Game of Breaths: A Mobile App to Treat Panic Attacks

Originally published by How We Get To Next

Maddie. Photo credit: Caroline / Flickr / CC BY 2.0.

Simon Fox, founding director of Playlab London, learned to cope with his own panic attacks using breath retraining exercises provided by his therapist. He wanted to find a way to share these with other people and wondered if it could be done through gaming.

Inspired by Droqen’s Asphyx — a simple platform game which requires players to hold their breath while their characters are underwater — the result is Flowy, a mobile app that incorporates breathing techniques into gameplay. “I wanted to make [treatment] more approachable and available,” Fox told me.

Depression and anxiety account for a large percentage of mental health problems worldwide. In the United Kingdom, where the app will be launched, three million people experience anxiety disorders — debilitating conditions with high economic and personal costs. Although treatment is possible, few people receive it, with health funding cuts making it now even more exclusive. Flowy hopes to offer a cheap and scalable intervention.

“We don’t plan to replace therapy,” said Fox. “Flowy is designed to work alongside the way the NHS delivers therapy to people who experience panic and anxiety disorders.” Flowy will give its users their data, enabling them to use it alongside other health-tracking apps and traditional therapy. It will also cater to those who don’t have access to treatment.

Due to the nature of anxiety disorders, it’s important that Flowy is a simple game, uncluttered by complicated narrative or game mechanics. In a play session involving a few short tasks, players use breathing retraining exercises to manipulate the game: They hold one button while inhaling and another while exhaling; the controls then translate their breathing into the game world. Flowy’s aim is to reduce the symptoms of a panic attack by the end of six minutes of play. The app is also equipped to signpost users to other means of support if their condition escalates.

Perhaps using gaming to manage real-world issues has the potential to change our future. In her TED talk, “Gaming Can Make a Better World,” game designer Jane McGonigal described gamers as “super-empowered, hopeful individuals.” We don’t give up in games as easily as we do in real life, she said; we always believe an “epic win” is possible so we keep trying. McGonigal’s research was a powerful inspiration for Flowy. It “gave us the courage to say that our games might do something meaningful,” said Fox. With some seed funding from Bethnal Green Ventures, Playlab has been working on Flowy with the Centre for Anxiety Disorders and Trauma at King’s College Londonand several National Health Service teams in London and Liverpool.

Committed to constant evaluation, Playlab London is developing the project according to scientific assessment. From the beginning, the team has evaluated the app’s success using a pilot study developed in collaboration with Queen Mary, University of London (and formally reviewed by the Queen Mary Research Ethics Committee).

This trial studied the effects of using Flowy on adults with self-reported anxiety symptoms. It found that the game produced a measurable effect. Users reported a significant growth in quality of life and showed a reduction in the symptoms of panic, anxiety, and hyperventilation. Playlab London plans to undertake a bigger study to help it understand where to take the project next and is currently investigating physical sensors and heart rate.

The game will be available to the public early next year. Until then, there’s a mailing list available at, which provides updates and opportunities to experiment with new ideas.

Review: Moth Smoke by Mohsin Hamid

Originally published by Hackwriters

Moth Smoke by Mohsin Hamid

Publisher: Granta Books

ISBN: 0374213542

I read Mohsin Hamid’s second novel, The Reluctant Fundamentalist, several months ago and was disappointed enough to be put off the idea of reading Moth Smoke for some time. Hamid is an experimental writer who clearly enjoys playing with point of view and the reader’s relationship with the story. The Reluctant Fundamentalist, despite being nominated for several literary prizes (and winning a few), in my opinion fell short of the mark. It was interesting but it was not engaging. The style was unique but it was not wowing. The Reluctant Fundamentalist, I felt, was an example of style over substance. 

Moth Smoke, however, proved to both stylistically interesting and page turning, with vivid description and an intriguing plot: a success in experimental writing.

Moth Smoke is set in Lahore, Pakistan and follows Darashikoh (Daru) Shezad through a spectacular downfall. At the start of the novel, Daru works in a bank and smokes a few joints; by the end, he is sitting alone in a dark and overheated house relying on heroin to get him through the day.

We begin chapter one from Daru’s point of view as he sits alone in a prison cell but we do not return to him in this position until the end of the book. We learn early on that he is being tried for the murder of a boy. You, the reader, hold the position of the judge and are addressed directly as such in sporadic chapters set in a courtroom.

The majority of the book is written from Daru’s point of view, chronicling events as he loses his job and slips slowly into a life of poverty and escapism. Every other chapter pulls away from Daru, however, and we are privy to the accounts of Ozi, (Daru’s best friend), Mumtaz (Ozi’s wife) and Murad Badshah (Daru’s rickshaw driver friend). I have come across several reviews that say this distracts from the main story and breaks the flow of the writing, though personally I didn’t find it jarring. It quickly becomes clear that none of the narrators are entirely reliable and it is the varied points of view that allow this to happen. Daru’s narrative grows claustrophobic as his story unfolds; the additional points of view provide welcome light. This makes your position as judge a difficult one when it is clear that no character is innocent and no character is absolutely honest with themselves.

