Yet another way of cleaning the brain

Is there more than one way to clear out the sludge?

If you’re like a lot of people who check Google News on a regular basis, you may have seen the news about sleep clearing the brain of metabolic build-up after a hard day’s work. Sleep is an important part of every living being, across all species, but until recently (medical) people haven’t know exactly why that is. Esoteric practitioners have a lot of different explanations for why we sleep, but in terms of hard science, the importance of sleep has been a mystery.

Not long ago, researchers discovered that when we sleep, the glymphatic system (the functional waste removal system for our central nervous system, or CNS), clears out metabolic buildup (read, junk that’s left over from our busy minds’ activities), getting rid of a lot of stuff that we don’t need. It just gets in the way. Which is why we need to sleep.

Here’s a video explaining the new research:

Not getting enough sleep means not getting enough time to clear out all the sludge from your brain that comes from all the mental activity we’re engaged in. It means you’re still — literally — carrying around extra “baggage” (albeit very miniscule stuff) from before, that you should really just let go — via a good night’s sleep that opens up passages in our brains to let the extra junk pass through and out — to our livers, where it’s processed out of our systems.

I’ve been pretty excited to hear about this, especially because concussion / mild traumatic brain injury produces an abnormal and complex neurometabolic cascade that floods the brain with all sorts of extras, like potassium, calcium, glucose, and other neurotransmitters which get our brains all worked up — it can really get us pumping. And afterwards, we’ve got a whole bunch of junk in our brains that we’re not used to having there… and we need to clear out.

This combination of extra junk in your system is one of the things that makes you foggy and dull after a concussion. All that stuff needs to get cleared out, for your brain to right itself — and then it’s got to do the extra work of healing and (re)learning how to do stuff that may seem very simple, but suddenly becomes hard.

So, long story short, sleep helps after concussion / tbi, because it cleans the junk out of your brain. Lots of sleep is good. At the same time, too much sleep can be a problem, too. So, you have to find a balance.

One of the issues that I have with my long-term concussion / PCS / TBI issues is problems with sleep. I have trouble getting to sleep, and I have trouble getting more than 6-7 hours a night. If I get 8 hours or more, it’s like a jackpot. Interestingly, when I get more than 8 hours, I usually feel drugged and not quite right in the head. In some ways, it’s worse than only getting 6 hours.

But when I only get 6 hours, like last night, I definitely feel it. I’m pretty much of a zombie, feeling jet-lagged and depressed and really down. The time change this past weekend did a number on me, for sure. And now that I’ve read about the glymphatic system and what it does, now I’ve got this much clearer sensation that I’m dull for a reason — there’s too much crap still clogging the lines of my brain. It’s bad enough being tired. But having my brain full of metabolic waste, on top of it… geez.

So, if I can’t seem to get at least 8 hours of sleep a night, no matter what I do, how can I ever hope to clear all the crap out of my brain? I mean, seriously, this is a real concern for me. I have been doing daily exercises to warm myself up in the morning and get the blood flowing to clear out the cobwebs and help my lymphatic system fight off infection, but while waking, the pathways in our brains through which waste passes are 60% smaller than when we’re asleep. How can I take advantage of my body’s systems and help them do their job?

Coincidentally (or perhaps not), I got an email from Coherence.com about how coherent breathing may help to wash the brain (you can read the PDF by clicking here), in a similar way that sleep does. A steady cadence of 5 full breaths per minute — about 6 seconds inhale and 6 seconds exhale — helps to not only balance the autonomic nervous system (ANS), getting you out of fight-flight craziness, but may also help to jump-start the glymphatic system which removes the leftover junk from your brain.

I find this encouraging. While it’s not proven by rigorous scientific studies, the logic makes sense to me. And it’s something I can do, even when I’m not getting enough sleep — like this morning, with my whopping ~6 hours.

So, this morning as I lay in bed at 6:15 (I woke up a little before 6 and got to sleep a little before midnight), I relaxed and did my coherent breathing — counting six seconds in and six seconds out. I focused on my diaphragm, making sure I was breathing deeply so that my belly was rising and falling smoothly, and I just counted. I timed myself a few times, to make sure I wasn’t going too fast — if anything, I breathe more slowly than 6-seconds in-out, but I can’t worry about that. The main thing is that I’m in the range and that I’m balanced with the length of time I’m inhaling and exhaling.

I didn’t worry about how many breaths I was taking — I used to count my breaths, back when I was sitting and breathing each morning — and I just lay flat, because that helps to regulate the overall system pressures in the body, which aids the flow of fluids (as in cerebrospinal fluid, or CSF).

I just focused on my breathing, keeping myself in the count-of-6-in / count-of-6-out zone, knowing that I was doing something good for myself, and that not only was I balancing out my nervous system so I wouldn’t start the day in fight-flight mode, but I was also moving the crap out of my system.

That’s an important part of this, because it is incredibly difficult for me to just sit still – especially first thing in the morning, when my head is racing and I want to get going! Getting my system to calm down and focusing my mind is quite difficult – especially after a short night’s sleep, when I’m waking up riding a wave of adrenaline.

Focusing on the idea that I’m making myself more functional and more capable, helps me to calm my system down and keep me focused. Definitely knowing that I did not get enough sleep last night — and haven’t gotten enough sleep in months, if not years — gives me all the more incentive to clear out the sludge that comes from my brain having to work so hard, day in and day out. Heck, even if it’s just conjecture and the folks who promote coherent breathing aren’t 100% correct about clearing out the metabolic waste with that technique, the fact of the matter is, my system chilled out, and I got up feeling a whole lot better than I did when I first woke up. And that’s no small potatoes.

I probably spent about 20 minutes doing this — probably longer than I would have done, were it not so cold this morning. I wanted to stay in bed, so this was good justification. 🙂  And after a few minutes, I started to feel a lot less “jazzed” and amped up. Waking up after a short night’s sleep can be pretty rough — I just jolt awake, all systems GO, with my heart racing and the blood pumping. While it’s sometimes energizing, over time it gets to be a pain in the ass, because it wears me down, and I crash later in the morning, after the pump wears off — major let-down.

This way — as was the case when I was sitting and breathing regularly, back about a year or so ago — I can stay in my warm bed a bit longer, I can work on my breathing to calm down my ANS, and I can also help my brain get a “clean start” on the day.

It’s a win-win all around. Good stuff.

Onward.

