Interesting reading


That anger thing

Source: racoles' photostream @ Flickr

I’ve been thinking a lot, this morning, about that anger thing — you  know, the way it just comes up, seemingly out of nowhere, like a sudden squall on the sea. I won’t say it’s like a tornado, because the signs of an approaching tornado are generally pretty obvious. They let you take cover. Anger following brain injury, on the other hand, is a completely different story.

Even after years and years of supposedly learning how to deal with it, I still get waylaid by those sudden temper bursts. Like yesterday, when I was having a really great day — did my chores, kept a decent pace, took good care of myself. Suddenly, after I’d eaten my lunch and had my shower and was getting ready to lie down for a nap, it came up, just out of nowhere. I snapped pretty badly at my spouse and groused and was difficult and just acted like a jerk. Arrgh! And I was doing so well…

Actually, now that I think about it, it’s not entirely accurate to say that anger after TBI can come just out of nowhere. Certainly, it can take people by surprise — especially if they’ve just happened upon someone who is having a tough time, and they don’t know about their issues. And if you’re not paying close attention to yourself, you can get swept up in it for no apparent reason. But people who are present during a lead-up to a temper flare are often in positions to see the warning signs, and to spot the conditions and warning flags that often preceded those TBI temper flares. The thing is, we need to be present.

It’s not like we never have any chance to observe TBI-related anger issues. Anger is by far one of the most common and most problematic challenges with brain injured folks. And it can be frighteningly frequent. So, if we just pay attention, observe, and make a note about what worked, what didn’t, and what led up to the flashpoint, we can learn. But we have to pay attention.

That’s one thing I’ve resolved to do more of — pay attention to my anger issues, and head them off at the pass. Granted, it’s not the most pleasant pastime. Throughout my life, I have frequently dealt with my temper issues, and over the years I have learned to overcome them — often with the help of friends and family and coworkers. But at this point in my life, I need to get in the habit of looking at them myself and dealing with them myself . It’s just silly for me to act like I can’t monitor and manage my issues on my own (tho’ that’s what I’ve often done over the years). I know I can do better, so it’s high time I did.

Looking around online, I found a great paper called Anger Following Brain Injury from the Brain Injury Association of Washington.

It talks about how anger is common after brain injuries, and that can have a number of sources which can work in combination with each other:

  • You may be angry about the injury and the problems that resulted, including disabilities, losing your job, being out of work, problems with your friends (those that stick around, anyway), money problems, and loss of control over your life.
  • Some folks were already angry people before their injuries. That problem doesn’t necessarily go away. (Although I have heard about folks who sustained brain injuries who became nicer people after the fact — but this is not a common occurrence, from what I hear.) If anything, existing anger issues may get worse.  In that case, psychotherapy may be necessary to teach the survivor new coping skills. In some instances, medication may be prescribed.
  • In many cases, impulsive anger can develop due to damage to the brain.  The parts of the brain which work to inhibit feelings of anger   and related behavior got damaged and they don’t do what they’re meant to quite as well as they used to.  This lowers the anger threshold of the survivor, and they become much angrier much more quickly and much more easily than before.

How can you tell that brain injury is the culprit, in this kind of impulsive anger? Here are some telltale signs:

  1. You didn’t used to get angry so intensely or so quickly; after your brain injury things got a lot worse.
  2. Your angry feelings suddenly come and go;  they’re here one minute and gone the next.
  3. You may get angry over “little” things; you sweat the small stuff.
  4. You are surprised and/or embarrassed or distressed by your angry episodes.
  5. Fatigue, pain, low blood sugar, or other physiological stresses make things a lot worse.

Unfortunately, a lot of people jump to the conclusion that personality, not brain function, is behind poor anger management and behavior control. This doesn’t help a TBI survivor constructively manage their issues. It just complicates things and muddies the waters and lays the blame at the feet of the very facility that’s trying to keep it together – when it doesn’t have all the resources it needs to do so. Being faulted and blamed for your anger issues, when you’re trying like mad to keep it together, just plain sucks. And it really works against everyone in the situation. In some cases, it can make the anger even worse, adding more emotional causes to the physiological/neurological ones.

For myself, I can use the five points above as a pretty clear reference point for tracking my TBI-related anger, and knowing when my outbursts are neurological, rather than being related to the stresses of everyday life that everyone experiences and has to contend with.

This is an important distinction. Because sometimes you have every right to be angry, and telling yourself that your TBI is to blame and you don’t really have the right to be upset, can cause you to put up with a lot of crap you normally wouldn’t. It can also give the people around you a “free pass” to be jerks and pains, because they say you getting angry with them is a malfunction of your system, rather than a proper function in response to their inappropriate behavior.

As always, discernment is the key. But TBI doesn’t make that any easier, so you have to be pretty resourceful and deliberate in dealing constructively with that powderkeg we call anger.

If I assume that my anger has to do with some “character defect” it slowly but surely bores a hole in my soul.  I’ve had anger/temper issues all my life, which have been really debilitating to my self-confidence and self-esteem, but after my most recent injury in 2004, all hell broke loose. And it wasn’t just at home, where my problems most commonly were. It was at work. It was out and about in the world. Whereas I was once cool as a cucumber at work, and I was the go-to person who stayed calm in any sort of crisis, after my fall, I started to fall apart, and each anger episode made things that much worse. It took a huge toll on me, personally and professionally, and it was freaky. All of  a sudden, as mentioned in point 1 above, I couldn’t keep it together.

And point 2 above  played into this, because the anger would literally come and go out of nowhere. I remember driving to relatives over one holiday season around 2007-2008, when I was having a lot of problems with sleeping and pain. My spouse and I were also on a long trip, and we’d been on the road for two days running. Driving down the road, I was practically overcome with flashes of rage – they would shoot up like geysers in Yellowstone, and I’d start to yell… then all of a sudden, the rage would subside, and I’d be back to normal, wondering “where that came from?” Then, a few minutes later, the rage was back, and I’d be yelling again. It wasn’t anything my spouse had done or said — out of nowhere, it was just back. And it felt awful to be taken over by that.