Perhaps the most honest character is Mumtaz, who has set up a double life for herself in order to deal with the bad choices she has made. Although she is, in a sense, finding a way to live a lie, she is always aware of why and has spent much more time addressing her failings than any of the other characters. As Daru and Mumtaz grow closer, both characters become more naked, reveal more of who they are than is sensible for either of them. 

The only real reservation I had with the novel was that some of the characters seemed a little thin. While everything Daru did made sense within his character, some of the behaviours of Mumtaz and Ozi seemed a little less credible. Although this worked to illustrate the divide between the couple and Daru, the fact that they were at times telling the story weakened this tool somewhat. Perhaps the problems that some critics had with the point of view shifts came not from the shifts themselves but from the wavering credibility of some of the peripheral characters. However, the characters are strong enough to hook you and their weaknesses are masked by their intentional unreliability and by the strength of Daru himself.

Moth Smoke illustrates very well the divide between the rich and poor of Pakistan. Although Daru was never rich, his connections allowed him to sample the lifestyle of the wealthy from time to time. His constant awareness of the wealth around him highlights the gulf between those who have and those have not, and when he eventually falls into poverty himself without even enough money to run electricity in his home, the distinction is glaring.

The central image in the novel is, unsurprisingly, a moth attracted to a flame, singed in its persistent attraction to the fire. This symbolises Daru’s own self-destructive behaviour and from the moment he watches a moth die in the light of the candle, he is unable to shake the smell of burning flesh. Daru rarely admits the danger in his own behaviour, but he is constantly aware of it, always trying to attribute it to exterior factors.

Another recurring theme is the nuclear competition between Pakistan and India, quietly mirroring Daru’s relationship with Ozi while building the tension and discomfort in their environment.

The writing itself is fresh and fast paced, cloying descriptions building when Daru is at his most claustrophobic. Hamid has a tendency to overwork a metaphor, but his ideas are original and often brilliantly executed in moments of vivid imagery. My favourite example of this is when Mumtaz recounts, I just gritted my teeth, took out a needle and worked him out of my heart like splinter.

This is a novel rich in images with a strong and unique voice and a fascinating story to tell. I say: read it!

Making Scents: What Live Theatre Can Gain from Catering to Our Olfactory Systems

Originally published by How We Get To Next

Smelling a flower // Dennis Wong / Flickr / CC BY 2.0.

Most people probably never consider what their favorite music might smell like — but it’s on the minds of some performers, like Katy Perry, whose 2011California Dreams world tour used scents to make her audience feel like they were in “cotton candy heaven.” Adding smell to a performance can enhance an otherwise ordinary gig, play, or recital.

“Scent can augment an atmosphere and give [audiences] a heightened anticipation of place,” explained Odette Toilette, a self-described “purveyor of olfactory adventures” who runs her own scent events company. “You can use a palette of scents to demarcate and zone different spaces.”

The technology involved isn’t as high-tech as you might imagine. Delivery systems can range from diffusers to sprays, to candles and incense. “The delivery method should be led by the experience,” she explained, and you have to consider how the scent will work “as part of the overall narrative of space, story, and flow of people.”

Toilette is currently working with creative agency Flying Object on a show — “Tate Sensorium” — for the Tate Britain art gallery in London, debuting in September. They’re developing a number of scents to act as companion pieces (alongside sounds and tastes) to abstract artworks in an interactive exhibition that more fully explores what it means to experience a piece of art, like a painting.

Jo Barratt and sensory agency Vetyver are also working with smells in performance — convinced that if an artist can directly stimulate our senses, they have even more control over the effect their work has. “People sense stuff all the time,” he said. “The more tools you have to manage it, the more effective the creation of an experience is.”

A good example of the power of smell in action came in 2014, when he teamed up with audio-specialist Nick Ryan, the composer of a piece for the London Contemporary Orchestra called “Synaesthesia.” Ryan worked with artists to create visual displays to match the music, while Vetyver “scored” the performance using smell. The result was an immersive show designed to give the audience a taste of what it might be like to live with synaesthesia, as scents were delivered to the audience through the venue’s air-conditioning system, timed carefully to work with the music. “The process of composition was almost in three dimensions,” Barratt said, with scent, visuals, and music all emerging simultaneously as the show went on.

Scenting an event is a multi-staged process: First the scent must be developed, and then it must be checked against the brief with technical, safety, and logistical considerations. The artist must consider the best delivery system for the space, and the likely associations the audience will have with the smell, as well as how to frame the experience of it. For Barratt, it’s important that the scent is in the background, making an audience focus on “themselves, each other, or the environment rather than the smell itself.”

In 2013, Barratt worked with the band Deaf Club, producing scents to use while on tour. While each member of the band designed a different aroma, each had similarities that would create “a sense of reassurance, continuance, and association with the band, but also a sense of moving on,” he explained.

Dave Pickering, creator and host of variety night Stand-up Tragedy, worked with Barratt to add an extra layer of interactivity to his show, inviting his audience to determine “the scent of tragedy” by sniffing three different smells distributed on sample strips during an event, and voting for which they thought was the best fit. “The final scent created an association,” Pickering said, “and its backstory helped to frame the concept of the show.” After the show, audience members and performers said that the winning scent did leave a lasting association with them.

With virtual reality looming large in the future, there’s a lot of potential for using smells in live and recorded art — and it could also play a role in forming more lasting memories, and encouraging people to share and discuss their experiences with each other.