Into the bleak mid-winter

winter sunset with geese flyingI have a confession to make. I love the bleak mid-winter. There’s a hymn about it, that sounds like a funeral dirge. The first verse starts off with a not-so-perky extended complaint:

In the bleak midwinter, frosty wind made moan,
earth stood hard as iron, water like a stone;
snow had fallen, snow on snow, snow on snow…

It’s actually a religious hymn about the birth of Jesus Christ, and I don’t want to get too faith-based here, but the bottom line is, the start of the song sounds pretty dire, but it ends up in a happy, light-filled place. If, that is, you’re a Christian believer. Everybody else will probably be left as cold as the first verse sounds.

Regardless of religious conviction, however, the point of the song is that despite the cold and gloom of the winter months, a light comes into the world. And that transcends it all.

Personally, I like the bleak mid-winter, because it slows everyone down. All the running around and chasing after things during the spring, summer, and fall… well, it all gets a little tiresome, after a while. Our systems aren’t really built to keep going at top speed, all year long. Or even all day long. We need our sleep. It cleans out the gunk that builds up in our brains, and it helps our systems restore their balance.

The idea that you can get up at 4 a.m. and push-push-push for 18 hours, till you collapse, and then get up and do it all over again, is a dangerous concept. Some people can do it, sure. But they’re the exception. The vast majority of us really need our sleep to function. And that includes me. A lot of us could also use a nap, each afternoon. That includes me, also. But I only get that on weekends and my days off. All the other days, I have to keep up with others.

Of course, getting enough sleep is more easily said than done for me. Lately, I’ve been pretty anxious about some work issues, and I’ve been waking up at 5 a.m. instead of 6:30 or 7:00. So, I’ve been losing sleep. I’ve also been staying up later than I should, watching the tail-end of movies that I really like. It’s irresponsible, I know, and I need to stop it. And I will. But right now, my focus is on making sure I’m functional for today… not focusing on the evening at the end of my day.

But I’ve digressed. I love the bleak mid-winter for its cold, which slows us all down, as we have to deal with more layers of clothing. I love it for its long nights, which help me rest and relax. I love it for its crazy weather that keeps me on my toes. I don’t even mind the snow so much, because it gets me active and out and about. And I love how other people slowing down makes it easier to shop and go to the gym, because people are not feeling up to working out (especially after the initial rush over their New Year’s Resolutions has passed), or going to the store at early/late hours of the day.

The bleak mid-winter solves a lot of logistical issues for me, slows things down, gives me a break from the onslaught of constant go-go-go, and it gives me space to move and think instead of having to constantly negotiate the world around me.

And that’s fine. It’s just fine with me. So… onward.

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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.

I really need to feed myself

I’ve been working my ass off, lately, being busy-busy-busy, and I’ve developed a nervous twitch on the right side of my face, so I know I need to do some “radical self-care”. Switch gears. Change direction. Take a break.

I did take a nap this afternoon, which is good, but it was only an hour. I feel like I need more.

I’m getting increasingly worried about money — who isn’t? I had a dream last night about not being able to find or keep work, having to dress in “drag” as a member of the opposite sex, in order to get hired, and having to switch back and forth between being a man and a woman, in order to make a living.

It’s sorta kinda freaking me out.

Not that there’s anything wrong with being a member of the opposite sex, but the pressure of having to pretend to be something I’m not really made me nuts in the dream. And, like so many other Americans these days, I worry a little more each day about being able to make my mortgage payments.

Well, I’ve been in really tight spots before, and I’ve always managed to come through. I just need to keep my head clear and steady and keep putting one foot in front of the other. Stay loose. Stay as relaxed as I can. Do relaxation exercises — deep breathing, too — to keep my parasympathetic nervous system engaged, and keep my whole system from frying. Keep doing my job at work, and keep my resume fresh and up to date.

Just tend to the basics, and don’t take anything for granted.

Double-check my assumptions — especially when I’m positive I’m 100% correct.

One way or another, things will work out.

I have to believe that. Or else.

And I have to keep my strength up. I’ve been working, working, working, yes, but sometimes a person needs to play. I’ve been focusing so intently on all the stuff I’ve got to fix, that I have at various points along the way, failed to acknowledge the things that are going right with me. And I’ve not always give myself the chance to recover and recuperate from my mad-and-intense drive to make right the things that go wrong with me.

