Forgot your password?
typodupeerror
Biotech Science Technology

Real Pain Dulled In Virtual Worlds 237

Posted by timothy
from the burns-are-serious dept.
26199 writes "The BBC is reporting on a novel use of Virtual Reality: as a distraction for burn victims who suffer excruciating pain during daily dressing changes. What's most interesting is that it actually works. Another use of VR discussed is in the treatment of patients suffering Post Traumatic Stress Disorder; memories can be relived until they are accepted."
This discussion has been archived. No new comments can be posted.

Real Pain Dulled In Virtual Worlds

Comments Filter:
  • Somehow ... (Score:5, Interesting)

    by RPI Geek (640282) on Tuesday February 24, 2004 @03:41AM (#8371319) Journal
    ... this part of the article rubs me the wrong way:
    In collaboration with Cornell University in New York, Hoffman has built a virtual reality programme that is a simulation of the events of 9/11 designed to desensitise the patient to the events of that day.
    It just seems too "Clockwork Orange" to me... :-/
  • by Vthornheart (745224) on Tuesday February 24, 2004 @03:42AM (#8371322)
    Some would say that people already suffer from the new disorder you describe.

    Like all medications, however, it stands to be abused. It's really up to the user to monitor themselves, or a doctor if such a system could be devised.

  • I wonder... (Score:4, Interesting)

    by bersl2 (689221) on Tuesday February 24, 2004 @03:46AM (#8371340) Journal
    if this means that in the distant future, I won't occupy the whole nursing staff for 15 minutes, while they try to give me a shot?

    Yes, I still have this childish behavior, because I don't like needles, and I don't like going into shock, which is what happens every time; yet, I don't want to be a nuisance.

    My arm is hurting right now, just thinking about this whole topic...
  • Re:Safe? (Score:5, Interesting)

    by harvardian (140312) on Tuesday February 24, 2004 @03:46AM (#8371342)
    I took an anxiety disorders class with one of the most famous voices in PTSD (McNally), so IANAP but IW a student of a psychologist.

    One of the aspects of virtual reality treatments for phobias (we didn't study its use for PTSD) is that the patient is always accompanied by their psychologist, and they always have the option of opting out, even mid-simulation. And a nice fact of psychology is that if you have a feeling of control (whether you have control or not), you're less likely to run away. So while many may be too fearful to go through with the treatment, it happens in a supportive, controled environment, and that can be very helpful. The result may well be better than what we've got now, since PTSD's not easy to treat.
  • by wiresquire (457486) on Tuesday February 24, 2004 @03:50AM (#8371355) Journal
    Here I was reading Tad Williams Otherland where one of the characters (Orlando Gardiner), is very ill and spends most of his time in a virtual world as an escape from reality.

    Is this science following fiction ?
  • Re:Somehow ... (Score:5, Interesting)

    by westendgirl (680185) on Tuesday February 24, 2004 @03:53AM (#8371365) Homepage
    Unfortunately, I think CNN's constant running of WTC clips subtitled "American Under Attack" has already had this desensitizing effect. The images don't make me retch the way they used to. Is this the passage of time, or the effects of seeing the same thing several thousand times?

  • by Anonymous Coward on Tuesday February 24, 2004 @03:56AM (#8371377)
    Ok troll.

    I can tell you I just got out of the hospital after having a tension pnuemothorax (life threatening)and I can tell you that morphine is about as useless as a nun with two tits. Might as well just smoke some 7up (the *good* addicts will know what I mean).

    Morphine is useless. It does nothing but make you want better drugs. The pain is still there. A good hit of some BC Bud would do much better. Plus, I can't walk straight after morphine.
  • Doom 2 did it for me (Score:2, Interesting)

    by sam0ht (46606) on Tuesday February 24, 2004 @03:58AM (#8371382)

    When my mouth was aching like hell after a trip to the awful dentist (orthodontist), playing iD's finest kept my mind off the pain very effectively. No time to whimper when you're fragging your friends :)
  • by beaverfever (584714) on Tuesday February 24, 2004 @04:09AM (#8371414) Homepage
    Dr Hoffman believes pain contains a significant psychological element which is why distracting thoughts by virtual reality lends itself so well to pain control.

    "Pain requires conscious attention..."