TBI Recovery: Getting used to the highs and lows – Part 2

For many, many years, I have swung from one extreme to the other — from euphoria to panic to depression — with intermittent periods of balanced moderation, where I caught my breath before going back into the fray. I’ve long sought out work situations which were crazy and stressful and stupidly health-endangering (which passed for “challenging” in the job-spin-speak of the tech world), because I needed that constant pump to keep myself going. TBI can slow down your processing speed and make you feel like you’re half asleep, so those stressful times passed for “wakefulness” and made me feel more alive.

In hindsight, I realize that I was pretty much a ticking time bomb and that it was only a matter of time before I hurt myself badly enough to be ejected from the “everyday world”. I have had multiple mild TBIs over the course of the years (at least 9 that I can recall — and there have probably been more that I can’t remember). So, the effects have been cumulative, and sure enough, back in 2004, I had another fall that eventually put me out of commission.

The past years have been about weaning myself off that need for drama and stupidity. I’ve become increasingly aware of how much damage it does to me, and I’ve been acclimating myself to the idea that I don’t actually need it all, like I used to think I did.

Now I feel like I’m in a good and centered space, where I don’t have to have it, but at the same time, I do need challenge. And even moreso, I need to be able to respond to challenging situations with a level head and a clear mind.

Looking back at my life when it was still dictated by after-effects of all those TBIs, I see how much my life was comprised of reactions. Just reactions. Not measured responses that were determined by me, according to what was best and right at the moment — but knee-jerk reactions dictated by fear, anxiety, panic, external circumstances, and others’ expectations. That’s no way to live. Surely, there must be a better way.

So, I’ve been headed down that road, of late, looking for ways to live better, live more fully, and to have the kind of life I want to have.  I think about the things that hold me back, the things that I have done that have held me back, and the habits of thought that have prevented me from moving forward. And it becomes more and more apparent to me, as I think about it, that no outside circumstances have been The Culprits in my limitations, rather it’s been my own reaction and my own experience and my own choices that have held me back.

Now, certainly, things like getting clunked on the head a bunch of times, being hounded and bullied in school, being mistreated by both my parents and teachers alike, and being raised without much money in a household turned upside-down by a drug addict sibling and their associates, certainly didn’t help. But those things didn’t keep me from doing the things I could have done to help myself. It was the patterns of thought in my mind that held me back — as well as the biochemical reactions to circumstances which short-circuited my choices and actions.

All those years, I certainly did take a beating. But plenty of people take beatings and get up and go back at it, like nothing ever happened. Not everyone interprets setbacks as signs of permanent disability. Granted, I wasn’t surrounded by people who were positive, pro-active thinkers who knew how to free their minds. But at any given point, I did indeed have the capacity to pick myself up and keep going, but the thoughts in my mind and the biochemical sludge in my system short-circuited a lot of the good that could have happened.

My constant biochemical state of intense fight-flight (which was made more intense by what I thought was happening — and never adequately questioned) made it all but impossible for me to imagine all that I was capable of doing, and over the years, and after all the injuries — especially the last one — my possible world became smaller and smaller and smaller, and I made myself less and less capable, in my own mind, of truly following my dreams.

Now, don’t get me wrong. Over the years I have done some Big Things, and I have had some big accomplishments that have gotten me awards and recognition. But these were all substitutes for what I really wanted to be doing. My One Big Dream that I had since I was seven years old, never “panned out”, and year after year, my resolution to do something about it drifted farther and farther from my reach.  Until I just about gave up on it.

These days, things are very different for me, and I realize just how much biochemistry has to do with what’s held me back. And at the same time, it both absolves me of prior blame, and it also offers me the opportunity to change things.

Because now I understand how those things work. I understand how TBI has prompted me to take risks over the years and keep myself in a constant state of stress. I also understand what a toll that has taken on my life over the years, and I’m now resolved to do something about it.

In order to do so, I need to get a grip on my autonomic fight-flight response, which is what I’ve been doing, slowly but surely. I am now moving into the next stage, where I am testing myself a bit, here and there, to get myself familiar with how it feels to be on the verge of panic, and then walk myself back from the edge with the tools I have. I’m stressing myself just a little bit, here and there, to inoculate myself against the stresses. Some call it “exposure therapy”, and maybe that’s what it is. Having read about exposure therapy, it strikes me as more intense than what I’m doing. I don’t want to force myself into a seemingly dangerous situation and then have to sweat it out. No thanks.

What I am doing is similar to doing interval weight training — I’m doing “stress intervals” — intentionally stressing myself for a short while, then backing off and taking a good break. I know I’m going to push myself hard — and I also know I’m going to let up. So, there’s not that impending sense of doom that comes when I can’t see an end in sight. I know there’s going to be an end, so I can push myself — sometimes pretty hard — and not get freaked out about it.

This gets me used to the highs and lows. And it helps me feel more comfortable with the sensation of those highs and lows.

See, that’s the thing – it’s not the highs and lows that get me. It’s my internal reaction to those highs and lows — the physical sensations of high energy or low energy trigger a dumb-ass (and extreme) reaction from me that sets certain behaviors in motion and put me into a certain mindset. Some examples:

• I get back from a long and grueling trip to see both sides of my family, and I decide that I’m a worthless piece of crap who will never amount to anything. I’m physically and mentally and emotionally exhausted from a temporary situation, yet for some reason I’m convinced that I’m permanently damaged beyond repair. Accordingly, I slack off on my work and do nothing productive with myself for days, even weeks.
• I work too hard and sleep too little, and I end up having a full-on blow-out/meltdown that fries my brain with a flood of raging emotions. Afterwards, I am exhausted, and it takes several days for the biochemical load to clear from my system. All during that time, I feel stupid and numb and dull and once again am convinced that I’m permanently damaged beyond repair.
• I am incredibly excited about something that’s happening in my life. The sensation of all that adrenaline pumping through my system feels an awful lot like danger — it feels just like it used to feel when I was being hunted down by the kids who bullied me in grade school. Consequently, I stop doing what I need to do, to make progress with my goals. I also look for other things to work on that are less “stressful”, and my project falls behind.

All of the above are problematic, but it’s the last one that’s the burner. It’s the thing that’s kept me back, time and time again, and it’s the one I need to really focus on addressing.

So, to that end, I’m deliberately putting myself in exciting and tiring situations, getting used to how they feel while telling myself that this is just a feeling, not an indication of what’s really going on. And then I take a break. I have all but cut wheat and cheap carbs out of my diet to reduce the “junk load” from my system — which in itself is a little stressful, but has great benefits. I’m also doing things like taking cool showers to get my stress response jump-started for just a few minutes in the morning, and I’ve changed up my morning routine a little bit to heighten my attention.

