David Ogez
Credit: Faculté de médecine, Université de Montréal
In a room at Maisonneuve-Rosemont Hospital in Montreal, a patient puts on a virtual reality (VR) headset. Bright bubbles float slowly up and down before his eyes while soothing sounds play in the background.
The scenery changes and the man sees a beach by a shimmering sea or a forest echoing with birdsong. Throughout the immersive experience, a gentle voice tells him to breathe deeply, relax and feel safe.
It's part of a project led by David Ogez, an assistant professor in the Department of Anesthesiology of Université de Montréal, to evaluate how VR and hypnosis can help lessen the emotional distress of patients who have blood cancer.
How? By modulating their negative emotions and pain.
After an initial study with 10 blood-cancer patients, the project has advanced to the next phase with approximately 60 participants divided into two groups: a test group using the VR headset in combination with hypnosis, and a control group that only fills out questionnaires.
The study will assess the effects of the therapy on factors such as pain, anxiety and quality of life. For the project, Ogez partnered with Super Splendide, the Montreal technology company that developed the VR application.
Mental escape from hospital
Customized immersive environments are at the heart of the project. Using 360-degree cameras, the developers captured calming scenes to transport patients out of their hospital rooms. Over 700 locations were used.
"We can shoot almost anywhere," said Super Splendide founder Jean-François Malouin. "For one end-of-life patient who dreamed of seeing (Quebec's) Anticosti Island, we sent a camera to a local resident, who recorded immersive landscapes with deer roaming about. The videos were then uploaded directly to our app."
The customized videos create a deep and unique emotional connection with the patients, Malouin said.
"Content that is meaningful to them resonates with their memories or desires and has a much stronger impact than generic videos," Malouin said. "But even standard settings like a beach or forest can be very soothing."
The videos are designed to loop continuously, providing an extended immersive experience. The patients, who often have limited mobility, can navigate the virtual worlds using a simple, guided interface.
"It's an ideal solution, because people in pain may not be able to use VR controls in the usual way," Ogez noted.
A multidimensional approach
The research team has incorporated interactive tools and hypnotic suggestions into the immersive experiences.
For instance, a "magic hand" lets patients see their own hands as sparkling diamonds. They can symbolically place the diamonds on painful areas of their bodies for relief.
"This is particularly effective for treating pain from conditions like oral mucositis, which is common after bone-marrow transplants," said Ogez.
The sessions can be guided by therapists who control the content in real time through a dedicated interface. "Our system enables therapists to tailor experiences to the patient's specific needs," Malouin explained.
"For example, a person struggling with fatigue might benefit from a meditation session, while someone seeking distraction from pain could explore different types of landscapes."
Therapeutic benefits after transplant
Ogez and his colleagues decided to work with a particularly vulnerable segment of patients: those who've had a transplant.
"In oncology, they're among the most fragile, because they must stay isolated - for more than a month in the case of a bone-marrow transplant, for instance," Ogez explained. The isolation, combined with the severe pain and fatigue caused by the surgery, compounds the patient's anxiety and emotional distress.
Early results from the tests with the VR headsets show promising therapeutic effects. Some patients have even wanted to keep their devices, Ogez said.
Every effort was made to enhance the well-being of the subjects during the immersive experience, he added.
"We did a great deal of testing in palliative care, which is the most challenging environment for keeping patients comfortable. One day, we gave a session to an 85-year-old terminally ill woman who was heavily medicated and hadn't eaten in 10 days. Nevertheless, she did a 90-minute VR session and afterwards she said 'I'm hungry' and ate a bowl of pasta."
In addition to the expected therapeutic benefits, the study found VR had unanticipated emotional effects. For example, the visualizations took one patient back to her childhood, which wasn't the original purpose. Participants are keeping journals to document long-term outcomes.
A promising future with hypnosis
If the study results are overall positive, the next step could be VR combined with hypnosis - something that could be introduced in other medical settings such as outpatient chemotherapy clinics, Ogez said.
His research team is also considering VR's potential in psychotherapy, to help treat anxiety and depressive disorders. The long-term goal is to expand the use of the technology by making it more accessible, user-friendly and robust.
As Ogez put it, "VR combined with hypnosis opens up immense possibilities for improving patients' quality of life."