    I've bought into this idea ever since the day I was curious and watched a mosquito land on my shoulder, get into its stance and pierce my skin. I was really shocked at how much it hurt in that one instance.
  • by Lordofohio (703786) on Tuesday February 24, 2004 @04:34AM (#8371474)
    The memory playback is a nice (but scary) idea, but I don't think it could ever be implemented correctly. If the plan is to play memories until a patient accepts what happened, a new memory program/video/experience would have to be generated for every patient.

    A shooting victim would need a different experience than a burning building survivor, who would need a different experience than the train wreck survivor that comes in the next day. Since the situations would have to be fairly specific for each individual case, this would be nearly impossible to implement.

    Also, if each different video/experience is produced, why not play it on a television? Even a big screen, if you want. I know the goal of the VR is to immerse the subject in the virtual world, but I don't know that it would be that much more effective than good old fashioned photos, videos, and psychiatry.
  • by ortholattice (175065) on Tuesday February 24, 2004 @04:34AM (#8371475)

    While VR pain relief may work to some degree initially, once the novelty wears off, or on an off-day when you just can't get interested in its "game", you'll probably find yourself screaming with pain.

    Should I ever find myself in such an unfortunate situation, may God have mercy on me and set me up with an MD who will prescribe adequate opioid pain relievers. Currently that is the only thing that works, period.

    Too often these days MDs are paranoid about prescribing opioid pain killers, what with the DEA breathing down their necks. See The DEA's Disastrous War Against Pain-Treating Drugs [mapinc.org] for example. It is customary to encourage the patient to grin and bear it or to seek pain relief through alternative therapies like meditation etc.

    I myself have had minor surgery were they'll give you plenty of local anesthetic during the actual procedure; then they send you home with instructions to take tylenol. When the anesthetic wears off, the pain kicks in. It is only by whining and complaining that they'll prescribe an opioid painkiller, and unless you go to the ER (and sometimes even if you do) you'll be in pain for hours more until all the paperwork and procedures are done to get the prescription filled.

    Chronic pain patients are in a real bind these days. They cruelty towards them by denying them long-term opioid pain relief is unspeakable.

  • virtual world view (Score:3, Interesting)

    by tloh (451585) on Tuesday February 24, 2004 @04:36AM (#8371481)
    One of my friends is a practitioner of Christian Science. If I understand what he tells me, Christian Science teachs that we experience the world because we choose to give it all a realty. In other words, it's all in your head. Most would agree there is some figuratively truth to this, but Christian Science takes it literally and uses the idea as the central component of their system of health and well being by wrapping this metaphysical layer around the bible. I wonder how he would react to the article. On the one hand, there is validation in the fact that we can channel positive perception into better health and healing. On the other hand, Christ and Christianity is completely unnecessary as implemented by the doctors featured in the article. I've tried to point out you don't need the biblical stuff in numberous conversations, but now there is something concrete I can show him.
  • by CB-in-Tokyo (692617) on Tuesday February 24, 2004 @04:43AM (#8371505) Homepage
    While it is certainly possible to develop addictions to VR, it is a bit of a mistake to compare them to addictions to painkillers. Most of the painkillers that you hear about in terms of addiction are the in the family of natural or syntetic opioids. These drugs cause physical changes inside the body that lead to a dependency on the substance itself. This physical dependency is what is usually being talked about when you hear the term "addiction" concerning these products. This dependency can be so strong, that if you cut off the chemical altogether, the patient can die.

    Having said that the problem of addiction to the VR, as you mentioned, is a real one. People become addicted to all sorts of activities, gambling, extreme sports, and sex to name a few.

    VR is realtively new, and being used for a treatment for pain should undergo studies to check to see if addiction may be a problem, or if there are any other adverse effects...like the flaming slashdotter!

  • Survivor Guilt (Score:5, Interesting)

    by malia8888 (646496) on Tuesday February 24, 2004 @04:52AM (#8371536)
    Some years ago I wrote a small book for the V.A. for spouses and children of veterans with PTSD. I found in talking to soldiers and other victims of PTSD that survivor guilt was such a crippling part of the disorder. So, I found this snippet encouraging in the article: One patient overcame her sense of guilt at running away from the scene and failing to help others who subsequently died.

    If this treatment can truly help deal with survivor guilt, then it is a very useful therapy.

