connections. In the brain, synaptic connections occur with new understandings, behaviors of insights. In the global mind of mankind, new platforms of consciousness occur with the increase of new “synaptic connections”, new connections between aspects of mankind. Internet is already demonstrating the impact of this phenomenon.
Virtual environments takes the process to a new level and dimension, allowing a deeper connection between the parts of mankind, unhampered by the social convention that keep us locked into the past patterns.

A pinch of prospective
Mankind is presently in a dead end. It is only a dead end caused by our present images and experiences of what is commonly decided to be real (authorities, nationalisms, religions, ideas of self, etc.). There is a way out of the doom days ahead, which implies a redefinition of our images of reality. This can be done safely and and very rapidly in virtual environments like Second Life.
There are many challenges ahead. In the context of this reflexion, let’s hope that the population of virtual communities will grow rapidly enough and will be composed of enough free spirits to allow this new set of values to become the norm, before the barochial businesses could corrupt this new potential.

Alain-Yan Mohr (aka Adalbert Singh)

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Article paru dans le magazine Sciences en décembre 2007.

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Review of a very interesting book: Coming of Age in Second Life: An Anthropologist Explores the Virtually Human Tom Boellstorff.

Millions of people around the world today spend portions of their lives in online virtual worlds. Second Life is one of the largest of these virtual worlds. The residents of Second Life create communities, buy property and build homes, go to concerts, meet in bars, attend weddings and religious services, buy and sell virtual goods and services, find friendship, fall in love--the possibilities are endless, and all encountered through a computer screen. Coming of Age in Second Life is the first book of anthropology to examine this thriving alternate universe.

Tom Boellstorff conducted more than two years of fieldwork in Second Life, living among and observing its residents in exactly the same way anthropologists traditionally have done to learn about cultures and social groups in the so-called real world. He conducted his research as the avatar "Tom Bukowski," and applied the rigorous methods of anthropology to study many facets of this new frontier of human life, including issues of gender, race, sex, money, conflict and antisocial behavior, the construction of place and time, and the interplay of self and group.

Coming of Age in Second Life shows how virtual worlds can change ideas about identity and society. Bringing anthropology into territory never before studied, this book demonstrates that in some ways humans have always been virtual, and that virtual worlds in all their rich complexity build upon a human capacity for culture that is as old as humanity itself.

Tom Boellstorff is associate professor of anthropology at the University of California, Irvine. He is the author of A Coincidence of Desires: Anthropology, Queer Studies, Indonesia and The Gay Archipelago: Sexuality and Nation in Indonesia (Princeton).

Reviews:

"Boellstorff applies the methods and theories of his field to a virtual world accessible only through a computer screen....[He] spent two years participating in Second Life and reports back as the trained observer that he is. We read about a fascinating, and to many of us mystifying, world. How do people make actual money in this virtual society? (They do.) How do they make friends with other avatars? The reader unfamiliar with such sites learns a lot-- not least, all sorts of cool jargon...Worth the hurdles its scholarly bent imposes."--Michelle Press, Scientific American

"If you thought a virtual world like Second Life was a smorgasbord of experimental gender swaps, nerd types engaging in kinky sex or entrepreneurs cashing in on real world money making possibilities, think again. . . .Could Boellstorff be right that we're all virtual humans anyway, viewing the world as we do through the prism of culture?"--New Scientist

Endorsements:

"Tom Boellstorff describes Second Life warmly and intelligently, highlighting its issues in a thought-provoking manner that is always backed up with evidence. There's an almost tangible depth to his analysis that makes it really stand out. This is just the kind of portrait of a virtual world that I've been waiting to see for years: a full-blooded, book-length tour de force."--Richard A. Bartle, author of Designing Virtual Worlds

"This is the first book to take a sustained look at an environment like Second Life from a purely anthropological perspective. It is sure to become the basis for a new conversation about how we study these spaces. It is impossible to read this book and not come away asking questions about how our lives are being transformed in very real ways by what is happening in the virtual."--Douglas Thomas, author of Hacker Culture

To read more (first chapter in PDF) or order this book: Princeton University Press

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From Times Online, April 23, 2008
By Jonathan Richards

Virtual worlds such as Second Life will become an indispensible business tool and vital to the strategy of any company intent on reaching out to the video-game generation, one of the world's leading consultancies has said.

