Real Pain Dulled In Virtual Worlds

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."

like dentists used to do with white noise

[johnjosephbachir]

iirc, dentists used to do something similar. patients would wear headphones while procedures were being done. i think they would play some sort of white noise.

j

Re:Safe?

[Vthornheart]

Well, the trick of PTSD is that, for most people, the daily struggle to not remember (and avoid things that remind them) is much more traumatic. Imagine walking down a street, and a certain type of tree or smell in the air sets you off. Between having that and having one extremely painful session of emotion-dulling via reliving the experience, I'll take emotion dulling. At least it will bring a somewhat permanent conclusion.

This is, of course, assuming that it actually WORKS. =)

Re:Safe?

[venicebeach]

Exposure therapy is not pleasant, but it does tend to work. I don't know much about PTSD, but for anxiety disorders and phobias exposure is quite effective and virtual reality techniques have been becoming more and more popular for this. For treating someone with public speaking anxiety it's easier to get a virtual audience than to arrange for a bunch of people in a room...

Re:Safe?

[Vthornheart]

Aye, PTSD is a type of Anxiety disorder... (I did a report on it once =) =) ) Treatments that work for Anxiety Disorders in general will tend to work for PTSD. PTSD is a hard one though, because of the things that can set it off, and how (at least up to now) the reliving of experiences had to be done pretty much in the domain of the mind or with a psychiatrist.

Re:Detachment from Reality

[harvardian]

It's not like patients take their VR machines home with them and dope up when their doctor isn't looking :-P

In all seriousness though, it's not like the simulation is of Cindy Crawford consoling you about your amazingly traumatic experience. It's an ACTUAL SIMULATION of your amazingly traumatic experience. How likely is it that people would turn away from normal life for the comfort of that?

Re:I believe we already have a cure...

[beaverfever]

"It's called morphine."

Wow - that's quite a medical breakthrough you have made. I'm sure the global medical community would like to hear more about this as it seems this idea never occured to them to use painkillers before.

Okay, enough with the sarcasm. If you had paid closer attention while reading the article you would recall this:

"Dr Hunter Hoffman, research fellow at the Harborview Medical Center in Seattle, has tested his virtual worlds on victims of burns injuries who suffer excruciating pain during their daily dressing changes which conventional drug therapy fails to control."

That's gotta be a lot of pain.

Re:Dulls the Pain of Social Rejection

[real_smiff]

I'm British and i know what a Wedgie is, but i've never (AFAIK) experienced a Wet Willie - care to enlighten me? :) Also have you heard of the Atomic Wedgie - it's when they manage to get your paints hooked right over your head. Painful - i've heard, and yes, it *is* possible. Plus of course, there's always Posting - three men, two legs (apart), one post.

This has been going on for quite a while

[FisterBelvedere]

I remember seeing a report on this probably around 10 years ago. The technology was in its infancy but was being used to adjust people with a fear of heights. A link with information along these lines (found it in 2 seconds on google) is here:

Here [gatech.edu]

even the screencaps look the same as in the story I remember, and they appear to have the look of 10 year old renderings.

Re:Safe?

[useosx]

I really think I am going to regret bringing this up on Slashdot, as it is inevitably going to be misinterpreted.

But... victims of sexual abuse sometimes sometimes end up having sexual fantasies about that abuse.

I recommend the following [bettydodson.com] three [bettydodson.com] articles [bettydodson.com] by Betty Dodson [bettydodson.com] as she, I think, understands the issue well. WARNING EXPLICIT CONTENT for those who care.

Post Traumatic Stress and other usages of VR

[rpiquepa]

It just happened I wrote yesterday about the usages of VR to treat fears. A company named Virtually Better [virtuallybetter.com], based in Georgia, creates virtual environments mixing video images and computer-generated ones to help people deal with their fears and anxieties. In this article [nytimes.com], the New York Times (free registration) writes this costs only 10 percent more than conventional therapy. The newspaper adds that therapists using this system claim a success rate exceeding 90 percent. Virtually Better "has created scenes of a glass elevator and a bridge to address fear of height, an airplane cabin for those who fear flying and a thunderstorm to diminish fear of bad weather." Other environments address the treatment of substance addiction or of post-traumatic stress. A (Virtual) Therapist's Dream [weblogs.com] contains selected excerpts. It also includes images on the virtual airplane environment.

reliving

[Tom]

Oh yes, reliving a traumatic experience is one great way to cure people.

The approach is quite controversial in psychology. There is enough indication that it will only dull instead of cure, and that in some cases it will increase the trauma.

Re:The undertreatment of pain problem

[Anonymous Coward]

The claim that VR Pain Control wears off is an unsubstantiated claim. Preliminary studies indicate indicate that the efficacy of virtual reality pain control did not diminish with repeated usage (Hoffman, H.G., Patterson, D.R., Carrougher, G.J., and Sharar, S.R. The effectiveness of virtual reality-based pain control with multiple treatments. The Clinical Journal of Pain. 2001 17:229-235). You may read this at (http://www.hitl.washington.edu/research/burn/mult iplepain.htm).

