Re: Bipolar disorder

July 19, 2006

Hi Sheila (we met at Pete's workshop in Vermont I think :-))

I have worked with one Bipolar client very conservatively since she was doing

very well with psychotherapy but wanted to do nfb since she said it was such

hard work managing her thoughts, emotions and behavior consciously. I started

off doing a LOT of what you are doing - t3t4a1 bipolar placement finding the

reward band which was helpful to her (it was 12-15 hz for her) along with

continuing working psychotherapeutically with her and her husband also. She had

a lot of hibeta at the temporals which she learned to decrease with practice -

this decreased her anxiety and agitation. More recently I started doing Pete's

wideband squash with amplitude and variabilty feedback at fp1a1gfp2a2 and it has

worked wonders for her impulse control and ability to self soothe more easily.

Even with the eyeblink artifact it seems more helpful to her than NirHEG did.

At first she would almost fall asleep after just 30 seconds of practice - this

kept getting better and better until now she can go for about 20 minutes and

just take a few breaks when the amplitude starts to go way up. I keep in close

contact with both partners as her husband can see problems developing that she

doesn't always report but does recognize when he talks about them. I also

started off with very short practice runs and watched the eeg closely. I

DON'T want to see her becoming more disregulated!! One thing that I learned

somewhere :-) is that it can be disregulating to work with frontal balance

protocols with bipolar clients - they move from depression to mania so quickly

sometimes that training to quiet or activate on side or the other can trigger

problems.

Good luck - I think your client may well be different - I would go slowly and

look at the eeg as you train and use Pete's protocols depending on what they

want to change and what the eeg patterns are. I don't thing there is a " one

size fits all " training protocol. She really needed to work on her executive

function and that's why I chose prefrontal work.

Tegan

---- Sheila McQuinn wrote:

> I have not been successful in locating the portion of the brain-trainer

website that discusses disorders and/or general EEG conditions such as cortical

instability and treatment approaches. Could someone help me out here?? Also,

I'd like to know what your experience has been with various protocols and

bipolar disorder. Currently I am using single channel bipolar placements C3/C4

and T3/T4. I need a jumper and don't have one, and some feedback from others in

moving to two channel feedback for this. I am getting good results with two

clients with the above, but think we can probably do even better. What have you

all experienced?

> Thanks,

> Sheila

July 19, 2006

Sheila~

For Bipolar the Othmers use interhemispheric training starting at T3 T4 g squashing 2-30 and rewarding a sweet spot which actually goes quite low in some folks. and then you move around the head changing the reward slightly according to what you found it was at T3 T4, always ending with a T3 T4 session. Jane, if she sees your post would be a good person to tell you more as she has had great success with this method. If you look back at posts from Jane, I think around Feb of last year, she talked about what she has done .

My understanding is that you will find these folks have a lot of variance in their EEG, the interhemispheric squashing helps to stabilize that.

~

Bipolar disorder

I have not been successful in locating the portion of the brain-trainer website that discusses disorders and/or general EEG conditions such as cortical instability and treatment approaches. Could someone help me out here?? Also, I'd like to know what your experience has been with various protocols and bipolar disorder. Currently I am using single channel bipolar placements C3/C4 and T3/T4. I need a jumper and don't have one, and some feedback from others in moving to two channel feedback for this. I am getting good results with two clients with the above, but think we can probably do even better. What have you all experienced?

Thanks,

Sheila

July 19, 2006

Thanks to both and on the bipolar info. I was not on the list in Feb to go back and find Jane's material. Would that be in the archives Nick was asking about? Also, how do I get a jumper when moving to two sites?? I am worried about introducing ANY variance between the hemispheres, and am unclear as to how the placements go when not doing Othmer's but rather Pete's. Would I have homologous pairs for each active? Like T3gT4 and P3 gP4 ?? I presume the jumper would go on the ground??

Thanks,

Sheila

Bipolar disorder

I have not been successful in locating the portion of the brain-trainer website that discusses disorders and/or general EEG conditions such as cortical instability and treatment approaches. Could someone help me out here?? Also, I'd like to know what your experience has been with various protocols and bipolar disorder. Currently I am using single channel bipolar placements C3/C4 and T3/T4. I need a jumper and don't have one, and some feedback from others in moving to two channel feedback for this. I am getting good results with two clients with the above, but think we can probably do even better. What have you all experienced?

Thanks,

Sheila

July 19, 2006

Sheila:

You can order jumpers from MVAP for $7.25. Phone is .

Jim

-----Original Message-----From: braintrainer [mailto:braintrainer ]On Behalf Of Sheila McQuinnSent: Wednesday, July 19, 2006 1:59 PMTo: braintrainer Subject: Re: Bipolar disorder

Thanks to both and on the bipolar info. I was not on the list in Feb to go back and find Jane's material. Would that be in the archives Nick was asking about? Also, how do I get a jumper when moving to two sites?? I am worried about introducing ANY variance between the hemispheres, and am unclear as to how the placements go when not doing Othmer's but rather Pete's. Would I have homologous pairs for each active? Like T3gT4 and P3 gP4 ?? I presume the jumper would go on the ground??

