Straight to execution…

Way back when, at one of my first technology jobs, my boss (the company owner) chided me for “jumping straight to execution.” He wanted me to spend more time researching a new program — learning to use more of its features in a lot of different ways — before I started using it.

It rankled me, that he was trying to “hold me back” and not give me my head, so I could just jump right in. But now, when I look back, I realize that this has been an ongoing pattern with me — and it appears to be directly linked to my TBI after-effects.

I do tend to jump right into things without thinking them through completely, up front. It’s a huge drawback, and seems to stem from my diminished self-assessment abilities, which don’t tell me enough about my limitations… not to mention a lack of impulse control.

It really upset me, when he told me I should be forging right ahead with things… But now that I think about it, that was a really important piece of information for me to have. And I’m grateful to him for passing it along to me, so I can benefit from it.

When they think your TBI is PTSD

I just checked my blog stats, and somebody came over to this site while Googling for info on soldiers and PTSD.

I want to quickly put in a word for military folks who are seeking help for post-combat/deployment issues, who may be headed down the PTSD treatment road, but may miss TBI treatment in the process.

I started professional counseling about six months ago for “coping issues” that I couldn’t get my head around. Everything in life had just gotten so difficult, and I couldn’t understand why I kept running into dead ends with jobs and relationships and why I couldn’t seem to advance in life. All my peers have “moved on” and “grown up” — many of them now with grandkids and advanced careers, long-term homeownership, and all the accoutrements of adult life… while I languished in a no-man’s-land of false starts, scattered ideas, and a long line of failed or aborted attempts at living a normal life.

Now, don’t get me wrong — on the surface, my life looks like it’s highly advanced. I’ve got a great home, a wonderful marriage, and two cars in the garage. My resume looks fabulous, and I’ve got a lot of respect from folks. But my external circumstances don’t match my internal state… and they haven’t for a long time. Nobody really knows just how deep the self-doubt, anxiety, self-criticism, abysmally low self-esteem, and constant invisible struggle really goes.

Except me. And I don’t breathe a word of it to anyone. Not if I can help it.

So, when my health and career and personal life all started to tank in a very big way, this past year, I sought professional help. The counselor I found is highly experienced, compassionate, insightful, kind, caring, and very adept at what they do. But I found myself over time feeling as though they were looking for some sort of horrific trauma in my past that would cause me to lose big chunks of my memory, be uncertain around people, and erode my emotional and behavioral (and cognitive) foundation.

I got the distinct impression they were looking for emotional trauma. Abuse. Neglect. Some sort of terrible thing(s) others did/do to me that cause me to have PTSD. Or some life-threatening event that brought on PTSD.

We had talked about post-traumatic stress a good deal, and both of us accepted that it could have a part in my difficulties. But no matter how closely I looked at my life, I couldn’t for the life of me find THE Event(s) that had wrecked me for “normal” life.

It just didn’t make any sense to me. And when I dug deep and did my own research and realized that sustaining a traumatic brain injury at the age of 8 (and possibly other times), as well as another TBI three years ago, did actually fill in a huge, gaping missing piece of the puzzle.

It’s not that my counselor was incapable or incompetent. They were just looking for the wrong thing in the wrong place. They’re a wonderful resource for me, and I really value their input, but in the case of TBI, I had to come up with my own diagnosis.

This article was very helpful:

Concerns grow about war veterans’ misdiagnoses – Brain injuries can defy easy detection” – I passed it along to my counselor, and they found it very helpful… as well as a bit disconcerting.

And the blog “A Soldier’s Mind” has some more info.

If you’re in the same boat I am/was, you may need to do your own research & preliminary diagnosis, too. After all, TBI tends to make it very difficult for people to tell what’s going on inside our heads — and it can make it tough for us to figure that out, too. Doing research online is a great way to make a start.

I’m finding that TBI is not particularly well-known in the psychotherapeutic community — I have a bunch of friends and associates who are therapists, and when I’ve talked about TBI, I’ve gotten blank stares. That’s not entirely their fault. They aren’t always trained to look for physical ailments, which are the domain of medical doctors. If anything, they’re taught to look away, in terms of medical issues — liability issues, I suppose. Unfortunately, there seem to be a lot of highly trained individuals who simply don’t have the kind of physiological orientation that treats cognitive-behavioral symptoms as possible neuro-physiological phenomena. They are accustomed to looking at emotionally traumatic life experiences as the root of PTSD problems. They’re looking for the right thing… but they’re looking in the wrong place.