Opiate Withdrawl

[The Tyro]

Is not usually life-threatening (you'll certainly wish you were dead while you're going through it, but you don't usually die).

Much more dangerous are the withdrawl syndromes associated with Alcohol and Benzos (diazepam, lorazepam, alprazolam... aka Valium, Ativan, and Xanax, respectively). Those folks have a much harder go of it than heroin and painkiller addicts, at least physiologically speaking... they get autonomic hyperactivity, refractory seizures, hallucinations... there's a very significant mortality if not medically treated.

Stimulants tend not to have such a severe withdrawl syndrome, at least in a life-threatening sense. I'm referring to cocaine, methamphetamine... there's a crash when you come down, and they can deplete your body's stores of catecholamines and other neurotransmitters, leading to periods of agitation, depression, insomnia, etc, but that's typically after longer term use.

A psychological addiction to VR should be a very minor issue compared to any of the above.

Neurolinguistic programming

[Mxyzptlk]

Have you heard about NLP (neurolinguistic programming)? NLP is a therapy method which is based on reliving a traumatic period - and yes, this is used on PSTD patients, such as refugees from war ravaged countries (see Dr. Richard Bolstad's work), or rape victims. The basic idea of NLP is that the patient replays the traumatic event inside his/her head multiple times, while varying the playback speed, colours, pitch of the sound et cetera. The goal is to replay the event in such a way that it is so ridiculous, that you cannot help laughing at it, thereby creating a more positive (or less negative) feeling towards the traumatic event.

So:
- NLP has been shown to work very well, and
- NLP is very similar to the VR technique in that you relearn your response to a traumatic event with more positive feelings.

By the way - where did you learn to program? You should get your money back...

Tell me

[The Tyro]

you should see it from my perspective... I often get patients who have chronic pain, and show up in my ER looking for medication refills.

I often can't help them, or at least, not the way they want... some of these people are prescribed monster doses of Oxycontin, MS-contin, Methadone, you name it. I treat acute pain in the ER, but I can't refill someone's 90-count bottle of 80mg Oxycontin tablets; it's inappropriate practice. I'm not trained or credentialed in chronic pain management, I've never seen the patient before, will probably never see them again, and those kind of medications at that kind of dose require follow-up (something I'm not set up to do), adjustments, documentation, etc... and I don't need to get "interviewed" by the DEA any more than the next doc. Ironically, some time ago the feds hauled away a physician in an area where I was practicing... then all his patients couldn't get their medications any more, and started coming to the ER looking for refills. Unfortunately, I'm ill-equipped to fill that void.

Chronic pain is a real problem, not only for the docs who run the pain clinics and take care of these folks (they're well-advised to keep impeccable records), but for guys like me who get caught in the middle.

And dont even get me started with the addicts and abusers who doctor shop... using the exact same stories as the chronic pain folks in an effort to get their party supplies for the weekend... those gomers are the bane of my existence.

Been there (Burn units) and this is GOOD!

[Tsu Dho Nimh]

I've worked in burn units, and had a couple of deep tissue burns as a kid, and even if this only works on 5% of the patients, it's worth using, starting NOW!

• It doesn't add anything to the load of medications they are already on.
• It has little chance of undesireable side effects, such as the breathing depression of opiates.
• If it minimizes stress, it minimizes the biochemical load of stress hormones that interfere with healing.
• It gives the patient control over something in an otherwise helpless situation (you have very few choices in a burn unit except maybe what to order for lunch, and that's hospital food)
• It gives sensory stimulation in a very DULL environment of limited visitors, staff in biosuits for your protection ... nothing to do but think about how bad it hurts, contemplate your chances of permanent disfigurements, and hurt

Creating more VR worlds for those that aren't helped by the action games would be a logicla next step.

It's retraining your brain to NOT panic

[Tsu Dho Nimh]

PTSD patients reliving memories until they're accepted? Doesn't that seem a little like forced traumatic recollection?

It works because it is under the PATIENT'S control. They can rerun the images, repeatedly stopping at a spot that makes them uncomfortable until they are comfortable there, then run a bit farther the next time. Similar to the "fear of flying" seminars that start with looking at pictures of planes. You help them push into an uncomfortable zone until they learn that fear won't kill, it's just unpleasant, and the memories no longer trigger excessively strong emotions.

There is a portion of your brain called the amygdala that triggers fear way under the level of consciousness. It has a hair-trigger in persons with phobias and PTSD. It can be retrained to stop sounding the alarm so quickly, which is what various "exposure" therapies and hypnosis do.

Re:Amazing...

[UpnAtom]

Post Traumatic Stress Disorder is often one of the more difficult psychological disorders to treat,

Difficult for whom to treat in what way?

PTSD is one of the easiest to treat in my experience (7 years as a clinical hypnotherapist). You know exactly what the problem is (recurring memories), and you know what the therapeutic outcome is (ability to remember whilst remaning calm). Where's the difficulty?

and is pretty much tops in the category of anxiety-related disorders.

tops??? Who modded this up?

It would be a wonderful thing if it actually is useful in treatment.

The drug companies have a near stranglehold [counterpunch.org] over psychiatry. Without big money to fund the trials and marketing, it will never reach mass-usage.