And all the while, I’m using the techniques I’ve learned for balancing out my ANS and keeping the fight-flight response within a manageable, non-tyrannical range. I do it both — stress and relax. Intermittently. Not constantly, because that would be counter-productive, but at intervals.

I have to say it feels incredible. It’s tiring, at first, and taking cool showers instead of hot, is definitely an adjustment. But it’s really helping.

TBI Recovery: Getting used to the highs and lows – Part 1

One of the things I’ve been actively doing, over the past months, is getting use to the highs and the lows that are just outside my comfort zone. I’ve struggled a great deal with panic and anxiety over the decades, which I believe has been connected to a hefty dose of post-traumatic stress (or PTS). The classic symptoms of “disturbing recurring flashbacks, avoidance or numbing of memories of the event, and hyperarousal” have been a regular part of my life for as long as I can remember. The strange thing is, my flashbacks and numbness have been related to events that many others would not consider that stressful — making a fool of myself in front of other people, having bad choices of words, doing stupid things, making poor decisions that got me in hot water with authorities (including the police), and so on.

I’ve been flashing back on things that others would consider “just embarrassing” for a long, long time, and I’ve been intensely stressed out over it, avoiding situations, and on edge (that is, ON EDGE) for as long as I can remember.

Until, that is a couple of years ago, when I really started to come out of my TBI fog and things started to fit together for me, better and better, like they never had before. To be clear, I didn’t just magically come out of my fog for no apparent reason. I did the following, which all helped:

• Got myself on a daily schedule of doing specific things at specific times in specific ways, so I didn’t spend a lot of mental energy figuring out how to do things. This allowed me to develop the objective, observable 100% certainty that I could get myself up and cleaned up and dressed and out the door each morning in a predictably good way. It took the pressure off my mornings and let me relax about the details — because I didn’t have to think about them. At all.
• Exercised on a regular basis. For several years running, I got up and lifted weights and did some light cardio, the first thing in the morning before breakfast, each and every day. I never wavered from that. It was my morning routine, part of what I Just Did, and the jump start to my brain and body made me feel worlds better than I had in a long, long time.
• Started cooking more complicated meals. I have been the main cook in my household ever since my spouse got very ill about six years ago, and it made a great deal of difference in both our health. I got into a bit of a rut, and ended up making the same things over and over. When I started cooking more complicated meals, it pushed me to work on my timing as well as my sequencing. And it make our diet more varied, which was good.
• I learned to relax. This took some doing, but with some guided imagery tapes that I combined with rest/nap time, I have slowly but surely acquired the ability to relax. And for the first time, I know how good it feels to do that. Up until a few years ago, that was not the case.
• I started sitting za-zen (my own version of it) and doing conscious breathing. My version of za-zen involves just sitting and breathing, sometimes a short while, sometimes longer. I have come across a number of pieces of scientific literature talking about how this helps to balance out the autonomic nervous system (ANS) and get you out of fight-flight. It helps stimulate the parasympathetic nervous system and get you back to a place where you’re not tossed about by every wind that comes along.

Over the past couple of years, I’ve changed how I do things — some of the things, like regular exercise and za-zen, I stopped after a while. I guess I just got bored with them and felt like they were keeping me from doing other things I needed to do. I also let them get rote and boring, and they stopped being any kind of a challenge. I need to be challenged, or I can’t keep my interest piqued. It’s a shortcoming of mine, I know, but that’s how I am.

Currently, I’m back at the regular exercise. All I have to do is look at my skinny little forearms (typing isn’t nearly enough exercise for them) and look at myself in the mirror to realize that I need to do something about this sad state of affairs. Also, my endurance is way down for doing chores outside, which is not good, either.

I’m also taking a za-zen type of practice into my everyday life, using it in my 90-second clearing approach to really take the edge off my everyday experience. I haven’t completely abandoned it. I just needed a new way of using it in ways that got me going in my life, instead of taking me away from life — as sitting za-zen will do.

As for the exercise, after laying off for a long (too long) while, I’m doing more strengthening in actual movements that I do on a daily basis — not the isolated types of movements that focus on a specific muscle group and are useful for bodybuilders. I’m building overall strength, not just specific muscles.

I’m continuing to do my rest/relaxation thing, stepping away from work during my lunch hours to listen to guided imagery and relax — sometimes sleep, too.

And these several pieces are important for what I’m doing now, which is pushing myself a little beyond my routine to challenge myself and keep things interesting. I’m training myself to handle my highs and my lows, and not let them get to me.

To be continued…

Engaging Anyway

September 14, 2012

Vacation is treating me well, I have to say. The weather is gorgeous, the condo is great, and the beach was amazing last night. We got here late – off to a delayed start, no surprises there — but we had some time to get something to eat and then crash on the beach. We must have slept for at least an hour. I was exhausted, and I could barely keep my eyes open. I have been pushing really hard at work for a number of weeks – and I got sick in the meantime, too – so small wonder that I’m shaking-tired, my stomach is in knots, and I look like I have permanent dark circles under my eyes.

I’m hoping this coming week will change that up a bit. Just being able to rest will be great… though with a spouse who suffers from intense panic-anxiety, it’s constant work to keep stabilized and even-keeled. All the drama about little things… things not being placed in the right way, things not being done in the right sequence… it’s surprising what some folks get hung up on. Oh, well. I think it’s biochemical – no logically thinking person would get this bent out of shape about how a towel is hung in the bathroom.

I’m on vacation, after all.

So, we’re having some friends come to visit later today – one of the friends is very much like me – even-keeled and very “grounding”, as they say. Another one is like my spouse – always on hyper-alert, very uptight about every little thing, and always looking for something that’s WRONG that they can take on and fight over. The third friend, I’ve only met once, by my spouse knows them, and they seem cool. We’re going to hang out and just chill for a few days. That’s the plan, anyway.

Last night I had an interesting conversation with the strung-out friend over some housing issues they’re having. They’ve been having trouble finding a place to live for a couple of years, and they’ve been bouncing around, here and there, living out of their truck (they have a big-ass pickup with a cap on it that they have a bed and all their earthly belongings in) and looking around for other options. They’ve had a bunch of opportunities come up, but they keep deciding that’s not good enough. They say if so-and-so offers them something, then they’ll have to offer something in return, and they don’t want to get into that. Yada-yada-yada. And winter is coming. There’s not a lot of time to screw around.