But if the central nervous system has anything to teach me/us, it’s that you can’t keep going-going-going all the time. At some point along the way, you really need to take a break and let yourself get back the reserves you’ve depleted along the way. That means taking more naps. Eating good food. Getting to bed at a decent hour. And not getting down on myself for cutting back on my activities.

Just today, I cut short an outing that was starting to wear on me. It’s a beautiful day here, and I wanted to be out and about, active and engaged and having a grand time. But I just couldn’t. I ran out of steam. I lost my temper a few times. I got overwhelmed by all the activity around me, and I realized I was really tired and needed to sleep.

So, I had someone take me home and I took a nap. I needed a longer one, I think, but I did get about an hour’s worth of sleep, which is something.

I need to feed. Restore myself. Get back what I’ve spent. Replenish my stores.

I need to feed myself, so I can be human again.

The Magic of “Analgesic Stress”

Clearly, the human body is built to survive. And the mechanisms that kick in to save our asses are as built-in as breathing heavily after a sprint or sex, as instinctual as brushing shaggy hair out of our faces when we encounter someone or something we need to see more clearly.

What’s more, the survival mechanisms we employ to escape imminent physical doom are also important parts of less extreme, yet equally vital physiological and psychological survival strategies. Physical responses to mortal danger don’t have to originate only from physical situations, like a mother grizzly discovering you standing between her and her cubs. They can just as easily — and probably, in today’s world readily — arise from psychological ones, such as a sneaking suspicion that your boss is going to fire you at the one-on-one meeting they just scheduled, or the surprise discovery of your spouse in bed with the neighbor.

In order to trigger the biochemical cascade of fight-flight-fright, our brains don’t have to be presented with cut-and-dried physical reasons to pump our systems full of glucose, adrenaline, cortisol, etc. The juices can start flooding our systems over perceived threats, as well. And those threats can be just as existentially distressing if they’re job-related or relationship-related, as threats that involve our physical being.

If something truly threatening to any aspect of your survival is registering, your brain doesn’t particularly care whether it’s a charging bear or a discharging boss. It doesn’t matter if the grizzly is coming at you with a roar, or your spouse is coming with a scream. A threat is a threat, and the part of our brains that differentiates between different sorts of threats is offline, at the time we’re reacting to something wretched happening to us. Sure, the refined, discriminatory, gray-area-friendly parts of our brains are still there, but they are waiting till after the excitement has died down, before they start to tell the difference between a purely physical fight-flight-fright scenario and one that’s all about our emotions or our self-worth or our hopes for the future. The problem is, in the interim, while the sensible part of our brains is “down,” the survival-based part of our brains is flooding our bodies with all sorts of biochemical franticness that both hops us up and dulls us down, that pumps us full of energy, while shutting down the very systems that can regulate the rest of our delicately balanced systems.

So, where does that leave us, if we’ve experienced tons of traumatic stress over the course of our lives? Where does that leave us, if we’ve been stressed and over-taxed and put-upon in very intense ways over a long term? Chances are, it dopes us up with a pretty compelling case of Post-Traumatic Stress Disorder, that modern version of “shell shock” or “combat fatigue” or “nervous exhaustion” that clouds our judgment and heightens our reactivity.

And the more it happens, well, the more it happens. If you get sucked into a cycle of intense trauma response often enough, your reactions become so sensitized that your experience doesn’t need to be extreme to trigger a heightened stress respose. I’m no neuroscientist, and I’m not a formally trained psychologist, but it’s my understanding that if you’re put through enough trauma over the course of your life, your body can get in the habit of switching on those stress hormones at a moment’s notice, just to get you through the day. You don’t even need to be in severe mortal danger, for the action to take effect. It can just look/feel/seem like severe mortal danger to the body, and the mechanisms that prevent disaster will spring into action.

