Welcome to the brave new world of wellness where pills, needles, and patches are passé. Rather, attention is shifting to altered states of consciousness (ASC) that can help heal trauma and disrupt detrimental behaviors.
Altered states of consciousness can be facilitated by diverse experiences. Psychedelic substances represent one well-known method of inducing an ASC. Virtual reality (VR) represents another. Both psychedelic journeys and virtual reality can shake up the rigidity and limitations of typical conscious experience. A recently developed VR framework called Isness-D, for example, delivers an experience comparable to a medium-sized dose of LSD.
Given the natural parallels between psychedelics and VR, forward-thinking researchers and clinicians have started exploring whether it might be useful to combine the two in complementary ways. One company that has got a jump-start on this emerging field is Enosis Therapeutics, an Australian medical technology and research company. According to Enosis co-founders Dr. Prash Puspanathan and Agnieszka Sekula, PhD, Enosis’ VR protocol is less focused on emulating the psychedelic experience, and more oriented towards using VR to augment and enhance its effects.
“Our approach isn’t focussed on the phenomenology of the psychedelic experience–we prefer to let the medicines do their work as nature has intended them to,” explains Puspanathan. Enosis is harnessing VR to help support memory and anchor insights from psychedelic journeys, rather than focusing on its aesthetically-inspiring multisensory features.
“While the aesthetics (of VR) are important and add to the sense of awe which we leverage effectively, the aesthetics are often the simplest and most easily altered element of the experience and are easily interchanged; think of them as skins,” says Puspanathan. “Rather it is the functionality that is programmed, and in our case, to best augment the neuropsychological mechanisms that underpin memory formation, recall and engagement that determines the success of our models as a psychotherapeutic tool.”
Puspanathan and Sekula believe that VR can amplify the emotional, embodied moments of the psychedelic journey, which represents a fundamental feature of psychedelic-based treatment. “VR seems to be uniquely suited to promote those experiential aspects of psychedelic therapy, in contrast with a traditional talk therapy process, which is more cognitive and analytical. Our work is strongly rooted in research showing that combining different state-altering practices can lead to an augmented effect in producing a mystical experience,” says Sekula.
Puspanathan also points out that virtual reality allows control over the context and richness of the stimuli that are provided.
“Unlike the therapist’s office, where the patient is always a visitor, the virtual world is under the full control of the patient,” he explains. “If you consider the impact that the physical environment has on the nature of the psychedelic experience, being able to choose and modulate that setting gives patients a sense of agency over their own healing.”
Furthermore, virtual reality can transport the user out of a typical, clinical treatment environment into an alternate reality by replacing familiar settings with wondrous objects and symbols. This, in turn, helps to facilitate deep immersion into the psychedelic experience.
“This is important, for example, if the physical presence of the therapist feels intrusive or if domestic elements of the room, like the bed or a chair, tether the patient to the familiar reality, making it more difficult to surrender into the mystical experience,” explains Puspanathan.
Anchoring psychedelic experiences through virtual reality
Sekula and Puspanathan believe that VR can enhance psychedelic experience by offering a non-verbal bridge between altered and normal states of consciousness. The two researchers have developed a novel method of integrating virtual reality into psychedelic-assisted therapy: the AnchoringVR™ scenario. AnchoringVR™ can be used at the end of a psychedelic session after the acute peak experience concludes when participants begin the journey back to normal consciousness. “The insights are most profound but also most difficult to put into words –as well as to communicate face-to-face with another person,” says Sekula.
“In the AnchoringVR™ scenario patients select or create visual expressions of that experience and fuel them with audio recordings of their insights,” explains Sekula. “Those insights, represented with stars, are then formed into constellations to serve as a personal memory library of the psychedelic experience. During the integration process, patients revisit those constellations or memory libraries that they built for themselves.”
These constellations or memory libraries serve as multisensory anchors that capture raw, profound psychedelic insights, which can be revisited during integration. The therapeutic process is therefore developed around the altered state of consciousness experience, rather than around a talk therapy framework.
