Virtual reality for pain and anxiety management in children

I am intrigued by the fascination for high tech, as exemplified by Arane et al . I have not the slightest doubt that VR is efficacious in reducing pain and anxiety, but children, (and most adults), have no need for such gadgetry – they carry within them the capacity to create their own VR. Every parent will have observed their children so engrossed, for example, in a TV program that they are oblivious to all other stimuli. This is an innate capacity which can readily be enlisted therapeutically, graced with the term “hypnosis”. Unfortunately, despite a century of scientific study, a vast body of literature supporting its efficacy in a remarkable range of conditions, and the formalisation of training and certification in hypnosis by professional associations, it has never entered the mainstream of medical care. It is true that in much of adult medicine the use of hypnosis may require both skills and time which many clinicians may lack. But in children, who live much of the time in their imagination already, the use of hypnosis is both very easy and efficient. During the time I worked in a pediatric emergency department I routinely offered children with lacerations the opportunity to “go watch the imaginary TV in [their] head,
(a TV that even Mummy could not turn off!), so that they didn’t need to pay attention while I fixed their cut”. This process took less than a minute, and I was consistently able to suture the laceration with no further anaesthesia. Not only did this avoid the usual assault wreaked upon the hapless child in the ED, but it returned the locus of control to the child himself, leaving him with a powerful sense of mastery rather than the all too frequent fear and anxiety, as a memory of their experience.