Making up the difference

The road to Lalu Farm, Bredon Hill

Things are coming together. The weeks are passing, and I’m getting more and more into the swing of my work. I’ve gotten past the initial worry of not keeping up, and I’m going with the confidence that I have in the unseen, seemingly mysterious ways my brain wraps itself around experiences.

Because it does. I can’t explain exactly how or why, but it manages to take care of itself, one way or another. And when I mess up, which I tend to do (being human and all), I sit up, pay attention, learn… and move on. I keep going. I’m a little like a shark, that way — I have to keep moving, or I’ll drown.

Thinking about the unusual ways my life has unfolded, I was marveling this morning at how well I’ve actually done for myself, despite having a very different perspective than most people I know. I guess I’ve had my synapses and axons mixed up often enough, to end up with a brain that’s obviously not like everyone else’s. Or maybe I might have turned out this way, even if I’d never been injured. What-ever. The point is — and I was contemplating this today while I was driving to work… I heal.

I adapt.

I figure this sh*t out and move on.

I always have… even when I couldn’t understand what people were saying to me, and I couldn’t decipher the words on the page in front of me, and people were tormenting me for fun, and when I had a heck of a time staying vertical, and when I would completely freak out at the drop of a hat (literally), and I couldn’t sleep past 3 a.m. for months and months on end.

One way or another, I figured out how to heal, how to move on. I figured out how to abandon the strategies and ways of doing things that used to work so well for me, but suddenly no longer did, for no reason I could decipher.

I think in a way it was lucky that I never fully realized why it was that I was having so much trouble. It forced me to not look outside myself, but to look within. It forced me to buckle down and just figure things out. Not many people were  cutting me any breaks, coming to my assistance, etc. And the ones that tried often screwed everything up. And then they’d get pissed off at me(?)

The usual expectations of growing up and performing on par with everyone else were totally on me, even though I was often not up to fulfilling them for a very good reason. I didn’t start out being up to it, but eventually I often figured out how to get myself up for it. The same pressures, the same tasks, the same responsibilities as everyone else around me had, were laid squarely on my shoulders. And I had no excuses. I had no reason for my start-stop life. I had no explanation for why I was the way I was.

So, I had to make do. I had to figure out a way to make up the difference.

There was no point in struggling to hang on to old ways of doing things. There was no “old” way of doing things, because countless things I tried and did often ended up in the crapper before my activities could become habits. I’m not sure my life has ever allowed me the luxury of developing certain habits for long. Something was always happening to screw things up — little did I know why.

But that’s not important. The important thing is, I adapted. I changed. I shifted my focus. Because I had to. No excuses. No explanations allowed. Not even a plausible reason for my track record of underachievement was permitted. It screwed me to the wall countless times, but it was also necessary for my growth and development. No matter how hard it was, no matter how much I struggled, no matter how intensely painful it was, none of that mattered.

All that mattered was the results. That I did what I was supposed to. That I lived up to basic expectations — and paid the piper, if I didn’t.

It’s interesting — I’ve been having ongoing conversations with people here and there about our “culture of accommodation”. And the same people who publicly support accommodating people with disabilities, secretly admit to not wanting to cut everyone a break just because they have a tough time of things. Sometimes, you just gotta suck it up and get on with your life.

Now, I’m sure I’m going to ruffle a few feathers with this little missive, but I have to say, if people had accommodated me throughout the course of my challenging life, I doubt very much that I would have gotten as far as I have. Truly.

Making up the difference. It’s made all the difference.

Knowing your warrior nature

Four Samurai - Source: wikimedia commons

Something came together for me over the weekend — it’s something that has been in my mind for a number of years, now, but suddenly it has a whole new meaning. It seems to explain pretty well some of the things that have puzzled me over the course of my life.

It’s the idea that the injuries I’ve sustained are a warrior’s injuries. And to address those injuries, I need to do so as a warrior, using a warrior’s tools. My main tool of choice is Zen. Za-zen. Sitting with the intention of overcoming the limitations of my unruly mind.

As a bit of background, I have been fascinated by warrior codes and cultures for as long as I can remember. As a kid, I was practically obsessed by King Arthur and the knights of the Round Table. Something about the stories of the knights really captured my imagination, and I spent many an hour as a child studying heraldry, swords, draft horses, and castles.

To this day, I’m still fascinated by stories of chivalry and the exploits of knights errant. Something in me really relates to them.

In the course of my travels, I have had the good fortune of having encountered a handful of people who have been Zen practitioners. The ones I related to most strongly were solitary practitioners. They sat za-zen in the morning outside — in all seasons of the year, no matter what the weather –before they did anything else, they traveled around and had adventures, they wrangled with family and community problems, and through it all they had a sparkle in their eye (even a wicked gleam) and their most common response to anything unexpected was, “Isn’t that fascinating!”

I sat and listened to their stories of what they encountered along the way in their lives, and I was amazed by the courage they showed in the face of tremendous adversity. But to them, it wasn’t a question of courage, it was a question of simply being with the situation and responding the the way that seemed most appropriate.

I guess it rubbed off on me, because I felt myself drawn to zen — particularly za-zen, the act of sitting motionless for some time, focusing on the breath and just letting the attention disperse. Not following any of the thoughts that come up, but noticing them and then letting them go. I practiced this for some time, myself, years back. I didn’t attend any formal sitting sessions at zendos or meditation centers. I was a solitary and I liked it that way. Plus, I was very nervous about being around other people who knew how to do something I was new at. I was so accustomed to new people taking issue with the way I did things and/or finding fault with me and/or making a public example of me doing things “wrong” that I just couldn’t bring myself to spend any time with people who did this sort of thing.

I thought about it many times. But I could never bring myself to move forward.

Then I fell in 2004, and my practice fell apart. It just disintegrated. I couldn’t be bothered with sitting in silence. I couldn’t be bothered with intentional breathing and paying attention to what was rattling ’round in my brain, for the sake of letting it go. I couldn’t be bothered with any of that silence stuff. I was too agitated, too restless, and I was too injured to realize that something was amiss.

Over the past 5 years or so, however, I’ve been drawn back to zen. I can’t be bothered with a lot of the doctrine that gets tossed about – all those words and pontifications about something that is essentially about just being. Maybe I’m just a contrarian, but many of the people who purport to practice zen annoy the crap out of me. But in place of the people, there are the writings of practitioners and students from years gone by, and I’ve been digging into them a bit — one of the pieces I’ve found that I’m enjoying is The Religion of the Samurai, which is a free download at Project Gutenberg.

I have been reading a few places where scholars have wondered aloud why Zen (which may or may not be part of Buddhism, depending whom you talk to), would have been adopted by the Samurai, a warring class, as their “religion”. Buddhism, from what people say, is a practice that honors all life and warns away from killing other living creatures. How could Zen end up the practice of a warrior class specifically dedicated to being highly effective “killing machines”?

The answer, I think, lies in the effect of Zen on the autonomic nervous system. It’s been my experience that Zen is extremely effective at teaching you how to modulate your fight-flight responses, as well as training you to ignore the pointless chatter of an overactive mind. In my own experience, it seems to specifically condition your mind and your body to do as you choose, not simply race from one stimulus to the next, in a never-ending and ultimately futile attempt to assuage every fear, satisfy every appetite, and overcome every perceived foe. Za-zen practice (in my own experience) trains you to “hold your sh*t”, if you’ll excuse the expression, and keep your act together, even in the face of truly daunting odds.

That, I believe, is why Zen (especially za-zen) became such an important part of Samurai culture. It trained and toned their minds and their systems to be masters of their own unruly passions, and put them in the driver’s seat of their own lives.