  • Reliving memories (Score:1, Interesting)

    by Anonymous Coward on Tuesday February 24, 2004 @05:08AM (#8371591)
    I don't have PTSD, and I probably can't imagine how bad PTSD is.

    I do however have some painful memories. The last thing I want to do is relive them. Whenever they come up I try and "change the station" mentally.

    Is it really a good idea to get PTSD sufferers to relive the memories? I honestly would like to know.
  • Re:Amazing... (Score:5, Interesting)

    by fpga_guy (753888) on Tuesday February 24, 2004 @05:12AM (#8371604)
    I have a friend who works on a similar idea in the rteatment of schizophrenia and other hallucinatory mental illnesses.

    They use VR and graphics technology to simulate the visual and auditory hallucinations that sometimes accompany these diseases. NewScientist had a small writeup [newscientist.com]

  • Re:Somehow ... (Score:2, Interesting)

    by Anonymous Coward on Tuesday February 24, 2004 @05:20AM (#8371626)
    Actually even lower resolution graphics (which happen to be necessary to render the world at acceptable frame-rates) still evoke a substantial response from patients, and can be used to treat PTSD.
  • Re:Safe? (Score:2, Interesting)

    by Muhammar (659468) on Tuesday February 24, 2004 @05:23AM (#8371633)
    What you do not want to get is an ambitious psychologist with 2 years of college and fresh councellor's certificate. (She is gonna cure your PTSD through re-living with you your trauma - no matter what's wrong with you).

    What helps is a private talk with a friend or mom, lot of sleep and active program. I can't see how virtual reality videogame-like setting can do any good for PTSD.
  • Re:Safe? (Score:3, Interesting)

    by orthogonal (588627) on Tuesday February 24, 2004 @05:50AM (#8371706) Journal
    Physical pain (like that of the burn victims) is one thing; emotional pain is something else entirely. reason an organism feels physical pain, and the reason it feels emotional pain are pretty much the same: both serve to signal to the organism that its current activity, in its current environment, is detrimental to the organism. A burning pain in my finger tells me that either I should modify my activity -- by moving the finger --, or the the environment -- by moving the stove-top the finger is touching.

    Similarly, emotional pain -- feelings of guilt, or rejection, or etc., -- exist pretty much to tell me that I'm earning the ire of my fellows, and that my ancestors became my ancestors by virtue of not doing those ire-raising things. Those organisms that too often ignored pain, either physical or emotional, of course failed to become ancestors by virtue of that, and so the genes for ignoring pain tend not to have propagated as much as the genes for heeding pain.

    So if physical pain and emotional pain exists to do the same thing -- essentially behavior modification -- and if evidence exists that they are produced by the same structures in the brain, why do we tend to take for granted that they are not the same things?

    Part of the reason, of course, is that emotional pain can last far longer than (many forms of) physical pain. My guess is that this is partly because emotional behaviors -- such as social awkwardness or shyness -- are resistant to change, and part -- as with grief -- is due to reinforcement by memory. I'll further guess that this reinforcement by memory is to some degree an "unintended" side effect of the greater precision of human memory.

    Why are certain social behaviors resistant to change? Probably this is also an evolutionary adaptation -- research on pecking order in primates suggests that there are genetic components to social dominance hierarchies (proximally mediated by hormones, so that changes in hormone level by human researchers can subvert the hierarchy). Why is it adaptive to reinforce the social hierarchy even to the point of making the subordinates feel "bad"? Because feeling bad is preferable to challenging the hierarchy and literally having your head torn off. A geek who asks a girl who's "out of his league" for a date may only risk being laughed at today, but his reluctance may stem from an ancestor whose penalty for flirting with her might well have been death at the hands of the alpha male.

    But I also suspect that the main reason that we see physical and emotional pain as being different is that we see emotional pain as uniquely human, something that separates us from "the animals". This desire for separation from "animals" (scare quotes because, of course, humans are a kind of animal and not an image of God) seems to be a strongly engrained trait at least in the Judeo-Christian tradition -- as is the traditional Judeo-Christian belief in mind-body dualism. Since we know that animals feel physical pain but are less informed about the animals' psychological worlds, it perhaps predictable that we would see emotional pain as uniquely human and thus unconnected with "animalistic" physical pain, a malady of some uniquely human "soul" rather than the mundane -- literally mundane, earthly -- body.

