impulse control problems

[Guest guest]

I’ve just done an assessment on a 36 y.o. male

with impulse control problems. The referral from the MD says he has “obsessions

towards wanting to be kissed and cuddled by girls”. He actually has a

history of assault charges and did 8 years in jail for rape … the last

two years being raped himself almost daily by a murderer. He is really scared

of ending up there again, but can’t keep his hands off women.

I expected frontal dysfunction, but all theta/beta

ratios are within range and SMR is 10.3%. There are no elevated beta

percentages (except P4 at 15.7%) and beta is nice and low on the frontal

midline. Swingle ratio is just outside the range at 0.61 and there is no

obvious blocking pattern. He also performed extremely well at all tasks.

The obvious thing on the assessment is elevated alpha

in the EC condition, although it blocks very well. Alpha percentage and

amplitude are largest at FZ and alpha peak frequency, which is slow everywhere,

is also slowest at FZ at 8.53 Hz. He started taking Zoloft two weeks ago. There

are also reversals present.

I know there is an alpha subtype for OCD, so perhaps

this is what is going on? He was also doing a lot of throat clearing and

sniffing throughout the assessment which he says he always does, which sounds

like a tic.

Any feedback would be appreciated.

Mark Darling

[Guest guest]

Hi Kat,

We must be on a similar wavelength (ha ha ha!), because I’ve

already done the first session with a C4-Fz montage, inhibiting 2-10 and 22-38

Hz and rewarding 12-15 Hz. We’ll see what happens! Thanks for your input.

Mark

Re:

impulse control problems

Dear Mark,

I've been working with a similar client in his 50s

who came wanting to stop his " criminal ways " so he wouldn't get sent

back to prison, where he's spent most of his adulthood. As we

discussed his criminal ways, it became clear that the issue was primarily one

of impulse control, secondarily lack of empathy. The only distortion in

his assessment was excess alpha 30+% all over, primarily 8-10HZ.

We've had great success using nirHEG and an alpha peak

up design (inhibit 2-10 & 15-38, reward 10-13) at F3 and FZ (based on the

highest figures in his assessment). He says he feels awake and

" crisp " for the first time he can remember, able to check his

impulses before acting, remembering a lot more of his history, and having

feelings for the first time. And having feelings, he's beginning to

imagine what other's might be feeling. He also stopped biting his nails

and grinding his teeth.

So, I would recommend working with the alpha to bring down

amplitudes increase peak frequency. I've also heard that any excess

frequency at FZ can relate to OCD, especially alpha.

Kat Duff

impulse control problems

I’ve just done an assessment on a 36 y.o. male

with impulse control problems. The referral from the MD says he has

“obsessions towards wanting to be kissed and cuddled by girls”. He

actually has a history of assault charges and did 8 years in jail for rape

… the last two years being raped himself almost daily by a murderer. He

is really scared of ending up there again, but can’t keep his hands off

women.

I expected frontal dysfunction, but all

theta/beta ratios are within range and SMR is 10.3%. There are no elevated beta

percentages (except P4 at 15.7%) and beta is nice and low on the frontal midline.

Swingle ratio is just outside the range at 0.61 and there is no obvious

blocking pattern. He also performed extremely well at all tasks.

The obvious thing on the assessment is elevated

alpha in the EC condition, although it blocks very well. Alpha percentage and

amplitude are largest at FZ and alpha peak frequency, which is slow everywhere,

is also slowest at FZ at 8.53 Hz. He started taking Zoloft two weeks ago. There

are also reversals present.

I know there is an alpha subtype for OCD, so

perhaps this is what is going on? He was also doing a lot of throat clearing

and sniffing throughout the assessment which he says he always does, which

sounds like a tic.

Any feedback would be appreciated.

Mark Darling