This virtual reality game encourages rhythmic breathing to help with mental health

At first glance, Deepwell DTX’s game, Zengence (which rhymes with “vengeance”), might be classified as a rail shooter by video game enthusiasts. The game begins by guiding you down a predetermined path swarming with invisible enemies called “Wraiths.”

To reveal these hidden foes, players utilize their VR headset’s microphone in a rhythmic breathing exercise, synchronized with the game’s soundtrack. By humming on beat, you release a magical orb that uncovers the Wraiths, allowing you to engage them with your avatar’s crystalline pistols.

Zengence is described by its developers as the first virtual reality therapeutic application available on the Meta Quest store.

The game is an unusual blend of guided meditation and mild action, with a lo-fi soundtrack, vibrant and slightly surreal environments, and, most notably, no real failure conditions. Taking damage from Wraiths only reduces your final score; the focus is on maximizing points rather than merely surviving.

After experiencing the game, its relaxing nature is apparent, though its therapeutic value may not be immediately clear. To understand this better, I spoke with Ryan Douglas, the chairman and founder of Deepwell DTX, based in Seattle.

“When designing a therapy for stress, there’s a specific sequence we follow,” Douglas explained. “The first step is creating a distraction. We need to interrupt the cycle of rumination, anxiety, and negative self-talk. Without that, it’s impossible to calm someone down.”

Douglas, a technologist with expertise in medical device design, previously founded Nextern, a firm based in Minnesota. His work includes innovations in AI-driven treatment systems, surgical robotics, and wearable technology.

The core idea behind Zengence is to immerse the player in a focused state, commonly known as “flow.” This concept, often associated with the “Tetris effect,” refers to the intense mental absorption that can occur when playing games like Tetris for extended periods.

If you’ve ever played Tetris for hours and then saw falling blocks in your dreams, or began noticing similar shapes in real life, you’ve experienced the Tetris effect. Your brain became so deeply engaged in the game that it temporarily rewired itself. Similar flow states can be triggered by other games like Beat Saber or Call of Duty, but the phenomenon was first observed with Tetris.

Zengence aims to induce this flow state through its “rhythm on rails” gameplay. The game is designed to pull the player out of their thoughts and immerse them in a controlled, voluntary environment.

“A key aspect of stress and anxiety is the lack of perceived control in daily life,” Douglas said. “Games offer a powerful tool by giving players a sense of agency quickly.”

Zengence is built to adapt to the player’s level of engagement. The Wraiths only appear when you choose to reveal them, and your involvement in the game is entirely optional. While a high score requires uncovering and defeating as many Wraiths as possible, it’s not compulsory.

During combat, the game emphasizes what Douglas calls “microtransactions” of success—staying on beat, dodging an attack, or revealing an enemy. Each of these small victories triggers dopamine responses in the brain, akin to the satisfaction derived from classic games like Super Mario Bros. The goal is to keep the player in a challenging yet manageable state of focus.

“Once a player reaches a flow state where time and effort seem to disappear,” Douglas continued, “the brain enters a highly neuroplastic state.”

He elaborated: “In this state, learning can occur up to 40 times faster than outside of it. The actions you take in the game start to reshape neural pathways… What happens in Zengence begins to feel familiar to your subconscious, much like real-life experiences, facilitating limbic-level, subconscious learning.”

At this point, the player is in a simulated stress situation, but one they fully control. This setup allows for the rapid internalization of coping strategies, which might be difficult to convey through traditional talk therapy, as the player’s subconscious mind begins to draw parallels between the game and real-life scenarios.

Zengence is Deepwell’s inaugural project, launched in 2022 by Douglas along with former Devolver Digital executive Mike Wilson (who has since left) and Dr. Sam Browd, a professor of neurological surgery at the University of Washington and co-founder of Seattle-based startups such as Vicis and Proprio.

Douglas shared that the budget for Zengence has been kept under $4 million, largely thanks to contributions from professionals across various fields who offered their expertise pro bono. These collaborators include neuroscientists, inventors, and veteran game developers like Lorne Lanning, the creator of the Oddworld series, and Che-Yuan Wang, known for his work on games like Descent, Grim Fandango, and Diablo III.

Currently, Deepwell’s team of 50 employees is working on further updates to Zengence and other projects. These updates aim to expand the game’s scope to address additional mental health challenges, such as anxiety and high blood pressure.

“People think we released a game,” Douglas remarked. “But we actually launched a laboratory.”

While Zengence is currently focused on managing stress, future updates, informed by player data and feedback, will aim to help with other mental health issues.

Douglas concluded, “We’re not naturally inclined to do things that are good for us. The most effective therapeutic games weren’t designed with that intent—they just happened to have therapeutic value. Moving forward, our goal is to blur the lines between what’s fun and what’s therapeutic, using the intrinsic therapeutic nature of play, which we’ve gathered substantial data on.”

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