Oh, look – there’s hope after all…

Great info over at The Rogue Tomato about The Bravewell Collaborative and their recent Summit on Integrative Medicine.

I’m just now finding this, myself, so I don’t have a lot to say about it. But it looks quite promising — especially since the Summit involved some very established physicians from some very established institutions.

If they’re paying attention to this, then my day just started looking a little brighter.

Which just goes to show, it’s never a good idea for me to completely lose hope. I don’t know nearly enough to despair responsibly ;)

A Perilous Relief – When Survival Backfires

The only problem with being able to survive terribly traumatic things is that our bodies have a way of hanging onto the stress of the situation, long past the event. Healthy processing of traumatic stress is a two-part process. Yes, traumatic stress is perfectly normal — one would expect that traumatic events carry a good deal of stress… if it doesn’t, something is wrong. The problems arise, when the stress becomes post-traumatic — when we continue to react to situations long after they’ve passed, and history hijacks our present (and future) by forcing us to react to situations and essentially live a life that has no basis in present reality.

While we’re in a state of crisis, our sympathetic nervous system (SNS) is aroused, delivering all the hormones and glucose and various biochemicals to our system. But after all is said and done, we need to get back to a resting state, so our bodies can recover. This means getting the parasympathetic part of our nervous system in gear.

The parasympathetic nervous system (PSNS) is the opposite of “fight-or-flight”. It’s about “rest and digest”. Some literature describes it as acting “in opposition to” the sympathetic nervous system, but it’s not antagonistic — it’s complimentary. The function of the PSNS is to offset the effects of the SNS, so our whole system functions properly. The PSNS calms down the racing heart, the panting lungs, the high blood pressure, and restores the blood supply to our digestive and reproductive organs. Everything that the SNS has demanded our bodies give up in order to save our ass from imminent destruction — attention to non-essential details, blood flow to digestive organs, the ability to sleep and have sex and pick up on subtle social cues — is restored by the PSNS in a far more gradual process than the hair-raising roller coaster ride that the SNS took us on. If we survive the ride, our parasympathetic nervous system lets us lift the proverbial safety bar, climb out of the car, and collect our spinning wits.

Now, if our SNS were allowed to constantly run unmodulated and unfettered, it would eventually wear us down to a nub. Like easy credit that makes it possible to buy sexy big-ticket items, purchase more house than we need, vacation at swanky exclusive resorts, and run up a massive tab buying rounds of Long Island ice teas for coach-loads of beautiful tourists who lavish you with attention, a constantly active sympathetic nervous system can really tax the physical system over time. As exciting as it may be, the drain on our physical resources is the equivalent of spending a whole lot more than you make with total intoxicated abandon. And we’ve all learned where that can take us, given enough time and intemperance.

Physically speaking, long-term one-sided excess takes a toll. Cortisol builds up… Blood sugar spikes throw off the body’s ability to effectively manage its own glucose and insulin… Adrenaline rushes keep muscles tense and stressed and unable to recuperate so they can recover their full strength… And more. Our internal organs, especially our heart, feel the burn. We put on weight. We can lose our hair and our ability to have sex. The list of issues that arise from persistent stress is lengthy, and it’s a little different for each person. But the fundamental rule of sustaining healthy living systems still applies:

You can’t keep taking away without putting back in, and expect to last for long.

Now, in a perfect world, for every shock and crisis and emergency (real or perceived) that comes up, we’ll have ample time to step back and relax, have a good meal, sleep long and deeply, and regain our strength. But that doesn’t always happen (and I would hazard to say, it happens relatively rarely in our modern American world). Our sympathetic nervous systems get all worked up, but our parasympathetic nervous systems don’t always get a chance to kick in to chill us out. After all, we’re very busy people with a lot of (real or perceived) important things to do, and our current culture has a way of socially rewarding people who are “on the go” constantly.

And so our systems can’t operate full-spectrum — what goes up must come down, but we won’t let it. We have only half of our God-given pistons cranking — at double speed — and we get into a state of physical distress that actually feeds back into itself. Our high-alert condition, which saves our asses in tight spots, can persist… and keep firing off warnings about every little thing, regardless of whether it’s truly dangerous or not.

As much as our survival wiring may protect and preserve us, if left to its own devices, it can also rake us over the coals. If we don’t discharge the stress of base survival and return to a restorative resting state after all our agitation has passed, we can end up experiencing even more physiological stress after the fact. We get tired. Our judgment gets clouded. We make poor decisions and do ill-conceived things, and then we spend a whole lot of time playing catch-up, in a state of heightened stress and crisis. The stressors we experience don’t even have to be real. They just have to seem real. Our bodies don’t know the difference, and they respond to what our minds tell them with a response that seems reasonable to them. One problem feeds another… and another… and another… and eventually, we find ourselves in a deep hole we can’t stop digging.

Which brings me back to my own situation. The hole I have found myself in, after many years of “digging,” is a pretty deep one. It’s been dug by a challenging childhood, lots of troubles as a teenager, drinking, drugs, petty crime, and plenty of poor decisions that were spawned, not only by past social and emotional traumas, but by mild traumatic brain injuries, as well. I’ll spare you the gory details of my tale. I’m sure you have enough excitement in your own life. The bottom line is, after over four decades of knocking around on this planet, one of my pieces of “baggage” contains a lot of post-traumatic stress, which I need to actively manage and factor into my decisions and actions, even when I’m feeling 100% sane and competent.

Make no mistake, I am a survivor. But that survival has come at a price. And some days, what I wouldn’t give to not have to pay that price, just for an hour or so.

A Perilous Relief – Table of Contents

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Defending Natasha Richardson… and everyone else

Like many TBI survivors and their loved ones, I’ve been thinking a lot about Natasha Richardson’s tragic end. She was one of my favorite actors, and the world was a better place for her being in it.

