Duty to Warn: The Fort Hood Murders/Suicide and the Taboo Question

The Baltimore Chronicle has an interesting article by Gary G. Kohls, MD about the role of psychiatric medications in the Fort Hood incident. From the article:

Most of us have been listening to the massive, round-the-clock press coverage of the latest mass shooting incident at Fort Hood, Texas. Seemingly all the possible root causes of such a horrific act of violence have been raised and discussed. However, there is an elephant in the room, and it’s something that should be obvious in this age of the school shooter pandemic.

We should be outraged at the failure of the investigative journalists, the psychiatric professionals, the medical community and the military spokespersons who seem to be studiously avoiding the major factor that helps to explain these senseless acts. Why would someone unexpectedly, irrationally and randomly shoot up a school, a workplace or, in this case, an army post? Why would someone who used to be known as a seemingly rational person suddenly perpetrate a gruesome, irrational act of violence?

The answer to the question, as demonstrated again and again in so many of such recent acts of “senseless” violence, is brain- and behavior-altering drugs.

…

You can read the rest of it here.

I can see his point, and I think it is a good idea to factor in the potentially dangerous effects of psychoactive drugs. But I also believe there are many layers to this, the effect of drugs being only one of them. Something(s) else contributed to pushing the shooter to that point. And I’m not sure we can fairly lay all the blame at the feet of the pharmaceuticals industry.

Whatever the cause of the rampage, this issue of pharma-gone-bad is of particular interest to me, because as a multiple-TBI survivor with a bunch of cognitive-behavioral issues, it could be all too easy for a “qualified” doctor or neurologist or psychiatrist to load me up with a bunch of pills and send me on my way. I consider myself unbelievably fortunate and blessed to be working with a neuropsychologist who is very wary of pharmaceuticals and approaches them as a last resort, when all else fails. They are also very happy when I come up with alternative solutions to my issues that work well and do not involve drugs –  like exercising regularly as an antidote for fatigue and drowsiness and a way to wake up fully in the morning.

Interestingly, my psychotherapist tends to come down on the side of drug therapies for individuals with attentional difficulties. I may have to cut them loose, if they turn out to start pressuring me to resort to drugs. If they so much as start hinting at me using them, simply because other approaches “don’t appear to work as effectively” I may have to have to reconsider working with them and seek help elsewhere. Who knows? I may even cut out the psychotherapy completely.

Hard to say, at this point. I think it’s been helping me in some ways… no, I’m pretty sure it has.

But I have been growing a little more leery of my shrink, over the past month or so. They seem more distant than they did at the start. They also have said some things to me over the past couple of sessions that don’t sit right with me, but I haven’t actually followed up on. I should probably do that, to clear the air. It’s hard for me to spend the time and money with someone who I think doesn’t believe me, or seems to be insinuating that I’m misrepresenting my difficulties to the rest of the world. I’m not sure if they think I’m worse off than I appear to be, or if they are just having a hard time, themself.

To be fair, they did suffer a devastating personal loss, last year about this time, so I think it may be messing with their head a little bit. They have definitely not been at their best, of late. So, I’ll cut them some slack, give it some more time, slow things down, and not let them pull any punches with me. We’ll see how it goes.

Bottom line (if there is one) is… mental health care providers can have problems, too. And those problems can get to them in some pretty serious ways.  I’m just glad my shrink isn’t trained in small arms — I’m assuming they aren’t — and that they don’t work in an environment where the use of firearms is part of the job.

My solution for TBI/PTSD rage

Anger (or out-and-out rage) is one of the places where my TBIs and PTSD intersect to cause real problems. I’ve been having some rage issues, lately. Getting worked up over little things — getting angry over nothing, really. Just getting angry. Temper, temper…

In the moment, my anger — my rage — seems completely justified. I feel with every cell in my being that I am entitled to be outraged. I am entitled to be angry. I validate my emotional experience, and I end up spiraling down into a deepening pit of anger, resentment, and acting out. Yelling. Making a fuss. Putting up a stink. And getting aggressive with whomever happens to be offending me at the moment.

This is not good. I’ve done it with police officers, and I’m lucky I didn’t get cited. Or arrested. I’ve done it with family members, and it’s cost me plenty, in terms of peace of mind and my relationships. I’ve done it with co-workers, and it strained our connections to the point of breaking.

Not good.

But lately, I’ve been able to pull myself out of my downward spiral before it gets too much of a hold on me. I’ve started doing some basic things that stop the progression of rage before it picks up so much speed it’s like a runaway freight train.

First, I recognize that I’m angry, and I am convinced that I’m right about being angry. This might not seem like a big thing, but I have trouble figuring out how I’m feeling sometimes, and anger is one of those emotions that I don’t always identify well. It just feels like a rush of energy — and while everyone around me knows I’m pissed off, I usually can’t tell what’s going on with me until it’s progressed to a really problematic point. I recognize that I’m angry, and I remember that I need to not let myself get carried away.

Second, I step away. I take a time-out and just walk away. I stop myself from saying what I’m about to say, no matter how badly I want to say it. I tell myself, I’ll give it some thought and figure out how to say it exactly the way I want to say it. I tell myself… anything … just to extract myself from the situation. I step away, telling myself I’ll come back when I’m better able to express myself.

Third, I take some deep breaths.  This helps stimulate my parasympathetic nervous system, which is the part of the nervous system that chills you out. The sympathetic nervous system is what gets you worked up to respond to a crisis situation — and when I get really angry, it’s often because I think and feel like I’m in a crisis situation, and my body is getting all geared up for fight or flight (more often fight). I consciously take some deep breaths to get my parasympathetic nervous system to chill out.

Fourth, I seek out some kind of tactile stimulation. I need to get out of my head, which is spinning out of control, and just give myself a different point of focus. My head is going so madly, at this point, that I cannot even think straight, so I seek out some kind of physical sensation to get my mind off the madness. I press the side of my face against the cold side of a door that leads to the outside. I pick up something rough and rub my fingers along it. I jingle change in my pocket. Or I find something heavy and hold it. The physical sensation, along with the deep breathing, gets my mind off the crazy cycle it was in, just a minute ago, and it lets me focus on a single point — the feel of the cold door against my cheek or the feel of quarters and nickels and dimes juggling among my fingers. Tactile stimulation, like looking at a flame of a candle while meditating, helps me center and get my mind off that crazy downward cycle.