That’s a mighty powerful thing. And the clearer I get — each month seems to bring a little more clarity (though I do have set-backs) — the more drawn I am to the practice of Zen… za-zen… sitting with my breath and taming my unruly mind.

Because in a classical sense, I have a warrior’s injuries. I’ve been attacked. I’ve been hurt in accidents when people ran into my car. I’ve fallen from heights while attempting some exploit. And my last injury in 2004 came from me being over-tired, pushing myself to “so my job” and not paying attention to my posture and position when I was in the midst of an important task. I was literally  injured in the line of duty.

What’s more, the types of injuries I’ve sustained are the kinds of injuries warriors sustained, back before there were guns and cannons and laser beams. Back in the day, warriors fought hand-to-hand. Think Braveheart. Think Lakota raiding parties. Think Maginificent Seven. Once upon a time, when you went into battle, you had a sword and/or a spear and/or a shield. And you did what you could with what you had. Sure, there were often archers, but on the ground, you went up against a live person. And you got hit on the head a lot.

Think about it — when you’re going for the kill in a spot that’s the least protected, what’s often the easiest target? The head. The body has arms and legs and usually some sort of clothing or armor to protect it. But the head can be difficult to protect — you almost have to have it unprotected, so you can see and hear and smell and taste your way through the heat of battle. A lot of people take swings at your head, and maybe you duck and miss some, but you can also get clunked on the head by a glancing blow or a direct hit, and you have to keep going. You still have to keep standing, keep fighting, keep swinging.

When I think about it, that’s one of the things that TBI-induced stubbornness is good for — staying in the fight. The very thing that works against athletes when they’re concussed — that determination to get back in and keep going — is precisely the kind of quality a fighter needs in times of war. You can’t just sideline yourself, when you’re injured. Not if you’re in the thick of battle and you have no escape route at all. What are you supposed to do? Lie down and play dead?  Meanwhile, your comrades in arms are battling on around you, possibly dying themselves, because you’re lying there taking a breather.

From where I’m sitting, TBI is a warrior’s injury. It’s not just a recent “signature wound” from the recent Iraq/Afghan wars. It’s been that way since the beginning of time.  We probably lost sight of that with the advent of firearms and cannons and long-distance warfare, with soldiers sitting at consoles pressing buttons instead of grabbing a jagged knife and wading into the fray. But think back and imagine, if you will, how wars used to be fought. Take a trip to the library, if you’re unclear on the images. You’ll see what I mean.

Now, I’m sure there are folks who will say, “Having a car accident isn’t the same thing.” Or, “Getting clunked on the head by a piece of falling tile isn’t the same as getting knocked out in an IED blast in Kandahar Province.”

True enough. But keep in mind, the after-effects can be quite similar — and maddeningly so, because that car accident or the thing with the falling tile hardly seems significant enough to produce the kinds of complications that come afterwards — lost jobs, lost relationships, lost money, lost homes, lost self.

That being said, I believe that to effectively treat TBI and restore the aspects of our lives which have been disrupted/trashed, we need to treat the injury as a wound of our warrior lives. Maybe we were Type A personalities who were always on to go, who never took no for an answer, and managed to overcome any obstacle in our path… before the accident/attack. Maybe we were innocent bystanders who were in the wrong place at the wrong time when the car full of thugs pulled up and attacked us. Maybe we were just a little too tired and a little too distracted while we did something that demanded more than we had to offer. Whatever the disparate source(s) of our injury, the aftermath of each person (though every brain is different) shares so much in common with others, in terms of the quality of disruption and difficulty, it would be silly to overlook ways that other peoples and other cultures (especially in the past) developed to not only rehabilitate their injured, but also get them back in the game and let them rise in the world to positions of considerable wealth and power.

Like the  Samurai.

Now, I’m not saying that wealth and power should be our exclusive goals. But the same approach that made excellence of the political sort possible in Japan, those many years ago, can be used to make excellence of any kind we choose possible in this time, in our present lives.  Once upon a time, warriors got head-injured regularly. And some of them found a way to recover successfully and continue on in illustrious careers. They were the lords and barons and kings of the Western world. They were the Samurai of Japan. They were the warlords of countless lands in between. And many, if not all of them, had probably sustained multiple traumatic brain injuries over the course of their lives.

If that holds true (though I may certainly be mistaken in some respects, human as I am), and if we can find the path they followed to restore themselves to functionality, and there are vestiges of their codes and their disciplines still in place today, why can’t we use those same principles to effect the same sort of positive change in our lives?

Why indeed?

Recovery from TBI is possible. People have been doing it for eons. Since the beginning of time. For me, they key is to know my warrior nature, and to respect it as such — and treat my wounds as I would treat any injury from battle: with discipline and focus and the determination to get back out there into the fray again… next time with more insight, more experience, and yes, more success.

Know thyself.

The biochemistry of beginning

Source: nasa1fan/MSFC

I’ve been giving a lot of thought, lately, to my suboptimal tendency to procrastinate. I think “procrastinate” is actually a euphemism — I don’t just put things off. I simply don’t do them.  I know there are things I need to get done. I know I need to do them. I know I need to do them sooner, rather than later.

I just don’t.

Until much later. When it’s almost too late. Then, on the verge of calamity, I throw myself into a full-on drive to make it happen. And I do. It’s very exciting, and when I’m done, it’s very gratifying. But it’s exhausting. And it’s no way to live.

Case in point:

I have a number of things I need to do on a weekly/monthly basis:

  • Bag up the trash and take it to the transfer station.
  • Mow the lawn.
  • Order meds for my pet when they are running low, so they don’t get violently ill.
  • Pay certain bills, so the utilities stay on and I can still talk on my cell phone.
  • Etc.

My life is no different from others’ in these respects. Some things just need to be done, and nobody else is going to do it for me. I know I need to do these things. I understand the importance of doing them. Yet, week after week and month after month, I consistently don’t do them. It makes no logical sense. It’s counter-productive and problematic, and I each week/month I promise myself I’m going to do things differently the next time.

But I don’t. Once again I let things slide. The phone gets turned off. The pet needs to go on half-doses till the next order comes in. The trash sits in the garage, piled up in the garbage cans waiting for me to haul it away. And the lawn gets wild and high all over again.

Etc.

Then, when all seems just about lost, I kick into high gear, I set about doing the things I’m supposed to, and I do them extremely well, extremely efficiently, and with an ease that belies my days/weeks of procrastination and makes me look like a jerk/loser/slacker for not having just done it all up front, when things were still relatively normal.

I’ve spent a ton of time feeling bad about this tendency to allow myself to drift into the danger zone, trying to “whip myself into shape” and failing all over again. Not understanding why, not fathoming why I slack so terribly, when I know full well that I need to do this stuff, and I am perfectly capable of doing it. Does this, in fact, make me a total loser? Some might say yes, and I often agree.

But I’ve been giving this a lot of thought, lately, stepping back from the self-recrimination and agitation and anger (from myself and my spouse). And I think I’ve figured out why it is that A) I don’t do things right away, and B) why I can do all those things so very well, when I finally kick into gear.

Essentially, for me, it seems to boil down to an issue of Tonic Arousal

Tonic arousal refers to relatively slow changes of base-level arousal. For example, the daily cycle of sleep and wakefulness represent changes of tonic arousal. Stimulants (such as caffeine) or depressants (such as alcohol) also produce notable changes in tonic arousal — changes that may last several hours. The most important factor affecting tonic arousal is the diurnal cycle of wakefulness and sleep.

