Traditional hypnosis asks you to close your eyes and imagine. Virtual reality hypnosis does the imagining for you. You put on a headset and find yourself drifting down a snowy canyon while a recorded voice guides you into relaxation. It is one of the newest developments in the field.
What it is
Virtual reality hypnosis (VRH) combines two things that each reduce pain and anxiety:
- Immersive virtual reality, which holds attention with a three-dimensional world that moves as you move your head.
- Hypnosis: an induction, deepening and therapeutic suggestions, delivered as recorded audio matched to the visuals.
A typical session has the viewer descending through a calm landscape as numbers count down, followed by suggestions for comfort, and then a return.
Where it came from
Much of the early work was done by psychologist David Patterson and colleagues in Seattle, who were already known for using virtual reality as a distraction during burn wound care, among the most painful procedures in medicine. Their idea was that VR might make hypnosis available to patients who are too distressed, medicated or exhausted to generate imagery themselves, and where no trained hypnotist is on hand.
What the research shows
Burn care. In an early report, 13 burn patients received virtual reality hypnosis before wound care. They reported an average 20 per cent drop in worst pain, a 29 per cent drop in anxiety, and needed about half the opioid medication around the procedure. There was no control group, so the result was preliminary.
Trauma patients. A later randomised controlled study of 21 hospitalised trauma patients tested VRH for pain, with encouraging findings in a small sample.
A review. A 2020 literature review by the Liège group, known for hypnosis in surgery, found only eight studies combining hypnosis and virtual reality: two in healthy volunteers and six in patients. Short-term results showed reductions in pain intensity, pain unpleasantness, time spent thinking about pain, anxiety, and opioid use.
Two important cautions came with that. Results were not consistent for every patient on every day. And the reviewers could not confirm that virtual reality added anything to hypnosis when the two were combined.
So VRH looks promising, but it has not been shown to beat ordinary hypnosis.
The possible advantages
- No imagination required. Helpful for people who struggle to visualise.
- It blocks out the room, including the sight of a needle or a dressing change.
- It does not need a hypnotist present, so it could reach more patients.
- It is standardised, which makes it easier to study.
- It holds attention in people who are in pain, drowsy or distracted.
- It may appeal to people who are sceptical of hypnosis but comfortable with technology.
The drawbacks
- Cost and equipment.
- Cybersickness. Some people feel nauseous or dizzy in VR.
- It is not tailored. A recording cannot respond to you.
- Practical limits. Headsets are awkward with head or face injuries, and need cleaning between patients.
- The evidence is thin. Few studies, small numbers.
- It may replace your own imagery, which could matter if skill at self-hypnosis is the goal.
Where it is being explored
- Burn wound care and dressing changes
- Before, during and after surgery
- Intensive care
- Cancer treatment
- Chronic pain
- Dental and medical procedures
- Anxiety in children
Consumer VR apps
Relaxation and “hypnosis” apps are now sold for home headsets. Most have not been tested in studies. Treat them as relaxation aids, check who made them, and be sceptical of health claims.
Do not use VR if you are prone to seizures, and stop if you feel sick or dizzy. Always use it seated, somewhere safe.
Do you need it?
Probably not. If you can close your eyes and picture a place, ordinary self-hypnosis or an audio recording gives you the same ingredients for free. VR is most likely to help where imagination is hardest: acute pain, exhaustion, a frightening clinical setting.
The bottom line
Virtual reality hypnosis is an inventive way of delivering hypnosis to people who might otherwise miss out. Early results are encouraging. Whether the headset adds anything beyond the hypnosis itself has yet to be shown.
Next in the series: How Hypnotizability Is Tested: The Stanford Scales and the Eye-Roll
This article is for general information and is not medical advice.