BPD и HEG

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Dan Tuttle
I'm sure this has been asked before, but has anyone actually successfully treated a borderline personality disorder case with Neurofeedback? I could write paragraphs on why it might or might not work, but am interested in what others have experienced?

Leon Petchkovsky
Dear colleagues
PLEASE be aware that Borderline can be a pejorative term, and that a much kinder and more accurate description of these conditions is Developmental Trauma Disorder.
Appropriate psychotherapy combined with a range of NF protocols can have a MAJOR healing effect (Check out the writings of Bessel Van der Kolk and Sebern Fisher on this and related topics).
I have found in my practice that sometimes, ketamine enhances this positive effect. (Read Martin Teicher on this)

Orli Peter
The dx of BPD is complex in and of itself — about ten years ago there was a movement among trauma specialists to substitute the category “early childhood trauma” for BPD because 1) BPD was so highly correlated with developmental trauma and 2) the same detrimental effects on brain development found in those with developmental trauma mirrored they symptoms in BPD. Soon after that, NIMH required those who wanted to study BPD to substitute the dx of BPD (and others) with its “brain based” effects.
So with those caveats, I can tell you that I have seen great success with using NFB in treating the emotional regulatory component of BPD. There is an emotional regulation network that goes from the PGA to the Amygdala to the mPFC. Ruth Lanius has down trained the amygdala to allow the mPFC (especially the right mPFC) to come on line to strengthen the network. And a couple of other researchers have down trained alpha (yes, down trained) on the PCC (the major hub in the DMN network) that has had a similar effect.
I often go straight for the mPFC with simple HEG while I instruct the patient (after a number of psychotherapy sessions for prep) to recall the emotionally turbulent event while increasing blood flow to their mPFC.

Michael Sitar
Thanks, Orli for sharing this... but which HEG... nir or pir?

Orli Peter
In answer to your question, I have used both NIR and PIR and have not noticed any significant difference between them. In terms of where on the mPFC to place them, research on the network is a bit mixed, but leans towards the right mPFC showing more disruption pre-treatment, so I usually place it there.