That’s where PTSD really digs in and becomes more persistent, more pronounced, more likely to take over. Which cycles around to exacerbate not only its own instantaneous reactiveness, but also its after-effects. And they aren’t pretty. PTSD’s symptoms can include (in no particular order, and in a bunch of different combinations):

Re-experiencing the traumatic event

  • Intrusive, upsetting memories of the event
  • Flashbacks (acting or feeling like the event is happening again)
  • Nightmares (either of the event or of other frightening things)
  • Feelings of intense distress when reminded of the trauma
  • Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating)

Avoidance and emotional numbing

  • Avoiding activities, places, thoughts, or feelings that remind you of the trauma
  • Inability to remember important aspects of the trauma
  • Loss of interest in activities and life in general
  • Feeling detached from others and emotionally numb
  • Sense of a limited future (you don’t expect to live a normal life span, get married, have a career)

Increased arousal

  • Difficulty falling or staying asleep
  • Irritability or outbursts of anger
  • Difficulty concentrating
  • Hypervigilance (on constant “red alert”)
  • Feeling jumpy and easily startled

Other common symptoms

  • Anger and irritability
  • Guilt, shame, or self-blame
  • Substance abuse
  • Depression and hopelessness
  • Suicidal thoughts and feelings
  • Feeling alienated and alone
  • Feelings of mistrust and betrayal
  • Headaches, stomach problems, chest pain

Which can all conspire to make you feel like you’re either losing your mind, or you’re not fit to live in the world, or everyone is out to get you, or you just can’t make it through the day, or all of the above. And more. I’ve had a pretty eventful life, myself, thanks at least in part to the after-effects of multiple traumatic brain injuries, so I’ve got my fair share of trauma in my past. And post-traumatic stress. And full-blown PTSD.

My brain’s biochemical reactivity has, in many cases, worked very much against me. And I freely admit that I haven’t done nearly enough tending of my parasympathetic nervous system to decompress and regain my balance on a regular basis. But where my brain has often worked against me in stressful times, it has also worked for me, thanks to stress. And the things that have worked for me are those handy endogenous opioids I talked about in my last section.

Remember, the biochemical/hormonal stress response in humans doesn’t care what the stimuli are that are freaking out the brain. All it knows is that it’s freaking out, and it needs to supply the right magic cocktail of hormonal juices, so that the taxed system can function adequately in the face of mortal danger. Even in the absence of lions and tigers and bears and horrific natural disasters, in our modern world, endogenous opioids kick in to numb us to our pain, suppress responses that would keep us from fleeing to safety, and keep us bright and alert on some level — and they can save our asses just as much as they did our Grendel-fleeing ancestors’. At least that’s my experience.

And this is not something we can necessarily stop, once it gets started. We are literally hard-wired to have these biochemicals kick into gear when we’re in danger, we’re uber-stressed, and when we’re in pain. Whether the stress is from a charging bear or an angry boss chewing us a new one in a performance review… whether we’re in danger of losing a limb or losing our job (and our house and our car and all the stuff we owe money on)… whether we’re in pain from lacerations to our legs or sleep-deprived, repetitive-stress-fried joint agony… our bodies are still sending signals via stress hormones (our messengers to/from the gods) and our instinctively hard-wired brains are going to get a shot of numbing sweetness that takes our mind off our ills and lets us live to see another day.

And so a heightened stress response becomes a self-fulfilling prophecy, a self-perpetuating loop of spontaneous over-reaction that not only jacks us up, but chills us out, as well. It’s like having an existential smoke — nicotine has the dual effect of first stimulating the system, then chilling it out (which is what makes it more addictive than heroin, I’ve been told). Getting that rush of adrenaline, feeling the mind clear, sensing the body coil and prepare to pounce or flee… and then getting that soothing rush of endorphins… It’s hard to beat that, when it comes to being fully functional.

And it does make me fully functional. In more ways than one. The net result of our inborn neuro-biochemical survival/support system is the heightened ability to respond to immediate threats, reduced pain experience, and clearer, more focused thinking. And when I am in a state of extreme agitation and sensitivity, the effect on me is like the effect of clicking the button on a morphine pump for someone who has recently come out of surgery.

Indeed, I have to say that the same survival mechanisms that let me haul my ass out of mortal danger, also enable me to function at a “normal”level in my day-to-day life. This is probably going to sound crazy to some people, even mentally ill to others, but there’s a logistical reason I find my ass in a sling, time and time again — an inborn, ingrained need, even dependency, on stress hormones to function adequately in the world, and actually feel like a normal person.

