Gray's neurobiological model
Psychoeducation is done during the first group therapy session and consists of explaining the models of anxiety for patients: phobic, who have OCD, or who have generalized anxiety disorders. The models help explain the causes and mechanisms of anxiety, the goal is to help patients understand what is happening in their brains. Ignorance leads to fear. During group therapy, it is important to establish dialogue with patients and to establish an exchange; give patients the opportunity to participate as often as possible. In this article we will see Gray's neurobiological model and its implication in anxiety, phobias and OCD.
Key takeaways
- Gray's model describes three stages of anxiety: the situation, the primary assessment of danger (BIS system) and the action (fight or flight, FFS).
- Anxiety is a protective mechanism inherited from evolution, preparing the body for action in the face of danger.
- Avoiding the feared situation strengthens conditioning; Forced confrontation is not recommended in therapy.
- The Camille AI assistant supports the patient without judgment throughout the treatment.
1. 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 ask patients: “Give me a situation that scares you?” » (patient response).
When you are in this situation (stated by the 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 (cited according to the fears stated), what do you pay attention to? » Patients will pay attention to the elements present in the situation linked, in general, to the danger. For example, ventilation grilles in the elevator for patients with claustrophobia, the expression of the stewardess and exits for aviophobes, etc.
This primary assessment is possible thanks to a functional entity of the brain: the BIS (Behavioral Inhibition System), a behavioral inhibition system. It is this system in the brain which will cause anxiety, an increase in alertness, and it is this entity which will cause a secretion of adrenaline at the level of the adrenal medulla, the glands located above the kidneys. This adrenaline will cause symptoms; get them to talk about their symptoms: “What symptoms do you have? » (patient response) Everything you described to me: increased sweating, heart rate, muscle tone, etc. This is what adrenaline causes.
2. CARRYING OUT 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 to flee to avoid this situation. New question to ask: “What do you do?” (patient response).
The majority of them generally avoid the situation. Some may say that they have faced the situation, however forcing themselves is not useful in therapy because it will accentuate the conditioning and provoke bad memories.
Anxiety exists in all people and all mammals and is the result of millions of years of evolution. Patients must ask themselves the question: “What do you think anxiety is for?” (patient response)
Anxiety was created by evolution to protect itself, it is an individual protection mechanism. Anxiety was present in human beings 20,000 to 30,000 years ago. New question: ”Where did your ancestors live?” (candidates’ answer) Our ancestors lived in hostile environments, to survive they lacked 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 survive until now. Anxiety serves to protect us. Go back to the symptoms mentioned by your patients previously, for example, if the symptoms are an increase in heart rate: “Why is your heart beating fast?” (patient response)
The heart accelerates 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 was used in the event of a fight with a bear to give the body superhuman energy. The symptoms caused by anxiety are therefore preparations for action.
3. AN EXAMPLE ON ANXIETY
New question: “Give me an example in which anxiety saved a life?” (candidates' response) Angela Cavalo is an American who lived in the 80s. She saved her son's life by lifting a Chevrolet Impala. His son was repairing it, had installed trestles allowing him to be under the car. The sawhorses gave way and began to crush his son. Angela realized the situation, she did her primary assessment, her heart beat very fast, she started to sweat. Angela lifted the car and saved her son. Anxiety gave him superhuman strength which allowed him to save his son.
Learn about Beck's cognitive model, and Barlow's cognitive model
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FAQs about Gray's neurobiological model and virtual reality
How long has this existed?
C2Care has been testing its virtual reality software in hospitals since 2016. This field experience has made it possible to gradually refine the immersive environments and graduated exposure protocols now offered to practitioners equipping their office or healthcare establishment.
How is virtual reality used?
The practitioner installs the patient with a virtual reality headset and chooses an immersive environment corresponding to their phobia or anxiety disorder. The patient is gradually exposed to anxiety-provoking stimuli, according to the principle of graduated exposure, with the support of the AI assistant Camille.
What is a virtual environment?
A virtual environment is an immersive scene reproducing an anxiety-provoking situation, such as an airplane, an elevator or a crowd. The patient progresses there via his headset, while the practitioner adjusts the stimuli present to adapt the exposure to his phobia.
Can I feel nauseous while using the headset?
Some patients may experience cybersickness (nausea, disorientation) while using a virtual reality headset. This phenomenon affects around 10% of exposed people and generally remains transient, unrelated to the effectiveness of the therapy.
What pathologies can be treated in virtual reality?
Virtual reality treats anxiety disorders (phobias, post-traumatic stress, obsessive-compulsive disorders), addictions and mood disorders. It is also used in cognitive remediation, to support patients with cognitive disorders.
Who can use virtual reality for treatment?
Practitioners such as psychologists, psychiatrists and occupational therapists use virtual reality to support their patients. These devices equip both self-employed professionals and healthcare establishments: CHU, hospitals, clinics or EHPADs.
Which patients can benefit from a VRET?
Patients suffering from anxiety disorders, phobias, addictions or cognitive impairments may benefit from virtual reality exposure therapy. The practitioner adapts the immersive environment and the progressiveness of the exposure to the specific situation of each patient.
Author
C2Care
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