Tonic arousal is your general level of wakefulness. It affects attention, learning, and level of irritability. And it’s affected by sleep disruptions. Also, it’s very commonly affected by TBI. It’s related to brain stem formation and its connection to the frontal lobes, and given that the brain stem is so frequently damaged in TBI, tonic arousal issues often go hand-in-hand with head injury.

Now, there’s another aspect of arousal, called Phasic Arousal, which is defined as: “those transient states of arousal that are stimulated by significant environmental or internal events.” It’s that charge that you get out of something novel or something pressing, an alert or an alarm of some kind. If our lives are exciting (or even normal) we all go in and out of phasic arousal at least several times a day.

I (and many other people) tend to use phasic arousal to offset the dull effect of chronically low tonic arousal. We seek out excitement to perk ourselves up. We watch shows and videos that “bring us to life” with phasic arousal and get us out of our doldrums. We drink coffee and other concentrated caffeine drinks, we eat lots of “cheap” carbs and sweets, that get us going.

In addition to this, alarm coming from problems that emerge in my life can also have the same effect as a strong cup of coffee or an apple turnover. The sudden rush of stress hormones (as one of my friends once said) “is fun!” It feels good to be immediately alert and engaged. It feels good to be sharp. It also feels wonderful to have all that extraneous crap blocked out, and to be totally focused on only the main THREAT at hand. Being suddenly on alert over something I completely forgot to do, 10 minutes before the deadlines, brings me back “online” in a way that no caffeine or carbohydrate can.

That gets me started. It gets me to begin what I need to begin. It gets me to begin what I needed to have begun two weeks ago, but “never got around to it.” It overrides my procrastination, my anxiety, my fears, my phobias, and sets me in motion. When it works well, it puts me on the fast-track to success. Of course, it can also send me hurtling head-first into a great cosmic face-plant in the snowy slopes of life. But at least it gets me jump-started.

After giving this a lot of thought, and examining my behavior over the course of my lifetime (especially over the past years), I’ve come to the conclusion that I use the alarm states created by procrastination to perk myself up and get going on things that need to be done. Essentially, I use procrastination and the stress hormone biochemical cascade from the relative dangers of me not doing important tasks in a timely manner, to wake myself up and raise my overall arousal level.

It’s not very healthy, overall, but it works. And it works to my detriment, as often as not.

Below is a picture of what I tend to do. The red line represents the level I’d like to be at, to really feel like “myself” and be at my peak best (which I really need to feel like a real human being).  The brown line at the bottom represents my tonic arousal, or my general level of wakefulness and arousal. The blue line in the middle represents my phasic arousal — the intermittent, transient level of wakefulness and arousal that I experience in response to specific events/stimuli.

Here’s how this works:

I start out with a task (shown in the boring gray stars). My overall tonic arousal (shown at the bottom in brown)  is low, blah, and I’m just not feeling like doing much of anything. I’m not feeling very good about myself… not feeling like I’m “me”.

But stuff needs to get done. And all of a sudden, there’s an alarm(!) (shown in the yellow bursts) when I realize that if I don’t get going, I’m screwed. Body goes on alert. Stress hormones start to pump. And I kick into gear. My phasic arousal jumps way up, to about where I’d like to be all the time. All of a sudden, extraneous distractions like hunger and thirst and irritations from the neighbor’s barking dog are blocked out, and I’m fully focused on the task at hand. I’m ON, and I feel like myself, I feel capable, I feel competent. I feel human.

And I get the job done. Sometimes in record time.

However, after the alarm has passed, my phasic arousal starts to drop again, and I end up down where my basic tonic arousal is. Bummer. Eventually, another task shows up, which I don’t respond to very well, because my tonic and phasic arousal levels are way down.  I might also be pretty tired from the burst of energy — or, worse, my sleeping schedule might be totally hosed by my burst, and my overall arousal is lower than it could be.

Ack! It’s terrible. I feel awful. I feel blah. I don’t feel like myself. I feel boring and drab and useless. Until another crisis comes along. Then I feel great – energized, and useful and needed.

But the crisis takes it out of me, and I end up down again, before very long. Plus, the people around me who depend on me to be steady and consistent and reliable are starting to get a little peeved with me. If this happens enough, even if I eventually get my work/tasks/jobs done, the drama and delays and uncertainty that others feel at my erratic behavior takes a toll on my working (and living) relationships.

And so it goes… The rollercoaster of drama-fed effectiveness. It’s not the most efficient way of doing things, though it’s effective according to some criteria. People get tired of me not being as steady as I once was. And I find myself having to make up for past infractions on a regular basis – which is in itself a source of stress and focusing biochemical “pump”. Again, it helps focus me, but not forever. It wears me — and others — out. Worse-case, I set myself up for an anxiety attack or a full-blown panic attack. My autonomic nervous system can only take so much.

Like I said, it’s not rare for people to do this. Tons of people do it, according to my neuropsych. In fact, if you look around, you can probably find thousands of examples on large scales and small, of how people use this strategy — TBI or no. (I believe that PTSD sufferers and trauma survivors may be prone to this “strategy” since prolonged effects of trauma tend to dampen down the nervous system.)

But it’s no way to live. I need to do better. I want to do better.

Now that I’ve figured this out, I need to figure out a way to work around this. It’s no good for me to be on this perpetual roller coaster of drama/doldrums. It’s way too exhausting, and I don’t want to do it anymore. I need to develop tools to spot the danger zone ahead of time, before it starts to take too much out of me. I need to train myself to develop habits that keep me healthy and off that roller-coaster.

My primary purpose, these days, is twofold:

  1. Identify times and places where I am dull and low and not getting started on things, and I’m in danger of falling back on the “cheap” high of crisis to get me through life, and
  2. Find ways to avoid/address those scenarios in a proactive, productive way.

I need to watch out for the following things:

  • Being over-tired. That screws with your tonic arousal, especially. And when I am over-tired, I am even more prone to push myself and over-do my activity levels, just to feel human.
  • Dodging tasks without thinking about them, because I’m not taking the time to consider what I’m doing and why. Avoiding tasks for no apparent reason is a great way to get myself into trouble and get totally backed up — and stressed.
  • Diving head-first into things without stopping to think about them first. This is a great way to mess things up, and introduce even more phasic-arousal-producing “energy” that sends me up to a high, yes, but ultimately throws me even more out of whack.

And once I’ve identified these problem areas, I can do the following:

  • Get some sleep. Get to bed earlier than usual. And keep myself from staying up so late. If I’m overtired in the middle of the day on the weekends, I can stop doing what I’m doing and take a break. Or I can step away from what I’m doing, do some conscious relaxing for 15 minutes or so.
  • Stop and think about what I’m not doing — and why. I find that when I take a long look at what I’m avoiding, I can get past the unconscious avoidance tendency. A lot of times, I run away from doing things just because I don’t feel like I have the energy to do them.
  • Get some energy. For real. Going for a brisk walk, doing some jumping jacks, or even some stretching, often does wonders for me. A small cup of coffee can help, too, but I have to be careful I don’t drink it too late in the day (never after 3 p.m.), or it will screw up my sleep schedule.
  • Steer clear of cheap and easy energy. Stay away from the vending machine at work. Stay away from the snacks and treats and cheap carbs that spike my energy, but then let me down terribly afterwards.
  • Stop and think about what I’m about to do. Pause for a moment to make sure it makes sense. And be open to the idea of not doing it at all. Not everything I feel compelled to do — like go to the library and check out more books before I’ve finished reading the ones I already have — makes sense. I have to really check myself at times, and when I do, I rarely regret it.