Thinking about how she died, it’s all too easy to try to find someone or something to blame. A hundred things could have been done differently, which might have saved her life. Different people could have made different choices. Different actions could have been taken. Different policies could have been in place. Things could have turned out otherwise for her. She might have survived in one piece. Or she might have sustained permanent brain damage. Or she might have …

Who can say? The list of possibilities is endless. All I know is, a light has gone out in our world, and that’s a terrible shame.

Like many people, I’ve been tempted to think that Ms. Richardson was too cavalier about her injury. She should have taken it more seriously. I’ve been tempted to think the resort was irresponsible and unresponsive to her needs. I’ve been tempted to fault the EMTs and hospitals and even the location where the tragedy took place. I’ve been tempted to blame those close to her, for not prevailing on her to seek help.

But it really doesn’t change anything, and it runs contrary to what I personally know about TBI. When head injury happens, it can be all but impossible for others to gauge the real effect of the injury — in the moment and even in the minutes or hours afterwards. It can be all but impossible for the injured party to even know how badly they’ve been hurt. The part of the body that gets damaged has no nerves to indicate it’s in trouble. All it can do is bleed. Or swell. Or seize. And even those things can be imperceptible till it’s too late. And the part of the body that got injured can be terribly contentious and cranky and uncooperative, effectively refusing to seek help and attacking anyone who tries to override its intransigence.

Without adequate education and experience, in the event of a deceptively ‘minor’ fall, and in the presence of an unexpectedly fragile cerebral vascular system, the odds of someone dying, like Natasha Richardson, are actually pretty good.

So, when all the drama around mandating helmet use has faded, and people have recovered from the shock of the loss, I hope a lot of people can learn some valuable lessons from that awful experience. People who have sustained head injuries need to be protected — from their injuries, and sometimes from themselves, and above all, from the ignorance and blame of the uninformed.

PTSD/TBI Factor #1 – Proximity to a traumatic event

This is a continuation of the discussion about PTSD from TBI – Exploring some possibilities. (Updated June 10, 2012)

When it comes to who develops post-traumatic stress disorder and who manages to recover from the trauma without post-event effects, how close you are to a traumatic event can determine the degree to which you are affected.

People who are closer to traumatic events have been shown to develop more symptoms — folks who were closer to Ground Zero after the attack on the World Trade Center in 2001 had almost three times as much PTSD symptoms (up to 20%, versus 7.5%) as folks who were in Lower Manhattan, but farther away.

Physical proximity doesn’t always play a role in the development of symptoms. Research has shown that people who watched the WTC attack on television from a great distance, many miles away, developed PTSD after the event, and in some cases, their symptoms were more extreme and persisted longer than folks who were physically closer to Ground Zero.

One of the key factors in all this is not only actual physical proximity to a threatening event — it’s the individual’s interpretation of the even as threatening… their perceived level of danger.

Now, when it comes to this aspect of PTSD, TBI can play a significant role.

But the role that TBI plays can be quite different from the role that other injury situations (like war or motor vehicle accidents) can play. In the case of those other two examples, the danger is immediate, extreme, and it can lead to deer-in-headlights freezing, which “locks” the experience in place, to be played out time and time again. In the cases of “classical” trauma, the single injuring event itself is the culprit. In TBI, while the injury itself can be a source of trauma, very often the injured party has either dim or missing recollections of the event, so like someone who’s drunk behind the wheel of a car who gets into an accident but comes out the other side without any PTSD whatsoever, in traumatic brain injury, the brunt of the trauma is felt after the injury, when cognitive functioning and decision making and perceptions are all out of whack. Not only can you end up making decisions and taking action which puts you in harm’s way over and over again, but your reactions to those situations can be heightened to make matters far more traumatic than they “should” be.

Let’s get into this a little more…

First, brain injury can impact a person’s ability to assess risk. They can end up underestimating the danger of a given situation and rush in “where angels fear to tread.” They’re not necessarily fools. They’re brain-injured.

I myself have been a walking, talking example of this. I can’t even count the number of times I’ve done really dense things that I didn’t realize were dense, till much later. One time stands out, in particular:

One day, a couple of years after my most recent head injury (but before I realized that I had been injured as much as I was) I went hiking bright and early one morning on the first day of deer hunting season. I was wearing natural earth-tone colored clothing and wandering off the beaten path, deliberately following deer tracks because I wanted to “get in touch with nature”. Seriously poor judgment. In the course of my ill-conceived hike, I happened to cross paths with a deer hunter who was watching the very area where I was hiking, gun in hand, ready to shoot.  I was in very real danger of being shot.

Now, I know better. I’m from a family filled with avid deer hunter – my dad and all my uncles and my brother go hunting regularly with almost religious fervor. I know that the first day of buck season is NOT the day to go hiking in the woods, and if you have to, you wear bright colors and you stick to the trail(s). But that morning my brain totally failed me. I literally could have been killed in one of those hunting accidents I grew up hearing about.

Believe me, I’m not proud of this genuinely impaired choice, but it’s a great example of how TBI-limited thought processing can put a person in mortal danger, without them even knowing it.

The second way TBI can contribute to the proximity of danger is by heightening the intensity of one’s response to situations.

For example, a head-injured person can quickly lose their temper in a confrontation with someone bigger and badder and meaner than them. That has happened to me many times, and I’ve been injured in the process. I know from personal experience that an impaired brain can make you think you can take on that opponent — and win — only to have your body find out that’s not the case. And if you piss someone off who carries a grudge, you can find yourself looking over your shoulder at every turn… becoming increasingly paranoid and jumpy… which eventually can add up to a hefty dose of PTSD.

Now, one of the things that Belleruth Naparstek mentions in her book Invisible Heroes (this discussion is based on info from Chapter 4 therein), is that another factor is internal perception of danger/trauma. If someone doesn’t know they’re in danger, they may not be impacted by even a serious event. People who are involved in accidents when they’re drunk have been shown to develop less PTSD than might be expected. That’s not to say everyone should run around intoxicated, only that having your perceptions impaired or dulled or distracted somehow can keep PTSD at bay.

