From 360° video to interactive virtual reality

The science of medical hypnosis is fundamentally based on the power of the imagination and the mind’s ability to visualise environments and scenarios that promote relaxation and care. Virtual reality (VR) technology offers a unique opportunity to transpose this practice into a digital environment and make it easier for patients to benefit from it.

However, unlike a traditional hypnosis session, which relies on the patient’s imagination, the VR session is based on a predefined visual and verbal guide. This difference raises a major challenge: it is essential to design VR scenarios in such a way as to remain faithful to the principles of traditional hypnosis, in both the verbal and visual elements.

In the HypnoVR medical device, we have combined hypnotic verbal support with music therapy and hypnotic visual scenarios to exploit the full potential of the total visual and auditory immersion made possible by virtual reality. This convergence between hypnosis and virtual reality offers considerable potential for innovative therapeutic approaches, particularly in pain management, stress reduction and other areas of mental and physical health.

In this article, we explore the creation of a visual scenario for HypnoVR, with the essential therapeutic elements to be integrated, as well as the challenges and opportunities linked to the evolution of headsets.

The fusion of hypnosis and virtual reality

To create an effective hypnotic experience in virtual reality, it is essential to master all the subtleties involved in a traditional hypnosis session. This requires meticulous attention to detail and an in-depth understanding of the visualisation techniques that accompany a session. The guiding principles were defined by our founders, Dr Denis Graff and Dr Chloé Chauvin, both anaesthetists and hypnopraticians.

These principles include :

a visual animation for
support the cardiac coherence exercise

immersive, soothing landscapes

strategic use of colour and pattern
that promote relaxation and concentration

textures and shapes designed
to evoke tranquillity and serenity

elements of visual focus

a move that reflects evolution
in the hypnosis course and limits boredom

symbolic and metaphorical elements
that give meaning to the experience

For the experience to be as profound and effective as possible, it is crucial to integrate these principles harmoniously and coherently into the visual scenario, in line with those of hypnosis. The aim is to guide the user towards a state of heightened receptivity, not only to the hypnotic discourse conveyed by a voice-over but also to the musical ambience (music therapy) that accompanies the experience.

Simulation or video: a look back at HypnoVR’s historic choice

HypnoVR’s fundamental objective has always been to reproduce as closely as possible the experience of a traditional hypnosis session, with the emphasis on immersion as the key factor. It is this approach that has proved so effective, with over 23 scientific papers to date. Our aim is to create a high-quality immersive experience, while complying with medical specifications to ensure maximum therapeutic effectiveness.

Faced with the complexity of meeting this need with live-action films, the structure of which would require colossal staging resources and special effects, so we opted for experiments designed by ourselves in 3D. To implement these 3D visual scenarios, we came up with two options: 360° video or real-time simulation.

View of a 3D visual scenario being designed

Why 360° Video?

The performance of standalone VR headsets played a crucial role in our development decision. Historically, their limited graphics processing power posed major challenges for the simulation of real-time environments. This meant making significant compromises either on quality and visual richness, or on the fluidity of the experience. This limitation was particularly pronounced when HypnoVR was first created in 2016.

Playing a video, even in 360° format, requires few resources but does not exploit 100% of the immersive potential of VR and limits the possible interactions with the virtual environment.

360 video proved to be the optimum solution, providing fluid, high-quality immersion despite the performance limitations of VR headsets. By creating videos from our 3D environments, we have been able to exercise complete control over the visual aspect, while guaranteeing a user experience that meets our standards, is comfortable and is adapted to the capabilities of the hardware.

The transition from 360° video to real-time simulation

In 8 years, the performance of VR headsets has improved considerably, as has our expertise in therapeutic virtual reality and our vision of the future of the product.

We are always looking to increase the therapeutic efficacy of our solutions and have identified 2 areas for development.

Improving your sense of presence

The feeling of presence helps you to step back from the real world and into a state of hypnosis. We know that improving the feeling of presence makes it easier to induce a modified state of consciousness (hypnosis) and its physiological impact (Murray, Computers in Human Behavior).

Add interactions between the patient and the virtual environment

Interactivity with the virtual world helps to control and channel the patient’s attention throughout the session.

Faced with this ambition, the video format proved to be limiting, and the arrival of the new generation of VR headsets in 2023 has changed all that. Their level of performance makes it possible to consider simulation in real time while meeting our initial requirements for quality and fluidity.

