[Researchers are exploring the use of presence-evoking virtual reality to produce the therapeutic effects of psychedelic-assisted psychotherapy, as reported in this story from PsyPost. See the new published article and the Psyrreal website for more information (and to download the software). –Matthew]
Psychedelic replications in virtual reality show potential in treating depressive symptoms
By Eric W. Dolan
April 15, 2023
Researchers at the University of Tartu in Estonia have developed a virtual reality (VR) experience that seeks to simulate the subjective effects of psychedelic drugs. They hope that replicating psychedelic experiences within VR will produce similar therapeutic benefits to psychedelic-assisted psychotherapy. Their latest findings, published in Frontiers in Psychiatry, provide preliminary evidence that such VR experiences might help to alleviate depression.
There is growing interest in the use of psychedelic drugs to treat mental health conditions like depression. Preliminary studies have shown promising results in reducing symptoms of depression, anxiety, and PTSD. Psychedelics, such as psilocybin (found in magic mushrooms) and MDMA, have been found to have a profound effect on the brain, potentially increasing neuroplasticity and promoting lasting changes in mood, behavior, and perception.
“One of the primary reasons for our study is that there is a need for novel methods to treat depressive symptoms,” explained study authors Karl Kristjan Kaup and Kadi Tulver, who are both research fellows at the University of Tartu’s Institute of Computer Science.
“Although psychedelic therapy shows promise, it is contraindicated for certain segments of the population, and the regulatory restrictions in several countries make it difficult to implement such interventions. Virtual reality, on the other hand, offers several benefits, such as safety, affordability, and ease of administration, making it a viable option for real-life therapeutic settings.”
“We also hope that showcasing the phenomenology of psychedelic experiences with virtual reality could help alleviate the stigmatization of psychedelic compounds,” the researchers said. “Furthermore, we are keenly interested in the therapeutic mechanisms of psychedelics. Studying this question with virtual reality allows us to avoid confounds by separating certain experiences or experiential alterations, and investigating the effect of psychedelic visual stimuli more directly.”
The researchers developed a computer program called Psyrreal that uses virtual reality to give people an experience similar to taking psychedelic drugs. They used a software called Unreal Engine to create different virtual environments that are surreal and meant to convey certain feelings and ideas associated with psychedelic experiences, like feeling connected to everything or losing your sense of self.
During the Psyrreal experience, participants start in a normal virtual world and then progress through 19 different psychedelic environments that use abstract shapes and patterns. The levels last between 30 seconds to 2 minutes.
The researchers conducted an open-label feasibility study with 13 people who had mild to moderate depression. They excluded people who were currently receiving treatment for depression, and those who were sensitive to motion sickness, had a history of psychotic disorders or seizures, or a family history of schizophrenia.
On the first day, the participants completed a 15-minute VR demonstration, which included guided VR meditation, to familiarize themselves with the technology. On the second day, the participants completed the Psyrreal experience. During the study, a psychologist was nearby in case there was a mental health emergency, and a technician monitored the VR system. After the participants completed the VR experience, they were allowed to rest and then had a meeting with the psychologist to discuss their experience and answer some questionnaires.
Three validated questionnaires were used to assess different subjective aspects of the VR experience: the Psychological Insight Questionnaire, the Ego-Dissolution Inventory, and the Revised Mystical Experience Questionnaire. These three measures are commonly used in psychedelic research. The Emotional State Questionnaire was used to evaluate differences in depression symptoms before the experiment and at the two-week follow-up.
The researchers found that participants showed a significant reduction in depressive symptoms two weeks after the experiments. “Our study provides preliminary evidence that virtual reality may hold promise as a treatment for depression,” Kaup and Tulver told PsyPost. “Our results suggest that VR experiences have the potential to go beyond mere entertainment and recreation, offering therapeutic benefits and transformative experiences.”
But the researchers found no evidence that Psyrreal consistently produced the type of experiences that are typically encountered after consuming a psychedelic substance. When comparing the guided VR meditation experience to the Psyrreal experience, participants did not show significant differences in their scores on the Psychological Insight Questionnaire, Ego-Dissolution Inventory, or Revised Mystical Experience Questionnaire.
The researchers also conducted a thematic analysis the transcripts of the conversations they had with participants after their VR experiences. They wanted to understand how the VR experience affected each person in different ways, so they analyzed the conversations to identify themes or patterns in what the participants said.
During the VR experiences, participants reported feeling positive emotions such as calmness, joy, pleasure, and fun. Some also reported having personal thoughts, changes in perspective, and alterations in their sense of self. Some also experienced somatic effects during the experience.
“A number of participants reported intriguing effects during post-experience interviews including changes to their sense of self, beneficial insights and shifts in perspective, some of which were remarkably similar to common reports of psychedelic experiences,” Kaup and Tulver explained.
“However, as our analysis did not reveal any statistically significant results on the self-report measures regarding insight, mystical experiences, or ego-dissolution, this has to be considered with caution, but the reports could indicate that VR tools could evoke similar effects to psychedelics, at least to an extent. We hope to address these questions with a larger sample in the future.”
There were no serious adverse events, although four participants reported transient nausea during the VR experience.
While the results seem promising, the study was focused on laying the groundwork for future research. The efficacy of this intervention remains unclear. Nevertheless, the preliminary findings encourage additional investigations into the use of VR therapy for depression.
“Given that this was a preliminary feasibility study aimed at exploring the potential of such methods, it was conducted on a relatively small sample and did not include a control group,” Kaup and Tulver said. “Consequently, we must exercise caution in drawing strong conclusions from our findings. It’s important to note that the scientific process often involves evaluating the potential of a treatment or intervention before embarking on large controlled trials.”
“Our study aimed to establish this potential and determine whether further investigation is warranted. To reliably establish whether psychedelic phenomenology applied in VR can result in the remission of depressive symptoms, further research using a placebo-controlled study design is needed. We are currently conducting an experiment that tackles these concerns.”
“Our research interests extend beyond the potential therapeutic value of VR,” the researchers added. “We are also curious about exploring the mechanisms that lead to meaningful insight experiences and changes to beliefs – something that psychedelics have been shown to induce. We are eager to demonstrate the potential of virtual reality as a tool to investigate these questions in a safe and controlled manner.”
The study, “Psychedelic replications in virtual reality and their potential as a therapeutic instrument: An open-label feasibility study“, was authored by Karl Kristjan Kaup, Madis Vasser, Kadi Tulver, Juhan Pikamäe, and Jaan Aru.
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