The science behind Stressjam

Stress

"Stress" has a bad name. For years, we have been assuming that stress makes us sick and increases the risk of just about everything: from a common cold to a burnout and cardiovascular disease. However, research from, among others, Stanford and Harvard University shows that stress can have positive effects! (See, for example, Alia Crum and Kelly Mc Gonigal) People who experience a lot of stress who do not consider this stress to be dangerous, even have the lowest risk of dying (compared to people who consider their stress responses to be dangerous). This is a groundbreaking insight and means a world of new possibilities.

Can stress be even healthy? And can changing your mindset about stress really make you healthier? Science says, "Yes, no without a doubt. If you change your attitude towards stress, your body will change to cell level! "

According to Kelly McGonigal, the Achilles heel in the matter is the relationship between different hormones that are activated during and after stressful events. It is about the relationship between the hormones Cortisol and DHEA and it appears that you can influence that relationship by changing your mindset. That's what we do using a Virtual Reality Game.

Cortisol en DHEA

Here's a little something about Cortisol and DHEA. Cortisol ensures that your body is capable of exceptional performance, especially when exciting things happen. Cortisol makes it easy to extract sugar and fat, and both your body and your brain can use that energy quickly. Especially in situations where your life is at stake, this is extremely useful. After all, it has great advantages if you have to make quick decisions to survive. Cortisol puts all other functions 'on hold' for a while. If things really get rough, you do not care about careful digestion, deep philosophical speculations are not very useful and even wound healing and cell recovery are processes that can wait until tomorrow. As you can see, a Cortisol response that lasts for too long has disadvantages, as it simultaneously cuts down a variety of other processes. DHEA, or Dehydro Epiandrosterone, is a hormone that helps to make your brains grow, it helps your brain to become stronger from stressful experiences. It also eliminates a number of adverse effects of Cortisol, and it accelerates, for example, the rate at which your wounds heal and enhances your immune function.

You really need both hormones (Cortisol and DHEA) and none is better than the other. A problem arises if someone has the first stress reaction and not the "growth-of-stress response". It is indeed true that the relationship between Cortisol and DHEA is a good predictor of your health. In the right relationship, when there is a higher growth index, you "bloom" under stress. If Cortisol has the upper hand and there is a lower growth index, your body will be spending too much time on all kinds of recovery functions and that is downright unhealthy.

Cortisol:

Helps your body and your brain to use energy. Puts digestion, reproduction, cell recovery and neuronal growth on the back burner.

DHEA:

Removes adverse effects Cortisol, enhances wound repair, immune function and neuronal growth.

That relationship between Cortisol and DHEA is a true predictor of the future. It predicts academic success, as evidenced by a study by, among others, Stephanie Wemm of 2010 [1], but it also predicts the chance that children who suffered abuse will overcome the misery [2]. And here's the interesting part: the relationship between Cortisol and DHEA is influential. Alia Crum did that by showing people videos explaining how healthy stress actually is and how much positive influence stress has on your thinking ability and your physical abilities [3]. Her research further underlined how drastically changes in your mindset can influence your body . So: your mind-set literally determines whether you create new connections under stressful conditions or not. Kelly McGonigal reaffirms everything in her inspiring book 'Stronger with Stress' from 2015.

Measuring stress, how do you actually do that?

When people experience stress, they respond to the production of different hormones and they are therefore of importance. This is especially the case in the relationship between Cortisol and DHEA hormones because this ratio predicts whether you are better off with stress or worse (in terms of health, recovery and learning ability). This ratio is called the growth-index and this indicates whether stress will either strengthen you or if you are going to develop health issues. The trouble is that those hormone levels fluctuate considerably during the day and there are also major individual differences. You really want to give someone a lot of personal information, because one does not really care for 'average'. We feel that it's very important to be as specific as possible for each individual. On average, the Dutchman may wear size 9 but this does not mean that the shoe fits everybody. An additional problem is that it is not so much about the exact hormone values, but much about the ratio. Of course, it would be best if we could measure that relationship directly. In doing so, we measure the ability of our bodies to create new neuronal connections. At the moment, this can be done, for example, by investigating someone's mucus. But to do that within a VR game does not seem to be the most practical way. You should make some kind of spout cup with a built-in lab function and that seemed a little awkward and also somewhat gross, to be honest.