I really want to devote a fair amount of time and energy on this site to explaining to psychotherapeutic professionals the personal realities of living with TBI, as it relates to trauma. There are different aspects of the condition that both mask post-traumatic stress and exacerbate it. TBI adds another wrinkle to the whole scene that complicates matters and requires greater sensitivity to our situation.

When I informed my counselor about my TBI, they seemed a bit concerned that I wouldn’t need their help anymore… or that I’d terminate my sessions with them. They seemed to think that TBI work would replace the cognitive-behavioral work I was doing with them. But in fact, the TBI aspect makes it even more important to do cognitive-behavioral counseling. It doesn’t make counselors superfluous. If anything, it makes them all the more essential.

Other posts about PTSD:

Better today… of pain and ptsd

Technorati tags: Brain Injury Bush combat counseling Emotional Fallout Employment fall Family Issues government head injury Head Trauma headache health insomnia Iraq Iraqi Freedom Mild Traumatic Brain Injury military mtbi neglect Neuropsychological Effects of TBI OEF OIF Personal Experiences with TBI PTSD recovery ringing in ears sleep disturbance Social Issues soldier TBI Symptoms tbi therapist therapy tinnitis trauma traumatic brain injury veteran veterans vets

I’ve been waking up early a lot, lately

This morning I woke up at 5:00. That isn’t very early for some people, but is early for me, especially since I didn’t get to bed till midnight, and I need 7-8 hours of sleep to be fully functional. I’ve been pretty tired, lately. Needing to catch up on my sleep. But try as I might, I can’t seem to get myself to bed before midnight, and I can’t seem to sleep past 5 or 6 a.m. I do what I can to get naps in during the day, which helps, but it’s been a long time since I had 8 solid hours of good, sound sleep. That’s what I’ve traditionally needed, ever since I was a kid, but it hasn’t happened for a while.

This is really nothing new, actually. I’ve been waking up at 3 a.m., on and off, for the past three years or so. Since I fell and whacked my head at the end of 2004, I haven’t been able to really sleep the way I want to. I either can’t get to sleep before midnight/1 a.m, and/or I can’t sleep past 6 or 7 in the morning, and/or I wake up throughout the night, and/or I wake at 3 a.m. and can’t get back to sleep. All told, I’m lucky if I get 6 hours of sleep a night. I can’t remember the last time I had a full 8.

I’ve often resorted to just getting up at 3 a.m. and busying myself with things I meant to do the day before, but didn’t get around to… then hoping that I’ll wear myself out and get back to bed for an hour or so of additional sleep before my day officially starts at 8 a.m. That’s worked for me in the past, but as often as not, I find myself caught up in the little “asides” I pick up, and I don’t get back to sleep. Then I spend the rest of the day worn out and frazzled.

I’ve become increasingly accustomed to being tired all the time. It’s not such a bad thing… unless I think about the impact it may be having on my health. It certainly doesn’t help my headaches any.

Speaking of which, I have another one today. I’ve been pretty much headache-free for a few days — that is, I’ve been at a .5 or 1 level, instead of the usual 3-4 level (on a scale of 1-10). Today it feels like a 3, for starters. In the upper occipital area — back of my head, around the middle, near where my skull starts to curve around towards the top. I’m not entirely sure if the headache is due to stress and strain and thinking too much (I started doing that at 5:30 this a.m., when I realized I couldn’t get back to sleep and started fretting about things like work and jobs and paying the bills)… or maybe it’s muscular. I did go to the gym yesterday and had a good workout. I’m sore, now, including my shoulders and neck, so that could have something to do with it.

There’s a pronounced ringing in my ears, too — it tends to accompany my stronger headaches, if I’m at a 3 or higher. It’s a hollow, high-pitched, whining ringing that’s constantly in the background. If I thought about it, it would be maddening. But I’ve had most of my life to get used to it, so it’s just there…

But back to my sleeping patterns. Sleep disturbance is a common after-effect of a TBI, and when I look at my sleeping patterns in terms of my most recent injury, it all makes total sense. Although I sustained a TBI when I was 8, I don’t think that sleep disturbances weren’t a part of my life till I was injured in 2004. Even when I was 10, I was able (and eager) to go to bed by 9 or 10 p.m. and I could sleep through till 6 or 7, no problem.