But if you believe you’re in danger — even in the case of a near miss — you can really find yourself on the PTSD ride of your life. It’s your perception of danger that sets off the reaction… which can build and recur, build and recur, build and recur, till you don’t know whether you’re coming or going and you feel like you’re losing your mind. Even if you escape a traumatic situation relatively unscathed, you can end up with some nasty symptoms.

The third way TBI can contribute to PTSD is by slowing information processing and reaction times, so it can be hard to get out of a worsening situation before it turns really ugly.

Remember, slowed processing time is one of the most common hallmarks of mild traumatic brain injury. And fatigue is not only a common after-effect of TBI, but it’s also a factor in diminshed attentional abilities and cognitive functioning. When you’re in a potentially dangerous situation, the last thing you need is to be thinking and reacting more slowly than you could/should/otherwise would. But with TBI and its after-effects, that’s precisely what can happen.

As an example, say you’re driving down a deserted country road after dark one winter evening. It’s late and you’re worn out from a long day, and you just want to get home and fall into bed. Out of the corner of your eye you see a shape standing on the grassy shoulder beside the road. A huge six-point buck comes into view in your headlights. Something tells you to slow down, but tou’re not thinking clearly, you’re tired and foggy and slower than usual, and it takes you a few seconds longer to hit the brake than you normally would.

Suddenly, the buck turns and starts across the road right in front of you. Before you can react, you hit the deer head-on, crumpling the front of your car and inflating the airbags in your vehicle. Your head bounces off the airbags, breaking your glasses, and slams against the headrest. Dazed and confused, you sit stunned for a few moments. Then you climb out of the car and go see what just happened.  As you approach the deer, you feel something sticky and warm on your face. Your broken glasses cut into your scalp, and the cut — like many scalp wounds — is bleeding profusely. Clamping one hand to your head, you you try to drag the deer off the side of the road so you can drive on, but it’s too heavy — the carcass won’t budge.

You head back to the car to find your cell phone, but you’re so confused you can’t find it anywhere. It’s dark, and it’s cold, and your car looks like it’s totaled. Your scalp is bleeding, you’re disoriented and confused, and it’s been over an hour since you passed an inhabited area. It’s too cold to get out and walk anywhere. You’re cut off. Alone. You spend the night keeping your car running, so you can stay warm, afraid you’re going to bleed to death, uncertain if and when you’re going to get help, having countless scenarios of impending doom running through your mind.

In the morning, a local deliveryman finds you and your car and the dead deer and radios for help. A tow truck comes and delivers you to the nearest town, which is just a quarter of a mile away, up the road, ’round the bend you couldn’t see in the dark the night before. You find your cell phone in your car’s glove compartment and you call a family member to come pick you up. Then you get on with the business of dealing with your totaled car, getting back to work, getting on with your life. You seem okay physically, with just the cut (that stopped bleeding) and a nasty headache. But you can’t get that vision of the deer out of your head, and you keep waking up in a cold sweat, your heart pounding, feeling like there’s something sticky on the side of your face.

Now, this is not to say that someone without a TBI wouldn’t have the same experience. But having thought processing slowed can contribute to slower reaction times, poor judgment calls, and impaired coping techniques… which can contribute to and complicate bad conditions, making them worse than need be — and making them seem worse, too. And that can happen not only with someone who has a TBI going into a tight spot, but someone who experiences a TBI and then has to deal with challenging situations with an injured brain. A double whammy.

The forth way TBI can contribute to PTSD is by making everything seem a whole lot worse than it is.

With TBI, impaired risk assessment can go both ways, I believe. It can not only be impaired, but it can be hyperactivated. TBI can make you think things are lot more hazardous than they are, that you’re in more dire peril than you are, and that you need to respond more intensely than you necessarily need to. PTSD alone can do this, but when your brain isn’t firing with all pistons, your impaired judgment just feeds the PTSD fire.

So, even if you don’t end up in that car accident, or you really aren’t in danger of getting your ass kicked by that Very Large And Angry Person, or you walk away unharmed from a fall that was broken by soft snow, your (impaired) perception of “immediate danger” can trigger a bunch of biochemical reactivity that puts you very much on edge and eventually adds up to full-blown PTSD.

Warning, Will Robinson!

Danger! Danger!

You may not be in danger at all. But your injured brain tells you that you are/were. And your impaired judgment, thinking it’s protecting you from a perceived threat, gets the gears going and sets off a potent chain reaction that — while bothersome at first — can lead to serious trouble, on down the line.

So, there are several distinct aspects to how TBI affects the proximity factor of PTSD (including, but not limited to):

  • It can create conditions of actual physical proximity to danger by impairing someone’s ability to detect (and avoid) risk/danger.
  • It can make a person’s responses more intense and/or more precipitous, so they overreact to situations and put themself (unintentionally) in danger.
  • It can keep someone from getting themself out of trouble in a timely manner and keep them from adequately dealing with an existing tricky situation.
  • It can heighten the perception of physical proximity to danger.

All of these (and I could think of a bunch of other examples, but I won’t take up the time here), not only do a number on your head, but also on your body. PTSD is very much about physical reactions… and they tie in with mental processes. So, if your brain is impaired by an injury, and you’re backed into a corner (or think you are), you can end up with a more potent mix of trauma experience that heightens the post-traumatic stress impact.

And that’s no friggin’ fun.

Thinking about PTSD and Tetris…

I’ve been giving some thought to the whole “Tetris fixes PTSD flashbacks” concept, over the past few weeks.

Some people agree, others don’t. Here’s an interesting discussion over at Vetvoice.com about it.

I have to admit, I have found some relief while playing Tetris. It’s so interactively neutral — no people to shoot, no mortal danger to avoid, no sudden loud sounds and flashing colors to tax my already frazzled system. I have tried playing it when I was extremely agitated about stuff that was coming up in therapy… flashbacks, in particular. For whatever reason, I found the flashbacks subsiding and images of dropping brightly-colored Tetris pieces showing up instead of the shadowy figure appearing suddenly in front of me. It seemed me me that Tetris images were literally replacing the unwanted flashbacks.

