What’s more, I have been realizing over the past weeks, that I have been able to take on more and more at work, and get a lot more done, than I have in a long time. It’s pretty amazing, really, how much I manage to accomplish. Some things get lost along the way, of course, but overall, I have a pretty strong reputation as someone who can juggle a lot of things and make progress.
Cooking, I believe, has helped me with this. The practice of preparing supper each night, going through the steps of organizing the ingredients and preparing more than one food item at a time, has helped me find a “flow” to my work, and that’s pretty amazing. I used to really struggle with getting the rice or pasta on the stove at the right time. I would miscalculate the timing, and one dish would be hot, while the others were cold. Or I’d completely forget about one of the dishes, till it was too late to start it.
This has gotten better. I have gotten better. Not only am I better able to handle my anger and agitation, but I’m also better at going with the flow and coordinating my activities. When I focus completely on the task at hand — preparing supper — it clears my mind and relaxes me, and I can get into a “zone” that’s healthy and happy.
And then I get to eat what I’ve made — which is usually a good thing 😉
Sometimes I’ll completely space out and screw things up, but that’s just one of the things I need to improve.
I think I’ll start looking for new recipes, actually. I’ve got the usual dinner down. I would like to start cooking a more varied selection of dishes. I expect this is going to be a bit of a challenge, but if I make the room for it and I plan for it, I think it can be good.
Main thing is to not overwhelm myself with the newness — give myself time to acclimate and get into it. But I think it will be a good thing to do.
I got a good lesson this morning. I managed to sleep in till 8:15, with my earplugs firmly wedged in my ears and extra curtains pulled across the windows to block out the light. Even the birds that fill the trees around my house, clamoring for attention from each other and battling for position at the bird feeder first thing in the morning didn’t wake me up, as they often do, ’round about 6 a.m.
I’ve been feeling progressively more under the weather over the past few days, with my balance getting worse and worse and the headache starting up again. Work has been really good – very rewarding and satisfying. But it’s taken a toll, and when I got up this morning — without doing my usual breathing exercise (I did that at 4 a.m. when I was trying to get back to sleep) — I was feeling wobbly and out of it. I had to lean against the walls as I walked to the bathroom, and while I brushed my teeth, I had to prop myself up with one hand firmly on the sink counter.
I managed to get downstairs in one piece, and I made my breakfast slowly, deliberately. I took my time with it, taking care to not move too quickly and put myself off balance. In the past, when I was still dealing with the early years after my last injury, being off balance would send me into a panic and it would throw me off for the whole day, even before the day began. But since I’ve been making important changes in my daily life — including regular exercise — the panic has subsided considerably, and I’ve learned how to handle the sense of teetering on the edge of collapse without having my psyche collapse, too.
And that’s important.
So, anyway, after I had my breakfast, I decided to spend my day reading and writing and checking in with myself. The weather has been pretty wet, lately, and I can’t do much outdoor work. Plus, I’m not feeling well, and I would love to just spend the day reading, studying, and writing. Taking it easy, instead of taking care of everybody else’s business. I put some water in the electric kettle and fixed myself some fruit with crackers and goat cheese and went up to my study to settle in.
After a little bit, I realized I’d forgotten my trusty writing cardigan, and I went back downstairs to get it from the kitchen. While standing in the kitchen, looking around to see if there was anything else I’d forgotten, I heard an odd hissing sound. I went over to the kitchen counter and found my tea mug with a dry tea bag in it, and beside it was the electric kettle, hissing away, nearly all the water boiled out of it.
Now, the way the kettle has always worked in the past, is that when it gets low on water or reaches a certain temperature, it shuts off. This time, it did not shut off. So, I did. And when I looked closely at the heating element, it was showing signs of rust — perhaps from the intense oxidation from the coils evaporating off the water?
I kind of went into a tailspin about this. Yes, I know my alarm was disproportionate to the situation, but I got seriously upset by this and I started to beat myself up over having put water on and then walked away. I won’t write all the things that went through my head, because they are not the kinds of things I care to archive for posterity. Suffice it to say, for a few minutes this morning, I was not my best friend.
But then I realized I was pretty off the charts with my distress — how much would a replacement kettle cost? not very much, really — and it was more about me being absentminded and not paying close enough attention … no to mention feeling ill and “off” this morning. So I was wasting a lot of precious time getting bent out of shape over this. It’s turned out to be a beautiful fall day, and I have given myself permission to take time off to take care of myself. Why should I waste my time and energy beating myself up over a simple case of absent-mindedness that really anybody could have done, too?
Okay, so I established that it wasn’t worth wrecking myself over this oversight. And I realized that this electric kettle is not going to automatically turn off whenever it’s low on water, as I assumed. I would just get in the habit of A) putting more water in the kettle and B) not leaving the kitchen till it’s done heating the water, which takes all of maybe 30-60 seconds. Simple solution, right?
Well, what came up next was the burning question (and yes, I realize this sounds a bit neurotic, but I am not feeling well this morning) about what to do with the “extra” water that I wasn’t using for my tea? See, when I pour water in, I pour exactly as much as I need, so when it’s hot, I don’t have to check the level of liquid in my mug. I just know that I have exactly as much water as I need. If I heat more than I need, what will I do with the extra?
This was the hotly burning question in my fuzzy brain this morning (in the moment it seemed extremely important). I was all up in my head about the evils of waste and getting frantic about not having the exact amount of water I needed in the kettle, and having to gauge how much I was pouring in… and so on.
Then it occurred to me that having the extra water would come in handy for clearing the drain. I’ve been having some problems with the kitchen sink drain getting sluggish. My fix for it is to pour boiling hot water down, and that often works. So, this “problem” is actually no problem at all — in fact, it solves some problems, namely:
I need to slow down more in the morning, and this will help me do it.
I need to heat more water in the kettle, so it doesn’t fry the coils, and this will let me do that.
I need to periodically clear the drain with boiling water, and this will let me clear it daily, so the buildup doesn’t accumulate and become a bigger problem down the line.
So, there’s really no problem at all. Not anymore. But this morning, for about 15 minutes, I was going into a tailspin that threatened to wreck my entire day and set me down a spiraling path of upset — at the innocent electric kettle and at myself for getting so bent out of shape.
The electric kettle is forgiven, and so am I. I know full well that I am off balance, not feeling well, and I am spending an awful lot of cognitive energy just trying to keep myself vertical and not get hurt. I can cut myself a break, and just get on with my day and my recovery from the past week+ of hectic activity.
I’d better cut myself a break. Because rust never sleeps.
Neil Young reminds me of that constantly, while I’m driving to and from work. For some reason, radio stations in my area keep playing his music, and “rust never sleeps” is often what I hear him singing about. My, my, hey, hey… It’s better to burn out, than to fade away… And this gets me thinking. Especially in the autumn, when the effusive growth of summer is giving way to frosts and withering and deadening, and the cycle of life turns to a cycle of death, my thoughts become, well, a little maudlin. The change of the season gets me to wondering “what’s it all about?” and “is this all there is?” and all manner of existentially angst-y ruminations. And my brain starts to perseverate and lock onto misperceptions and misconceptions and any number of irregular reasons to doubt my ability to live effectively in the world.
Some days, I suspect it’s due to the way my life turned in the course of my concussion-punctuated years. Each injury left a mark on me — a “ding” or two or three in the fuselage of my vehicle that didn’t exactly ground me, but kept me from achieving the heights I might otherwise have reached. I don’t want to blame the brain injuries for my ills — certainly, they have played a part, but they’re not the only reason I’ve had difficulties.
More than the traumatic brain injuries, in fact, I believe that the aftermath, the reactions, the later reactions of others and myself (which were based largely on ignorance about what brain injury does to the personality) and the meanings I gave to those reactions, had the biggest impact. And the time when I was actually recovering from the physical effects, I was sinking into a psychological morass of confusion, dread, insecurity, and the conviction that this temporary situation was permanent, totally screwed me up. After my injuries, my neuroplastic, adaptable brain was on the mend and finding new ways of doing the things I wanted to do, but because those new ways were different from the old ways — and therefore threatening and alarming to me — I discounted them and told myself they were WRONG and I should not be doing things the way I was doing them.
I had it in my head that the roundabout way I learned was Wrong.
I had it in my head that the way I communicated with people was Wrong.
I had it in my head that the way I structured my daily life — much more downtime than most people I knew — was Wrong.
I had it in my head that the choices I made about my social life — who I would and would not interact with — were Wrong.
I had it in my head that the choices I made about my domestic life — not having children and not officially getting married until 15 years into the settled, intricately entwined relationship — were Wrong.
