Anxiety Reduction, Pain Distraction and VR

doctor

In an effort to manage patient anxiety and control the costs of surgery, virtual reality (VR) is being used as an alternative to anesthesia and sedation in medical procedures with great success. One pioneering physician in Mexico began his research into this practice by beginning with the use of video games and moving to VR after experiencing success. The results have been published in an alternative to anesthesia and sedation in medical procedures with great success. One pioneering physician in Mexico began his research into this practice by beginning with the use of video games and moving to VR after experiencing success. The results have been published in an article by Jo Marchant with the BBC.

It has been said that necessity is the mother of invention. In 2004, Dr. Jose Luis Mosso Vazquez, a surgeon at Panamerican University in Mexico City, bought a Spider-Man game for his son. The game, an early form of VR, involved images projected onto a head-mounted display. Dr. Mosso was struck by how immersed his son became in the game and wondered if this was something that he could use to reduce the level of anxiety that patients experience during minor surgery. Dr. Mosso experimented using the Spider Man game with the head-mount while doing endoscopies. Patients were encouraged to play the game during the procedure instead of being sedated. He asked patients to score their pain level during the procedure and found that the immersive quality of the game reduced the need for sedation. In 2006, Dr. Mosso presented his results at the Medicine Meets Virtual Reality conference in California.

At the conference, Dr. Mosso met Albert “Skip” Rizzo, a psychologist (and now Director of Medical VR at the University of Southern California), who had been doing similar research with endoscopies. “He presented 10 cases,” says Mosso. “I presented 200.” Rizzo showed Mosso the expensive, state-of-the-art head-mounted displays he was using. “It was another world,” says Mosso. But then Rizzo revealed the equipment with which he had begun – it was the exact same Spider-Man game.

Rizzo was impressed with Mosso’s research and donated a headset to him. Rizzo also convinced a colleague, Brenda Wiederhold of the Virtual Reality Medical Center in San Diego, to let Mosso use some virtual worlds she had developed specifically for pain relief.

Mosso returned to Mexico and began using his new VR setup in a wide range of procedures, including childbirth and heart surgery. VR helped patients relax in all situations, but Mosso had the most success using VR in minor outpatient procedures where patients are awake but sedated. In these procedures, Mosso used a virtual scenario developed by Wiederhold called Enchanted Forest. This virtual world was meant to relax the patient and allowed them to explore rivers, lakes, trees, and forests. Virtual experiences involving guns and violence are not used because they tend to increase blood pressure, which could result in uncontrolled bleeding.

In using VR, Dr. Mosso found that patients required half as much sedation as they normally would require and, in some cases, required no sedation. In addition to relieving patient anxiety, there has been a significant cost savings for the clinics for sedative drugs such as fentanyl and midazolam, which are very expensive. Dr. Mosso estimates that the cost of surgery has been reduced by 25%. More important, less sedation reduces the risk of complications and recovery times. With these results, Dr. Mosso hopes to see VR more widely used not just for surgery, but to relieve pain in medical situations such as wound care and dentistry, as well as in chronic conditions such as phantom limb pain. And in areas where resources are limited, VR may be a welcome solution.

"Mosso doesn’t have the facilities here to sedate her, or offer her any painkillers more powerful than the local anesthetic, so he plugs in the laptop and switches the VR back on. Veronica keeps Oliveria talking as Mosso works. “What do you see?” she asks. “Fishes, water, stones,” Oliveria replies."

The University of Washington did a striking study with burn victims, showing them an experience they called SnowWorld during sessions of skin grafting. "Pain research using fMRI brain scans show significant reductions in pain-related brain activity..."

 

Photo credit: University of Washington

 

Using VR as a high-tech distraction technique allows surgeons to carry out operations that would normally require powerful painkillers and sedatives, with nothing more than local anesthetic. In addition to significant cost savings, VR has demonstrated that its immersive quality reduces patient anxiety and facilitates speedier recovery. Now that there is research to support these claims and the price of headsets has come down, consumers can hope that more doctors will take advantage of VR in improving patient experience and outcomes.

This attention distraction power is also a game changer for uncomfortable procedures such a dialysis and chemotherapy, waiting rooms, as well as what Mosso has done, for everything from fom childbirth to heart surgery. Distraction VR is sure to be a catalyst in VR wellness applications.

Please also read our white paper: "Using Virtual Reality for the Reduction of Anxiety: An Introduction to How Immersive VR Can Improve the Treatment of Anxiety"

Can Virtual Reality Sidestep The Time Travel Paradox?

tree bubble

There are two technologies that humanity has been looking forward to for decades. One of these technologies is time travel. The other is virtual reality. You may want to throw ‘flying cars’ up there somewhere as well, but some people haven’t seemed to realize that planes essentially are just that. Regardless, of all of these technologies that humanity has wished for, only one of them has come to pass so far: virtual reality. The thing is, with virtual reality, it may be possible to experience the other technologies through it. In fact, some of the leading physicists think time is an illusion.