McKinsey & Company, the management consulting firm whose observations about corporate behaviour are closely watched, said that virtual worlds were on the cusp of a major expansion - particularly as a way to reach younger customers - and that companies were "ignoring them at their peril."

A senior consultant at the company, which generally shies away from making public statements because its clients include major high street brands, said that any consumer-facing business "absolutely" had to be "experimenting in virtual worlds" if it wanted to get the attention of under 30s.

"Our clients are telling us that they're not able to reach out to the video-game generation the way they have to newspaper audiences, say, and that they want to distinguish themselves in the digital space," the consultant, who did not want to be named, said.

The company has produced a 150-page report on the way businesses can get a return for the investment they make in virtual worlds.
Some of the world's best-known brands, including IBM, Sony, BMW, and Coca-Cola, have a presence in Second Life, a sprawling online universe which costs $9.95 to join. 'Residents' of the virtual world fashion digital versions of themselves called avatars and wander about building virtual houses on virtual property and trading virtual goods.

The world, which was set up in 2003, claims to have 13 million residents, and says it facilitates daily trade worth $1 million in a currency known as the Linden dollar, which has a variable exchange rate with its real-world US counterpart. McKinsey's comments came as Linden Labs, the company which runs Second Life, announced that it had appointed a new chief executive to oversee the next phase of its global expansion.

Philip Rosedale, the founder and chief technologist of Second Life, is stepping down to be replaced by Mark Kingdon, until recently the chief executive of Organic, the San Fransisco-based digital marketing agency and prior to that a partner at Pricewaterhouse Coopers.

Companies setting up 'shop fronts' in Second Life over the past couple of years have done so in the hope that customers will be able to have a more immersive experience, trying out products in the online world before they buy them by linking to the store's website. But the world has been criticised for being difficult to use, and for failing to deliver any tangible benefit to companies doing business in it - which to date has mostly been marketing.

The next phase of Second Life's development, analysts said, would involve businesses developing very specific 3D applications, which for instance would enable them to conduct virtual meetings, saving on transport costs, and to undertake advanced staff training.

Trucking companies, for instance, are teaching drivers how to parallel park their vehicles using simulations built in Second Life; Hilton, the hotel chain, is collaborating on a tool to train receptionists in virtual lobbies, and energy giants are developing applications that can help them to train staff on how to deal with a hostage situation on an oil rig.

"What's happening with Second Life right now is exactly what happened with the web in the early days," Mr Rosedale said at an event in London this week. "People would say 'the internet is a horrible place for brands, there's all this stealing of property, and pornography', and now what you find is that the web is used relentlessly for information-sharing purposes. We're seeing exactly the same thing in Second Life."

About $1.5 billion has been invested in companies developing technologies for virtual worlds in the past year and a half, according to a report published this week by Forrester, the analyst firm. Driven by the near complete penetration of broadband, an increasingly technology-friendly workforce, and cheap computing tools, the 3D web would be "the next major wave of the internet's evolution," the report said.

Significant challenges remain, though. "There's a lot of interest in these technologies, but many companies find that it's simply too hard to become familiar with these worlds," said Ivan Croxford, head of BT Tradespace, a BT-run website through which small businesses connect with one another.

There was also the problem that agencies advising companies on digital strategy - for instance about how to run their websites - had traditionally been skilled in areas like graphic design, which did not necessarily translate well to virtual worlds.

"Whereas the needs of the 2D web were well-served by graphic designers, what the 3D web demands is cinematographers," a McKinsey consultant said. "You need story-tellers - actors and directors who can get customers involved in plots and incentive-based structures that are familiar from movies and video games."

Mr Rosedale said that Second Life was addressing issues such as the length of time it took users to become accustomed to the world, as well as the possibility of companies being able to use special ‘sectioned-off’ areas, easing concerns about privacy and confidential information.