Or maybe it’s just me. But I can tell you, my system really started to chill out. I don’t think it’s a coincidence.

One of the commenters at the discussion about this over at Vetvoice.com suggested. “And why not win every tetris computer game you play, while you’re at it design a new one!”

It made sense to me, so I decided to do just that. I’ve been working on alternative versions of the game, with different colors. My first attempts are a bit rudimentary, the changes being isolated to the colors alone. But it’s working.

Tetris Screenshot 1

Tetris Screenshot 2

Tetris Screenshot 3

You can get to “PTSTetris” by following this link: http://ptstetris.110mb.com/

I don’t know if it really works, but the logic seems sound. I think we can’t make generalizations all across the board about whether it will fix what’s wrong, but if nothing else, spending a few minutes rearranging colored blocks beats flashing back on wretchedness that intrudes on my regular day, getting all anxious and agitated and freaked out over stuff that happened a long time ago in a very different place.

I’ll probably be creating more color schemes, as time goes on, but for now, at least this is up and running.

Cheers

PTSD from TBI – Exploring some possibilities

I’ve been giving a lot of thought to how PTSD and TBI interrelate with one another. With so many soldiers coming back from Iraq and Afghanistan with serious issues related to TBI and PTSD… and considering how ill-informed and ill-equipped our society is in dealing with these very serious issues, I do want to try to explore some of the aspects of each.

I do this as someone with a history of TBI and PTSD. My injuries started when I was a kid, and children (and women) are more susceptible to developing PTSD, so that old habit I have of saying, “Oh, that was so long ago… I must be over it by now!” doesn’t hold water anymore. The fact of the matter is, I lived in very violent conditions as a kid, and it affected me. A lot. It was traumatic. It was distressful. I had a very disordered childhood. And the other fact of the matter is, I sustained several mild traumatic brain injuries as a kid, which did not help.

I’m going to be using Belleruth Naparstek’s book Invisible Heroes: Survivors of Trauma and How they Heal as a guideline. I’m not recommending that everyone run out and buy it — tho’ I won’t stop you if you want to. Be forewarned: I personally found a lot of the stories of trauma it recounted to be, well, traumatizing. If you’re squeamish about stories of violence and sexual abuse and terrorist attacks, you may not want to read it. I’ve read it — and struggled through it — so the damage is done with me. But you won’t necessarily have to go there, as I walk through the PTSD stuff I’ll be covering here and in later posts. I’ll also be drawing from other online sources about PTSD, and I’ll add links to other things you can read. I’ll try to avoid posting links to really awful stories. I don’t want to discount anyone’s experience, but some things I have a terrible time dealing with, and I’m guessing I’m not alone in that.

Note: This nasty habit of revealing horrible accounts to make a point about trauma is a common problem I find in current PTSD literature — it’s often written by psychotherapists who are accustomed to hearing people recount horrific events, so they can work through it. But I’m not a trained and objective psychotherapist, and I can’t stand hearing about awful crap other people went through. It makes me feel awful and wretched; there’s nothing I can do for them, which is deeply frustrating. It’s also sometimes vicariously traumatizing, which is no fun. If some therapists or researchers can find a way to recount trauma without needing to go into all the disturbing personal details, they’d be doing us all a big favor. I try to do it, here, but I’m not sure I do such a great job of it.

Anyway, back to my discussion…

Let’s start with the factors in and contributors to the development of PTSD from trauma (from Chapter 4 – “Who Suffers: How, When, Where, and Why”). They are (follow the links to see what I’ve written about each one – I’ll be updating these over time):

The Nature of the Traumatic Event

Survivor Traits

  • gender
  • age
  • psychological history
  • education
  • ethnicity
  • social support

Reactions Around the Trauma

  • panic and acute stress
  • dissociation
  • biochemical anomalies
  • drinking and intoxication
  • sense of control during the event
  • self-blame and negative beliefs
  • subsequent health problems

Many of these elements of PTSD tie in with experience of traumatic brain injury — even if it’s “mild” — in what I consider significant ways. TBI has a way of exacerbating a lot of problems, to begin with, but when it heightens the impact of something like PTSD, things can get really interesting.

In the past, I’ve talked about how PTSD can lead to TBI. In the future, I’m going to talk about how TBI can contribute to the development of PTSD.

But for now, it’s a beautiful day and I need to go outside.

Till later

What keeps me going

Ever since I read about how the ‘Thirst For Knowledge’ may be a kind of opioid craving, my thinking about how my mind manages my physical pain has really changed. Actually, it jumped ahead in a big way, when I read about Mary Meagher’s work on how fear and anxiety have different affects on physical pain. But having the kind of associational brain I do… a brain which isn’t very good at sticking with linear, sequential tasks, but eagerly hops around from one related topic to another… I did end up here, thinking about how the human brain craves novelty, and why that might be.

I’ve come to realize, in the past months, that many of my patterns of risk-taking and danger-seeking behavior, not to mention my constant stream of distractions that keep me all jazzed up, have a lot to do with relieving my constant levels of discomfort, distress, and pain. Not only that, but they seem to be linked to a sort of depressed state in my thinking — not necessarily emotionally depressed, but functionally slowed. My history of TBIs has not helped my cognitive processing speed, and there are parts of my brain (as evidenced on my EEG) that physically work more slowly than would be expected.

Actually, come to think of it, emotional depression sometimes follows on my cognitive depression/slowing, so I can’t discount that part of my experience.

Now, when it comes to getting on with my everyday life, risky decision-making and flawed judgment are just part of my problem. Chasing conceptual chimeras — such as my all-consuming obsession with my MRI, as well as new and emerging neuroscience research, which I may never fully understand but which fascinate me to no end — and commencing projects that I will never actually finish — like that 500-page documentation set for one of my favorite software programs of the day — are actually more disruptive and pose more of a risk to my adequate functioning than outright risk-taking behavior.

