Overcoming Self-Critical Attitudes in Virtual Reality

高度的自我批评和羞耻感会损害心理健康，并被认为会阻碍患者的康复。尽管如此，大多数心理治疗都有一个更一般的焦点，并不专门针对自我批评和羞耻。开发更有针对性的治疗方法可能会在更短的时间内带来更大的症状改善。最近的一个发展是以同情为中心的治疗，它通过使患者对自己感到更大的同情和接受来减少自我批评。这通常是由心理治疗师在一对一治疗过程中提供的。主要的用途是基于想象力的练习，研究表明，图像往往比文字具有更强的情感效果。然而，并不是所有的患者都有足够的视觉想象力，更重要的是，他们所看到的仍然是临床医生不知道的。尽管这种方法的结果令人鼓舞，但找到更有效和更科学的心理治疗方法是目前的当务之急。虚拟现实是一个术语，指的是具有现实环境的许多属性的计算机生成的环境。例如，它们可以让参与者导航到不同的方向，与计算机生成的人(化身)互动，或者做出他们在真实环境中会做出的选择。研究表明，参与者经常对这些虚拟环境的各个方面做出反应，就像这些环境是真实的一样，即使他们知道它们不是{Sanchez-Vives，2005#40}。此外，最近的研究表明，人们可能会体验到一种拥有真人大小的完全虚拟身体的错觉，这是他们通过虚拟现实耳机从第一人称的角度看到的，取代了他们自己的真实身体。然后，当与他们的虚拟身体相关的事件发生时，他们会经历情绪反应。这可以成为一个强大的变革性工具。这些发展提供了新的机会，在自我批评的人中诱导情绪，如自我同情，从而帮助减轻他们的症状。该项目将开发一套身临其境的虚拟环境应用程序，通过与虚拟人角色的互动，患者可以体验到对他人的同情接受和给予。此外，现代虚拟现实系统的身体转化能力可以用来以改变患者自我表征的形式向患者提供适当的反馈，以匹配他们日益增长的自我同情能力，而不仅仅是自我批评。该项目的一个关键方面，也是精神问题患者将参与的一个方面，是确定尽可能强烈地传达同情心的情景、表情和手势。该项目将涉及两项初步研究，其中方法是使用健康的志愿者开发的，这些志愿者被选为高度自我批评的人。我们将让他们在虚拟现实中进行几次自我同情心诱导，评估其有效性，并测量变化持续多久。最后，我们将使用所获得的知识来使用虚拟现实场景，其中精神病患者报告了高度的自我批评。我们还将衡量减少自我批评、相关情绪(如羞耻)和其他症状的程度和持续时间。一种减少自我批评和羞耻的有效技术，减少昂贵的治疗时间的需要，将有许多好处。例如，它可能会让不愿意去精神健康机构的人更容易接受治疗。对于有自杀倾向的人来说，它也可能是一种灵活、快速和容易获得的干预措施。由于高度自我批评而有可能发展成后来的障碍的儿童和青少年也可能很容易采取这种形式的预防。

High levels of self-criticism and shame are damaging to mental health and are thought to prevent patients from recovering. Despite this most psychological treatments have a more general focus and do not specifically target self-criticism and shame. Developing more targeted therapies is likely to bring about greater symptomatic improvement in a shorter time. One recent development is compassion-focussed therapy, which reduces self-criticism by enabling patients to feel greater compassion towards and acceptance of themselves. This is generally delivered by a psychotherapist in the course of one-to-one treatment. Major use is made of imagination-based exercises, building on research showing that images tend to have stronger emotional effects than words alone. However, not all patients have sufficient visual imagination and, more importantly, what they are 'seeing' remains unknown to the clinician. Although the results of this approach are encouraging, finding more efficient and scientifically testable ways of delivering psychotherapy is currently a priority.Virtual reality is a term used to refer to computer-generated environments that have many of the properties of real environments. For example, they may enable participants to navigate in different directions, interact with computer-generated people ('avatars'), or make choices of the kind they would in a real environment. Research has shown that participants often respond to aspects of these virtual environments as if the environments were real, even though they know they are not {Sanchez-Vives, 2005 #40}. Moreover, recent work has shown that people may experience the illusion of ownership of a life-sized entirely virtual body that they see from a first-person perspective through a virtual reality headset as substituting their own real body. They then experience emotional reactions when events occur in relation to their virtual body {Normand, 2011 #38;Slater, 2010 #23}. This can become a powerful transformative tool. These developments provide new opportunities to induce emotions such as self-compassion in self-critical individuals and thereby help reduce their symptoms. The project will involve developing a set of immersive virtual environment applications where through interaction with virtual human characters patients can experience both the receiving and giving of compassion to others. Moreover, the body transformation capability of modern virtual reality systems can be used to give patients appropriate feedback in the form of changes to their self-representation that match their increasing capability to be self-compassionate rather than only self-critical. A key aspect of the project, and one in which patients with psychiatric problems will participate, is to determine scenarios, expressions, and gestures that convey compassion as strongly as possible.The project will involve two initial studies in which the methods are developed using healthy volunteers who are selected for being high in self-criticism. We will expose them to several sessions of self-compassion-induction in virtual reality, assess its effectiveness, and measure how long changes last. Finally we will use the knowledge gained to use the virtual reality scenarios with psychiatric patients reporting high levels of self-criticism. We will also measure the extent and duration of reductions both in self-criticism, associated emotions such as shame, and other symptoms.An effective technique for reducing self-criticism and shame which reduces the need for expensive therapeutic time will have numerous benefits. For example, it may make treatment easier for people who are unwilling to attend mental health facilities. It may also be a flexible, rapid, and readily available intervention for individuals who are feeling suicidal. Children and adolescents at risk of developing later disorder because of high levels of self-criticism may also take readily to this form of prevention.