    But both Judeo-Christian dualisms -- soul/body and human/animal -- are found to have less and less justification the more we learn about the brain and its genetic basis; I think the dichotomy of "physical" and "emotional" pain will similarly go away as we learn more about how the brain constructs pain.
  • Re:Safe? (Score:3, Interesting)

    by orthogonal (588627) on Tuesday February 24, 2004 @06:06AM (#8371737) Journal
    Please ignore the above comment in favor of the corrected comment below; I must learn not to post after having three beers, as I tend to mismatch HTML tags.

    As a bonus for your patience, I've added a few links [scienceblog.com] that lend support [newscientist.com] for the idea that physical and emotional pain are similar.


    Physical pain (like that of the burn victims) is one thing; emotional pain is something else entirely.

    There was a recent study (posted here?) that suggests that both physical and emotional pain are produced by the same mechanisms in the brain.

    When you think about this, it makes sense: why would the organism produce -- and "pay" both the additional R&D on a species level, and the additional "construction" costs on an individual level -- an entirely separate faculty rather than adapt on already at hand?

    Not only that, the reason an organism feels physical pain, and the reason it feels emotional pain are pretty much the same: both serve to signal to the organism that its current activity, in its current environment, is detrimental to the organism. A burning pain in my finger tells me that either I should modify my activity -- by moving the finger --, or the environment -- by moving the stove-top the finger is touching.

    Similarly, emotional pain -- feelings of guilt, or rejection, or etc., -- exist pretty much to tell me that I'm earning the ire of my fellows, and that my ancestors became my ancestors by virtue of not doing those ire-raising things. Those organisms that too often ignored pain, either physical or emotional, of course failed to become ancestors by virtue of that, and so the genes for ignoring pain tend not to have propagated as much as the genes for heeding pain.

    So if physical pain and emotional pain exists to do the same thing -- essentially behavior modification -- and if evidence exists that they are produced by the same structures in the brain, why do we tend to take for granted that they are not the same things?

    Part of the reason, of course, is that emotional pain can last far longer than (many forms of) physical pain. My guess is that this is partly because emotional behaviors -- such as social awkwardness or shyness -- are resistant to change, and part -- as with grief -- is due to reinforcement by memory. I'll further guess that this reinforcement by memory is to some degree an "unintended" side effect of the greater precision of human memory.

    Why are certain social behaviors resistant to change? Probably this is also an evolutionary adaptation -- research on pecking order in primates suggests that there are genetic components to social dominance hierarchies (proximally mediated by hormones, so that changes in hormone level by human researchers can subvert the hierarchy). Why is it adaptive to reinforce the social hierarchy even to the point of making the subordinates feel "bad"? Because feeling bad is preferable to challenging the hierarchy and literally having your head torn off. A geek who asks a girl who's "out of his league" for a date may only risk being laughed at today, but his reluctance may stem from an ancestor whose penalty for flirting with her might well have been death at the hands of the alpha male.

    But I also suspect that the main reason that we see physical and emotional pain as being different is that we see emotional pain as uniquely human, something that separates us from "the animals". This desire for separation from "animals" (scare quotes because, of course, humans are a kind of animal and not an image of God) seems to be a strongly engrained trait at least in the Judeo-Christian tradition -- as is the traditional Judeo-Christian belief in mind-body dualism. Since we know that animals feel physical pain but are less informed about the animals' psychological worlds, it perhaps predictable that we would see emotional pain
  • Thank You! (Score:2, Interesting)

    by Anonymous Coward on Tuesday February 24, 2004 @06:45AM (#8371851)

    What a wonderful link/s!

    I was sexually abused repetdedly by my family dentist when I was six (he used a gas hose placed behind my head, but near my face, I can still hear the hissing sound...), I'm now 49, and have been dealing with the repercussions of those terrifying encounters for decades without actually realizing it (since my parents wouldn't believe that he was using gas on me, and I didn't know how to say I was being abused).

    Since I started working with a good therapist my life has just blossomed!

    But those fantasy's since I started to deal with this stuff... wow... and weird, to be sure!

    Glad to know I can get through it all, and move on.

    And that I'm not a nutter.