Putting myself in the direct line of danger — whether by cultivating friendships with people who are innately hostile towards me, seeking out work with employers whose environment seems custom-tailored to trashing my work-life balance, or taking on too much work at a time when my body is sorely in need of rest and rejuvenation — triggers that magic biochemical cascade of endogenous opioids, and suddenly everything is better. It’s not only BETTER, it’s just better. Normal. Regular. Boring. Standard-issue. Uneventful. Drab. Blah.

This probably sounds odd, but normal, uneventful, rote life is something I really need to work at. Whether due to my head injuries or just my nature, I seem to be hard-wired for excitement. And that tends to get in the way of living my life — especially around other people and when I’m at work. Plus, I have a raft of physical/sensory issues that really get in the way and keep me from getting on with it in a productive and steady way. I don’t need my experience to be over-the-top better, just normal. Just regular. Just standard-issue, run-of-the mill… the way everyone else’s life seems to be, and the way I wish my life were.

And analgesic stress lets me do just that.


A Perilous Relief – Table of Contents

A Perilous Relief: Bliss From Within – The Glory of Endogenous Opioids

For better or for worse, I tend to have pretty high stress levels. It comes from an eventful past, as well as a busy present, and the intense drive to realize my deepest desires for my future. Certainly, it’s not much fun having to constantly “quality control” my thoughts and my actions, so I don’t get myself in trouble over post-traumatic stress that has nothing to do with what’s really going on around me. I certainly don’t want my energy and attention to get pulled down by old stuff that still makes me jump when an unidentified figure appears out of the corner of my eye. And it’s no fun “melting down”

But being highly stressed isn’t as bad as it might sound. In fact, there is a side to my typically high levels of stress that feeds me. And I love it. After years of being down on myself for being “over-stressed,” I’ve come to terms with that shadow side of myself. And I’ve learned to love my stress.

Here’s why:

In addition to these classic “fight-or-flight” responses to get you going, the little almond-shaped gland in the brain, the amygdala, triggers the brain to release endogenous opioids (opium-like chemicals that originate in your own system) which help your system function adequately in high-demand situations.

These endogenous opioids are a built-in part of our naturally functioning system and they are ever-available in varying quantities. Endogenous literally means “from inside”. And endogenous opioids are magic opium-like potions our systems create on their own (it’s been discovered that the human body actually produces morphine in small amounts). Yes, Virginia, there is a way to get high on your own steam, as the biochemicals our brains produce are of the same type as the illegal, intensely addictive stuff you can buy in a plastic baggie from some sleaze who will take sex as payment for the goods instead of money. They’re just a little different, so they match our body chemistry better. And they aren’t usually available to our bodies through our brains in the intense concentrations that leave overdosed junkies dead on the street.

In particular, these internal substances can have a hypoalgesic or analgesic (pain reducing) effect on the body, which helps you deal instinctively with whatever threat is in front of you, without having to deal with pain, as well. I’ve read that endogenous opioids serve to suppress the “lick response” in injured animals, so they can escape. (An animal, when injured, will instinctively stop to lick itself and tend to its wounds, but if it’s been injured by a predator this instinctual response makes it easy prey for its hungry attacker. By suppressing the pain – and the lick response – this natural impulse lets the animal ignore its wounds and focus on escaping to live to see another day.)

The same holds true with us humans. Imagine how short-lived we would be in crisis situations, if we were distracted by pain and other heightened sensations. We’d be too busy going “Ow! Ow! Ow!” and checking to see what bone we broke or what piece of flesh we tore, to get out of the way of the oncoming rockslide, tidal wave, or speeding bus, or haul ourselves out a burning car and run to safety before the gas tank explodes. The adrenaline rush and sudden biochemical cascade of pain-numbing opioids makes it possible for us to do important things like rescue each other, even when the rescuer is injured… to pull ourselves from danger, even if we’ve been hurt… and do things that would be utterly impossible, if we had to deal – for real — with intense pain. Endogenous opioids may well have been what let that tech guy save himself from dying on an ill-fated hike through the California wilderness by hacking his arm off below the elbow with a pocket knife.