And yet, I chase after these new ideas and take up new projects, left and right, neglecting the real parts of my life that suffer from my lack of attention. I’m so busy researching and reading and exploring my MRI in 3D, that I forget to pay bills. Or do paperwork. Or make calls I need to be making.

I don’t think I fully understood the impact that my intense need for mental stimulation had on my life, until a little over a year ago, when I came across one of my old notebooks that had plans and details and milestones for all these projects I had once been utterly consumed by. There were no less than seven different highly involved, complex projects that filled different parts of that three-ring notebook. And then I found more in another notebook. I uncovered a whole bunch of different projects that I’d started… then got distracted from and completely forgot about.

Discovering those notebooks opened my eyes in several ways.

First, I realized that I had so completely forgotten about those projects, that they might as well have never existed. And that happened, after I had invested literally hundreds of hours scoping and planning in great detail for each of them. It seemed impossible that I would forget even one of these projects. But I had lost track of more than ten.

Second, I realized just how irrationally compulsive I was about my projects, and it occurred to me that someting might be very wrong in my thought processes. The majority of people I know don’t do this sort of thing… why was I?

Third, I realized that even if I had all the time in the world, I never could have finished all of these Very Important Undertakings. But that didn’t matter to me. What mattered to me, was the doing. The “journey”. The process of pursuing these things. It went against every fiber in my pragmatic being and seemed like a total waste of time. Yet, part of me didn’t care. It would create with abandon and not give a crap about what might actually come of it all. And that troubled me. Because it didn’t seem like me.

Or maybe it did. All my life, I’ve been fascinated by fringe interests and I’ve pursued them with gusto.  When I was a kid, I had a lot of projects going on all the time, and my parents and teachers used to just writhe with frustration at how I could never take any of my projects to a higher level, where they would develop fully and be shareable with others. I would read all about certain subjects and discourse on them at great length, but I could never seem to develop my interests in other directions. I had a “chemistry set” in the basement, where I did extensive studies on the interactions of vinegar and baking soda, and I mixed leftovers from my father’s aftershave with my mother’s talcum powder. But my interests never went much farther than that, for all I learned about fizzy cooking ingredients and the crackle patterns of dried personal care products.

In my adulthood, the intensity of my interests increased substantially, as has their esoteric “quotient”. Over the past 20 years, I have frequently found myself deeply engulfed in studies that interested maybe 5 other people in the world, but my devotion ran to the very core of my being. I’ve also found myself utterly consumed with a topic that was probably well beyond my ability to understand — quantum physics, biophysics, medieval history, and more — all sorts of information-intensive subjects that require years of training (which I didn’t have) to understand completely. My interest has intensified and evolved over the years, but the shareability of my learnings actually decreased. I would read and take in and then recount what I had taken in, but my writing was dense and obfuscated by way too much detail.

Then I fell in 2004 and hit my head and found myself unable to focus and sustain the same level of attention to my old areas of study. My office is filled with books I’d bought, intending to read them in my line of study, but it could be that will never happen.

Still, I do crave my distractions. And between 2004 and 2008, the number and kinds of projects I was consumed by increased exponentially. I just careened from project to project, spending long hours scoping and planning and thinking and noodling. I got so swamped in the details, I couldn’t see my way clear to completion on any of them. But I didn’t care. I just wanted the high of that novelty. The newness, the freshness, the rush that came from a bright new idea.

While I was in the thick of my planning and dreaming and scheming, all was well. But when I stepped back and took a closer look at how much energy I was expending, and how it was getting me nowhere, it just didn’t sit right with me. And I’ve been trying to figure out what the underlying mechanism of that is, ever since.

I think I’m closer now to figuring it out, than I’ve been in quite some time. I can’t speak for anyone else, but what I’ve found makes sense in my own personal context. It’s neurological. It’s biochemical. It’s ingrained. And it’s essential for my mental health and general well-being. I need my distractions, my rushes, my “pump” in order to feel normal. In order to feel human. And the thing that delivers a better rush and pump than just about anything else, is novelty. A new idea. A fresh concept. It’s a tonic to me… and an essential one at that.

Dr. Irving Biederman has some really interesting things to say about this stuff. It’s my understanding that he specializes in things like the neurology of face recognition (which, it occurs to me, could be really useful to folks who study autism/Asperger’s Syndrome and are trying to understand why ASD folks have a hard time decoding facial expressions). This “info junkie” track he occasionally writes about seems like a lesser area of interest for him, from what I’ve read. But it’s much more practically useful to me, than shape and face recognition.

So, that’s what I dwell on, vis-a-vis his reasearch.

Here’s an article about the sensual lure of mental novelty, which I swiped in its entirety from the LA Times:
From the Los Angeles Times

The 411 to avoid boredom

As ‘infovores,’ information is the fuel that keeps our brains all fired up.

By Irving Biederman

July 19, 2008

Crackberry. Only a metaphor for our addiction-like urge to check e-mail? Or does the term shed light on a deep biological truth about our hunger for information?

Human-motivation studies traditionally stress well-established needs: food, water, sex, avoidance of pain. In a culture like ours, most of these needs can be satisfied easily. Just open the refrigerator door, or blow on that spoonful of hot soup. (Satisfying the need for sex may require a bit more doing.)

What’s been missing from this scientific research is humans’ nonstop need for more information.

We are “infovores.” The human eye makes three fixations a second on the world around it, and not at random. Our gaze is drawn to items we suspect have something new to tell us — posters, signs, windows, vistas, busy streets. Confined to a featureless physician’s examination room, we desperately seek a magazine, lest we be reduced to counting the holes in the ceiling tiles. Cornered at a party in a banal conversation, we seek to freshen our drink.

Without new information to assimilate, we experience a highly unpleasant state. Boredom. Conversely, at one time or another, each of us has felt the joy of information-absorption — the conversation that lasts late into the night, the awe at a magnificent vista.