Thanks,

Sheila

Bipolar disorder

I have not been successful in locating the portion of the brain-trainer website that discusses disorders and/or general EEG conditions such as cortical instability and treatment approaches. Could someone help me out here?? Also, I'd like to know what your experience has been with various protocols and bipolar disorder. Currently I am using single channel bipolar placements C3/C4 and T3/T4. I need a jumper and don't have one, and some feedback from others in moving to two channel feedback for this. I am getting good results with two clients with the above, but think we can probably do even better. What have you all experienced?

Thanks,

Sheila

July 19, 2006

Sheila~

Yes, you would find the post is the archieves. Ill look for it.

I dont think you have to worry about increasing variances while doing 2 C squashes. Placements would depend on what is going on in the assessment. T3 A1 g T4 A2 is a common placement but you wouldnt nessesarily need a jumper for that. Jumpers are placed in the 2 reference plugs of your device and the 2 references leads are placed into the jumper., only if you want linked references.

Here is Jane's posting from 2/2005

~

>>>> Oops, I wrote the protocols in the wrong format. The protocols are>> T3/T4 with the ground at A2.>> P3/P4 with the ground at A2.>> Fp1/Fp2 with the ground at A2.>> Jane

Protocols for bipolar disorder

Message List

Reply | Forward

Message #8372 of 15143

< Prev document.writeln("< Prev"); |

Next > document.writeln("Next >");

Hello all,I've received many requests for the protocols I've used with my son.I'm posting them below. Please email me if you need clarification.These are Sue Othmer's protocols and she should receive full creditfor developing them and for her wonderful commitment to helpingunstable kids. Following the description of the protocols is anexplanation of the how it is that broadband inhibits combined with areward band works (from Sig Othmer). If you have any questions aboutthe protocols and how they work, Sue is available to help. Herconsultation fee is minimal, and she is a very generous and supportiveperson.INTERHEMISPHERIC TRAININGSue's protocols are 1-channel interhemispheric placements. She startswith calming at the temporal lobes and adds other protocols untilyou'll be doing 3 protocols each session with the child.1. Start with T3-A2-T4 for mood and physiological instabilities.Inhibit 2-13 and 14-30. You'll have to fool around to find the rightreward band. What you're looking for is a bit difficult to explain toa child. A good reporter should be able to tell you when he or shefeels a sense of body calmness or a sense of well-being. My son is nota good reporter, but I noticed when he had stopped fidgeting in hischair, and I used that reward band for 2 weeks. I didn't feel I hadgone as low as I could, though. So, I experimented again, going downtill I reached a band where he couldn't keep his eyes open. I went up0.5 herz at at time from there until I reached a band at which hecould keep his eyelids propped open. I stopped there (5-8 hz).Sue suggests starting as 12-15 as a reward band. In truth, you'llprobably end up rewarding a band that's very low. (I reward my son at5-8 and Sue used an example of 1-5 in a talk I just heard her give),so why not start at 10-13 or 9-12?Sue also suggests going down on the reward band very slowly. In otherwords, don't try to find the right reward band in one session. Spendthree or so sessions experimenting with it. I was impatient and foundour band in two sessions without doing my son any harm.Thresholds--Set the thresholds very loosely. The purpose of the broadbands is to cut off the activity spikes. Using Brainmaster software,she suggests setting the inhibit thresholds for the 2-13 band at 15percent and for the 14-30 band at 5 percent. Using Bioexplorersoftware, that would be 85 percent & 95 percent.. (I set mine a littletighter, adjusting between 70 and 85 percent for both). I set thethreshold for the reward band almost as loose, usually at 75 percent.Eyes open—All of these protocols are eyes open. My son used to watchthe screen and get both visual and auditory feedback. He's trained foralmost two years on and off, and I'm not very strict at his point. Hegenerally reads or plays play computer games that are independent ofthe auditory feedback.2. Do the T3-T4 training on its own until you or the child noticesthat his or her arousal triggers are lower. This was definitelyevident in my son after just a few sessions. He was not as quick toanger, etc. Although the mood improvements did not last very long, Iknew we were on the right path. When you notice that he or she iscalming, you're ready to add training at the parietals.3. Training at the parietals is for physical calming, emotionalawareness, empathy. At P3-A2-P4 , set the inhibit bands the same as atT3-T4. For the reward band, though, subtract 4hz from whatever bandworked at T3-T4. Training at the parietals made my son moreaffectionate. You'll end each session with training at T3-T4. (My sonwould only train for about 20 minutes. So, sometimes, if he was havinga bad day, I did only the T3-T4 training for 20 minutes rather thando the P3-P4 for 10 minutes and the T3-T4 for 10 minutes.)4. When you feel like you're getting some results from the P3-P4training, you'll add Fp1-Fp2 for impulse control, and compulsive anddisinhibited behaviors. Do this very carefully, as the kids can have avery extreme reaction to working at the front. The inhibit bands arethe same as they are at the other sites. For the reward band, subtract2 hz from the T sites. I started out very cautiously at the frontalsites. I think I started with 1 minute and went up 1 minute at a timeover several weeks. 've never trained my son for more than 5 minutesat the front. At this point, you're be doing the Fp sites training,then the P sites training, and still ending with the T sites trainig.(My son became depressed about a month ago. After so muchneurofeedback and such long-term stability, I thought it would be safeto try the alpha asymmetry training. I did exactly 1.75 minutes of itat f3 & f4. He jumped up from the chair, joking around and laughing. Ihaven't done it since. I'm telling this story because I think itsupports the idea that these kids are very sensitive to training atthe frontal sites.)Some advice from Sue· If you're too low, you'll see hyper-ness or goofy· If you're too high, you'll see agitation or meanness.· If as you add the other sites, you don't see good results, yourreward band may be too high. So, fiddle with the frequencies at theparietals or go back to the temporals and fiddle with the reward bandthere.· After months of training, when I felt we weren't seeing as goodresults, I went back to the temporals and ended up lowering the rewardband there. I also lowered the bands at P3 & p4 and at fp1 & fp2.However, that didn't' work well. I got extreme meanness. So, I endedup lowering the temporals' reward band by .5 hz and leaving the p'sand fp's alone.AN EXPLANATION FROM SIG OTHMER"The reward operates on the ebb and flow of spindle-burst activitywithin the band. This signal is always available, and nearly alwaysyields useful information. The inhibit cuts in only when the EEGamplitude in the relevant band exceeds a certain threshold, and thatthreshold is set so that it is only exceeded a small fraction of thetime, say 15%. You can think of the inhibit either in terms of eventdetection, or as a "disregulation detector.""When the EEG amplitude in the inhibit band reaches extremes of highamplitude under benign conditions, it is deemed to indexdisregulation. This disregulated activity can of course also involvethe same EEG frequencies that we focus on with the rewards. There areno intrinsically good frequencies, and there are no intrinsically badfrequencies. There are only good and bad states of brain function,which we do our best to discern."When a broad-band inhibit is installed, we can catch both narrow-bandactivity anywhere in the band, or broadband paroxysmal activity,whatever happens. We are really interested in the reward band activityonly when the inhibits do not compromise that signal. The overlap inthe bands is therefore not a problem for several reasons. It's reallynot a case of driving a car with one foot on the accelerator (therewards) and one on the brake (the inhibits). When the inhibits areengaged, the rewards at that moment are a secondary issue."Siegfried Othmer, Ph.D.www.eeginstitute.comOTHER PROTOCOLS FOR BIPOLAR DISORDERI've been at this for almost two years. Over this time, I've gotten somuch help and advice from practitioners on various listserves. I'llput this other advice together and post it over the next few weeks.Good luck to all!!Jane

