Conversion d/o and peripherial Biofeedback


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  • Creativity is derived from profound energy sources within humans. Simple day to day activities--creating forms or changing shapes in their environment
  • Poetic side of me-reach up-grab the placebo Teach child to take himself out of danger. Internal power of……. Little children leave with something in hand as access to covert force linked to placebo. Find a mechanism or pathway to access the sun within and place us context Children’s words spoken or silent are their active placebo
  • How do we make connections? Feel/touch/imagine
  • Conversion d/o and peripherial Biofeedback

    1. 1. A Case study (2006) Conversion DisorderPeripheral Biofeedback Elizabeth L. Stroebel, PhD Neurodevelopment Center Providence, RI
    2. 2. My “biofeedback prescription” for this caseProfessional adaptability and collegiality Histoires de Nez (Kruss) 1989
    3. 3. Reference and Definition Boundaries Conversion DisorderREFERENCEEtiology, pathogenesis, phenomenology and management continue to arouse debate. Isaac, M. (2006) Current Opinions in Psychiatry, 19, 61-66.• Hysteria• Malingering (less common)- Feigned-Factitious disorders• Somatoform disorder• Conversion disorder• Psychogenic nonepileptic, pseudo seizures, conversion seizures• Dissociative disorderSTATISTICSIn strictly defined CD-estimated one in 5,000 per years. 2/3 women, appears any age usually between adol and 40. Note 1%-3% mild CD patients referred to mental health clinics.DEBATEDSM-IV ICD-10 classification unsuitable across cultures-call for reviewsGENERAL DEFINITION Psychological factors and autonomic activity-symptoms create appearance of medical illness that has not clear medical explanation (Harvard Mental Health Letter. Vol 22. Number 2, 2005)
    4. 4. Unexplained dramatic physical symptoms• Nausea, vomiting, abdominal pain, dizziness• Pallor and peripheral temperature• Violent tremors, frequent eye rolls• Non-seizures• Blindness (black contact patch) Eye rolls• Reading difficulty, inability to write• Paralysis (waist to fee)• Involuntary sustained contractions of opposing muscles causing twisted movements or abnormal fixed postures• Dysponesis (clenched and weakened fingers/hands). Reported total “bodily pain”• Heightened anxiety• Shallow rapid breathing, racing heart sensation, loud voice
    5. 5. Brief patient history• Hospital Admission• Background• Profile (patient)• Onset• Previous medical and psychological care
    6. 6. Treatment Plan In-patient*Complete medical evaluation Peripheral Biofeedback: An unremarkable integrative approach• In-patient hospital Modalities• Psychiatrist HRV---HeartMath/Freeze-Frame• Peripheral Biofeedback GSR---Galvanic skin conductance• Hypnotherapy Home trainers/audio tapes Quieting Reflex (Stroebel)• Behavioral modification Autogenic Training• Group Progressive Relaxation• Recreation Guided imagery and visualization
    7. 7. “….it is not the muscles which refuse to obey the will, but the will itself which has ceased to work.” Brodie(1837) Static electricity generated by fear, anxiety, anger consumed her….
    8. 8. Osmosis of BeingShe whispered………. “Look at me” “What am I?” “Who am I?” “I am a non-being” “I feel non-existent”Heidegger The plight of the dehumanized. Of connection of that which is real and that which is possible.OsmosisA process of absorption or diffusion from higher concentration to lower vulnerability.Usually effortless often unconscious assimilation with intermingling of kinetic “It is the dead bird in the heart that energy of molecules. kills.” Laurence Ferlinghetti Coney Island of the Mind
    9. 9. Placebo Hidden Present PowerfulThe power of the individual’scomplexity is a covert force linked tothe placebo. Seems inaccessible todirect observation yet surfaces asempirical phenomena. (C.F. Stroebel, MD)
    10. 10. Lessons from Biofeedback….“Still waters run deep” propelled downthe pathways of the nervous system tofuel symbolic construction, imagery,emotion, thought, and reactivity,wellness or illness” E. stroebel
    11. 11. “I’m not sure I can get better?” EMPATHY Histoires de Nez (Kruss) 1989
    12. 12. Biofeedback loop Self Regulation-Inner core of strength• Emotional strength• Empowerment• Participation• Not just hope but actualization and restoration
    13. 13. “Talking heads, hearts, and bodies”
    14. 14. Electrodermal (EDR) biofeedback in treating psychogenic nonepileptic seizure Pop-Jordanova et al. University of Skopje, Macedonia. Prilozi: 2005;26(2):43-51.Discriminative and validation for levels of distressGood therapeutic results for enhancing patients awareness of choice/power to self- regulateInterrupting dysponetic patterns/reactivityStabilization of hypersensitivity, lower neurotic tendencies. “emotional maturation”
    15. 15. Initial behavioral plan
    16. 16. Softening stress related physical and emotional pain
    17. 17. HeartMath Freeze-Frame Heart rate variability
    18. 18. DISCHARGE“Yeah me!!!! Yeah Me!!!!!! I’M IN THE GREEN”