Fifth, I remind myself that my body and brain are playing tricks on me. I am probably not getting angry for the reasons I think I am — it’s my body that’s getting all worked up into a fight/flight/freeze state, and my mind is interpreting that as a real sign of DANGER. And I’m probably starting to panic a little, too. As a matter of fact, when I take an objective look at things, the rage that’s building inside of me might not even be real rage, rather a response to a hyperactive sympathetic nervous system response. It could very well be my body tricking my mind into thinking the wrong things. And I need to remember that I get to choose how I interpret my life. My mind gets to decide how I’m going to think about things, how I’m going to react. And my well-intentioned body, which thinks it needs help, is just misleading my brain into thinking that I have to do something about whatever it is that’s getting to me. When I remind myself that this is a physiological process that’s taking place, I am able to relax… and the anger subsides.

The thing I have to remember, when all this is coming down, is that It Is Not Worth It. No matter how justified my rage seems to be. No matter how entitled I am to be angry. No matter how wronged I may have  been. It is not worth it, to get so tweaked over things. When I go off on an anger “binge” I end up feeling really hungover and dumb and numb afterwards, which just makes my life more difficult, once it’s passed.

I’m no doctor, but I suspect that it may be connected with the mechanics of panic/anxiety… all that post-traumatic stress stewing in a pot, and my TBI brain being unable to sort it all out in a timely fashion… My processing speed is slower than I’d like, and by the time I figure out what’s going on, the damage is often done.

So, I do my best to recognize when I’m getting angry, I step away, I take some deep breaths and try to relax, and I do something that gets my body’s attention — like feeling something cold or rough or tactile in some way. And I remind myself that my brain and body are playing tricks on me again. They’ve done it before… and they’ll do it again.

Quick – before the snow flies

I’ve had an increasingly pronounced sense of urgency about getting my affairs in order. Could be it’s the end-of-the-year rush, or maybe it’s this sense of immanent change, or perhaps it’s the realization that my life is changing — yet again — but this time it’s changing for the better, and I need to be more mindful of how I manage my resources and energy.

Since I began my neuropsych testing and evaluation, over a year ago, I’ve been acclimating myself to the idea that disaster is not necessarily a given in my life. I’ve realized that the head injuries I’ve experienced, the mild traumatic brain injuries I’ve incurred over the course of my life (beginning in early childhood), have played a direct role in the course of my life. I’ve also realized that with the knowledge of how my brain functions (or fails to function), I can devise strategies to offset the after-effects of MTBI, and plan alternative strategies. And with the proper amount of mindfulness, I can follow through with them in a certain what that can — and does — help me head problems off at the pass before they become the kinds of catastrophes I’ve coped with my entire life.

Yes, I now have tools to help me make my way in the world. And I need to get my act together, to match the level of my mindfulness-augmented competence.

So, I spent the weekend cleaning and moving. Saturday morning, I cleaned my study. Finally. It’s been on my to-do list for months, now. The last time I cleaned it, two years ago, the space felt truly amazing. I just loved being in my study (where before I had dreaded it). But it’s gone slowly downhill over the past few years, which I knew I needed to fix. So, I worked on that consciously on Saturday morning. And while I didn’t complete the task (which took over a week, last time I did it in in 2007), I did make a sizeable dent. And it’s a deeper sort of cleaning now, than I have ever performed in any of my study spaces.

I really focused on doing it mindfully — cleared out a whole bunch of old files, filled several grocery bags with paper to be recycled, dumped old damaged items that needed to be “liberated” a long time ago, and the proceeded to rearrange the contents of my closet. I still have a ways to go. I’m probably about 10% along the path. But the point is, I started it. (And I continued this morning, cleaning out one of my over-stuffed, disorganized filing cabinet drawers.)

Saturday afternoon, I moved leaves. Raked. Used the leaf blower/vac mulcher. Moved 7 large tarps’ worth of material off the front lawn. I may need to make another pass before the snow starts to fall, but if I don’t, at least I’ve made enough of a dent to protect the grass from the effects of acidic leaves over the winter months. I also moved summer items from outside to inside, and I also fixed the dryer duct, which had  become too clogged for the dryer to work properly.

I should have fixed the dryer duct years ago, but that was one of the things that fell off my plate, after I fell down the stairs 5 years ago. You wouldn’t think that hitting your head on a bunch of steps would completely derail your life, but after that fall, I stopped paying attention to the list of things that needed to be done. I’d had a list I was working with — we’d only been in the house two years, up to that point, and the series of things I was planning to do over the coming years was starting to become more manageable and less clogged. Then I fell, and I stopped working on the list. I’ve been working hard to get back, ever since I realized, about a year ago, how badly I’d let things fall by the wayside.

Now my life consists of a whole lot of remedial stuff. Recover stuff. Rehab stuff. Life as rehab. Each and every mindful minute of paying attention to what I’m doing — and why.

Every now and then, I also get the chance to help someone else out with their list, which is what I did on Sunday. A friend of the family is breaking up with their partner of 7 years, and they needed to move some furniture and reconfigure their living space.

My spouse and I drove out to their place and helped them get a number of large, heavy items out of their living room, as well as from upstairs to downstairs. When we got there, they were looking pretty ragged and depressed and overwhelmed. But by the time we left, they were a whole lot more relaxed and up, and they had their home office set up and connected, so they could get their act together. I’m glad we could help. And it felt great — after several months of regular exercise — to be able to lift and carry the sorts of heavy furniture we were wrangling. Recliners, with all that steel, are NOT light items to move. And trying to angle stuff through two narrow doorways was not the easiest thing. But we did it. And it was good.

This friend of ours (I’ll call them C) has been struggling with getting ahead and staying that way, for as long as we’ve known them.  They make progress, and then they make poor choices and slide back… Interestingly, back in high school and college, C played team sports — the kinds of team sports that frequently result in head injury. In fact, they told my spouse onetime that they had been hit in the head a lot, so their memory wasn’t the best. But whenever I bring up the topic if TBI  — with reference to myself, as I’ve told them about my history — they shut down and stop listening.

