Home Therapeutic relationship Meet two researchers bringing virtual reality to psychedelic therapy

Meet two researchers bringing virtual reality to psychedelic therapy

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Two unassuming Australian psychedelic researchers are proposing a radical paradigm shift in the way psychotherapy is conducted. The duo have developed a unique protocol for incorporating virtual reality into the still-experimental mode of psychedelic-assisted psychotherapy, and it promises to shatter 20th-century ideas of therapy.

Psychedelic-assisted psychotherapy is still a deeply experimental concept. While MDMA therapy for PTSD has reached advanced stages of clinical trials and imminent FDA clearance, other more classic psychedelics such as psilocybin and LSD are still in relatively early research stages.

Agnieszka Sekula and Prash Puspanathan founded Enosis Therapeutics to explore ways to integrate virtual reality into psychedelic therapy. The duo’s philosophy behind Enosis is based on the idea that virtual reality technology can help people connect more directly to the visceral 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 chasm between the ineffable nature of a psychedelic experience and the pragmatic and analytical structure of talk therapy that Enosis attempts to bridge.

“Anything we can do to get things back to being more emotional, more embodied or grounded in the true principles of this [psychedelic] the experience would be incredibly beneficial in sustaining those ideas,” Prash told New Atlas.

Most current psychedelic psychotherapies follow a conventional structure involving a few preparatory therapy visits, before one or more active drug sessions, which are then followed by a handful of therapy sessions designed to help patients integrate the knowledge gained from of their psychedelic experiences. A full protocol of psychedelic-assisted psychotherapy can last anywhere from eight to 12 weeks.

The protocol proposed by Enosis is both simple and radical. Agnieszka and Prash envision virtual reality being used at all stages of psychedelic therapy, serving as a kind of adjunct to help patients stay connected to these deeply resonant altered-state experiences over weeks and months.

“The way we work is to inject virtual reality in a targeted way into different parts of the therapy,” explained Agnieszka. “We use it for the whole process, from preparation to dosing to integration, in every session if possible. In a way that keeps the treatment cohesive so that there is an environment that you keep coming back to that helps transition between the therapeutic space.

Enosis offers a number of different VR scenarios deployed at different stages of the therapy process. In the beginning, before any drug experience, there are preparatory sessions designed to help patients become familiar with the VR space and formulate certain intentions for future psychedelic sessions.

A photo of Enosis Therapeutics’ “Surrender” VR scenario experienced before the drug’s effects kicked in

Enosis

Perhaps the most conventional part of the Enosis VR protocol is a sort of 15-20 minute meditative scenario called “SurrenderVR”, designed to be played on a dose day, shortly after a patient has consumed their psychedelic. The goal of this VR engagement is to help reduce a patient’s anxieties while they wait for the medication to take effect.

Both Agnieszka and Prash are keen to point out that virtual reality is not used at all during the active experience of the psychedelic drug. It’s not about tripping in a VR environment, so the dose-day introductory storyline is short and ends at the point where a psychedelic experience is likely to occur.

The most interesting part of the Enosis Protocol is at the end of the psychedelic experience. At some point, four or five hours after taking the drug, another virtual reality scenario is engaged. This is dubbed “AnchoringVR” and involves placing the patient in a quiet VR environment by the beach.

The beach environment is part of the anchoring virtual reality scenario, which a patient returns to during follow-up therapy sessions to rekindle the felt experience of the psychedelic sessions
The beach environment is part of the anchoring virtual reality scenario, which a patient returns to during follow-up therapy sessions to rekindle the felt experience of the psychedelic sessions

Enosis

The patient is presented with a series of floating jewelry. As each piece of jewelry is held, the patient is asked to describe an idea they got from the previous psychedelic experience. Their own words are recorded and then attached to the jewelry. Patients can record as many ideas as they want, each connecting to a unique shape in this virtual beach environment.

When the patient returns to meet with their therapist in the days and weeks following the psychedelic drug experience, they reenter this virtual reality scenario on the beach. Each time a gem-related insight is touched, they hear their own voice telling what they felt in the moments immediately following the psychedelic experience.

Over several follow-up therapy sessions, these ideas begin to connect with each other in the VR scenario, creating a sort of three-dimensional visual map filled with interconnected ideas. Sometimes these ideas take the form of seeds, planted on the beach and grow bigger from session to session, other times disparate ideas can come together to form bigger clouds of achievement.

VR Protocol anchor party attaches psychedelic ideas to jewelry on a beach
VR Protocol anchor party attaches psychedelic ideas to jewelry on a beach

Enosis

This virtual reality-based mode of therapy feels unconventional, futuristic, and oddly appropriate in its relationship to a family of psychedelic drugs that are themselves known to destroy preconceptions. It’s certainly a fun, interesting, and unusual way to frame a psychotherapy experience, but does it actually help improve therapy outcomes or is it just a shiny tech gimmick?

Establishing the clinical effectiveness of this type of VR-assisted protocol will be a challenge given that psychedelic therapy itself is still in the preclinical stage. But Agnieszka and Prash are certainly doing their best to try, with clinical trials in the works.

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

Two main measures were investigated in this preliminary study, namely whether pre-session anxiety could be reduced using early virtual reality scenarios and whether post-session anchoring scenarios increased recall of psychedelic ideas the next day.

The data has yet to be published in a peer-reviewed journal, however, according to Agnieszka and Prash, these early tests were incredibly promising. Qualitatively and quantitatively, the emotional state of the psychedelic experience could be measurably revived during the subsequent integration session with the virtual reality scenarios.

“There were more memories than I thought,” said one participant in this preliminary study. “I thought I didn’t need to start recording this, but I said more than I remember.”

Building on these findings, Enosis plans to begin a more robust clinical trial next year. This will directly contrast the VR psychedelic therapy protocol against a more traditional psychedelic therapy protocol.

To be conducted in healthy volunteers and using the traditional psychedelic therapy setting as a control, the trial will compare the effects of VR on reducing pre-session anxiety and more rigorously measure how well VR anchors the psychedelic experience and helps subjects reconnect with these ideas in the after therapy sessions.

Ultimately, what Agnieszka and Prash are proposing is a relatively radical reimagining of how psychotherapy can incorporate psychedelics in the 21st century. If, as researcher Rick Doblin envisions, there could be thousands of psychedelic therapy clinics around the world over the next decade, then Enosis sees no reason why VR couldn’t be a new tool among others designed to increase the benefits of this treatment.

Underlying all of this discussion of virtual reality and psychedelic therapy is the idea that psychedelics may not be so well suited to our current medical models. So basically, the goal of using virtual reality as an adjunct to psychedelic therapy is more about getting closer to a clinical setting better suited to the intrinsic effects of psychedelics.

Prash candidly points out that trying to cram psychedelics into whitewashed clinical spaces is probably not ideal. Taking these substances into more natural outdoor environments would be a much better model, he suggests.

“While it’s optimal, it’s not scalable,” Prash said. “We understand that the Trojan horse for bringing this into the mainstream is that it fits into the medical model, however, we recognize that this model is not optimal. So what can we do to approach the unfortunate necessity of the one we need to fit into, in something that is 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 Agnieszka and Prash are already trying to imagine ways to improve it. It’s a bit like psychedelic therapy version 2.0.