Now, these endogenous opioids are truly wonderful things. Among them are Endorphin, Enkephalin, and Dynorphin. More research keeps trickling in about these substances — and others like them. It seems implausible that we could know so little about these important biochemicals until recently, but some of these have only been identified and studied since the mid-1990’s. And by the time I write (and you read) this, much more will probably be known about these substances, and how they interact with our sensitive systems.

It’s my understanding that the reason that artificial opiates work is because they are so much like the opioids we produce in our own bodies. Like a copy of a master key fitting into a lock, artificial/man-made opiates “open the same doors” that our own bodies normally have closed… and then open, when properly prompted by our biochemical “keys”. If you consider how strongly heroin and morphine can affect the human system, and if you consider that the only reason they work is ‘cause they mimic the qualities of opioids we already have in our own brains/brains, you can begin to understand just how powerful our own biochemical systems intrinsically are.

Yes, these endogenous opioids have the same sort of effect on us as opiates. They cut pain. They give us a euphoric feeling. They help clear our minds. They do amazing things to make life worth living. Lenny Bruce, the heroin addict, said of his addiction, “… it’s like kissing God.” If you consider that endogenous opioids can work the magic of relieving/inhibiting pain, imparting euphoria, and making us think better, it explains how human beings can sometimes perform at super-human levels irrespective of pain, danger, stress, or other normally stymieing influences (like, for example, the voice in their head urging them (in vain) to keep a low profile).

These magic potentialities we have in our brains have recently been getting more “air time” from scientists like Irving Biederman, who studies perceptual and cognitive pleasure. According to Dr. Biederman, we’re not only wired to survive — we’re wired to enjoy ourselves in the process. A lot. Things like learning new things, encountering novel situations, looking at innovative art, “tickle” the parts of our brains that release endogenous opioids into our systems.

So, under the worst and the best of circumstances, endogenous opioids are about as close to a gift from God as you can get. Not only do they buffer our bodies from the ill effects of extreme duress, but they also reward certain kinds of behavior (learning, in particular) with a pure shot of unbridled joy.

Kind of makes it all worthwhile, doesn’t it?

A Perilous Relief – Table of Contents

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A Perilous Relief – When Survival Backfires

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

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

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

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

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

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

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

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

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

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

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

A Perilous Relief – Table of Contents

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TBI and PTSD – The chicken or the egg?

I’ve been giving a lot of thought, lately, to how TBI and PTSD interconnect and “feed into” each other. In my experience, the two are closely interconnected, and they can make each other pretty confusing and convoluted. Each condition changes the brain in subtle but important ways, and when the two interact in one brain/body/mind/spirit, the compounded difficulties can be exponentially more difficult to identify — and treat.

Traumatic brain injury is by its very nature traumatic, and post-traumatic stress disorder comes out of trauma. So, when you fall and hit your head, or you are in a car accident, or you are attacked and knocked out, trauma happens to the body. The body is threatened – sometimes mortally – and the brain kicks in with all sorts of great hormonal and biochemical survival mechanisms. Adrenaline gets pumping. Endorphines start flowing. Glucose gets delivered to muscles. And the less-survival-based reactions we have get pushed off to the side, so our bodies can focus on one thing: survival.

Even if we are not consciously aware that we are in danger — like when I fell down the stairs in 2004, and I didn’t fully realize the extent to which my physical safety had been threatened — our bodies are aware that they are under attack, and they respond accordingly. It’s not something we can control, it’s not something we should control. We need our brains to be able to care for our bodies without our minds knowing how to do it. The problems start, when our brains don’t realize that we’re out of danger, and/or we get caught in a constant feedback loop of detecting perceived danger, reacting to it, stressing out, and never getting a chance to settle down.

That settling down piece is very important. After our sympathetic nervous systems have risen to the challenge(s) of a perceived threat, our parasympathetic nervous systems need to kick in and help our bodies chill out. Rest. Restore. Relax. Digest… Take a break and get back to balance. But if we never take a break and get our nervous systems to relax and get back to normal, we can get stuck in a constant roller-coaster of fear/anxiety/stress/hyper-reactivity that just won’t quit. And traumatic stress eventually turns into post-traumatic stress disorder. Not fun for anyone.

