 Obsessive Compulsive Disorder (OCD) is comprised of two parts: obsessions and compulsions. Obsessions are thoughts and compulsions are behaviors. OCD is classified as an anxiety disorder because it is generally driven by anxiety. Obsessions are unwanted, intrusive thoughts that cause a person distress. Compulsions are behaviors in which a person engages to reduce the anxiety caused by the obsessions. Common compulsions that the general public is familiar with include when people will engage in checking behaviors and cleaning behaviors. The variations of presentation of OCD are quite extensive and not the focus of this blog entry. But whatever the presentation, OCD can be a debilitating condition. Some of the more effective treatments for OCD historically has been exposure therapy and cognitive behavioral therapy. Medications, especially selective serotonin reuptake inhibitors and tricyclic antidepressants, are generally most effective for OCD. But medication is not able to help all cases. Additionally, medications can have unwanted side effects. Some people refuse to engage on exposure therapy because it is by definition unpleasant.  Brain image of a patient with OCD who has elevated activity in various locations in the brain related to OCD symptoms. Neurofeedback offers another treatment for OCD which can be very effective in treating all components of OCD including anxiety, obsessions and compulsions. In my office, a brain map (also known as qEEG analysis) is conducted to identify areas of the brain that have been found in research to relate to OCD. Areas of the brain frequently found dysregulated include the cingulate gyrus, anterior cingulate gyrus and orbitofrontal cortex (Brodmann area 11). Other regions can be involved including other parts of the frontal cortex, insula and the amygdala, which drives anxiety. I almost always find excessive theta wave activity in the anterior cingulate in patients with OCD.
After identifying which specific areas of the brain are dysregulated, Neurofeedback can be done to retrain these areas of the brain linked to OCD symptoms. Patients then report improvement in OCD symptoms. I do additional testing such as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) to get baseline measures of function and then track improvement. When Y-BOCS scores are normalized, treatment stops. I then track patients over a period of 6 weeks to see if scores remain normalized. In all the cases of OCD I have treated, the improvements made are permanent and no other therapy is needed. Some research has been done on OCD and Neurofeedback. Articles are listed below. If you or someone you know suffers from OCD, help is out there. Please contact my office in Palm Harbor, Florida and schedule an appointment.
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 SOT® uses wedge-shaped blocks placed under the pelvis to gently yet effectively bring the body, especially the sacroiliac joint, back into balance. In October of 2021, I received my Advanced Proficiency level of certification in Sacro Occipital Technique (also spelled Sacro Occipital Technic ® or SOT®). I already had a general certification in SOT®. This advanced certification documents a level of mastery in specific advanced parts of SOT®, including Chiropractic Manipulative Reflex Technique (CMRT) and chiropractic craniopathy.
CMRT deals with the function of the organs in the body. It includes visceral manipulation to treat dysfunction in the organs that are contributing to people's problems. Conditions I frequently treat with CMRT are respiratory problems (including viral illnesses), allergies, gallbladder issues, stomach and digestive problems, adrenal dysfunction, liver issues, kidney issues, constipation, diarrhea, heartburn, gastroesophageal reflux disease (GERD), menstrual problems, menopause symptoms, and prostate issues. There are so many issues that can be helped with chiropractic craniopathy, since 80% of your nervous system is in your brain. Some of the more frequent ones I help in my office are headaches, traumatic brain injury, temporomandibular dysfunction (TMD; including dysfunction of the temporomandibular joint [TMJ]), trigeminal neuralgia, learning disabilities, tooth pain, dizziness, and vertigo. Babies' heads are often traumatized by the birth process, leading to problems like plagiocephaly, difficulty nursing or latching, and ear infections which can all be helped by chiropractic craniopathy. Chiropractic adjustments that do not hold can indicate an unresolved cranial bone issue. Since the brain controls the rest of your body, I've had cranial adjustments help things like neck pain, low back pain, sciatica, lymph drainage, and even ankle problems (really!). I am the only chiropractor in Pinellas County Florida with Advanced Proficiency SOT® level certification. Interested in knowing if SOT® can help you? Please contact my office to schedule an appointment.  NeuroNavigator swLORETA analysis shows dysregulation in the amygdala and other areas of the brain of this anxious patient treated at my office. Some anxiety is a normal part of life. But when anxiety levels increase to a point that it interferes with someone's health and happiness, help is out there.
