凱文& 丹尼斯的兩人世界

[圖]笨笨地轉了好多轉才把投影片給轉成jpg檔，完全冷調很虛幻的感覺，看起來是有點陰森詭異，哈哈

剛過去的一整個周末(2/25)都在忙那個無聊到想去死一死的IT期末小組報告，因為我是Project manager，所以義無反顧也別無選擇地擔任起製作投影片的責任，也要把組員的資料收集起來統一格式化，再前一個周末(2/18)是忙著寫書面報告外加整合小組員的報告後呈交，一連兩個周末都浪費在IT的期末報告，真是很嘔，浪費這樣多時間搞這門沒營養的課。我們的題目蠻有趣的，叫”Virtual Reality Applications in Health Care”，虛擬實境在醫療保健方面的應用，聽起來很酷吧? 很多電影都有談到virtual reality，最最有名的莫過於駭客任務，還有關鍵報告，或者是超級戰警中的virtual sex，但是應該不知道虛擬實境可以拿來當做治療的工具吧?

為了配合主題，我花了點時間上網找圖片，然後設計製作投影片，不是很專業啦，但看得出是有點用心在做的吧? 我做了三份讓小組員選，我其實還蠻喜歡虛擬美女那份，但其實我承認他有點冷甚至有點陰森，有點虛了過頭，暖色系那份覺得讓人比較舒服些，也有點駭客任務的味道，我的其他四各組員都喜歡這份，唯獨我說的那個冷酷的日本組員喜歡虛擬美女這份，不知是因為日本男人都很好色，還是投影片的調性根本就是就是跟他冷酷的個性如初一轍。


[圖]這是第二份投影片，溫暖很多，像駭客任務女救世主版，不過我覺得她比較像是在睡覺啦

虛擬實境的應用跟背景我這邊先不贅述，我把最後報告中的簡單介紹貼在文後，有興趣的朋友請自行參閱，但最簡單地說當初是用來訓練太空人跟飛機駕駛員，但現今在醫療保健上則有相當廣泛的應用，我們共分做六小應用，分別是用來減輕燒傷患者的痛楚感，治療精神分裂症，治療各種恐懼症(phobias，像是懼高症，懼飛行症，還懼大眾前的演說症…很多囉) ，遠距的虛擬手術，醫療師的訓練，醫學影像的診療等。我負責的部份是治療精神分裂症。

在進入我的報告內容介紹之前，先來上一小段不算短的炫耀文一下，上一季的管理學期末報告，我獲得相當不錯的迴響，這一次出擊，我自認為沒有上一次好，是因為上一次有逗得滿堂哄笑，這次卻一點笑聲都沒有，不過我的題材本來就不是那種可以讓人笑得出來的(算是自我安慰)，後來好幾個同學都跟我說我表現的讓他們驚艷，有一個韓國主管級的同學更誇張的說我像是在授課一樣地那樣仔細，有一個美國女同學也興沖沖特必跑來跟我說她好喜歡我的簡報，他覺得我很自信很從容不迫，英文講得又很棒(這我持保留態度啦~~)，不過我這樣聽也覺得好高興喔，一直謝謝她這樣地捧場，於是我心情大好，呵呵。

不過我還蠻意外的也很高興的另外一件事是，我這次完全沒有準備”備忘錄””小抄”之類的講稿以備不時之需，我完全都是靠事前的反覆練習將近兩天之後的記憶來做簡報，雖然只有短短的五分鐘而已，但我覺得對自己的進步相當滿意，大概也是自己真的有下更多功夫來準備吧。也可能因為我都沒有太多結結巴巴，就很像是在做簡報，所以同學才會覺得我很有自信，其實我覺得流暢度可以再更好一些，還有進步空間，下一季繼續加油囉。

是的，拉哩拉雜地兩大段炫耀文，哈哈。回到我報告的主題吧。

精神分裂症(Schizophrenia)的兩大幻覺的症狀，一是會聽到可怕的聲音，像是從電視裡傳來或是莫名奇妙地從天而降，這聲音會唆使患者自己殺自己，一是會看到一個無生命物體，如車子或牆壁，會轉換成一個可怖的人臉或是人型，我特地去抓了The Mummy的那個圖來比喻，根據統計，在美國，每十個精神分裂症者有一個最後會受不了這樣的幻覺困擾而自殺，所以這是一個很嚴重的問題，我說到這樣的話題其實要讓全場有笑聲那也未免太不尊重病患了，不過我想我的介紹是有把大家的情緒導引得比較嚴肅了。