One of the big ways I think TBI contributes to the development of PTSD is in the “debriefing” phase after a crisis or trauma. TBI can impair a person’s ability to self-assess — sometimes we literally don’t know that something is wrong with how we’re experiencing/reacting to life. It can be harder to detect physical experiences and decode behavioral problems, not to mention cognitive ones. And that diminished ability to self-assess makes it more difficult to self-regulate… to consciously and deliberately change your behavior and actions so that you can “power down” and let your over-taxed body restore itself.

At least in my case, when I went through traumatic experiences — let’s take one of my auto accidents as an example — I wasn’t able to think things through after the fact and assess how I was feeling. I literally didn’t know that I was having trouble understanding what people around me were saying. I thought it was them, who were suddenly refusing to speak intelligibly. I literally did not realize that my sleeping schedule was off — I just stayed up later and got up earlier and pushed myself to go-go-go… and then drank and drank and drank to get myself to relax. I wasn’t even able to determine how I was feeling physically. All I knew was, something was up with me, and it really made me feel awful.

So, I pushed myself even more to “keep up”… and it just added to my already overtaxed body being stretched beyond its means. Not good.

A few posts back, I wrote about being wired to survive and all the biochemical activities that take place as a result of some traumatic crisis. The thing to remember about that wiring system is that it is totally independent of rational thought… but rational thought is necessary to deal with its aftermath. The physical experience of all that adrenaline and endorphins and glucose is not a walk in the park. Our bodies need our brains to take over, after we have rushed to safety, to tend to our frazzled nerves and make choices that allow us to relax, regroup, recuperate, and restore the delicate balance in our central nervous systems.

But with TBI, even mild ones, the brain is impaired and it cannot process clearly. So, we can end up making choices that do not help us relax, that keep us on edge, that keep us going-going-going, so we never really get a break from the crisis and drama.

And post-traumatic stress disorders emerge, which further alter our brain chemistry and how we make choices and take action in our world. PTSD actually alters our cognitive functioning. It makes us think differently than we would, under normal, non-stressful conditions. And that different thinking is not always the smartest thinking.

But wait, there’s more…

Impairments to our thinking — our heightened hyper-reactivity, our hair-trigger response systems that are fried and frazzled — can cause us to make choices that are dangerous and risky. Choices that can cause further head injuries. Being all PTSD’ed-out can make us very quick to anger, in situations where we’re likely to get in a fist-fight, even if our opponent is twice our size. It can make us “slow on the uptake” so we miscalculate choices while we’re driving. It can cloud our judgment about whether or not to take up skydiving. And our increased appetite for stimulation can cause us to pursue activities that are custom-made for yet more traumatic brain injury.

And so, we end up with a vicious cycle of traumatic head injury feeding our post-traumatic stress, which evolves into disorders of mind, body, heart, and spirit… and leave us wondering why the hell everything around us is going to shit. Our brains have been injured, and our judgment is impaired. And each condition feeds the other.

I’m not sure how much research has been done on the interactions of TBI and PTSD. I think it’s a topic that’s ripe for harvesting, and we could probably learn a lot from taking a close look at the two pieces of the puzzle. I think that folks being treated for PTSD should also be evaluated for TBI, and vice versa. Having experts and folks in positions of authority say that “most TBI suvivors heal” sends the message that the brain will just take care of itself, and everything will be fine. But while the brain is healing — to whatever extent that may be — post-traumatic stress can emerge, which can feed a vicious downward spiralling cycle that affects not only the mind, but the spirit and the body as well.

And that needs to be addressed.

And I do more of that here…

A Perilous Relief – Wired to Survive

Something wonderful happens, when our bodies are stressed beyond our means. The human system — ever expert at staying alive despite all odds — responds to threats with a biochemical cascade of various hormones (including adrenaline/epinephrine and noradrenaline/norepinephrine) which not only reduce sensitivity to pain, but also sharpen a select group of coping mechanisms to keep you from being injured (or eaten).

Note: In case you’re wondering about this, the words adrenaline and epinephrine, and noradrenaline and norepinephrine are often used interchangeably. Epinephrine and norepinephrine are the official names for the hormones our adrenals produce, but we tend to call them adrenaline and noradrenaline, as well.