Now, to be fair, there was an awful lot of social pressure to adhere to certain ways of doing things, so I had plenty of reinforcement for judging myself and my choices. And the rigidity of my upbringing didn’t help. But I suspect that the rigidity of my parents and wider social circles wasn’t the only reason I was so locked in, and so quick to judge myself. Indeed, I believe that the head injuries I sustained as a young kid (when I was about 4, then again when I was 7 and 8 ) predisposed me to an intense rigidity that locked out any alternatives to routines or “standard issue” behaviors.
WHY IS RIGIDITY/INFLEXIBILITY IMPORTANT FOR SOME STUDENTS AFTER TBI?
Students with TBI or other neurological conditions sometimes demonstrate extreme forms of rigidity or inflexibility. Rigidity/inflexibility is often associated with damage to the frontal lobes, the most common site of injury in TBI. Therefore, some degree of inflexibility is common in students with TBI. This may manifest itself as difficulty (1) making transitions during the school day (e.g., from lunch or gym back to classroom work), (2) tolerating changes in schedules or everyday routines, (3) adjusting to changes in staff, (4) ending an intense emotional feeling, and the like. In extreme cases, a transition as apparently simple as from sitting to standing may be difficult and cause stress.
Related but not identical to inflexibility is the phenomenon of perseveration. Perseveration is a possible result of neurologic impairment and is characterized by continuation of the same behavior or thought or words or emotions after the reason for the behavior, thought, word, or emotion has passed or the thought or behavior is no longer appropriate to the situation. . For example, a student may remain focused on a given emotional behavior state long after the reason for that state has been forgotten.
This pretty much describes me when I was a kid, though today I’d have to say that emotional rigidity and perseveration is much more of an issue than cognitive. Cognitively, I can move on. But emotionally, I’m still stuck. I think that getting out in the world and holding down jobs and having gotten positive reinforcement in work environments has helped me cognitively. I’ve been able to really reap great rewards from using my head, and that’s encouraged flexibility and creativity. Emotionally, though, I get jammed up and stuck. That’s where I get rusty — stuck in place and wedged into an old pattern that doesn’t serve me or the people around me.
No, rust never sleeps. So, what do I do? Do I drive myself onward-onward-onward, in hopes of burning out before I fade away? Do I race at top speed through life and damn the torpedoes?
Um… No. Racing around and pushing myself are the very things that encourage rust. Like the super-heated coils in electric kettle caused the metal to rust, so does my super-heated life cause my system to lock up and show signs of wear. Maybe not in Neil Young’s case, but in my case, pushing for burnout is a sure route to rust. And I don’t have all the time in the world — I’m not getting any younger, and my window of non-fatigued time is significantly less than most people’s I know — so I just don’t have a lot of time to spare, cleaning up after myself when I crash and burn.
That’s no way to live.
What to do?
This is the eternal question, and it keeps coming around with me, no matter how much time I put between myself and my injuries. My first TBI probably happened when I was about 4 years old. And there were two more when I was 7 and 8 years old. More came over the years, including sports concussions and car accident mTBIs, for a total of at least nine separate instances of head injuries that involved some level of disruption of consciousness, followed by cognitive, behavioral, and physical problems. I never got help for any of them, until about 3 years ago — just a lot of headaches (literally and figuratively) — and only in the past 3 years have I started to systematically and mindfully approach my issues with a focused desire to overcome them.
I’ve learned a lot about how to deal with the basic things — get my exercise regularly, eat right, get enough sleep, and check in with my neuropsych on a regular basis. But as the basic issues get resolved, the “higher level” questions emerge — as in, how to make the most of what life I have left, so that I can have the best life possible, whenever possible?
Ironically, the answer to this question has gone hand-in-hand with the answers to my most basic human needs. The answer is to just slow down and pay attention. For someone who is as driven as I am, it’s a tall order, and not that easy to do. But you know what? When I not only slow down but also pay very close attention to what I’m doing with myself and my life and my choices, many of my TBI related issues resolve.
When I slow down and pay attention to my physical fitness, my joint pain and headaches subside considerably.
When I slow down and pay attention to what people are saying to me, the problems I have with understanding and following clear up considerably.
When I quit going 150 miles per hour through every single day and pay attention to what I eat and how rested I am, my need to pump myself full of adrenaline and push past all sensible limits becomes far less pronounced.
Now, slowing down and paying attention is the sort of thing I’ve had to learn from scratch. A big driver behind my rushing is a constant low-level panic that simmers in my gut, day in and day out. It’s that constant restlessness, the constant agitation that comes with TBI. It’s my brain working overtime trying to find its way through the tangled networks that have developed over the years. It’s my body’s reaction to the intense energy needs of my very-active brain, and the low fatigue threshold I have.
Slowing down and paying attention has been closely connected with my exercise routine, taking the edge off my stress, finding outlets for the nervous energy, and clearing out the biochemical sludge that builds up after countless experiences of surprise/shock/dismay/confusion that come at me in the course of each day, when the things I expect to happen … just don’t… and I need to immediately adjust and move in a different direction to get where I’m going.
That surprise/shock/dismay/confusion is an ongoing situation for me, and it may never change. I may find myself spending the rest of my life realizing I was all wrong about something and needing to find another way to think/act/be. But at least I have my exercise to help me clear out the chemistry of those micro-traumas. And I have an understanding of that bio-cognitive action that lets me cut myself a break and not get all bent out of shape — for extended periods of time — over things that are either directly attributable to my brain having gotten a bit banged up over the years… or are long since over and done.
But even if I do spend the rest of my born days troubleshooting these kinds of cycles of pseudo-drama, I always have my fall-back, my comfort in the midst of the storms — the knowledge that slowing down and paying close attention to what’s going on around me, with heightened awareness and intense curiosity, can and will pull me out of my funks, can and will restore me to some sense of myself, can and will connect me to my life once more, in ways that running around at top speed never can and never will.
Rust may never sleep, but I don’t need to run from it. Ultimately, it’s not the quantity of life that staves off the debilitating freeze, the rust. It’s the quality. Cooling the hot elements, adding more water than I “need”, and just sticking with my life in all its aspects till I find some peace, some resolution, and I can make my tea… that’s what does it for me.
As I’ve been exploring the landscape of my head injuries over the past few years, one aspect of my life experience has consistently come to the fore — trauma… and its long-term effects on lives of both survivors and the ones they love and live/work with on a daily basis.
It’s almost a total fluke that trauma should even have this on my radar. But over the years, I’ve befriended — and been befriended by — a number of psychotherapists and counselors, most of whom specialize in trauma. In retrospect, I suspect that many of them have assumed that my difficulties were due to past traumatic episodes — rough childhood, misspent youth, etc. In fact, one of them has flatly denied that my issues could be due to TBI, and they became more and more insistent about me getting a therapist, which was probably the worst thing I’ve ever done, in retrospect. (This friend’s denial is a topic for another post — it’s quite interesting, “clinically” speaking.)
Now, I have to say that after more than 10 years of being around these friends of mine, I get a little tired of every ill known to humanity being ascribed to after-effects of trauma. When I talk about experiences I’ve had and people I’ve encountered who have annoyed me or done some seriously sick stuff, I’ve often heard the refrain, “Oh, they’re a trauma survivor, so they’re dissociating/being triggered/experiencing kindling/re-enacting their past traumas.”
There’s not much room for just being an asshole. For some of my friends, it’s all about the trauma. And in an attempt to better understand what it is they’re talking about, I’ve attended some trauma workshops, as well as read some books. I’ve got Peter Levine on my bookshelf, along with Belleruth Naparstek. And now I’m reading Robert Scaer, M.D.’s book The Body Bears the Burden, which explains (from a neurologist’s point of view) the effects of trauma on both the body and mind of someone who’s gone through awful experiences — and those whose experiences don’t seem that terrible, compared to, say, Pakistan’s flooding or suicide bombings in Kabul.
The DSM-IV defines a “traumatic stressor” as:
[an stressor] involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate
The part that interests me is the “direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity”. The other parts are just as significant, but I’m not going to speak to them at this time.
When it comes to mild traumatic brain injury, I think sometimes the severity of the experience tends to get downplayed. After all, the injury is mild, right? Well, interestingly, mTBI survivors apparently can show more disruptive symptoms of traumatization after the fact, than survivors of more severe injuries. And these long-term effects can wreak havoc in the lives of survivors, as well as their immediate circle.
Problems such as fatigue, emotional volatility (emotional lability), rage, agitation, irritability, insomnia, sleep deprivation, anger, temper flares, temper tantrum, anxiety, fear, panic, risk-taking, danger-seeking, not to mention all the crisis and drama that can accompany hormonal spikes during times of stress, certainly don’t make things any easier. If anything, they complicate recovery by flooding the system with stress hormones which interfere with your ability to learn from your experiences. So, at the time when you’re having to get a new grip on your newly changed life with its “new normal,” the biochemical processes going on behind the scenes may be getting in the way.