..

July 20, 2006

Hey Kat, How do you find the sweet spot to reward? Duncan wrote: Sheila~ For Bipolar the Othmers use interhemispheric training starting at T3 T4 g squashing 2-30 and rewarding a sweet spot which actually goes quite low in some folks. and then you move around the head changing the reward slightly according to what you found it was at T3 T4, always ending with a T3 T4 session. Jane, if she sees

your post would be a good person to tell you more as she has had great success with this method. If you look back at posts from Jane, I think around Feb of last year, she talked about what she has done . My understanding is that you will find these folks have a lot of variance in their EEG, the interhemispheric squashing helps to stabilize that. ~ Bipolar disorder I have not been successful in locating the portion of the brain-trainer website that discusses disorders and/or general EEG conditions such as cortical instability and treatment approaches. Could someone help me out here?? Also, I'd like to know what your experience has been with various protocols and bipolar disorder. Currently I am using single channel bipolar placements C3/C4 and T3/T4. I need a jumper and don't have one, and some feedback from others in moving to two channel feedback for this. I am getting good results with two clients with the above, but think we can probably do even better. What have you all experienced? Thanks, Sheila

July 20, 2006

Sheila,

The brain-trainer website doesn't try to cover " disorders " , partly because so

many of them (like " cortical instability " , as you mention, are so broad and

poorly defined--at least in terms of brain patterns--that there's not much to

say about them). And it doesn't offer treatment approaches, per se. The TLC

approach assumes that we look at the client in some detail (to identify target

behavioral changes) and then look at the brain through a brain-based assessment

to see if we can identify one or more activation patterns in the EEG that are

consistent with the difficulty the client is experiencing. Once we identify

several of those, we test them with the client (like testing hypotheses) until

we determine which one(s) have the most positive effect, and then we train those

consistently until they become stable new patterns.

You can get jumpers from a number of sites that sell electrodes. Can't tell you

off the top of my head what the sources may be, but they are pretty

cheap--usually $6-10.

I'll let others who have worked more with bipolar respond to your questions, but

I will say that it appears you are on the right track working both hemispheres

at the same time.

Pete

>

> Date: 2006/07/18 Tue PM 02:03:57 EDT

> To: <braintrainer >

> Subject: Bipolar disorder