The other interesting (and a little tragic) piece of C’s story is that their ex-partner of 7 years was in a car accident within the last year, and they took to the bed with overwhemling fatigue, irritability, wild mood swings… and more. It sounded an awful lot like things were with me, when I had whiplash in the past. Their change in personality was eerily familiar to me.

I tried to talk to C a few times about the possibility of MTBI playing a role in the relationship’s degeneration. I said nothing about C’s athletic history, but I focused on the car accident. But C couldn’t hear it. They just blocked it all out. They refused to admit that there had been a real change, or that the change was physical and neurological, rather than psycho-spiritual. C is very much into “energy medicine” and thinks about health in terms of karma and past lives and energy. They think they can address substantive issues with affirmations and intention.

Which is a shame, because they might have been able to get some relief and/or come up with some alternative strategies, by addressing the physical and neurological after-effects of that car accident, and developed real-world coping mechanisms, rather than realinging their chakras.

Now, don’t get me wrong. I am a strong believer in chakras and energies and intention and affirmations. But I’m also a firm believer in the power of the brain’s neurology to wreak havoc with one’s life. I know the domain of the brain can be very scary for people — especially people who don’t have good insurance and/or can’t get decent medical care — but by leaving out that very important aspect of our overall health, problematic situations can escalate and become even worse, on down the line.

Unaddressed TBI issues can literally cost you your job, your home, your marriage… and more. Especially if folks avoid dealing with them up front.

TBI — even “mild” traumatic brain injury — isn’t the sort of thing you can necessarily wish away or “clear with intention”. I’m sure there are people out there who are very capable mind-over-matter practitioners, but as far as I’m concerned, it’s prudent to give the brain its due and not just brush off a brain injury as something that time alone will heal. Brain injures don’t just go away. And left unaddressed, they can cost you a lot that means the world to you.

I’ve experienced that myself… And I spent most of yesterday moving heavy things with someone who is experiencing it, as well. My aching back and joints can attest to it.

Well, at least we got things moved while the weather was still nice. And for all the hard work over the weekend, it feels great to be this functional again, after years of ennui and inertia and neglect. I feel like I’m really starting to get back in the game, in many ways. My life and my attitude and my outlook is very different than it was, before things fell apart in 2004-2005. But I feel like my life force is returning — and it’s actually good for something.

By the time winter comes, this year, I might just be ready for it.

Goal One: Composure

So, I prepped very carefully for this contest I entered. I got all my information together and collected my creations, and with what I thought was a very nice submission package, I arrived at the jury room.

Late.

I was “too late” they told me.

How could that be? I had called ahead, and at the front desk, they told me I could arrive between 7 and 8 and all would be well.

Untrue. I needed to arrive by 7 in order to participate. And it was 7:40.

My face fell. My face flushed. I became flustered and could not figure out what to say. I stammered and stuttered and probably looked like the crushed child I felt like inside. I could feel the confusion wash over me — flood of frustrated emotions… so much hope at this, so much anticipation, so much…

I cast my eyes to the floor and stammered a weak protest. I felt the eyes of the jurors on me, apprising me, critiqueing me even before they saw my work. The sting of disappointment flushed me bright red. Indignation. Outrage. Childish tantrum kicking and screaming, trying to get out.

Not the best face to put forward. Not the best impression to make. Not for a contest of this stature. And it is of a considerable stature.

I managed to hold back the outburst I felt coiled in me. And I managed to blurt out that I had called ahead, and they had given me wrong information. In a moment of compassion — pity? — the jurors allowed me to open my submission packet and show them what I had. They didn’t send me packing. I may have a chance, yet.

I will know better, next time. Be there by 7, in order to participate.

I will do better, next time. When disappointment rears its unexpected head, I can — and shall — hold myself together.

And not cry. Or look like I’m about to.

I swear I’ll manage at least that.

I’m about to go upstairs and find out if I’m in or if I’m out.

I’m ready. I think.

Protecting the ones I love… from me

I’ve been thinking a lot, lately, about how well people respond to me, when I am bold and brave and daring and don’t let anything get in my way. I seem to have a sort of mystique about me, that causes people to have innate trust in my capabilities and “powers”… even if they have only just gotten to know me.

And likewise, when I am less than my best, when I am faltering, when I am struggling with my life, and I am in full contact with my failings, people around me tend to get miffed. As though I am intentionally being that way to piss them off. Or I’m being a lazy-ass and slacking off. Or I’ve decided to intentionally not live up to my potential.

What’s more, the people closest to me have an extremely bad reaction when I don’t take the high road — they get a bit anxious and agitated, as though I’m about to eat them, or something. It’s an either-or, all-on-all-off thing with me, this adoration of my “secret powers”, and frankly, it kind of irritates me, that I’ve always got to be superhuman, or I can’t be anything at all.

Over the past week, I’ve been deliberately sticking with my mystique thing – being the bold old soul I used to be, before I had my fall in 2004, and my life went to shit. I guess I just gave up on trying to be sensitive to my own needs, and I jumped off the bandwagon that a lot of my therapist friends are on — getting into the victim mentality and concentrating on my needs… my wants… my hurts… my… my… my…

Okay, so I was a bit into that frame of mind for a while. My previous therapist was really into “helping” me get in touch with my own needs and all that, for fear that I was being trampled by the all-too-needy world. My current therapist is on the opposite end of the spectrum — they’re really into me not going off on my sore spots and getting all mired in them. I’ve been re-adjusting, over the past six months or so, and I think it’s been really good for me. Sometimes, I do wish I could get a more sympathetic ear in my current shrink, but I’d rather deal with a hard-ass than someone who coddles me and turns me into an infant, ‘cuz my inner child needs attention.