After getting 8 hours of sleep a night, come hell or high water, ever since I was a kid, all of a sudden in 2004-2005, I just couldn’t manage to sleep through the night, and it made me crazy… until I resigned myself to it and just tried to adapt with afternoon naps. I’ve been an avid Saturday/Sunday afternoon napper for many years, even before my patterns were disrupted. But in the past three years, it’s become a really necessary part of my weekly routine.

Of course, three years ago, when I was waking up at 3 a.m. every night and unable to catch up on my sleep, I blamed job stress. Certainly, that could have something to do with it, but I was stressed before my injury, and I wasn’t up in the wee hours every single day. Not like I was after the fall. And after I left that job and had less stress in my life, I was still hassling with sleep disturbances.

I’ve been looking around online for resources on sleep disturbance. Over at http://www.tbihelp.org/sleep_disturbances_following_tra.htm, they say:

… It is generally accepted that sleep is usually regular and predictable. For instance, when a person is about to go to sleep, neurons within certain parts of the brain (e.g., the brainstem, thalamus, hypothalamus, and basal forebrain) become more active and prepare the person for sleep. Other areas of the brain then become involved, and seratonin is released, which facilitates the sleep process even more.

When the brain is injured (the severity of the injury does not appear to matter), the person’s sleep/wake cycle often becomes disrupted. Thus, many people who have sustained a brain injury experience difficulty getting to sleep, maintaining uninterrupted sleep, and subsequently remain quite tired during the day. Even those with mild TBI report sleeping difficulties. It has been found that when these individuals do sleep, their sleep is lighter, and less restful, where they often awake during the night. When a person is not getting enough sleep at night, they often become excessively tired during the day, and frequently experience depression. Unfortunately, while there are some studies that demonstrate particular sleep disturbances following TBI, there have not been any large studies that investigate the different ways in which such disturbances impact upon other areas of a person’s life (e.g., cognitive impairments, psychological functioning).

The article may be found at:Drake, A., & Bradshaw, D. (1999). ‘Sleep disturbances following traumatic brain injury’. Brain Injury Source, 3, Brain Injury Association: Alexandria, Virginia.

Since the article dates back to 1999, I suspect there have been larger studies about how sleep disturbances impact the lives of TBI survivors (not to mention their family members and employers).

Then again, other more recent studies report the need for more studies… Hopefully there will be more work done on this. I’ll need to check more recent brain injury research for updated information.

Other links about TBI and Sleep Disburbance:

It’s encouraging to see that researchers know this is an area that needs more exploration… and calling for more studies about sleep disturbance after tbi. As the “Sleep Disturbances after Brain Injury” site says:

Problems with sleep are another poorly understood, but absolutely central problem after brain injury. As serious of a problem as overattending fatigue can be, if the injured person doesn’t start the day refreshed, it can be debilitating.

I’ll say! When I had my fall in 2004 and went back to work A) without having a clue that I’d been injured, or to what extent I’d been affected, and B) never getting adequate sleep to keep up with not only my healing but also my day-to-day experiences in a highly stressful job, the results were personally and professional catastrophic.

Not only could I not cope with the day-to-day demands of everyday activities, like keeping up with my chores, cleaning, taking care of the house, doing yard work, etc… but I couldn’t keep up with my workplace responsibilities. I became increasingly hostile to people around me, I became insubordinate to my manager(s), I lashed out at co-workers without provocation, and I frankly scared a lot of people at work with my temper and my intensity.

Everything around me became that much more “amped up” with me, and I had a very hard time both moderating my reactions to people and regulating my pro-active behavior. Eventually I had to leave… though nobody understood exactly why I’d imploded. Least of all, me.

I’m convinced that lack of sleep exacerbated a lot of issues I had, and not only made me more difficult to deal with, but also prevented me from healing adequately. Not getting enough sleep pushes me to the point where I had ongoing difficulties navigating the social landscape at work, and my self-confidence was pretty much shot, as a result. The emotional fallout from that has been intermittently devastating, and it’s still causing me grief, trying to figure out how to integrate into the working world in a positive way — meeting the needs of my clients, as well as my own physical demands.

