Means and methods for facilitating trauma integration

Abstract

An apparatus and method for diagnosing and/or treating autonomic dysregulation is disclosed. In a preferred embodiment, a user is presented stressful audio-visual content at a known time. The resulting amount of deviation of the user's autonomic nervous system from stasis is automatically quantified periodically subsequent to the presentation of the stressful audio-visual content by monitoring a parameter of the user's heartbeat over time, thus automatically measuring both the amount of disturbance in the user's autonomic nervous system, and the re-settling time of the user's autonomic nervous system for given stressful audio-visual content. The apparatus may then guide the user through one or more awareness exercises, and subsequently re-measure the user's response to stressful audio-visual content.

Claims

1. An apparatus for diagnosing autonomic dysregulation, comprising: a computer subsystem, comprising a digital processor, an AV display, random-access memory, at least one user-operable input device, a digital input data interface, a digital data output interface, a real-time clock, non-volatile read-write memory, and a computer-readable medium containing instructions executable by said digital processor; heart monitoring circuitry in communication with said digital input data interface, operational to digitize at least one parameter of a user's heartbeat; said instructions for said processor operative to direct said processor to: acquire through said heart monitoring circuitry while said user is at rest a first set of values of said first parameter of said user's heartbeat, and derive from said first set of values of said first parameter a first value of a second parameter of said user's heartbeat; and subsequent to deriving said first value of said second parameter, output first stressful AV content through said AV display, to activate said user's autonomic nervous system; and while outputting said stressful AV content, acquire through said heart monitoring circuitry a second set of values of said first parameter of said user's heartbeat, and derive from said second set of values of said first parameter a second value of said second parameter of said user's heartbeat; and subsequent to deriving said second value of said second parameter of said user's heartbeat, terminate the output of said first stressful AV content at time t.sub.1 and record the value of time t.sub.1 in said random access memory; and subsequent to time t.sub.1, monitor over time said first parameter of said user's heartbeat, periodically deriving values of said second parameter of said user's heartbeat, until said second parameter of said user's heartbeat returns to within a predetermined tolerance of said first value of said second parameter of said user's heartbeat at time t.sub.2; and output over said digital data output interface or store in said non-volatile read-write memory data at least indicative of the time difference between t.sub.1 and t.sub.2.

2. The apparatus of claim 1, wherein said first heartbeat parameter comprises heart rate derived from electrocardiogram data or blood pressure waveform data or plethysmograph data or skin color fluctuation data, and said second heartbeat parameter comprises heart rate variability.

3. The apparatus of claim 1, wherein said instructions for said processor are further operative to select audio and/or video content in part based on input received from said user through said user-operable input device.

4. The apparatus of claim 1, wherein said second parameter and said first parameter are both heart rate derived from electrocardiogram data or blood pressure waveform data or plethysmograph data or skin color fluctuation data.

5. The apparatus of claim 1, wherein said instructions executable by said processor further comprise instructions to: subsequent to time t.sub.2, output through said AV display first awareness exercise content, instructive to guide said user through a first awareness exercise; and subsequent to the output of said first awareness exercise content, output second stressful AV content through said AV display, to activate said user's autonomic nervous system; and while outputting said second stressful AV content, acquire through said heart monitoring circuitry a third set of values of said first parameter of said user's heartbeat, and derive from said third set of values of said first parameter a third value of said second parameter of said user's heartbeat; and subsequent to deriving said third value of said second parameter of said user's heartbeat, terminate the output of said first stressful AV content at time t.sub.3 and record the value of time t.sub.3 in said random access memory; and subsequent to time t.sub.3, monitor over time said first parameter of said user's heartbeat, periodically deriving values of said second parameter of said user's heartbeat, until said second parameter of said user's heartbeat returns to within a predetermined tolerance of said first value of said second parameter of said user's heartbeat at time t.sub.4; and; based on the difference between the time interval between t.sub.1 and t.sub.2, and the time interval between t.sub.3 and t.sub.4, store in said non-volatile read-write memory or output through said AV display content indicative to said user of said user's progress in reducing autonomic dysregulation.

