Filled reality: virtual "comfort zone" will reduce anxiety in PTSD

For the first time, Russian scientists have analyzed people's perceptions of a "safe place" and identified key images that help reduce anxiety. Based on the data obtained, thematic catalogs of virtual scenarios will be created for use in VR psychotherapy sessions in patients with diagnosed disorders. According to experts, this technique may be especially in demand by people who are unable to attend face-to-face sessions, as well as patients with post-traumatic stress disorder (PTSD). At the same time, psychologists interviewed by Izvestia emphasize that VR therapy is not suitable for all patients - it is necessary to consider each person's case individually.

Personal space in virtual reality

For the first time, psychologists have identified optimal visual images for VR relaxation in patients of different ages. A group of Russian scientists from Sechenov University, the Russian University of Medicine, Lomonosov Moscow State University and the Federal Scientific Center for Psychological and Interdisciplinary Research studied people's perceptions of a "safe place" and used a set of psychological tests and interviews to understand which mental images make people feel comfortable. The analysis of the participants' responses will become the basis for creating effective VR programs to combat anxiety disorders and stress.

The study surveyed Muscovites between the ages of 18 and 82. To assess their condition and preferences, the "Social Adaptation Assessment Scale" was used to measure the accumulated stress load and the questionnaire "Well-being, activity, mood" (SAN) to record the current emotional background. Using the "Safe Place" interview questionnaire, respondents described an imaginary space where they feel completely safe. The analysis of these descriptions allowed us to identify the key images that people subconsciously seek in search of reassurance.

One of the main findings of the study was age differences in preferences.

— We have found a fairly clear pattern: if for people under the age of 50 a safe place is most often an open space (forest, riverbank or sea), then after this age the need for psychological comfort is increasingly associated with the presence of reliable borders. Older respondents choose images of "their personal space" (house, room, cottage) almost four times more often than young people. It is important for them to feel stability and shelter, which must be taken into account when creating relaxation programs for this audience," said Tatiana Buzina, Head of the Department of General Psychology at RosUniMeda.

Development of VR psychotherapy

The data obtained makes it possible to abandon the random selection of content from available databases in favor of a scientifically based choice. Knowing the age and stress level of a person, we can already assume which virtual landscape will have the maximum relaxing effect: whether it will be a secluded ocean shore to relax a young specialist or a cozy veranda of a country house to relieve anxiety in an elderly person.

"Based on our typology, we plan to create catalogs of images that will form the basis of personalized VR programs to combat stress," said Anastasia Kotelnikova, professor at the Department of Pedagogy and Medical Psychology at Sechenov University.

The semantic categories of images identified by scientists will form the basis of thematic catalogs of virtual libraries, which will allow creating personalized psychological assistance programs. This will open access to high-tech care for those who cannot attend traditional therapy for various reasons. According to Anastasia Kotelnikova, the researchers plan to test the effectiveness of these images directly on users of VR devices and study the preferences of people with already diagnosed anxiety disorders.

Over the past 15 years, virtual reality technologies have gone from an experimental technique to one of the most evidence-based and widely used tools in the treatment of anxiety disorders and panic attacks, Olga Valaeva, head of the NPC Virtual Clinic at the Moscow Institute of Psychoanalysis, told Izvestia.

— The main body of data concerns exposure therapy in a virtual environment, where the patient gradually and controllably encounters individually significant frightening situations — from riding the subway to being in a crowd or an open space — while more and more attention is being paid to resource-based VR environments, acting as a "safe place" to stabilize the condition, — she noted.

VR relaxation and VR exposure are among the most evidence-based digital tools in anxiety therapy, and the main value of this work lies in the transition from random content to personalization for age and stress levels, added psychologist Yulia Stolyarova.

"I consider the creation of VR libraries to be a logical step: the catalog of validated environments makes assistance scalable and accessible to those who do not go as far as face—to-face therapy, but it requires clinical verification, not just a questionnaire," she said.

The path is healthy: Mental disorders were 1.5 times more likely to be detected in adolescents.

Why do neurosis, depression, psychosis, and even dementia actively develop at the age of 15-17?

It is important to remember that such a method may have limitations for people with psychotic episodes or those prone to non—chemical dependence - for them, such techniques need to be tested separately, clinical psychologist and psychoanalytic psychotherapist Jan Levitsky told Izvestia.

— But for patients with PTSD, this is especially true. In these disorders, the memory of psychological trauma is not integrated into the overall picture of life, but lives as a foreign body, reacting to external or internal triggers. VR helps to safely "ground" and start the recycling process. In addition, such technologies are useful for anxiety, depression, burnout and adolescent crises," the expert emphasized.

Some people may have difficulty imagining things. Often, a person is so focused on the problem with which he turned to a specialist that it is difficult for him to see his own resources, imagine the desired result of therapy and formulate the goals of psychological work, said crisis psychologist, ORKT practitioner, schema therapist Anna Bazanova.

— VR relaxation can help to connect the imagination, which will positively affect the work in any psychological approach and with any problem, — she believes.

According to her, systematizing the issue of a safe place can help practicing psychologists find it easier to approach more closed people who find it difficult to think outside the usual anxious framework.