It’s all a process of course. It’s a never-ending exploration of what works and what doesn’t. I keep learning, all the time, about my limits and capabilities, which can be as discouraging as it is encouraging. The important thing is that I don’t quit, that I don’t give up on myself, and that I keep refining my approach.

It’s also important that I understand there is a physiological/neurological basis for these kinds of behaviors, and what I’m doing is actually an ingenious short-term solution for potentially debilitating levels of low tonic arousal. It’s not a character defect or a sign that there is something desperately wrong with me. Ultimately, it’s me trying to take care of myself and feel like a real person again. But I have to understand the limitations of the overall approach, and use it judiciously so I don’t overtax my system and do more harm than good.

Obviously, nobody’s perfect. But if I keep paying attention to myself, I can teach myself to be more effective at being the person I am meant to be.

If it WAS a TBI, then this is good news

A visualization of the number of times the words "hope" and "crisis" were used in the New York Times. Click the image to see more details. Very cool.

I’m making good progress reading Mindsight by Daniel Siegel. I’ve been reading in the mornings while I ride the exercise bike, as well as sometimes in the evening. It feels good to be reading again — I’ve realized that the main thing that makes it so hard to read, is being constantly distracted by stray thoughts.

With all due respect to my association-driven brain and the tons of (sometimes useless) knowledge I’ve crammed into all those nooks and crannies — and there are a lot of them, if you ever examine a brain closely — the main challenge with my reading is having mind seize on an idea and think, “Hey – that reminds me of _______!” and runs off in a different direction, making connections with other ideas and information I have. And I get left in the dust, the book unread and what parts I’ve read not being fully grasped.

Sigh

But the Mindsight reading is going well. And I’ve gotten some really great ideas from it. The main gist of the book, that I can tell, is that intently focusing the attention on something for extended periods of time helps to build connective fibers in the prefrontal cortex — the place where planning complex cognitive behaviors, personality expression, decision making and moderating correct social behavior, originate and are managed. Mindful awareness can strengthen the physical structures that make these things possible, and add more skill to one’s practice of them. The activities of the prefrontal cortex are where I have huge issues:

It is responsible for the executive functions, which include mediating conflicting thoughts (uh-oh), making choices between right and wrong or good and bad (it’s not that I WANT to choose wrong, I just tend to have trouble distinguishing my choices), predicting future events (what will happen if I press this button?), and governing social control — such as suppressing emotional or sexual urges (sexual urges I can manage — it’s the emotional ones that get me). The prefrontal cortex is the brain center most strongly implicated in qualities like sentience, human general intelligence, and personality. (That could be why some people think I’m an idiot and treat me like one, or treat me like I’m not anyone at all. Or maybe they’re just assholes? That’s entirely possible.)

Anyway, I can really use some help with my prefrontal cortex, and I’m hoping Mindsight will do me some good.

In the book, Siegel talks about how practicing Mindsight helped that kid with the problems with outbursts — dysregulation, I believe folks call it. It helped him get a grip, handle himself better, and have an overall better view of himself in the process.

Another important piece of this kid’s treatment was exercise. He combined exercise with mindfulness work, and he used going for a run as a way to take the edge off his temper and issues. Sounds like a plan.

Hearing about this kid’s problems made me think there was more to his situation than just being a teenager. I latched onto the idea that this kid may have sustained some sort of head trauma when he was around 13. I know it’s all conjecture, but if there was some brain injury involved, then the fact that he could overcome his crying jags and his raging outbursts with this mindful awareness practice and exercise (and nutrition – let’s not forget that), then it really give me hope for myself. What’s more,  it is also consistent with my own experience in the past few weeks.

I’ve been practicing Mindsight, myself, in hopes of strengthening the parts of myself that seem to be particularly challenged. In addition to doing my morning workouts, I have started doing breathing mindfulness practices each day. While I’m still in bed, I breathe deeply 45 times (the number of years I’ve been alive), really concentrating on the breath. It’s interesting how I tend to wander and “get lost” in the course of this practice. I also tend to get tense and hyperventilate, if I’m not careful. But I’m working on it, and it’s getting easier over time. And after doing this for the past 2 weeks, I’m starting to get the hang of it.

Perhaps most significant, it’s helping me get out of bed in the morning, since I do it before I get up. I had been having a terrible time just getting out of bed — I’d lie there for30… 45… 60 minutes (sometimes longer), before I actually got up. Doing this breathing work helps me wake up more quickly, and for some reason, I actually want to get up. Magic.

Anyway, over the course of the past week or so, I have been noticing how I don’t get as upset over “triggers” like I used to. It’s really wild. Things that used to just set me off into a freakish rage, sometimes now just happen. I notice them, but I don’t react to them immediately. They just occur. I don’t jump into judging them, or making them into bad things, or deciding that they demonstrate beyond a shadow of a doubt that I’m a total friggin’ loser. They just happen. And I have an extra few minutes to decide what I’m going to do in response.

Case in point:

This morning I woke up at 4:00 a.m. I had gotten to bed at 11:30 p.m. last night. Now, 4-1/2 hours is not my idea of a good night’s sleep, especially when I’m at a real deficit lately, and I was pretty upset about being awake. I lay in bed for half an hour, trying to get myself, to relax, getting more and more agitated and upset. And I started to worry about money. I start a new job on Monday that’s going to pay me less each paycheck (though the benefits and total value of the position is far greater than the job I just left), so I’m concerned about my money situation.

My head got hold of that, and it started to churn. I started to make up all these mental spreadsheets and calculations of how much money I was going to have each month, and how to stretch what I had. I tried to put a better light on things, telling myself this was something I needed to figure out, but I was getting really agitated and tweaked over it.

Then, all of a sudden, I realized what was happening — I was awake before I wanted to be, I was anxious about having left my last job, and I was not on the same schedule today that I normally am on Fridays. I was off-kilter, and that was making me anxious, and my energy was trying to find an outlet.

The moment I realized that, my agitation started to subside, and I felt myself looking at my behavior like I was at a distance from it. I could see that it was just my body getting wired and getting my brain in on the action. And I could see that I had choices about what I did with the energy.

I decided to make a different choice — to direct that wave of energy towards doing some deep breathing and progressive relaxation. I also realized that the windows were open in my bedroom, and the birds singing outside were really loud. So, I closed the windows, put in my earplugs, lay back down, and did my progressive relaxation, starting at my toes and working my way up to the top of my head. I hadn’t even gotten past  mid-thigh when I was back to sleep.

And I slept through — up to 5 minutes before I was supposed to run out to my chiro appointment. I didn’t get a chance to work out and stretch and get myself woken up before I left for the chiro, but I was also able to navigate that, instead of getting all tweaked about it and flipping out with myself. I just got up, washed off, threw on some clothes, and went to my appointment. Then I came home did my workout, read my book, had my breakfast, and got on with the morning.

Simple enough, right? It sounds like it, but up until a few months ago, it was a real challenge for me. Up until a few weeks ago, even. This mindful awareness practice, this “mindsight” stuff actually seems to be working for me — and this after only a few weeks of doing it every day. I do make a point of doing it every day, just like my workouts/warmups. It’s become part of my daily routine, and it helps me get on with my life, not postpone it. That’s a good thing. It’s a really good thing.

So, even if that kid in the Mindsight book was just dealing with being a teenager (rather than having sustained a mild TBI), for me the practice is working. I feel a lot more chilled out, a lot more present, and a lot less driven by events that happen to me. I know it probably sounds implausible, for it to have an effect so soon, but I hear others have had the same experience.