Actually, I have to say, I’m a whole lot happier now, and I’m a whole lot more functional — and leaning towards increased functionality — than I was for about a year. That whole victim orientation makes me a little nervous, and I also have to say that getting in touch with my needs is vastly overrated. To tell the truth, I’m so self-obsessed at times (I credit my right-hemisphere brain injury) that the whole rest of the world takes a back seat to my needs. The weird thing is, half the time, I don’t even realize it, ‘cuz I’m so deep in my own crap, I can’t see the fact that I’m being pathologically ego-centric. Truly, I have so many needs, there is literally no end to them… and the more I “get in touch” with them, the more I find I need, and it rapidly becomes an endless cycle of identifying my newest and most novel needs, and trying to figure out how to get them met. Which is a never-ending cycle of self-perpetuating ego-centricity of the highest order.

Sigh…

Anyway, what I’m realizing more and more all the time, is that sometimes it’s not such a great idea to focus on myself. And in fact, if I want to do my friends and family a favor, I’ll take the focus off me for a little bit. Or a lot. When I’m given free rein, I can be petulant and childish, foolish and self-serving, needy beyond words, spiteful, bitchy, cranky, and aggressive. It’s not pretty.

So, this trip I’m doing now, with being the strong silent type and holding my shit, even when I feel like I’m about to come apart inside… (which, by the way, is a trip I was on for many, many years, until some well-meaning but head-injury-oblivious person encouraged me to start thinking more about myself and consider what I wanted in life. Then, my literal head jumped on that bandwagon and we were off to the races)…  well, that old stoicism, that warrior composure, that ability to just remain calm in the midst of everything… it’s actually a very good trip, which has really good consequences, and it gets me back on the good foot, even when everything around me feels like it’s going to pot.

And this self-sacrificing trip also lets me keep my friends and family from living with a madperson, a crazy-ass nut-case who jumps at every sound and attacks their own shadow. When left to my own devices and allowed to act like a child, there’s a part of me that will jump at the chance. But when someone — like my current shrink — pushes me to buck up and grow up… well, even if that costs me my warm-fuzzy in-touch-ness with all my feelings, it does make me a better person.

And that’s a good thing.

More morning brain boosts

I came to my senses and rode the exercise bike again this a.m., before I did anything else. It’s amazing to me, how much more awake I feel, after I finished my (relatively short) ride.

One of the things about TBI is that it can slow down the brain’s processing. That makes total sense, if the usual connections are sheared and the impulses need to hunt around for other ways to get where they’re going. It’s like the Loma Prieta earthqake in the SF Bay area back in the late 1980s – a former co-worker of mine spent 4 hours trying to get home from work, when the drive usually took them 45 minutes, tops. All the usually routes were washed out or diverted. And when they got home, their apartment was fine and there was no sign of anything having gone wrong… but all the dishes and glasses were lying smashed on the kitchen floor. Apparently, the building had rocked one way far enough to open all the cupboard doors, empty the shelves onto the floor, and then it rocked back and closed all the doors neatly.

I tend to think about TBI the same way — especially Mild TBI. Our world is rocked, and things get broken inside, but then we get rocked back into place, and as far as anyone can tell, we’re just fine. But all our dishes and glasses are lying smashed on the floor — and we have to tread carefully to not cut ourselves.

And the routes our thought processes normally take to get to and from where they’re going are also diverted and changed. So, it takes us longer to get where we’re going.

Absent restoring my brain to its original condition — as if there ever was such a thing, as I’ve been having mild TBIs since I was 7 — I can do some things to help it along.

This morning, I did some of those things — exercised, and then had a big glass of water, ate my breakfast, and took my vitamins. I am religious about breakfast — high fiber cereal with rice milk, a cup of coffee, and a piece of fruit. I’ve really cut back on coffee — I have a mug in the morning and another in the afternoon (no longer the 3-4 big mugs each day). And when I have it, I make a point of eating something while I’m drinking it, so it doesn’t upset my stomach.

This morning, I had a banana with my breakfast. I’ve read that a banana and coffee will help your brain work better. The potassium in the banana helps, and the caffeine helps with the absorption. Or something like that.

I also (amazingly enough) remembered to take my supplements.

• B-Complex for my nerves — very important
• Chromium Picolinate — helps my body manage insulin production and helps with how I use glucose in my system — also very important
• Fish oil from Norwegian salmon — deep sea, algae-fed fish which have lots of good fatty acids and Omega-3’s
• Evening Primrose Oil — for the Omega-6 essential fatty acid gamma linolenic acid (GLA), that is said to “support the body’s heart, nervous, immune and reproductive systems. The GLA contained in Evening Primrose Oil is a nutrient used by the body to maintain healthy cells and vital body functions. Evening Primrose Oil enhances the health and strength of cell membranes throughout the body, and promotes a proper inflammation response. Evening Primrose Oil is also used by the body to maintain healthy hormone levels.” (Note, I’m not including an attribution here, because it comes from a sales site… nevertheless, I think it’s interesting information. If you really want to know what site it comes from, you can Google the above sentences in double-quotes.)

Basically, my morning brain boost is about helping my brain get going in the morning and stay that way. I take the B-Complex to help my nerves, so I don’t get physically taxed by stress, which then fogs my mind. I take the oils for the brain and cellular support, and I take the chromium picolinate to help with how my body handles glucose.

The brain is the Number One consumer of glucose in the body. It needs it to survive — to think properly and to keep its energy level up. There’s good reading over at http://www.fi.edu/learn/brain/carbs.html — I’ll post a tiny bit of it below, but please follow the link to get the whole story.

Brain Energy Demand

Your brain cells need two times more energy than the other cells in your body.

Neurons, the cells that communicate with each other, have a high demand for energy because they’re always in a state of metabolic activity. Even during sleep, neurons are still at work repairing and rebuilding their worn out structural components.

They are manufacturing enzymes and neurotransmitters that must be transported out to the very ends of their– nerve branches, some that can be several inches, or feet, away.

Most demanding of a neuron’s energy, however, are the bioelectric signals responsible for communication throughout the nervous system. This nerve transmission consumes one-half of all the brain’s energy (nearly 10% of the whole body’s energy).

