Training Protocol for OCD

[Guest guest]

Hello,

I have been biofeedback training for about 6 months now, and I

currently have a brainmaster system that I use at home.

I train C3/C4, for augmenting Beta/SMR and inhibiting theta 4-5 times

a week. On average, my ratios are as follows.

C3 - Beta:Theta:Alpha = 1:2:2

C4 - SMR:Theta:Alpha = 1:2:2

My relaxation and sleep have improved tremendously, but Beta/SMR

still need some work. I have eliminated sugar, salt, and caffiene

from my diet, and this has reduced my obsessions immensely. In

addition, I started taking 18 g of inositol a day 4 weeks ago, in

accordance to the Israeli study for treatment of OCD. The following

is a link to this study.

http://www.mvelectric.com/inositol/ocd.htm

Can anyone tell me which portion of my brain inositol would be

affecting and how? Moreover, would you reccomend any other

neurofeedback training protocols for treatment of OCD?

Thanks,

Mike

[Guest guest]

Mike,

You say you are training C3/C4. I assume that means you are using the two sites in one-channel in a bipolar montage. If not, then I would not recommend training beta in that protocol. You may find you get better results training C3/A1 beta and C4/A2 SMR, either in two separate training segments (I'd try that first) or in a two-channel protocol (if you get good results doing them individually).

If you haven't done an assessment, you may not be aware of the answers to some of these questions, but ordinarily OCD is what we call a Switching issue, which results from a hyper-active pre-frontal lobe. In many cases, if you look at activity at Fz, referenced to Pz, you will see very high BETA. That's the cingulate gyrus running in overdrive to try to hold down major emotional activity in the mid-brain. I would also expect that, if you looked at alpha at P3/A1 or P4/A2, you would find alpha/theta ratios below 1 with your eyes closed.

Inositol has been used as an alternative to SSRI drugs to artificially increase the level of serotonin in synapses throughout the brain. By increasing your posterior alpha levels to a point where eyes closed A/T ratios are 1.5 or higher, you will usually increase serotonin levels in a more natural and lasting way.

If I were going to train, I'd be inclined to try eyes-closed alpha training at P4/A2 (if it's not already higher than theta at that site).

For OCD, I would train with one active lead in the mastoid crease behind the right ear (feel right behind the ear, near the top, for a channel in the thick bone there that runs toward the back of the head; that's the crease) and the reference lead at Fp1. I would train up SMR (12-15 Hz) and train down theta, but focus on the SMR. You'll have to keep your eyes partially closed (peeking through your eyelashes) to avoid major eyeblink artifact that looks like bursts of theta or delta.

Please be aware that, as we discuss in all trainings, OCD is NOT A PRIMARY PROBLEM! It is a way that many brains cope with an underlying mood issue--sometimes anxiety, often depression. If you just remove the coping mechanism but don't deal with what it's coping with, you may not be very happy with the results.

I'd strongly suggest that you try to make it to one of the Level 2 workshops, where you will actually perform a full assessment and develop a tailored training plan for yourself in two days. That's the safest way to make sure you are doing something that is more likely to have a positive and lasting effect.

BTW, what was your sleep issue: 1. difficulty falling asleep (or falling back to sleep after awakening at night) or 2. waking up often during the night and/or sleeping heavily but not feeling rested? If it was 1, then it is probably the SMR training which is having an effect; if 2, then it may be the beta training.

Pete

-----Original Message-----From: mike_willster [mailto:mike_willster@...]Sent: Sunday, September 15, 2002 4:32 PM Subject: Training Protocol for OCDHello,I have been biofeedback training for about 6 months now, and I currently have a brainmaster system that I use at home.I train C3/C4, for augmenting Beta/SMR and inhibiting theta 4-5 times a week. On average, my ratios are as follows.C3 - Beta:Theta:Alpha = 1:2:2C4 - SMR:Theta:Alpha = 1:2:2My relaxation and sleep have improved tremendously, but Beta/SMR still need some work. I have eliminated sugar, salt, and caffiene from my diet, and this has reduced my obsessions immensely. In addition, I started taking 18 g of inositol a day 4 weeks ago, in accordance to the Israeli study for treatment of OCD. The following is a link to this study. http://www.mvelectric.com/inositol/ocd.htmCan anyone tell me which portion of my brain inositol would be affecting and how? Moreover, would you reccomend any other neurofeedback training protocols for treatment of OCD?Thanks,Mike

[Guest guest]

Pete,

I have done an assesment and underwent around 38 training sessions

with trained professionals. I would say around 33 of the 38 sessions

were spent on augmenting Beta and inhibiting Theta in C3. The rest

of the sessions were encompassed augmenting SMR and inhibiting Theta

in C4.

