Creating pain without ‘real’ pain – can it be real then? We say YES!

Many things have changed. Where do I begin?

First, I have a few more collaborators for my CRPS project now:

Dr Andrew Burrell, VR artist

Prof William Martens, acoustic architecture scientist, University of Sydney

– Meisha Stevens, Post Grad acoustic architecture science student, University of Sydney

– Tom Hazell, electrical engineer student, University of NSW

– Rob Yuan, design computing student, University of Sydney

 

In the last post, I mentioned some of the difficulties we were having designing the glove device. We still have some issues but we now have two extra engineering students to help us experiment.

The effects/sensation of CRPS we want to simulate via the glove are:

– heat

– throbbing (possibly in sync with the participant’s heart rate)

– heavy

– clammy, sweaty

– pressure

– swelling

an example of a hand with CRPS
an example of a hand with CRPS

 

We have found a pair of TENS gloves, which will go on the first layer – directly onto the participant’s hand.

 

TENS gloves
TENS gloves

 

This will produce a tingling sensation that we can increase or decrease, depending on the individual’s response. Rosie Menzies (University of Sydney) and the engineering students are working on the rest of the effects. It’s tricky without bulking up the thickness of the glove, and its design has to be robust enough that the glove should be able to manage constant handling.

 

Anyhow, we’ve been doing lots of research and talking/meeting for the last few months. My idea of using rows of rotating barbed wire in a room (to enhance the anxiety) has been scrapped. What will replace it is more effective and is full of potential for my next few projects. I am now planning to build an anechoic chamber (an example here)  coupled with auditory manipulation using low frequency sound to temporarily disturb the participant’s sensory and cognitive perceptions. I will probably need a couple of subwoofer speakers for this, which we will hide behind the acoustic foam. My anechoic chamber, however,  is not going to look like a typical chamber with foam wedges. Instead, I’m covering the foam with a white fabric. The fabric will be tufted and pierced with short barbed wire spikes and will cover the walls and ceilings, thereby creating both the feeling of a domestic environment, since most pain patients suffer alone at home, with one where it is impossible to find a comfortable position to rest in.

 

concept drawing: anechoic chamber
concept drawing: anechoic chamber

 

So this is what happens when I take each participant into the anechoic chamber:

The influence of the acoustics in this room, with low frequency sound manipulation, symbolically simulates the altered sensory-cognitive responses of people living with chronic pain. The participant then wears a purpose-built glove and a pair of Virtual Reality (VR) goggles. With a remote control I produce selected CRPS symptoms and visual effects, felt and seen through the glove and VR. Instead of looking at the gloved hand, they will see the VR 3D hand that looks something like this:

Work in progress CRPS 3D model, image by courtesy of Dr Andrew Burrell
Work in progress CRPS 3D model, image by courtesy of Dr Andrew Burrell

 

As they feel the effects from the glove, what they see of their virtual hand will become purply red and blotchy, then progressively swollen and shiny.

 

Up till then, they don’t actually feel pain on their hand because those are only mechanical sensations of tight pressure, throb, very warm heat etc. They might feel uncomfortable but it will not be pain. Now, here is the thing. What they will experience next will, as my collaborating pain scientists hypothesise, feel pain because their brains will start firing pain signal to their effected limbs. This is what I’m going to do:

At the height of the effect, the participants will see, through the VR goggles, a strand of barbed wire from above slowly creeps toward the affected hand. It will continue to advance until it “touches” the virtual wrist to scrape and tear. What they won’t realise is that the actual mechanical touch onto their real hand will only be a feather-like tickle. But the visual feedback (the external threat) that their hands are being scraped and torn is so much stronger and threatening than the actual feather touch. So their brains will decide that what they are seeing is more real and in urgent need of protection, that their brain will activate pain signals to the affected hands.

 

In summary, this is what our research is really about. We are NOT giving pain to participants’ hands in any way. What we are studying is to find out whether we can provide just the right environment for each participant so that it is their own brains will send pain signals to their hands. I’m particularly interested in the outcome personally. Why? Because people in general think that pain is a sign of weakness. This is one of the reasons why there is so much misunderstanding and stigma attached to chronic pain. I want to show people that pain is more than a mere weak mindset. It has so much to do with the brain, and its plasticity. We think we can make most of the participants produce pain from their brains, regardless of their ‘weak’ or ‘strong’ minds. But then again, we don’t really know that yet until we actually try.

 

Anyhow, so what are the elements that can create that ‘just the right environment’ for pain? I had to think about this a lot. The ‘right environment’ is not only involving biological/mechanical input – like heat, pressure, touch etc. It also has to involve psychological and social factors like anxiety, stress, isolation, other people’s attitudes and relationships with others etc. The anxiety level for people with chronic pain for instance, seems always high compared to people with no pain. What I really want to include in this project is incorporating these subjective states – their anxiety, fear, anticipation, and catastrophising – and how they contribute towards creating pain narratives for each individual. I think my collaborators and I are close to bringing all these in, especially inside the anechoic chamber, but it’s all just theory at this stage.