How maddening is that? At just the time when you need your brain to be able to recover, it’s busy cranking out all sorts of interesting concoctions that specifically get in the way of your recovery.
Because (I believe) there is unresolved and un-dealt-with trauma wreaking havoc behind the scenes.
Trauma in mild traumatic brain injuries is particularly tricky. After all, the injury itself may not have been that dramatic — something gets dropped on your head, or you get in a fender-bender, or you slip and fall down and clunk your head on something. You get up again, walk away from the scene… maybe pay a visit to the emergency dept of your local hospital, get scanned, and you get a “clean” bill of health (and maybe a few pointers on what to watch out for to make sure you don’t have more serious issues later on). Then you’re expected to get on with your life.
But inside your skull, something else is happening. Some of the fragile connections in your brain have been sheared or severed or frayed, and your brain isn’t able to communicate with itself like it used to. On a fundamental, profound level, your very existence has been threatened — only nobody can see it. Even you can’t see it very well, because your brain is either still bathed in the stress hormones designed to keep you from feeling a bunch of pain (and thus preventing you from fleeing an immediate threat), or it’s just not making the connections it “should” in order to give you — the resident owner — a clear picture of what’s going on. Or it could be both things going on.
In some cases, from what I’ve read in Dr. Scaer’s book, the onset of problems can be delayed by hours, even days. So, right after the accident/event, you’re walking around looking fine, seeming to be fine… maybe you’re a little shaken up, but that’s to be expected. But then you start to slip away… decline… feel the effects of what was supposed to be a mild event that had no serious immediate effects you. In your system, hidden from view, the process of gradual (and possibly debilitating) problems has begun.
This process is utterly maddening. Everyone around you, who was worried for your safety, just wants to be relieved that you’re okay. But all of a sudden, you’re acting strangely, you don’t seem like yourself, and you’re complaining all the time. The complaints don’t get better over time, either. They get worse. And for no apparent reason. People think you’re looking for attention, that you’re trying to “milk” your accident for all it’s worth. They just want you to get back to being your old self. But you’re doing the exact opposite.
And the pressure to return to normal builds, even as your system is being eroded by the biochemical havoc of trauma that was introduced to your system which has not been cleared — it hasn’t even been recognized. How can you clear away what you can’t see/hear/detect?
Indeed, the most insidious and problematic manifestations of trauma take root when the person having the experience is taken by surprise. Studies have shown that bracing for impact limits the impact, but being blindsided makes it worse. And it makes the experience as a whole worse. The body detects this threat to its safety and existence — all of a sudden out of nowhere — and it unleashes myriad biochemical substances for us to deal with it — including endogenous opioids designed to numb the pain of injury. Animals in the wild which are being chased by predators, when there is no way to escape, will often fall down as though dead, their bodies full of chemical substances that will both numb the pain of being devoured and turn them into “dead” prey which might discourage a predator from actually killing them.
The same biochemical process is in place with human beings. After all, once upon a time, we were hunted as prey by animals larger than us. Indeed, we still are, in some cases — the predators happen to be other people, more often than not. In times of combat and assault, when all escape routes have been blocked off and we believe (on some level) that we’re done for, our brains and bodies do their natural thing — they bathe us in substances to protect us from feeling that knife going through our lung or feeling that bullet smash through muscle and bone.
Our brains and bodies are doing their utmost to protect us as best we can. But our minds tend to interpret the experience differently.
In the case of animals who freeze and then survive the assault, they shake themselves, go through a series of shuddering/jerking motions, do heavy, deep breathing, and then pick themselves up and get on with their lives. In the case of humans who freeze and then survive the assault, we tell ourselves we were wusses for freezing the way we did, and we plunge into cycles of self-doubt and conflict, feeling like we failed — when we were simply being the biological creatures we are designed to be.
And the self-perpetuating downward spiral of the PTSD loop starts. Where it stops, is anybody’s guess.
Therapies which have been successful in freeing people from that negative feedback loop are those which engage the body to discharge the sudden burst of biochemical self-protection, and get the autonomic nervous system back into balance. In the completion of the fight-flight-freeze cycle, the body is allowed to return to its most effective ways of working. And we can get on with our lives.
Here’s where the problem starts with mTBI. (Note, I’m not a doctor or certified health professional — this is just my belief system about how our systems interact with the world around us.) If the injury is “mild” then what’s the big deal? Why should we even need to complete the fight-flight-freeze cycle? Wasn’t the injury itself mild? We just got clunked on the head. Big deal, right?
Hardly. I think with mild traumatic brain injury, there may be another aspect of it that comes into play. With “mild” injuries (not that any brain injury is ever mild, mind you), the brain itself perceives the threat on a basic, biological level. It knows something’s wrong, and it kicks into overdrive, trying to right what’s wrong.
I suspect this is why people who have sustained concussions or mTBIs are so prone to denying that there’s anything wrong. Our brains are so busy trying to right their internal systems, that they fail to communicate with the rest of the world — that includes our conscious mind.
Based on what’s happened to me, what I’ve observed, and what I’ve read, here’s the cycle that I believe gets set up:
An individual experiences a sudden, unexpected impact or injury, which injures their brain. This can be a fender-bender, a tackle or collision in a sports game, getting cold-cocked by an attacker, or having something fall on/hit their head.
Fragile connections in their brain are frayed, sheared, or destroyed completely… or all three. On the surface, they seem to be fine. The injury doesn’t look like that big of a deal. It’s just a bump on the head or a hard hit or a bit of soreness or being dazed after the fact.
The body interprets the impact as a threat to the system, and it unleashes a biochemical cascade of hormones and other neurochemicals which narrow the focus, numb the system to pain, and shunt energy away from “extraneous” body functions.
The injured person’s brain senses something is amiss, and it works like crazy trying to sort out what just happened. The whole body-brain connection needs to be tested to make sure everything is still online, so the system can correct itself as need be. Any outside talk or input is dismissed and rejected — “Are you alright?” isn’t a sign of concern, it’s an intrusion into the vital process of the brain checking through the bodily system for problems. And the brain is so focused on its internal process, that it “forgets” to tell the rest of the world what’s going on. There is no full communication loop with the brain — it’s in damage assessment mode, and it blocks out any input as well as refuses to provide output.
The impacted individual wanders around in a bit of a daze, then they appear to recover, and they get on with the rest of their activities. They drive on in the car, they get up off the bench and go back in the game, they pick themself up off the pavement, or they go back to work.
In the course of going about their business — both immediately and over the course of the coming days and weeks — their brain is having trouble figuring out how to do the things it used to do so effortlessly. The old connections have been disrupted, as though a massive storm had torn through a region, torn up trees, unleashed flash floods, and made many of the old roadways either treacherous or impassable.
The brain senses something is amiss — the inability to do things it used to do before is intensely distressing, and it doesn’t understand why things aren’t working. This confusion represents a “threat to one’s physical integrity” and the body reacts as though its very existence were being threatened. The cascade of stress hormones and fight-flight-freeze substances wash through, and the sympathetic nervous system is activated.
Unfortunately, the incidents of confusion and disorientation and disrupted functioning aren’t intermittent. They can be regularly occurring — as well as unexpected. Time after time, the brain is surprised by its sudden (and unexplained) inability to do what it’s always done. Surprise sharpens the experience, making it both more intense and more indelible in the body and brain.
The brain/mind interprets these inabilities as a problem with the self, and a chain reaction of personal recrimination starts up, which assigns more meaning to the events, which triggers further releases of adrenaline and cortisol into the system when the amygdala is tweaked by this interpretation.
When cortisol and adrenaline are released, higher reasoning is impaired, and lessons which might be learned from trial-and-error are not retained. One misstep after another occurs… one screw-up after another… confusion compounding confusion… anxiety heightening anxiety. What was originally “just a bump on the head” elaborates into a full-scale debilitating condition which becomes more and more entrenched over the ensuing months, even years.
Social pressure doesn’t help at all. Impairments to speech understanding (that happened to me) aren’t interpreted as symptoms of brain injury, rather as laziness or stupidity. Sensitivity to light or sound, which foster distractability and make holding a conversation difficult are not perceived, but the results — wandering attention and apparent oblivion to what others are saying — are obvious (and not at all appreciated). Social pressure leads to increased stress, which in turn triggers the release of more chemicals that prevent the injured person from effectively learning new patterns and building new pathways in their brain.
The brain is still trying to sort out what’s going on, and it’s not very communicative, either with others or with the “resident” in this body. It gets wrapped up in the drama of flawed interpretations of what’s going on, the crisis of stories it’s invented about what’s going on around it, and the increasing struggle to make sense of anything.