Granted, virtual reality will never be able to truly, physically send you through time and space to exist in a different era. But, with the power of virtual reality, it may be possible to experience the past and future in every sense besides the legitimate physical.

Imagine, for instance, virtual reality that lets you experience the American Revolution firsthand. As a soldier perhaps, or even one of the commanders. Or perhaps you would just be present in an ethereal sense, watching everything from the safety of virtual reality. Or consider the opposite. What if you could go into virtual reality, and experience a programmer’s idea of the world in the year 3000? While you can’t claim any accuracy to what people think is the future (though Back to the Future did an uncannily good job with their Cubs World Series prediction), you could still experience what people believe the future will be like, from flying DeLorean’s to those hover boards we never got when we were supposed to.

Obviously, none of this will truly take you to the past or the future. You will still physically be present in the world of 2017, but, the real question is, does it make a difference? If you experience something that is so real to your senses that it may as well have been, does it really matter if it actually happened? To some people it might, but to many others it does not.

If you could use virtual reality to experience say, sky-diving, would it not be the same as actually sky diving so long as it was realistic? The same notion can be held to the idea of pseudo-time travel through virtual reality. Maybe you didn’t really travel in time back to the Crusades, the American Revolution, or one of the World Wars. Maybe you didn’t really travel to the year 3000 and witness the future. But if the experience is real enough, is it not the same as though you actually did?

It is something that is yet to be seen, but highly anticipated by all. Moreover, the potential is nearly limitless. With this kind of virtual reality, will the way history is taught change? Will students be able to experience renditions of the history they are learning first hand? And what of religion? Rather than read the Bible or the Quran, will you be able to experience every part of it from the perspective of someone who was actually there? You very well could, provided that a programmer desires to make it so. Coincidentally, SpiritualVR officially announced it's developer partner program this week, inviting creators to publish through its network of spiritual and wellness-minded apps.

Virtual reality is one of the most exciting things to happen to humanity in decades. And though we may never truly travel through time, who knows what we could one day experience through the power of the technology we now have. I’ll meet you there or, rather, then.

How Research in “Awe” Can Inform Creating a Spiritual Experience in Virtual Reality

awe

Even if we have not had a “spiritual experience,” we are probably familiar with stories of these experiences. While Virtual Reality (VR) is being used to create greater immersion in video games and as a tool used by therapists for exposure therapy in treating phobias, SpiritualVR is leveraging the unique properties of VR to create emotionally powerful spiritual experiences that can have a positive impact when you return to the real world. These experiences are being developed to help people change their thinking and, as a result, change their behavior.

How does that change happen? It is helpful to look at the research done on awe by Dacher Keltner, a professor at the University of California, Berkeley. His work in awe helps us to understand the nature of spiritual experiences and how they can have a positive impact on how people live their lives. “...[A]we involves a challenge to or a negation of mental structures when they fail to make sense of an experience of something vast.” Encountering something vast and surprising evokes feelings which cause the self to feel small, powerless, and confused. In this state of confusion, the self is faced with the challenge of either dismissing or negating the experience, or accommodating the experience. Accommodating the experience involves accepting the feelings of power, wonder and fear, which can create feelings of timelessness, selflessness, humility, and a greater sense of connection with the world around us. This is similar to the sublimation of the ego (and conditioned belief systems) required for all spiritual transformation. In simpler terms, you cannot have a spiritual experience without letting go of preconceived notions of being in the world.

Predictability prevents change. We do not change in situations which are predictable. “Fleeting and rare, experiences of awe can change the course of life in profound and permanent ways.” Awe involves a need for accommodations. If such an experience is not negated or dismissed, feelings of enlightenment and rebirth can occur when mental structures expand to accommodate truths never before known. It is these “peak experiences,” as described by Abraham Maslow, which have the ability to create transformative, or spiritual, experiences.

What does this have to do with Virtual Reality? It is the immersive quality of “presence” in VR that makes it so powerful. At a basic level, VR creates an alternate reality in a virtual world with props to increase its reality. Adding sound and touch greatly enhances the virtual world to the point where it can be indistinguishable from the material world that we inhabit. The props used in VR are capable of “tricking” the brain to make the virtual world indistinguishable from the real world. It is in this virtual world that “reality” can be manipulated to create desired change. With awe, change occurs as a result of successful accommodation to an unexpected and overwhelming experience. In VR, change can be created by manipulating this environment and providing predetermined stimuli to cause a desired change in behavior.

Virtual reality gives us the capability to manipulate reality in ways that can be therapeutic. In one of SpiritualVR's prototype applications where we are testing the powerful properties of psychology, we examine "self-criticism". The user/subject appears as an avatar (a figure representing an actual person). Another avatar appears and begins to criticize the subject. The subject is next greeted by a third avatar who releases a large quantity of bubbles from above. Some of these bubbles contain “gifts” which are captured and held by the self. The self then gives these gifts to three new avatars who are expressing discomfort. Each gift is a compliment to counter the criticism received by the self. It is this act of altruism in giving the gift of compliments to the distressed avatars that creates the experience of compassion. This modeling of behavior in expressing compassion to others is meant to counter feelings of self-criticism. If we can learn to treat others with compassion, we can learn to treat ourselves with compassion.

