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Research into the utility of virtual reality (VR) technology is rapidly evolving, including in the treatment of mental disorders. Already, studies have shown that exposure therapy (exposing people to things that scare them) through virtual reality applications can be beneficial in the treatment of fear of flying and spider phobia.
At this time, it is unclear whether VR could help improve standard therapies for generalized anxiety disorder, post-traumatic stress disorder or obsessive-compulsive disorder (Meyerbroker & Morina, 2021). It is also unclear whether VR provides clinical benefit in addition to hypnosis in the treatment of pain. (Patterson et al., 2021).
Given the recognized utility of hypnosis for the improvement of mental health (Anbar, 2021), this blog explores how VR might augment hypnosis applications for psychological therapy. Beyond use with the facilitation of a clinician, perhaps these approaches could be made available to the public as stand-alone self-therapy.
Use of Positive Language
Positive self-talk can be an important tool for therapy and within a hypnotic trance. Patients can be provided with a convincing demonstration of this technique by being told to attempt to maintain their arm flexion against a clinician pulling the forearm to straighten it. They are then instructed to tell themselves that they are weak, at which point their arm muscle strength typically weakens because of their subconscious response. Conversely, when they tell themselves they are strong, their strength returns. Thus, the importance of positive talk is illustrated with a physical example.
A VR approach could provide another type of lesson that would emphasize the importance of positive talk. Patients could be told that they can see how their brain feels because of their mood through VR. They would be invited to think of something positive or negative. Through facial recognition a coupled VR application could then present a sunny or cloudy setting to match the patient’s positive or negative mood.
Hypnosis can be used as a way of calming oneself through imagining a safe, comfortable place. Patients can be instructed to imagine what might be perceived with each of their senses in that location. This process can be associated with a feeling of calm, slowed heart rate, slowed respiratory rate, and decreased blood pressure. They can then be given a suggestion that whenever they would like to feel such calm without the use of hypnosis they can trigger a relaxation response through the use of a gesture, such as clenching their fist or crossing their fingers.
A VR approach, which may be especially helpful for patients who have difficulty with visualization, would show patients a scene of a calming locale of their choice, eg, a beach, mountain, forest, or grass field. Once they indicate that they feel calm, or when the VR application is coupled with detection of calming signs, eg, lowered heart rate or dilation of their pupils, the patients could be given the suggestion that they are able to trigger a similar relaxation response through use of a physical gesture.
Interactions with the Subconscious
Hypnosis can be used to gain insight into the psychosocial stressors that can trigger or perpetuate behavior or symptoms, such as overeating, smoking, abdominal discomfort, or headaches. The subconscious can be accessed in multiple ways including through paying attention to muscle movements that are controlled by the subconscious, rather than under conscious direction.
Subconscious thoughts can also be elicited by asking patients to close their eyes, and once they open to fix their attention on whatever object they see first. The suggestion is made that contemplation of that object will bring forth a useful thought from their subconscious.
A VR application to help derive insight from the subconscious could involve showing the patient scenery that involves multiple subtle unusual juxtapositions, such as a bird-sized griffin, a house window that gazes into outer space, or a door behind which is another door. The patients would be instructed to explore the scene until they feel particularly drawn to a particular VR object.
They would be given the suggestion that contemplation of that object would be associated with a helpful thought from the subconscious. The utility of this approach would depend on the patients’ subconscious promoting attention to an object that serves as a metaphor for an issue that should be brought to conscious awareness.
A spiritual perspective helps people navigate challenges more effectively because it can give them a sense of purpose in their lives. Hypnosis can help patients achieve a spiritual perspective including through its use to introduce them to their wise and knowledgeable subconscious.
A VR application to enhance a spiritual perspective could present patients with immersive awe-inspiring scenes including of outer space, amazing nature scenes, or beautiful artwork. After that, patients may be more receptive to hypnotic interventions that involve change in perspective, eg, thinking of anxiety provoking situations in new ways that allow patients to become calmer.
Hypnosis-Aided Exposure Therapy
Once patients are taught how to use hypnosis to calm themselves, VR can be used as a training ground for coping with triggers of their anxiety. This has already been demonstrated for patients with spider phobia and fear of flying. For example, patients with needle phobia can practice calming themselves in a virtual emergency department or doctor’s office. Patients with fear of bees or other animals can practice calming themselves in virtual outdoors.
There are many potential applications of VR within medical and psychological therapy. Research will need to be undertaken in order to assess whether any of the ideas presented in this blog about hypnosis and VR would be a helpful addition to usual hypnosis within clinical practice.