The great thing is, I don’t have to go to an ashram or a retreat center or sign up for some special class to do this. I can read a book, watch/study videos of Dan Siegel talking about this on YouTube, and practice it myself. I know about the vagus nerve and how it helps with relaxation. I know about the parasympathetic nervous system and how it helps tone my overall nervous system, so I’m not so tweaked and fried and hair-trigger-happy over every little thing. I know some background neurology and psychology stuff, so that helps me get my head around this.

But the proof is really in the pudding. I can “know” all I like about this mindful awareness practice, but does it really work?

So far, for me, it does. I recommend others try it, too.

Or was it a traumatic brain injury?

Source: http://www.army.mil/

I’m reading Mindsight by Daniel Siegel, these days. I’ve been slowly making my way through it while I ride the exercise bike each morning. 15-20 minutes is about the right amount of time for me to read and ride. I’ve been wanting to learn more about mindfulness, and this mindsight variation of it, which (from what I gather so far) involves intentional focus on something specific, seems like it could be quite useful to me.

Apparently, the practice of “mindsight” helps to physically build connections in the prefrontal cortex, which is where complex processing and social “maps” are created. I’m not 100% clear on all the details of it — I’ll have to re-read the book, most likely — but it looks promising.

One thing that grabbed my attention right off, was the opening story about a family that came to therapy, because one of the kids had stopped talking. She was selectively mute, except at home. One thing that appeared to be the main factor was that her mother had sustained a traumatic brain injury in a car accident, and she was no longer the same person she was before the accident.

Needless to say, that got me to sit up and pay close attention.

The story culminated with the little girl starting to talk again, but the mother was still relatively incapacitated. The discussion of the family situation was a lot more about the little girl, than about the mother, so I didn’t get much more out of that account that could help me, specifically relating to TBI.

Later, in the second part of the book, the author talks about a young man who came to see him who was essentially a normal teenaged boy — 16 at the time — but who was having a lot of trouble with feeling low, crying in bouts that came out of nowhere, and flying into rages over relatively minor incidents. His explosions of rage were getting worse, he admitted sheepishly, and both he and his parents were increasingly concerned. He was depressed, and he sometimes had thoughts of suicide.

He hadn’t always been this way — this had started around the time he started middle school, when he was 13. He’d had some outbursts, but everyone thought he was just being a teenager. Still, things were getting worse.

The diagnosis that might have been assigned to him, according to his symptoms, was either depression or bipolar disorder.  But the description of his situation sounded a whole lot like a concussion or mild traumatic brain injury to me, when I first read it. We pretty much always see what we’re trained to see, so of course I thought, “That kid’s not mentally ill! He’s dealing with the after-effects of a head injury that either nobody realized he’d had, or they didn’t take that seriously.”

Indeed, reading about this guy’s situation — the  unprovoked, uncontrolled rages, the bouts of feeling down, the general blah-ness, the crying jags that came out of nowhere, and the embarrassment about it all on top of it — really hit a nerve with me. It sounded all too familiar. And I wondered if he might have had a concussion when he was about 13. Maybe he got beat up at school. Maybe he fell off his skateboard. Maybe he had a bike accident. Most TBI’s happen to boys, so the odds are not exactly against  him having sustained a traumatic brain injury.

I’m no psychiatrist, of course, but I wonder… if mental health professionals first screened for TBI before they cracked open the DSM, what would that mean for mental health care in this country? How many people would be kept off medications — a TBI can really muck with your body’s sensitivities to medicine — that they either didn’t need or couldn’t tolerate? How many people would have actual answers to why their behavior has evolved as it has? How many people would be spared the stigma of a diagnosis of “biopolar disorder”?

Of course, the stigma of traumatic brain injury could be even worse — and given the low level of awareness around what TBI survivors are like in real life (especially mild TBI survivors), a TBI diagnosis could socially do more harm than good. Perhaps.

But still, what if screening for TBI were the first thing that happened, instead of some afterthought or the result of a chance inquiry? What if instead of medications and talk therapy, a regular regimen of exercise and good sleep hygiene and a battery of taught coping skills for their specific difficulties were prescribed? What if, instead of medicating kids who are having these kinds of troubles, we took away their mobile phones and cut off their texting and IM’ing at least an hour before bed, and enforced good sleep hygiene — or else? What if we had them get on a treadmill or an exercise bike for 20 minutes, before anything else happened in the day?  What if people could see past their conditioning and their formal training, to see the underlying physiological/neurological underpinnings of these kinds of conditions, and clinicians were open to the idea that structural changes in the brain could be the root cause — and the best way of addressing that is NOT to numb/dull the symptoms, but build in new neural pathways to “route around” the compromised areas?

If you come to a washed-out road on your way to an important appointment, you don’t pull the car over, wring your hands, talk to someone for hours about how sad it is that you can’t go that normal route… and take a pill to take the edge off your discomfort while you contemplate your bad fortune. You turn the car around, and you go find another route. The brain’s neural pathways are much the same as the roads we travel in larger life — if one route doesn’t get us where we need to go, there are other ways to get there.  Imagine what would become of us, if we all did the logistical equivalent of diagnosing a disorder, and then coming up with a pill to take the edge off the discomfort of our inactivity… Would anything ever get done?

Of course, what really drives a lot of the diagnosing is the DSM, is that fact that it  offers codes to plug into insurance forms. So you can get your care paid for. And it has designations of disorders which map to certain drugs and therapies — TBI is not nearly as clear-cut or straightforward as a “standard-issue” mental illness. Not enough is known about it. And not enough people (therapists, doctors, and other sorts of clinicians) are willing to take on the seemingly daunting task of dealing with an injured brain at the neurological level.

What’s more, there aren’t any clear, easily obtained, ready-made, neatly packaged treatments for TBI, that people can prescribe and dispense. TBI recovery is an extended process, and a tricky one at that. It could lend itself well to a hybrid sort of therapy, which involves cognitive behavioral elements, nutritional and fitness education and coaching, not to mention plain old-fashioned talking things through with an impartial party who has a good head for what you’re tackling. But that sort of treatment (from what I’ve seen) doesn’t yet exist. What’s more, TBI has a nasty way of telling you you’re fine, so even if you do engage in that therapy for an extended period of time, you’re prone to quit, ’cause you think you’re all better now (and then you’re likely to end up back in therapy again, after things get mucked up all over again).

It’s worth the effort and well worth the investment of healthcare professionals to develop a system like this. But until people get more educated — and they stop being so afraid of the brain — and they develop formally recognized ways of dealing with TBI, a mental illness diagnosis is the most likely thing one can expect from a trip to a clinician for help with inexplicable mood and behavior issues.

Which, frankly, sucks.

We need a better approach. And we need something that works. ‘Cause no therapist I know of is going to start poking around looking for trouble that they don’t know how to solve — or that seems innately unsolvable.

Until we do figure out how to solve this brain injury problem, it’s going to keep getting categorized as good old-fashioned mental illness. And in that case, a lot of us are probably safer going it alone, rather than seeking out clinical assistance in the mental healthcare swamp that’s lined by the slippery slopes of DSM-driven diagnosis.

But let me ponder this a while longer. Maybe practicing mindsight will help me settle down the outrage and frustration I feel and channel it into more productive activities, than cursing the darkness that seems to surround us.

Being bigger than the little problems

Source: akhater

I’m taking a break today from my usual routine. I had a mixed day, yesterday, which started out excellent after my good evening on Friday. Saturday morning, I went to the chiro, ran some errands, and then headed home for a nap. All good.

It got hot, though, and that puts my spouse on edge – big time. We both have a bunch of things we’ve got going on, and not nearly enough time to take care of it all. Or so it seems. After I woke up from my nap, we had a bit of fireworks, as we were both feeling pressured and inadequate and totally behind the 8-ball.