One of the therapies I used for anxiety is Neurofeedback. The first step is to utilize quantitative electroencephalography (qEEG) and do a brain map to identify the parts of the brain that are not functioning efficiently. Neurofeedback can then be used to retrain those dysregulated areas of the brain. When this is done, symptoms go away. In my office, patients report these changes to be permanent and I some of them years after treatment as they may choose to also pursue chiropractic care with me or may have been an existing chiropractic patient before Neurofeedback. More recent research has shown that there is an anxiety network in the brain. Different areas of the brain can be involved. These include the amygdala, the insula, the middle frontal gyrus and superior parietal lobule. For conditions like OCD, the anterior cingulate, cingulate, and orbitofrontal gyrus should be considered. PTSD includes other regions. There are other areas that may be involved, depending on patient symptoms. Do you or someone you know have anxiety? They may have dysregulation in these areas of the brain. The good news is there is treatment for this including Neurofeedback. I also do traditional psychotherapy and EMDR in my office, which may be more appropriate, especially if the anxiety does not have a brain basis. This is all part of the comprehensive analysis and diagnosis done at Tuttle Health, LLC in Palm Harbor, Florida.  swLORETA map of a patient with an Anxiety Disorder and ADHD showing excessive alpha activity in the thalamus and other areas of the brain related to presenting symptoms. Neurofeedback works on the brain. Through pioneering research I developed, I have been able to show that the technique of chiropractic I use, Sacro Occipital Technique, also affects brain function. Many "brain problems" that result in conditions like ADHD, ADD, PTSD, OCD, Traumatic Brain Injury, insomnia, depression and anxiety can be viewed as a brain being "stuck" in a physiological pattern that needs to be disrupted to change. Adding chiropractic to a Neurofeedback program, adds another way to disrupt old patterns and introduce new ones. For much of its history, Neurofeedback used one or two electrodes placed on the head. I have successfully treated many patients with this form of Neurofeedback. However, not all patients are the same. Sometimes Neurofeedback with one or two electrodes isn't what the patient needs to reach their treatment goals. For this reason, I have invested in additional technologies and forms of Neurofeedback. These include:
 Research I conducted showed that SOT® blocks placed under the pelvis resulted in changes in brain activity suggesting enhancement of neuroplasticity.
You have a choice as to who provides you therapy. With this variety tools in my toolbox, I can create an individualized treatment plan to help you reach your treatment goals as quickly and effectively as possible.  swLORETA image showing elevated alpha activity in the thalamus and cerebellum as well as other locations. One of the new technologies I have for Neurofeedback is something called swLORETA z-score Neurofeedback. It is part of a program I used called Neuroguide.
Traditional neurofeedback uses one or two electrodes on the head to increase or decrease a particular frequency or frequencies. swLORETA z-score Neurofeedback uses 19 electrodes on the head to train the brain in 3 dimensions. It divides the brain into over 12,000 voxels or pieces and calculates the brain activity at those locations. I then compare that data to a normative database to determine what areas of the brain are different from the average human. If those areas of the brain are different, and they relate to the symptoms a person is having, then we can re-train those areas of the brain. For the first time, swLORETA allows deeper structures in the brain like the cerebellum to be viewed using qEEG technology. The cerebellum is very important in balance and coordination disorders, conditions like Parkinson's and is also now even being found to be involved in things like attention. swLORETA stands for standardized weighted low resolution electromagnetic tomography analysis. Advantages to swLORETA Neurofeedback is that it is more specific than traditional neurofeedback. Because it is more specific, it is being reported to work faster than other forms of traditional Neurofeedback and may succeed where other forms of Neurofeedback have reached a plateau in progress. Neurofeedback can be used to treat anxiety, depression, PTSD, OCD, ADHD, Autism, insomnia, traumatic brain injury, and is being investigated for use in cognitive problems associated with COVID-19. You can be assured you are getting the latest and greatest in technology when choosing Neurofeedback at Tuttle Health, LLC. Call today to schedule an appointment. 727-509-3760.  Neurolink Q links patient's symptoms to locations in the brain. Are you wondering what part of your brain might be involved in the problem you are having? Yeah, there's an app for that! There is a new app out called Neurolink Q. It allows a person to enter into it whatever symptoms they might be having and see what parts of the brain may be involved in generating their symptoms. For example if a person has anxiety, it will show what parts of the brain may be involved in generating anxiety. I use it in conjunction with a program called Neuroguide to do Neurofeedback with patients. I use Neuroguide in conjunction with a program called swLORETA which allows me to train the brain in three dimensions.  swLORETA technology shows elevated electrical brain activity in an anxious traumatic brain injury patient, show here with the yellow and red colors. Neurolink Q can be used with the doctor and patient to see what parts of the brain may be involved and then see how the patient's symptoms are changing over time.
The questions assess things like anxiety, depression, post traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), chronic pain, insomnia, attention deficit hyperactivity disorder (ADHD), early dementia, Parkinson's disease, alexithymia, autism, cognitive issues related to the coronavirus and various issues related to traumatic brain injury or concussion. If you enter this information, Neurolink Q does not send your information anywhere so you do not need to be concerned about privacy. If you WANT to send it to me, we can arrange for that but it takes additional steps. You can download the app here: http://anineurolink.com/mobile/APPgallery.htm Call 727-509-3760 to schedule an appointment. I am proud to announce that I am now a diplomate in QEEG (quantitative electroencephalography) as determined by the International QEEG Certification Board. QEEG is the mathematical analysis of brainwave activity and the skill and technology behind Neurofeedback. This is an advanced level certification currently only held by 126 other people in the world. This demonstrates a level of mastery that is not typically seen in most people providing Neurofeedback.