Time passes, and things just seem to get worse. Self-esteem plunges, and resilience declines. Self-recrimination builds, and difficulties at work and at home erode the ecosystem of the impacted individual. Jobs are lost, relationships fail, and money seems to fly away for no apparent reason.
If they’re lucky, the impacted individual can find help from a competent neuropsychologist, counselor, or neurologist — or even friends who are up to the task of helping them get back from the brink. If they’re like all too many traumatic brain injury survivors, they cannot get the help they need, and they end up becoming permanently unemployed (or sporadically employed), with no savings or source of income, no social support network, and no justification for going on disability or collecting insurance payouts.
Muddling through, maybe they make it, maybe they don’t. Ultimately, many end up on the streets, in jail for behavior problems, or on medication for psychological disorders that mimic brain injury after-effects and carry lasting side-effects. And unfortunately, a number eventually commit suicide, hastening the process that an oblivious, uneducated society and tough-it-out culture sets in motion.
As you can see — assuming this progression is at least somewhat accurate (and I believe it is) — the impact of a head injury need not be severe, in order to lead to severe consequences.
To fully understand the pervasive effects of mild traumatic brain injury, you need to look at multiple systems — from the brain’s inner workings, to the autonomic nervous system, to the demands of adult living or childhood development, to the expectations of one’s surrounding social milieu. With mild TBI, it’s never just one issue that sends you down the dark road — it’s a million little, subtle, interrelated issues that combine to create a recipe for disaster that, like bread dough sitting near a hot wood stove, will inevitably begin to rise and expand.
Trauma and the body’s internal responses to perceived threat and our interpretation of those threats, is like yeast added to a sugar-water-flour mix of our injury. With enough heat and time, it’s going to double, triple, even quadruple (and more) the issues that initially come with mild traumatic brain injury. Unfortunately, it appears that our systems are designed to work that way, and unless we can figure out alternative ways to address the issues, we’re in for a rough ride… till we can find help, sort things out, or end up incarcerated or dead.
What strategies and approaches we can hope to employ in this trickiest of situations — which might actually work — is a topic for another post.
Well, the change-of-weather insomnia issues are starting again. Last year, I had a hell of a time dealing with temperature changes and getting enough sleep. I would wake up in the middle of the night, too hot. And/or I would wake up at 4:30 — too cold.
The early morning hours are the worst for me. When the temps start to dip just before sunrise, is when I’m fast asleep and unable to pull more covers up over me to keep warm. Then, I wake up shivering an hour or two before I’m supposed to get up, and my head gets going, thinking I should just get myself up and get into the day, since my head is going, anyway.
But my head’s going at a weird-ass pace, and it’s coming up with all sorts of strange thoughts (all of which seem perfectly logical to it), and if I stay in that “groove” it’s a total dead-end.
On good days, I realize this before I have wasted too much time obsessing over stupid shit. One of the benefits of knowing about my brain injuries and understanding the consequences is being able to self-monitor a whole lot better than I could before I knew why I do/think the things I do.
Actually, “self-monitor” is probably not the best word, because at 4:30 in the morning, I’m not particularly adept at gauging the quality of my thinking. “Self-critique” is a better choice. Or even “self-doubt” — because a good dose of skepticism when my head is off to the races can be a powerful antidote to early a.m. crazies. Just being aware that I am capable of coming up with all sorts of insanity when I’m sleep deprived — and knowing that it’s not because there’s something wrong with me — it’s my brain acting up again — helps me stop the cycle of madness before it takes me into the morning hours.
On bad mornings, I get stuck in a loop and end up just getting up after lying there staring at the ceiling or tossing and turning while my brain is obsessing. I’ve had one bad morning like that in the past week. On better mornings, I can get my attention back to my body, do progressive relaxation as I remind myself that whatever is holding my attention hostage will be there in another few hours, and it could be that the things it’s locked onto are not going to be that big of a deal when I actually do wake up… and then I can roll over and go back to sleep.
One of the things that tends to wake me up during colder weather is pain. If I don’t stretch adequately before going to bed, I often wake up at 3:30 with my back and legs in knots. Not fun. And then my head gets going. Sometimes I can stretch and crack my back and get my legs to settle down. But sometimes even that doesn’t work to help me. It’s maddening. Especially when my head gets going yelling at me about not remembering to stretch or take Advil.
I need to start taking Advil again before I go to bed. During the high summer, when I was ultra-active, swimming regularly and out and about a lot, I had less pain. I was pretty vigilant about what I was eating, I took more time to shop and prepare my meals, and I was moving a lot on a regular basis.
I was also better about taking my vitamins, especially magnesium, which someone told me helps with pain. I had been doing really well with taking my vitamins — B-Complex for nervous system support and to help me with stress… D for immune system support, bone health, and cancer prevention… Magnesium for joint pain… and Chromium Picolinate to help my body with insulin production and how it handles sugar.
When I take these supplements regularly, I notice a marked improvement in my daily well-being, which in turn helps me sleep better. When I’m stressed throughout the course of each day, I tend to get over-tired, and when I’m over-tired, I push myself even harder. That leads me to put in longer days and get all revved in the evening, which makes getting to bed at a decent hour harder. Then, when my body is all fried form the daily stress, I’m susceptible to increased pain and temperature sensitivity, not to mention waking up in an adrenaline rush.
Those adrenaline rushes are no fun at all. Out of the blue, I wake up in a frantic panic, all systems on full alert, my heart pounding, sweat pouring out of me, the sheets soaked, and my chest clenched up tight. I’m on full alert, out of nowhere, and it’s a good thing my spouse and I have been sleeping in separate bedrooms for the past year and a half — if they were in bed with me, it would not be a good thing. I can’t guarantee, either, that I would be able to tell that they pose no threat to me. I might lash out at them — that would not be good. That’s no way to live. I had an uncle who would wake up in panics and hit my aunt, thinking she was attacking him. No way do I want to repeat the performance. He was killed in a tractor trailer accident out in the Southwest about 30 years ago, but those inexplicable and totally unexpected attacks left a mark on my aunt that’s still there.
Yeah… stress… When you’ve been tweaked and freaked-out way too many times, it can really do a number on your nervous system. Fortunately, when I was much younger, I learned how to slow my heart rate and chill out my system. It has to do with the breath — slow, measured breaths… stopping the breath at the end of each inhale and exhale, and then slowly continuing. It’s all about the breath. When I was in high school, at track practice after school, my heart would sometimes start beating so hard it felt like it was coming out of my chest. I would hyperventilate, and I would start to feel like I was falling down a deep hole. All this, just because I was at track practice. I suspect that my concussions throughout my childhood and adolescence may have had something to do with it. It’s my understanding that concussion can lead to more extreme heart rate variability, where your heart isn’t beating at a steady pulse all the time. So, perhaps my concussions had something to do with it.
I have to admit it worries me a little now, when it happens, because I just learned a few years ago that I have a slight heart murmur. Nobody ever mentioned it to me before, that I can recall (or maybe I just don’t recall). So my heart health is a bit of a concern to me. And when I wake up in a cold sweat, with my heart pounding a mile a minute for no reason that I can tell, I get concerned.
I start to talk myself down and start to do my slow, measured breathing, which brings me back to a stable state. Still and all, I’d rather not be waking up at 3:30 a.m. with this crap.
So, clearly it’s time to start taking my vitamins regularly again. I’m not sure why I stopped. Maybe I was feeling fine and didn’t feel like taking them — for about a week. While I was taking them, I was getting good sleep, I was pretty chilled out in my daily life, and difficult things were not derailing me as much as they have been lately. I don’t want to lay it all at the feet of supplements, but you know what? When I was taking my vitamins, I was sleeping pretty well. And I want to sleep well again.
Another thing I’ve been trying, to deal with the pain and anxiety, is homeopathy. I’ve got a friend who’s a homeopath who swears by it. They actually had a “widow-maker” heart attack a few years back, died on the table and came back, and proceeded to change their entire life. They were in the traditional western medical field before their heart attack, and after, they changed over to homeopathic remedies, and they’ve been urging me to use it for my own issues.
I must say I was really on the fence about it, for a while. I tried some things, and they didn’t seem to have an effect on me. Then I tried Magnesium Phosphate for some pain that I just couldn’t shake, and it seemed to take the edge off it. So, I would use that remedy and it gave me relief. (Please note, I am an extreme skeptic, when it comes to alternative remedies. I resist novelty when it comes to my health with almost every fiber of my being.) But that was it.
Then I started using Rhus Toxicohendron for joint pain, and it too seemed to take the edge off. I’ve been using that, on and off, with a variety of results, for several years, now.