This person seems to think that they can hold out indefinitely and the perfect thing is going to come up. I’m going to have a talk with them when they come around this weekend. They have got to quit acting like they’ve got all the time in the world. Because they don’t. They seem to think that “the universe” – whatever that is – is going to provide for their every need perfectly. They keep talking about “the universe” like it’s a benevolent parent who wants to make sure they’re taken care of and all set.

News flash — “the universe” (at least, the one that I live in) doesn’t work that way. It’s all very nice and wonderful to think so, but from what I’ve seen, you’ve got to get involved in your own life and take responsibility for your own decisions and do what you can when you can – not wait around for some invisible Force to step in and save you from everything. Interestingly, this friend was treated really badly as a kid – they were beaten and shuttled around between family members and foster homes and probably have a history of tbi in the mix. (When I say “interestingly” it’s not to make light of their hardship – I think it’s just an important piece of the puzzle they are.) They’re also dyslexic and have a really hard time reading. And they’ve got major ADHD. Those are some more pieces of the puzzle.

The puzzle that they are seems to be living in some fantasy world – like maybe they did when things got so rough for them as kids and they had nowhere to hide but in their own mind. They seem to be all hung up on the idea that something outside of them needs to come and save them – that they can’t figure things out for themself. I think that’s a big piece of it – they don’t seem to want to figure things out. Because it might get messed up as it does so many times. And then, no matter how hard they try, they will be back at square one.

Now, in the midst of all of this, the place where I see them needing the most help – and not always asking for or using it – is with communicating with people. I think they’ve got huge problems following what others are saying, they have a hard time comprehending, they jump around a lot, and by the end of the conversation, they have wandered off in different directions and are in a different cognitive “neighborhood” than when they started out. It looks and sounds so familiar to me – like I’m looking at myself, from the time before I got help for my TBI issues. It’s crazy – all the faking it through, all the bravado, all the halting interactions, the jumping around, the inability to hold conversations and make real decisions… it sounds eerily familiar. It reminds me so much of how I was before. Really, truly.

And I wonder how I got past all that. Because I really was locked into that for years and years. For over 40 years, actually. That’s a long time to be locked away in that prison of non-comprehension and confusion.

The way I got past all of it, when I think about it, was doing the exact opposite of what I was used to doing – I started reaching out to others and engaging. I started extending myself and taking a chance at sounding stupid, so that I could have actual conversations with people. To be perfectly honest, I had gone most of my life without having actual conversations with anybody – it was just nodding my head, repeating back to people what they’d said to me, and pretending I got it, when I was actually losing much of what they’d said to me, in the past few minutes. It got me by, but it was a really shitty way of living. And it only helped others, not me. In fact, it didn’t help others, either, because they were talking to a ghost. They were talking to someone who didn’t even exist.

When I started working with my neuropsych, however, that really started to change. To be completely accurate, a lot of the “work” we did each week was just sitting and talking – me saying stuff that probably sounded like I was half insane, and them sitting there just listening and responding to me like I had good sense. They didn’t call me on the crazy stuff I came up with; they just let me talk. And eventually I built up some skills in having a conversation with another person that I could actually participate in. I learned how to engage.

And what a difference it made. I can’t even begin to say. Between those weekly conversations and my regular blogging, I gradually learned how to put thoughts together in a relatively coherent way that had something to do with reality, rather than some fantasy concoction in my head – some fantastical interpretation of what was really happening and what it all meant.

Crazy. I mean, it was just nuts, the way I used to live. It had nothing to do with actual reality – it was all about my own internal interpretations of what was happening and what people were saying to me.

And that’s exactly where I see this friend of ours living. That’s the “cognitive neighborhood” where they live. And it’s where my spouse lives, as well, with their anxiety-driven interpretations of how everything that’s out of place, everything that isn’t perfectly to design, is a sign of imminent danger — and it needs to be fought against and overcome right away – right now – no hesitation – just strike hard and fast – and rule with shock and awe. It holds you back, it stops you from interacting with the world. It keeps you from engaging with your life, and it keeps all the best ideas from showing up and becoming reality.

That’s what happens inside our heads. We all do it. We all get pulled into that, at some point or another. And all the while, the chance at having a peaceful, happy life is draining away, as our anxiety and interpretations of What’s Happening pull the plug out of the tub of our presence of mind.

If you’ve been following this blog at all, you can probably guess what I’m going to suggest next – that these are issues with the Autonomic Nervous System – the constant activation of fight-flight that keeps us on edge and keeps us from being present, even intelligent, in our daily lives. It’s our histories of trauma, our mass of experiences with being beaten, abused, violated in some way, neglected, mistreated, dismissed, and generally treated like ever-loving CRAP that puts us in that state of mind, and keeps us there indefinitely, when our lives are filled with drama that we cannot control.

It’s when we grow up that we get the chance to control the drama – or at least manage it. But if we’re so accustomed to (and comfortable with) the drama that we feel out of place or we feel like strangers to ourselves if it’s not around, then we end up re-creating it, over and over and over again, and we keep ourselves stuck in that place where we cannot think on our own and act, only react. We end up in that place where we are our own worst enemies – even when we think we’re being our best friends.

And there you have it. At least, that’s my neat little sum-up of how it works. In the case of this friend, I can totally see it. They’re so strung out on anxious drama, that they can’t even think. All they can do is find reasons to doubt every option they have – and poke holes in it. Till their whole life looks like a loosely woven wicker basket they’re trying to use to carry water.

Huh.

People sure are funny… Except it’s not funny when your life is hanging in the balance and you don’t have a clear view to how to get the hell out. Which is where this friend is, right about now. So, maybe I’ll get to talk to them, maybe I won’t. I’m going to try. Because winter’s coming, and they have GOT to get their shit together. They can’t keep living like this, living in some fantasy world about how things will be so great, if the impossible happens. Life is full of contradictions and hard choices. We always have to make trade-offs and we always have to deal with things that are less than perfect, and anything but ideal. The way I’ve found to deal with all of these, is to step up to life and really engage with it – get involved, don’t hold back, just get in there. I can’t afford to think about what other people think of me. It’s just not worth my time and energy. Anyway, people are so self-obsessed that they probably don’t notice half the stuff that I do, and if they do notice it, they probably have a completely different interpretation of what it means and what it’s about.

So, I’ve just gotta engage, no matter what. I’ve just gotta keep going, and make it all work. Just keep at it, never give up, never give in to the fears and hesitations. Acknowledge them yes, but keep moving forward.