My concern is that the approach of the clinic I attended was too

narrow. This is why I am trying to get other opinions on the matter.

I found this comment pretty interesting.

" It is a way that many brains cope with an underlying mood

issue--sometimes anxiety, often depression. If you just remove the

coping mechanism but don't deal with what it's coping with, you may

not be very happy with the results. "

If this is true in all cases, I honestly don't know what it is I am

attempting to cope with. I have been classified as a purely

obsessive type. And these days, I experience anxiety on occasion

with regards to worrying about worrying...if that makes sense;

especially after I eat certain foods. I am looking into the

possibility that I am hypoglycemic...but the foods that are

affecting me don't necessarily contained refined sugar. My

ruminations have become more manageable after eliminating sugar,

salt, and caffiene.

Also, could you give me a little more info on the level 2 workshops?

Maybe cost, dates...etc. And as far as my sleep was concerned, I

had trouble falling asleep. So, this may imply that SMR may have

more of an affect?

Lastly, I become extremely tired after doing a biofeedback session.

For instance, I just completed a Beta training session in C3, and I

am having lots of trouble getting my thoughts down in this memo.

Is there anything you reccomend to minimize this effect?

Thanks,

Mike

[Guest guest]

Mike,

As you have probably noticed from the responses to your question on Biofeedback as well as mine, OCD is generally characterized by an EXCESS of beta--not a shortfall of it. I believe you said on Biofeedback that you had done a Q, but this orientation toward doing C3 beta and C4 SMR for "primary OCD" suggests your professionals had been trained in the EEG Spectrum model (perhaps some time back) and, if they did get a Q, didn't have much of an idea what to do with it.

Switching problems show up as extremely high activity in the cingulate area, an area which is responsible, among other things, for providing some cortical control for the emotional brain. When it is very very active, that certainly suggests that it is working very hard to keep something under control, though I suppose it might be so for other reasons. Looking at the behavioral characteristics of "OCD", there is a racing mind, and a tendency to intellectualize rather than expressing emotions easily. Those are the behavioral analogues of what the brain is doing via the EEG. If you aren't aware of any emotional issues, it may be that there aren't any--or it may simply be that the defense system your brain/mind have developed are working very well.

Sugar (which is required for the brain to produce the high pulse rates) and caffeine (which stimulates same) would both be "helpful" in maintaining that overactive cingulate, so I would expect that cutting them back would feel helpful. That feeling of a hypoglycemic attack is also the feeling many folks experience during a panic attack. Different people call it different things, but the heart racing, sweating, shortness of breath, weakness and dizziness are all signs of an autonomic response, and the autonomic nervous system is directly linked to the limbic system (emotional brain).

Sleep onset problems can be related to SMR production problems or to anxiety or high levels of beta, especially coherent beta, so your experience there would be consistent with what we might expect.

If you are a heavy beta producer already, then pushing your brain to produce more beta would not be a great idea and might very well make you feel more sleepy.

Level 2 workshops cost $350 and will be held this fall in Irvine, CA (9/21-22), Minneapolis (10/25-26) and Detroit (11/9-10). Depending on how much you have spent on assessments, this is a pretty exceptional bargain. In 2 days (16 training hours) you will not only have an assessment done and develop a training plan for yourself, but you'll actually learn how to DO it, so you can review and update it in the future if you wish.

Without more information about what your EEG looks like, it's hard to do anything more than speculate. I recall that I did suggest several possible protocols in my last response to you, and I'm wondering if you've tried any of those.

Pete

I have done an assesment and underwent around 38 training sessions with trained professionals. I would say around 33 of the 38 sessions were spent on augmenting Beta and inhibiting Theta in C3. The rest of the sessions were encompassed augmenting SMR and inhibiting Theta in C4. My concern is that the approach of the clinic I attended was too narrow. This is why I am trying to get other opinions on the matter.I found this comment pretty interesting."It is a way that many brains cope with an underlying moodissue--sometimes anxiety, often depression. If you just remove the coping mechanism but don't deal with what it's coping with, you may not be very happy with the results."If this is true in all cases, I honestly don't know what it is I am attempting to cope with. I have been classified as a purely obsessive type. And these days, I experience anxiety on occasion with regards to worrying about worrying...if that makes sense; especially after I eat certain foods. I am looking into the possibility that I am hypoglycemic...but the foods that are affecting me don't necessarily contained refined sugar. My ruminations have become more manageable after eliminating sugar, salt, and caffiene.Also, could you give me a little more info on the level 2 workshops?Maybe cost, dates...etc. And as far as my sleep was concerned, I had trouble falling asleep. So, this may imply that SMR may have more of an affect?Lastly, I become extremely tired after doing a biofeedback session. For instance, I just completed a Beta training session in C3, and I am having lots of trouble getting my thoughts down in this memo.Is there anything you reccomend to minimize this effect?Thanks,Mike

[Guest guest]

Pete,

I never had a QEEG done, but only an EEG. From this, the

professionals I worked with determined my training protocol.

