June 19, 2013

September 14, 2012


Burning Man [Graphic Military Injury Content]

I was deeply moved both by the descriptions of Sam Brown’s pain, and the cleverness of the proposed pain treatment. There are some very graphic passages in this article from GQ—I’m excerpting a bit of the description of Hoffman’s work below, but feel free to read the entire piece.

Hunter Hoffman hadn’t set out to help burn patients. As a cognitive psychologist—who had gotten his start back in the ‘80s conducting experiments at Princeton to test the mind’s ability to discern between real and false memories—he had begun experimenting with virtual reality as a treatment for arachnophobes. Using a VR game he’d designed called SpiderWorld (see box), he had helped a number of individuals so crippled by fear that they had to seal up their windows to sleep. Outfitted with virtual-reality goggles, the patient began at the far end of a virtual kitchen, opposite the counter, upon which was a small, barely visible spider. Once the fight-or-flight response had subsided, the patient could inch closer until he could stand being close enough to see the spider’s reflection in the toaster’s chrome finish. Hoffman had created a world that people could enter, reemerging with their nightmares erased. It was an artificial world with the power to transform meaning itself in the so-often-insufferable sphere known as the real.

One day in 1994, a colleague of Hoffman’s told him he’d been observing patients at a burn center using hypnosis to control pain. His colleague wasn’t exactly sure how the treatment worked, but he thought it had something to do with distraction.

“Distraction?” Hoffman said. “I’ll show you distraction,” and he showed his friend SpiderWorld.

Not long after, Hoffman went to meet the hypnotist himself, who agreed VR sounded like a pretty good idea. On the very first

burn patient they tried, SpiderWorld worked. He simply forgot to think about his pain. Still, stoves and toasters didn’t seem right, considering—kind of cruel, really. So Hoffman hired a world builder to make something else, something colder, fireproof.

Later, after Hoffman became director of the Virtual Reality Analgesia Research Center at the University of Washington Human Interface Technology Laboratory, or HITLab, he had some remarkable success. Using $35,000 goggles—the sort of hardware ordinarily used for training fighter pilots—researchers obtained drops in pain ratings by 30 to 50 percent.

If distraction was the key, why not just use over-the-counter video games for a fraction of the cost? To answer that question, Hoffman had run a control experiment. In his first case study, he had a teenager with a severe flash burn play Nintendo Mario Kart while having five staples removed from a skin graft. The data showed that in terms of reducing pain, anxiety about pain, and time spent thinking about pain, playing Nintendo Mario Kart compared poorly to SpiderWorld. The reason VR was so much more effective than a regular video game came down to a quality called “presence”—that sense of being immersed inside an artificial world.

In 2006, Hoffman presented his findings at a DoD conference on combat-casualty care. The most prominent image Hoffman had played on the screen had been a giant digital snowman, somewhat menacing in mien. Yet it was hard for all the high brass in the room to ignore the two 3-D brain scans comparing activity in the region of the mind known as the pain matrix. In the scan of a patient who had received only conventional opioids during wound care, the matrix was lit up like a cortical pool of lava. The other brain—the brain on VR—was a cooling star. “According to our results,” Hoffman said, “VR not only reduces pain perception; it changes the way the brain processes pain signals.” A day or so after the conference, he got a call from Colonel John Holcomb, commander of the army’s Institute of Surgical Research, or ISR, at Brooke Army Medical Center in San Antonio.

ISR was a unit born during World War II, in part out of the need to find better ways to treat thermal injuries, in anticipation of the waves of atomic-burn casualties that many reasonable, if gloomy, individuals regarded as inevitable. Ironically, sixty years later, those new techniques were being used more than ever, in response not to the most sophisticated weapons on earth but to the most crudely effective. An approximate 70 percent of injuries and deaths of U.S. troops this decade have involved an IED.

“Hoffman, we need VR,” Colonel Holcomb said when he called. “Make it happen. Get it over here.”


Share this story:


Recent Related Posts

Comments

Facebook comments are closed.

3 comments

This is a truly amazing story of technology and neuroscience teaming up with human grit.  I thought the “graphic military injury content” not nearly as grim as the author’s reflections on potential “battlefield applications”:

It doesn’t seem like much of a stretch to imagine a near future in which combat patients could simultaneously distract themselves from their own pain while inflicting it on a virtual and remote enemy. A soldier could put his mind inside a drone instead of watching as a medic changed his bandages. In such a future of techno-utopian warfare, at least for those combatants equipped to fight outside the pain matrix, victory will indeed belong to those who have rid themselves of the inconvenience of being men and who, for all we know, may as well bleed snow.

(emphasis added.)
Reminds me of a SciFi series my son was reading some years ago where fierce battles are waged remotely from “safe” locations where the combatants lie on virtual reality couches ... can’t remember whether the combatants risked any personal injury (real, not virtual.)