Yes, sleep disturbances are a huge problem for me. I’ve been plagued by them for over three years, now, and it’s a huge pain in my neck. But knowing that they can be traced back to my TBI(s) helps tremendously. Now I can explain it to myself and the people around me. Now I can put it in terms that actually make sense to other people.Now I don’t feel quite so helpless and alone anymore. And that makes all the difference in the world.

Technorati tags: brain damage Brain Injury brain childhood counseling Emotional Fallout Employment fall Family Issues head injury Head Trauma headache health insomnia Mild Traumatic Brain Injury mind mtbi Neuropsychological Effects of TBI pain Personal Experiences with TBI psychology psychotherapy ringing in ears rock self-assessment sleep disturbance Social Issues TBI Physiology TBI Rehab tbi survivor TBI Symptoms tbi testimony tinnitis trauma traumatic brain injury

A good day… sort of… I think…

Today was a good day.

I think.

So far, anyway.

I’m actively looking for work, right now, after taking a little over a month off for the holidays. I’m finding that dealing with people — especially co-workers — during the holidays is just too much for me to take, these days. I can’t stand the hurried pace, the rush, the frantic-ness of it all, not to mention all the issues that people at work have around their families, their emotional issues, their holiday trauma-drama… It’s just so tiresome, and my coping skills could really use some improving. So, until I get/feel better this time of year, I’ve taken to checking out from Thanksgiving through New Years.

This is the third year I’ve done this. I’m a consultant, so I can adjust my schedule accordingly — work like a dog for 10-11 months, bill all the hours I can get my hands on, then take the last month of the year off. It works for me. It’s much better than getting overloaded in December and then acting out. That just wasn’t working with me. Plus, after my re-injury at the end of 2004, I just had to quit the the holiday season wholesale, to take care of myself (and spare the world from my outbursts and social uneasiness).

In the months after my fall over Thanksgiving of 2004, I became increasingly non-functional in tight spots at work — with no clue why. I became a real problem at the office, what with my temper flaring and socially inappropriate outbursts around co-workers and my concentration shot to hell and my impulse control and emotional extremes all over the map. Unfortunately, I didn’t know why it was happening to me… all I knew was, I couldn’t function around those “a**holes at work” anymore (I won’t tell you what they thought about me!), and I had to make some choices. After enduring a grueling year of real struggles with myself and others, I realized at the end of 2005 that it just wasn’t working, that combination of holiday stress and my mental/emotional situation (tho’ I didn’t realize I was dealing with a TBI at the time).

So, I decided to just quit. Take the time away from the office. Stop working. And it was great!

I have to admit, I was pretty nervous, when I first “dropped out” at the end of 2005. I am a workaholic by nature, and the longest I’d ever gone without work in nearly 20 years was 2 weeks. So, being away from an office and a client for longer than 10 working days was a whole new thing. But it was a good thing. And when the New Year came around and I had brand new clients in 2006, I realized the sky wasn’t going to fall if I wasn’t working 51 weeks out of the year. So, I did it again in 2006. Took six weeks off between Thanksgiving and New Years. And I did it again this holiday season.

Now I’m back in the job market, looking for clients. Sending out curriculum vitaes. Quoting hourly rates. Hob-nobbing and networking and schmoozing, oh my! I’ve had some good nibbles, but I’d be a lot happier if things were nailed down.

That will come. Some of my leads are very strong, and I’m feeling positive. I never mention TBI when I deal with clients. That’s not the sort of thing I feel comfortable telling people as a consultant. As a full-time permanent employee, it would make sense to tell my employer that I’ve got this disability, since the ADA was created to protect people like me/us in such a situation. But as an independent consultant, there’s just no way I’ll ever breathe even a hint about my TBI background to prospective clients.

My job is to make their lives easier, not more difficult, and throwing brain injury into the mix is not something that makes their lives easier… or my life, for that matter.

Still, a part of me pines for a full-time job that lets me be protected by legislation passed to help people like me. I’d love to be able to show up at an office and know that there are laws in place to keep me from being preyed upon, persecuted, exploited, and treated like a second-class citizen by ignorant boobs. It might take some of the pressure off.

Maybe if the independent consultant gig gets too dicey, I’ll look for a gig like that. But for the time being, while I’m still of sound mind — well, mostly, anyway 😉 — and body, I’ll keep billing at my professional services rate and retain my freedom.

Today was a good day. So far. Good progress.