PMID- 35310225
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220322
IS  - 1664-1078 (Print)
IS  - 1664-1078 (Electronic)
IS  - 1664-1078 (Linking)
VI  - 13
DP  - 2022
TI  - Virtual Reality as a Moderator of Psychedelic-Assisted Psychotherapy.
PG  - 813746
LID - 10.3389/fpsyg.2022.813746 [doi]
LID - 813746
AB  - 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.
CI  - Copyright (c) 2022 Sekula, Downey and Puspanathan.
FAU - Sekula, Agnieszka D
AU  - Sekula AD
AD  - Centre for Human Psychopharmacology, Swinburne University of Technology, 
      Hawthorn, VIC, Australia.
AD  - Enosis Therapeutics Pty. Ltd., Melbourne, VIC, Australia.
FAU - Downey, Luke
AU  - Downey L
AD  - Centre for Human Psychopharmacology, Swinburne University of Technology, 
      Hawthorn, VIC, Australia.
AD  - Institute for Breathing and Sleep, Austin Hospital, Melbourne, VIC, Australia.
FAU - Puspanathan, Prashanth
AU  - Puspanathan P
AD  - Enosis Therapeutics Pty. Ltd., Melbourne, VIC, Australia.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220304
PL  - Switzerland
TA  - Front Psychol
JT  - Frontiers in psychology
JID - 101550902
PMC - PMC8931418
OTO - NOTNLM
OT  - MDMA
OT  - altered state of consciousness
OT  - integration
OT  - psilocybin
OT  - psychedelics
OT  - psychotherapy
OT  - set and setting
OT  - virtual reality
COIS- AS and PP are co-founders of Enosis Therapeutics Pty. Ltd., a self-funded 
      commercial venture that specializes in the design of VR environments for the 
      psychedelic experience. The remaining author declares that the research was 
      conducted in the absence of any commercial or financial relationships that could 
      be construed as a potential conflict of interest.
EDAT- 2022/03/22 06:00
MHDA- 2022/03/22 06:01
PMCR- 2022/03/04
CRDT- 2022/03/21 08:59
PHST- 2021/11/12 00:00 [received]
PHST- 2022/02/11 00:00 [accepted]
PHST- 2022/03/21 08:59 [entrez]
PHST- 2022/03/22 06:00 [pubmed]
PHST- 2022/03/22 06:01 [medline]
PHST- 2022/03/04 00:00 [pmc-release]
AID - 10.3389/fpsyg.2022.813746 [doi]
PST - epublish
SO  - Front Psychol. 2022 Mar 4;13:813746. doi: 10.3389/fpsyg.2022.813746. eCollection 
      2022.