Perspective on the Double Edges of Virtual Reality in Medicine - both Addiction & Treatment

Abstract

Although the therapeutic potential of virtual reality has been foreseen since over half a century ago, the lack of graphical processing power made it impossible to apply in medical therapeutic sciences until last decade; nowadays, the hardware required for virtual reality is even 100 times more affordable. A head-mounted display induces immersivity engulfing the subject's eyesight perception in a stereoscopic manner. The same tool that may aid better self understanding and bonding can also trigger psychopathological mechanisms through which the user becomes alienated from the real world. As virtual reality became even more popular during SARS-COV2 pandemic, users worldwide have spent more time into a virtual world. Depersonalization/derealization syndrome can occur if virtual reality is abused. The greater the person's involvement in virtual reality, the greater the chance of a lack of bodily self (depersonalization). Controllers that mimic hands could prevent the subject from acknowledging the real world as true — derealization. Virtual reality's dissociative potential is related to individual psychological traits and prolonged exposure. Children are the most prone to develop behavioral changes. Adults may develop behavioral problems related to virtual reality gaming, gambling, pornography and also social networking through created avatars. Blue light wavelength could harm sleep architecture and circadian rhythm by disrupting melatonin, therefore making virtual reality exposure problematic after sunset. State of the art reveals that using virtual reality in a therapeutic manner, actually facilitates the fight against addictions with cue therapy intended to extinguish conditioned response. The exposure to a substance (nicotine, alcohol, or any other psychoactive recreational abuse potential substances) can trigger craving in a controlled environment, that is malleable in the hands of the therapist. Virtual reality can offer an exposure perspective that is both vivid enough to be a challenge, but also safe enough to ensure patient involvement and to amplify the therapeutic alliance.