VIRTUAL REALITY HYPNOSIS

摘要

Scientific evidence for the viability of hypnosis as a treatment for pain has flourishedover the past two decades (Rainville, Duncan, Price, Carrier and Bushnell, 1997; Mont-gomery, DuHamel and Redd, 2000; Lang and Rosen, 2002; Patterson and Jensen, 2003).However its widespread use has been limited by factors such as the advanced expertise,time and effort required by clinicians to provide hypnosis, and the cognitive effortrequired by patients to engage in hypnosis. The theory in developing virtual reality hypnosis was to apply three-dimensional,immersive, virtual reality technology to guide the patient through the same steps usedwhen hypnosis is induced through an interpersonal process. Virtual reality replacesmany of the stimuli that the patients have to struggle to imagine via verbal cueing fromthe therapist. The purpose of this paper is to explore how virtual reality may be usefulin delivering hypnosis, and to summarize the scientific literature to date. We will alsoexplore various theoretical and methodological issues that can guide future research. In spite of the encouraging scientific and clinical findings, hypnosis for analgesia isnot universally used in medical centres. One reason for the slow acceptance is the exten-sive provider training required in order for hypnosis to be an effective pain managementmodality. Training in hypnosis is not commonly offered in medical schools or even psy-chology graduate curricula. Another reason is that hypnosis requires far more time andeffort to administer than an analgesic pill or injection. Hypnosis requires training, skilland patience to deliver in medical centres that are often fast-paced and highly demandingof clinician time. Finally, the attention and cognitive effort required for hypnosis maybe more than patients in an acute care setting, who may be under the influence of opiatesand benzodiazepines, are able to impart. It is a challenge to make hypnosis a standardpart of care in this environment. Over the past 25 years, researchers have been investigating ways to make hypnosismore standardized and accessible. There have been a handful of studies that have lookedat the efficacy of using audiotapes to provide the hypnotic intervention (Johnson andWiese, 1979; Hart, 1980; Block, Ghoneim, Sum Ping and Ali, 1991; Enqvist, Bjorklund,Engman and Jakobsson, 1997; Eberhart, Doring, Holzrichter, Roscher and Seeling, 1998;Perugini, Kirsch, Allen, et al., 1998; Forbes, MacAuley, Chiotakakou-Faliakou, 2000;Ghoneim, Block, Sarasin, Davis and Marchman, 2000). These studies have yieldedmixed results. Generally, we can conclude that audio-taped hypnosis is more effectivethan no treatment at all, but less effective than the presence of a live hypnotherapist.Grant and Nash (1995) were the first to use computer-assisted hypnosis as a behaviouralmeasure to assess hypnotizability. They used a digitized voice that guided subjectsthrough a procedure and tailored software according to the subject's unique responses and reactions. However, it utilized conventional two-dimensional screen technology thatrequired patients to focus their attention on a computer screen, making them vulnerableto any type of distraction that might enter the environment. Further, the two-dimensionaltechnology did not present compelling visual stimuli for capturing the user's attention.