[-empyre-] II

[Diane Gromala]

Jon,
>  
> >In any case, when one of my former colleagues at UW's HITLab discovered that
> >VR was as effective as opioids for people who suffered 3rd degree burns,
> >I was compelled to return. (Videogames don't come close.)
>  
> this is extraordinary.
> What kind of VR was it? and did it work for other pains -chronic or accute
SnowWorld. Lots of papers, mostly in science journals. 
It is for ACUTE pain only.
Besides a group at a military base in Hawaii who seem not to be pursuing it any longer, 
we are the first group to develop VR for CHRONIC PAIN -- the two are very, very different. 
Acute pain is a symptom, chronic pain is a disease.
Pain distraction won't work for chronic pain, for obvious reasons, so my paradigm is very different as well.

SnowWorld is immersive VR (HMD version), based on the notion of pain distraction.
The immersants travel down a kind of river, mostly in an ice cave. There are flying fish,
a mastadon, and snowmen (men). Immersants use a mouse (they are often using VR while
in a cold bath, so there are definite limitations) to shoot snowmen, who shatter.
Yes, most people have an issue with shooting snowmen.

The first version was more-or-less like skiing -- it's evolved over the last 10 years.
The HITLab was almost all computer scientists and engineers -- Peter Oppenheimer was the 
only other artist at the HITLab (Human Interface Technology Lab) at the University of Washington. 
It took me forever to convince most of the people there that the KIND of virtual environment 
and interaction mattered. At the time, most of the work focused on phobias, so I tried to show 
them that a photo-realistic spider (for arachnophobia) was very different from a Disney-like spider, etc.
For the context of burn patients, similarly, I argued that a cold looking and sounding VE would 
make a difference. To this day, most still don't think that these things matter, porbably because
it can't be easily measured in scientific tests.
So my group is conducting a scientific study comparing SnowWorld with a volcano world
(same terrain). Think of it as an inverse "Sokal affair" :-)

> 
> >Currently, I organized and direct a group of researchers 
> are there publications, or places where we can read about this research?
Yes. Our papers are in many diverse disciplines tho.
There have been a few short papers at ISEA, and an exhibit at UCLA last fall,
but we have a Leonardo paper ready to submit.
You may be able to a sense by checking out the confrontingpain URL in my contact info
at bottom.

> 
> >question
> >I'm interested in what constitutes the virtual -- is the term useful? 
>  
> My argument is that it is not... but that is still coming.
>  
> Certainly i have not seen uses of the term which are not embedded in magic
Yes, though that itself seems interesting enough to explore.
Also, it seems to me that there is something about immersive VR experiences that persist.
Not all, to be sure. And it is obvious that training is an area where the effects persist.
But there is an aspect I can't yet articulate that seems to stick in one's teeth,
or to haunt in a powerful way, beyond hype or utopian fantasies or novelty . . . but that is still coming, as you say.

> that is in the idea of power that is not quite present
Yes, exactly. And again, I think it may touch something that is beyond
novelty, or perhaps beyond the technological imaginary too.
More on this?

> >As my niece would say, "you can't pee in VR" -- that is, there are obvious limits, as there are with any media form.
> >On the other hand, it can elicit or provoke perceptually intense responses, some of which persist. 
> Indeed, but pointing at Artaud again, so can theatre, so can movies, so can text, so can hypnosis.
Yes, it is difficult to talk about peculiar characteristics of a media form without seeming to valorize it,
or without asserting that any media form can provoke. Just for the record, I think VR is as interesting
as other forms -- we also have a furry robot, for instance, that mitigates anxiety (a common sequelae of chronic pain)
better than VR. And what underlies my approach to VR for chronic pain is mindfulness meditation
(think neuroplasticity). In brief, the system I devised incorporates biofeedback, which changes
the visuals and sounds in real-time as patients learn how to meditate. Of course, technology
isn't necessary, but we found that it does help because (we think) it provides feedback, and
it tracks users' states. So it is related to affective computing, and of course I realize that it is impossible
to really measure many aspects of states and state changes. It's just an inference. But one that seems to work.


>  
> Maybe so much of what we think is ourselves, depends upon one or two senses that when these are simulated or overwhelmed, we end up in different states.
>  
> As already noted, in terms of this theme, pain is very much one of those overwhelming sensations. It can become everything, or shut down everything as we avoid it.
Yes, that's the biggest challenge of pain. Chronic pain too has many sequelae:
anger, depression, anxiety, insomnia, kinesiophobia, increasing immobility, social isolation.
Add to that the fact that conservatively, 1 in 5 people in industrialized countries are estimated
to have it, no one knows what causes it or what can cure it. Most people can't even wrap
their heads around the idea that pain can be a DISEASE (systemic disorder where the pain response
system "gets stuck" at a very high rate), let alone a degenerative one that kills -- eventually.
> 


The great thing about many pain doctors is that they realize they can't maintain
the usual categories, or medical protocols, so they are quite open to alternatives.
Also, the research demonstrates that the problem goes well beyond their abilities,
so many are open to experts from other fields. They just aren't familiar with what
others do though, and many experts forget that they have highly specific terms. 

But, for example, a standard (1 of 6) protocol for chronic pain self-management programs
is for patients to draw themselves. There are a lot of reasons for this -- the most important
three seem to be to help patients to express the inexpressible (i.e., to crawl back into the social realm),
to try to better communicate with them beyond the 6 minute visit,
and to not avoid what their pain is doing to them. 
I won't use the term art therapy, and pain doctors don't either, mostly because they want 
to maintain the value of expression and art instead of getting caught in specific ways to do that.

--------
Obviously, I'm motivated to be a keen lurker here. I'm also working on assembling the names of artists
and others who have chronic pain and whose work grapples with it in some way (Susan Leigh Star, for example),
so if anyone could contribute, I'd very much appreciate it.

Diane

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