Which brings me to another point, kind of unrelated to the topic, but

important. When I started my EEG sessions I informed the clinicians

I was working with that I wouldn't be able to handle the cost of

treatment without aid from my insurance company. My insurance

company initially rejected, but my clinician informed me that due to

his contacts, insurance will in fact cover the treatment. Based on

this and this alone, I continued to recieve therapy from this

institute.

In addition, they told me that I no longer had to pay for sessions

out of pocket, so I didn't. Well, about 2 months after I completed my

last session, I got a letter from this institute informing me that my

insurance will not cover any of the payments, and that I will have to

foot the bill myself...upwards of $2500.

I wrote back, informed them of what had happened, and they completely

denied the above referenced conversations ever took place. At this

point in time I don't know what I can do except file a report with

the Better Business Bureau. I was wondering if you knew of any

biofeedback guilds or organizations that I can report this to.

But back to the issue at hand...I am currently not a heavy producer

of beta...at least not in C3 and C4. In these areas my beta to theta

ratio is around 1:2.

I will try some of the protocols you suggested later on tonight.

Because I usually get pretty tired after training and wouldn't want

that to affect me throught the day. Also, if you could tell me which

regions would be beneficial to see, I can take a few screen shots of

eeg readings and email them to you,

Thanks again,

Mike

> Mike,

>

> As you have probably noticed from the responses to your question on

> Biofeedback as well as mine, OCD is generally characterized by an

EXCESS of

> beta--not a shortfall of it. I believe you said on Biofeedback

that you had

> done a Q, but this orientation toward doing C3 beta and C4 SMR

for " primary

> OCD " suggests your professionals had been trained in the EEG

Spectrum model

> (perhaps some time back) and, if they did get a Q, didn't have much

of an

> idea what to do with it.

>

> Switching problems show up as extremely high activity in the

cingulate area,

> an area which is responsible, among other things, for providing some

> cortical control for the emotional brain. When it is very very

active, that

> certainly suggests that it is working very hard to keep something

under

> control, though I suppose it might be so for other reasons.

Looking at the

> behavioral characteristics of " OCD " , there is a racing mind, and a

tendency

> to intellectualize rather than expressing emotions easily. Those

are the

> behavioral analogues of what the brain is doing via the EEG. If

you aren't

> aware of any emotional issues, it may be that there aren't any--or

it may

> simply be that the defense system your brain/mind have developed

are working

> very well.

>

> Sugar (which is required for the brain to produce the high pulse

rates) and

> caffeine (which stimulates same) would both be " helpful " in

maintaining that

> overactive cingulate, so I would expect that cutting them back

would feel

> helpful. That feeling of a hypoglycemic attack is also the feeling

many

> folks experience during a panic attack. Different people call it

different

> things, but the heart racing, sweating, shortness of breath,

weakness and

> dizziness are all signs of an autonomic response, and the autonomic

nervous

> system is directly linked to the limbic system (emotional brain).

>

> Sleep onset problems can be related to SMR production problems or

to anxiety

> or high levels of beta, especially coherent beta, so your

experience there

> would be consistent with what we might expect.

>

> If you are a heavy beta producer already, then pushing your brain

to produce

> more beta would not be a great idea and might very well make you

feel more

> sleepy.

>

> Level 2 workshops cost $350 and will be held this fall in Irvine, CA

> (9/21-22), Minneapolis (10/25-26) and Detroit (11/9-10). Depending

on how

> much you have spent on assessments, this is a pretty exceptional

bargain.

> In 2 days (16 training hours) you will not only have an assessment

done and

> develop a training plan for yourself, but you'll actually learn how

to DO

> it, so you can review and update it in the future if you wish.

>

> Without more information about what your EEG looks like, it's hard

to do

> anything more than speculate. I recall that I did suggest several

possible

> protocols in my last response to you, and I'm wondering if you've

tried any

> of those.

