High in VR: How VR headsets might positively influence the psyche
Virtual reality, in combination with psychedelic substances, is said to help with mental illness. The world's first clinical trial of psychedelic therapy with VR is taking place in Germany.
In 2022, Australian researchers will travel to the Netherlands for a so-called Psychedelic Retreat to recruit participants for a VR study. In these retreats, interested participants take part in ceremonies in which they legally take hallucinogenic substances under controlled conditions.
Many of the guests participate in the scientists' experiment, consuming the psilocybin contained in magic mushrooms and, when the intoxicating effect wears off, put on VR headsets. This immerses them in a soothing virtual environment with glowing stars and giant fireflies.
In this VR world, they can grab a star and use it as an audio recording device. Have them talk about what happened inside them in the last few hours at the height of their intoxication. The audio recordings then form a sparkling constellation of stars in the VR environment.
The next day, the subjects return to this VR world and listen to their recordings. The goal is to remember the experience. Within the virtual world, participants can then expand and add to certain stars and the thoughts and emotions associated with them while symbolically burning others in a virtual fire. What's the point?
LSD + Virtual Reality = ?
In recent years, both VR technologies and research on psychedelics in psychotherapy have evolved. The two fields will now be more closely linked. LSD and magic mushrooms, for example, have been used in psychotherapy for several years to treat addictions or depression.
In Australia, a small group of researchers is developing the world's first VR-assisted treatment in this field. Traditional psychedelic therapy sessions focus on the insights and emotions that occur while taking the drug. The next step is to identify and analyze the underlying issues and problems.
This can be difficult, says Agnieszka Sekula, a doctoral student at Australia's Swinburne University. That's because patients can rarely fully recall their thoughts and feelings while intoxicated. Is virtual reality the solution to this problem? Can VR headsets help capture the fleeting memories that occur during intoxication?
In 2020, Sekula co-founded the startup Enosis Therapeutics with physician Prash Puspanathan. The company is exploring VR as a tool in psychedelic therapy. In an informational video on the company's website, you can see VR environments like a beach at sunset or a fantastic desert scene.
While patients draw a "mind map" of their psychedelic experience, therapists can observe the world on screen without entering it. According to Sekula, voice recordings prove to be powerful "memory tools," explaining, "They're reminded of what the experience was like by hearing the account of that experience in their own voice, with all those expressions and the emotional load that is attached to their voice."
Why VR instead of audio recording?
Some therapists were skeptical of VR, says Professor Luke Downey, who was involved in the Dutch pilot study. "They suggested it was maybe interrupting the genuine mystical experiences among other people," he said; however, "About 90 percent [of the participants] said they thought it was appropriate, they enjoyed it, and they would do it again as part of the psychedelic experience."
Sekula reports that those who used VR had better recall of their psychedelic experiences. On Australian Broadcasting, she shared quotes from anonymous participants in the study:
"There were more memories than I thought. I thought I didn’t need the star to record this but then I actually said more than I remember."
"VR helped me to reflect on the experience, it kept the marvel; you're not tripping anymore but you are reminded by this magic vision."
"The stars fueled with memories were helpful in structuring the mind."
Virtual reality apparently helped some participants relive memories of the psychedelic and emotional experience. The visual elements and disconnection from the real world may make it work better than an audio-only recording.
World premiere in Germany
Late last year, Enosis announced a partnership with Berlin-based Ovid Clinics, which uses ketamine to treat depression, anxiety, trauma, and obsessive-compulsive disorder. Together, they are conducting the world's first clinical trial of psychedelic therapy with VR.
"They're offering it at the moment to the clients that are starting their ketamine treatments," Sekula said, noting that some psychiatric hospitals in Melbourne are seeking a partnership with the startup. "[Clinics] are still learning, and we're in the very early days with them."
Enosis will be at SXSW on March 10, 2023, with a panel of experts to discuss VR and psychedelic therapy in more detail.
Criticism of VR therapies
Some longtime proponents of psychedelic therapy are wary of the new interest in virtual reality. Rick Doblin, who founded the Multidisciplinary Association for Psychedelic Studies (MAPS) in California in 1986, criticized the use of "guided imagery."
"You're having a VR program that's supposed to somehow remind you of your own inner imagery, so it will be not as precise as your own imagination," he said.
In other words, VR is solving a problem that doesn't exist. Moreover, he says, numerous clinical studies have shown that psychedelic treatments worked well without the assistance of VR. Doblin points to studies that have shown an improvement in the therapeutic process for people with post-traumatic stress disorder using the ecstasy agent MDMA, asking, "what are we trying to fix?"
Criticism and skepticism don't seem to stop VR therapies. On the contrary, one might ask if VR can be used to get by without drugs altogether. In a study published in the journal Nature Scientific Reports in August 2022, a British-Spanish research team describes attempts to create in virtual reality what psychedelics reliably induce, a "self-transcendent experience."
Digital therapeutics as a business area
In any case, the pharmaceutical and financial worlds are showing some interest in VR therapies. According to Professor Luke Downey, investors want to cash in on the emerging market for psychedelic treatments.
"You can't patent the cannabis plants or LSD. You've got to have something else," Downey stated, noting two critical details — a treatment that will be patentable while having efficacy.
For example, researchers at Monash University in Melbourne have developed a treatment for anxiety that combines VR and psychedelics.
VR meditation apps that use methods like those described are already available. The CEO of the maker of one of these apps, Tripp, is already talking about "digital therapeutics" and sees a growth opportunity in the Metaverse. In a funding round last year, Tripp raised millions from companies such as Amazon and Pokémon Go developer Niantic.
But whether the whole thing is more than just a questionable way of doing business with VR and the psyche of patients remains to be proven by renowned researchers and their studies.