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.

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.