>

> Pete

>

> I have done an assesment and underwent around 38 training sessions

> with trained professionals. I would say around 33 of the 38 sessions

> were spent on augmenting Beta and inhibiting Theta in C3. The rest

> of the sessions were encompassed augmenting SMR and inhibiting Theta

> in C4.

>

> My concern is that the approach of the clinic I attended was too

> narrow. This is why I am trying to get other opinions on the matter.

>

> I found this comment pretty interesting.

>

> " It is a way that many brains cope with an underlying mood

> issue--sometimes anxiety, often depression. If you just remove the

> coping mechanism but don't deal with what it's coping with, you may

> not be very happy with the results. "

>

> If this is true in all cases, I honestly don't know what it is I am

> attempting to cope with. I have been classified as a purely

> obsessive type. And these days, I experience anxiety on occasion

> with regards to worrying about worrying...if that makes sense;

> especially after I eat certain foods. I am looking into the

> possibility that I am hypoglycemic...but the foods that are

> affecting me don't necessarily contained refined sugar. My

> ruminations have become more manageable after eliminating sugar,

> salt, and caffiene.

>

> Also, could you give me a little more info on the level 2 workshops?

> Maybe cost, dates...etc. And as far as my sleep was concerned, I

> had trouble falling asleep. So, this may imply that SMR may have

> more of an affect?

>

> Lastly, I become extremely tired after doing a biofeedback session.

> For instance, I just completed a Beta training session in C3, and I

> am having lots of trouble getting my thoughts down in this memo.

>

> Is there anything you reccomend to minimize this effect?

>

> Thanks,

>

> Mike

>

>

>

>

>

[Guest guest]

Mike,

Did the clinician file your insurance forms and get a pre-certification for treatment? The only way I know of that insurance would cover NF is if psychotherapy is included as a part of your treatment. As of now, neurofeedback is NOT covered by any insurance company, it is still considered by insurance companies to be experimental.

This clinician should have known about 6-10 weeks into treatment that the insurance rejected your claim and should have informed you. Unless you sent off the claim forms yourself for reimbursement? As a clinician, I do believe the patient has a responsibility to call their insurance company to make sure benefits are being paid as well. Sorry to hear you had such a bad experience in our field. You can always call the AAPB (Wheat Ridge Colorado), to make a formal complaint about your experience. The phone number is 303-422-8436.

Best, JoAnn

Biofeedback Center of Florida,INC

Bonita Springs, Florida 34135

239-949-2300

[Guest guest]

Mike,

I'm sorry to hear about your experience with these folks. You could try reporting to the Biofeedback Certification Institute of America (you can find them by searching on the internet) or whatever professional organization they belonged to (your state psychological association, for example, if they were psychologists), or to your state insurance commissioner. All in all, though, it sounds like it will be your word against theirs, unless you got something in writing.

I guess the old caveat is still worth remembering: when something sounds too good to be true, it probably is.

A theta/beta ratio at the C sites of 2.0 isn't terribly high. But the place I'd be looking, as I mentioned before, would be at Fz or Cz. Try running an eyes-closed session for 2-3 minutes at Fz referenced to your left ear and see what it shows.

Let me know what your reactions to the protocols are.

