Virtual Reality & Hypnosis
Virtual reality technology, which enables a person to interact with a computer-simulated environment, has been used in a variety of training settings, such as medicine and the military, as well as in the gaming industry in places like Game Works. It typically involves donning a special helmet that enfolds the wearer in a virtual world of sight and sound and can be manipulated with manual controls, such as a joystick.
The Univerty of Washington (UW), Department of Rehabilitation Medicine, has been working with the UW Human Interface Technology (HIT) Lab to use virtual reality to help induce hypnosis. One of the pioneers in virtual reality, the HIT lab was approached years ago by the military to help develop flight simulators for military pilots. The dept. of Rehab Medicine has a simulated emergency room where trainees can practice treating patients in an emergency situation, as well as simulated operations and surgical procedures.
Using Hypnosis for Treating Chronic Pain
David Patterson, along with Hunter Hoffman at the HIT Lab, came up with the idea of using virtual reality to help induce hypnosis in hospital patients with severe acute pain, specifically burn patients. These patients were taking opiate medications and as a result were often too sedated to be able to focus their attention and benefit from hypnosis.
Patterson and Hoffman speculated that virtual reality might make hypnosis less effortful because it frees the patient from having to come up with the image of something relaxing or comforting to focus on; all they have to do is open their eyes and they are immersed in another world. Hoffman first published on the therapeutic use of virtual reality in Scientific American in 2004.
With burn patients in mind, Hoffman created Snow World, which gives the illusion of gliding through a cool, snowy canyon. In one version, patients can interact with the environment by shooting snowballs at snowmen and penguins to make them disappear in a puff of powder. Unlike conventional video games, all peripheral vision is sealed off from outside distractions. In comparison studies, virtual reality was far more successful than Nintendo for reducing pain during burn care.
Snow World can also be used for virtual reality hypnosis (VRH) for chronic SCI pain. Wearing a special helmet, the patient is immersed in the Snow World program while undergoing the same steps of hypnotic induction as in regular hypnosis. As the patient floats (virtually) down the canyon, the therapist guides the patient verbally through progressively deeper stages of relaxation, ending in the deepest stage at a beautiful lake.
At that point, the therapist gives post-hypnotic suggestions for comfort, relaxation, and pain management. At the end, the therapist guides the patient back up the canyon to alertness. The whole process takes about thirty minutes.
In a single case study at Harborview, VRH was used for the first time with a patient with SCI who had recurrent severe neuropathic pain for many years. Her pain did not respond to any pain medications, and hypnosis alone was not beneficial. After several VRH sessions, her average pain rating went from a seven (out of 10) to a five—not a huge drop, but significant for someone experiencing ongoing pain. Although this involved only one patient, these findings are promising, and we will continue looking at how we can use the VRH for all types of chronic pain syndromes.