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V.S. Ramachandran | Invention Of Mirror Therapy

Mirror therapy was invented by Vilayanur S. Ramachandran due to his interest in phantom limb pain. Ramachandran is Director of the Centre for Brain and Cognition, and Professor with the Psychology Department and the Neurosciences Program at the University of California, San Diego. He is trained as a doctor and then obtained a Ph.D. from Trinity College at the University of Cambridge.

In the early 1990s, he performed two experiments to explore the nature of phantom limbs and the origin of phantom pain. These paved the way for his development of mirror therapy. Multiple studies was carried out around the early and mid-nineties showed examples of “re-mapping” of the brain and referred sensations. In 1992, Ramachandran introduced the use of mirror box illusion for the treatment of two disorders that had previously been thought to be permanent and incurable; chronic pain of central origin (such as phantom pain) and hemiparesis following a stroke.

With his colleague, Ramachandran proposed that mirror box therapy could help alleviate phantom limb pain by allowing patients to “relax” the phantom limb. He thought phantom limb pain was caused by a “learned paralysis” of the phantom limb as it can no longer be moved  He suggested that using a mirror to trick the brain into thinking the phantom limb was moving would allow it to relax and would therefore reduce pain. He hypothesized that when a patient attempted to move the paralyzed limb, they received feedback that the limb did not move. This feedback impacted on the brain, so that, even when the limb was no longer there, the brain had learned that the phantom limb was paralyzed. To retrain the brain, and thereby eliminate the learned paralysis, Ramachandran created the mirror box.

His first patient was seen in 1993. The patient had a brachial avulsion leading to his left arm being amputated above his elbow. For the 11 years following the amputation he had phantom limb pain. The patient took part in a mirror box session and reported that he could not only see his phantom moving in the mirror but could also feel it moving through the mirror box illusion. He stated that the pain was immediately reduced and that it felt good to be able to move the phantom again. By having him repeat the procedure several times with his eyes closed and open, they verified that the effect required visual feedback from the mirror.

Since then, many groups have explored different types of visual feedback in different patient groups and have shown them to be at least partially effective. Patient feedback is generally overwhelmingly positive and there are very few side effects reported. This makes mirror box therapy a widely accepted therapy modality in many patient groups.

More about V. S. Ramachandran:
Centre for Brain and Cognition - University Of California, San Diego
Vilayanur S. Ramachandran - Wikipedia


Ramachandran VS, Rogers-Ramachandran D, Cobb S. (1995) Touching the phantom limb. Nature 377: 489–90.
Ramachandran, VS, Rogers-Ramachandran, D. C. (1996), "Synaesthesia in phantom limbs induced with mirrors", Proceedings of the Royal Society of London (263(1369)): 377–386, doi:10.1098/rspb.1996.0058, PMID 8637922
Ramachandran VS, Hirstein W. (1998) The perception of phantom limbs. The D.O. Hebb lecture. Brain; 121: 1603–30.