As for sweating the small stuff in point 3 above, well, that’s one of the toughest things for me. Because I’ve often been in the role of a first responder to crisis situations, and having a level head has always been my saving grace. I’ve found people collapsed on public byways a number of times, and I’ve gotten them help. I’ve rushed people to the hospital when they appeared to be having heart attacks and strokes. I’ve been the one to take command in some dicey situations, and I’ve always relied on that ability to block everything out except the most critical pieces of information. After each of my head injuries in adulthood, I noticed a distinct drop in my tolerance level for stressors, and it’s costs me jobs and friends along the way. My sudden, inexplicable failure to not sweat the small stuff wasn’t something my inner circle could tolerate.

And that just sucks. Because so many times (see point 4 above), my outbursts or meltdowns have taken me by surprise. I wasn’t watching for them, I wasn’t anticipating them. I didn’t understand them and I couldn’t plan for them and address them either ahead of time or in the moment. Not good. I guess my brain just got hijacked by the biochemical cascade, and the parts of it that used to monitor and modulate my responses didn’t work the way they used to. Yeah, it sucks.

But here’s the thing — since I know that I’ve got these issues, and I know that physiological stressors like fatigue and pain and low blood sugar make me more inclined to “go off” over every little thing, I’m in a position to monitor that and make sure I don’t get too far into the danger zone. Point 5 above is really critical, and it’s probably one of the most useful of the points, because it gives me a tangible thing to pay attention to — fatigue, pain, low blood sugar. I can often tell when these things are coming into play, and knowing what I know about how they make my flashpoint much lower, I can take constructive steps to address them. I’ll write more on that later.

This holds true for my friends and family, too. My spouse is well aware of what can happen when I am over-tired, so they help me get to bed at a decent hour. I need the help at times, too, since my foggy brain gets even more foggy when I’m tired, and my tendency to perseverate over every little thing can keep me up for hours. Like last night, when I headed to bed around 11, but ended up staying up till past 1 a.m. It’s a problem, but it’s one that I’m capable of monitoring myself. I just need to make the effort.

So, yeah, the anger thing is a challenge. Rage, temper tantrums, low flashpoints, acting out, lashing out. Not good. Some days, I really despair about the kind of person I’ve become, and I wonder if I’ll ever be able to get myself fully back on track. I wonder if I’ll ever be able to be fully independent, or if I’m going to have to rely on my spouse or a significant other for the rest of my born days to keep out of trouble. Because the anger is pretty bad. I’ve gone after police officers with verbal attacks over little things, and that’s a clear warning sign (Fortunately, I haven’t done it for over a year, now, so that’s a sign of progress. It’s also a sign of progress that I haven’t gotten pulled over for attention-deficit-related traffic violations, like not noticing a stop sign).

The worst part is when an intense anger flare shows up when everything is going great — like yesterday — and it messes everything up. What I wouldn’t give to have some level of confidence in my emotional stability, and know that I can, indeed, control my anger and manage the conditions that give rise to it. What my spouse wouldn’t do for that, too. And, come to think of it, my coworkers who literally fear my wrath at times.

Well, it’s a journey and an adventure, and as always, I have a lot to learn. Don’t we all? I need to explore this more and learn more… and put it into action.

More to come… Onward!

Source: Anger Following Brain Injury by Tedd Judd , Ph.D. Neuropsychologist (April 1992) – Brain Injury Association of Washington

Simple is good

Today has been a simple day. Started out with my warm-up exercises, then moved into writing a bit. Before the morning was up, I took care of some odd chores I needed to do, and then I took care of some Big Chores that I’ve been waiting on doing.

Lots of physical labor, around mid-day. Felt great. And with my daily exercise supporting me, it was actually a lot less difficult to do the heavy lifting and moving (and yes, even going up a ladder) that I was dreading doing.

I realize now that I had been waiting on doing those important chores, because in the past I’ve gotten really winded and wiped out by them, and it threw me off for days. I got angry very easily and my flashpoint was low. It screwed up my home life and sent me into a tailspin for the whole weekend. Plus, I’m nervous about getting hurt — especially with the ladder business.

But I was fine today. And I had great stamina. And there was only one little outburst that passed like a sudden thunderstorm. I just don’t know what happens to me when I get into that tired state of mind. I turn into such a jerk.

After I finished my Big Chores, I ate some lunch, ran another quick errand, and then lay down for a nap. Slept for three hours. I’ve been up for a while, making dinner and taking care of more little things.

All in all, it’s been a Good Day. A Simple Day. A Really Good Day.

And the weekend is just beginning.

Stamina = sanity

I paid a visit to some members of my extended family a few days back, and I’m happy to report the visit was a good one. I was able to actually enjoy myself.

This visit was in fact very different from past ones, when I really struggled with interactions and had a pretty rough time keeping up with everyone, mentally and physically. My relatives eat very different food than I’m used to — lots of sugar and fats and heavy sauces. And that tends to bog me down and make me feel sluggish… which makes me feel badly about myself.

I often start feeling bad and have trouble interacting after the first couple of meals. I get cranky and irritable and start to snap at people.

But this time, even though I was eating the same food they eat, I was able to keep myself together and stay really positive and upbeat throughout the whole visit.

This is good. And I do believe it has to do with my increased fitness and stamina, since my last visit, over 6 months ago. I’ve had more time to work out, get myself in better shape, and be better fit overall, so my body can handle the extra load of the travel and the change in schedule and meals.

I’ve been “hooked” on the idea that I can build back my stamina after TBI in much the same way I built up my stamina while running track in high school. Thinking back on my freshman year, I never thought I’d be able to work my way up to the 5-mile training runs we did for the mile and 2-mile races. But I did. It didn’t happen overnight, and it took a lot of hard work and practice, but I eventually got there.