Read More…

Interestingly, one of the points of this web page is that the brain needs carboyhydrates to function properly. It pretty much pointed me away from those low-carb diets that everyone is crazy about. Especially with my head injury history, I’m not going to deprive my brain of its primary source of energy — carbs. I’m just going to be smart about it.

As in, balance my carbs with other things — if I have bread, I’ll have it as part of a sandwich that has plenty of protein and extras on it, like lettuce and tomatoes and other stuff, if possible. If I have crackers, I’ll have an apple (fresh with the skin on) to complement it. And if I’m really craving carbs, that won’t be the only thing I have.

Well, anyway, I have a full day ahead of me, and I’m off to a good start.

It’s wild, how much of a difference just 15 minutes of aerobic exercise helps me. That, and my brain boost breakfast.

Stay strong everyone — and eat right!

Shoring up my reserves

It’s been a really rough 24 hours. I finally got to a breaking point, and melted down in a huge screaming/crying jag last night. I just ended up pushed over the edge by my fatigue and exhaustion and being overloaded by a lot of extra issues, including homeowner concerns — maintenance, upkeep — and health problems.

My newest concern is not having adequate dental coverage. It’s a huge added stress in my family that I know I need to rectify. Dental bills can run into the many thousands, as Judge Sonia Sotomayor can attest (she’s got $15,000 in back dental bills according to her personal financial records), and it doesn’t feel good, even in terms of hundreds of dollars. I’m not over my head in hock over dental bills, at this time, but I could get there quickly, and I need to arrange for coverage, so I don’t get to that place.

But the prospect of doing that drives me nuts. I get so turned around and confused by all the information, and then I never know if I’ve made the right decision, and I’m afraid I’ll end up paying all this money and making decisions that can’t be reversed very easily. I know I need to keep my head on straight about this and not panic. I just need to figure out how to do it, map out my plan, and do it. But I haven’t been able to manage that. I’ve just been kind of marginal, lately, and I haven’t been able to get a lot of the things done that I need to.

So much of this TBI business really is about having adequate resources to deal with what life throws my way. Whether it’s learning new things at work, handling odd jobs around the house (which I’ve been lagging at, too),  or arranging for medical/dental coveratge, how rested I am, how involved I am, how strong I’m feeling all have a huge role to play. And my resources have been slowly but surely eroding away, over the past while. I haven’t been sleeping well for months, now, and that makes it difficult to handle much of anything. My temper’s short, I don’t get the things done that I need to, I tend to push off all but the most exciting and interesting activities (which means I push off about 85% of what I’m supposed to be doing), and I have trouble learning and processing information.

For a while, there, I was pretty intent on keeping my sleep deficit to a minimum. But then I got sick of having to live such a limited life, always going to bed at a responsible hour, sleeping a full 8 hours (or at least 7), and being very deliberate about everything I did.

How boring!!! I didn’t want to have to tip-toe through life, always anticipating everything I did and said and thought, and adusting my behavior to be nice and acceptable. Plenty of other people wing it, and they’re fine. And I’m sure a lot of people out there have sustained TBIs and don’t even know it. Does that stop them? Not always. Sometimes… maybe lots of times… But it seemed to me — and it still does — that life is a messy prospect, at best, and in the end I’ve always been more of a creative bohemian type, even if I am a software engineer, so I’d much rather enjoy my life and be flexible and keep up my activity level and have a good time and do things that interest and uplift me, instead of playing it safe all the time and being so careful about every danged thing.

It was such a relief, to just stay up past my 10:00 bed time and watch a good movie till the end, without needing to watch the clock. It felt so good to just get up first thing in the morning – around 5:00 or so – and futz around with this personal resources management program I’ve been designing. It felt so great to not be tied to a schedule, to not force myself to be on some hour-by-hour time-clock, day in and day out. Maybe that works for some people, but it doesn’t work for me. It works for maybe a few days, but then it starts to break down, and my self-management techniques turn out to be more of a burden than a help.

Of course, I’ve found out the hard way (again…) that I can’t keep driving and driving and driving myself. Even if it’s all fun(!) I need to pace myself and give myself time to recharge. Last night, I headed off to bed at 10:30, and I got to sleep around 11:00. And I slept till about 6:00 this morning. Seven hours is the longest I’ve been able to sleep in weeks — I usually clock in around 5 or 6. I don’t know if it’s that pineal cyst that’s throwing me off, or it’s my stress level, or it’s my pacing during the day.

I know I’ve been spending too much time, late in the evening, on the computer. My diagnostic neuropsych tells me that computer screens emit light that is very similar to daylight, so our bodies think it’s day, and they need to wake up. That could explain why sitting down to my laptop in the evening always makes me feel better. And it could explain why I have a hard time winding down later in the evening when I log off. I know I need to change that. It’s not like I don’t have anything else I could be doing. Relaxing is a lost cause with me — I’m also in a lot of pain, these days, so unless I keep my mind busy, I am in a lot of discomfort. But I can find other things to do that relax me, don’t get me all charged up. Things like washing dishes or folding clothes from the dryer. Things that need to get done, boring or not.

It could also be that I’m so tired, I can’t rest — which is what happens with me. I have to do something extra-ordinary to drag myself (kicking and screaming) into slumber. Left to my own devices, I’ll just keep going…

I think this weekend is going to be a Benadryl weekend. I don’t have any outside commitments that are overly demanding on my cognitive abilities, so I’m going to just take the drugs and sleep as long as humanly possible.

With any luck, by Monday, I’ll have gotten at least a little bit back on track.

Using my head – for real

A while back, I was wracked with a sort of remorse. It was really sinking in that the way I worked before is not the way I worked now. I saw it more each day, on the job again with people whom I had worked with, 10 years ago. I am not the same person I was back then. That’ s for certain. My temperament tends to be more snarky and snappish, my attention span is shorter, and my ability to grasp and hang onto information over extended periods of time is very different than it used to be.

It’s a problem. ‘Cause this job and my ability to perform it is my bread and butter. And I don’t want to let the people on my team down. But I was having a hell of a time remembering the things I learned only a few weeks ago, especially when I hadn’t used them on a daily basis since I learned them. I was getting pulled off my past projects by new priorities, and I was spending more time testing and tracking and planning my work, than actually doing it. So the stuff I thought I had “down” about a month before, seemed like it had mysteriously evaporated.