 

Within the last few months, our research development has finally started to have a very tangible form, at least in our minds, and I want to involve participants in something that is both an art project and a scientific research. So this is how it will pan out:

 

It’s going to be an interactive performance installation that will take each participant on a one-on-one journey through three interactive rooms. Using new technologies, I invite them to experience an illusion of Complex Regional Pain Syndrome (CRPS), by temporarily manipulating their sensory and cognitive perceptions.

 

concept drawing
concept drawing

 

Stage1-Room1: a simple Augmented Reality play using a Mirage Machine (read the previous post, Establishment and Development) makes their hands ‘disappear’ – a method used for neuroscience study – psychologically priming them for Stage 2.

 

Stage2-Room2: an anechoic chamber that deceptively looks more like a domestic setting. The influence of the acoustics in this room, with low frequency sound manipulation, symbolically simulates the altered sensory-cognitive responses of people living with chronic pain. The participant wears a purpose-built glove and a pair of Virtual Reality (VR) goggles. With a remote control I produce selected CRPS symptoms and visual effects, felt and seen through the glove and VR.

 

Stage3-Room3: evaluate the participant’s responses with questionnaires and share the concept behind the artwork.

 

There are a lot of collaborators working on this project, and it’s nearly time to put everything together. It’s been relatively smooth sailing so far, so I hope it continues that way.

McGill

Struggles and anxieties in order to create anxieties

My first ideas for this collaboration came towards the end of last year. Since then, many things have changed, but for the better.

For example:

– what kind of devices can we attach to the participant’s hand to simulate the physical sensations of CRPS?

– What CRPS symptoms do we want to imitate with the devices?

– We began to think about using gloves to get the right effects, but we then had to retrace and ask another question: do these gloves even exist?

– The answer was…. no. So our next mission was to find something basic and then modify it with all the juicy effects built in to it.

– Our solution: Use a good old ski glove.

Amazingly, everything seems to be going well and we are slowly ploughing on. We are currently up to the stage where our 3D model hands change in accordance with the effects of the glove. What would I do without Rosie?

Creating a perception of pain through physical manipulation is only one part of this research. What I’m also interested in is the sufferers’ state of mind – their anxiety and fear, anticipation, catastrophising, and hyper vigilance – and how they contribute towards creating pain narratives for each individual. I want to include these subjective states somehow in the research we are doing together during the Synapse Residency. I have been thinking about this for a while now, and I think I might be able to do it using one of the materials I have used from my previous artworks: Strings of barbed wire (see my installation, McGill Pain Questionnaire). I feel like I haven’t explored its full potential yet – the entangled nature of pain surely entices me to scrutinise further the rich possibilities of barbed wire. By artistically employing the barbed wire to create a threat value, I think it will enhance the narrative in the experience of CRPS. I will explain further in the next post.

Establishment and Development

BiM-TransparentTwo of my collaborators from Sydney Uni have joined me for the trip to Adelaide today – Prof. Philip Poronnik (Biomedical Sciences) and 2nd year medical student, Rosie Menzies. Philip and Rosie have never been to Body In Mind (BIM), at the Sansom Institute UniSA, where my other collaborating scientists are based, so they have flown over to check out their lab. Until now, much of our communication has been over emails and Skype. So it was a great occasion to get together in person to further discuss our project after seeing BIM’s equipment. Dr. Tasha Stanton (postdoctoral research fellow, Pain Science) from BIM had already seen what USYD can offer when she came for a visit a few months ago, so it was now USYD team’s turn to check out BIM’s assets.

First, they were in for a real treat. They were invited to try the ever so mind boggling ‘Disappearing Hand Trick’ which uses the Mirage multisensory illusions box, developed by Associate Professor Roger Newport from University of Nottingham. As the professor aptly puts it, the purpose of the Mirage is to investigate “how the brain perceives and controls our body. Normal goal-directed action and the perception of our body requires that the brain can put together information about vision, touch and proprioception (body position sense) in a fast, accurate and efficient manner. Such multisensory integration can be disrupted by brain damage or by experimentally manipulating the senses in healthy individuals.”

The ‘Disappearing Hand Trick’ manipulates the visuospatial perception of the user.

 

Philip is being tricked by the Mirage box - his right hand will disappear and he won’t be able to find it! Dr Valeria Bellan is gently guiding Phil here.
Philip is being tricked by the Mirage box – his right hand will disappear and he won’t be able to find it! Dr Valeria Bellan is gently guiding Phil here.

 

Tasha applying the mirage box on Rosie, who will help me program my VR project this year. Even our super smart Rosie couldn’t find her own hand!
Tasha applying the mirage box on Rosie, who will help me program my VR project this year. Even our super smart Rosie couldn’t find her own hand!

