Active imagery rescripting in virtual reality as a promising tool to address psychological conditions

Imagery rescripting (IR) is a cognitive-experiential technique used for the treatment of various mental conditions through the re-working of aversive memories. It has been widely applied in psychotherapy to address Post-Traumatic Stress Disorder (PTSD) and personality, anxiety, and eating disorders. Despite usually being effective, IR's underlying mechanism has not been clarified yet. Consistently, different assumptions may correspond to different IR versions and outcomes. Among these versions, active IR (AIR) – meaning a rescripting where the patient is the active ‘rescriptor’ – seems to have particularly positive effects. So far, IR use has been almost exclusively limited to in vivo settings. But the increasing availability of Virtual Reality (VR) in the last few years has favored the in virtuo implementation of safe and effective psychological treatments. On these grounds – and given that virtual scenarios can offer the possibility to perform any necessary actions and even more than real ones – we hypothesize that implementing AIR in VR can be effective in treating psychological conditions. As a preliminary evaluation of this assumption, we systematically searched the literature and reviewed the studies concerning VR realizations of AIR addressing mental issues. Our literature analysis provides the first evidence supporting this hypothesis, yet urging further research and testing.