I already had the experience using qEEG technology having practiced and studied under great mentors in the field recording and processing thousands of EEGs and then conducting Neurofeedback with those patients. However, I saw the opportunity to refine and advance my skills even further and I chose to get this advanced certification. While over 100,000 studies have evaluated the use of qEEG, there is very little standardization as to how proficient a person is in using the technology, especially when used in a clinical setting (i.e., working with patients). One of the biggest advancements this certification gives is the ability to screen and read EEGs like a medical doctor does which is different than how they are read for Neurofeedback. This allows me to screen EEGs more effectively for red flags that would require a referral to a neurologist. It also brought me up-to-date on latest advancements in the field and ways of treating patients using Neurofeedback. Neurofeedback can be used to train a variety of brain-based conditions such as anxiety, depression, Post Traumatic Stress Disorder (PTSD), Attention Deficit Disorder (ADD), Attention Deficit Hyperactivity Disorder (ADHD), Traumatic Brain Injury (TBI), Obsessive Compulsive Disorder (OCD), insomnia, chronic pain, migraines and autism. In collaboration with neurologists, it can also be used treat epilepsy. Call my office at 727-509-3760 to learn more and schedule an appointment.  The COVID-19 virus is having unprecedented effects on society and individuals. I recently watched a presentation by world renowned expert on PTSD Bessel Van Der Kolk about COVID-19 and PTSD. As a mental health professional, I have taken his seminars and even had lunch with the man. His knowledge and understanding of PTSD cannot be understated and his approach to dealing with patients is something I use in my office everyday.
He had some strategies for how to approach this situation with PTSD patients, but it's really good advice for everyone. One of the things he talked about was the need to keep moving. One of the reactions in a traumatic experience is the fight or flight mechanism. From an evolutionary standpoint, if we were to be attacked by a bear we would either fight it or run away from it. We are now being attacked by a virus. But instead of being able to directly fight it or run from it, we are for the most part constrained to our homes which can leave us sedentary. What can we do? Our ability to attack it or run from it has been stopped by being on lockdown. But we can take that energy and put it into other things. We can do things around the house. We can clean. We can build things. We can do at-home exercise programs such as yoga or tai-chi which have a calming effect on the body. As a family, we can do things together like cook meals. We can go outside and walk or run. Using this approach can help relieve some of the built up tension from this global crisis and put us in a better state of mind.  A common New Year's resolution is to begin exercising more. As we move in the year 2020, I have noticed that several of my patients have decided to go from little or no exercise to very intense exercise training programs. These people then end up in my office injured seeking my chiropractic services.
This brought to my attention an important point that I think people forget about. Part of being strong and mighty is also respecting your body and limitations of matter. I am a big supporter of exercise with my patients. Generally speaking, the more they can keep moving, the better. Peak performance, trying to reach goals in fitness to maximize a person's physical capacity and being a hard worker are all good things. And while these things can be done at any age, people's well-intentioned ambitions can blow up in their face landing them at the chiropractor or worse orthopedist if they move faster than there body will allow. These injuries occur because the body is being shocked into a state it is not accustomed to. It's a good idea to build up gradually and incrementally to reach your fitness goals. I can recommend personal trainers that can help you start working out without hurting yourself. I'm always here to help my patients or a new patient who may have injured themselves. If you have hurt yourself, professional help is right here at my office. 727-509-3760 or click above to schedule online.  Chiropractic is so important for a healthy pregnancy and easier birthing process. Why?
The pelvis consists of your hips (ilium) and sacrum (what people often call their tailbone). The uterus and hence baby are positioned over these structures. The uterus is suspended by a series of ligaments that attach to the pelvis. When they are out of alignment or proper position, they will create tension and distortion of the uterus. This in turn puts strain on the baby inside the mother. It is more difficult for the then distorted baby to then pass through a distorted pelvis. This increases the likelihood of a longer labor, more difficult delivery, and c-section. The sacroiliac joint is particularly prone to instability in pregnancy because the ligaments of the body become looser to allow the baby to pass through the pelvis. Because of this, the sacroiliac joint can become out of alignment, which creates the scenario described above. I use Sacro-Occipital Technique ® (SOT ®), which is a gentle way to help stabilize the sacroiliac joint. It is also helpful for things like sciatica, which can happen during pregnancy. Why not give you and your baby the best potential for a healthy and uneventful pregnancy and childbirth? Call the office 727-509-3760 or book online by clicking the link above. |
AuthorI'm a Chiropractic Physician, Psychotherapist and researcher. I'm interested in helping people live their lives to their full potential. That could be simply without pain. Or it could be without more complicated physical or mental health problems. Or it could be getting help in making changes in their life so that they can achieve their dreams. Archives
June 2022
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