They don't have a lot of control over what happens when they embark on a trip. A person could either be floating through the universe or face-to-face with terrors that haunt them.
It is less intense at the end. The drug begins to wear off but the effects of the trip haven't gone away. This is a crucial time for those undergoing therapy. A person's profound insights and emotions can begin to slip away during these moments. They can't express their feelings in words. It is difficult to use the experience of a trip as a catalyst for change for some people. Integration, or the therapeutic process by which people make meaning of their trip, is usually designed to help patients remember and interpret their insights, but their recollections aren't always as intuitive the farther they get from dosing.
A few years ago, a Psychiatrist and a scientist founded an Australian startup to develop virtual reality scenarios to aid in the treatment of mental illness. They created a protocol for delivering psychedelic therapy with virtual reality, as well as a proprietary software called AnchoringVR, which creates animmersing scenarios for patients once they emerge from their trip.
A patient can start the AnchoringVR scenario at the tail end of their session if they use a commercially available set.
Audio and visual elements can be used to create a virtual world for the patient. They could sit on the beach, interact with a large rock, and throw it into the waves, like a specific trauma. A star can be plucked from the sky and a recording of a memory can be made. A symbolic representation of a key insight is turned into the patient's North Star. The handful of patients who've tried AnchoringVR did so for 45 minutes at the end of their experience, then played their recordings in the company of their therapist.
Puspanathan, the company's sole funder, says that patients feel encouraged to speak freely and comfortably when they are encased in a cocoon. Puspanathan was the CEO of a successful boutiquecryptocurrencies broker.
An unexpected niche has been created by Enosis amid the billion-dollar rush to find effective drugs. While virtual reality can be used to achieve or enhance consciousness-altering states, it's not known if it can be used with psychodynamic therapy. The wonder and awe produced by virtual reality can be harnessed by Enosis. The treatment phase doesn't capture the popular imagination in the same way as the search for new drugs or the wonder of a trip, but experts say it's essential to successful treatment. In trying to build technology that helps integration, Puspanathan and Sekula are raising important questions about why that aspect of the experience matters so much.
Dr.Sergio Pérez Rosal, CEO, cofounder, and medical director of OVID Clinic in Germany, personally tested AnchoringVR, and he says it was a "no brainer" to bring Enosis into the psychiatric and psycho therapeutic clinic. The two patients who have undergone four integration sessions have been immersed in the experience. They used stars to record insights. Plants were converted into stars. Some were brought to a fire for burning. Their own symbols include drawings of hearts, partners, pets, and birds. Patients were not allowed to speak with media, but a demo of AnchoringVR was shown.
This style of engagement is in line with OVID's approach to psychedelic-assisted psychotherapy, which combines pharmacological and psychotherapeutic treatment with a well-integrated Psychedelic Experience.
The focus is shifted away from the idea that the substance will change.
High-quality integration is important to helping patients draw conclusions from their insights and make new or different choices in their lives. Patients at OVID Clinic are treated with a drug that makes them feel like they are floating in water. The aim is to make the treatment as effective as possible.
Dr. Margaret Ross is a senior clinical psychologist at St.Vincent's Hospital and the principal investigator for the country's first psilocybin-assisted psychotherapy study. Ensuring that the integration process is successful is one of her main concerns as a psychologist. She thinks Enosis' technology is extraordinary.
The design can help patients bridge the conceptual and real without making it too concrete or reducing it to words. Patients desperate to cure their severe anxiety or treatment-resistant depression assume that the substance will lead to a life-changing transformation, according to Ross. They don't know how much emotional work it takes to make those changes after a drug wears off.
The efficacy of MDMA-assisted therapy for the treatment of post traumatic stress disorder is being researched in a clinical trial unrelated to Enosis' work. One of the trial investigators said participants have three integration sessions with a therapist after each dose. The integration process can be supported by meditating, creating art, or using movement. It's not always necessary to analyze insights with language.
It's as if a client walks away with a bunch of seeds that may be new insights, awareness, changes to their self-concept, or even mystical spiritual experiences, which can contribute. The seeds will eventually blossom if they are planted in the right place. The right environment can be created by integration.
"If proper integration doesn't happen, the best-case scenario is those seeds just never get planted and change doesn't really stick."
"If proper integration doesn't happen, the best-case scenario is those seeds just never get planted and change doesn't really stick," she said of her experience working with private practice clients. People may feel lost or confused after treatment.
She said that Enosis' technology could hold promise if used in a client centered way. Avoid over stimulation. Light, noise, color, and movement can undermine a patient's ability to interpret the sensations of their trip in virtual reality. If you have a history of anxiety and trauma, an over-the-top virtual reality experience could make you feel worse.
Even if some people might expect the software to come with every bell and whistle, Sekula says it has been designed with these risks in mind.
Sekula says that everyone has an idea based on their own experience with the drug. Someone wants angels, someone wants tarot cards, or someone wants to have little humans.
While one person might find an angel comforting, the next person might find it terrifying, which is why Enosis has built nature-based environments with imagery that mimics the traditional setting for psychedelic use.
"We really need to test and check how does that work, when does it not work, how risky is it," says Sekula of design elements that could be more overwhelming than helpful for most patients."
The paper written by Sekula and Puspanathan was published in the journal Frontiers in Psychology. Four people were tested at a retreat in the Netherlands. The participants received treatments for their illnesses.
While their findings haven't been published in a peer-reviewed journal, Sekula and Puspanathan found that AnchoringVR helped recreate similar emotions to those the participants experienced while on psychedelics. The results weren't the same for participants who only experienced a "awe-evoking" virtual reality scenario. A big clinical trial is planned for next year.
Sekula and Puspanathan are worried that virtual reality companies will try to get into the market for drugs. Commercial, off-the-shelf virtual reality scenarios have not been designed with this purpose in mind.
He says that an evidence-based approach is important because of the risks involved. The industry starts to be tarred with that brush, which isn't actually reflective of the science that's behind what will be the optimal approach.
"We do maintain our stance that an evidence-based, science-first approach is very important because of the risks that are involved."
PérezRosal has been impressed by Enosis' pace of innovation. The calm environment that AnchoringVR created allowed the user to follow their own thoughts without being immersed in a stereotypical '60s-style version of a trip. The staff was trained to use the technology. There were no software or hardware failures that slowed it down.
Enosis has a lot of work to be done. The clinical trial must show that AnchoringVR is better than standard integration practices. Who pays for virtual reality sets and licenses? Clinics and research institutions will need licenses to use AnchoringVR. The licenses of Enosis can be used for an unlimited number of patients.
Developing a business model for what Enosis is doing won't be easy, but he and Sekula are driven by their belief that patients who use their virtual reality technology will benefit from it.
"If you're in control, you're more likely to stick to the therapy, and come up with solutions that are personally relevant to you," says Sekula.
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