But the real breakthrough remedy for me showed up a couple of weeks ago, when I was out shopping for some help for my spouse (who is into alternative remedies — needless to say, I tend to temper my opinions about these alternatives in their presence). I picked up some Kali Iodatum that I’d read is good for certain types of nerve pain. But on the label, it said “colds with frontal sinus pain”. Apparently, homeopathic remedies treat a variety of different conditions – not sure how, they just do.
Anyway, my spouse decided to go with more bodywork than homeopathy, so we had these remedies lying around. And then I started to get sick with a cold, with lots of frontal sinus pain and post-nasal drip and coughing that was keeping me from sleeping. Just for the heck of it, I took the Kali Iodatum, and my symptoms cleared up within the hour. Pretty amazing. I woke up this morning with that same cold and sinus stuff, and I took some a little while after I ate my breakfast, and once again, it appears to have cleared things up. Part of me wants to believe that it’s just getting moving and getting in to the day that helps, but it really felt like my body was stronger and able to fight off what was ailing it. So, I’m going to add the Kali Iodatum to my health regimen, as needed.
So, while I know that homeopathy is widely discredited (by allopathic medicine competitors, in particular) as a placebo and a bogus mode of treatment, I do know that when I take some of these remedies, I do feel better. And when I feel better, I am less stressed. And when I am less stressed, I am less fatigued, less likely to indulge in carbs and coffee to keep myself going for long hours. That means I sleep better and can sleep through the night.
I’ll probably continue to take Advil before going to sleep, now that colder weather is here. I’ll keep up with my exercise routines and focus more on my morning workouts, now that I’m not going to be able to swim at the lake several times a week. I’ll also make a continuous effort to eat well and watch out for drinking coffee after 2 p.m. and loading up on carbs just to get myself feeling better. I’ll definitely make a point of stretching plenty before going to bed. And I know what to do, if/when I wake up early with cold sweats and pounding heart and panic. The main thing for me is to do all these things regularly and consistently, and not let myself get behind.
When I let myself get behind, my head has more ammunition to attack me at 3:30 a.m. for screwing up — yet again. And the last thing I need is to give it even more ammo than it already has.
Well, the job situation is looking up. The new responsibilities at work are good things, and they are definitely going to test me in ways that will help me grow. The level that I’ll be expected to perform at is about the same level I was at, when I fell in 2004. In a way, it’s like the big detour my life took after my head injury is coming back around to meet up with where I was before.
And it scares the be-geezuz out of me. A thousand different thoughts are running through my head, many of them not so good. In the past 5 years, I’ve been so derailed so many times, and I’ve had so much practice coming up with wrong answers to important questions, that a deep-seated self-doubt has gotten lodged in my brain. Every time I come up short and don’t meet a goal I set, I get confirmation that that self-doubt is right — See?! You really can’t do it after all. See?! There’s no hope for you, and you might as well pack it in and go home.
I’ve had extended discussions about this with my neuropsych, and they’ve been good about telling me that I don’t have to listen to those voices — I can listen to my “better angels” and make better choices. I don’t have to let my future be defined by my past. The brain heals. It mends. Life has a way of self-healing in some ways, or just finding different ways of being, in the face of extreme adversity. Broken bones heal. Broken brains may not heal in quite the same way, but broken lives can. And brains can rewire and reconnect.
It ain’t over till it’s over. And I need to quit making things look like they’re over, before they’ve even begun.
It really feels like this new development at work is a milestone test for me. It’s like I’ve crossed an invisible line between determined-to-recover and committed-to-ongoing-recovery. “Recovery” for me is about more than fixing frayed connections in my brain’s wiring. It’s about recovering the important things in my life that mean so much to me — allowing the strengths I have, which I have had for decades, to come forward again, after being in cold storage for the past several years. Recovery for me is about getting to a point where I can regain my self-regard and objectively see that I am doing well at many things, I’m challenged at others, and I have uneven results with a bunch of stuff in between. It’s about getting my distance back — not getting sucked into every little drama that comes up (inside and outside my head), and being able to step back and make my own decisions about how I perceive and react to the world around me.
Recovery, for me, means being able to finally get out of my own way, so the people around me who sometimes have a much clearer view of my capabilities and potential than I, can promote me and support me and point out ways that I can make my — and their — world better. Those people can’t sit inside my head, which has a full inventory of all the ways I’m in need of improvement. So, I have to trust them and their assessment of my potential and ability to contribute to the whole. After all, they can probably see things that I can’t, and they wouldn’t be supporting me if it weren’t in their best interests. I just have to trust them on this.
And I have to quit listening to carefully to myself about every little thing I think I’ve done wrong. I went through a period where I was cataloguing every single thing I did wrong, digging myself deeper and deeper into holes of self-doubt and misery. It was important for me to realize where I was impaired and struggling. But all the while that I was keeping records of what was wrong with me, that very exercise was helping me to regain my ability organize my thoughts, motivate myself, monitor and manage my own behavior, and function in the world at large. Ironically, at the same time my mind was becoming increasingly convinced that something Awful was amiss, the awfulness was slowly but surely subsiding. And I ended up inventing a story about myself that became less true, with each passing month.
That’s not to say I didn’t have issues. I certainly did. But the story I told myself deep down inside about my ability to deal with those issues was not always a good one. And the more I learned about my issues, the more anxious I became, which impacted my ability to think clearly and sort out my recovery. It impacted my ability to formulate an objective, accurate view of myself. And it held me back from living my life in ways that I couldn’t even begin to fathom.
What remarkable creatures we are. We’re so alive, yet we’re so eager to avoid living life to the fullest. There burns within each and every one of us a spark of vibrant life, yet our very makeup seems to come “pre-loaded” with a sort of psychic brake that slows us down when we are picking up speed. Maybe it’s a self-defense mechanism — too much speed can do serious damage, as so many of us find out the hard way. But after we’ve taken our lumps and gotten knocked down, we can be all too all-or-nothing — either driven to rebound immediately (and damn the torpedoes) or frightened of our own shadows and refusing to participate in even the most rudimentary aspects of life for fear of yet another bump or fall or crash.
For me, it’s been both — after my many falls, I’ve tended to be driven to immediately dive back into the fray, with no rest, no recovery and not even a shred of perception that I needed rest or recovery. But after realizing what had happened, I swung to the opposite extreme and set about constructing for myself an alternate personality that was so encased in protective measures that I could barely move. I ended up like the little brother in “A Christmas Story” who was so bundled up against the cold that he couldn’t get up after he got knocked down.
Fortunately, for me, the virtual winter of my past 6 years has been easing up. And I’m getting to a point where I can just get on with my days, instead of second-guessing everything I do and say. There is a lot riding on my shoulders — a household to support, loved ones with health issues, a mortgage to pay, a professional position to pursue. But I can’t second-guess every single thing I do right or wrong. Even the things I think I do ‘wrong’ aren’t always bad, in the eyes of others.
I can be my own best friend or my own worst enemy. Deciding which I’ll be, from moment to moment, seems to be the theme of my life, these days. Today, I choose to be a friend.
Swimming at a local lake, this morning, I almost got trampled by a herd of bicyclists, heading out for a group ride. There are often triathletes training at the lake on weekend mornings, with bikes at the ready in the bike racks along the shore. They arrive in small groups — probably training buddies who stick together — stand on the shore, stretch, and climb into their wetsuits… swim distances that will get them in good shape to race… then emerge from the water already running. They jog gingerly across the pebbly sand and asphalt, peeling off their second skins, donning their bike shoes, and head off down the road, dodging pedestrians heading down to the water and cars with bikes attached to the top and/or the hatchback.
Alone in the midst of these groups, I am often seized with a sense of isolation and loneliness. They sound so happy being together. And they talk amongst themselves with a familiarity that I have rarely known with other people. It’s not that I don’t connect with others — I just rarely have a long enough connection with the people in my life to develop that depth and breadth of closeness.
Life often takes me away. Or it takes others away. I could cry about it (and sometimes I have), but I’d rather just live my life.
Anyway, not so terribly long ago, I overheard a few well-equipped swimmers talking about what was going on in their lives. Family coming to visit. Flying in from Houston. Heading out to the Hamptons. Traveling and doing important, expensive things. The person sharing the most details sounded, well, sad and lonely, as though all this was supposed to mean something to them, but it really didn’t.
And in that moment, when the pathos in their voice sank in, it occurred to me that being practically almost-broke and living from paycheck to paycheck and having to think hard about everything I did that took money, wasn’t too high a price to pay for having a life that I love, having my health, and being able to talk about my life in a way that is direct, involved, appreciative, and very, very basic.
This morning, as I dodged the bicyclists heading out on their ride, I felt that familiar pang of embarrassment at my stuff being really, really basic — plain old swimming gear that I’ve worn for years, now… ragged sandals that fit my feet just right… a car that is clearly “sub-standard” as I’ve heard it described… and the almost-too-expensive sunglasses that I bought with half my monthly salary in 1989, and which still fit me just right.
