Trial PaperAnxiety DisordersDepressive DisordersSubstance Use Disorders (SUD)Palliative & End-of-Life Distress

Psychedelic replications in virtual reality and their potential as a therapeutic instrument: an open-label feasibility study

This open‑label feasibility study tested Psyrreal, a virtual reality experience that mimics psychedelic phenomenology, in 13 people with mild-to-moderate depression and found a significant reduction in depressive symptoms at 2‑week follow‑up (n = 10, p = 0.007, Hedges’ g = 1.046). Semi‑structured interviews suggested the VR sessions could produce insight and alterations in sense of self for some participants, indicating VR psychedelic replications with psychological support are a promising therapeutic approach warranting further controlled research.

Authors

  • Kaup, K. K.
  • Vasser, M.
  • Tulver, K.

Published

Frontiers in Psychiatry
individual Study

Abstract

Background

Recent research has shown promising results for the therapeutic benefits of psychedelics. One popular view claims that these benefits are mediated by the subjective experiences induced by these substances. Based on this, we designed a virtual reality experience, Psyrreal, that mimics the phenomenological components of psychedelic experiences.

Aims

We aimed to investigate the therapeutic efficacy of Psyrreal and psychedelic VR experiences in treating depressive symptoms as well as explore the effect of Psyrreal on subjective factors which have been suggested to mediate the therapeutic benefits of psychedelics.

Methods

In this open-label feasibility study, thirteen participants with mild-to-moderate depression underwent a 2-day therapeutic intervention implementing Psyrreal. Depressive symptoms were evaluated by the Emotional State Questionnaire (EST-Q2) at the start of the intervention and 2 weeks after. A thematic analysis of semi-structured interviews after Psyrreal was also conducted as an additional assessment of the method.

Results

A 2-day intervention implementing Psyrreal led to significant decreases in depressive symptoms at the 2-week follow-up (n = 10, p = 0.007, Hedges’ g = 1.046) measured by the Emotional State Questionnaire (EST-Q2). The analysis of semi-structured interviews suggests that Psyrreal could lead to insight and alterations in the sense of self in some people.

Conclusion

This work proposes a novel method using virtual reality to augment the treatment of psychological disorders as well as to precisely investigate the mediating subjective factors of the therapeutic effects of psychedelic substances. Our preliminary results suggest that VR experiences combined with psychological support show potential in treating depressive symptoms and further research into similar methods is warranted

Available with Blossom Pro

Research Summary of 'Psychedelic replications in virtual reality and their potential as a therapeutic instrument: an open-label feasibility study'

Introduction

Psychedelic-assisted therapies have seen a strong resurgence because of promising results across conditions such as depression, addiction and end-of-life distress. A central unresolved question in this literature is whether therapeutic benefit arises primarily from neurochemical action or from the subjective experiences psychedelics produce — for example mystical-type states, ego-dissolution and insight. If subjective phenomenology is a key mediator, then replicating those phenomenological elements without drugs might produce at least some therapeutic effects and offer a more accessible alternative for people who cannot, or prefer not to, take psychedelic compounds. Aday and colleagues designed a virtual reality (VR) experience called Psyrreal intended to mimic a broad set of audiovisual and narrative features of psychedelic, mystical and meditative states. This open-label feasibility study tested Psyrreal in a 2-day augmented therapeutic protocol for adults with mild-to-moderate depressive symptoms, with the main aim of assessing whether the intervention reduced depressive symptoms and whether psychedelic-like subjective factors (mystical experiences, ego-dissolution, insight) were elicited and measurable.

Expert Research Summaries

Go Pro to access AI-powered section-by-section summaries, editorial takes, and the full research toolkit.

Full Text PDF

Full Paper PDF

Create a free account to open full-text PDFs.

Study Details

References (69)

Papers cited by this study that are also in Blossom

Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study

Bogenschutz, M. P., Forcehimes, A. A., Pommy, J. A. et al. · Journal of Psychopharmacology (2015)

Psilocybin-occasioned mystical experiences in the treatment of tobacco addiction

Garcia-Romeu, A., Griffiths, R. R., Johnson, M. W. · Current Drug Abuse Reviews (2015)

Cessation and reduction in alcohol consumption and misuse after psychedelic use

Garcia-Romeu, A., Davis, A. K., Fire Erowid et al. · Journal of Psychopharmacology (2019)

211 cited
Persisting Reductions in Cannabis, Opioid, and Stimulant Misuse After Naturalistic Psychedelic Use: An Online Survey