It was a problem. It felt like a huge one. And I felt like I was spending all my time playing catch-up.

So that’s what I’ve been doing, lately. Catching up. It often happens that I  need to retrace my steps and redo my work, so I’m doing it once more. This time, though, I’m employing a different learning strategy than I used before. This time, I’m actually putting the learning into action by applying it to my workaday tasks — and working on a private project I’ve been designing for the past several months. This private project actually relates to my workaday world — it’s a special productivity tool I use to manage my strengths and limitations and constructively overcome the hurdles that get in my way, based on what I know about my own tendencies, and my inventory of strengths and weaknesses and coping skills that have worked for me in the past.

This is good. Not only am I integrating my whole life — personal and professional — in complementary ways, but I’m also creating new ways to master the new skills I need to acquire. Instead of just reading and making notes, like I did six weeks ago, I’m now using the new skillset I need to master.

It’s gotta be hands-on. Or I’ll never retain the new information.

It’s so wild, how I forget that. I’ve written before about how I learn best — by doing — and there’s a part of my brain that knows all about it. But putting it into action is the challenge. A big one. And I forget that I have to take a break, let the information sink in, and actually use it before moving on to “learn” something else. Instead, I keep reading. It’s not enough that I learn — and master — one single skill at a sitting. Oh, no — I must read and conceptualize more… and more… and more…

I’m not sure what it is — I think my hungry brain wants to race ahead and learn-learn-learn. It gets into this groove and instead of stopping to implement what it’s just read, it gets lazy or acclimated or lulled into a false sense of security, and when I’ve gotten to the end of one section or one chapter, it wants to jump ahead and read more stuff that’s new, different, interesting. It gets into this habituated flow and gets stuck in a loop. Especially when it comes to reading, studying, taking in new information.

That’s very unproductive, and it has a tendency to overwhelm me, before too terribly long.

But I can’t be too hard on myself over this. The fact of the matter is, I’ve had six weeks for the initial flood of information to sink in. It may feel like I’ve forgotten it, but when I get back into using the information I read about a while back, a little bit at a time, I can actually sense some familiarity with it. So, it’s not gone. It’s just tucked away in the back of my head, and I need to find a way to coax it out again into plain view, where I can put it to good use.

Here, again, is a great example of where my brain is leading my mind astray. It’s convinced that I’ve lost what I gained, some time back, and it’s ready to panic, run for the door, relegate me to second-class status. The mis-firing processes in my brain are interpreting this extended learning process as a sort of failure. Its artificially elevated standards say, “If you could really do a good job with this, you’d be proficient, by now,” totally underestimating the complexity and level of involvement required to do this new work I’m taking on. My brain gets turned around and confused and disoriented, so it thinks it’s lost in the wilderness for all time and is going to wither and die there like that kid from New Jersey who starved to death in Alaska, instead of it just being momentarily disoriented on a street corner in New York and needing to ask for directions from a passerby. It can’t immediately see a way through my passing frustration, so it thinks there is no way through. It can’t immediately access the information I stashed some weeks back, so it thinks it’s gone for good.

But here’s the thing — it’s not that I’ve lost what I’ve learned before. It’s that it’s filed in a virtual drawer in my head that I just need to find and open up again. I have learned, actually. It might not feel that way, but I have. And now I’m shifting into a different stage of my total learning process. All that reading and reading and reading without associated mastery isn’t a terrible thing. It’s not — I just have to realize that the reason I was reading and reading and reading before was different that what I thought it was — and it’s actually a lot more pragmatic and clever than I realized up till this point.

The real reason I was reading and studying like crazy before was for preparation, not execution. I was reading compulsively, not to master the material, but rather to familiarize myself with it, to get the feel of it, and to get myself to a point where I could listen to someone talk about all the topics and subjects and issues and aspects without being flooded with an overwhelming tidal wave of information overload… and eventual panic. Thinking back, I can remember many instances where conversations with my team members landed me in the middle of an emotional avalanche that totally shut down my brain. I just blanked. They were talking and talking about all this stuff, and I wasn’t able to keep up. So, I spent a lot of time reading about the things they were talking about. It was for the sake of putting my anxieties about verbal communication at rest, rather than implementing anything.

That first piece — the panic switch shut-off — was the first thing I had to do before I could move forward. I realize that now. And in its hidden wisdom, my mind devised this way for me to do just that — through reading and studying and familiarizing myself with the material before I started into all the doing.

So, actually, it wasn’t bad for me to spend all that time just reading and not doing. In fact, it wasn’t spending time, it was investing it. And now it’s paying off. Because I can sit through a conversation with people who are talking about stuff that used to be brand-spankin’ new and totally intimidating… and I don’t freak out.

That’s a good thing.

Getting it right… most of the time

Had a mixed weekend… My parents came to visit for their annual catching-up time. We’ve been getting together in a spirit of peaceful co-existence for a little over 10 years, now. It’s a way to make up for the years lost to our mutual inability to agree on many things in life — an inability that bordered on overt hostility for many years. My parents aren’t bad people. They just have their own point of view that isn’t always tolerant of me and my opinions, or inclusive of my limitations, and they frequently refuse to budge. And since I’ll admit I have the same tendencies. This apple didn’t fall that far from the tree.

Over the last 20 years or so, their hardline stances have gradually eased (helped a great deal by my vacating their house, 25 years back), and the range of what they consider acceptable has widened considerably. I’ve also learned to accept them for what they are, appreciate their strengths, and cut them some slack for their limitations. But it’s taken a long time to get to this place.

They used to give me so much crap about how I lived my life, how I conducted my affairs, and how I behaved. They didn’t much care for the jobs I held, the clothes I wore, the way I cut my hair, the schedule I kept. I was doing the best I could, but they didn’t always see it that way. And my standard response was to either go on the attack, or withdraw from any contact with them at all.

