Virtual Reality Hypnosis in the Treatment of Chronic Neuropathic Pain:A Case Report

Abstract

This case report evaluates virtual reality hypnosis (VRH) in treating chronic neuropathic pain in a patient with a 5-year history of failed treatments. The patient participated in a 6-month trial of VRH, and her pain ratings of intensity and unpleasantness dropped on average 36% and 33%, respectively, over the course of 33 sessions. In addition, she reported both no pain and a reduction of pain for an average of 3.86 and 12.21 hours, respectively, after treatment sessions throughout the course of the VRH treatment. These reductions and the duration of treatment effects following VRH treatment were superior to those following a trial of standard hypnosis (non-VR) treatment. However, the pain reductions with VRH did not persist over long periods of time. The findings support the potential of VRH treatment for helping individuals with refractory chronic pain conditions. Hypnotic analgesia has become an increasingly important aspect in the treatment of clinical and experimental pain (Lang et al., 2000;Montgomery, DuHamel, & Redd, 2000) and has been used on virtually every type of pain (Patterson & Jensen, 2003). Patterson and Jensen reviewed 29 randomized, controlled studies of hypnotic analgesia and concluded that (a) the evidence supporting the efficacy of hypnotic analgesia is strong, and (b) hypnotizability is usually related to outcome in studies that measure this variable. With respect to the importance of hypnotizability, one potential strategy for increasing the impact of hypnosis is to make hypnotic induction less effortful. We hypothesized that by providing visual stimuli for a patient during hypnosis treatment and giving the patient an illusion of "sinking into a virtual world," the induction would require less concentration and mental effort from the patient and therefore might be more effective than standard hypnosis. As Patterson, Tininenko, Schmidt, and Sharar (2004) posited, using computer-generated stimuli to capture and to guide the patient's attention may not only make the induction less effortful but also more widely available, given that such a treatment would not require the presence of a clinician trained in hypnosis.

Virtual reality for persistent pain: A new direction for behavioral pain management

“…A subsequent series of 13 cases of patients with burn injuries by this group [30] found the VR hypnosis not only produced substantial decreases in pain and anxiety but also reduce patients' requirements for opioid medications by 50%. Oneal, Patterson, Soltani, et al [27] published the first study to test the effects of a VR hypnosis protocol for chronic pain. In this study, the effects of 33 sessions of VR hypnosis was evaluated in a patient with chronic neuropathic pain who had failed to respond to prior conventional medical treatment.…”

“…First, such a combined intervention may be beneficial for patients who fail to respond to a conventional behavioral treatment such as meditation or hypnosis [27]. Second, VR can standardize the presentation of images, instructions, and environmental sounds used in hypnosis (or other behavioral interventions) for persistent pain [2, 28].…”

The Effectiveness of Hypnosis in Reducing Pain and Suffering Among Women With Metastatic Breast Cancer and Among Women With Temporomandibular Disorder

“…Both conditions consisted of four individual 1-hour sessions with a take-home compact disc and instructions to practice during the week. Those assigned to the hypnosis intervention were administered the Harvard Group Scale of Hypnotic Susceptibility to track whether symptom improvement is associated with hypnotizability (Iglesias & Iglesias, 2008;Lichtenberg, Shapira, Kalish, & Abramowitz, 2009;Nash et al, 2009;Oneal, Patterson, Soltani, Teeley, & Jensen, 2008;Pyun & Kim, 2008;Raz, 2008;Wagstaff, Cole, & Brunas-Wagstaff, 2008;Whitehead, Noller, & Sheehan, 2008;Xu & Cardeña, 2008;Yard, DuHamel, & Galynker, 2008). The authors include a host of measures to detect changes in cognition and coping strategies sometimes associated with hypnotic interventions (Karlin, Hill, & Messer, 2008;Nathanson, 2009;Pekala et al, 2008;Pyun & Kim, 2009;Robertson, 2009aRobertson, , 2009bSala et al, 2008;Szendi et al, 2009;Tschugguel & Hunter, 2008).…”

A Novel Application of Virtual Reality for Pain Control: Virtual Reality-Mirror Visual Feedback Therapy

“…However, a novel approach is to enhance the existing treatment, which is already known to have some analgesic efficacy for chronic pain, with VR technology. In this context, VR technology has been successfully applied as VR-hypnosis [13], VR-MVF therapy for phantom limb pain [14], and treatment for CRPS [15]. Hypnotic analgesia has gained special attention as an analgesic modality [16].…”

“…Hypnotic analgesia has gained special attention as an analgesic modality [16]. Oneal et al integrated hypnotic analgesia with VR technology and applied the combination in the treatment of chronic neuropathic pain [13]. A patient with a 5-year history of C4-quadriplegia and upper extremity neuropathic pain received an audio recording of a hypnotic induction, i.e., suggestions for pain relief.…”