那治療師如何利用虛擬實境來治療精神分裂症者呢? 他們用投影技術在一個有投影螢幕(像會議室那樣可以整片拉下來的投影布幕，wraparound screen) 的小房間內，投影出一個典型的客廳影像，(不過病患當然要戴上特製的設備)，因為客廳是病患出現幻覺非常頻繁的地方，之後治療師可以控制虛擬的影像來模擬病患可能出現的幻覺，像是一面牆突然朝病患壓擠過來，或是最典型的是牆面換化成一個可怖的人型，這還不夠，還有同時放出恐怖的聲音增加真實感，治療師可以用這樣的人造幻覺來讓病患信服他們所看到的聽到的幻覺都不是真的，漸漸地，病患不再害怕這些幻覺，而最後能夠回到正常人的生活，這樣的治療不是讓他們的幻覺不見，而是讓他們習慣之後而不再懼怕，因為病患之所以自殺是因為太害怕他們無中生有的幻覺了。

這樣的虛擬實境有幾個優點，一是這是個安全又被保護環境，二是對病人的保密性，三是治療師可以先從簡單的慢慢移到比較難應付的幻覺，這我等一下再多做解釋一下，四是同樣讓病人害怕的虛擬實境可以一再一再地出現讓病人經歷，不需要等，四是相對於傳統跟心理醫師做長期的面談治療方式，虛擬實境的治療費相對上是便宜許多許多。

說到第三點優勢，我在解釋治療師從簡單到比較難以應付的狀況時，特別準備了一張投影片上片有兩張電影的劇照圖片，一是鬼馬小精靈(Caspter)，一是The mummy，分別以動畫前後出現，算是比較輕鬆一點點的部份。病人一但可以對很可怕的影像幻覺適應的話，那病患一但在日後出現了相對比較不可怕的幻覺時，就不會感到害怕了，這也是說，病患可以先去體驗一下比他曾經出現過的更可怕幻覺來事先練習以備不時之需。這就像飛行員的模擬訓練，模擬很多狀況是在現實生活中不大會出現或是出現機率及其低微的狀況。


[圖]鬼馬小精靈的幻覺若真出現，只要不調皮搗蛋而且都這樣乖乖的，我覺得也會有點生活樂趣呀，這讓我想到"艾莉的異想世界"也常常有些很可愛的幻想

雖然有這樣多的優點，但目前的主要缺點還是虛擬實境的真實度無法逼真到讓人像是在真實的世界中那樣，影像仍然有明顯的人工鑿跡，甚至只有像錄影攝像那樣的品質，不過虛擬實境在過去五年來進步非常快，科學家也很樂觀其成地在接下來幾年有更大的的進步空間，另外一個大缺點是在接受治療完之後，病患會有生理上的副作用，例如嘔吐、昏眩等。

這個話題跟無聊的IT不大有直接的關係，因為我們是著重在Innovation，the next possible big money thing. 搞完這個期末報告，可以專心一點讀書囉，進度嚴重落後，這個周末要趕緊快馬加鞭呀，不然到時又要狼狽不堪了。


Introduction

Virtual reality (VR) is a relatively new technology that consists of a graphic environment in which the user not only has the feeling of being physically present in a virtual world, but he or she can interact with it. It is a fully three-dimensional computer-generated world in which a person can move about and interact as if he were actually in a physical space. Thus, VR is immersive as well as interactive – the user does not passively visualize the virtual world, rather he or she uses devices that allow him or her to touch and move objects, and the virtual world responds in real time to those actions. This is accomplished by totally immersing the person's senses using a head-mounted display (HMD) or some other immersive display device.

The first VR workstations were designed for big companies that wanted to simulate certain situations to train professionals. For example, elements of this tool were part of Russian and American space programs and helped the astronauts to practice many skills in simulated situations. Pilots could receive many hours of training in virtual contexts and they could acquire a high degree of mastery in many diverse circumstances.

In the 1990s, VR matured significantly. Better and more sophisticated virtual environments and worlds became more economical, easier to use and more widely available. Today, a great expansion of this technology is taking place in several fields, including the area of health care. In our report, we will explore many applications in this area, including virtual therapy for burn victims, virtual training for physicians, medical imaging for diagnosing patients, virtual treatment of psychological problems, and virtual remote surgery.


