Gray's neurobiological model
Psychoeducation is done during the first group therapy session and consists of explaining the patterns of anxiety for patients who are phobic, have OCD, or have generalized anxiety disorders. The models help explain the causes and mechanisms of anxiety, the goal is to get patients to understand what is going on in their brains. Ignorance leads to fear. In group therapy, it is important to establish a dialogue with your patients and to set up an exchange, giving patients the opportunity to participate as often as possible.
Key takeaways
- Gray's model explains anxiety mechanisms during psychoeducation, for phobias, OCD and generalized anxiety disorder.
- Step 1: the situation triggers a primary threat assessment via the Behavioral Inhibition System (BIS), causing adrenaline release and physical symptoms.
- Step 2: patients react through the Fight or Flight System (FFS), most often choosing avoidance.
- Anxiety is an evolutionary protection mechanism inherited from ancestors, preparing the body for action.
- Example: Angela Cavallo's exceptional strength illustrates anxiety's protective, life-saving function.
THE FIRST STEP: THE SITUATION
According to Gray's model the first step is the situation. This is the time for the first question to be asked of patients: "Give me a situation that scares you?" (patient answers).
When you are in this situation … (stated by candidates) that you consider threatening, you make a primary assessment of the danger present in the situation. Continue the dialogue: "When you are faced with dangers… (listed according to the fears stated) what do you pay attention to?" Patients will pay attention to the elements present in the situation, generally related to the danger. For example, the ventilation grids in the elevator for patients suffering from claustrophobia, the expression of the hostess and the exits for aviophobes etc.
This primary evaluation is possible thanks to a functional entity of the brain: BIS (Behavioral Inhibition System). It is this system in the brain that will provoke anxiety, an increase in vigilance, and it is this entity that will provoke a secretion of adrenalin at the level of the suprarenal medulos, these are glands situated above the kidneys. This adrenaline will cause symptoms, make them talk about their symptoms: "What are your symptoms?" (patients answers) everything you described to me: increased sweating, heart rate, muscle tone etc.
THE REALIZATION OF THE FFS ACTION
Once the situation has been assessed, according to Gray's model, the patient carries out an action called Fight or Fly System (FFS). He will have two choices: either he fights and stays in the situation, or he will choose flight to avoid the situation. New question to ask: "What do you do?" (patients answers).
Most of them usually avoid the situation. Some may say that they have confronted the situation, but forcing themselves to do so is not helpful in therapy because it will reinforce the conditioning and cause bad memories.
Anxiety exists in all people and all mammals and is the result of millions of years of evolution: "What do you think anxiety is for?" (patients answers)
Anxiety was created by evolution to protect itself, it is a mechanism of protection of the individual. Anxiety was present in human beings 20 000 or 30 000 years ago. New question: "Where your ancestors lived?" (patients answers) Our ancestors lived in hostile environments, to survive they needed a system that allowed them to react quickly to dangers and this system is anxiety. It is thanks to anxiety that our species has been able to live until now. Anxiety serves to protect us. Take the symptoms your patients mentioned earlier, for example, if the symptoms are increased heart rate: "Why does your heart beat fast?" (patients answers)
The heart speeds up to bring more oxygen and sugar into the body because it needs it, if we take the survival model of the ancestors, the increase in heart rate served in case of a fight with a bear to give the body superhuman energy. The symptoms caused by anxiety are therefore preparations for action.
AN EXAMPLE ON ANXIETY
New question: "Give me an example in which anxiety saved a life?" (patients answers) Angela Cavalo is an American who lived in the 80s. She saved her son's life by lifting a Chevrolet Impala. Her son was repairing it, had set up trestles allowing him to be under the car. The trestles gave way and began crushing her son. Angela realized the situation, did her primary assessment, her heart beat very fast, she started to sweat. Angela lifted the car and saved her son. Anxiety gave her superhuman strength that saved her son.
Discover Beck's cognitive model, and the Barlow's cognitive model
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Frequently Asked Questions
Why use virtual reality in the field of mental health?
Virtual reality allows gradual and controlled exposure to anxiety-inducing situations in a secure, reproducible environment. It increases patient engagement and can be personalized to each patient's needs, supporting treatment for anxiety disorders, phobias, obsessive-compulsive disorders and other conditions.
Can virtual reality be dangerous?
Virtual reality exposure is generally well tolerated, but it is not recommended for patients with epilepsy or for pregnant individuals. These are the two contraindications identified in the literature reviewed on the subject.
What pathologies can be treated in virtual reality?
Research shows good feasibility and significant results primarily in adults, for anxiety disorders (including school phobia), autism, addictions, eating disorders, neuropsychological disorders, psychotic disorders and mood disorders. Similar outcomes are reported in adolescents and elderly patients, particularly for cognitive stimulation.
Can I feel nauseous while using the headset?
This can happen; it's known as cybersickness, a phenomenon well documented among a portion of the population. It is reversible. Starting with static environments before progressing to slow movements helps the body adapt.
Which patients can benefit from TERV?
Therapy by exposure in virtual reality is effective across a wide age range. Studies report significant benefits in adults, adolescents and elderly patients, with added therapeutic engagement in adolescents and cognitive stimulation for elderly patients. It is not advised for epileptic or pregnant patients.
What are the benefits for therapists using VR?
Virtual reality helps therapists differentiate their practice from traditional treatment options. It relies on extensive research supporting its use as an exposure method, increases patient engagement, and saves time by giving direct access to exposure environments without external logistics.
Who should I contact in case of software issues?
C2Care's technical support team is reachable via live chat from your control panel. If your headset has an issue, the team helps diagnose the problem, provides a return label, and replaces defective equipment within 48 hours.
What role does artificial intelligence play in therapy?
C2Care uses artificial intelligence through the AI assistant Camille and through virtual characters within scenes. Camille offers support as a trusted companion patients can talk to without fear of judgment, while virtual characters replicate real-life social behaviors in everyday situations.
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