Garcia-Romeu, A., Davis, A. K., Griffiths, R. R. et al. · Frontiers in Psychiatry (2020)

121 cited
Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer

Grob, C. S., Danforth, A. L., Chopra, G. S. et al. · JAMA Psychiatry (2011)

Psilocybin with psychological support for treatment-resistant depression: six-month follow-up

Carhart-Harris, R. L., Bolstridge, &. M., Day, C. M. J. et al. · Psychopharmacology (2017)

Show all 69 references
Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study

Carhart-Harris, R. L., Bolstridge, M., Rucker, J. et al. · Lancet Psychiatry (2016)

1174 cited
Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report

Osório, F. L., Sanches, R. F., Macedo, L. et al. · brazilian Journal of Psychiatry (2015)

420 cited
Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression a SPECT study

Sanches, R. F., Osório, F. L., Dos Santos, R. G. et al. · Journal of Clinical Psychopharmacology (2016)

380 cited
On the Relationship between Classic Psychedelics and Suicidality: A Systematic Review

Zeifman, R. J., Singhal, N., Breslow, L. et al. · ACS Pharmacology and Translational Science (2021)

Psilocybin, psychological distress, and suicidality

Hendricks, P. S., Johnson, M. W., Griffiths, R. R. · Journal of Psychopharmacology (2015)

84 cited
Safety, Tolerability, and Efficacy of Psilocybin in 9 Patients With Obsessive-Compulsive Disorder

Moreno, F. A., Wiegand, C. B., Taitano, E. K. et al. · Journal of Clinical Psychiatry (2006)

Exploratory Controlled Study of the Migraine-Suppressing Effects of Psilocybin

Schindler, E. A. D., Sewell, R. A., Gottschalk, C. H. et al. · Neurotherapeutics (2021)

82 cited
Relief from intractable phantom pain by combining psilocybin and mirror visual-feedback (MVF)

Ramachandran, V., Chunharas, C., Marcus, Z. et al. · Neurocase (2018)

The therapeutic potential of psychedelic drugs: past, present, and future

Carhart-Harris, R. L., Goodwin, G. M. · Neuropsychopharmacology (2017)

Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern-era clinical studies

Andersen, K. A. A., Carhart-Harris, R. L., Nutt, D. J. et al. · Acta Psychiatrica Scandinavica (2020)

Psychedelics

Nichols, D. E. · Pharmacological Reviews (2016)

Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function

Johnson, M. W., Hendricks, P. S., Barrett, F. S. et al. · Pharmacology and Therapeutics (2019)

Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance

Griffiths, R. R., Richards, W. A., Mccann, U. et al. · Journal of Psychopharmacology (2006)

The Subjective Effects of Psychedelics Are Necessary for Their Enduring Therapeutic Effects

Yaden, D. B., Griffiths, R. R. · ACS Pharmacology and Translational Science (2020)

Classic hallucinogens and mystical experiences: phenomenology and neural correlates

Barrett, F. S., Griffiths, R. R. · Current Topics in Behavioral Neurosciences (2017)

The entropic brain: a theory of conscious states informed by neuroimaging research with psychedelic drugs

Carhart-Harris, R. L., Leech, R., Shanahan, M. et al. · Frontiers in Human Neuroscience (2014)

Reduced precision underwrites ego dissolution and therapeutic outcomes under psychedelics

Stoliker, D., Egan, G. F., Razi, A. · Frontiers in Neuroscience (2022)

The entropic brain - revisited

Carhart-Harris, R. L. · Neuropharmacology (2018)

Development of the Psychological Insight Questionnaire among a sample of people who have consumed psilocybin or LSD

Davis, A. K., Streeter Barrett, F., Griffiths, R. R. et al. · Journal of Psychopharmacology (2021)

108 cited
Pivotal Mental States

Brouwer, A., Carhart-Harris, R. L. · Journal of Psychopharmacology (2020)

Predicting Reactions to Psychedelic Drugs: A Systematic Review of States and Traits Related to Acute Drug Effects

Aday, J. S., Davis, A. K., Mitzkovitz, C. M. et al. · ACS Pharmacology and Translational Science (2021)

Psychiatry & the psychedelic drugs. Past, present & future

Rucker, J., Iliff, J., Nutt, D. J. · Neuropharmacology (2017)

Adverse effects of psychedelics: From anecdotes and misinformation to systematic science