Pete

-----Original Message-----From: mike_willster [mailto:mike_willster@...]Sent: Wednesday, September 18, 2002 2:12 PM Subject: Re: Training Protocol for OCDPete,I never had a QEEG done, but only an EEG. From this, the professionals I worked with determined my training protocol.Which brings me to another point, kind of unrelated to the topic, but important. When I started my EEG sessions I informed the clinicians I was working with that I wouldn't be able to handle the cost of treatment without aid from my insurance company. My insurance company initially rejected, but my clinician informed me that due to his contacts, insurance will in fact cover the treatment. Based on this and this alone, I continued to recieve therapy from this institute. In addition, they told me that I no longer had to pay for sessions out of pocket, so I didn't. Well, about 2 months after I completed my last session, I got a letter from this institute informing me that my insurance will not cover any of the payments, and that I will have to foot the bill myself...upwards of $2500. I wrote back, informed them of what had happened, and they completely denied the above referenced conversations ever took place. At this point in time I don't know what I can do except file a report with the Better Business Bureau. I was wondering if you knew of any biofeedback guilds or organizations that I can report this to.But back to the issue at hand...I am currently not a heavy producer of beta...at least not in C3 and C4. In these areas my beta to theta ratio is around 1:2. I will try some of the protocols you suggested later on tonight. Because I usually get pretty tired after training and wouldn't want that to affect me throught the day. Also, if you could tell me which regions would be beneficial to see, I can take a few screen shots of eeg readings and email them to you, Thanks again,Mike> Mike,> > As you have probably noticed from the responses to your question on> Biofeedback as well as mine, OCD is generally characterized by an EXCESS of> beta--not a shortfall of it. I believe you said on Biofeedback that you had> done a Q, but this orientation toward doing C3 beta and C4 SMR for "primary> OCD" suggests your professionals had been trained in the EEG Spectrum model> (perhaps some time back) and, if they did get a Q, didn't have much of an> idea what to do with it.> > Switching problems show up as extremely high activity in the cingulate area,> an area which is responsible, among other things, for providing some> cortical control for the emotional brain. When it is very very active, that> certainly suggests that it is working very hard to keep something under> control, though I suppose it might be so for other reasons. Looking at the> behavioral characteristics of "OCD", there is a racing mind, and a tendency> to intellectualize rather than expressing emotions easily. Those are the> behavioral analogues of what the brain is doing via the EEG. If you aren't> aware of any emotional issues, it may be that there aren't any--or it may> simply be that the defense system your brain/mind have developed are working> very well.> > Sugar (which is required for the brain to produce the high pulse rates) and> caffeine (which stimulates same) would both be "helpful" in maintaining that> overactive cingulate, so I would expect that cutting them back would feel> helpful. That feeling of a hypoglycemic attack is also the feeling many> folks experience during a panic attack. Different people call it different> things, but the heart racing, sweating, shortness of breath, weakness and> dizziness are all signs of an autonomic response, and the autonomic nervous> system is directly linked to the limbic system (emotional brain).> > Sleep onset problems can be related to SMR production problems or to anxiety> or high levels of beta, especially coherent beta, so your experience there> would be consistent with what we might expect.> > If you are a heavy beta producer already, then pushing your brain to produce> more beta would not be a great idea and might very well make you feel more> sleepy.> > Level 2 workshops cost $350 and will be held this fall in Irvine, CA> (9/21-22), Minneapolis (10/25-26) and Detroit (11/9-10). Depending on how> much you have spent on assessments, this is a pretty exceptional bargain.> In 2 days (16 training hours) you will not only have an assessment done and> develop a training plan for yourself, but you'll actually learn how to DO> it, so you can review and update it in the future if you wish.> > Without more information about what your EEG looks like, it's hard to do> anything more than speculate. I recall that I did suggest several possible> protocols in my last response to you, and I'm wondering if you've tried any> of those.> > Pete> > I have done an assesment and underwent around 38 training sessions> with trained professionals. I would say around 33 of the 38 sessions> were spent on augmenting Beta and inhibiting Theta in C3. The rest> of the sessions were encompassed augmenting SMR and inhibiting Theta> in C4.> > My concern is that the approach of the clinic I attended was too> narrow. This is why I am trying to get other opinions on the matter.> > I found this comment pretty interesting.> > "It is a way that many brains cope with an underlying mood> issue--sometimes anxiety, often depression. If you just remove the> coping mechanism but don't deal with what it's coping with, you may> not be very happy with the results."> > If this is true in all cases, I honestly don't know what it is I am> attempting to cope with. I have been classified as a purely> obsessive type. And these days, I experience anxiety on occasion> with regards to worrying about worrying...if that makes sense;> especially after I eat certain foods. I am looking into the> possibility that I am hypoglycemic...but the foods that are> affecting me don't necessarily contained refined sugar. My> ruminations have become more manageable after eliminating sugar,> salt, and caffiene.> > Also, could you give me a little more info on the level 2 workshops?> Maybe cost, dates...etc. And as far as my sleep was concerned, I> had trouble falling asleep. So, this may imply that SMR may have> more of an affect?> > Lastly, I become extremely tired after doing a biofeedback session.> For instance, I just completed a Beta training session in C3, and I> am having lots of trouble getting my thoughts down in this memo.> > Is there anything you reccomend to minimize this effect?> > Thanks,> > Mike> > > > >

[Guest guest]

Mike,

I guess you have to weigh the positives Vs the negatives here. Unfortunately, clinicians sometimes try to find a way to get the sessions paid for by insurance companies to help open the doors for individuals that would not otherwise be able to pay for the treatment. From a professional and personal standpoint, I would not bill for a service I did not provide, it is called fraud. Insurance companies take this issue very seriously. You will figure out how weather to report them or just enjoy your new found clarity.

Good luck, JoAnn

Biofeedback Center of Florida,INC

Bonita Springs, Florida 34135

239-949-2300