Based on several scientific publications (Hendrix, Teleoperators and Virtual Environments), we knew that real-time simulation could have a major impact on the feeling of presence that we wanted to improve. The immersive experience offered by a real-time simulation is directly enriched by the use of the stereoscopic image concept (see illustration) and sound spatialisation, offering a more realistic perception of the depth and dimensions of the virtual environment. This approach strengthens the emotional connection with the user, creating a more intense and engaging sensory immersion.

With a virtual reality experience generated in real time, it is possible to interact dynamically with the virtual environment, increasing the sense of control and involvement. This interactivity allows the experience to evolve from a passive to an active format, increasing user engagement and focusing attention.

Last but not least, there is the practical aspect of the volume of data to be stored. Unlike video, which requires a huge amount of storage space, real-time content is more compact and allows us to expand and diversify our content catalogue, offering our users more options and diversity.

By choosing real-time simulation, you are strategically moving towards a highly interactive solution capable of exploiting the full potential of the latest current and future technologies. Offering new features, enhanced capabilities and improved graphics. This choice opens the way to increasingly rich, engaging, customisable and, above all, therapeutically effective virtual experiences.

Producing scenarios in real time: from level design to technical optimisation

This transition to real-time simulation has given us the opportunity to reinvent our visual environments, injecting new creative life into them. While we’ve been keen to retain the themes of our historical scenarios, this reworking has allowed us to incorporate innovative ideas and more advanced artistic approaches, significantly enriching the aesthetic.

Forest scenario before (left) and after (right)

When reworking our scripts, it was essential to strike a balance between technical performance and visual quality. Despite the increased power of the latest generation of VR headsets, their computing capacity remains limited, requiring ingenious optimisation to enhance the experience.

HypnoVR – A tour of the “tropical beach” universe

The notion of evolution and movement is paramount in our visual scenarios and is materialised by a journey (with very slow movement to prevent motion sickness or cyber kinetosis). It’s a large environment that has to be simulated, with many visual elements to display, and this increases the problem of balancing performance and quality tenfold. Particular attention has therefore been paid to the design and layout of the environment (level design), as well as to technical optimisation.


Various optimisation techniques from the world of 3D simulation are used in the design and optimisation of HypnoVR.

– Level of Detail (LOD), which adjusts the fineness of a 3D model according to its distance.

– Baking, which consists of pre-calculating the lighting effects on static objects to limit dynamic light to moving elements only.

– batching, which consists of multiplying the occurrence of a model in order to share the calculation of their rendering.

Example of batching on corals in the world of scuba diving

This work enables us to offer high-quality virtual reality experiences while exploiting the full potential of standalone VR headsets.

This experience is available as part of the HypnoVR offer with the latest generation headsets such as PICO G3 or PICO 4 Enterprise. Information is available on the product page.

Towards a new generation of interactive digital therapy

Finally, we can take the HypnoVR experience a step further and continue to increase therapeutic effectiveness with real-time simulation and the latest VR headsets. As well as improving the feeling of presence, interaction with the virtual world is now possible. However, when we talk about interactions, we need to consider them in the context of medical use, where we are trying to induce a sedative effect with VR and therefore minimise the patient’s movements.

Historical methods of interaction, using manual controllers, are unsuited to our needs because of their complexity and the physical movements required to manipulate them. However, the latest generation of headsets incorporate eye-tracking technologies that allow us to determine the position of the patient’s gaze during the virtual reality experience. This technology can be used to interpret the patient’s behaviour and dynamically adapt the session according to the patient’s attention, by triggering visual events for example, and maximise the patient’s concentration during the hypnosis session.

Real-time simulation is also at the heart of our next solution, HypnoVR Biofeedback, which uses sensors on the patient to adapt the hypnosis session according to certain physiological constants. Whether it’s adjusting the cardiac coherence exercise or triggering specific events in VR depending on the patient’s comfort, HypnoVR Biofeedback will enable a much higher level of interactivity.

Real-time simulation offers fascinating prospects for HypnoVR. This evolution allows us to explore new possibilities, merging the latest technological innovations with the unique needs of the medical sector, and pushing back the boundaries of what we can offer in digital healthcare.

Augustin Darre, lead developer & Jordan Rous, lead 3D artist

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