The past two years have done wonders for helping me get me to that place. I’m not perfect at it, and I’m still learning, but I’m a hell of a lot better now than I was just a few years ago. A lifetime of holding back and not being able to stand on my own, make my own decisions, speak my own mind, and have actual conversations with people, is gradually giving way to something else, something different, something new.

And I’ve got to keep on keeping on. I’ve got to keep moving forward. I really feel like I need to talk to this friend and let them know A) they’re not alone – I know exactly what it’s like, and B) I have discovered some tools that have helped me a whole lot, and might actually help them, too. They have to know they are not alone. I used to operate like they operate – every single day of my life. And they have to know that I figured out a way to live that works for me. With the help of a handful of people who know how to not make fun of me, how to not beat me down, how to not treat me like shit, I have come a long way. If anything, I hope that I can get this friend to trust that I’ll be able to do the same for them.

Winter is coming. There’s no time to wait. Life wants us to engage with it. So, let’s engage.

What REALLY happened

Storms happen

Just a quick note before I head out the door to work — I had a somewhat rough weekend, feeling sick and out of it, after my meltdown on Friday. I really felt like I’d screwed up, and I didn’t know how to make it better or what to do to fix it. I knew that I’d been over-tired, that I’d been stressed, that I’d really had a hard time handling everything, and that the next time I needed to do a better job of managing my time and my energy — and come up with an alternate plan, in case the first one doesn’t work out (d’oh).

Yesterday, though, while I was doing some work around the yard, I was giving this all a lot of thought, wondering what the hell would have possessed me to say and do the things I did. It made no sense. I know better. I have better sense. I am capable of better things than that, and I know it. I tried to do better. I really did. I almost pulled it together a bunch of times, but I could not let it go. And it tore the sh*t out of both my spouse and me.

So, why didn’t I do better? Why did I end up getting hijacked by those emotions and carried away to the abyss? Seriously, the things I was “up against” were minor, compared to other more serious things I’ve faced with more agility and control. So, why was I in such terrible form on Friday?

It occurred to me that the thing that got hold of me was not psychological. It was not mental. It was not a problem with my thinking. After all, on Friday while I was having that meltdown, there were periods when I was completely calm and lucid and at peace — then BAM! — everything changed in an instant, and I was off to the races again. The only explanation that fits, is that it was an actual neurophysiological reaction — a physical thing that got sparked by something that actually precedes rational thought in my mind. Of course, I could not defend against it, because it got hold of me before my mind could get a hold on it. And that has the hallmarks of an over-activated fight-flight response written all over it.

That is, it was not a problem with my thinking, per se, it was a problem with my body. The whole drama was based on a purely physical response. It was not a psychological drama that I created, it was a physical phenomenon — a physiologically rooted set of behaviors that kick into action way before any kind of logically calm and mindful activity could take place. In fact, it was based on a system of response that is hard-wired into me (into all of us, actually) to save me from being burned up in a fire or carried away in a tsunami. When things seem dangerous (and my body is primed to be hyper-alert to danger), like they did on Friday when things weren’t working out the way I wanted them to and I was really uptight over not having enough time to rest, my fight-flight kicks in big-time. And then look out.

Like on Friday.

Oh – I’m running out of time. Gotta go.

More on this later.

One last thought for the day: 50 bucks says that before the end of the decade, people are going to have a friggin’ clue about the role the autonomic nervous system plays in not only trauma and PTSD, but problems with TBI healing and recovery, panic-anxiety, anger management, various behavioral syndromes, ADD/ADHD, self-injuring behaviors, mental illnesses of many kinds, as well as autistic spectrum disorders… and they are going to actively incorporate physiological therapies (including regular well-designed exercise) into the mix that target specific physical elements that need to be strong and balanced, in order to get your act together. Less drugs, more exercise and attention to the body. Better health overall.

And fewer meltdowns. At least for me. (And not before the end of this decade for me 😉

‘Cause seriously folks, it’s all connected.

More on the Polyvagal Theory (pdf) later. It helps explain what really happened on Friday.

Traumatic Brain Injury Linked to Post-Traumatic Stress Disorder, Study Suggests

Find the connections to get some relief

I continue to think a lot about the connections between mild TBI and PTSD. After going off the rails last month over some stressful stuff at work… and continuing to struggle with stress and how it affects me, I cannot help but see a lot of connections between the stress I’m under, the way I respond to it, and the way my brain has been working lately.

This article came out back in February, 2012, and I may have blogged about it before — it’s worth mentioning again:

ScienceDaily (Feb. 15, 2012) — UCLA life scientists and their colleagues have provided the first evidence of a causal link between traumatic brain injury and an increased susceptibility to post-traumatic stress disorder.

Their new study, published Feb. 15 in the in the journal Biological Psychiatry, also suggests that people who suffer even a mild traumatic brain injury are more likely to develop an anxiety disorder and should take precautions to avoid stressful situations for at least some period of time.

The motivation behind the study, which was conducted in rats, was the observed correlation of traumatic brain injury, or TBI, and PTSD, particularly in military veterans returning from service overseas, said Michael Fanselow, a UCLA professor of psychology and the senior author of the study.

The reasons for this correlation are unknown. It could be simply that the events that cause brain injury are also very frightening and that the link between TBI and PTSD could be merely incidental. Fanselow and his colleagues, however, hypothesized that the two “could be linked in a more mechanistic way.”

Using procedures to separate the physical and emotional traumas, the scientists trained the rats using “fear conditioning” techniques two days after they experienced a concussive brain trauma — ensuring the brain injury and the experience of fear occurred on different days.

“We found that the rats with the earlier TBI acquired more fear than control rats (without TBI),” said Fanselow, a member of UCLA’s Brain Research Institute. “Something about the brain injury rendered them more susceptible to acquiring an inappropriately strong fear. It was as if the injury primed the brain for learning to be afraid.”

To learn why this occurred, the researchers analyzed a small piece of brain tissue, the amygdala, which is the brain’s critical hub for fear learning.

“We found that there are significantly more receptors for excitatory neurotransmitters that promote learning,” said Maxine Reger, a UCLA graduate student of psychology in Fanselow’s laboratory and the lead author of the study.

“This finding suggests that brain injury leaves the amygdala in a more excitable state that readies it for acquiring potent fear,” Fanselow said.

The research was funded by the National Institutes of Health, the U.S. Department of Defense and the UCLA Brain Injury Research Center.