And I felt a pang of self-consciousness, as I watched the fit, muscular, tan athletes on their racing machines pass me by without a glance. I looked down at my average body and felt the extra weight wobble around my waist… my arms won’t firm up for any amount of coaxing, and my legs refuse to get “ripped” even after all the bicycling I do almost every morning. And I felt like a bit of a failure, for not having that kind of body and not having the nice bike I had only six months ago, but had to sell because I have to pay my mortgage.
I’m not sure why I’m getting hung up on all this material stuff (again). Perhaps it’s because I’m working at a company that’s filled with people who value the finer things in life and own cars like Maseratis and Feraris and custom motorcycles. Perhaps it’s because the car I got fixed last week (the better one of the two late models I have) is having problems again and I hate being without my trusty wheels. Or maybe it’s because the seasons are changing, and I won’t be able to go to the lake for much longer, and I’m already feeling that loss.
Or perhaps it’s because I really am a very solitary person, and sometimes I’d prefer things were different, and I had a broader social circle (if only I had the energy for it).
In any case, I was feeling a little sorry — and sorry for myself. But then I got to the edge of the lake. The faint sliver of moon was still high in the sky, and along the edges of the water, mist was rising, till the heat of the morning sun found it. Across the water, the flashing of wet arms windmilling through the waves sparkled, and somewhere overhead, a red-tailed hawk was crying.
I pulled off my t-shirt and stepped out of my sandals, stretched my arms and legs, and waded into the water up to my waist, pulling on my goggles as I went. The water was warmer than the air, and the wind was up, churning up waves. I took a deep breath and dove shallowly. At that depth, the sunlight streamed into the water with bright beams that lit the way before me.
As I reached and pulled myself through the water. My body was waking up, the blood starting to course through my veins, my lungs filling with air when I came to the surface. The feel of the water streaming across my skin washed away the self-consciousness, the embarrassment, and it occurred to me that the water… the lake… the sky and sun and moon and hawks overhead didn’t give a rat’s ass about my sorry gear and my average body. ll the anxieties about “stuff” faded away, and I was flooded with gratitude that I was able to do this thing called swimming at the lake on a Saturday morning.
See, just two years ago, it would have been impossible for me to do something as simple as this thing called swimming in the lake on Saturday morning. First off, I was always deeply fearful of putting my face in water, and I couldn’t manage to get my breathing together to swim more than a hundred yards or so. As a kid, I loved to be in the water, but I was terrified of putting my face in it – even when I took a bath, I freaked out if my face was in the water, or it got wet. And I failed swimming lessons miserably — the only reason I “passed” the test (the second time through), was that I faked it. I held my breath for the length of the swimming pool during the front crawl test, and I pretended to breathe as I moved my face back and forth in the water. The instructor couldn’t believe any kid could hold their breath that long, so they passed me.
Water on my face is not something I have ever much cared for — even in the shower, I didn’t like having any water on my face, and I would go to great lengths to keep my face away from the streaming liquid.
And then there’s the swimming thing. I am anything but buoyant, and if I’m not moving, I tend to sink. Slowly but surely, my legs go down, down, down, pulling the rest of me after them. If I’m not kicking, I start to sink. And floating? Not much potential there – again, my legs pull my body down. The feel of my body being pulled under the water has panicked me for as long as I can remember, and I hate feeling panicked. Especially in water.
So, this lack of buoyancy and panic stuff has kept me from doing much swimming beyond visits to the beach and some splashing around with friends, now and then. Still and all, I do love water. I love how it feels, I love the freedom from gravity’s tyranny, and I love being able to move freely in any direction I please.
So, this summer, I’ve been working on that. Maybe it was the Gulf of Mexico getting tainted with all that oil that’s made me crave clean, open water. Maybe it’s my lifelong love of the beach that I haven’t been able to accommodate this summer, and I needed to offset that with some sort of water activity. Maybe it’s just that I need to do more in the morning than get on an exercise bike and lift weights. Whatever the reason, I’ve done a lot of swimming, this summer, and it’s been great.
I started meeting up with a friend of a friend who was looking for someone to swim with. After a few times of venturing out across little inlets in the lake, they told me that I was a strong swimmer. I’d never thought I was, but they said so, so… After a few more times, we ventured farther and farther, till we were swimming farther than I’d ever thought I could. When they went away on vacation, I kept swimming. I had never entertained the thought of swimming alone, but I actually wasn’t entirely alone, because there was always someone at the lake.
The friend of a friend come to swim with me a few more times, but they got busy and couldn’t make it a lot of the time. Still, I continued to swim by myself. And it was good. I was going farther and farther out… till one day I swam out and back in about an hour — over a mile of swimming, and I’d done it myself. I’d done this thing I’d never in all my life dreamed I’d be able to do.
So, this morning, as I slid through the water, feeling my arms reach out and pull myself forward, as my legs scissor-kicked, and I breathed in and out, watching the air bubbles fill the water around me, I gave thanks. Because I can do this thing. I can swim like I never thought I could, and I can move like I never thought I would. I can make it out and back in one piece. That’s what I’ve done. It’s what I do. Even in the center of a lake that’s deep-deep-deep at the middle, with lifeguards a quarter of a mile away, with my heart pounding and my lungs struggling for air (just before I roll over on my back and slowly back-stroke along to catch up with myself), I can do this thing. I can swim. I am a strong swimmer, and I can tread water indefinitely. I know how to float now (I just have to keep my legs kicking a little). And I know how to keep calm when I’m on my own in the center of the lake.
Yes, I gave thanks. Because despite all the crap that’s been thrown at me, despite the loneliness and confusion and dead-ends and frustrations, there are still beautiful days and beautiful lakes, and the sun and moon and sky and hawks and win don’t care about my difficulties. They don’t pick me out of the crowd and make fun of me. They don’t try to make me look small, because they feel small. They don’t contradict me and pick fights for the sake of picking fights. They just are. And they let me be who and what I am. They let me slide through their clean waters and breathe in their clean air. They let me watch them with wonder and admiration, and they feed my senses with a constantly changing collection of stimuli.
I could have been dead, many times before. I could have been ruined. Wrecked. Trashed. And I have gotten slammed a number of times. But I’m still here. I’m still alive. I’m still going strong, and it’s good. I’m good.
Well, I’ve remembered my resolution intermittently over the past couple of months, and I realize that — intentionally or not, I’ve become the official cook of my household. My spouse has been having health issues that prevent them from standing and walking around much, so it’s been pretty much on me to get dinner on the table when it needs to be there. On top of that, they have been working a lot of jobs lately, so I’m the only one in the house with a predictable schedule.
So, I’ve been cooking. I don’t do fancy meals — mostly things that just need to be cut up and put in a pan and turned on low for an hour or so. Most of my work is preparation of vegetables to go in the pan — peeling and slicing and what-not. Oh, and keeping an eye on the clock, so I don’t burn it.
And I have to say, it’s actually been helping me. Not only is it good to eat food that I’ve prepared (I know what’s in it), but it’s really good for my timing and my coordination. Things like chopping or peeling used to be a real problem for me, when my spouse would say something to me, or I would be distracted by something. It’s really embarrassing to admit, but I used to just freak out, if they talked to me while I was preparing supper. I simply could not handle more than one task at a time. I would drop things and get panicked and yell and really pitch a fit — waaaaaay out of proportion for what was going on:
my spouse said something to me while I was dicing an onion.
Well, anyway, I’m really happy to report that that foolishness has stopped. My neuropsych has helped immensely, training me to think in terms of being able to control that kind of behavior, rather than give into it, just ’cause I’ve been injured. Plus, I’ve realized that when my spouse talks to me, I don’t have to respond immediately in that moment. They can wait a few minutes till I get done chopping. And I don’t have to cut my fingers anymore. I used to do that a lot, when people talked to me, which freaked me out (needless to say). So, I developed this complex about people talking to me when I was cutting things with a knife.
But that’s cleared. And I can chop up my food without losing it.
Woot – woot
It’s the little things, you know?
Well, anyway, I just wanted to do a quick check-in about that. Cooking, with its timing and patience and impulse control elements, is extremely good exercise for me. It helps me on so many levels. And when I’m done, I actually have something to show for my work. If I screw something up, there’s always tomorrow night. I haven’t burned the house down (though I’ve ruined a few pans by turning up the heat “for a little while” and then forgetting all about them… and then discovering something was amiss, thanks to the smoke alarm). And even when I’ve burned the food, I’ve managed to salvage it. Most of the time.
Probably the best thing about this, though, is that it makes me a productive contributor at home, in ways I can actually manage after long days at work. I don’t have much energy for much anything else, by the time all is said and done, but I do have energy to cook. And lo and behold, I often find that after cooking supper, I’ve got some energy back, which is good for my home life.
