A theoretical inquiry into the role of enaction in Cybertherapy

Some of the problems faced by Cybertherapy along the last two decades are far from being restricted to technical issues. They entail new challenges of medical education, mainly related with the adequate insertion of new technologies in therapeutic processes without distorting the relation between medical professionals and clients. We contend that the acknowledgment of the effects of the systemic effects of therapeutic applications of virtual reality is not fully predictable and can only be achieved attending to the way the patient enacts certain tasks oriented by goals. Enaction means the patient is placed at the centre of the treatment processes, not only as an informed agent, but also as the agent of change through practice. Focusing on the requirements of Cybertherapy applied to Post-Traumatic Stress Disorder, we propose a theoretic reflection on the conditions of training and treatment in virtual settings. We underline the decisive role of Health Care professionals in applying and improving the potentialities of biometric sensors, graphic and aural engines in virtual (and hybrid) settings. This role can only be adequately understood within a framework of different levels of recursion of the therapeutic system. Two main levels are referred, the first encompassing the patients adaptation and learning to "move within" the interfaces, the second requiring a reflection on the architecture and design of the physical setting and the computerized rendering of sensory data. Further levels concern the larger framework of therapy, relating to its allocation of resources and the social ends that therapeutic technologies, particularly those concerning mental health, must accomplish.