    Anyhow... thanks for the links, lots of neat stuffff here.

    Thanks a lot!

  • by The Tyro (247333) on Tuesday February 24, 2004 @07:08AM (#8371909)
    as far as I'm concerned... if a VR simulation takes a patient's mind off their pain, God bless 'em.

    Listen... I've spent my share of time in burn units, where the morphine flows like a mighty river; VR is far preferable to using drugs, with all their attendent side-effects. Also, contrary to popular wisdom, addiction isn't usually a problem... only a very very small percentage of burn unit denizens ever develop an addiction to their narcotics after they recover, and there's large studies and good research to back that up... anyone who tells you that narcotic use for severe pain makes normal people into addicts is about 20 years out of date.

    Honestly, we already use a pharmacological variant of VR in pediatric burn units... it's called Ketamine (or "Special K" to all you ravers out there stupid enough to use it). Ketamine creates a dissociative anesthesia, and is sometimes used in kids who are having their dressings changed.... it's not really recommended in adults because it can produce extremely vivid hallucinations... most kids I've used it on report nothing, or just say "I had a bad dream."... gotta love kids. I personally think the difference in experience between pedi & adult has to do with the amount of bad things adults carry around in their subconscious... there's something to be said for innocence.

    Whether it's distraction (I use that on kids all the time), the gate theory of pain, or whatever. If it works, I say use it... it's certainly preferable than risking the side-effects of mega-doses of narcotics.

  • Re:I wonder... (Score:3, Interesting)

    by achurch (201270) on Tuesday February 24, 2004 @08:23AM (#8372113) Homepage

    Close your eyes (so you don't see the needle) and bite your tongue (fight pain with pain). I used to scream like the devil, until my mom taught me that; works for me every time.

  • Re:Safe? (Score:3, Interesting)

    by wideBlueSkies (618979) on Tuesday February 24, 2004 @08:44AM (#8372194) Journal
    Well, running around in downtown Manhattan every day it's kind of hard to not remember.

    After all this time I still look up and expect to see those 2 buildings. Then I remember seeing the plane hit and all the fire.

    I don't think memories like this are supposed to go away.

    wbs.
  • also (Score:3, Interesting)

    by SolemnDragon (593956) * <solemndragon@nOsPAm.gmail.com> on Tuesday February 24, 2004 @01:00PM (#8374653) Homepage Journal
    i'm on the other side: i'm a patient who works with other patients. Fibromyalgia, for example. And the first thing that they come crying for is, "How do i get my doctor to prescribe pain meds?"

    The first answer that we have to give- HAVE to, because we don't know them, either, is, "You don't."

    Plain and simple, unless they are doing EVERYthing else- the physical therapy, the exercise, the effort, the tests for concurrent/comorbid conditions, they shouldn't be given pain meds. It's a tough rule but a vital one, because it pushes them into a relationship with the doc, so that they can get checked out, make sure that they aren't just doc shopping.

    And we tell them that if the doc gives them a scrip on their first visit, something's wrong. We have to tell them the order of things that will be tried, and explain that some of them might help. It's hard because the perception in this country is that there's a pill for every problem, and with pain meds, that's just not always the case. When they get to the pain med stage, and find themselves with side effects, some of them get angry, because they wanted it to just be all better, why would these meds be held back unless they really fixed everything?

    But that's not how it works. So we end up with people getting depressed, and even when we explain all this up front, it still goes that way for some people. For others, the pain meds work, and we wish that they could actually get them when they needed them to start with, without all the secret personality testing.

    This looks like it's a great idea. One thing that i have to say for biofeedback and other therapies- they work on the biofeedback level, but they also work because they are something different. they can distract the person from their pain long enough for them to focus elsewhere, and if you're going to learn to live with chronic pain, that's a very important skill.

    I think this is a great idea. I know that they did a study a long time ago showing that people who exercised to music or some other distraction felt less workout pain than people who focused solely on their workout. I use that study all the time.

    I'll be very hapy when this makes it to take-home stage, and i'll be interested in seeing if it can be combined with workout equipment, for example, for some of the physical therapy that some of my fellow patients have to go through. When they haven't moved much for awhile, i get to see people cry when they try to start up again. And it's not because they're wimps, it's that extra 300-400% of pain chemicals along with the muscle atrophy.

    sol

  • Yeah, well duh. (Score:2, Interesting)

    by SyniK (11922) <tom&gamerzday,com> on Tuesday February 24, 2004 @02:12PM (#8375478) Homepage Journal
    School sucks.
    I'll play a game instead.