[1] Posted by Rich Gabrielson on 9-14-2012 at 09:30 PM · [top]

Rich, I agree completely that it’s inspiring to read of this healing technological breakthrough but also terrifying to see virtual reality militarized.  Yet again another example of the unexpected (unconscious) consequences of playing God with human boundaries—it turns out that drone warfare generates huge levels of anxiety:

Of course this goes only for our side, but I believe that the really ultimate fantasy is we will have war which is somehow virtual and takes place nowhere. In the last bombardments of Iraq a few months ago, in daily reports Baghdad was depicted as just a normal city, as if the bombing is just a nightmare which happens during the night and somehow life goes on. It’s as if war becomes simply virtualized. What’s my point here? I will try to answer the question of why we fantasize about violence. This tendency to erase death itself from war should not seduce us into endorsing the standard notion that war is made less traumatic when no longer experienced by soldiers as an actual encounter with another human being to be killed but as an abstract activity in front of a screen. That’s the idea, that today war is virtualized, nobody even sees the bodies, it’s a kind of videogame. What I learned from talking with war psychologists in the States is that the result is not less guilt but more anxiety. Even in the Gulf War of 1991, I read that in a report, that of American soldiers who had psychological traumas after the war, the majority of them were not as you would expect the ones who actually killed the Iraqi soldiers. It’s even the obverse correlation, those who experienced the war as strictly virtual, they didn’t feel guilt but an unbearable anxiety. This can retroactively explain another paradox. Already in World War I a mysterious phenomenon occurred which is I think a kind of military counterpoint to false memory syndrome. Sixty to seventy percent of soldiers remember this mythical, “authentic” experience of warfare such as that hailed by Ernst Junger. I see you, my enemy and briefly our gazes meet, there’s an authentic real encounter with another flesh and blood being, then it’s always the same, I stick you with a bayonet and throw you over my shoulder. However, according to all data it’s maximum one half percent that actually had this experience of killing in face–to–face combat. Far from being the ultimate traumatic point that you try to erase, the need to have this face–to–face encounter rather has a pacifying aspect of getting rid of anxiety for us. What really causes anxiety is virtualized warfare. My point I hope is now clear. This opposition between modern, virtualized warfare and the need to have the brutal encounter with another soldier this opposition is ultimately the same as the opposition of Benigni’s father and Vinterberg’s father. In the same way that it’s not that unfortunately we have to kill real persons and then we imagine how nice it would be to play just keyboard wars, but that it’s the soldier playing war behind the screen who is full of anxiety and fantasizes about a face–to–face real encounter, which although it would make him guilty would give him a real guilt, but the true horror would be to have a father like Benigni. That’s unbearable, that’s suffocating. It’s Benigni’s son who then fantasizes about a secret, concealed but nonetheless violent rapist aspect. You say “My god, my father cannot just be this maternal, ersatz placebo, that would suffocate me. I need to imagine some horrifying secret behind him in order to survive family life.” This then is the deadlock of the superego.

http://www.egs.edu/faculty/slavoj-zizek/articles/the-superego-and-the-act/

[2] Posted by The Plantagenets on 9-15-2012 at 01:19 AM · [top]

And of course—since the advent of the crossbow—a huge chunk of war became “virtualized.”

One could shoot an arrow and not see the results of the shot. Steadily, with the advance of technology, the effects of war became more and more “virtualized.” Guns meant killing could take place at an even greater distance. Cannons—even greater. Long-range sniper rifles—same.

And on and on it goes.  I don’t see drones as intrinsically much different, except their acts are far more precise than a cannonball.

While I’m confident that all killing is traumatic, I don’t think there’s any more level of trauma associated with drone warfare than plunging a battleaxe into somebody’s skull and trying to pull it back out again before you yourself have a battleaxe plunged into your own skull.  There’s a different quality of “stress” of course. But all killing is traumatic and stressful—it is supposed to be.

[3] Posted by Sarah on 9-15-2012 at 08:00 AM · [top]

Registered members are welcome to leave comments. Log in here, or register here.

Comment Policy: We pride ourselves on having some of the most open, honest debate anywhere. However, we do have a few rules that we enforce strictly. They are: No over-the-top profanity, no racial or ethnic slurs, and no threats real or implied of physical violence. Please see this post for more explanation, and the posts here, here, and here for advice on becoming a valued commenter as opposed to an ex-commenter. Although we rarely do so, we reserve the right to remove or edit comments, as well as suspend users' accounts, solely at the discretion of site administrators. Since we try to err on the side of open debate, you may sometimes see comments which you believe strain the boundaries of our rules. Comments are the opinions of visitors, and do not necessarily reflect the opinion of Stand Firm site administrators or Gri5th Media, LLC.