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By Rob Stein
From Washington Post Online, Saturday, October 6, 2007

After suffering a devastating stroke four years ago, Susan Brown was left in a wheelchair with little hope of walking again. Today, the 57-year-old Richmond woman has regained use of her legs and has begun to reclaim her life, thanks in part to encouragement she says she gets from an online "virtual world" where she can walk, run and even dance.

Roberto Salvatierra, long imprisoned in his home by his terror over going outdoors, has started venturing outside more after gaining confidence by first tentatively exploring the three-dimensional, interactive world on the Internet.

John Dawley III, who has a form of autism that makes it hard to read social cues, learned how to talk with people more easily by using his computer-generated alter ego to practice with other cyber-personas.

Brown, Salvatierra and Dawley are just a few examples of an increasing number of sick, disabled and troubled people who say virtual worlds are helping them fight their diseases, live with their disabilities and sometimes even begin to recover. Researchers say they are only starting to appreciate the impact of this phenomenon.

"We're at a major technical and social transition with this technology. It has very recently started to become a very big deal, and we haven't by any means digested what the implications are," said William Sims Bainbridge, a social scientist at the National Science Foundation.

In addition to helping individual patients, virtual worlds are being used for a host of other health-related purposes. Medical schools are using them to train doctors. Health departments are using them to test first responders. Researchers are using them to gain insights into how epidemics spread. Health groups are using them to educate the public and raise money.

These increasingly sophisticated online worlds enable people to create rich virtual lives through "avatars" -- identities they can tailor to their desires: Old people become young. Infirm people become vibrant. Paralyzed people become agile.

They walk, run, and even fly and "teleport" around vast realms offering shopping malls, bars, homes, parks and myriad other settings with trees swaying in the wind, fog rolling in and an occasional deer prancing past. They schmooze, flirt and comfort one another using lifelike shrugs, slouches, nods and other gestures while they type instant messages or talk directly through headsets.

Because the full-color, multifaceted nature of the experience offers so much more "emotional bandwidth" than traditional Web sites, e-mail lists and discussion groups, users say the experience can feel astonishingly real. Participants develop close relationships and share intimate details even while, paradoxically, remaining anonymous. Some say they open up in ways they never would in face-to-face encounters in real support groups, therapy sessions, or even with family and close friends in their true lives.

"You're in this imaginary world. People don't know much about who you really are. In that anonymity, in that almost dreamlike state, people express things about themselves they may not otherwise," said John Suler, who studies the psychology of the Internet at Rider University in New Jersey, noting the experience can be especially useful for people with disabilities and those in remote areas where support groups or therapists are far away.

While the emergence of these worlds has generated controversy over the gender-bending, sexually outrageous, profiteering and even violent virtual behavior of some participants, their usefulness for meeting health needs has just begun to draw attention.

"There is a fundamental irony here," said Thomas H. Murray of the Hastings Center, a medical ethics think tank in Garrison, N.Y. "Avatars tend to be young, beautiful, and never age or get sick. But at the same time they can serve as an important way to share information about health."

Murray and others, however, worry that participants may neglect potentially more helpful real-life relationships, or have unrealistic expectations about what virtual worlds can do. Users and health-care providers may be rushing ahead, they say, without validating the usefulness of these worlds or identifying the dangers.

"We've seen the power of the Internet and what it can do," said Albert "Skip" Rizzo, a University of Southern California psychologist who treats traumatized Iraq war veterans with virtual reality. "But as we all know there can also be negative consequences. We really need to step back and think, 'What are the practical and ethical things we can do in the area of health, and what can't we do?' "

The emotional punch of virtual worlds make them fertile breeding grounds for false, misleading and possibly dangerous information. Sick, lonely and psychologically fragile people are particularly vulnerable.

"You have the same risks as elsewhere on the Internet," Murray said. "A lot of the information is garbage. There is always the possibility fraudsters will try to gain people's confidence to peddle phony cures or otherwise do things that are not in people's interests."

Still, an increasing number of major health organizations are trying to take advantage of virtual worlds for public health education, patient support and fundraising.