The process essentially works like this:

  1. Something happens that isn’t “normal” or expected, like a sudden loud sound or flashing lights.
  2. The senses relay the perception of this environmental “stressor” from the sensory cortex of the brain through the hypothalamus to the brain stem. In the process, “noradrenergic” activity (which is connected with norepinephrine/noradrenaline) picks up in the brain, and you become instantly alert and attentive to what’s going on around you.
  3. A sudden rush of stress hormones at neuroreceptor sites in your brain tells your whole system to use its spontaneous or instinctive/intuitive behaviors which keep you alive in combat or escape situations. Your brain takes non-essential functions “offline” and pours its energy into only the most vital elements of survival.
  4. Your body is infused with energy, your mind is suddenly clear and wiped clean of extraneous distractions that have nothing to do with saving your ass, and you’re immediately ready for action.

The process is purely automatic, and the brain knows quite well how to kick into survival mode. If it didn’t, you – and everyone else – would probably be dead, and the planet would be inhabited by creatures that did know how to survive by brute force and instinct. Possibly ticks.

Now, things get really interesting, if you perceive a stimulus as a threat. The “firing” in your brain becomes more intense and prolonged, and the sympathetic part of the autonomic nervous system (the part that responds to threats and stressors) gets all worked up. (Remember, the other part, the parasympathetic nervous system, is what calms us down and chills us out.) In the process of sympathetic nervous system arousal, a bunch of epinephrine (adrenaline) and a bit of norepinephrine shoots into your system from the little star-shaped adrenal glands, which sit atop the kidneys (the word adrenal comes from ad (atop) – renal (kidney), or literally on top of the kidneys) and regulate the release of the stress hormones adrenaline (epinephrine), noradrenaline (norepinephrine), as well as cortisol into our sensitive systems.

The release is, again, totally automatic, totally necessary, and pretty much beyond our control. It’s also triggered by other biochemicals that originate within our intricately wired brains, which I cannot pronounce and have a hard time spelling. There are other complex factors that come into play, but basically, this is how your adrenaline-pumped fight/flight response gets started in your brain.

But wait – there’s more. The rest of your body is drawn into the action, in the following ways. The list below is not exhaustive, but it gives you an idea of what goes on:

  • Your heart beats faster and you start to breathe faster/pant/hyperventilate
  • You pale or flush, or you alternate between both
  • Your stomach and upper-intestinal action go off-line, and your digestion slows down or stops altogether
  • Lots of blood vessels in many parts of your body constrict
  • A “shot” of glucose – sugar, sugar, sugar – gets released into your body to fuel muscular action
  • Blood vessels in your muscles open wide to allow more blood to pass through (there’s more blood available to them, since vessels in other parts of the body constrict)
  • Your eyes and mouth can get dry
  • Your pupils dilate, so you can see better
  • Your bladder may relax and your colon may empty (hence the popular expressions “pissing or shitting your pants”)
  • Erection is inhibited (the body needs the blood elsewhere, including for your muscles – see above)
  • You can lose (some or all of) your hearing for a while
  • You can lose your peripheral vision for a while
  • Instantaneous reflexes accelerate and become hyper-responsive.

All this basically spring-loads you for action, and it’s wholly automatic. You couldn’t stop the neural/biochemical escalation in a crisis, if you tried. (Well, some people probably could, but they’ve very likely been sitting in intensive zen meditation for years or they’ve received training in how to do this, which most of us have not.) Signals get fired in the brain, screaming Run!!! Run!!! or Fight!!! Fight!!! overriding (by design) your rational brain that wants to sit back and assess the situation and not get all worked up until there appears to be a good reason.

And it totally saves your ass. Like an instinctive response to the shrieking wail of approaching fire truck sirens, bright red lights suddenly flashing through your bedroom window at 3 a.m., and/or the smell of a big smoky fire coming from the apartment next door. Your body takes over automatically, making you instantly alert and highly attentive to what’s going on around you. As your brain takes non-essential functions “offline”, everything around you fades to a blur, except for the sound of roaring flames tearing through the building, the scent of thick smoke, and the sight of the window across the room that leads to the fire escape. Suddenly, the petty distractions of the day before mean absolutely nothing, as do any extraneous activities not related to living to see another day. Forget about making the bed and fluffing the pillows and making sure your hair is combed before you go outside – pull on your bathrobe, grab your keys and the cat, and climb out the bedroom window onto the fire escape. Don’t worry if the firemen can see up your shorts – just get the hell down to the ground level and away from the flame-engulfed building.