If I could do it then, why shouldn’t I be able to do it now? I know I need more stamina; being overtired frays my nerves and makes me very difficult to deal with… which in turn cuts into my self-esteem and makes all my issues that much worse. I can work to change that the same way I got myself in race condition when I was a freshman in high school — starting from where I am, not worrying about being out of shape — why would I start this, if I were in shape? …  Deliberately building up my stamina with regular work and exercise to get myself into “competition shape” that will support me and make it possible for me to live my life without a lot of needless stress and strain that comes from fatigue. When I was 14, it didn’t happen overnight, but with proper encouragement, and gradually working my way up, I got into race condition, and by my senior year, I was really kickin’ some serious ass.

Yeah, if I could do it then, I can do it now. Never mind that I’m 30 years older, and I’ve got a long history of injuries and trauma along the way. The simple fact is, my body is still responsive to exercise and attention. And when I was visiting my relatives and we went out for walks, everybody except me got out of breath walking up steep hills. That felt pretty great, I can tell you. In the past, I was the one who was out of breath and had to slow down.

Not anymore.

And whereas before I would always end up pretty rough and ragged by the end of each visit, this time I kept my act together and was able to interact with my relatives and their friends, as a normal person without the temper and edginess that has dogged me ever since I was a little kid.

Whew — what a relief it is, to be able to spend time with my family and not lose it constantly! My moods are definitely connected with my fatigue levels, and pushing that threshold back, bit by bit, makes all the difference in the world. It’s huge, actually.

There was none of the usual emotional volatility, the temper flares, the anxiety, even the rage that would come out of nowhere… gone. The panic, the tension, the agitation, the quick frustrations, the difficulty sleeping and resting, the tension… gone. And in their place was relaxation, rest, and heightened attention to what was going on around me. I could actually enjoy myself, which is something I have rarely had in that place, for more than 30 years. Amazing.

Now, my neuropsych is keen on telling me that I’m doing better cognitively and emotionally, but I think the real key is my physical fitness. My family is pretty high-maintenance, and they like to be on the go. Constantly. They usually wear me out, and this time they took a bit out of me. But I was able to rest and relax and regroup and take care of myself so I didn’t start to lose it when I was running out of steam. Not having such a low fatigue “set point” frees up a whole lot more energy for interacting in ways that I want — in ways that I choose. It takes a lot of energy for me and my brain to get through each day, especially with my family, so the more stamina I can build up, the more strength and flexibility I can foster, the more sanity I enjoy overall.

And so does my family.

Absolutely, positively, the cognitive behavioral stuff helps. But there’s nothing like having a solid, sturdy physical foundation for your mental health. After all, the brain is part of the body. Take care of the body, and the mind can take care of the brain.

First, tackle the anxiety

Over the course of my life, one constant companion has been all but invisible to me… until this past year. That companion is anxiety. A persistent, low-level sense of impending disaster, which has never actually been far from me, in all the years of my life that I can remember. It’s been so constant, and so thoroughly woven into the fabric of my life, that it’s largely undetectable. I am so familiar with it, that not being anxious feels odd and unusual (and a little anxiety-provoking).

I’m not sure when it started — perhaps the experience, when I was brand new to this world, of being handed off to daycare workers almost from the first month of my life set me off. Perhaps growing up in a family that was fraught with financial issues put me on edge. Maybe it was the violent social problems of the world around me when I was in the public school system (I was bussed in the early years of integration, and the city where my family lived was a bit of a war zone in places).

Who can say? I could lay it at the feet of countless experiences I had as a kid. And I could also lay it at the feet of my TBI’s, which started when I was seven years old, and continued to occur every year (or few years) or so, till my most recent one in 2004. I can’t say for certain that I’ll never have another. But I’ve had enough to last me for one lifetime — trust me.

Anyway, all the cause-finding and determinism aside, the fact of the matter is, anxiety is a significant issue for me. In the past year, especially, I’ve gotten a really good look at how it has colored my life and derailed me and my plans countless times. I can also track how it has contributed to a number of my TBI’s, like some weird-ass self-fulfilling prophecy. It’s fueled lots of my activities that were born of “nervous energy” — the books I’ve written, the software programs I’ve coded, the jobs I’ve jumped into (and then jumped out of). It’s driven me like a steel-tipped bullwhip through days and weeks and years of “productivity” which was tightly coupled (and dependent upon) my exhaustive list-making/project-management system. It’s propelled me out of bed, as soon as my eyes opened, and sent me hurtling through my days with an intensity that intimidated people around me.

People I know have told me I’m “the most driven person they know” and I’m sure it’s true. Not a lot of people walk around with this level of anxiety — and live to tell the tale.

It’s interesting how I’ve harnessed this franticness. It’s like I’ve been riding a rocket through the sky. Some people — some of them very close to me, in fact — have panic-anxiety disorders and it keeps them from doing anything with their lives. They’re literally trapped in a cocoon of safety-seeking behavior. Of course, life being what it is, building your existence around making sure you’re safe in every conceivable way doesn’t leave you much room to, well, live, so they end up spending a lot of time hiding from the myriad dangers they anticipate just around the corner.

I, too, am wracked with anxiety about what-might-be. But my anxiety propels me head-first into life, and it drives me to achieve-achieve-achieve. The only problem is, it’s not sustainable energy, it’s based on an emotion and a state of mind that is not strong and solid, and the successes I’ve achieved with this nervous energy have been short-lived and somewhat hollow. They have also been prone to collapse under pressure. Because no matter how well and how productively I appear to perform, to the outside world, the fact of the matter is, it’s not self-confidence and surety that serves as the foundation for many of my successes; it’s a constantly shifting, constantly worrying sense of impending doom that I need to avert. And I often get to a point in my work where the sense of doom is too great, and I just have to “dump out” of the undertaking… leaving my backers and supporters angry and perplexed about why it didn’t work out… but leaving me feeling immensely relieved that “I don’t have to do that anymore.”

I really started to get my head around this, over the past couple of years, as I paid close attention (and I mean really close attention) to what I was doing with myself each day… what was going on behind the scenes… what was underlying all my activities. At first, I was incredibly impressed with how much I was undertaking, all my ambitious plans and whatnot.

