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Virtual Reality: Is It Really Any Better than Guided Imagery?

05 Apr

Hello again.

I was intrigued and puzzled by the results from last week’s Virtual Reality research, showing that a session of virtual reality relaxation actually increased the perceived pain by 30% of burn patients getting their dressings changed (already a very painful procedure).  I wondered if it had anything to do with giving the session ahead of time (instead of during the procedure), thus increasing the anticipation of pain; or if it had to do with using straight relaxation content, as opposed to distraction content.  (An older study with chemo patients showed that distraction was far more effective at alleviating anxiety and distress than relaxation imagery during that procedure.)  

I went looking in the data bases and was amazed at the number of VR studies proliferating, in spite of the dearth of solid data in support of its efficacy - there are as many encouraging findings as equivocal or discouraging data, and the numbers of subjects in most of these articles are pretty low - either case studies or very small pilots.  One multi-site study is underway in the military which hopefully will yield some decent findings.

I’ll report back in more detail, but so far, what’s showing up is that VR may be helpful in training surgical residents and staff in certain complicated procedures (without experimenting on actual live bodies); in helping remediate certain deficits from stroke, especially gait-related problems; and it may or may not be more effective than imaginal exposure therapy in reducing posttraumatic and combat stress.

And I guess that’s the question I have: is using this very expensive equipment any better than simple guided imagery at improving symptoms?  And if it’s no better, why are we focusing so heavily on this intervention?  Could it be we’re irrationally blinded by an infatuation with sexy technology?
Why indeed would we think it would be more salutary to simulate external events that replicate real external events, rather than having a subject go inward, into the body and the psyche, for sensation and perception?  

In short, I don’t get it.  Not yet, anyway. I’m open to be shown I’m wrong, but up to now, I can’t find the data to disabuse me of my assumptions.  At least now that so many studies are getting completed and posted - dozens this year alone - we should be getting some answers or at least direction soon.

In the meantime, I’ve posted one study on this week’s Hot Research page and it’s showing no difference between VR and exposure therapy in soldiers with combat stress at Camp Fallujah in Iraq.  Check it out if you have a minute.

Healthful Sleep Relieve Stress Ease Pain Stress Hardiness Optimization
Successful Surgery Caregiver Stress Chemotherapy

And that reminds me, speaking of military matters, we now have 20 of our guided imagery audios available for you delivered via PLAYAWAYs, the durable little widget - a high-quality, preloaded, digital audio player that’s all-in-one and ready to go.  You can send your favorite soldier our guided imagery for stress, sleep or stress hardiness training, and it’ll be the gift that keeps on giving.  Same with your favorite chemo, radiation, surgery or dialysis patient.  This is all they need to take with them if you’re worried that they won’t have a CD player or MP3 with them - and it’s fully sterilizable and congruent with a hospital or clinical setting.  So when you get onto a product page, take a look to see if it’s also available on Playaway, along with the standard options of cassettes, CDs and downoads.

Lynne Newman
’s brand new CD, Divine Alchemy, is now in the warehouse.   Like her other work, this guided meditation is pretty amazing - inspired and profound.  It’s about nothing less than transforming your life, transcending difficulties, connecting with powerful spiritual sources and helping the rest of humanity.  Lynne uses her very favorite image, the rainbow, as the central element that guides and weaves her narrative, catalyzing empowerment and change.  As with all her CDs, this has Steve Kohn’s wonderful music supporting and enhancing it.  Check it out here.

OK, take care and be well!

All best,


Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award