Basically, what went down was that my spouse had some things they needed to get done. They had not planned well with their time (even though they knew that they needed to take care of these things — and they’ve known they had a deadline for weeks, now, but they waited till the last minute to do anything), and they suddenly wanted me to go out and run all sorts of errands for them, to pick up the slack.

My spouse has a lot of anxiety issues, and it’s quite soothing for them, when they get to boss me around. It’s kind of funny, actually. I can tell when they’re feeling antsy and insecure, because they give me a long list of things to do, and they complain constantly. But when they come up with all these things I “have” to do and they send me out to do them, they feel so much better. They also like getting me out of the house  so they have the place to themself.

Yesterday, they were really nervous, so they came up with this long list of items they wanted me to take care of. I, however, had my whole afternoon planned out, to take care of some work things I need to finish up. I didn’t have time to go on an extended shopping trip. Besides, I’d already bought a bunch of things, earlier that day when I was out and about. I said “No, I’m not going shopping.”

Well, when I refused, you’d think the earth had shifted off its axis and everything was sliding into the oily Gulf of Mexico. I got my head chewed off, big-time. But you know what? I wasn’t going to take it, yesterday. So, I chewed back.  I didn’t just tuck my tail between my legs and slink away, when they got nasty and obnoxious and started in with “that tone” that sounded like they considered me a form of life lower than slime, and who was I to question their infinitely wise judgment?

Okay, so you wanna play that way? Let’s throw down, then.

And I did. I stood my ground and didn’t just quit and leave. I said my piece and didn’t let them just run roughshod all over me. Throughout our relationship, my spouse has often talked to me like I was an idiot — like countless people have over the course of my life, and my parents did before everyone else. Same old same old. And I’m sick of it.

So, I told them that I was sick of them treating me like I’m brain damaged and saying that because I behaved one way in the past, that’s how I’m always going to behave. I told them I’m tired of feeling like I don’t exist in this marriage, that I’m tired of just taking orders from them and being treated like crap if I don’t just hop-to and do their every bidding. All the while they were looking at me like they hated my guts and they were completely disgusted that I had anything to say at all.

But I said my piece. I felt like a miserable little piece of you-know-what while I was doing it, but I did it anyway. I didn’t let them dismiss me, and I didn’t let them run the entire conversation. The whole experience felt… well, wrong… but I knew in my heart that it was right for me to stand up for myself. It was just an unfamiliar situation, with me using new skills that aren’t second-nature to me (yet), and that unfamiliarity was what was making me feel terrible.

Of course, the fireworks weren’t the worst thing. The worst thing was the aftermath, when I proceeded to beat myself up for losing it. But in retrospect, some of the things that pushed me over the edge are “old stuff” from years gone by, when I would capitulate to every single demand, not ask any questions, just do as I was told. And it’s understandable that I would have a bad reaction to them.

Since I started out on my active mTBI recovery, the road has been a bit rocky. Understand, for years — decades, even — I was compliant and agreeable and went along with pretty much what anybody said. That was especially true of people who I thought cared about me. I trusted their judgment and their ideas more than my own — after all, if left to my own designs, I often got things completely screwed up. And I was game for just about anything that someone else suggested I should do — even things that I instinctively questioned.

I just gave in. Went along. Didn’t make a fuss when people called me names or talked to me like I was an idiot. My spouse has done that quite a bit over the course of our marriage. They would just flip out on me when I wasn’t following what they were saying, or if I messed things up, I was “pathetic” or “stupid”. I never spoke up in my own defense because I pretty much agreed with them. In fact, if anything, I had an even lower opinion of myself than they did.

But over the past few years, as I’ve learned about the true nature of my issues and how to deal with them, I’ve been less able to tolerate nasty behavior towards me. I’ve stopped just shutting down and blocking off unkind words as though they didn’t matter. Words do matter.

And over time, they take a toll. I never gave much thought to how people have treated me, until about three years ago. I just took it in stride as one of those things that makes life more challenging. I never wanted to let on that all the bad treatment was affecting me in any way, shape or form. But the truth is, it has — and not for the better. Indeed, the most hurtful thing for me yesterday wasn’t my spouse’s tone or the words or the general sense of being attacked. Yesterday, one of the things that made the fireworks so uncomfortable for me, was my thinking that I didn’t have a right to defend myself.

For anyone reading this who lives with or deals with a traumatic brain injury survivor, rest assured, although it might not look like we “get” the mean things you’re saying to/about us, we actually do. It might take a while to sink in, and we might not be able to defend ourselves in the moment, but there’s still no excuse for verbal abuse.

No matter who/what the target of your attack is, it’s still an attack. And it can be very hurtful.

The last part of yesterday was pretty rough for me. I felt terrible, really  “hungover” from the emotional outburst, and I didn’t get anything done that I’d been planning to do. I felt terrible about  missing the cues in my spouse’s tone and words that were setting me off. I felt awful about having stood my ground — crazy as it might seem. And I felt like I’d been the bad person. I also regretted some of the things I said, which were hurtful and just slipped out. Derailed. I hate that.

But when all was said and done, after I got another full night’s rest and spent some time meditating this morning, I got a lot more clear.

Basically, what I’ve realized is that the terrible feeling I get from these kinds of fireworks is more physiological than mental or emotional. I feel physically ill from the biochemical cascade of the stress hormones that flood my system when I’m on high alert like I was yesterday. I was really on high alert. Freaked out. Flipped out. Anxious. Angry. Assertive in unfamiliar ways. And yes, a little aggressive at times. My body bears the brunt of the experience, and the feeling I have after the fact is a biochemical one — it’s not actually a mental or emotional state. It’s a physical state. I realize this now.

It’s important that I realize this, because last night I didn’t. I let my body get the better of my brain, with me thinking that the bad feeling I had was an emotional one, or a mental one. I thought about that feeling in terms of coming from my broken brain – that I was having it because there was something wrong with me. But the fact of the matter is, I was having that bad feeling because my body was doing its job (protecting me from the “threat” to my schedule of yet more things to do and the attack from my spouse, when my time was already limited), but it was doing it a little too enthusiastically.

In fairness to my spouse, they’ve had some neurological issues, themself, and they were also not fully awake after their extended lie-in. They were on edge, under pressure, and feeling boxed in by life in general. It doesn’t excuse their behavior, but at the end of the day they realized their part in things and they promised they were going to look at that and do better in the future.

So, there’s progress. I do believe them. There’s a lot of love between us, and we’ve been together for almost 20 years. Neither of us is going anywhere. We just need to work through this and not give up. We’ve been through worse.

And I need to cut myself a break, when I stand up for myself. It’s unfamiliar to me, and unfamiliar things make me uncomfortable and start that fight-flight biochemical cascade. It’s not a defect of my personality or character. It’s my body doing its job — and sometimes overdoing it.

In the end, what is really needed is just open communication and openness to the situations of others. To understand where they are coming from, and take the time to step back and be gentle with one another. To not let my sympathetic nervous system take over when things get a little dicey. Life is full of pressures for both of us, these days. We have some pretty significant money issues, and I’m starting a new job shortly. We have logistical issues, as my spouse expands their business and takes on new clients. We just have a lot going on, and we have to (re)learn how to let each other BE. Especially when things are heating up.

The last thing either of us wants to do, is tear each other to shreds, just because we’re tired and have a bunch of things we need to get done. It’s important to be bigger than that.

I did it – at last

Source: bandungraya.blogspot.com

Last night was amazing (of course, I’m paying for it today — totally wiped out). I was able to do something that has eluded me for some time. I actually went out to a big social gathering on a Friday night after a day of work, and I was able to make it through the evening without a meltdown or wipe-out. And I was able to ask my spouse to drive us home at the end of the evening.