But over time, as I started to see that thing were not coming to fruition the way I expected and hoped them to, I had to look deeper. And I started to get in touch with the fact that the things I was doing weren’t really for their own sake. They were for the sake of assuaging a deep-seated restlessness and anxiety that was constantly in the background of my mind and spirit.

At the same time, I was working with Belleruth Naparstek’s Stress Hardiness Optimization CD, trying to get my sleeping in order. I wasn’t on a good schedule, I was constantly tired, and I was having a hell of a time keeping viable. I was literally careening from one crisis to the next, and that’s no way to live (even though tons of people do it). In the process of working on my stress hardiness, I learned about techniques for relaxing. I had known about these techniques — and used them — some 20 years ago, but in the course of my very-busy life, and the subsequent injuries, the whole idea of relaxing just kind of fell off the edge of my attention.

…For, like, 20 years.

I guess I got hooked on the whole crisis business, and I found the nervous energy, the steady throb of anxiety, a valuable source of fuel for my overtaxed life. It got me through, I’ll say that. But the life it produced was one of being constantly wired, in a lot of pain from being so tense, and being so depleted and compromised that I ended up with more head injuries as a result of not being rested enough and not paying close enough attention to what was going on around me.

Granted, the car accidents I was in weren’t my fault entirely, but I wonder how they might have turned out, if my reaction time had been better — if I’d been more rested and more present. Each of the times I was in car accidents, I was “under the gun” — rushing to get somewhere, feeling that ever-so-familiar sense of pressure to accomplish something, anxious about not being able to do it, paying the best attention I could, but consumed by all sorts of worries and not really at the top of my game. I was either distracted or fatigued or both. And my life, at all those times, was a pressure-cooker of serious worries. The same thing holds true of my fall in 2004 — I was over-tired, distracted, rushing around, tremendously anxious about the state of my life at that time, and not paying full attention to where I was and what I was doing at the instant I slipped and fell. And so I ended up at the bottom of a flight of stairs, without a clear sense of the trouble I had just gotten myself into.

Anyway, that’s all water under the bridge. The bottom line is, anxiety has driven me and depleted me for as long as I can remember. I’ve lived my life in one unpleasant situation after another, which was extremely concerning and needed to be dealt with. Unavoidable. And fraught with worry. And I have to admit, I’ve kind of liked it. It’s energizing. It’s thrilling. It keeps me pumped up and go-go-going.

But it’s no way to live.

Which I have discovered almost by accident over the past year or so.

See, as I listened to the stress hardiness CD, something amazing started to happen. I found myself learning to relax. I found myself learning to chill and let go of the constant agita that propelled me through life. I found myself able to breathe deeply — perhaps for the first time in my life. And the more I did it, the more I enjoyed it. The more I did it, the more I realized I had an alternative to the standard-issue anxiety and stress that typified my life. And the more relaxed I became, the more I realized that there was another source of energy I could tap into — rest and relaxation and a revitalized parasympathetic nervous system that could support my fight-flight way of life. And I realized that I could take the edge off my intensity, and still perform extremely well. Better, in fact, that if I was constantly taxed by all that nervous energy.

Furthermore, I started exercising regularly each morning before I did anything else. I started riding my exercise bike… then stretching… then lifting. And the boos I got from it was a whole lot better (and more lasting) than any amount of nervous energy my anxiety could stir up.

I guess you could call me a Type A personality. People have. And some of them have said it in a derogatory way. But I am what I am, and there it is. In the course of my relaxation quest, it’s become plain to me that it’s not so much about turning myself into someone other than a Type A person — it’s about making me into a better Type A person. It’s not about making myself all soft and cuddly and mellow. It’s about giving that edge a rest, taking the sword out of battle, and giving it time to get its edge back. It’s about taking care of my vehicle, my body, so it can keep up with my Type A character. Ironically, the better I support my Type A person, the more healthy I become, and the more effective a Type A person I can be.

And that’s been an important discovery for me. Because it frees me up to build my system back up. And it gives me permission to rest, without feeling like I’m giving in to the pressure to give up. It lets me take care of myself without feeling like I’m “quitting.” It lets me be who and what I am without guilt and shame and feeling like I’m less-than.

In the process of taking a break from the pressure, I’ve been able to break the cycle of being mindlessly driven by the anxiety… constantly goaded on by the impending sense of doom… and I’ve been able to separate out the things in my life that are truly mine, and the things that are born of dread and an impending sense of disaster. I’ve realized that much of what I’ve done in my life has been about just relieving the pressure of my nerves. All those books I’ve written, all the pictures I’ve drawn, all the pages and pages and pages of journals I’ve kept over the years (many of them saying exactly the same thing, day after day, week after week,  month after month, year after every livelong year), all the software projects I’ve undertaken… a huge proportion of all of them has been about creating some sort of pressure release… giving my nervous energy somewhere to go… keeping myself from flying off the rails with panic.

I have to say, this is a very strange place to be in — for the past 40-some years, it’s like I’ve been living another person’s life, all this time. It hasn’t even been another person’s life — it’s been a gut-response to a biochemical process that has driven me like a goat across the deserts of my nervous life. Granted, in the process, I’ve acquired a lot of skills and a lot of experience, which I can use for my own benefit. And I’ve made some good money in the process (if only I hadn’t fallen in 2004, and lost almost all of it afterwards). It’s not like it’s been a total waste. I can reclaim a ton of good things from it. But I realize my motivation has been askew. My rationale and raison d’etre has been, well, off. And that needs to change.

I need my life back. MY life back.

Of course, change is hard. When I’m feeling really anxious, I still find myself dusting off old projects that used to consume me, and I have to check myself before I launch into them all over again. And the idea of getting away from the kinds of work I’ve done in the past — the heavy-duty technical work — because I’m not driven by the same level of panic that I used to be, is a hard one. I’m working on that one, steadily but surely, and it’s a real challenge to shift away from that way of working, which was closely coupled with my sense of self and well-being. My 40-some years of habit-forming use of that old anxiety isn’t going to change overnight, but it’s got to change. Because now I see it for what it is, and now I realize that if I’m going to truly live up to my potential, I need to find a better way to motivate myself than sheer nerve-fraying fear.