 

Rosie’s view of her hands through the Mirage screen.
Rosie’s view of her hands through the Mirage screen.

 

After hanging out at BIM’s playground in the morning, Prof. Lorimer Moseley (Clinical Neurosciences and Chair in Physiotherapy) took us to have a lovely lunch and to continue brainstorming about our VR project. Super excitement, inspiration, exchange of new ideas and skills were on the menu. I was also very pleased to be able to provide a connection between the BIM and USYD scientists. And Phil made sure we were very well fed with the finest Adelaide cuisine.

With my collaborating scientists (left to right) – Prof. Philip Poronnik, Rosie, Prof. Lorimer Moseley and last but not the least, Dr. Tasha Stanton. Thanks to ANAT, who is funding my VR project research and collaboration, we were able to finally get together face to face.
With my collaborating scientists (left to right) – Prof. Philip Poronnik, Rosie, Prof. Lorimer Moseley and last but not the least, Dr. Tasha Stanton. Thanks to ANAT, who is funding my VR project research and collaboration, we were able to finally get together face to face.

 

One of the most exciting discussions we had was about how the Mirage box could be incorporated into my upcoming exhibition at the UNSW gallery next year. Phil also expressed an interest in building one for Sydney Uni as an educational tool for his students as well. Tasha is going to consult Prof. Newport about designing a modified version with easier construction and transportation in mind, since the exhibition will be travelling around regional NSW after the UNSW show. What an exciting development it is! The wonders of the Mirage box will soon be able to be experienced not only by both academic institutions, but also by the general public in an artistic context.

Then we came back to BIM lab after lunch for more fun.

bring out the good old vibrators! Tasha and Dr. Valeria Bellan are tricking Phil’s brain to think that his forearm is shrinking.
bring out the good old vibrators! Tasha and Dr. Valeria Bellan are tricking Phil’s brain to think that his forearm is shrinking.

 

It turns out, Rosie has a much distorted image of her own backside! Tricky Mirage goggles at BIM. Oh, hello there Phil!
It turns out, Rosie has a much distorted image of her own backside! Tricky Mirage goggles at BIM. Oh, hello there Phil!

 

Progressing further with our VR project, Rosie and Stuart Esdaile (IdeaLab, USYD), our programmers for the project, have asked to purchase these realistic 3D hand models to be incorporated into the VR. After much research, we’ve decided to go with these two. Please click on the links below if you’d like to have a look.

http://www.turbosquid.com/3d-models/3d-male-human-hand/842799

http://www.turbosquid.com/3d-models/3d-rigged-female-hand-realistic/782801

I look forward to seeing what they come up with after playing around with these hands.

McGill

Introduction

Eugenie Lee and chronic pain research with Body in Mind (Sansom Institute, Unversity of SA) and Charles Perkins Centre (University of Sydney)

Here is a brief introduction of myself and my project for Synapse residency 2015 by Australian Network for Art and Technology (ANAT).

I am an interdisciplinary artist with a strong focus on chronic pain, founded on my own personal pain experience. For the last few years I’ve been working on sculptures, installations, performance and paintings to communicate the complexities of chronic pain issues.

In 2014, I received a research residency grant from Accessible Arts to work with a neuroscientist who specialises in chronic pain, Professor Lorimer Moseley, and his team Body in Mind (BIM) at the University of SA and Neuroscience Research Australia (NeuRA) in Sydney. The 8 month long residency gave me an opportunity to learn, witness and participate in various scientific experiments and studies, and also to meet a number of world-renowned scientists in the field.

During my Synapse residency this year I will be researching and developing toward an artwork with my collaborating scientists that will simulate the experiences of chronic pain patients – specifically of Complex Regional Pain Syndrome (CRPS) – within a Virtual Reality Environment (VRE). The idea for this VRE concept came as a direct result of Accessible Arts research residency. To accompany the VRE I will also be looking into creating an installation to enhance the VR experience – possibly by incorporating other fun devices to manipulate visual perception in the brain of a participant.

Chronic pain is a complex disease and studies into it have shown that by altering our sensory perceptions the brain can be made to interpret pain differently. This is the core theme of what we are trying to experiment during my residency.

The key members of the project team are:

Dr. Tasha Stanton, a postdoctoral research fellow from Body in Mind (BIM), Sansom Institute, UniSA and Neuroscience Research Australia (NeuRA),

Prof. Philip Poronnik, a professor of Biomedical Sciences at the University of Sydney (USYD),

Dr. Valeria Bellan (BIM),

Dr. Carolyn Berryman (BIM),

Stuart Esdaile, a programmer, IdeaLab (USYD)

Rosie Menzies, a medical student, programmer (USYD)

Matindi Twyford-Moore, science student (USYD)