6. An apparatus for diagnosing autonomic dysregulation, comprising: a computer subsystem, comprising a digital processor, an AV display, random-access memory, at least one user-operable input device, a digital input data interface, a digital data output interface, a real-time clock, non-volatile read-write memory, and a computer-readable medium containing instructions executable by said digital processor; heart monitoring circuitry in communication with said digital input data interface, operational to digitize at least one parameter of a user's heartbeat; said instructions for said processor operative to direct said processor to: acquire through said heart monitoring circuitry while said user is at rest a first set of values of said first parameter of said user's heartbeat, and derive from said first set of values of said first parameter a first value of a second parameter of said user's heartbeat; and subsequent to deriving said first value of said second parameter, output first brief stressful AV content through said AV display at time t1, to activate said user's autonomic nervous system and record the value of time t.sub.1 in said random access memory; and immediately subsequent to outputting said brief stressful AV content, acquire through said heart monitoring circuitry a second set of values of said first parameter of said user's heartbeat, and derive from said second set of values of said first parameter a second value of said second parameter of said user's heartbeat; and subsequent to time t.sub.1, monitor over time said first parameter of said user's heartbeat, periodically deriving values of said second parameter of said user's heartbeat, until said second parameter of said user's heartbeat returns to within a predetermined tolerance of said first value of said second parameter of said user's heartbeat at time t.sub.2; and output over said digital data output interface or store in non-volatile memory data at least indicative of the time difference between t.sub.1 and t.sub.2.

7. The apparatus of claim 6, wherein said instructions executable by said processor further comprise instructions to: subsequent to time t.sub.2, output through said AV display first awareness exercise content, instructive to guide said user through a first awareness exercise; and subsequent to the output of said first awareness exercise content, output second brief stressful AV content through said AV display, to activate said user's autonomic nervous system at time t3 and record the value of time t.sub.3 in said random access memory; and immediately subsequent to outputting said second brief stressful AV content, acquire through said heart monitoring circuitry a third set of values of said first parameter of said user's heartbeat, and derive from said third set of values of said first parameter a third value of said second parameter of said user's heartbeat; and subsequent to time t.sub.3, monitor over time said first parameter of said user's heartbeat, periodically deriving values of said second parameter of said user's heartbeat, until said second parameter of said user's heartbeat returns to within a predetermined tolerance of said first value of said second parameter of said user's heartbeat at time t.sub.4; and; based on the difference between the time interval between t.sub.1 and t.sub.2, and the time interval between t.sub.3 and t.sub.4, store in said non-volatile read-write memory or output through said AV display content indicative to said user of said user's progress in reducing autonomic dysregulation.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) FIG. 1 is a block diagram of the hardware of a preferred embodiment of the present invention.

(2) FIG. 2 is a flow chart depicting a method of operation of a preferred embodiment of the present invention.

DETAILED DESCRIPTIONS OF SOME PREFERRED EMBODIMENTS

(3) FIG. 1 is a block diagram of the hardware of a preferred embodiment of the present invention. In a preferred embodiment, personal computer (PC) 103 (containing random access memory (RAM) 102, non-volatile read/write memory 104 (which also acts at computer-readable non-transitory program media), central processing unit (also herein referred to as digital processor or CPU) 107, and input/output (I/O) hardware 108 (including digital input and output data interfaces) interfaces with audio/video (AV) display 101, real-time clock 111, one or more user-operable input devices such as keyboard 105 and/or mouse (or other pointing device) 106, and heart monitor circuitry 109. Heart monitor circuitry 109 may produce an analog waveform (representative of heartbeat) which is digitized in PC 103, or it may produce a digital waveform, representative of heartbeat. Any hardware within PC 103 used to digitize an analog waveform from heart monitor circuit 109 may be deemed to be part of heart monitor circuit 109 where heart monitor circuitry used is deemed to have a digital output.

(4) The waveform produced by heart monitor circuitry 109 need not have the same shape as an electrocardiogram (ECG) waveform. The waveform could, for example, be a simple pulse train where the timing of the pulses matches the timing of a known portion of an ECG waveform or a waveform produced by an optical sensor such as a plethysmograph sensor applied to a fingertip or other body part, which acts to sense heartbeat.