The first step in all of this is to tackle the anxiety. Learn to see it when it comes up, talk myself through it, and find ways to address it that are healthy and make sense. I have been doing better about noticing the warning flags — I’m starting to make lists again, or I’m starting to dig through all my old files again to see what old projects I can resume (note: I say projects, because I can never stop at just one, when I’m anxious). I notice it more, now, when I’m getting tense, and I’m doing better about just breathing. And when I can’t take a deep breath in, because I’m so tense, I just exhale as completely as possible so my body naturally takes in a deep breath in response.

It really is amazing, what dealing — physically — with anxiety makes possible. Once I started doing conscious relaxation, conscious breathing, and deliberate exercise on a regular basis, I was able to actually get my head around the mental/cognitive/behavioral parts of this puzzle that is my life. Before I did that, I was constantly going-going-going, rushing from one exploration to another, taking on one mammoth project after another, just diving headlong into everything, everywhere I could find it.

And I thought I was doing good things. But I wasn’t. I was just doing for the sake of doing. Just going for the sake of going. I didn’t actually care what was to come of all of it. I just wanted to go and do… till I dropped from exhaustion.

Once I took the edge off my anxiety, though, all that began to change. I started to see what was really going on, and I was able to start seriously considering the nature of my life. Most importantly, I started to find places where I need to make changes, and I was able to look at them without the intense level of anxious judgment I used to. It has helped tremendously, to have a neuropsych to work with, who has been a voice of stable reason throughout this process. (Ironically, they aren’t as avid a fan of exercise and physical rehab as I am, but that’s another discussion for another post.) But truly, I have to say that even without a neuropsych to work with, the benefits of exercise would still be the same, and I would probably still be making  the same kinds of changes I am, reading the same things, discovering the same old truths about myself which have been hidden for many years behind the curtain of crisis-driven biochemical freak-out.

And I have to say, too, that until I started to exercise and work on my relaxation and resting and breathing, a lot of what my neuropsych was telling me didn’t make a lot of sense. Freeing up my energy to NOT deal with constant drama and anxiety and franticness makes it possible for me to process real, genuine aspects of my life, not just stuff that I pick up along the way to distract me from my anxiety. The more I address my anxiety, the better I am able to just life my life. Make new choices. Make better choices. Take pro-active steps, not just be in a state of constant reaction.

Well, it’s all an adventuresome journey. And the more I know, the more I learn, the better it gets. I’m profoundly grateful that I’ve had the chance to learn all this, and I’m also grateful for the happy coincidences that have led me down this road.

It’s all good.

And it keeps getting better.

Life without lists

I’m trying something new and different these days — I’m doing without my exhaustive lists of what I need to do, when I need to do it, and how it should be done. This is a real leap of faith for me. A key component of getting myself back on track and building some kind of structure in my life has been my list-making habit. After my last fall, I had a hell of a time keeping track of what I was supposed to be doing, and tracking whether or not I was getting it done. So I got in the habit of making lists and using them to keep myself focused on important tasks.

I have been writing out all the things I need to get done for a number of years, now. And it’s a good thing, too, because there have been plenty of times in the past when I would literally forget from one minute to the next what I was supposed to be focusing on. I’d get distracted by something, and my “problematic” short-term working memory would lose track of what it was I needed to be doing.

It was maddening. I’d get to the end of a day and I’d look back on all the things I had planned, and lo and behold, nothing would have gotten done.

It was pretty bad. Everything from returning books to the library, to people I was supposed to call or email, to picking up pet food on the way home from work, to taking a certain route home so I could run my errands on my way home… a ton of important things got lost along the way. And each time that happened, I felt worse and worse about myself. As though I intentionally blew it all off and didn’t give a crap.

At least, that’s what my spouse thought. And they weren’t happy with the situation. Or with me. Nor was I.

So, I got into making my lists. I tracked my activities, marked the things I got right, the things I messed up, the things I forgot, the things I needed to remember for the next day. I had the list-making habit down to a science of sorts. And it helped. A lot.

One of the ways it helped was actually getting me away from making exhaustive lists. ‘Cause when I looked at all the things I had scheduled for myself, and I compared the list of “successes” with the list of “failures”, I saw how much I had loaded up for myself. And I saw how impossibly busy I was making myself, with no hope of ever digging out from under the mountain of to-do’s I needed to dispatch. Only when I took a look at the written record of all the stuff I had slated for myself to do over the course of weeks and months, was I able to step back and say, “Hey – what’s going on here? Is it really necessary to do all that stuff? Is the world going to stop spinning on its axis, if I just give up some of that stuff?”

And I realized that a big part of my most dysfunctional behavior is the habit of loading up a lot of crap on myself to keep myself so busy I can’t pay attention to the things that bother me. I get all stirred up and all worked up and all tweaked over things, and rather than sitting down and thinking it through and working my way through the feelings I’ve got and constructive ways of dealing with those feelings/situations, I make myself even busier, even crazier, and the stress of it all pumps my body and brain full of stress hormones that dull the constant pain and confusion and help sharpen my thinking for basic activities (but do nothing for the more complex aspects of my life).

So, my lists have given rise to plenty of ah-ha’s over the past months. And slowly but surely, I’ve gotten away from the crazy-busy franticness that used to drive me like a low-level nuclear reactor pumping a steady stream of energy that is fundamentally toxic and very hard to dispose of safely.

My lists have grown progressively shorter and shorter, as I’ve forced myself to make decisions about what I really wanted to spend my time on. As I’ve realized that there is no way on G-d’s good earth that I’m going to get everything done that I want or would like (or even “need”) to get done, I’ve had to pick and choose the things that I absolutely positively cannot live without… and then figure out why that is… understand what part of my life those things fill… and then bump them to the top of the pile of constantly shifting priorities in my life.

It has been hard — very, very, very hard — to do this. You have to understand — my daily list of to-do’s used to fill two sides of a sheet of paper, and by the end of the day, there would be even more things listed in the margins that I had either started or wanted to start or had gotten done just on the spur of the moment. Culling my list is not my first instinct. It’s exactly the opposite of that. But doing anything less was simply — obviously — not sustainable.