底下是我書面報告的文字內容

Virtual therapy for psychological problems

By Kevin Liu

At present VR has shown that it can be very useful in the treatment of many psychological problems. The use of VR in the psychological field has made a big impact in the last five years. VR can facilitate several tasks that are very important for psychological therapy. VR can be effectively used to treat anxiety disorders such as acrophobia, fear of spiders, and fear of flying as well as eating disorders and sexual disorders. There are many advantages of VR used to treat psychological problems.

1.The virtual environment is a safe and protected environment. It can be considered to be an intermediate between the consulting room (completely protected) and the real environment (totally threatening). The therapist can make the patient understand that he or she will be exposed to a virtual scenario that he or she has always considered threatening. The person can explore and face the feared situations at the pace and speed that he/she requires.

2.VR allows the therapist to evaluate the situation so that the patient can move forward from the easiest performances to the most difficult ones. Little by little, he/she will be able to cope with the situations in the real world.

3.VR allows a remarkable control of the situation. There is no need to wait for the events to occur in the real world because they can be generated in the software in an increasingly routine way. This implies that the desired situations can appear repeatedly and the patient can re-experience them many times.

4.VR allows the person to go beyond reality. It is flexible enough to permit the designing of different level of contexts in which the patient can affront virtually. The contexts are not only what he/she fears, but what would be totally impossible to achieve and control in real world.

5.VR exposure is also useful from an ethical point of view, offering to the patient a higher degree of confidentiality. VR treatment is conducted in the therapist’s consulting room so that the person does not have to be afraid of losing control in front of others or to be worried about someone knowing his/her problem.

Recently, Emmelkamp’s group has proved in a controlled study that VR is as effective as the most commonly used choosing method for the treatment of phobias. The Kaiser-Permanente Medical Group of California developed a test system to use VR in the treatment of acrophobia. In this system the patient has to pass through a depth gully crossing over a suspension bridge and a narrow board. The use of this system in 32 patients gave as a result a 90 percent of success. Dr. Lamson, the person in charge of this project, stated that patients had the feeling of having coped with this fear and having overcome it. In 1992, Rothbaum and North’s group at the University of Clark-Atlanta created a virtual environment for the treatment of acrophobia:

原文摘錄自研究報告中----> They created a scenario with an exterior elevator that reached to different heights and the patient could lean out of a balcony in every floor. The patient reported feeling a high degree of immersion in the virtual environment and in 8 sessions he could feel relaxed in a height level similar to a 15th floor.

On the other hand, VR is also used to treat schizophrenia. It can recreate psychotic illusions, including patients hearing their TV sets instructing them to kill themselves or seeing inanimate objects morphing into faces or people. Scientists believe that by showing schizophrenic patients “virtual reality” illusions, they could help convince patients their own illusions are not real:

原文摘錄自研究報告中----> University of Queensland psychiatrist Peter Yellowlees and his team have built a prototype 3D VR simulation that shows a typical living room projected onto a wraparound screen. The virtual setting can be modified to mimic common illusions by making the walls appear to be closing in, photographs of one person's face morphing into another's, and straight lines such as the edge of picture frames wobbling. At the same time, a soundtrack gives an abusive running commentary, typical of many schizophrenic illusions.

Dr Yellowlees admits some patients might find the virtual illusions frightening but he is optimistic that many will be able to distinguish between their own illusions and the virtual ones. Eventually, the researchers plan to tailor illusions to individual patients. This 3D 'virtual' experience would allow the public to rethink their attitudes to people who live with illusions and to appreciate the courage of the many people with schizophrenia who are able to recover a meaningful and fulfilling life.

When using VR to treat psychological problems, there are two major shortcomings that require improvements in the future. Firstly, the virtual world is still rudimentary. However, a number of researchers are working diligently to get a higher degree of realism, and the very fast development of technology is allowing more realistic environments. Another issue is that VR can produce negative secondary effects such as disorientation and neural-vegetative symptoms like dizziness and nausea.

However, an important fact is that VR can be effective with relatively cheap hardware and software on stand-alone computers currently on the market. If the VR field keeps up the development, we can expect that in a few years VR treatment can be in all clinical consulting rooms.

References Used

http://www.psychiatrictimes.com/p030731.html, A New Approach: Using VR Psychotherapy in Panic Disorder With Agoraphobia

http://www.namiscc.org/News/2002/Summer/VirtualReality.htm , VR aid for schizophrenia

http://www.cybertherapy.info/cybertherapy/3_Botella.pdf , VR and psychotherapy