Neil, J. C., Nutt, D. J. · Journal of Psychopharmacology (2022)

Isness: Using Multi-Person VR to Design Peak Mystical Type Experiences Comparable to Psychedelics

Glowacki, D. R., Wonnacott, M. D., Freire, R. et al. · Association for Computing Machinery (2020)

32 cited
Phenomenology, Structure, and Dynamic of Psychedelic States

Preller, K. H., Vollenweider, F. X. · Behavioral Neurobiology of Psychedelic Drugs (2016)

Patients’ accounts of increased “Connectedness” and “Acceptance” after psilocybin for treatment-resistant depression

Watts, R., Day, C. M., Krzanowski, J. et al. · Journal of Humanistic Psychology (2017)

Ego-dissolution and psychedelics: validation of the ego-dissolution inventory (EDI)

Nour, M. R., Evans, J., Nutt, D. J. et al. · Frontiers in Human Neuroscience (2016)

Factor analysis of the mystical experience questionnaire: A study of experiences occasioned by the hallucinogen psilocybin

MacLean, K. A., Leoutsakos, J. S., Johnson, M. W. et al. · Journal for the Scientific Study of Religion (2012)

350 cited
Psychometric evaluation of the altered states of consciousness rating scale (OAV)

Studerus, E., Gamma, A., Vollenweider, F. X. · PLOS ONE (2010)

Serotonergic Hallucinogen-Induced Visual Perceptual Alterations

Kometer, M., Vollenweider, F. X. · Behavioral Neurobiology of Psychedelic Drugs (2016)

Dreamlike effects of LSD on waking imagery in humans depend on serotonin 2A receptor activation

Kraehenmann, R. ;., Pokorny, D. ;., Vollenweider, L. ;. et al. · Psychopharmacology (2017)

138 cited
LSD Increases Primary Process Thinking via Serotonin 2A Receptor Activation

Sumiyoshi, T., Kraehenmann, R., Pokorny, D. et al. · Frontiers in Pharmacology (2017)

Patient Experiences of Psilocybin-Assisted Psychotherapy: An Interpretative Phenomenological Analysis

Belser, A. B., Agin-Liebes, G. I., Swift, T. C. et al. · Journal of Humanistic Psychology (2017)

Neural Mechanisms and Psychology of Psychedelic Ego Dissolution

Stoliker, D., Egan, G. F., Friston, K. J. et al. · Pharmacological Reviews (2022)

Psychedelics and virtual reality: parallels and applications

Aday, J. S., Davoli, C. C., Bloesch, E. K. · Therapeutic Advances in Psychopharmacology (2020)

REBUS and the Anarchic Brain: Toward a Unified Model of the Brain Action of Psychedelics

Carhart-Harris, R. L., Friston, K. J. · Pharmacological Reviews (2019)

Making “bad trips” good: How users of psychedelics narratively transform challenging trips into valuable experiences

Gashi, L., Sandberg, S., Pedersen, W. · International Journal of Drug Policy (2021)

Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance

Wolff, M., Evens, R., Mertens, L. J. et al. · Frontiers in Psychiatry (2020)

143 cited
Mood and cognition after administration of low LSD doses in healthy volunteers: A placebo controlled dose-effect finding study

Hutten, N. R. P. W., Mason, N. L., Dolder, P. C. et al. · European Neuropsychopharmacology (2020)

95 cited
Virtual Reality as a Moderator of Psychedelic-Assisted Psychotherapy

Sekula, A. D., Downey, L., Puspanathan, P. · Frontiers in Psychology (2022)

19 cited
Dose-response study of N,N-dimethyltryptamine in humans: subjective effects and preliminary results of a new rating scale

Strassman, R. J., Qualls, C. R., Uhlenhuth, E. H. et al. · JAMA Psychiatry (1994)

Broadband Cortical Desynchronization Underlies the Human Psychedelic State

Muthukumaraswamy, S. D., Carhart-Harris, R. L., Moran, R. J. et al. · Journal of Neuroscience (2013)

427 cited
Finding the self by losing the self: Neural correlates of ego-dissolution under psilocybin

Lebedev, A. V., L€ Ovd En, M., Rosenthal, G. et al. · Human Brain Mapping (2015)

Self unbound: ego dissolution in psychedelic experience

Letheby, C., Gerrans, P. · Neuroscience of Consciousness (2017)

Your Personal Research Library

Go Pro to save papers, add notes, rate studies, and organize your research into custom shelves.