Co-authors of the study were David Hovda, a professor of neurosurgery and of molecular and medical pharmacology at the David Geffen School of Medicine at UCLA and director of the UCLA Brain Injury Research Center; Andrew Poulos, a postdoctoral fellow in Fanselow’s laboratory; Floyd Buen, a former graduate student in Hovda’s laboratory; and Christopher Giza, an associate professor of neurosurgery at the Geffen School of Medicine.

The research was a collaboration between Fanselow’s laboratory, which studies neural mechanisms of anxiety disorders, and Hovda’s laboratory, which investigates brain injury.

“One of UCLA’s great strengths is the spirit of collaboration that allows scientists from very different departments to combine their very different expertises to answer important but difficult questions,” Fanselow said.

This is very encouraging (if I haven’t said it before). The fact that clinical researchers are looking at the biomechanical actions of mild TBI and PTSD opens up new routes for better understanding more pieces of this puzzle. I’ve said a number of times that TBI and PTSD are intricately intertwined in some really fundamental ways, many/most of which are experientially biochemical in nature. And the fact that researchers are now paying attention to this and publishing papers about this, really gives me hope for the future of handling this “co-morbid” condition.

I have also long believed (and I think also said) that mild TBI is especially vulnerable to PTSD development, because by its very nature it is confusing at the most fundamental level — which leads to continual activation of the fight-flight reflex, which ultimately builds up a biochemical load that’s heavy on the stress hormone side — and light on the rest-digest impulse. Mild TBI and its successive “micro-traumas” of continuously baffling and inexplicable experiences, many of which are either negative/threatening or perceived to be negative/threatening, is the experiential equivalent of all those subconcussive hits sustained in football, and the biochemical overload of stress hormones that builds up, day after interminable day, serves to further fry the system and the brain and the circuits which would normally serve to chill us out and manage to find a way around (or through) the troubles in one piece.

Unfortunately, I’m not a clinical researcher with an internationally recognized facility, so there’s only so much that I can do to advance this understanding in the circles where people make the diagnoses and treatment decisions. But I can at least do my part here, in hopes that the people who are actually affected by mTBI and PTSD will find some answers — and relief. And those who treat people with PTSD and/or TBI would be well-served to explore the connections between the two. It is such an obvious connection, when you stop dismissing life experience as “anecdotal” that it surprises me that no one is confronting it head-on. Or that anyone is still being territorial about their explanations for why some of us do and experience the things we do. If the professions would cross-pollinate and cross-promote, they would uncover a vast opportunity to not only expand their service, but come up with a whole new slew of approaches that actually work with those suffering from stress-hormone-overload-induced dysfunction/disorders in the aftermath of TBI.

I can’t control the fields/industries, but I can always hope. And keep working…

What it takes

And plenty of rest

I’m resting today. I had a good workout yesterday, and today was an easy day. I’m sore, and I need to recover. Eat right, rest, recover. And then go back at it later, when I’ve built my reserves back up again.

I’ve been thinking a lot about how the last few months have unfolded for me. I know I pushed myself harder than I probably should have, and I might have done things differently. At the same time, however, I do believe that every now and then it’s important to push — and see what happens. I just have to be prepared for the fallout. I just have to be prepared to rest and recover after the all-out rush to Get It Done.

See, this is the thing — I really believe that any kind of progress requires some discomfort at times. And I also believe that one of the ingredients to ongoing success is being able to live with some discomfort — even outright pain — and then find ways to “integrate” that into your life in a new way that makes it useful. I don’t believe that important things come without work or effort. I just don’t believe in the whole “ask and it will be given you” idea that excludes the work factor. I’m sure that’s heresy to some, but to me, I just haven’t seen results of non-workers anywhere near equaling the results of hard workers.

I work hard. I like to work hard. It pays off for me. Unless I overdo it.

The area where I’m presently getting schooled, is with regard to rest. Recovery. Allowing my body and system to catch up with my mind. I have so many amazing ideas in my head — all of which seem fantastic and desirable and useful.  But I get so caught up in the excitement, that I push myself way too hard, and then I fall off into nothing. Doing nothing. Thinking nothing. Just nothing. And while it is a relief for me to go into that nothing-ness, it stops me from getting where I’m going. It stops me from actually achieving anything.

That oscillation of everything-nothing-everything-nothing is fine, if all I want to do is entertain myself. Well, that’s one way to live. Because it is quite entertaining. But if I actually want to get anything done…? Hm. Maybe not so much.

That calls for a very different approach.

And I think about the video about Arthur Berman’s dramatic recovery from “disability” that I watched — both in the short version and the extended cut. I think about all the messages I’ve heard people tell me about myself over the years — that I was slow, that I was stupid, that I was lazy, that I was a screw-up, that I was a huge disappointment, that I was faking it, that I was just looking for attention or drugs or whatever — and I think about how, like Arthur, I believed what they said. Because they were my parents or my teachers or some other authority figure or expert who I thought knew what they were talking about. Believing them cost me a whole lot — like believing the MD’s cost Arthur 17 years of his life hobbling around and being wheeled around like he was a cripple.

How many times are we crippled, not by actual circumstances, but the things in our minds that believe certain information for whatever reason… and the behaviors we adopt that support and reinforce that information. And until we hit a wall, we just don’t have a reason (or often occasion) to really change.

So, that being said, I do believe it is important to hit a wall, on a regular basis. I have to push myself, I have to test myself. BUT I also need to “build in” recovery time and the chance to integrate all the new information into my system, just as I would need to give myself time to digest a big meal. I can’t just jump up and run off to the lake for a swim after a 7-course meal. I need to take time to rest and let my system digest and absorb everything.

It’s the same way with my life. And I’m learning this big-time, these days — the importance of resting and digesting after the fight-flight activity.

It’s all part of a larger theme with me, that I believe has been with me since I was a kid and started getting concussions/TBIs — the imbalance of sympathetic nervous system (SNS) fight-flight go-go-go activity, that ultimately has fried my system in a big way, and which I need to really offset with behavior choices that make it possible for me to live my life to the best of my ability. And those choices, that rest, that “digestion” is going to take some real effort to get used to. But I’m sure I can. It’s largely a question of habit. And so I’ll develop the habit.

Anyway… Speaking of living to the best of my ability. It’s time for me to head out to work. Life goes on, and so do the lessons.

Onward.

The hazards of mtbi micro-traumas

Another Monday, another week. The weekend was pretty good, all things considered. I got a fair amount done, and I also had some time to just relax. Not much, but some.