In retrospect, I can see that I’ve often misjudged their reactions to me. I was a very intense kid, and I took everything hard – including their judgment. My other siblings somehow manage to let their criticisms roll off their backs, or at most treat them as an inconvenient distraction. I, on the other hand, have always taken my parents’ criticisms to heart — I’ve taken things they’ve said and done far more personally than they probably ever intended it.

But truth be told, my parents were often overtly hostile and antagonistic towards me, when I was growing up. Even though I was very intense, they were pretty hard on me. They seemed to think that I intended to screw up, or I just wasn’t trying hard enough. They rarely seemed to grasp the fact that I needed help sorting things out — and when they did, it was cause for embarrassment. Teasing. Angatonism. Name-calling. Shame. Etc.

In retrospect, I think that of their rough way of relating to me possibly had to do with their concern about me not being okay in life. They worked overtime trying to steer me back on the right path, after I’d fallen off… never really understanding why I’d fallen off or gotten turned around. They were big into correcting me after I’d screwed up, which — with head-injured kids — is not the most effective thing to do. You’ve got to be pre-emptive with head-injured kids. Steer them in the right direction before they have the chance to get turned around. My parents, for some reason, never seemed to be paying enough attention ahead of time, to steer me right. So, I was constantly being corrected for things I didn’t realize I was doing wrong — till it was too late.

But despite all my screw-ups, my false starts, my blunders… after all this time, my folks have seen that despite the “worst” of my work and life decisions, I’m still here, and I’m happier than ever. I think their onetime hardness towards me had to do with worry about/for me. And I think a lot of their softening has to do with them seeing me actually grow up to become a productive member of society, holding down steady work and buying a house and keeping a very involved marriage going for 18 years, now. Even though I’ve done most things “wrong”, according to their standards, on the whole, things have worked out very well for me.

My spouse has also helped immensely, as they flatly refuse to put up with my parents’ most intrusive and verbally abusive crap, and they challenge them on their fondly held assumptions, to make them think about what they say and do. My spouse has been able to stand up to them far more than I ever could — or probably ever will. They don’t have the history with them, and they also don’t get the brunt of my parents’ aggressive judgmentality. For some reason, my parents don’t try to corner my partner the way they come after me.

But then, my partner didn’t grow up with head injuries, and my parents never acclimated to treating them with the proverbial iron fists in velvet (when I was lucky) gloves they used on me. In their eyes, I suppose I am still the “damaged goods” kid that used to worry them sick and bug the crap out of them with my poor choices, my bad behavior, my inability to get all the facts straight about much of anything, and just give up doing whatever I was doing whenever I was under pressure. To them, I’m still the sibling who beat up on the others, the one who wasn’t safe to leave alone for long, the one who would just do things that would get me in trouble — like run out in traffic, or wander off in the woods, or drop/lose/run into various objects, or say the wrong thing to the wrong person at the wrong time — without apparently having a clue what I’d just said or done.

I’m still the “special” one in the family. Not the bold adventurer who’s overcome tremendous obstacles and difficulty to achieve some measure of success in my life — success far beyond anyone’s expectation (except mine), which is notable on any level — and even more remarkable, given my history and my neurological profile. My parents haven’t seen me go through all my cycles and changes, they haven’t seen me in action, day in and day out, so they can’t appreciate everything I’ve accomplished or the sacrifices I’ve made to accomplish it. And frankly, they are so different from me, with such different social and cultural priorities (they were raised in a completely different place and time than me), even if they had been privy to all my adventures over the years, they probably wouldn’t have been able to fully appreciate what I’ve accomplished.

The things I’ve achieved — the good-paying job, the beautiful home in the well-to-do community, the mainstream social status, the public service position, the attainment of material success… those aren’t things that my parents particularly value. They’re much more interested in church and raising kids and alternative local community — none of which are regular parts of my life. So, the accomplishments I’ve achieved are all but invisible to them.

Likewise, the things that they value most are just not on my radar. I think I’ve just had so many problems with communication and interactions and behavioral issues, from an early age, that I never fully acquired the skills necessary to have the kind of life my parents have — lots of social interaction, lots of friends, lots of activities and travels and explorations. I have also had problems with fatigue for as long as I can remember, so I’ve never had adequate energy to match their pace. And when they pushed me to keep up with them, as they so often did when I was a kid, it just led to meltdowns, behavior problems, processing problems, judgment problems… Problems.

So, the enjoyment they feel with activities like getting together with large groups of people for fellowship and fun, and constantly going-going-going, working-working-working are not on my radar, either. Which leaves us with precious little to share, at times. Much as we would all like to find common ground, I’m just not there… and neither are they. And when they try to reach out to me, I’m often so overwhelmed and overwrought with their energy, their intensity, their sensory bombardment — they love to talk-talk-talk at the tops of their lungs and make contact a lot with hugs and reaching out to touch my arm or my shoulder as they’re talking — I end up experiencing a lot of auditory/sensory distress and sometimes pain. I don’t much care for it, and I don’t know how to articulate what I need them to do. And they still don’t know how to interpret it when I withdraw and start to get snappish with them.

So, we all end up on pins and needles, unsure how to interact. I try… I really, really do. But frankly, they’re too much for me to handle. And to this day, they cannot seem to temper their expression and tone down their level of excitement and activity to a tolerable level for me. They don’t seem to realize that they need to. And I can’t figure out how to get them to back off of me. When I do ask them to chill, they get upset and seem to feel rejected or pushed away. They just don’t understand the issues I have, and I’m not sure how to explain it to them without them taking it as though I’ve hurt them, or them sliding into some abyss of guilt and shame over not taking better care of me when I was little.

Well, it probably sounds pretty bleak — and in some ways, it is. On the whole, though, my parents’ visit this past weekend was pretty good. We didn’t have any of the blow-ups that sometimes happen with me, when I’m alone with them. My spouse had to work, one of the days, so I was all by my lonesome with Mom and Dad for most of  Sunday, which made us all a bit nervous. But I got through it without losing my temper or freaking out or inadvertently saying things that they found hurtful.

I also managed to get through without getting “pinned down” by my mother over my financial situation (no, I did not divulge details, as there’s nothing they can do — they have no money to lend me and they don’t know anyone who does). And I managed to avoid breaking down in tears as I sometimes do, when she “locks” onto me and starts grilling me for information. I came close to losing my cool — my mother, for some reason, loves to poke and pry and pick at emotional “scabs” until you break down in tears.