Okay, you may think, that’s fine, you’re trimming back your list, but how do you get anything done? Good question. I asked myself that many times, when I started getting away from my list-mania. How would I manage to get anything done? How would I manage to remember the things I needed to do? How could I get away from all those lists AND keep myself on track?

Well, for one, I started getting more involved in my life. I’m talking, think-it-through-plan-and-vision involved. I realized that keeping those lists was keeping me from getting involved in the actual living of my life. I was so busy looking at the list of stuff to complete, that I stopped paying attention to the WHY of what I was doing. Or examining the ultimate outcomes of my actions.

For example, I once had it in my head that I was going to start a new business. I had it all mapped out, all planned. I had my unique selling proposition, my schedule, my business plan, my project plan, my lists of all the different people I was going to contact, how I was going to go about doing this-and-that, etc. I had it all mapped out on paper, and the list of stuff to do was voluminous. Someone in the “getting it done” camp probably would have gotten a thrill out of all my lists. Because there were many of them, and they had every single activity broken down in to a series of smaller steps, each with its own timetable, etc.

The problem was, in the process of getting all those lists in place, I neglected some critical, fundamental aspects of any new undertaking — as in, my motivation for starting this business in the first place. Why did I want to do it? What did I hope to accomplish with it? Where did I see myself in another five years, and what kind of life did I want to emerge out of this new venture? When I thought back, I detected some faint recollection of wanting more freedom and independence, but by the time all my lists were written out, my mind was pretty well enslaved to the tasks-at-hand, and freedom and independence were about the farthest things from the situation I was creating for myself.

So, I let that go. I learned some valuable lessons, and I had to let it all go. Because the lists took over.

The same thing had been happening in my life, over the past six months or so. I had refined my list-making practice, had created numerous to-do templates which listed the most common things I needed to do each day (that I was prone to forgetting), and I had my system for tracking what I did and did not get done, and why. I even wrote a computer program to help me keep track of everything, which was very helpful at the time.

But it got to a point where the list became the thing, not the doing, not the getting done. And I found that in the process of making sure I got things done, I had lost my connection with why I was doing it all, in the first place. And without that motivation, there was less and less chance of me actually getting those things done. The very tool I was using to help me along, was holding me back.


Plus, I found that making daily to-do lists made me more prone to distraction. By the time I had the main things written down that I wanted to do, I had worked up a head of steam, and suddenly I could think of a gazillion other things I wanted to get done. And they would end up on the list. And some days, the distractions I’d written down would get done before the main items. But I checked them off, so it looked like I had been successful that day — when I really hadn’t. Not really. Effectively distracted, yes. Effective in living my life, no.

So… I have been living more and more without my lists. And I’m starting to love it. Oh, sure, for things like going to the grocery store to buy more than three things (more than two, actually), I have to have a list. But who doesn’t? I know I’m prone to distraction and confusion in grocery stores — so many choices, so much extraneous input to screen out (no, I do not want a diet of cheap carbs and high fructose corn syrup!) And if I have more than one library book I need to find on the shelves, I make a point of writing the numbers down. But for the overall flow of my life, I’m moving away from planning out every single thing I do in advance.

It was kind of a losing battle, anyway. For all the things I finished in the course of each day, there were always other things that I hadn’t gotten to, and it was those things that got to me, to no end. Even if I’d done 9 out of 10 items, it was that remaining one thing that would stick in my head. And the next day I’d start out playing catch-up. Yet again. And by the end of the day, I’d have a couple more things that needed to get done, which needed to be added to what I’d do the next day. Eventually, I would amass such a heap of undone stuff, I’d just bag it all and have to start from scratch… all the while knowing in the back of my mind that I had a lousy track record… and I was really just another loser making a losing bid at trying to do stuff only winners could do.

Why did I bother?

Why indeed? Man oh man did I need a change.

So, I bit the bullet a little while ago and started taking on each day without a list of stuff to do. Instead of spending my time on the exercise bike listing out all the crap that needed to get done, I spent my time focusing on my workout and thinking about what kind of life I wanted to live, what I wanted to accomplish — on a much grander scale than ever before — and I quit fixating on details. I resolved to let a lot of stuff go — a lot of anxieties about “lack of effectiveness” and not being good enough. I let myself off the hook, thinking back on all my years of compulsive list-making… and looking realistically at how much I had actually gotten done (far less than I’d intended). And I took a long, hard look at the toll it had taken on me and my quality of life and my relationships.

I was so busy with my damned lists, I didn’t get around to living.

And I let the lists go. I quit fretting about the exact order in which I did my morning routine. I quit worrying about making sure I had the exact proportion of sleep to activity. I quit freaking out over drinking coffee after 2 p.m. And I quit stressing out over how much sleep I was — or was not — getting. I stopped making myself and everyone around me nuts, if I/we didn’t get everything done that I/we originally said we would. I wrote stuff down when it was critical that I remember it, and I started using my work calendar more creatively and regularly, so I wouldn’t have to hover over my list(s) every moment of every day. And I gave up the all-consuming need to satisfy every single damned requirement they had for me at work.

I have probably pissed off a lot of people I work with because I haven’t been as anal retentive as I used to be, but you know what? I’m a lot happier. And healthier. And that makes me a better co-worker and employee.

Plus, it frees me up to actually get things done. Because in lieu of lists, I have a larger picture in mind for what I’m doing with my day and my life. I’m less focused on the details, but I’m more focused on the bigger picture — not just what I need to do and how, precisely, but what I intend to do and why.

That why makes all the difference. Because lo and behold, even in the absence of lists, I am actually making progress. Granted, I may not be as frenetically ‘efficient’ as some folks would love me to be, but you know what? I’m a lot happier this way, and if others want to wreck their health and their sanity over a bunch of detail and have-to-have’s, then have at it. I’m not going there. Not anymore.