Cognitive neuroscience — the science that seeks to explain how mind emerges from brain — is beginning to unravel how this all works. At USC, my students and I use brain scanning to specifically investigate the neuroscience behind the infovore phenomenon.

The explanation involves opioids, one of many neurotransmitters — which are molecules that the neurons in our brain release to activate or inhibit other neighboring neurons. The effect of opioids is pleasurable. In fact, the same neural receptors are involved in the high we get from opiate drugs, such as heroin or morphine.

In the past, these opioids were believed to exist primarily in the spinal cord and lower brain centers, where they reduced the sensation of pain. But more recently, a gradient of opioid receptors was discovered in a region of the cerebral cortex, humans’ enormous outer brain layer that is largely responsible for perception and cognition.

In the areas of the cortex that initially receive visual or auditory information, opioids are sparse. But in “association areas,” where the sensory information triggers memory and taps into previous knowledge, there is a high density of opioid receptors. So the more a new piece of information tickles that part of your brain where you interpret the scene or conversation, the bigger the opioid hit.

Staring at a blank wall will produce few, if any, mental associations, and thus standing in a corner is punishment. Looking at a random mass of objects will produce strong activation only in the initial stages, where there is little opioid activity to be had.

Gaze at something that leads to a novel interpretation, however, and that will spur higher levels of associative activity in opioid-dense areas. We are thus thrilled when new insights tap into what we have previously learned. We seek ways to feed our opioid desires; we are willing to endure the line at the movie theater in anticipation of the pleasure within. We pay more for a room with a view or a cup of coffee at a Parisian sidewalk cafe.

But if we get more opioids from making connections to our memories and knowledge, why do we then prefer the new? The first time our brains take in a new perception — a scene, a movie, a literary passage — there’s a high level of activity in which a few neurons are strongly activated but the vast majority are only moderately or weakly activated. The strongly activated neurons inhibit the weak — so there’s a net reduction of activity and less opioid pleasure when our brain is exposed to the same information again. (Don’t feel sorry for the inhibited neurons, the losers in this instance of neural Darwinism. They are now freed up to code other experiences.)

No wonder we can’t resist carrying a BlackBerry 24/7. Who knows what goodies it will deliver? A breaking news item. A piece of gossip. An e-mail from a long-ago girlfriend. Another wirelessly and instantaneously delivered opioid hit.

I hope you got a few opioid hits, too, in learning about your inner infovore.

As for me, I’m starting to feel separation anxiety. Where’s my BlackBerry?

Irving Biederman directs the Image Understanding Laboratory at USC, where he is a professor in the departments of psychology and computer science and the neuroscience program.

I did indeed get more than a few opioid hits while I was reading this. As Dr. Biederman says, in “association areas,” where the sensory information triggers memory and taps into previous knowledge, there is a high density of opioid receptors. So the more a new piece of information tickles that part of your brain where you interpret the scene or conversation, the bigger the opioid hit. And because I’ve devoted so much of my life to acquiring and taking in information… data… knowledge and what memories I am able to create and maintain are quite intact (my info absorption during memory creation is about around 60%, but my retention is close to 100%, so I have very detailed recollections of a little more than half of what I am exposed to), that my association areas are well-disposed to getting high off this information.

I suspect that’s what makes the internet so addictive for me — and others. It’s not about the movies and games and pictures. It’s about the novel information that I can read and take in and assimilate and use to feed my inner needs, which are more than just an information addiction.

And I suspect this is what makes my world of projects so fascinating and compelling for me. It’s not about commercializing or publicizing my work. It’s not about profiting from it or getting famous from it. It’s not about taking the projects public, or even actually finishing them. It’s just about doing them. Creating. Being. Doing. Having at it and seeing what happens. Learning. Driving. Getting energized. And cutting the pain I’m usually fighting, in the process.

It’s not about the projects. It’s not even about my progress. It’s about the pain. Getting rid of it. Doing away with it. Keeping my mind off it. Not being debilitated by it. It’s about relieving the distress that comes from the daily difficulties I have with the most basic shit on earth — getting out of bed, taking a shower and using soap and shampoo, making sure I don’t lose my balance and fall in the tub, getting dressed in clean clothes that I didn’t wear yesterday, making a breakfast that will get me through the morning, feeding the cat and gathering my work stuff, making sure I have my wallet and car keys and my daily minder, and getting in the car without bumping against it and getting my work clothes covered with salt and dust that’s leftover from the winter and I haven’t gotten around to cleaning off my car, just yet.

There is so much that others can take for granted, when it comes to everyday life. How hard can it be? Well, if you don’t know… trust me, you don’t want to know. All I can say is, when I look at my distractions, my intellectual compulsions, my wide array of Beloved Projects That Will Probably Go Nowhere, I see a pattern of analgesic activity that may not serve a higher purpose and come to much, in terms of published papers or fame and glory and prizes, but which is utterly essential to my daily functioning as a “regular” person. Without my all-consuming interests, my fascinations, my cognitive compulsions, my life would be a lot more painful, my mind would be a lot less clear, and I’d be a lot less useful — not only in advanced ways, but in the most fundamental ways one can imagine.

Now, where are those printouts I’d gotten on the long-term biochemical effects of post-traumatic stress? I’ve got work to do…

More evidence of analgesic stress in my life

A quick note before I head off for my day…

One of the big, unmentioned pieces of the past few weeks has been the pain I’ve been in. My body has been really aching a lot — and I did a bunch of yard work last weekend, which threw me out of whack. My shoulders are giving me trouble, and my knees were acting up, too, which kind of sets me off.

Back in the late 1980′s and early 1990′s, I had real problems with chronic, debilitating pain. It just seemed to come out of nowhere. I didn’t connect it with the car accident I’d had in late 1987, but now it seems like the two were more than co-incidental.

I was never able to get help for that condition, and I spent years trying (in vain) to find a treatment that worked. Ultimately, the only thing that has helped me has been getting plenty of rest, taking hot baths, and keeping my stress level down.