She’s always had a somewhat sadistic streak, and she loves to push people till they break. She did it to her older sibling (who is “special”) when they were growing up, I’ve seen her do it to many of her friends and relatives, and she did it to me a lot, too, when I was little. She used to just hound me, when I was a kid, pushing and pushing and pushing me to talk about sensitive subjects, talking and talking and talking, and never letting up until I was beside myself with confusion and frustration… and snapped. I’m not sure what makes a grown woman do that to a child, but she always seemed to really enjoy it when I was growing up, and she still gets into that “mode” at times.  She almost got to me on Sunday,when I was alone with her and my dad, pushing and pushing and pushing me over not having any retirement savings (I didn’t get into the details about why with her). But I managed to avoid a total freak-out and redirected the conversation — with the help of my Dad, who is none too keen on my mother’s mean streak.

Thinking back on the weekend, it’s kind of sad that the best measure of how well it went, was how well I managed to avoid something bad happening. I’ve never had an easy relationship with my parents. It’s nothing like what I see my other siblings having, and when they took turns calling my dad on Sunday to wish him happy Father’s Day, it was tough to hear the relief in his voice that he had someone else to talk to, besides me. It’s always been that way — he tries and I try, but he’s always happy to have a chance to talk to someone else when I’m around. I know I can be difficult at times, and it’s not easy to for me to interact and talk about things, but it would be nice if he could at least pretend to be interested in spending some uninterrupted time with me

It would be nice if I could just hang out with my parents without needing to do anything. But that’s just not how they are.

At least I did try to meet them on their terms. They tried to meet me half-way, too. And I managed to not lose my cool and cause any more damage that I already have with my hot, hair-trigger temper and my poor choices of words, so that’s progress.

We ended the weekend with me running out the door on Monday morning to catch the train to work, leaving them to finish their breakfast in the spacious family room of my beautiful house. I wasn’t around to make them nervous, and they got to enjoy the domestic evidence of how well I’m doing. It was probably the best way we could part ways after those 2-1/2 interpersonally challenging days. I wish I could say they left too soon, and that I wish we had more time together. But right here, right now, at least my parents and I are on amicable terms, we do care about each other, and we do all make an effort to peacefully co-exist when we’re in the same room.

That’s more than I can say for our relationship 15 years ago. And it’s more than a lot of other people can say.

I didn’t get everything right over the weekend, but I managed to get enough.

Yesterday was a wash

… Just about.

I had carefully made up a list of all the things I needed to get done — I’m on deadline at work, and it’s vital that I get the things done that I started, and that I do them on time. But I never checked my list until about 3:30 p.m., and then it was too late to do a lot of it.

I was just exhausted from the weekend — lots of activity and staying out too late. It was fun at the time, but it took its toll. And the people I’m working with are not pleased.

I’ve just got to let it go. I can’t start out today feeling bad about yesterday. It’s a new day. And I also have to remember that I’m not the only one in my group who’s struggling with work, right now. We all are, pretty much. We’re a challenged bunch of people with divided attention, conflicting interests, and way too much going on in our lives, overall. We’re also getting used to working together in new ways. There’s old bad blood that keeps people stuck, and there’s new opportunity to move forward. Main thing is, keep moving forward. But yesterday that didn’t happen nearly as much or as well as it should have.

I have to do something about this. I have to get out in front of my tasks. I know better than to do this. But the part of me that was playing all weekend wanted to keep playing, so I ended up messing up some stuff — and feeling badly about it.

More than anything, what takes the biggest toll is the emotional stuff. Feeling badly about myself. Feeling badly about how I’m doing. Feeling incapable and incompetent. And then, even if I’m doing okay by most people’s standards, my performance is thrown off even more. Because I’m feeling badly about myself and my abilities.

But it’s a waste of time to feel badly. My brain is just different now, than it was before my fall in 2004. It just has different needs and inclinations, which I have to factor in and accommodate/adjust to, if I’m going to have the level of ability that I desire. If I’m going to accomplish what I set out to, I need to use my tools — my planner, my notebook, my to-do list.

And I need to have just enough things on my list to keep me moving, without overwhelming me.

The thing about lists, though, is that I have to keep all the items I have on my plate (short- and long-term) in front of me in some way. I have to keep all my priority items in plain view, or I just forget about them. Other people look at my list, and they get all freaked out.  They tell me “It’s too much!” But for me, it works. I don’t mind all that stuff in front of me. I’d rather have it there, than forget about it — which is what I’ve done in the past … only to remember that I’d forgotten things I seriously needed to remember.

Until I find a way to remember everything — or hire a secretary/executive assistant to do the remembering for me — the stuff I need to do eventually is going to stay on the list.

But back to yesterday. What did I do which didn’t work, that I can do differently today?

1. I didn’t check my list, first thing in the a.m. — I’ve checked my list for today already, so I’m good with that.
2. I got down on myself for falling behind — I’m not going to do that today… get down on myself. I’m going to try the best I can, and leave the rest to fate.
3. I thought the whole problem was me — I know I’m not the only one having issues. It’s just that the other folks I work with are really good at covering up their shortcomings and problems, and so of course (since I’m very open about the areas where I am lagging), I end up looking like the one who’s bringing everyone down. Matter of fact, I’m not — in fact, one of the reasons I’m behind on my tasks is that the folks I’m working with made a total friggin’ mess of it before, and nobody bothered to sort it out, till I came along and said, “This will never do!”
4. I didn’t take time to plan my day and catch myself up – Today I am taking the train to work, so I can read and prepare.
5. I let myself lollygag around in the afternoon, when I was tired -- Today, I need to pace myself and do at least something in the p.m, when I hit my low point (as I always do). If I plan for my lull, and I do something like walk around the office or take a break away from my desk when I’m tapering off, I may have better luck. There is a common work area I can go to that’s far away from my desk — I’ll try going there today and see if the change of scenery helps.

These are just a few of the things I can do differently today. I already feel better.