A Brave New Virtual World?
Updated: Jun 6, 2018
Traditionally, VR technology has resided in the mainstream for its entertainment value. It’s use within Science however has been somewhat limited; predominantly used within research laboratories it has served as a useful exploratory tool in academia, particularly within the Neurosciences.
With the development of reasonably priced headsets this technology has now filtered through into healthcare settings, and VR has now been successfully applied in a number of clinical domains including pain management and psychiatric disorders.
VR: The newest painkiller on the Market?
Everyone has experienced pain, whether it be from the mundane niggling headache, the constant discomfort of a bad back or the agonising pain of a traumatic injury. Pain, simply put, is our body’s way of telling us that something is wrong. Its function is invaluable - imagine putting your hand on a hot stove, and not experiencing the searing pain that triggers the reflex action that makes you pull your hand away. Most people are familiar with, and have used the readily available and numerous sources of cheap pain relief medication. Now with technological advances, virtual reality might be a new player in the pain game.
As a means to reduce pain by acting as a non-pharmacological form of analgesia, VR draws an individual’s attention away from ‘real world” stimuli and into the “virtual world”. As such, the demand VR places on our conscious attention makes for an effective pain reduction method, and shows increasing promise in pain management for patients recovering from illness and surgery. A good example is AppliedVR, a start-up company that has been building a “pharmacy” of virtual reality content that can be used to relieve pain and anxiety before, during, and after medical procedures. A randomised control trial of paediatric VR found that in comparison to standard care, VR significantly reduced pain and anxiety when administered to those in outpatient phlebotomy. Results suggested that patients who experienced more severe physiological symptoms in response to the phlebotomy procedure benefitted more from the VR interventions.
Further, numerous studies support the effectiveness of VR in burn units, where patients often undergo wound care that causes excruciating pain. In one study, patients played a specifically designed VR game called SnowWorld whilst on a course of painkillers - participants reported a 20% reduction in pain and a 37% reduction in time thinking about the pain.
Perhaps then, there is the promise that one day your doctor may prescribe you a dose of virtual reality as first line pain treatment.
VR: Face to face with fear?
Another intuitive application for VR is as a therapeutic tool for the treatment of phobia. By simulating an aversive environment, an individual can begin to confront their fear at whatever increments the therapist chooses. Whilst maintaining a substantial degree of ecological validity, the patient can begin to deconstruct whichever irrational beliefs and fears they may hold towards the object of their phobia. The value of this cannot be understated, when it is considered in the context of phobias which are hard to replicate inside a clinician’s office. For those with arachnophobia, we can quite easily simulate a spider on the arm of a nearby chair, but for those with a fear of flying, physically re-creating the inside of an aeroplane complete with cabin crew, oxygen masks and screaming children might be too much of an ask. As such, virtual reality offers an alternative (and more sensible) approach to manufacturing a setting geared towards behavioural therapy.
Generally speaking, the evidence base for the efficacy of VR in behavioural therapy is both compelling and optimistic. One account from a Spanish clinic details a woman who came to them with a destabilising fear of enclosed spaces, who actually needed to have a CT scan to identify a lesion in her spinal column. Unfortunately, she found the concept of being even slightly enclosed so terrifying that this procedure simply wasn’t a possibility. The fact that she was able to go through with the scan following only 8 VRET sessions is testament to the efficacy of this technology. The environments indeed might be virtual, but the results are clearly very real.
VR: A Golden Bullet?
Virtual reality is undoubtedly a unique clinical intervention; a novel, immersive and valuable means of addressing difficulties we may experience physiologically and psychologically. The clinical significance of the results cannot be ignored, however at this stage it is apparent VR works best as a supplement, whether it be within behavioural or medicinal contexts. The flexibility and fluidity of VR is mesmerising, and as a clinical instrument it is surely the beginning of a brave new virtual world.
Authors: Matthew Price & Caitlin Black