What a drag it must be, to live with someone who can’t manage to stay up past 8:30 every night… Staying up a little later gives me a few hours to check in and remind my spouse who I am, what I’m about, and keep our marriage going.
And what a drag it must have been, for those many years, when I was a terror in the kitchen, freaking out and flying into a rage over small and simple things… having temper flares and melt-downs over little things like dropping a spoon… getting all agitated, just when my spouse would talk to me… and being so unbelievably irritable, there was almost no dealing with me.
Cooking lets me focus in on what’s in front of me, do something useful and needed, and it lets me practice each night the skills I need to live beyond the kitchen — patience, executive functioning, sequencing, coordination, time management, working memory stuff, and more. It doesn’t just feed me for an evening — it can feed me for a lifetime.
Somebody needs to do a study on the cumulative biochemical impact of constantly finding out you screwed up. I’m serious about this – especially for new mTBI survivors. And long-term survivors, as well.
See, here’s the thing – stress impacts thinking. Cortisol mucks with your thought process. Stress hormones block out complex reasoning abilities, in favor of pure fight-flight-freeze reactions. And the long-term effects of high levels of stress hormones do have a cognitive impact.
So, after you sustain a TBI, and you’re in that initial phase of cluelessness, where you are so positive that you’re fine and everyone else is screwed up… and you keep undertaking things that seem perfectly reasonable to you, but aren’t exactly good ideas… and you keep bumping up against your new limitations (I won’t say “newfound” because it takes a while to find them)… all the while, you’re getting hit with these little “micro-blasts” of stress. The plans you make don’t work out. The relationships you depend on start to erode. Your behavior becomes not only mysteriously different, but also uncontrollable and unmanageable, and every time you turn around, something else is getting screwed up. You weren’t expecting it at all. It’s a shock — to your self and to your system.
Lots of false starts, lots of botched attempts, lots of pissed off people… and all the while, the cumulative effect of your body’s stress response to these “micro-traumas” is building up. The really messed-up thing is, that when you’re freshly injured, the experiences you have can take on vast proportions, and every little thing can seem like a monumental event. Which makes your reaction to them that much more extreme — a lot more stress hormones get released into your system that might otherwise, if you had a sense of perspective that was proportional to the actual events of your life.
But no, when you’re freshly injured, EVERYTHING can seem like a
Of course, you have no reason to clear out the biochemical sludge with something like exercise or mindfulness meditation or anything like that, because either your brain is telling you that it’s much more pleasant to sit around and watch television, and/or you’re so exhausted from the stresses of daily living that making additional efforts or changes is out of the question, and/or you’ve got a lot of pain, and/or you don’t have access to the equipment or a support system or good guidance for how to start with something like that.
You’re off in your own private Idaho — no, wait, your own private hell — of watching your life fall apart for no reason that you or anyone else can discern.
After all, it was just a little bump on the head, right?
People have been puzzling for some time about the connection between TBI and PTSD, as though they are two entirely different and distinct conditions. I can tell you from personal experience that traumatic brain injury, even mild head injury, can and does result in post-traumatic stress disorder. Because even though the build-up of stress hormones is gradual and incremental, it still happens. And unless and until you figure out a way to clear out the biochemical sludge of one alarming stress response (no matter how small) after another, you’re going to have a heck of a time clearing your mind to the degree you need to clear it.
Being a mild traumatic brain injury survivor (I’m actually thriving, not just surviving), and having experienced what my neuropsych has called a “phenomenal” recovery, I can personally attest to the importance of exercise and good nutrition in helping the brain recover. I can’t even begin to tell you how “gunked up” I was, when I first showed up for my neuropsych testing. I was a wreck. Just a walking series of screw-ups waiting to happen. I bounced from job to job, just dropped out of a couple, made really bad choices about my money and my career and my home and my relationship, and to those who were watching, I was indeed teetering on the brink.
Now, I’ve been extraordinarily blessed to have connected with a neuropsych who firmly believes (after 25 years of working in TBI rehabilitation and 30 years in neuroscience) that recovery is possible, even probable, and that there is hope of some kind for even the most intractable cases. But even they weren’t expecting me to do as well as I have.
Especially in the last year, I’ve made some pretty great progress, and it coincides with my starting to exercise each morning. I don’t do a lot, most days — just get my heart rate up for 15-20 minutes, then stretch, then do some light strengthening exercises. The main thing is that I get my heart and respiration rates up, and that I jump-start my system. This is something that anyone can do — and you don’t need special equipment to do it. We all have bodies, and most of us are able to exercise them enough to get our heart rate and breathing up.
This is key. I can’t say it enough — to help clear out the buildup of stress hormones in the body which can impair thinking and make the aftermath of an mTBI even more challenging than it is already, exercise helps like nothing else.
Why does this work? How does it work? There are lots of possible explanations, but at the core — for me — it’s about giving your body the ability to deal with the constant onslaught of surprise and alarm and reaction to situations which emerge (often blindsiding you) in situations where you thought you were fine. For me, it’s very much about giving your body the ability to return to balance, to homeostasis, so it can just get on with living life. It’s about clearing out the cortisol, the adrenaline, the noradrenaline, and the handful of other biochemical substances that our brains normally secrete in order to help us deal with emergencies. Humans don’t have the same ability as animals, to clear this stuff out. Rabbits and antelope will shiver violently and shake and run around to clear out their biochemical “load”, but humans just end up hanging onto it, for better or for worse.
But, you may say, having things turn out differently than you expected isn’t such a big deal. Why would that be so stressful?
Trust me, when you’ve sunk a whole lot of time and effort into something and your self-image and survival (i.e., job) depend on things going the way you planned… and then things turn out to be screwed up in a way you hadn’t anticipated, and everyone is all worked up and pissed off and gunning for you ’cause you wrecked things (again), it does produce an extreme reaction. Especially in someone who has to contend with the extreme emotions and volatility, uncontrollable anger, rage, inexplicable confusion, and all that crazy anxiety and agitation that go hand-in-hand with traumatic brain injury. Even folks with “mild” injuries have these kinds of issues, and it can exacerbate and compound matters to no end.
Ultimately, if it builds up enough (and let’s not forget the embarrassment and shame and confusion that can be socially isolating), it can all become utterly debilitating. Disabling. And all because our bodies haven’t had a chance to recover adequately from all these little incremental alarms, shocks, and other reasons to get pumped full of adrenaline and cortisol.
So, it’s important to not gloss over the effect of those million little hits. Inside our bodies and inside our minds, they do add up. And as our bodies accumulate the sludge of fight-flight-freeze, our minds are affected. Fortunately, there is a way to deal with it — exercise. Vigorous to a degree that gets your heart and respiration rate up.
Don’t have access to a gym? So what? Take the stairs instead of the elevator. Don’t have a set of weights? Big deal. Carry around some heavy stuff in your home. Don’t have an exercise bike? Do some knee bends, jumping jacks, and run in place. Swing your arms around. Stretch and move. Just get going — enough to get your heart rate up and create a noticeable difference in your body.
Now, I’m not saying it can fix things overnight. It’s taken me a year of consistent effort and commitment to get to this point, and when I started out, it was about the last thing I wanted to “have” to do each morning. But I wasn’t making the kind of headway I wanted to in my recovery, and the doctors were starting to talk about putting me on meds for my attention and mood issues. Given the choice between pharmacopia and 15 minutes of exercise each morning, I went with the latter. I’ve done the drug thing before, and it just made my life that much worse. I can’t go back there again. I just can’t.
So, I started getting my butt out of bed, and am I ever glad I did. I’ve read about biochemical stresses and PTSD in the past, and I’ve read about how animals can clear out the “soup” but humans can’t. But until I started exercising and got clearer as a result, the full impact of what I’d read didn’t sink in.
Now it’s sunk in, and it makes total sense. TBI can very much lead to PTSD — by right of the constant barrage of surprise and alarm and shock (not to mention our tendency to over-react to the unexpected or unfortunate events in our lives) which bombards us with stress hormones that don’t automatically clear themselves out of our sensitive systems. Given that TBI survivors’ systems tend to be even more sensitive after our injuries, it’s all the more reason to get up and get moving.
If you’re still sitting down while reading this, please get up off your butt and move. Your brain — and your life — will thank you for it.
I’ve been giving a lot of thought, lately, to how fragmented and disconnected my life tends to become when I’m tired. When I’m fatigued, head injured moments start to show up and proliferate, like a couple of rabbits in close quarters. And my thinking becomes a lot less resilient, a lot more brittle, a lot less fluid.
I’ve been tired a lot, lately. My new job is going pretty well, but I have a tendency to overdo it, and I’m so intent on proving myself, that I’ve quickly fallen into a pattern of overwork (which leads to fatigue), which is not good.