The Centers for Disease Control and Prevention tested a small "office" in the popular virtual world Second Life "staffed" by Hygeia Philo, an avatar named after the Greek goddess of health, and is now planning a bigger, permanent presence. The American Cancer Society has an elaborate "island" offering virtual lectures by avatar doctors, support group meetings and other activities, such as an annual fundraising marathons that last year raised more than $115,000 in real money. The March of Dimes is building a virtual neonatal intensive-care unit to warn about the dangers of preterm births. The National Library of Medicine is helping fund HealthInfo Island, where users can get reliable medical information.

Meanwhile, scientists are beginning to study virtual worlds for insights into real-life health problems. Two teams analyzed a virtual epidemic of "corrupted blood" that devastated the World of Warfare online game for clues to how people might react during a real pandemic. Another examined a pox that infects avatars in a children's virtual world called Whyville, which the CDC is using to learn better ways to boost pediatric flu vaccination rates in the real world.

Medical schools and health departments have also started using virtual worlds. A University of California psychiatrist developed a virtual psych ward echoing with disembodied voices to help caregivers better understand schizophrenia. Stanford University doctors built virtual operating and emergency rooms to train young doctors. Britain's National Health Service constructed an entire virtual hospital.

So much is happening in virtual worlds that researchers at Harvard Medical School are planning to explore the possibilities at a seminar later this month, and the National Defense University in Washington is hosting a conference next month about ways that federal agencies, including the CDC and the National Institutes of Health, can use the phenomenon.

Individual practitioners, meanwhile, are discovering virtual worlds on their own. After meeting other health-care professionals in Second Life, which with 9 million members is among the largest, Lawrence Whitehurst, a family doctor in Culpeper, Va., founded the Second Life Medical Association.

"I don't diagnose, and I don't treat. What I try to do is provide medical advice and support for people undergoing real-world medical problems," Whitehurst said.

Some therapists, however, have started using virtual worlds to treat patients for a host of problems, in both their real and virtual lives.

"It doesn't work for everybody, but it works for a large majority of patients," said Brenda Wiederhold of the Virtual Reality Medical Center in San Diego, who uses the virtual world DigitalSpace to help patients overcome fear of public speaking and severe shyness.

While Wiederhold said she treats only patients she has counseled in her office first, others are offering therapy to patients they have never met or know little about.

"My clients' problems range from domestic love tangles to complex and difficult real life situations," Elena Mangan, who counsels patients anonymously in Second Life from Britain, wrote in an e-mail.

Such anonymous counseling disturbs many therapists. Internet therapy denies counselors vital clues from subtle body language, affect and tone of voice, they say. And anonymity can carry risks.

"How do you ensure the patient's safety?" said Richard Bedrosian, a clinical psychologist at the University of Massachusetts Medical School. "Suppose they say, 'I'm going to shoot my girlfriend or kill myself.' How do you protect that person? How do you intervene?"

But the biggest users of virtual worlds for health purposes so far appear to be individual patients. Dozens of support groups have formed by and for those with cancer, paralysis, strokes, depression, cerebral palsy, cystic fibrosis, autism and other ailments.

Susan Brown, the stroke victim, said encouragement from other survivors in Dreams, one of several protected areas in Second Life for people with disabilities, and the experience of seeing herself walking again, aided her recovery.

"It helped me visualize," Brown said through her avatar, Marie Hightower, during an interview in a virtual field near a virtual home she built in Dreams, as virtual butterflies flitted past. "I stumbled here just like I stumbled in RL [real life]," she typed.

Salvatierra, the agoraphobic, Dawley, the patient with Asperger syndrome, and others tell similar stories.

"It's kind of like getting your life back again, but even better in some ways," said Kathie Olson, 53, who uses a wheelchair, lives alone and rarely leaves her home near Salt Lake City. In Second Life, she roams about as Kat Klata, a curvy young brunette who runs the Dragon Inn nightclub. "I've met so many people. I can walk. I can dance. I can even fly. Without this I'd just be staring at four walls. Mentally it's helped me so much."

For Stephanie Koslow, 48, of Poughkeepsie, N.Y., her virtual life is helping sustain her as she fights advanced breast cancer.

"It's not real, but it's real in a way," said Koslow, whose avatar is a pink fox named Artistic Fimicoloud. "I might spend an afternoon trying on silly wings and laughing with friends. And laughter heals."

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