Which opens me up to other possibilities. And it makes more possible in my life. Because it’s not just about what gets done, but why. And when you know why you’re doing things, more details emerge that add to the overall work you’re doing. Those details add higher quality and greater dimension to what you’re up to. And that’s a good thing.

It’s all good.

So, here I am, up early on a Tuesday morning. I woke up at 4:30, worried about money and how I’m going to make ends meet. I tried to get back to sleep, but by 5:15, it was pretty clear that wasn’t happening. So, I got up, exercised, and sat down to have my breakfast and write. I resisted the temptation to make a list of ways I can deal with my finances, and focused on the larger work of my life. Now my money problems aren’t gone, by any stretch, but the worry has subsided and within the larger context of my life, all the drama and anxiety and worry is a lot less overwhelming. I’m ready for my day, full of tasks and duties and worry and anxiety as it is. And I’m actually feeling pretty hopeful. Because there is more to my life, than a few hours’ worth of concern. And there is more to my work, than fretting over distinct details and trying to control and “manage” every single aspect of my existence.

Some times, you just gotta let yourself be. The lists will always be there, if I need them. The challenge is telling the difference between needing them and wanting them — for the wrong reasons.

For today, I don’t want one. Not like I used to. For today, the day will take care of itself.

Almost normal

I’ve been making more changes to my life, of late, not least of which is doing away with a lot of the rigid guidelines I have relied on, for quite some time, to keep me on track.  I have been making far fewer lists, and I’ve been tracking a lot less of my “problematic” behavior, in favor of just living my life and getting on with it.

Once upon a time, I had some serious issues which I paid no attention to whatsoever. Those issues totally screwed up  my life.

Then I caught on that something was amiss, and I started paying really, really, really close attention. To everything. Things stopped getting royally screwed up all over the place. Yet there was this rigidity and brittleness to me that was wearing me down to a nub.

I had to make more changes. It just didn’t feel right. Plus, my neuropsych wasn’t all that impressed by my compulsive note-taking and control issues. They were far less enthusiastic about it than I. I didn’t exactly understand why, but I think I do now.

Since I started really focusing on my physical fitness — and working on my endurance/stamina… and I started pushing myself outside my little comfort zone… and I stopped insisting that everything I did be absolutely perfect all the time… things have loosened up a lot for me, and I find myself better and better able to just take life as it comes, without losing it as often (or as intensely) as I used to.  I find myself better able to be… spontaneous. And a lot more good-natured than I’d been for the past 5 years or so.

Make no mistake – my flashpoint is still a lot lower than I’d like it to be. Just this morning I “went off” — not pretty. But I don’t have the frequency of meltdowns. And I am able to recover much quicker afterwards. It’s taking me hours instead of days to right myself again. And I’ve actually been able to laugh and joke. That’s been missing for a while.

Anyway, I’m getting used to this, actually. And I’ve been cutting myself a bit of a break with my daily workouts, too. More intervals. Less strict attention to precise counts and controlled movements. Now, it’s really about strengthening motion and range and functionality, not just single muscles.

Much more like life… after all, when was the last time you did something with ONLY your bicep?

Well, it’s getting late and I’m pretty tired (as you can probably tell).

More later — I’m bushed. But I guess that’s normal, too.

Move UP to feel UP

The next time I start to feel down and need to lift my spirits, I think I’ll do it physically as well as mentally.

An interesting blog post links bodily motions and memory and emotion.

If I weren’t so tired, I’d write more, but I’m bushed. Time to call it a day.

But first, I’ll head UPstairs, and perhaps that will lift my mood 😉

Ode to neuroplasticity

I’ve been a little quiet on this blog, lately. Work has picked up, the job interviews I went on have not panned out. The failed job bids are  probably the universe’s way of telling me I’m not extending myself enough and I’m going after the wrong type of job, because given my interviewing skills, which are mad (if I say so myself), if the jobs were good fits for me, I’d already be in and I’d be writing about how my new working life is going.

I had to seriously give that some thought, this morning as I did my morning warm-up. My neuropsych has been pushing me a bit to stretch myself and really test the limits of my ability. They tell me I aim too low in life, given my innate abilities, and there is really no logical reason I should be struggling with the things I struggle with.

Now, they’ve been saying this almost since I started seeing them several years ago. They keep saying, over and over, that I’m actually capable of a lot more than I think I am, and that a lot of my “issues” have to do with the stories I tell myself about myself. It used to bug the crap out of me, when they would tell me that I’m more capable than I give myself credit for, and they would encourage me to step up and do the work that needs to be done. But when I look around me at the larger world, and I consider what others are doing — and doing quite well (or not very well at all) — and then I compare myself to them, I actually turn out looking pretty good, in some ways.

My neuropsych says it’s just human nature to do this kind of deprecating self-talk, where you talk yourself out of being competent and able and capable. And I think it’s especially true, in my case. Given my history of injuries and the fact that I’ve had tons of opportunity to go through some pretty nasty stuff and rack up a ton of unpleasant and disorienting and downright scary experiences, thanks to my TBI’s, I can totally see where I have gotten in the habit of telling myself things about myself that simply aren’t true — that I’m stupid or I’m bad or I’m ignorant or I’m a bad seed or I’m incompetent. I’ve had tons of opportunity to “view the evidence” of all this, through the years of the injuries and the aftermaths. Since I didn’t realize the nature of my difficulties, it seemed quite logical that the problem was me, and that there was something wrong with me that simply couldn’t be fixed, because it kept coming up and taking me by surprise.

Once those stories about being stupid or lazy or crazy or bad got worked into my system, they got easier and easier to tell myself, and they kind of got lodged there in my brain. Even as I was recovering from my injuries and learning how to compensate for my problems and developing new skills and new connections and neural pathways in my brain, I was getting in the habit of telling myself things about myself that were less and less true.

The less true the stories became, however, the more comfortable I was telling myself them. So, as my thinking and cognitive state stabilized, time and time again, it stabilized around a set of false assumptions and flawed assertions that felt right, but just weren’t true.

Like the “fact” that I was bad.

Like the “fact” that I was stupid.