This is progress.

It’s huge, because it’s been quite some time, since I could stay out later than usual — in the midst of a bunch of people who were almost all total strangers to me — and behave like a regular human being. In the past, I’ve gotten extremely agitated and aggressive and combative with my spouse, when we were out late and I was tired.

This time was different. I didn’t start twitching. I engaged others in conversation. I got pretty tired, but I didn’t start in on my spouse, haranguing them over stupid little details that didn’t matter. I stayed present and level-headed, and I kept myself chilled out. When I started to get antsy, I stepped away and hung out in a foyer area where there were things to read.

And I didn’t insist on driving home, like I often do when I’m tired and intractable. I asked my spouse if they could drive, pulled over, and then slept for half an hour while they got us home.

And once home, I tied up a few loose ends, did some minor chores, stretched, and went to sleep.

No muss, no fuss, no meltdown, no making my spouse regret that they took me with them on the trip. We had a great time, and I was actually a normal human being, despite being pretty wiped out and emotionally drained from my work transition.

And I met a bunch of new people who I’m probably going to be doing more with in the future.

I had a normal night out. At last…

Of course, it’s going to take some doing, to retrain my spouse’s expectations for how I’ll do under those kinds of circumstances. They’re still leery of going out with me in crowded, unfamiliar circumstances when I’m tired. I can hardly blame them — I can be such a bear. And I’m going to have to learn how to keep up with my sleep, so I can do more things like that. But aside from all the things I still need to do, last night was a huge success for me, and I’m pretty proud of myself, right now.

Proud… and tired. Time for my nap.

Getting back on track

Source: Kevin Collins

One of the things I’m really looking forward to, in the coming weeks, is being able to get back on track with my life. I haven’t said much about it, but the job search and interview process really disrupted my daily schedule, including my sleeping patterns and my ability to take care of basic tasks that are part-and-parcel of my daily life.

I’ve let some things slip, since I’ve been job-hunting and position negotiating, and I’m looking forward to things settling in, so I can get back to my sleep and my studies. I’ve been meaning to delve more deeply into the different symptoms and issues that come along with TBI, but I’ve been so focused on my basic survival, I haven’t had much energy left for that.

I have also been meaning to finish my paper (which has by now become book-length), A Perilous Relief, which is about the physiological bases of risk-taking and danger-seeking behavior. I personally believe that a lot of risky and dangerous activity has a physiological foundation — in my case, anyway. It’s been my experience that when I’m participating in high-stakes pastimes or pushing the envelope with risky types of behaviors, I just feel better. I feel awake. I feel alive. I feel calm and collected and a whole lot more centered, than when I’m just moseying along, taking my time, going about my everyday life. When I’m pushing the envelope, I feel human. And I need to feel human, so I tend to push myself.

The problem is, all that pushing comes with a cost. You can’t continue to amp up your system, revving your sympathetic nervous system, day in and day out, without some physical effect. Eventually the autonomic nervous system is going to get stuck in high gear, and the continuous effects of stress, cortisol, adrenaline, epinephrine, and all those other stress hormones that — in small doses — feel divine, are going to tear the crap out of your nervous system and essentially cause your body to “forget” how to ratchet it back and slow down.

You can’t drive 95 mph forever. You’re going to have to stop and refuel, sometime or other. And you’re going to have to change your oil and get your engine tuned up. Getting jammed in sympathetic nervous system overload is like keeping the pedal to the metal with no thought of refueling, oil changes, or tune-ups. Any vehicle will start to break down after too much prolonged use without some sort of repair. Witness the irritability, the agitation, the rage, the emotional volatility, the temper tantrums, the meltdowns, the snapping out, the roller-coaster of moods, the exhaustion that’s barely staved off by yet another cup of coffee.  It just can’t go on indefinitely.

Unfortunately, I tend to think I can. A lot of folks do, actually. Especially these days when the “new busy” (i.e., never being without your mobile phone and being constantly connected to “what’s next”) is touted as a good thing and lauded as a condition that everyone should desire. We all want to participate, to be a part-of, to have a hand in the excitement that is modern life. Mobile technologies bring us into the midst of the action in an instant, and ever-expanding social networks keep us connected with people we had never thought cared about us (and vice-versa). All around us, there’s constant movement. And we like it. I like it. It feels good, to be included in life, to be popular, to be connected. It makes us feel vital and needed and useful.

But in extremes, it is utterly distracting, even exhausting. And that’s where I find myself, now. I’ve been so caught up in my job situation, so immersed in it, that I’ve let a lot of things around me slide. Things I need to do every day, to keep healthy and happy and with-it. (In fairness to myself, I have been exercising each morning, which has been a huge help.) Now the job situation is settled, I’m in my final week at my current job, tying up loose ends, and I can turn my attention back to the regular business of my everyday life.

Again, I find myself striving to find the fascination in it. I will find it, but it takes effort. And with my initiation issues — I just can’t seem to get started — it’s like trying to get a rocket off the ground, sometimes. I read somewhere that it takes 90% of the fuel to get a rocket out of the earth’s gravity pull. That’s how I’m feeling, these days. But at least I’m not alone in my inertia — many, many rockets have the same problem.

So, I’m moving forward. Bit by bit. Piece by piece. And it feels, well, oddly normal. You have to understand — since I got a handle on the concepts of A Perilous Relief, I’ve been actively working with my parasympathetic nervous system, to chill out my nerves, and the results have been pretty amazing. I’m actually able to relax, which is a new experience for me. Understand, I was a very tightly wound kid, when I was little, with a host of strange mannerisms that ran the gamut from talking a mile a minute, to rubbing the silky lining of my blanket till I wore a hole in it, to banging my head on the wall beside my bed, to rolling myself up in a blanket from head to toe so tightly that no light or sound or anything could get in, to picking at myself till I bled. I was a mass of jangled nerves, with a pronounced startle response, intense sensitivities (tactile and hearing, especially, though smell and taste have never been my strong suits), and I would blow up at the drop of a hat.

So much of it, I realize now, was my nerves. My family lived in a borderline part of town in a small city, where there was lots of racial violence during the late 60’s and early 70’s. And being bused across town to a massive holding pen for thousands of K-2 children, through some pretty rough neighborhoods didn’t help. I was constantly on edge, constantly alert, constantly on the lookout for who was going to come after me next. So, from an early age, my autonomic nervous system has been skewed towards the sympathetic fight-flight-freeze end of the spectrum. And with all the drama in my life over the years, there hasn’t been much opportunity for me to cultivate that other side — the parasympathetic, rest-and-relax-and-digest part.

Looking back, I see that my predisposition to fight-flight responses, and my craving for situations that challenged me on the nervous system level, has contributed a lot to my behavior and choices. If I’d been aware of what I was doing, I could have seen time and again how I was making choices that put me into an intensified, hyper-alert, jazzed-up state which actually made me feel better, with all those stress hormones. And I can see how my lack of knowledge about the other side of things — the parasympathetic repair of the jangled system — kept me from doing things that could chill me out. I can also see how not knowing that I needed my system to be ON caused me to make choices that were clumsy attempts at heightening my arousal and clarity — and their clumsiness led to a lot of mis-steps, confusion, drama, and additional brain injuries.