Keltner concludes his discussion of awe by stating that “Awe can transform people and reorient their lives, goals, and values” making “awe-inducing events ... one of the fastest and most powerful methods of personal change and growth.” The same can be said of SpiritualVR.

Please also read our white paper: "Using Virtual Reality for the Reduction of Anxiety: An Introduction to How Immersive VR Can Improve the Treatment of Anxiety"

Mindfulness and Technology

Mindfulness and Technology

Originating in Buddhist philosophy, mindfulness is becoming increasingly popular in the West as the incidence of anxiety, depression, and stress-related disorders plague the undercurrent of our fast-paced industrialized way of life. Recent scientific research on mindfulness has demonstrated beneficial effects on several holistic aspects of personal health, including the mind, the body, and behavior. 

Mindfulness meditation has been proven medically effective to decrease stress and improve well-being when practiced consistently. Yet many people still struggle with the concept or application of mindfulness-based therapy. A new wave of delivery is emerging which is combining this ancient practice with modern technology to bridge the gap and appeal to a modern generation of meditators. Studies show not only relaxation, but important shifts in cognition, emotion, biology, and behavior that may work synergistically to improve health. There is also emerging evidence that mindfulness training is associated with greater meaning and peace in one’s life (spirituality), as well as enhanced relationships with others (Carmody et al., 2008Carson et al., 2004)

Imagine you are sitting peacefully on a beautiful beach. You can hear seagulls against a backdrop of pebbles clinking together with each breaking wave. You take deep belly breaths and listen to your meditation teacher as she sits beside you and guides you through the film roll of anxiety and consciousness unfolding behind your eyes. Now imagine that you take off your virtual reality headset to discover you in fact never left your own living room (and saved hundreds of dollars on a flight to a meditation retreat in India.) This is an example of one scenario that modern entrepreneurs are envisioning the marriage of mindfulness and technology to enhance the effectiveness of well-being and relaxation intervention. Virtual reality devices can be combined with health tracking technology such as Provada Health's iOS app; “…incorporated into (the) app (is) the ability to link health-tracking wearables, such as the Apple Watch, to quantify the effects of a meditation session on, for example, your resting heart rate. Or look at how your sleep is being affected by taking time out to meditate.”

Modern gaming technology is another avenue where it seems there is potential for mindfulness to be cultivated. Take for example one gaming app available via Play Store called 'Pause,' which was created through the principles of mindfulness meditation and Tai Chi. The creator Peng Cheng explains, “It started with my own severe experience of stress and depression. I gave myself 6 months, I practically didn't do anything but I meditated and practiced Tai Chi with the goal to do nothing but staying in the here and now as much as possible.” The simple game involves a little blob which follows your finger across the screen and facilitates focused awareness by growing in size as you maintain a slow concentrated speed. “Most of our stress only exists in our head and absorbs all our attention. To break this pattern, I need to focus on what is physical and tangible and actively put my attention in the moment.”

Cultivating focused attention in the present moment is the core foundation of mindfulness practice preached hundreds of years ago, in ancient India, and today via a squiggly blob on a hand-held screen or through a high-tech headset. Proper use of technology has the capacity to transform the quality of our lives and the delivery of ancient therapies such as mindfulness which are being lost on a section of the modern generation unaccustomed or afraid of 'spiritual mumbo jumbo.' Many trials of research have found that people with higher levels of mindfulness – even without “formal” meditation training – report feeling less stressed, anxious and depressed, and more joyful, inspired, grateful, hopeful, content, vital, and satisfied with life (Baer et al., 2006; Brown & Ryan, 2003; Cardaciotto et al., 2008; Feldman et al., 2007; Walach et al., 2006).

Another benefit of mindfulness is the ability to recognize and accurately label emotions (Analayo, 2003). More mindful people appear to have a greater ability to control emotional reactions in the middle part of the brain (the amygdala and the dorsal anterior cingulate cortex [ACC]) by engaging the front part of the brain (the prefrontal cortex [PFC]), which is associated with attention, concentration, and emotion regulation. This means when you’re practicing mindfulness you’ll better be able to control your emotions and correct unpleasant mood states.

Believe it or not, there is increasing scientific evidence to support the therapeutic effect of mindfulness meditation training on stress-related medical conditions, including psoriasis, type 2 diabetes, fibromyalgia, rheumatoid arthritis, chronic low back pain, and attention-deficit hyperactivity disorder.

Several new technologies, including brain imaging, wearable tech. and virtual reality, are being used to look at and extend the potential health benefits of mindfulness. Finally, research is beginning to prove what mindfulness practitioners have known for centuries…that greater focus, awareness, acceptance, and empathy can make for more flexible, adaptive responses to stress, which, in turn, can help free us from suffering and realize greater well-being & happiness.

Please also read our white paper: "Using Virtual Reality for the Reduction of Anxiety: An Introduction to How Immersive VR Can Improve the Treatment of Anxiety"

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