Like the “fact” that I was lazy.

Like the “fact” that I was a loser who couldn’t finish anything and would never amount to anything.

Like the “fact” that I was a waste of others’ time who wasn’t worth their time of day.

How clever of my mind to be telling myself things like this — things that seemed true enough, but were in fact the exact opposite of how things truly were. And my neuroplastic mind, as it healed and returned to improved functionality molded itself around these flawed assumptions, using its plastic nature against me, as it locked onto those fallacies, those fictions, those out-and-out lies that I was telling myself about myself.

Huh — how ’bout that…

It’s like the very thing that helps me, hurts me too. My greatest strength — my brain’s ability to adapt to circumstances and reorganize itself around data and information and input and make lasting connections that translate into action and results — has worked wonderfully… against me. All the years when I was bumping into things (literally and figuratively) and “messing up” and getting turned around, I was explaining it all with reasons that simply weren’t true. And my whole life got built around a series of unfortunate misunderstandings, which went from being guesses and suggestions to “facts” about who I was and what I was about.

So, now my primary task is to undo those old connections. To re-tell the story about my life from a perspective of truth and hope, not fantastical despair. Now, instead of telling myself stories that hold me back, I need to tell myself stories that build me up and strengthen me. We all tell ourselves stories about ourselves and our lives. We all have our interpretations and our biases. The thing is, we get to choose which ones we want to stick with, and we get to decide for ourselves what we’ll think and believe about ourselves.

Sometimes it’s easier to opt for the more negative ones — it’s a lot easier to go through life saying, “Oh, well… I guess I can’t do it after all…” than to say, “Oh, it appears I need to improve… what more can I do, to make my life and my performance better than before?”

Improvement takes work. It takes energy. It takes determination and discipline. But it’s well worth the effort. In terms of quality of life, you get what you pay for.

Do head injury lawyers do more harm than good?

In my travels, I come across a lot of people with a lot of different skills and abilities, difficulties and challenges. Every now and then, I’ll come across someone who has experienced a brain injury, and they retained a lawyer to represent them and recoup damages. Unfortunately, I have rarely come across anyone who has actually won their case, or gotten as much compensation as they felt/told they were entitled to.

Having worked with lawyers a lot in the past, I can say that I have rarely seen clear-cut cases which turned out the way people expected/hoped them to. And I have seldom seen results which truly matched the circumstances. Either the lawyer had to work a lot harder and longer than they expected — and their fees went way up. Or the other side had a great lawyer, too, and they prevailed in at least slashing the damages to what was — after all was said and done — a pittance.

The problem is/was, that one of the main components of the cases I’ve heard about was often the “injury” or “damage” piece of the story. The damages had to be justified by the degree of the damage done. So, in order for the case to proceed, the injured party had to live, breathe, eat, sleep their injury. And they had to present plausible evidence that they were severely harmed enough to justify a sizeable amount.

And in the meantime, valuable time and recovery were lost, in the initial weeks and months — sometimes years — that could have been used to get the victim back on their feet and take them from being a victim to a survivor. They lost critical windows of time in which they could have be rehabbing themself — they had to maintain the appearance of damage, until the lawyers were done with their part of the business. Which always took much longer than expected.

Or (almost worse), the person decided that they couldn’t wait for the litigation to be concluded before they started rehabbing themself, they got help from qualified professionals, and they made good progress. But by the time they got to trial, they were well enough restored to what looked like full functionality, that nobody would believe that they had ever had problems, and the court didn’t think it warranted damages being awarded.

I have huge issues with litigation as a way to right the wrongs of the world. It’s often demeaning and dismissive to everyone except the attorneys and court, and it’s expensive and rarely produces the results the victims anticipate. Even defending yourself against an accusation with the help of a lawyer can be an exercise in abject humiliation — no matter how innocent, justified and/or exonerated you are. It’s expensive. Lawyers bill by the hour. And you never know exactly how things are going to turn out.

Losing all the time that a court case takes to your recovery can be a terrible blow. And let’s not even discuss the blow to your dignity. Litigation always takes longer than expected. And it is more expensive and more taxing on the parties involved, than anyone believes it will be at the inception. And in that prolonged waiting period, when it’s critical that the victim obviously be victimized, valuable time and opportunity to heal and recover are lost.

Now, I’m not saying that the results/symptoms of tbi from a car accident or other mishap can eventually be addressed by rehab. I’m not saying that healing isn’t possible on down the line. I firmly believe that it can. I’m living proof that you can recover and get back on your feet, even years on down the line. The problem is, people who have been injured can end up sacrificing not only their health and well being, but their employment, their savings, their families, their relationships… because it’s incumbent upon them to present plausible evidence that damage has been done to them as a result of their accident.

By the time you start to recover, it can work against your credibility in injury damages litigation

And while the attorneys are drafting and filing their motions and briefs, valuable time and opportunity to get back what was lost, to cultivate necessary relationships, to readjust to your new world… slips away. And in the end, you can sit there in court being told, “Well, you don’t look that bad off to me!”

Now, I don’t for a minute think that this MUST be the case all across the board for every TBI case in the book. But at times, “going the attorney route” is not the way to go. And anyone who’s seriously considering it needs to carefully weigh the pros and cons of appearing injured and getting on with their life.

For if you wait and delay your recovery until after your case has settled, you may end up losing even more than you originally did. And all the money in the world won’t be able to replace at least some of what you’ve lost, because your lawyer told you that it will be in your favor if you look the part of an injured party.

Now, admittedly, I’m not a definitive subject matter expert on this subject. I’ve never been embroiled in a personal injury case over my tbi’s. But I have worked with a lot of lawyers, and I have seen how the court system works — very, very slowly. My recommendation to anyone seeking legal assistance to recoup damages after a head injury is to only get into it if you can afford to live without your whole self for as long as it takes to settle the case. No lawyer is going to tell you they’re incompetent and can’t bring the bacon home. They may reset your expectations along the line, but too often I’ve seen that reset happen long after everyone has passed the point of no return, and the only thing anyone can do is press on… and hope for the best.