Meta­plas­tic­ity and Inner Body Schemas: VR Phar­makon for Chronic Pain


Session Title:

  • An Alembic of Transformation: Virtual Reality as Agent of Change

Presentation Title:

  • Meta­plas­tic­ity and Inner Body Schemas: VR Phar­makon for Chronic Pain




  • Panel: An Alembic of Transformation: Virtual Reality as Agent of Change

    Im­mer­sive VR has been ex­plored over the past decade as a “non-phar­ma­co­log­i­cal anal­gesic” for acute pain dur­ing short pe­ri­ods of time. The mech­a­nism that ex­plains VR’s ef­fi­cacy is thought to be “pain dis­trac­tion,” with VR serv­ing as a rich way to di­rect at­ten­tional re­sources away from pain. This out­ward di­rect­ing of per­cep­tual and sen­so­r­ial at­ten­tion — more ef­fec­tive than videogames, and on par with opi­ods — is a provoca­tive use of VR. Yet pain is no­to­ri­ous as a cat­e­gory-de­fy­ing ex­pe­ri­ence, its in­ten­sity, as Elaine Scarry posits, de­fy­ing even the most basic lin­guis­tic ex­pres­sion.

    At the same time, re­search in how longer-term pain is re­lated to body image and body schema grew from use of a more basic tech­nol­ogy to pro­duce anal­gesic ef­fects for phan­tom pain – mir­rors. Still other forms of tech­nol­ogy ini­ti­ated by the work of Paul Bach y Rita demon­strates how sen­sory sub­sti­tu­tion demon­strates that our neu­ro­log­i­cal sys­tems are plas­tic or not as hard-wired as it was once be­lieved.

    In these are­nas of re­search, how­ever, the role of inner or in­te­ro­cep­tive senses, as Drew Leder de­scribes in The Ab­sent Body, have rarely been ex­plored. A cen­tury ear­lier, Her­mann von Helmholtz found that we have 100,000 times more re­sources ded­i­cated for sens­ing inner states, com­pared to those states de­rived from the so-called five ex­te­ro­cep­tive senses. For the most part, our abil­ity to at­tend to our inner states is nec­es­sar­ily qui­es­cent, lest they over­whelm our con­scious aware­ness. How­ever, hu­mans have the abil­ity to learn how to ac­cess at least some of these inner states, from yogic tra­di­tions to those en­abled by biofeed­back and newer tech­nolo­gies.

    This paper pro­poses that novel uses of VR for chronic pain, both artis­tic and ther­a­peu­tic, built upon a new par­a­digm that os­ten­si­bly in­verts “pain dis­trac­tion,” can fruit­fully ex­tend no­tions of body image and body schema through the ways VR can en­able and en­hance aware­nesses of oth­er­wise qui­es­cent inner states. The focus on aes­thetic as­pects of VR as they re­late to mech­a­nisms thought to be at work, from ex­pe­ri­enc­ing the sub­lime and dis­so­cia­tive states to neuro- and meta­plas­tic­ity.

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