I did a little reading about “The Cognitive Control of Emotion” by Ochsner and Gross, who say

“Conflicts, failures, and losses at times seem to conspire to ruin us. Yet, as Marcus Aurelius observed nearly two millennia ago, we humans have an extraordinary capacity to regulate the emotions occasioned by such travails. Importantly, these regulatory efforts largely determine the impact such difficulties will have on our mental and physical well-being.”

They also include a good quote from Marcus Aurelius:

If you are distressed by anything external, the pain is not due to the thing itself, but to your estimate of it; and this you have the power to revoke at any moment.
Marcus Aurelius (Meditations)

The rest of the paper is about fMRI results and neural mechanisms, most of which went over my head because I’ve been having trouble focusing and comprehending what I’m reading. I’ll have to go back and re-read it, because I believe there’s something in there I can use. But the thing that I took away from it, is that we actually can choose how we will experience and react to and emote over our circumstances, and the better we are at that, the better off we may be.

Or course, this doesn’t speak to people being in just plain crappy living situations, but there is at least a little bit there that I can use.

Anyway, I’ve been thinking about how bent out of shape I’ve been for the past month or so. It feels like a whole lot is piling up with me, and I haven’t been able to get out from under. Certainly, not getting enough sleep is not helping. I’m working at turning that around. It’s slow going, but at least I’m making the attempt.

And I’ve been thinking about all the things that have gotten me worked up, bothered, troubled, anxious, etc. A lot of those things aren’t even that big a deal, on some people’s scale. But for me they are. And they seem to add up a whole lot faster than one would expect. It’s a little dispiriting, but that’s how it is. Everything adds up. Quickly. Even the little stuff.

Especially the little stuff. I have a name for all those little things that “shouldn’t” bother me — micro-traumas. Specifically, mtbi micro-traumas. They’re the little things that get under my skin and set me off — because I’m tired and/or stressed and/or not paying attention. They’re the little things that “shouldn’t” happen because regularly functioning people don’t have these problems — like waking up one morning and not being able to read or write as well as you could the day before… like forgetting so much stuff that if you don’t write it down, it might as well not even exist… like getting incredibly bent out of shape over developments at work that most people take in stride… like flipping out over dropping a spoon while you’re making your breakfast.

Those little experiences, those tiny explosions, may not seem like a whole lot in and of themselves. But when they happen again and again and again, tens (even hundreds) of times a day, they add up. And they wear at you. It’s like a death by a thousand cuts. It’s not even the exact events themselves that constitute the explosions — it’s the experience of those events, the biochemical bursts and blasts and ka-booms that take place out of sight of anyone else, that set you on edge and tear the living crap out of your interior.

Isolated and not considered in light of the continuous whole, these explosions, these micro-traumas probably don’t look like much to the outside observer, but internally and over time, they add up. And they add up to cumulative trauma — just like all those sub-concussive hits (from practices and full-on collision play) take down professional football players years later, the micro-traumas that bombard mtbi survivors day in and day out also take a toll. And it all adds up.

This is coming back to the ANS balancing issue I talked about yesterday. And it also ties in with PTSD and resilience. I really believe that unaddressed TBI issues — especially “mild” TBI issues — lend themselves extremely well to creating an everyday “substrate” of stress and fight-flight orientation, which erodes our personal resilience and gradually over time in countless invisible ways pulls us down into a way of life that is hallmark PTSD. For all the talk about traumatic brain injury, there is remarkably little overlap between the TBI and PTSD conceptualizations, that I can see. Everybody is trying to establish that THEY are the ones who have it all figured out, and precious few people are giving quarter. But that’s a bit dense and self-serving. It’s also not practical, nor is it accurate. The two overlap and feed into each other — obviously (to me at least) — and any approach to TBI recovery (yes, I’ll say recovery) must necessarily include an approach to trauma that is patently unlike the talk-therapy approaches that just serve to drive us half-mad with all the emotional stirring-up and provocation.

Let me put it simply. This is what I believe:

• That Traumatic Brain Injury is by nature a traumatic event. It is a physiologically traumatic event. Even if the individual is not aware of their environment at the time of injury (or they forget it due to their brain trauma), their physiological experience nevertheless primes them for trauma.

• The nature of brain trauma, as a fundamental insult to the very command center of so much of our functioning (as well as the biochemical reactions which take place as a result) puts the body into overdrive to both survive the injury and escape the imminent danger that TBI poses to the individual. The brain has to work overtime to recover and come up with compensatory techniques. And the individual can be in a perpetual state of insecurity and confusion and fight-flight, because their usual ways of approaching life are no longer available the way they once were.

• The extreme fluctuations of emotion and ability, can fire off biochemical reactions that are disproportionate to many of the events. This is a function of an over-tweaked autonomic nervous system which is “stuck in high gear” like a Prius with its floor mat wedged to the accelerator. The injured individual can be so confused and disoriented that their ability to monitor and understand their own situation can be completely compromised, which leads to more stress — Post-Traumatic Stress.

• To make matters worse, the general cluelessness (even hostility) of the surrounding social environment exacerbates things even further, by insisting that everything should be fine, that there should be no problems, and that the TBI survivor should be able to function as they did before. This puts the survivor into an all but permanent fight-flight mode, eventually either pushing the parasympathetic nervous system out of the picture or creating wild swings between the two ANS branches, which totally screws things up (that’s my scientific assessment 😉

• This is especially true of mild traumatic brain injury survivors, whose brains are still rewired and who have to make more subtle changes and advances, in the face of — among other things — cognitive fluctuations, and surprisingly extreme and shocking biochemical reactions to “non-events”.

• Unless and until a TBI survivor deals with the trauma aspects of their situation (no, not “They did this to me, and it hurt” kind of dealing, but the physiological effects of the biochemical roller coaster), they can continue to suffer and continue to struggle. Long-term prospects may actually worsen, as their post-traumatic stress is exacerbated and accentuated by ongoing issues which have not been properly balanced by exercise, rest, nutrition, and plenty of water.

It might sound over-simplistic, but may be to some extent it is that simple. And in the end, I believe that TBI survivors are not going to get proper care and assistance until the physiological aspects of trauma recovery are fully explored and matured. The vast majority of trauma research that I have encountered has to do with psychological trauma, and certainly there is plenty of that. But approaching trauma only in terms of psychology, and addressing it only in terms of talking and emoting (both of which can be extremely taxing for TBI survivors to do with great success), is just pulling us backwards.

It’s not helping.  There has to be a better way, and I think I have actually found it.

