Phobics face virtual reality to overcome their fears.

One person who suffers from a fear of heights stands on the balcony of a 10-story building. Nearby, somebody else petrified of crowds gives a speech in front of thousands.

Neither, however, are where they appear to be. They are in a doctor's office undergoing virtual reality therapy, using a high tech helmet and visor to provide all the sounds and images of a tall building, a crowded auditorium or a jet airliner.

Gerald Tarlow, a psychologist and director of the Center for Virtual Reality in Calabasas, said a technology developed for military uses is the latest addition to his practice.

"The equipment has always been extremely expensive to purchase and the programs available have been very limited until now," said Tarlow, who along with his partner, Alan Berkowitz, has been offering the virtual reality therapy since January.

The new therapy allows the treatment of phobias such as fear of flying, heights, driving and public speaking. Treatments for other phobias are being developed, Berkowitz said.

According to Georgia-based Virtually Better Inc., which makes and sells virtual reality devices for psychotherapeutic purposes, Tarlow and Berkowitz operate the only virtual reality psychotherapy center in the Los Angeles area, one of only 25 such clinics in the United States.

"They're in the unique position to be the only game in town when it comes to virtual reality therapy," said Ken Graap, Virtually Better's CEO.

The technology, originally developed to train fighter pilots and U.S. army tank crews for combat, has been modified into a low-end version that costs between $2,500 and $23,000 to get off the ground, compared to the $2 million to $5 million units the military uses, Graap said.

"It doesn't have to be as realistic for a patient as it is for the military because you're not training someone to fly a $40 million jet fighter," he said.

In the past, therapists had to rely on essentially two kinds of therapy to treat phobias: systematic desensitization and so-called flooding. In the first, patients were asked to face their fear gradually, such as asking a person afraid of heights to go to a second floor, a third, and so on, Tarlow said. Flooding is when a person is immersed in a phobic situation, such as a person afraid of spiders being asked to handle many of them.

The virtual reality device is a helmet and visor on which virtual images are projected to simulate a roomful of people, for those with fear of public speaking, or the inside of a commercial jet, for those with fear of flying.

The patient wearing the virtual reality visor, for instance, can move his head to view the entire room or aircraft, much as if he or she were in an actual situation.

The technology was developed about five years ago by Emory University scientists in Atlanta, but only in the past two years have psychologists in the civilian world begun to embrace virtual reality therapy.

"Now more people can afford to get the equipment," said Brenda K. Wiederhold, executive director of the Virtual Reality Medical Center in San Diego and one of the pioneers in the field.

Last year, Wiederhold said, she had about 300 patients undergo the therapy, compared to just a handful four years ago.

Patient counts like Wiederhold's are what attracted Tarlow and Berkowitz' interest. So far, virtual reality therapy makes up only about 5 percent of the psychologists' practice, but Tarlow expects it to grow gradually.

"Within two or three years, we could see it be about half the practice, easily," he said.

A 45-minute session costs $200, about the same as a non-virtual reality therapy, and most patients complete between 10 and 12 sessions, Tarlow added.

"It takes about half the time that it takes with more traditional psychotherapy," said Wiederhold.

Tarlow said the clinic has about a dozen clients, but he expects the practice to grow within two years to about 20 patients a week, worth about an additional $200,000 in annual revenue.

Dina Azarkman, a 45-year-old artist and homemaker from Encino, swears by the virtual reality therapy that, she said, has nearly cured her fear of flying.

"I flew all my life. The phobia developed on a long transatlantic flight and I couldn't fly anymore," she said. "I actually tried two other therapies and that didn't work. I felt like a complete failure and it was very humiliating."

Azarkman said the virtual world isn't as realistic as some of today's top video games, but it's real enough to do the trick.

Berkowitz said most patients are hesitant at first, but eventually respond to the virtual world.

"We can control everything, like, for people with a fear of public speaking, we can make the audience clap or stay quiet or yell and scream," Tarlow said.