When it comes to basic survival, we’re hard-wired to make sure we get through in one way or another, and the tidal wave of biochemicals that floods our system really does take over, whether we like it or not. If those handy hormones do their jobs properly, they give us the chance – after we’re once again hauled out of the fire to safety – to sit back and process what just happened and decide in retrospect if we should have gotten worked up or not. But if they don’t do their job and we end up on a cold slab, we never get the chance to sort things out. So, it’s not a bad thing, that our survival brain hijacks the rest of our cognition in situation-appropriate ways.

It’s not a bad thing at all.

A Perilous Relief – Table of Contents

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Mind-brain-body-stress connections

I’ve been reading Robert Scaer’s book The Body Bears the Burden, about how the brain and the body interact in times of stress and trauma. It is absolutely fascinating reading, and I’m surprised it’s not a best-seller. It really clears up a lot of confusion for me and gives great insight into how the body’s experiences can shape the brain’s activity. He talks about the fight/flight response and the body’s instinctive freeze response, too. I’ll have to write more about it, when I go through it again. My head’s kind of whirling right now.

One thing that I immediately got… After reading just a bit of his book, I can now let myself off the hook for freezing “like a deer in headlights” when I’ve been in situations of high-threat. I am usually pretty hard on myself for being a ‘wuss’ when I freeze up in times of intensity. It doesn’t happen all the time, but now and then it does, and then I tear myself a new ___ (well, you know) for days after, beating myself up for not speaking up, not stepping up, not being as capable as I would have liked to have been. Turns out, I don’t necessarily have any control over freezing up. It’s instinct. Instinct that’s designed to keep me alive.

Yeah, I’ll have to write more about this later. It also ties into my paper about A Perilous Relief, which I’m in the process of researching. (See the link on the left for a current table of contents that will take you to what I’ve written so far.) There’s only one problem — I have to keep going back over it to re-read sections, because my attention span leaves a little to be desired… but I don’t realize I stopped understanding what I just read, until a few pages past the point where my brain stopped parsing the information.

Apparently, according to my neuropsych, this is not uncommon with TBI. So, I’ll just have to factor it into my research and leave myself plenty of time to digest everything I’m taking in. Lucky for me, it’s fascinating stuff, so I don’t mind taking my time with it. I don’t mind at all.

Shout-out to the guided imagery folks

Belleruth Naparstek has noticed this blog and has nice things to say about it, which is really very gratifying.

I’ve been using her guided imagery for about couple of years now, and if anything has helped me to come to terms with the complications and hurdles of my TBIs, it has been her Healing Trauma and Stress Hardiness Optimization CDs. I owe her a great debt for her assistance, not least of which because the CDs are self-manageable… as in, I don’t have to endure an in-person session with someone else, I can start and stop them and listen to them as often or as seldom as I like, and I can be totally under the radar when I use them. For all anyone knows, I’m just listening to a relaxation tape or music at work — Note: I only listen to the affirmations at work, as the guided imagery tends to put me into a super-relaxed state, which is not what I need at work.

Personally, I have historically tended to steer clear of guided imagery and meditations. They often strike me as smarmy or condescending or namby-pamby. They often make me feel like the narrator is talking down to me or over-simplifying things. As a TBI survivor, I’m particularly sensitive to being talked down to, so that gets in the way.

Plus, I have trouble hearing at times, and some voices really grate on me. Belleruth’s narration, however, really works for me. I’m able to understand her words, even when I have the sound turned down really low, which I often have to do, ’cause my hearing is very sensitive when I’m stressed. It took a little while to get used to how she pronounces “worry” and “courage”, but after a bunch of times listening, I could eventually deal with it 😉

It might not for everyone, but I gotta tell you, it’s like some kind of magic bullet. Amazing stuff. And it doesn’t make me feel like a total idiot, which is a plus.

I’ll explain more how I think it’s helped me. The mechanics are pretty fascinating. I’m not formally trained in this stuff, but I can definitely relate the details my experience that might help folks understand — and make use of this invaluable resource.