“In the first few integration sessions, the participant is actively reminded of those insights, through their own audio and visual expressions, and passively reminded through immersion in the VR scenario that became inextricably entwined with the psychedelic experience,” explains Puspanathan. “Further integration sessions are based on exploring those constellations, organising and re-structuring them, identifying common themes and putting them into action. A lot of those actions are symbolic, multisensory representations of processes that are currently used in therapy through visualization or dialogue–like burning insights that no longer serve you in a bonfire on a beach.”
Puspanathan and Sekula believe AnchoringVR™ allows patients to express the insights from their psychedelic experience in a multisensory manner that is more emotional and embodied than cognitive psychotherapy models allow for. However, the VR scenario isn’t just confined to post-dosing: it can also be used shortly after dosing to act as a buffer and help the user surrender into the psychedelic experience as it unfolds, or used throughout a dosing session when psycholytic (low to medium doses of a psychedelic) are administered.
The world’s first-ever study investigating the synergy of virtual reality and psychedelics
Enosis recently teamed up with Swinburne University and the Psychedelic Society of Belgium to complete the world’s first-ever psychedelic and VR study during a 2-day psychedelic retreat in the Netherlands. The study included four healthy volunteers who received a single therapeutic dose of truffles containing psilocybin. Volunteers were guided through their psychedelic experience within a psychotherapeutic framework.
AnchoringVR™ was administered at the end of the psychedelic session, about four to five hours after dosing. The length of time participants spent engaged with the VR scenario had no fixed timing, but participants used the VR scenario for 40-45 minutes on average. The next day participants experienced the same AnchoringVR model that contained their recordings from the previous session to aid the process of integration.
Preliminary results from the study indicated that AnchoringVR™ was capable of re-invoking similar emotions to those that occurred during the dosing session, without the need for repeat dosing. The VR scenario, within the framework of the guided psychotherapeutic psychedelic experience, also increased the recall of psychedelic insights during the integration session. An awe-evoking control VR scenario did not generate the same effects in the participants, which suggests that the personalized VR experience of AnchoringVR™ was critical to enhancing the psychedelic experience.
Participant insights from the study included the following:
‘VR helped me come in touch with thoughts and feelings and also sort out the difference between the thoughts and feelings in the experience and how I thought about it afterwards.’
‘VR brought me back to the feeling of something ineffable and a feeling of knowing. It made me feel oooooh!’
With the successful completion of this study, Enosis has now turned its attention to developing and leading the world’s first clinical trial of VR and psychedelic-assisted psychotherapy, which is slated to begin in the last few months of 2022.
Virtual Reality and Psychedelics: A new frontier in mind medicine?
Enosis’ research within this emerging space has diverse future applications for therapists, clinics, and psychedelic companies. For example, one of the main challenges faced by therapists and patients during psychedelic-based treatments is the elusive nature of psychedelic insights. VR offers a tool that can reconnect them with those sometimes ineffable insights, so they can be successfully integrated into tangible outcomes.
Sekula also emphasizes that VR can help patients to become familiar with ASC so psychedelic experiences don’t feel so daunting. Pre-session anxiety is common, so, inducing a sense of openness, security and acceptance is a critical component of the preparation process. What takes place before the dosing session can influence the depth and quality of the psychedelic journey–and ultimately, the impact and outcomes of the whole experience.
“VR is known to be capable of evoking altered states of consciousness (ASC) and can be used to prepare patients for what an ASC experience feels like, to train their ability to surrender to it and feel more relaxed about it, before they are exposed to a psychedelic substance,” she explains. By practicing this process of surrender, the patient can more easily enter an ASC and optimize its benefits.
Enosis is not the only company exploring the nexus of VR and psychedelic therapy. SoundSelf, developed by digital therapeutics company Entheo, for example, offers users a visual/auditory experience that can help them prepare for psychedelic therapy, which can be used at home. Resurgent Biosciences (Resurgent), has also recently filed for a US patent to develop a suite of VR applications for use during psychedelic-based therapy to enhance and guide patients. It’s likely the coming months and years will see the synergy of VR and psychedelics surge and further evolve.