But when I’m flaring up, as I have been for the past few weeks, it starts to drive me. I start to get increasingly anxious about it and I don’t do well with managing myself and my situations. I feel absolutely driven – propelled – through life, with sudden flashes of interest in things that don’t normally catch my attention. I feel compelled to pack each day full of as much interesting stuff as I can find. And I push myself beyond my means.

When I push myself hard, I feel better. I really do. Physically, I feel better… mentally, I feel clearer… and my self-esteem isn’t in the crapper. I feel like I can function, for once. The pain is gone. The anxiety subsides. I have an outlet for all my energy, and the stress I put myself under has a strongly analgesic effect on me.

I’m writing about this in greater detail in A Perilous Relief, and the past few weeks have been a great illustration of my underlying premise — namely, that risk-taking and danger-seeking behavior isn’t just a psychological compulsion. There are actually physical reasons for why people test their limits in extreme and sometimes dangerous ways, and those physical reasons are just as valid and vital as the psychological ones.

They’re also intimately connected — the psychological and physiological reasons for risk-taking/danger-seeking behavior. And in my own personal, daily experience, they feed each other… and soothe each other, too.

The stress I’ve been under has been taking a toll on me. But I’ve been compelled to push even harder. Why?

Because it cuts the pain.

When in doubt… sleep

Last night I officially wore too thin.

It was not a good night. After what felt like an impossibly long day, I just fell apart and broke down around the time I should have been going to bed. I got into a fight with my partner and shouted and slammed doors and stormed off and wept bitterly for about an hour.

This morning I feel hungover and groggy and stupid for having let everything get to me.

Note to self: When it’s all getting to be too much, stop trying to think things through and just get some rest.

Looking back, I can see how everything just piled up on top of me. The session with my therapist, that left me feeling like an idiot. The challenge of keeping functional at a job I’m only going to be at for another week. The pressure of learning specific skills I need to have, when I start my new job(!) in a little over a week. The insecurity I feel at stepping up my career path at this dream job of mine, which is a continuation of what I had been doing back before I had my fall in 2004. I’m terribly concerned that I’m not going to be able to hang in there and do the work. And I’m worried that my TBI stuff is going to get in the way.

But instead of paying attention to all that and slowing down and taking care of myself, I’ve been pushing myself harder and harder. My “Perilous Relief” has now swung around to bite me in the ass, and I melted down. It wasn’t awful, but it wasn’t pretty. And now I feel like crap.

This is something I really need to pay attention to. I haven’t been getting the kind of sleep I need, lately. I’ve been too busy, too wrapped up in all kinds of important stuff, too worried, too everything. I’ve been driven by my anxiety, my insecurity, my bubbling borderline panic.

Letting that get hold of me is no good. And it just makes my headache more intense. I need to pay attention to my warning signs… and do something about them.

So, what are my warning signs?

Being 150% convinced that a new project is something I must do.

I find myself starting to come up with new projects to work on that suddenly infuse me with all sorts of energy and fascination. I come up with things like creating 6-week courses in online job-seeking skills, or writing a full documentation set for a favorite software program that needs more detail, or launching a new career as a technical translator. In actuality, those projects are ill-conceived and not practical. They appeal to me on a high level, but I do not have the stamina — or the sustainable interest — that is necessary to make them “fly”. And I don’t usually think them through well enough at the outset to realize that there’s a whole lot more detail and involvement in them than I’m ready or willing to devote myself to.

So, I end up canning the ideas in the early implementation stage… and I get down on myself for having gone down that track.

In reality, what I am really doing is infusing my tired brain with energy. It has nothing to do with my life’s work or my chosen path. These new projects are just ways to invigorate a brain that’s pulsing a little more slowly than I’d like.

Not bothering to sleep.

The more tired I get, the harder it is for me to sleep. Funny how that works… I have been so caught up in running here, there, everywhere, tending to stuff, tending to what needs to happen, that I haven’t slowed down long enough to get some rest.

That’s bad. Fatigue is a huge stressor for me and it turns my triggers into hair-triggers.

Going too fast.

I have been kind of going a mile a minute, lately. I’ve been cramming in all kinds of extra activities into my days — running errands, writing emails, doing chores, picking up extra projects. Some of it has been really important, of course — like getting my new job situation lined up. But some of the other stuff has been non-essential — like trips to the library to get books I don’t need to be reading. I’ve been careening from one activity to the other, instead of taking my time. And that’s caused me to make little mistakes along the way, like forgetting to do certain chores and forgetting to send the emails that I do need to send. Little mistakes throw me off and turn into larger issues.

Not self-assessing.

It doesn’t really take much for me to self-assess each week. Or even each week. But I’ve been avoiding it like crazy, and it’s not helping. I’m not keeping tabs on my different issues, so they get out of hand, and I literally forget that I’ve got problems in certain areas. It’s just not good. Ironically, knowing what problems I’m having alleviates them. But ignoring them and pretending they don’t matter just makes them worse. Some people (who I say belong to the “think happy thoughts” school) say that you shouldn’t “give any energy” to troubling conditions, as though paying attention to them makes them worse. But in actuality, not paying attention to them makes them so much more problematic, than if I blithely disregard them.

So, what do I do about all this?

First, start self-assessing again.

Pay attention to what’s going on with me.

Second, get some sleep.

Real sleep. In the pitch-black guest bedroom at the back of the house.

Take looooong naps on the weekend.

Make sure I start going to bed no later than 10:00 p.m. each night.

Enlist the help of my partner to make sure I do this religiously, until I’m caught up.

Listen to my guided imagery to help me with restful sleep.

Deprioritize everything that is not essential, until I am caught up and am feeling better.

Third, stick to my plan.

I actually do have a plan for my life and work. I have specific steps I am going to follow to set things in order and keep myself on track. And I need to abide by it. Stick with the program. Don’t deviate. Just follow it through, one step at a time. Having a specific, expressed plan of action takes the pressure off the part of me that gets anxious about unknowns. And sticking with the plan makes my life a whole lot simpler — and less stressful.

