This Virtual Reality Game Encourages Rhythmic Breathing To Help With Mental Health

(Deepwell DTX Image)

At first glance, Deepwell DTX’s Zengence (pronounced like “vengeance”) is what video game fans might call a rail shooter. At the start of the game, you’re sent down a one-way path that’s lined with hostile “Wraiths,” but they’re initially invisible.

To reveal the Wraiths, you use your VR headset’s microphone to conduct what’s essentially a rhythmic breathing exercise with an audible hum, in time with Zengence’s music. When you do so on the beat, you send out a magical orb that breaks the Wraiths’ concealment. That’s when you can start a fight, using the crystalline pistols your avatar holds in either hand.

Zengence is, according to its developer, the first virtual reality therapeutic app on the Meta Quest store.

It’s an odd combination of a guided meditation and a PG-rated action game. It features a lo-fi soundtrack, mildly surreal but colorful environments, and most crucially, no failure states. If you take a hit from the Wraiths, it simply reduces your final score. The challenge is in finding ways to earn as many points as possible, not simple survival.

After playing it, I could see how Zengence would be relaxing, but it wasn’t immediately obvious why it qualifies as being therapeutic. I brought that question to Ryan Douglas, the chairman and founder of Seattle-based Deepwell DTX.

“In general, when we design a therapy for stress, we have this order of operations that we have to go through,” Douglas said. “The first thing is that we need a distraction state. Right away, we have to stop the rumination, shut down the worry and the self-talk. We can’t do anything to settle you down if you’re continuing to rev yourself up.”

Douglas is a Washington-based technologist who specializes in designing medical devices, and previously worked as the founder and CEO of the Minnesota-based firm Nextern. His patents and designs include AI-driven treatment systems, surgical robotics, and wearables.

The idea behind Zengence’s central model is that it engages the player in a focused state, or “flow activity.” This has been widely nicknamed the “Tetris effect,” after studies of how players’ brains reacted to playing the puzzle game Tetris for long periods of time.

If you’ve ever spent a few hours playing Tetris and subsequently started to see falling blocks in your sleep, or found yourself noticing similar shapes in the real world, that’s the Tetris effect; you focused so intently on the game that you’ve temporarily realigned your brain. You can get into the same cognitive state with many other games, such as Beat Saber or Call of Duty, but researchers first noticed it with Tetris.

That same flow state is what Zengence’s “rhythm on rails” approach is supposed to trigger. The game is designed to take the player out of their own head for a while, in a simulated set of voluntary circumstances.

“We need to put agency in your hands,” Douglas said. “A lot of stress, worry, and anxieties come from the idea that we don’t have a lot of day-to-day control. That’s where games become really powerful. You can put a lot of agency in people’s hands very quickly.”

Hence, Zengence is built to shape itself around the player. The Wraiths don’t show up unless you force them to appear. Your level of participation in the game is entirely up to you. A high score does depend upon you revealing and fighting as many Wraiths as possible, but it’s not treated as mandatory.

When you do start a fight, every element of the game is built around “microtransactions” (Douglas’ word) of success: you stayed on beat, you dodged an attack, you revealed an enemy.

That in turn triggers little dopamine reactions in your brain, in a way that Douglas compares to classic video games like Super Mario Bros. The idea is to put the player in a sweet spot where the game is consistently just challenging enough to keep their attention.

“Once you’ve got someone in a flow state, where they’re losing track of time and effort,” Douglas said, “now the brain is in this state that we’ve been studying where you’re very neuroplastic.”

He continued: “We think you may be learning up to 40 times faster than you would be outside the flow state. The things you do next start to rewrite neural pathways… Something that’s in this game starts to look or feel to your subconscious self like things that you’ve done before that are relevant. It opens you up to learn on a limbic level, subconsciously.”

At this point, a player is in a simulation of a stressful situation that they nonetheless fully control. It opens the door to quickly internalize lessons like coping skills that simple talk therapy might struggle to convey, because the player’s subconscious mind theoretically recognizes parallels between Zengence and the real world.

Zengence is the first project from Deepwell, which Douglas founded in 2022 alongside former Devolver Digital executive Mike Wilson (who has since departed) and Dr. Sam Browd, professor of neurological surgery at the University of Washington who previously co-founded Seattle startups including Vicis and Proprio.

According to Douglas, the budget on Zengence to date is under $4 million, but it would’ve cost a lot more to develop if it weren’t for multiple professionals from several different fields who were willing to donate their expertise to the project.

This includes neuroscientists, inventors, and video game developers, such as Lorne Lanning, creator of the Oddworld series, and Che-Yuan Wang, programmer and director on PC games such as Descent, Grim Fandango, and Diablo III.

Deepwell currently has a team of 50 employees working on Zengence and other projects, including upcoming patches that will broaden Zengence’s overall approach.

“Everybody thinks we launched a game,” Douglas said. “We didn’t launch a game. We launched a lab.”

In Zengence’s current state, at time of writing, it’s designed to deal with stress. In future updates, using data and feedback from Zengence’s players, Douglas hopes to expand the game’s reach and mechanics to help the player with other mental health issues, such as anxiety and hypertension.

“We’re not neurologically wired to do things that are good for us,” Douglas said. ”The most wildly therapeutic games so far that have treated mental health have done it completely accidentally. It’s not the serious games, it’s not the brain teasers. It’s a bunch of games that were created by the masters [i.e. Call of Duty, Super Mario Bros.] with no intent to ever have therapeutic value.”

“You’re going to see us evolve this until you’re hardly going to be able to tell what part of the game is treating you,” Douglas continued. “We really feel like the therapy here is not, ‘Let’s make something therapeutic fun.’ It’s ‘let’s break into the intrinsic therapeutic nature of fun,’ which we have a lot of data about.”