Whether anyone in a position to study this and pursue new courses of treatment is going to catch on, is anybody’s guess. I do believe that the military is the closest to making progress on this front, due to their increased focus on Total Force Fitness. They have a vested interest in coming up with what works, because their (and our) survival literally depends on it. And it is in their research that I find the most hope and the most useful material to work with, at this time.

Researchers at institutions may or may not get it. I think in fact that they usually don’t, in no small part because they are so far removed from the issues, personally speaking. Doctors and therapists may or may not get it, because of their indoctrination and their intellectual biases (plus their own trauma issues get in the way). Those of us out here walking around in the word trying like crazy to figure out WTF is going on in our lives… we’re like mobile laboratories, chock full of anectdotal tidbits.

We’ll see if things change. But for now, it’s time to go to work. Onward.

From the DCoE – Mind Body Skills for Regulating the Autonomic Nervous System

Warrior Resilience Conference – Thank you for your service – at home and abroad

Last June, the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury released a report (pdf) called Mind Body Skills for Regulating the Autonomic Nervous System, which surveys a number of techniques for regulating the fight-flight and rest-digest functions of the ANS.

I may have seen this before, but I honestly don’t remember. In any case, I’m recording it now here on this blog, so I can remember and find it later. I also saved a copy to my hard drive, and I am reading through it.

The ANS has been hugely important to me over the past years of my recovery. When I am able to step back and objectively view my progress and my capacity to live well, I can generally judge from the degree of ANS balance, how happy, productive, and involved I am in my life. More ANS balance = more sense of well-being. Less ANS balance = struggle and difficulty and feeling useless. And that holds true, whether I am more unbalanced towards rest-digest or towards more fight-flight. Either way, it’s a recipe for struggle and difficulty.

ANS balance is hugely important to me. And the mind-body approach is the often-missing piece of TBI recovery that I’ve been filling in myself, along with weekly visits to my neuropsych, to help balance things out. When I have kept my fight-flight/rest-digest nervous system activities in balance, things have usually been going well. When I have not had them in balance, things have gone rapidly south, and it’s taken me weeks to get back to where I am functioning to my satisfaction again.

I’m smack-dab in the middle of one of those recovery periods right now.  It’s taking me longer than I expected, to “right my ship” so to speak, and it’s frustrating and feels defeating, but I do feel like I’m getting there… gradually. I do need to be easy on myself – pushing harder has a way of setting me back, ironically. It doesn’t feel “right” but backing off and paying attention to the small things, while letting events take their course and work themselves out, seems to be what works best for me.

The main thing is to not get all caught up in myself and get down on who I seem to be at the moment. I keep seeing this slogan, “Life isn’t about finding yourself – it’s about creating yourself.” I agree. And I really believe it’s also about creating things that benefit other people — about literally making the world a better place through our words and thoughts and deeds.

When I don’t take care of my ANS, and I allow myself to wallow in that awful feeling of sympathetic overdrive, things tend to not go so well. I also tend to get down on myself AND not be able to see the future prospects ahead of me. The more I strive, sometimes, the more depressed I get — someone once said to me that depression is the result of driving too hard for too long, and having your system get fried, without allowing it to catch up and rest. I can see that in my own life – in the way I get so down, after I have been so up.

My neuropsych once told me about an individual with TBI who had been diagnosed as “bi-polar” by their doctor, and they’d been put on meds for it. The doctor believed that they had a “short cycling bi-polar disorder” where it took them less than a day to run the gamut between manic episodes and a depressive crash. My neuropsych worked with them to work out their daily routines and activities, and when they had gotten some balance, back — poof, the “fast-cycling bi-polar disorder” was gone.

Now, I’m not a doctor, and I’m not board-certified to make diagnoses and prescribe treatments, but in my own life, I can see a direct correlation between episodes of intense activity (even if it is activity for the greater good and/or activity that is beneficial to me), and sinking into a pit of despair. I can see patterns of lots and lots of activity being followed by an extended crash.

So, regulating my ANS — when I remember it — is really a big key to me keeping stable and sane. (If you have any doubts, check out the posts when I have not been at my best – 9 times out of 10, they came at times when I was stressed and in full fight-flight mode without respite.)

Seeing the Defense Centers of Excellence releasing a report on Mind Body Skills for Regulating the Autonomic Nervous System is really encouraging to me. I have been very troubled by the lack of support and assistance that’s been offered to our returning vets (thank you to all of you for your service, by the way). It sort of seems to me that a report like this is a way for the DCoE to provide extended assistance in the way of ideas that people can learn and use to help take care of themselves. I think it would be absolutely impossible for the VA to provide personal assistance to each and every vet who returns — especially because there are so, so many who are returning with brain injury issues, and so little is actually known about brain injury AND each injury is a little different, so short of providing a full comprehensively trained team to assist each vet who returns, the level of care is just not going to be enough, coming only from the VA. There aren’t enough people and there isn’t enough money to do it all from one central source. We literally need to pull together as a country and provide support in a variety of ways.

But a report like this from the DCoE is a step in the right direction.

The cover these topics:

• Introduction and Background
• Practices for Regulating the Autonomic Nervous System (ANS)
  • Emotions, Arousal and the ANS
  • Breath Techniques for Regulating the ANS
  • Posture and Tension-Modulation Techniques for ANS Regulation
  • Mindfulness, Meditation and Guided Imagery
  • Mind-Body Programs
  • Biofeedback

There are other approaches, and I’m sure time will show changes to how each of these is perceived. But it’s a start. I’m having a little trouble focusing today and keeping my attention on what’s in front of me, so I can’t speak in depth about what’s there. I haven’t been able to read more than a page at a time, honestly. But in the coming days and weeks, I hope to see that change. And I’m taking steps to get that to happen.

I encourage you to follow the link and read up on it yourself. There may be something good in it. In any case, the report was created in the interest of strengthening troops in the face of new kinds of war, and since dealing with TBI can be a series of battles, in and of itself, I can see how this same orientation might benefit me and many, many others.

These techniques are not just for soldiers — although they were explored with soldiers in mind. They can help the rest of us, too.

Now obviously, there can be no true comparison between coping with the daily micro-traumas of TBI, and being deployed three times to several different desert battlefields. The scale and quality is completely different. But in principle, if not in practice, there are ideas and habits that can cross-pollinate and assist on many levels. In TBI, especially, where we are so often in uncharted territory, it makes no sense to write off a potentially beneficial approach because of perceived differences between cases. We have to pull out all the stops and do everything we can to achieve what progress we can.

Now I need to pull out all the stops and run some errands. Life goes on.