(5) In embodiments where heart rate variability is measured correlated with respiration, respiration monitor circuitry 110 interfaces to a respiration monitoring device such as a chest band or other movement sensor, and feeds an electronic signal representative of respiration to digital input/output circuitry 108.

(6) FIG. 2 is a flow chart depicting a method of operation of a preferred embodiment of the present invention. In a preferred embodiment, in step 201, a user runs software of the present invention, which causes an audiovisual introduction to be displayed on audio-visual display (also herein referred to as AV display) 101. In preferred embodiments, AV display 101 may be a video display such as a liquid crystal display (LCD display) or other video display, or one or more loudspeakers, or one or more earphones or headphones, or any combination thereof capable of delivering audio and/or video content (also herein referred to as AV content) to a user.

(7) The introduction may also include assessment questions asked of the user through AV display 101, and the collection of user answers to such questions through keyboard 105 and/or mouse 106. The introduction may include instructions showing the individual using the software how to hook himself or herself to heartrate monitor 109 (for instance by clipping an optical sensor to a fingertip). In a preferred embodiment, step 201 also includes automatic verification that the user has hooked himself or herself up to heartrate monitor 109 properly, and automated aid in solving any heartrate monitor functionality problems that may be encountered. Step 201 may also outline one or more of the steps or sub-steps of FIG. 2 that follow step 201.

(8) In a preferred embodiment, in step 202, the user is presented stressful AV content to activate his or her autonomic nervous system. In one such embodiment, the user is instructed to play a frustrating game that is presented through audio/video display 101, and the frustrating game acts to activate the users autonomic nervous system. In an alternate embodiment, the user may passively watch AV content containing an unpredictable stressful event.

(9) In an embodiment where the user interacts with a stressful game, the user may use some combination of mouse 106, keyboard 105, and/or other game input devices as may be or become known in the art, such as but not limited to joy stick devices, touch pad devices, accelerometers, etc. While the user interacts with the frustrating game, the user's heartrate is recorded over the span of time of game play (as a measure of the activation of the user's autonomic nervous system (ANS)), and game circumstances (including the user's actions in response to computer-generated game circumstances) are recorded such that heartrate changes may be correlated with circumstances within the frustrating game. Heartrate variability (HRV) correlated with respiration may also be measured as a second measure of ANS activation. Data measured in step 202 is stored in non-transitory computer-readable media. When some predetermined set of conditions involving some combination of time, and/or heartrate, and/or HRV are automatically sensed, the process moves to step 203.

(10) In step 203, the recovery over time of the users autonomic nervous system is automatically measured through heartrate monitor 109. In a preferred embodiment, during this step, non-stressful audio/video may be presented to the user on AV display 101. In a preferred embodiment recovery time determination is made based on how long it takes the users heartrate and/or HRV to return to within a predetermined tolerance of baseline heartrate and/or baseline HRV. Data measured and results of calculations made in step 203 are stored in non-transitory computer-readable media.

(11) In step 204 computer 103 calculates parameters based on activation measurements made in step 202, recovery measurements made in step 203, and questions answered by the user in step 201. In a preferred embodiment, one of the parameters calculated is representative of ANS resilience (or, inversely, autonomic dysregulation) of the user. In a preferred embodiment, parameters calculated in step 204 may influence content played to the user through AV 101 subsequent to step 204, and may influence timing of the presentation of such content.

(12) In step 205, the user is automatically led through a series of awareness exercises, guided by content played on AV display 101, and the user may be queried (through AV display 101) to provide information (for instance through keyboard 105 and mouse 106) about what the user experiences during such awareness exercises.

(13) In a preferred embodiment, in step 206, the user's autonomic nervous system is once again activated through the presentation of stressful content played through AV display 101, and subsequent to activation, the return of the user's ANS to within a predetermined tolerance of baseline levels is measured. Data measured and results of parameter calculations performed in step 206 are stored in non-transitory computer-readable media.

(14) In decision step 207, criteria (such as total time elapsed, user-provided answers to questions, and reduction achieved in autonomic dysregulation compared to baseline) are evaluated to automatically make a decision whether to continue to step 208 or whether to end the interaction session with the user. In a preferred embodiment, if the decision is made to end the interactive session, session-ending content is played to the user through AV display 101. If the decision is made to continue the interactive session, the process proceeds to step 208.

