How VR Can Help Patients Connect With and Express Their Emotions In Therapy

Have you ever had a patient come into your office and recount a traumatic experience, but with a completely flat affect? Or a patient who knows they deserve love and respect, but struggles to feel and express that self-worth? 

Sometimes patients experience a disconnect between what they intellectually understand about an event, and how they emotionally feel about it. 

And it can be challenging to help a patient process and understand their emotions when they’re unable to access them in the first place. However, virtual reality might be able to offer a solution. 

Erica Kaitz, LCSW discusses her experience using VR to help patients connect their thoughts and feelings in our webinar Bridge the gap between head and heart with VR. Watch the full video here.

The Gap Between Mind and the Heart 

First, what do we mean by this gap? 

The gap between the head and heart is when one’s emotional reactions don’t seem to align with their cognitive understanding of the situation. 

In therapy, this often shows up when patients have experienced trauma. But it can also happen with patients having other challenges such as depression, anxiety, stress, or interpersonal conflicts. 

When this gap exists, patients may struggle to connect with and express their emotions. The challenge for therapists then is to bridge the gap between the head and the heart, so that the patient can tap into their emotions, process them through treatment, and overcome their struggles.

What Are Examples of This Head-Heart Gap?

In practice, we see this happen in various scenarios: 

– When patients are working on changing core beliefs: “Yes, rationally I know I’m loveable but emotionally, I feel worthless…” 

– When patients are dealing with interpersonal conflict: “My partner is really, really wonderful (positive emotion), but I am doing 90% of the household duties and I just can’t take it anymore.” 

– When patients are dealing with unprocessed trauma: The patient reports a horrific experience with a blunted affect.

Helping Patients Connect With Emotions During Therapy 

Regardless of the cause of this gap, the key is to help patients integrate their emotional responses with their cognitive understanding of the situation they report to you. 

Step 1: Identify and Address the Barrier

Part of the process requires patients to identify the barrier to integration. This could have various reasons, but is often rooted in fear or shame that comes along with acknowledging that emotion. 

Many patients struggle with negative emotions. And it can be hard for them to accept the challenging events they have experienced. It means they need to integrate these—often negative—experiences into their understanding of themselves. 

Step 2: Help Catalyze the Patient’s Emotional Response Using Immersion

How do we do this? 

The key is to create space and safety so they can sit with their words. With the hope that they start to identify their emotions instead of resisting them. 

Here are some ways to help them bridge that gap: 

– Pause and sit in silence with the difficult things they just said.

– Take a deep breath and repeat what they said.

– Repeat back the intensity of their words. Empathize and show your (authentic) reaction to their story. If they see that you were touched by their story, they may start to make that connection now.

– Use virtual reality to immerse the patient into the situation that they have a hard time connecting emotionally with.

Using VR to Help Patients Connect With Emotions During Therapy 

VR environments provide an opportunity for patients to become immersed in a memory or situation that has been difficult for them to process emotionally. 

As they experience the environment firsthand, they will start to gain insight into how certain events and memories make them feel, which can lead to further progress in therapy.

Case Example: Identifying Emotions in Relationship Issues

Ken (name changed for privacy) is a 43-year-old male. He is married and has a young child who has a rare genetic condition that requires additional caregiving. Ken is struggling to confront his wife about the division of labor within the household. 

He is aware that he can no longer tolerate his current workload, but during these discussions he shuts down emotionally.

In therapy he expresses how much he loves his wife and how wonderful she is. But he can no longer deal with his current situation. At the same time, he cannot confront her. He is scared to show that he is upset about the way she places most of the household tasks on him.

Ken’s therapist uses VR to place him in an environment facing a female avatar, so he can practice communicating. The therapist provides the voice for the partner, starting with sentences that Ken has identified as triggers for his emotional shutdown. 

Immediately, Ken’s emotions become heightened, and he notices himself becoming more agitated.

Why did the VR environment elicit an emotional response? 

Ken had grown accustomed to shutting down his emotions in front of his partner. But when confronted by the avatar in VR, he could project his partner onto the avatar, while still having an opportunity to practice expressing his emotions without fear of judgment or criticism. 

Through this practice, Ken begins to recognize his feelings of anger and frustration toward his partner. And how he can move from emotional shutdown to having a productive conversation. 

Why VR Is a Powerful Tool for Immersion 

Here are some of the big ways VR can help patients who struggle with emotional connection.

Practicing Difficult Conversations 

From speaking up in a group to having a serious conversation with your spouse, VR can help patients practice difficult conversations in a safe, controlled environment. 

For Ken, the female avatar within VR served as a realistic, but safe environment for him to start connecting with his emotions. His therapist noticed that the immersive experience of VR provided Ken with an opportunity to express himself and connect to difficult emotions in a way that was not possible outside of the virtual world. 

Helps Focus the Session 

When treating patients with trauma, often when we ask them to imagine something, what they imagine often gets clouded out by the intense scary emotions or memories of other events. They can become overwhelmed by all the things they are feeling at once. 

You may not want your patient to start to recall all the traumatic events they have experienced. Rather, you want them to focus and be present in one memory. 

Using VR can help focus the session on one particular memory, allowing them to stay grounded and present with their emotions of that specific moment.

VR Solves Issues of Imagination

One of the challenges of traditional therapy is that the patient has to be able to imagine and vividly recall past experiences. This can be recalling a traumatic memory or confronting their most feared situations. 

The challenge with this is that, as the therapist, you do not have insight into the patient’s mind. Even if your patients are fully motivated and ready to face their ears, they may still struggle to imagine scenarios that cause them distress. 

VR solves this problem by immersing patients in an environment. There, they can explore that memory or scenario instead of having to imagine it. This can also help the patient focus on what is important in the memory and how they are responding without getting distracted by other thoughts or memories that might arise. 

Virtual Reality in Therapy: A Tool For Immersion & Connection With Emotions 

VR immerses patients in an environment where they can explore memories and scenarios in a safe and controlled session. Thus it helps them focus on what is important while still being grounded and present with their emotions. 

Not only does VR provide therapists insight into how the patient responds to difficult situations, but it also helps patients practice conversations that would otherwise be hard to imagine. 

This also allows for the personalization of treatment and can enhance patient engagement and treatment adherence. 

Want to learn more about how VR can help your patients engage and connect with their emotions? Watch the full webinar here: Bridge the gap between head and heart with VR.

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