<p>Hypnosis Associated with 3D Immersive Virtual Reality Technology in the Management of Pain: A Review of the Literature</p>

Abstract

Hypnosis is well documented in the literature in the management of acute and chronic pain. Virtual reality (VR) is currently gaining credibility in the same fields as hypnosis for medical applications. Lately, the combination of hypnosis and VR was considered. The aim of this scoping review is to understand the current studied contexts and effects of virtual reality hypnosis (VRH) for the management of pain. We searched on PubMed, Taylor & Francis Online, and ProQuest databases with the following terms: "virtual reality," "3D," "hypnosis," and "pain". We included 8 studies that combined hypnosis and VR. All articles are in English. Two included healthy volunteers and six are clinical studies. Short-term results indicated significant decreases in pain intensity, pain unpleasantness, time spent thinking about pain, anxiety, and levels of opioids. However, results are not consistent for all patients all the days. VR alone seems to reduce pain independently of the hypnotizability level. One study claimed that VR and hypnosis could alter each other's effects and another argued that VR did not inhibit the hypnotic process and may even facilitate it by employing visual imagery. We cannot affirm that VR added value to hypnosis when they are combined. These trials and case series gave us indications about the possible applications of VRH in different contexts. Additional randomized clinical trials on VRH in the future will have to test this technique in clinical practice and help define guidelines for VRH utilization in pain management.

Individual Traits and Pain Treatment: The Case of Hypnotizability

“…Interestingly, the suggestions for analgesia have been found effective also in healthy mediums undergoing nociceptive stimulation (Fidanza et al, 2017 ) and in chronic pain patients independently from hypnotizability (Elkins et al, 2007 ; Jensen, 2011 ; Jensen and Patterson, 2014 ; Mazzola et al, 2017 ; Facco et al, 2018 ; Sandvik et al, 2020 ). This can be accounted for by expectation of/motivation to analgesia (Milling et al, 2005 ; Krystek and Kumar, 2016 ; Montgomery et al, 2018 ; Perri et al, 2020 ) leading to placebo responses (Benedetti, 2013 ) which can reduce pain and pain-related psychological symptoms in the general population (Liossi et al, 2006 ; Brugnoli, 2016 ; Wortzel and Spiegel, 2017 ; Rousseaux et al, 2020 ). Thus, suggestions may induce non opioid analgesia in highs, opioid placebo responses in lows and, probably, mixed reactions in mediums.…”

Virtual Reality Hypnosis for Anxiety and Pain Management in Intensive Care Units. A Prospective Randomized Trial Among Cardiac Surgery Patients.

“…Although hypnosis and VR are well documented in the literature, a few studies used the combination of both (VRH) or compare them in their protocol. We recently identi ed 8 studies about VRH and pain that showed VRH as useful for pain and anxiety reduction in different clinical settings such as chronic pain, burn pain and physical trauma (26). However, most of the investigations are case studies and results about VRH and pain did not show consistent e cacy for all patients all the days (22)(23)(24).…”

“…This tool is today known as virtual reality hypnosis (VRH) (23). Although VRH showed is effectiveness in the management of anxiety and pain in different medical contexts such as physical trauma, chronic pain management or intensive care units (12,(24)(25)(26), to our knowledge, VRH has not yet been used during pre and postoperative cardiac surgery.…”

The Use of Self-Help Strategies in Obesity Treatment. A Narrative Review Focused on Hypnosis and Mindfulness

“…The Rationale for Using Hypnosis in the Treatment of Obesity Hypnosis has been successfully used as an anti-stress and relaxation strategy to treat many chronic conditions exacerbated by negative emotions and social factors (e.g., quitting smoking [30]), chronic digestive diseases [31], cancerrelated symptoms in palliative care setting [32], acute and chronic pain [33]. Individuals can practice hypnosis on their own (self-hypnosis); hypnotherapy (either alone or in addition to other psychotherapies, such as cognitive-behavioral techniques) has been involved in the obesity multidimensional approach to increase self-control, to improve exercise levels, to boost self-esteem, and to strengthen motivation in changing eating habits [34].…”