(15) In a preferred embodiment, in step 208, based on prior measured parameters (which may include user answers to questions) coaching/counseling vignettes are selected to be played for the user through AV display 101, and the next stressful game is selected.

(16) In step 209, coaching/counseling vignettes selected in step 208 are played for the user through AV display 101. Subsequent to the playing of such vignettes, step 206 is re-entered with a new set of parameters calculated in step 208, and interaction continues as described above until ending step 210 is reached, or until the user terminates the interactive session with the present invention. In a preferred embodiment, the user is shown a summary of his or her progress toward decreasing autonomic dysregulation, to motivate further use of the present invention, and further progress toward decreasing autonomic dysregulation.

(17) In embodiments of the present invention for use only in diagnosing or quantifying the severity of autonomic dysregulation, the process depicted in FIG. 2 may terminate after step 204, outputting data indicative of the level of autonomic dysregulation measured, where longer settling time for given stressful content indicates more autonomic dysregulation.

(18) Within this document, the term set of values refers to one or more values.

(19) In the foregoing description, for the purposes of illustration, methods were described in a particular order. It should be appreciated that in alternate embodiments, the methods may be performed in a different order than that described. It should also be appreciated that the methods described above may be performed by hardware components or may be embodied in sequences of machine-executable instructions, which may be used to cause a machine, such as a general-purpose or special-purpose digital processor or logic circuits programmed with the instructions to perform the methods. These machine-executable instructions may be stored on one or more machine readable non-transitory mediums, such as CD-ROMs or other types of optical disks, floppy diskettes, ROMs, RAMs, EPROMs, EEPROMs, magnetic or optical cards, flash memory, or other types of machine-readable mediums suitable for storing electronic instructions. Alternatively, the methods may be performed by a combination of hardware and software. Digital results of any automated process herein may be stored in a non-transitory storage medium such as ROM, RAM, FLASH memory, magnetic disc, etc.; may be displayed visually (for instance on a computer monitor, cell phone, or other visible display); may be displayed in audio (for instance synthesized speech); or may be displayed by printing.

(20) Specific details were given in the description to provide a thorough understanding of the embodiments. However, it will be understood by one of ordinary skill in the art that the embodiments may be practiced without these specific details. For example, circuits may be shown in block diagrams in order not to obscure the embodiments in unnecessary detail. In other instances, well-known circuits, processes, algorithms, structures, and techniques may be shown without unnecessary detail in order to avoid obscuring the embodiments.

(21) Also, it is noted that the embodiments were described as a process which is depicted as a flowchart, a flow diagram, a data flow diagram, a structure diagram, or a block diagram. Although a flowchart may describe the operations as a sequential process, many of the operations can be performed in parallel or concurrently. In addition, the order of the operations may be re-arranged. A process is terminated when its operations are completed, but could have additional steps not included in the figure. A process may correspond to a method, a function, a procedure, a subroutine, a subprogram, etc. When a process corresponds to a function, its termination corresponds to a return of the function to the calling function or the main function.

(22) Furthermore, embodiments may be implemented by hardware, software, firmware, middleware, microcode, hardware description languages, or any combination thereof. When implemented in software, firmware, middleware or microcode, the application code or code segments to perform the necessary tasks may be stored in a non-transitory machine readable medium such as a storage medium. Operations described as being carried out by one processor may be carried out by multiple processors, and vice versa. A code segment may represent a procedure, a function, a subprogram, an application, a routine, a subroutine, a module, a software package, a class, or any combination of instructions, data structures, or application statements. A code segment may be coupled to another code segment or a hardware circuit by passing and/or receiving information, data, arguments, parameters, or memory contents. Information, arguments, parameters, data, etc. may be passed, forwarded, or transmitted via any suitable means including memory sharing, message passing, token passing, network transmission, etc.

(23) The foregoing discussion should be understood as illustrative and should not be considered to be limiting in any sense. While this invention has been particularly shown and described with references to preferred embodiments thereof, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the spirit and scope of the invention as defined by the claims.