Fourth, write… write… and write some more.

Writing really soothes me a great deal. It helps me focus, it helps me get in touch with what’s going on with me, it helps me keep my act together. I just need to write in ways that are structured and on-p0int. For many years, I kept journals that were rambling, stream-of-consciousness explorations of my inner world. They seemed to make me feel better, while I was writing in them, but in actuality, they were a kind of drug that numbed me to my troubles. They didn’t help me overcome them; they actually got me mired in them even more — I filled them with perpetual, rambling detail that was meaningless to everyone except me in that moment.

The kind of writing I need to do now is very pointed, very lasered, very specific to the real world I experience around me. It’s not all meant for public consumption — I have a number of writing projects behind the scenes that will probably never see the light of day in my lifetime, if at all. But the discipline of writing in a deliberate, structured way is good practice for my life.

In a way, I think that writing is my spiritual practice. I’ll have to write more on that later. But for now, it’s time for me to get on with my day. Take care of some errands I need to do, and prepare for a day of work at a job I’m phasing out.

I actually have a lot of really wonderful things happening in my life. But if I’m not rested and fully functional, all the wonderful things become a terrible burden for my little brain, and the sweet nectar of life gets gooey and a little rancid.

Yes, yes, yes… When in doubt… Sleep.

On being beyond help…

I guess I’m feeling sorry for myself today. It started this a.m., when I had a pretty intense discussion with my new shrink about what I was going to do with the information that came from my new neuro. After talking with totally outraged friends who were incensed that my present neuro didn’t tell me about the pineal cyst and were miffed about how my experiences were described in the letter to my PCP, I was seriously considering looking for a new neuro.

Until my shrink talked some sense into me.

Said they, “So, this is Neurologist Number … Three?

Said I, “Yes.”

Said they, “You can’t keep jumping from doctor to doctor…”

Said I, rather abashedly, “Uh… I know…”

We had a pretty frank discussion about how the medical profession is not having a particularly good century, thus far, and how doctors have so much pressure on them, these days, so there’s only so much I can expect from them. And there are plenty of people with much more pressing problems than mine — which are really borderline and are more exploratory than anything else, at this point. True, there are things that have been going on with me for some time, that I’ve been urged to follow up on, but it’s not like I’m in serious trouble and unable to function at all.

I’m high functioning in some ways. In others, I’m less so. It’s getting past the okay stuff to the problematic pieces that’s the major conundrum in my life.

Frankly, I’m not sure I’ll ever be able to get to the bottom of what needs fixing, so I can function as well as I can all across the board. Not really. I just can’t describe my symptoms and issues in ways that others can understand. At least, I haven’t been able to do it, yet. Maybe someday I’ll be able to, with the help of a speech therapist, but right now, I have no great hope of it. I’m just so awful at communicating what’s going on with me, when pressed for information. Just awful.

And it just pisses off the people who are trying to help me.

So, I’m beyond help.

I don’t mean to sound depressed or anything, even though I kind of am. I guess I just had higher hopes of being able to connect with medical folks, and not only failing at that, but also being told there’s no great hope of me being able to do it any better with anyone else, bums me out, too. I’m probably being a drag, right now, and I apologize for that. But for others out there who are dealing with TBI stuff, and for the sake of those who are trying to understand what people like me have to go through, I hope my words can help shed at least a little light on what problems TBI folks face in seeking health care.

I suspect this is going to be a pretty significant issue in the coming years, as our veterans return from Iraq and Afghanistan with head injuries and PTSD and lots of other issues that they need help with. What is this country going to do, when thousands of folks with communication and self-assessment problems like mine — and physical conditions that are far more severe — show up needing help? What are the doctors and nurses of this country going to do? Shrug their shoulders and say, “Oh, well…” and turn away? Or dismiss them as malingerers? Or, absent any clue about what the real problems are, pump them full of drugs that will either ease the symptoms or knock them out sufficiently to not notice them so much?

It makes my heart hurt, to think about it. It’s bad enough that I have to go through all this, when I’m relatively able-bodied and in possession of my faculties, a job, a house, a family, and a relatively stable life. But those who are far less fortunate, and who have paid an unimaginably high price for the sake of this nation… well, it just seems awful to me.

What seems even more awful is this attitude I keep coming across about how doctors have to work hard enough at their trade, without having to extend themselves for people like me. As though learning to communicate with me and figure out what’s up with me in ways that are accessible to me doesn’t matter one bit. As though any communication breakdown is totally on me. I am more than willing to do everything I can to communicate with my doctor(s), but I’ve been injured a bunch of times, and I’m a bit impaired, so I do need some help.

That’s why I seek out medical attention, to begin with. And that’s why I try like crazy to communicate in any way I can find… only to be rebuffed by docs who are irritated at my approach and don’t really have the time to get to know me well enough to tell if I’m really okay, or if I just think I am.

I really want to be positive. I really want to be hopeful. I really want to be generous and gracious and extend myself to my beleaguered doctor(s). But right now I’m too tired from being lectured about how hard doctors have it, and how I can’t expect too much from them, and how other people are much worse off than me, so I shouldn’t take up too much of their time, I’m too frustrated, too … well, everything… to see things in a rosy light.

The ironic thing is, I started out this whole quest from a place where I was totally DIY with regard to my health. I stepped into the fray, agreeing tacitly to call a truce with the establishment and give the medical field the benefit of the doubt, and keep an open mind, be compliant, try to be the best patient I can be. But now I’m being sent away again.

So, I’ll just keep looking. I’ll keep asking questions. I’ll keep recording my life. I’ll keep pressing for answers I need, even if I have to look outside the usual areas (and inside my own heart) for the answers I need. I’ll go back to doing things  the way I always have — on my own, because nobody else has the time or the energy or the willingness to help me in the places I’m the most vulnerable. And I can’t leave myself wide open to that level of dismissal and neglect.

Not anymore.