Meet two researchers who are bringing VR to psychedelic therapy

A few humble Australian psychedelic researchers propose a radical paradigm shift to the way psychotherapy is performed. The pair have developed a unique protocol for incorporating virtual reality into the still experimental mode of psychedelic-assisted psychotherapy, and it promises to destroy 20th-century ideas about therapy.

Psychedelically assisted psychotherapy is still a deeply experimental concept. While MDMA therapy for PTSD has progressed into late-stage clinical trials and looming FDA approval, other more classic psychedelics, such as psilocybin and LSD, are still in relatively early stages of research.

Agnieszka Sekula and Prash Puspanathan founded Enosis Therapeutics to explore ways to integrate virtual reality into psychedelic therapy. The philosophy of the couple behind Enosis is the idea that virtual reality technology can help people connect more directly with the deep-seated nature of a psychedelic experience.

The psychedelic experience, according to Prash, is an embodied and emotional experience. Yet modern psychotherapy frameworks often operate within cognitive therapy protocols. It is this gap between the ineffable nature of a psychedelic experience and the pragmatic, analytical structure of talk therapy that Enosis tries to bridge.

“Anything we can do to bring things back to more emotional, more embodied or anchored in the true principles of that [psychedelic] experience would be incredibly helpful to support those insights,” Prash told New Atlas.

Most current psychedelic psychotherapy follows a conventional structure with a few preliminary therapy visits, prior to one or more active drug sessions, which are then followed by a handful of therapy sessions designed to help patients understand the insights they have gained from their psychedelic experiences. integrate. A complete protocol for psychotherapy with psychedelics can take anywhere from eight to 12 weeks.

The protocol proposed by Enosis is both simple and radical. Sekula and Prash envision virtual reality being used at all stages of psychedelic therapy, as a sort of tool to help patients stay connected to those deeply resonating altered state experiences as the weeks and months go by.

“The way we work is to inject VR into different parts of the therapy in a targeted way,” explains Sekula. “We use it for the entire process, from dosing preparation to integration, in every session if possible. In a way that maintains the coherence of the treatment so that there is an environment that you keep coming back to and that helps with the transition between therapeutic space.”

Enosis proposes a number of different VR scenarios deployed at different stages of the therapeutic process. Early on, before drug experiences are made, there are preparatory sessions designed to introduce patients to the VR space and formulate certain intentions for the future psychedelic sessions.

A still from Enosis Therapeutics’ “Surrender” VR scenario, experienced before the drug’s effects set in

Enosis

Perhaps the most conventional part of the Enosis VR protocol is a 15- to 20-minute meditative scenario called “Surrender,” designed to be played on a dose day, shortly after a patient has consumed their psychedelics. The goal of this VR engagement is to ease a patient’s fears while they wait for the drug to take effect.

Both Sekula and Prash want to emphasize that VR is not used at all during the active psychedelic drug experience. This isn’t about tripping in a VR environment, so the introductory dose-day scenario is short and ends at the point where a psychedelic experience is likely to arise.

The more interesting part of the Enosis protocol comes at the end of the psychedelic experience. At some point, four or five hours after taking the drug, another VR scenario plays out. This is called ‘anchoring’ and involves placing the patient in a quiet VR environment on the beach.

The beach setting is part of the anchoring VR scenario, which a patient returns to in follow-up therapy sessions to revive the felt experience of the psychedelic sessions

The beach setting is part of the anchoring VR scenario, which a patient returns to in follow-up therapy sessions to revive the felt experience of the psychedelic sessions

Enosis

The patient is presented with a series of floating jewels. While holding each gem, the patient is asked to describe an insight they have gained from the previous psychedelic experience. Their own words are recorded and then attached to the jewels. The patients can capture as many insights as they see fit, each connected to a unique shape in this virtual beach environment.

When the patient returns to meet with his therapist in the days and weeks following the psychedelic drug experience, they re-enter that beach VR scenario. Each time a jewel-engaged insight is touched, they hear their own voice narrating how they felt in the moments immediately following the psychedelic experience.

Over multiple follow-up therapy sessions, these insights begin to connect together in the VR scenario, creating a sort of three-dimensional visual map full of interconnected ideas. Sometimes those ideas take the form of seeds planted on the beach and grow from session to session, other times disparate insights can come together to form larger clouds of realization.

The anchoring part of the VR protocol links psychedelic insights to jewels on a beach

The anchoring part of the VR protocol links psychedelic insights to jewels on a beach

Enosis

This VR-driven form of therapy feels unconventional, futuristic, and oddly fitting in its relationship with a family of psychedelic drugs that are themselves known for destroying prejudice. It’s certainly a fun, interesting, and unusual way to frame a psychotherapy experience, but does it really help improve therapeutic outcomes or is it just a shiny technical gimmick?

Determining the clinical efficacy of this kind of VR-assisted protocol will be challenging, as the psychedelic therapy itself is still in the preclinical stages. But Sekula and Prash are certainly doing their best to try, with clinical trials in the pipeline.

The first real-world tests for the tech recently took place in the Netherlands. In collaboration with the Psychedelic Society Belgium, the Enosis VR system was tested with four volunteers as part of a two-day psychedelic retreat.

This preliminary study examined two key measures, whether pre-session anxiety could be reduced using the early VR scenarios, and whether the post-session anchoring scenarios increased psychedelic insight recall the next day.

The data has yet to be published in a peer-reviewed journal, but according to Sekula and Prash, these early tests were incredibly promising. Qualitatively and quantitatively, the emotional state of the psychedelic experience could be measurably rekindled during the later integrative session with the VR scenarios.

“There were more memories than I thought,” reported one participant in this preliminary study. “I thought I didn’t have to include this, but then I actually said more than I remember.”

Building on those findings, Enosis plans to begin a more robust clinical trial next year. That will directly confront the VR protocol for psychedelic therapy with a more traditional protocol for psychedelic therapy.

The study should be conducted in healthy volunteers and using the traditional psychedelic therapy framework as a control. The study will compare the effects of VR on reducing session anxiety and more accurately measure how well VR anchors the psychedelic experience and helps subjects reconnect with those insights in subsequent therapy sessions.

What Sekula and Prash ultimately propose is a relatively radical rethinking of how psychotherapy can incorporate psychedelics into the 21st century. If, as researcher Rick Doblin imagines, there could be thousands of psychedelic therapy clinics around the world within the next decade, Enosis sees no reason why VR cannot be one of many new tools designed to deliver the benefits of psychedelic therapy. increase this treatment.

All this talk of VR and psychedelic therapy is supported by the idea that psychedelics may not be a good fit for our current medical models. So at its core, the goal of using VR as an adjunct to psychedelic therapy is more to get closer to a clinical setting better suited to the intrinsic effects of psychedelics.

Prash honestly points out that trying to jam psychedelics in whitewashed clinical spaces probably isn’t ideal. Taking these substances in more natural outdoor settings would be a much better model, he suggests.

“While that would be optimal, that’s not scalable,” Prash said. “We understand that the Trojan horse in getting this into the mainstream is that it fits into the medical model, but we recognize that model isn’t optimal. So what can we do to approach the unfortunate necessity of the one we have to fit into, in something perhaps more closely related to what will be an optimal model? These are some of the tools we can use to help us get there.”

While the first iteration of psychedelic psychotherapy has yet to reach mainstream clinics, researchers like Sekula and Prash are already trying to figure out ways to make it work better. It’s a bit like psychedelic therapy version 2.0.

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