Part of it is because I’m still learning my way around the company, and my first project that I launched was not done properly. Ugh. Now I feel like I have to work even harder. Which means I have been eating more sugar and drinking more caffeine. Which means my sleeping is thrown off and I have been staying up later. Which means my thinking has become fragmented and partial and incomplete — like my decision the other day to just stop this blog. The idea suddenly emerged — and very strongly, almost overwhelmingly — and without giving it more thought or careful consideration, I decided, “This is it – I’m just going to stop blogging.” And I announced it to the world.
Hmmmm. Red flag.
I must be tired.
Yes, I certainly am.
When I’m tired, a single thought in a single context can take on monumental significance for me, and I can decide — for a few hours at the most — that the course of my life will necessarily change with this thought.
And yet, when I think about it later, and I talk to others or hear feedback from others, I come to realize the fleeting nature of that thought, and I’m reminded, yet again, that short-term ideas shouldn’t necessarily be applied to long-term circumstances. I’ve completely missed the larger context in my thinking (if you can call it that), and I’ve run the risk of cutting off my nose to spite my face. Or cutting off my face to spite my nose, to put it in a larger perspective.
Truly, the fragmentation of my thinking process is one of the trickiest aspects of this traumatic brain injury business. It’s like I’m walking around with a fragmented hard drive in my head, and I never think to check to see if it needs defragging.
My thinking tends to get so localized, so specific, that I can’t seem to see the forest for all the different trees. I think it may originate in part from my distractability — I need to focus intently on specifics, at times, in order to get my head around them, so I have learned to block out everything else. When I am tired, especially, this single-minded focus is what keeps me afloat.
But the “everything else” is what adds texture and context to my life. It’s what enables me to make good decisions that take multiple factors into consideration. When I lose sight of that texture, in favor of single-minded focus, I run the risk of making poor decisions — the kinds of decisions my spouse and my neuropsych help me noodle my way through. The kinds of decisions that make the people close to me (and perhaps some of the people who read this blog) a little crazy from my contradictions.
Perhaps the most maddening aspect of this fragmentation of thought process, is that I don’t even see it, when it’s happening. In fact, the more severely impacted I am by fatigue, the more my brain-injured side steps in and takes over and tries to push everything else out of the way. It’s like that tendency I’ve always had — right after a head injury — to push away help or input from outside sources… each time, to my own detriment. My unhinged brain decides it’s going to take the helm, like a drunk driver who declares they’re a better driver than the designated teetotaler for that night, and wrestles the sober friend to the ground, takes the keys from them by force, and drives off — going the wrong direction on a divided highway.
It can be very frustrating. And the most confounding piece of the puzzle is that I don’t even see it, till it’s progressed… sometimes past the point of no return.
So, what to do?
I think the thing that saves me, time and again, is remembering what a “fickle” nature I have, due to my conflicted thought processes. I have a tendency to jump the gun, yes, but I also have the tendency to question myself and my thoughts and my decisions on a regular basis. People who know me, tell me I am far too cautious and distrustful of my own instincts. They haven’t lived inside my head, nor would I ever wish that upon them. My caution and distrust is NOT due to low self-esteem or faulty messages I internalized as a child. They are entirely due to a lifetime of watching myself making bad decisions that felt 100% right at the time… and reaping the fruits of what I sowed.
Knowing how changeable I am, and how unreliable my head can be, prompts me to invest a fair amount of thought in the things I do. Now, that’s a fine line to walk, because I’m given to getting stuck in a rut and having my oft-injured brain go over the details again and again and again. Analysis paralysis doesn’t begin to describe it. It’s more like ALL SYSTEMS STOP, until I figure it out. But the problem is I rarely feel as though I’ve actually figured it out.
So, that leaves me with the option — which is a good one — of running things by people and getting their input. It’s a bit nerve-wracking when I do this, however, because when I’m nervous and anxious, I am more distractable. And when I’m easily distracted, it’s hard for me to talk to people and understand what they’re saying to me. I miss big pieces of what they say, because my attention is being pulled in a hundred different directions — unless I make a concerted effort to laser in on what they’re saying. I tend to have a hard time following, and all the head-nodding in the world doesn’t make up for the lag time I experience between when they say something and when I get it, and the various details I miss.
Ultimately, though, the input of others isn’t going to do my job for me. So, I have to sink a lot of thought, a lot of time and energy, into processing what I’m experiencing. It’s not an awful thing — in fact, it’s quite pleasant, when I’m thinking about something I like and enjoy. But it does take intention. And it does take effort.
Main thing is, I need to be prepared to do the work. I need to not get caught up in thinking, “Okay, I’m all better now! No need for compensatory activities!” I just need to hunker down and do what needs to be done — not gloss over details and cut to the chase, but really consider what it is I’m doing, why I’m doing it, and all the different elements and aspects of my activity. It’s more time-consuming, yes. But it’s also a very valuable use of time. And ultimately, it deepens my experience of life to an almost technicolor degree.
Well, this has been a mixed week. On the one hand, I’ve been settling in more and more at work, taking on more projects and getting synched up with my team and the larger department.
I’m making good progress, and it feels great.
On the other hand, I’ve been very erratic at home, perhaps because of the pressure I’m feeling about this new job, making sure I don’t screw up, and keeping my facts straight. I’ve noticed a few times, already, that I’ve gotten facts and figures turned around — not for lack of trying… I was really trying to get it right — and now those incidents are looming large in my head, taking up space and making me feel like crap.
Which hasn’t been helping at home. I’ve been volatile and cranky and have blown up a few times over the past week. And my spouse is only too happy to spend most of the day away from me today. They’ve got a job they’re doing later today, so they get to be with their “posse” while I spend some quiet time at home getting my act together, catching up with myself, moving at my own pace, etc.
Some good has actually come out of this fairly challenging week. Both of us have been looking at our behavior and our parts in the fights and squabbles, and we’re both taking responsibility for our less-than-helpful habits. Both of us know it takes two to tangle, and we both know that we’re each as high-strung as the other, at times. We both have our issues, and at least we’re both willing to take steps to do something about our behavior.
And we’ve been deliberately mindful of our interactions, in the aftermath of the electrical storms. We’re both making an extra effort to be responsible and not fly off the handle over every little thing. Unlike times in the past, this week, we’ve been able to rebound and treat each other with dignity and respectful consideration, which is really the cornerstone of any healthy relationship, whatever its nature.
Bottom line is, we know we’re both better than how we’ve been acting. We’re not total jerks, but we do really good impressions of them at times 😉 The thing to remember, is that what we do and what we say is not who we are. We’re much better than that. And we know it.
I guess that’s the main thing — knowing who you are and realizing that you’re capable of a lot more (and better things) than you are currently engaged in. There are all sorts of strategies one can apply to motivate oneself to better behavior — thinking about what’s in it for you, if you do such-and-such… thinking about how you want your life to be and deciding if what you’re doing now is going to help you get there… having compassion for those you’re dealing with and being willing to extend them the respect they deserve.
Those are all great, and they work for a lot of people. But in my case, that’s a lot more thinking and a lot more abstract than I care to get on a regular basis. For me, it boils down to What sort of person am I… really? And would that sort of person be doing this sort of thing at this point in time? What kind of character do I have, and what principles matter most to me in life? Am I acting in a way that honors those principles and is a true reflection of my character — or the character I seek to develop.
Now, I know that the whole “character” discussion is not something people often talk about. But it matters to me. It matters a whole lot to me. What other people do and how they behave is one thing. It’s not my concern. But how I act and what I do, ismy concern. It’s a big one, too. Maybe I’m old-fashioned, maybe I’m just a throwback to the last century when these things mattered a whole lot more than they do now. But the bottom line is, character matters. My character matters. And when I keep that uppermost in my mind, it keeps me out of the mire.
Another thing that keeps me out of the muck of self-destructive behaviors, is realizing that as important as character is to me, my brain has been jumbled up enough to want to go off and do its own thing. And it’s up to my mind to keep my brain from derailing my life.
I share Dan Siegel’s belief that the main is a guiding force that directs energy and information throughout the system, and the brain is the organ that generates and conducts energy and information. Brain and mind are not the same. Character and behavior are not necessarily equivalent. They are connected, but behavior can go off the rails temporarily without making a permanent statement about my underlying character.
No matter what I do, no matter how badly things go for me, no matter how many things I confuse or how often facts get turned around, the bottom line is, I’m a good person who wants to do right. If I weren’t… if I were a total jerk and a-hole, the problems I have wouldn’t even bother me. I’d just go on with my life, as though none of it mattered.
But it does matter to me. And I know I can do better. So long as I keep trying, I always have the opportunity to show — yet again — that I am better than the things that try to bring me down.