Virtual Reality as a Moderator of Psychedelic-Assisted Psychotherapy
The paper proposes virtual reality (VR) as a full‑spectrum adjunct to psychedelic‑assisted psychotherapy, arguing VR can catalyse and shape altered states of consciousness—supporting relaxation, sensory modulation, mystical‑type experiences and therapeutic alliance—and outlines specific VR models for integration. The authors caution the idea is currently speculative, list potential harms (sensory overstimulation, cyber‑sickness, retraumatisation, distraction) and call for rigorous, evidence‑based evaluation before clinical adoption.
Authors
- Sekula, A. D.
- Downey, L.
- Puspanathan, P.
Published
Abstract
Psychotherapy with the use of psychedelic substances, including psilocybin, lysergic acid diethylamide (LSD), ketamine, and 3,4-methylenedioxymethamphetamine (MDMA), has demonstrated promise in treatment of post-traumatic stress disorder (PTSD), anxiety, addiction, and treatment-resistant depression. Psychedelic-assisted psychotherapy (PP) represents a unique psychopharmacological model that leverages the profound effects of the psychedelic experience. That experience is characterized by strong dependency on two key factors: participant mindset and the therapeutic environment. As such, therapeutic models that utilize psychedelics reflect the need for careful design that promotes an open, flexible, trusting mindset and a supportive setting. To meet this need, the PP model is increasingly supplemented by auxiliary methods, including meditation, relaxation, visualization or spiritual practices. We suggest virtual reality (VR) as a full-spectrum tool able to capitalize on and catalyze the innately therapeutic aspects of the psychedelic experience, such as detachment from familiar reality, alteration of self-experience, augmentation of sensory perception and induction of mystical-type experiences. This is facilitated by VR’s evidenced capacity to: aid relaxation and reduce anxiety; buffer from external stimuli; promote a mindful presence; train the mind to achieve altered states of consciousness (ASC); evoke mystical states; enhance therapeutic alliance and encourage self-efficacy. While these unique VR features appear promising, VR’s potential role in PP remains speculative due to lack of empirical evidence on the combined use of VR and PP. Given the increased commercial interest in this synergy there is an urgent need to evaluate this approach. We suggest specific VR models and their role within PP protocols to inspire future direction in scientific research, and provide a list of potential disadvantages, side effects and limitations that need to be carefully considered. These include sensory overstimulation, cyber-sickness, triggering memories of past traumatic events as well as distracting from the inner experience or strongly influencing its contents. A balanced, evidence-based approach may provide continuity across all phases of treatment, support transition into and out of an ASC, deepen acute ASC experiences including mystical states and enrich the psychotherapeutic process of integration. We conclude that the potential application of VR in modulating psychedelic-assisted psychotherapy demands further exploration and an evidence-based approach to both design and implementation.
Research Summary of 'Virtual Reality as a Moderator of Psychedelic-Assisted Psychotherapy'
Introduction
Yaden and colleagues frame psychedelic-assisted psychotherapy (PP) as a resurging clinical approach in the past decade, using classic psychedelics (psilocybin, DMT, LSD) and psychedelic-like substances (MDMA, ketamine) to treat conditions such as PTSD, treatment-resistant depression and substance dependence. Earlier research emphasises that therapeutic outcomes from psychedelics depend strongly on the phenomenology of the acute experience—notably peak or mystical-type states—and on two contextual drivers often summarised as “set” (mindset) and “setting” (the therapeutic environment). The authors note that clinical PP has tended to fragment treatment into separate preparation, dosing and integration phases, producing discontinuities in context, therapist role and supporting practices that may impede continuity of care, complicate integration of ineffable experiences and contribute to adverse reactions in some cases. This paper sets out to explore virtual reality (VR) as a potential moderator and adjunct to PP. Rather than reporting original experimental data, the work offers a theoretical and integrative examination of features of VR that map onto processes important in PP—relaxation, sensory buffering, promotion of mindful presence, training for altered states of consciousness (ASC), elicitation of mystical-like experiences and strengthening of therapeutic alliance and self-efficacy. The researchers propose specific ways VR could be incorporated across PP phases and enumerate potential disadvantages and safety concerns, concluding that the combined application is promising but currently speculative and in urgent need of empirical evaluation.
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Study Details
- Study Typeindividual
- Journal
- Compounds
- Topics
- APA Citation
Sekula, A. D., Downey, L., & Puspanathan, P. (2022). Virtual Reality as a Moderator of Psychedelic-Assisted Psychotherapy. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.813746
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