Another option is that we look directly into the brain and measure whether there is the desired activity. In the research of Carol Dweck, that's exactly what they did. In that case, we would have to make some kind of cap with a built-in real-time scan function. Indeed, we want to play with the stress immediately, so the scan must be read at the same time and not just an hour later. There are some indications that something like this will be possible in the near future, not with a brain scan really, but with an EEG measurement. But at this point that is not yet possible.

HRV

A good alternative choice already available is the so-called heart rate variability measurement, or HRV. The theory behind this is that people are constantly adapting to the demands of the environment. Sometimes we need to be extra alert, eg when someone explains something or when you make a mistake. A minute later, you'll have a moment of relaxation. The heart rate study (and the same is found in brain research) teaches us that we constantly adapt our stress system. Every second, your stress condition changes slightly, literally every second. As it were, you fiddle with the thermostat buttons constantly and by doing that you can read your heart rate variability. Kind of logical that you can deduce that from your heart rate because your heart provides your body with oxygen. With less oxygen, your brain and your muscles do not work full-time. Because we are naturally frugal with energy (yes really), we do not keep the thermostat at full force constantly, but we mainly focus on the stuff that is important to us: especially the things you care for deliver a stress response quickly . You can rightly say, as Kelly McGonigal does, that only stressful life is a meaningful life.

We can measure stress responses by following the heart rate and especially by studying all differences in heart rates (heart rate variability). These differences indicate whether someone is in a good state or is shifting to a state of stress that leads to complaints in the long run. Meanwhile, ways have been developed to do this and for that reason, algorithms are devised, mathematical formulas. We have developed an algorithm based on the so-called rMSSD, especially because it is the simplest measure that is as reliable as much more complex computing, anyhow, that is what Annebet Goedhart concludes in her 2008 promotional research [4].

However, measuring the heart rate frequency (HRV) may not be a direct measure of the so-called growth index, but it does provide a reliable indicator of which hormone is superior, Cortisol or DHEA. For our game this is very important. After all, we want people to really recognise when they reach the right state, the right mindset.

To measure the HRV we have chosen the Zephyrband so far. This is an expensive device, but this chest strap provides a reliable real-time measurement. In the hospital Nij Smelinghe in Drachten, who cooperates with us in this project, this band is already used in their rehabilitation programs. We are currently developing a cheaper product that is more reliable and easier to apply (with a clip on the pants or bra straps) and found a partner the Trimbos Institute. We not only want to capture the HRV, but also the respiratory rate, because that is also one of the indicators . Respiration seems important to trigger a higher growth index. Obviously any financial support for this development is more than welcome. The cheaper the bands get, the more people can benefit from them.

Virtual Reality

What have we actually done? We have transformed the knowledge of this wonderful and groundbreaking research into a serious game, so that you are literally immersed into a world in which you practice this positive mindset towards stress. We measure your stress condition and the VR world is always adapting to your particular state of the moment. Thus, you literally play the game with your own stress, your stress condition is the joystick, you could say. Jam with your stress, with great effects!

The game really works in a variety of fields, in hospitals, people can play the game to make the wounds heal faster, but you can also use the game to offer a French course. Especially because the creation of new connections is so important when learning. Because you are helped to keep your mind-set positive for stress, the game encourages a higher growth index (and thus the creation of DHEA). Your wounds heal faster, you make more new connections, you can handle the disadvantages of stressful events much easier and your immune system will work better.

Jamming with your stress

Why a game and not a brief instructional film like Crum did in her research? Well, especially because we want those who seriously get started with this kind of knowledge to get the opportunity to really train. It is not always easy to keep a positive mindset. Imagine you have just experienced a terrible thing, a huge fire, for example, and you also have a lot of pain from the burns that you have sustained. The stress that the pain gives you is so big that, most likely, you will develop a negative mindset with all the consequences that go with it: worse wound healing, worse immune system and more effort the processing the events. Training your mind-set becomes important.

Infinite possibilities

But there is more, for example, we see a large number of drop-outs in schools; especially boys. What would be more fun than to learn boring stuff in an exciting game environment that also gives them a boost in their learning ability? Even the French lesson will be inspiring!

Meanwhile we have done a great deal: we have built a whole world of VR full of animations, challenges and quests. We have developed a series of training levels. And you will encounter many bumps on the way. You have got to cope with wasps, climb walls, cross over swinging walkways, extinguish fires and for those who have practised a lot and are well trained; calm down a volcano. At the same time there is still a lot of work to be done. The possibilities are so great that we need to find sponsors to be able to live up to the enormous amount of possibilities.

Do we think that the game is fun? Yes. We think so. We have experimented a lot with this and so far our test persons are very happy to agree with us!