The Proteus Effect by Proxy: Neuroethical Implications of Avatar Embodiment, Therapeutic Identity Change and Digital Grief

Abstract

Background: Immersive virtual reality (VR) is increasingly moving beyond its traditional role as an exposure-based therapeutic environment and is emerging as a technology capable of modulating bodily self-consciousness, self-perception, and identity. This shift is closely linked to avatar embodiment and the Proteus Effect, whereby users unconsciously adapt their behaviours, attitudes, and self-representations according to the characteristics of their digital avatars. Although these mechanisms may offer promising therapeutic applications in psychiatry, they also raise important neuroethical questions, particularly when applied to vulnerable clinical contexts such as depression, body image disturbance, and grief.
Methods: This hypothesis driven article provides a conceptual synthesis of literature on VR embodiment, the Proteus Effect, therapeutic identity change, digital bereavement, continuing bonds, prolonged grief disorder, and neuroethics. The aim is to examine avatar embodiment as a hypothetical micro-model of therapeutic identity modification and to introduce a novel theoretical framework for understanding immersive interactions with avatars of deceased loved ones.
Results: The paper proposes the concept of the “Proteus Effect by Proxy” to describe a process in which the bereaved individual does not embody the deceased, but interacts with a highly immersive and responsive avatar of the deceased. Through simulated reciprocity, conversational responsiveness, and activation of relational schemas, the avatar may influence the mourner’s emotional state, behaviour, autobiographical memory, and post-loss identity. This framework highlights three major neuroethical concerns: threats to patient autonomy and narrative authenticity through implicit identity modification; risks of internalizing algorithmic distortions, biases, or maladaptive relational scripts; and the ethical boundaries of digitally mediated interactions with the deceased, particularly in individuals vulnerable to prolonged grief disorder.
Conclusions: Avatar embodiment represents a powerful frontier in psychiatric technology, with the potential to facilitate therapeutic identity change but also to disrupt autonomy, memory, and grief adaptation. The Proteus Effect by Proxy offers a heuristic framework for examining how immersive digital bereavement technologies may reshape the mourner’s identity through interaction with simulated representations of the deceased. Before such technologies are integrated into clinical practice, rigorous ethical, regulatory, and empirical safeguards are required.