    Work sucks.
    UT2K4 is nice.

    Girls are EViL...
    (X-Com) UFO is a nice distraction.

    Etc, etc, etc. Gamers have known the escapist and therapeutic benefits of games for years :).
  • by cr0sh (43134) on Tuesday February 24, 2004 @02:19PM (#8375564) Homepage
    I have three books on NLP - Frogs into PRINCES (by Richard Bandler and John Grinder - ISBN 0-911226-19-2), TRANCE-formations (by same - ISBN 0-911226-23-0), and Using Your Brain for a CHANGE (by Richard Bandler - ISBN 0-911226-27-3). These were all published between 1979-1985 - and are easily among the most strange of books I have in my occult collection.

    I found them at a garage sale at a house in Escondio, CA - being sold by a family that as far as I could tell, spoke no english at all. The titles and the covers looked interesting, and the subtitles detailing "Neuro-Linguistic Programming" seemed like they would fit right into my occult collection anyhow, so I purchased them.

    As I said, the covers were interesting - all of the book's covers have a strange, near psychedelic flavor to them - fanciful images of dragons and wizards (though the last book, which has the latest publication date, drops this look in favor of a more refined outdoor scene of gloomy mountains in the backdrop, a green meadow with colorful flowers and a waterfall in the foreground, with a "transparent" profile of a person where everything is tinted "lighter" through it). I only got about halfway through what I thought was likely the first book (being of the earliest publication date), "Frogs into PRINCES". I believe this to be the only book I have ever read that screwed with my mind, in a very strange way.

    As I was reading it, I was also trying to use some of the techniques, because they seemed like very powerful tools, for both internal and external use. As an example, one of these tools involved recognizing body language, and using that in opposition to what you were saying (simple example, nodding your head "yes" while discussing something in a negative tone, or disagreeing with someone) - this was a tool by which you could convey information to others to stimulate them to perform certain things in a certain manner. There were other techniques of a similar nature, some which you could use internally.

    As I read, my SO (now my wife) was telling my that I was changing - that I acted differently since starting to read the book. She asked me to stop reading the book, which I did, because I could feel this change as well - and it bothered me. After I stopped reading the book, I felt that a curtain or something had lifted, like a slight fog or something.

    Now, I realize that this is just a anecdotal story, and that it carries no weight from an objective standpoint - take it as you will. I have kept these books, though, and I intend one day to try reading them again, knowing my prior experience.

    What you describe of NLP I never got to in the books - perhaps it was in a later chapter or in one of the other volumes which I didn't read? The technique, though, sounds like something from NLP. I still don't know what or why these books are - they seem like self-help books, but if they tend to affect others like they did me, I wonder just what NLP really is about - and what its ultimate use could be? Personally, I wasn't looking for a self-help or self-change book - but I was interested in the idea of "hacking my mind", so to speak (yeah, I know that sounds like a contradiction. I was only looking for changing myself in a controlled manner for the hell of it and to learn how to do it in a different manner, not because I felt I needed it - probably not a good reason, now that I look back on it)...

  • by DynaSoar (714234) * on Tuesday February 24, 2004 @05:12PM (#8377798) Journal
    ... it has to do with attention, specifically divided and focused attention. I've replicated some VR experimental work using VR vs. other techniques for redirecting attention. The techniques work according to how deeply the person can immerse themselves into the alternate stimulus context. Hypnosis is extremely good, but some people are better at hypnosis than others. Manipulating a physical object is exactly as effective as manipulating an object in VR (I got the same results with $20 worth of wooden blocks that someone else got with an SGI Indigio and complete submersion VR tank, worth $40K).

    The one technique I haven't got to try yet is implicit learning under anesthesia, which seems to work like hypnotic suggestion, but doesn't rely on the person's own ability; it works the same for everyone.

    Whenever you see any study claiming "VR does so and so" question why it took VR to do so, and what else might also work. There's nothing magical about VR that almost certainly can't be done as well for cheaper.

With your bare hands?!?

Working...