Nowadays, now that I know that my system is inclined to be sluggish, due to my repeated TBI’s (slower processing and less “tonic arousal” — which is the relatively slowly changing metabolic/physical readiness to act or respond to the world around us), I know that I literally need to jazz myself up in some way, in order to be fully engaged with the world around me. Traumatic brain injury has a way of mucking with your metabolism and your tonic arousal, and I’ve had a number of brain injuries, so based on that and the results of my neuropsychological testing, I have a pretty clear understanding of my need for an extra “pump” to get through my days.

And knowing this, I can make conscious, deliberate choices about how I do that. I have a bunch of choices:

  • I can seek out pharmaceuticals to wake me up (my doctor has mentioned them, but I’m very wary of a drug “solution”).
  • I can drink a bunch of coffee, which will get me all wired and fry my system.
  • I can watch what I eat and make sure I don’t consume a lot of “cheap” carbs, like muffins and cupcakes and sweetened drinks, and make sure my body has a steady supply of real energy coming from complex carbs like fruits and vegetables and whole-grain breads.
  • I can get up earlier and exercise first thing before I do anything else.
  • I can make sure I get enough sleep.
  • I can do some or all or none of the above.

It’s my choice. And therein lies the power.

Getting back on track after the excitement and pressure and stress of lining up this new job is proving to be a challenge in itself. There’s none of the fear-for-my-life adrenaline rush to keep me on my toes, there’s none of the intense anxiety over my existential uncertainty to flood my brain with pain-numbing, sense-centering hormones. There’s not the same immediacy and sense of crisis that I had before, which kept me alert and fully engaged. Now I need to center in and get down to work and have that be okay, in the absence of the biochemical always-at-the-ready cocktail that bathed my brain for the past few months.

I’ll need to find a way to replace that. I’ll need to find a way to balance out my desire to drive, with my need to rest and rejuvenate.  Exercise is one way. Also, getting fully engaged in my daily life is another. Being “on” by choice, rather than by gut reaction, takes a lot of practice. But I’ve got time. And I’ve got ample opportunity to do just that — practice.

Onward. The world is waiting.

Rehab of the everyday

Source: W.I.P.

I’ve been giving a lot of thought, lately, to my recovery. I’m going to call it a recovery, because I do feel that’s what’s been taking place with me over the past years. I know that some ascribe to the idea that an injured brain cannot fully reverse its damage — what’s lost is lost. But I’m not entirely convinced. And I hope I never will be. As long as there is a shred of hope that the functionality I once had can be restored, I’m sticking with that.

One of the big reasons I’m sticking with the concept of recovery is what I’ve read about individuals who have sustained serious — even catastrophic — brain injuries, through stroke or accidents, and still came back to do amazing things. There’s the story I’ve read about the man in his 60’s who suffered a stroke, and then worked his way back from not being able to even crawl, to hiking and doing mountain climbing regularly — to the point where his final hours before he died were actually spent mountain climbing. When they autopsied his brain, it was discovered that the  region responsible for motor control had been severely damaged and 97% of the nerves that run from the cerebral cortex to the spine had been destroyed.

Yet, he managed to work his way back after a year to teaching full-time at the college level, and he remarried, kept working and hiking and traveling.

His brain and nervous system had sustained tremendous damage. Yet, he was able to get back on track and on with his life.

He recovered — his functionality, his participation in life, his physical capabilities… things and activities he desired and loved to do. He may not have been “the same person” he was before the stroke (not knowing him, it’s impossible to say), but he nevertheless restored his life to a fullness  that most — with or without brain injury — would value.

What struck me about this recovery, which I read in Doidge’s The Brain That Changes Itself, is how he worked his way back — with the help of others — through doing the everyday things. Learning to crawl after paralysis… then learning to walk again. Learning to type, one finger at a time, then with a whole hand. Bit by bit, gradually, with determination and consistency, he worked his way back. And he eventually ended up mountain climbing at 9,000 feet in Columbia, where he had a heart attack and died not long after.

I contemplate that man’s example, and I wonder how I can apply it to my life. I also see how my path runs parallel to his — despite what’s happened to me, despite the injuries and the setbacks, despite the false-starts and disappointments, I keep going. And I keep intent on my life. The thing with me is to not dwell so intently on my injuries or my difficulties, as I did before. The thing with me is to not get caught up in constantly second-guessing myself and trying to sort out what went wrong. I did that for years — decades, even. And all it got me was more self-doubt and insecurity. Now I have a much better understanding about the true nature of my difficulties, and I can see past the cloud of confusion and doubt, and focus on the goals, rather than the difficulties.

And in focusing on the goals, in focusing on the step-by-step process of getting from one place to the next, going from one phase of my progress to the next with deliberate mindfulness, I find myself getting better and better at the business of living my life. It’s like starting out with anything new — you have to really pay close attention to little details and little signs and signals, in order to refine and develop your technique. It’s like beginning a new sport — you have to pay such careful attention to your form and technique, sometimes for years and years, before you finally get to a place of mastery.

I’ve read that it takes 10,000 hours to become an expert. 10,000 of focused attention and practice on what it is you do. That’s 8 hours a day, 5 days a week, for about 5 years. Or 4 hours a day, 5 days a week, for about 10 years. That number is pretty widely agreed upon, and it’s the figure I’m using for my own purposes. In my case, it’s been over 5 years since my last injury, and I haven’t devoted 10,000 consistent hours to my recovery. I only really started focusing on it — realizing what it was — a couple of years ago. So, I’m feeling a bit behind. But I can’t let it get me down.

No, I need to just keep on keeping on. The things I want to re-learn and/or recover — my composure, my ability to manage my anger in positive, productive ways, my interactions with others, my ability to sustain relationships with people I care about, my ability to stay with a job, even when I’m getting pulled in a hundred different directions… those things take practice. It’s like starting over, in some ways — except that in some cases I never really had a first starting place. Those abilities never got fully and consistently developed with me, since I’ve had so many injuries throughout my childhood, youth, and adulthood. Arrested development? Perhaps.

But you know what? I’m still here. And I’m still willing to work to get to the place where I want to be. It’s tiring, often boring, frustrating, irritating work. But the payoff is huge. I want to recover the things I’ve lost — composure, focus, regular sleep and rest, physical fitness and strength — and it’s going to take work.

So, I’ll work. {shrug} I’ll pay close, even rapt, attention to the little things, put myself in situations that stretch me and teach me about myself, and I’ll leave time to recover, as well. I’ll treat this like any other sort of training — athletic training, especially — and follow the same guidelines I followed when I was first learning to run races and throw the javelin in track. You have to start somewhere, and it’s no good to blame yourself for not being an expert when you’re just starting out. Like it or not, in many ways, I am just starting out with recovering things I’ve lost. Patience is key. Yes, patience.

It’s hard work, but it’s worth it. In the end, I get what I pay for.

What am I recovering?

I’ve been thinking a lot about the concept of TBI recovery, lately, after some really great comments that came in within the past week or so.

I tend to think of this process as recovery — much like my recovering alcoholic friends. We are all recovering our dignity, our functionality, our involvement and engagement with life.

Certainly, what’s gone is gone. Deceased brain cells are just that – deceased. And some abilities may never come back to me.

But still, I guess I look deeper for what to recover. For me, it’s about recovering the character and quality of my life, not just specific abilities. Even if I can’t go from Point A to Point B as quickly as I once could, even if my memory is so fragmented and fried that I have no choice but to live in the moment, I can still take steps to regain my self-respect and dignity and approach my challenges creatively.

That, for me, is what recovery is all about. There is a lot of rebuilding, to be sure. That is a lifelong process for me, and I hope I never get to a place where I think I’m “done”. But ultimately, the recovery I seek is about overall quality of life, not just individual specifics. The details can be handled in any number of different ways.

But I need to recover my ability and willingness to handle them.

Onward.