TBI Issue #2 – Aggression

This post relates to the ongoing series Then And Now – Managing TBI Issues Over the Long Term which I’m slowly but surely building out.

I should probably call this TBI Issues #2A and 2B – Verbal and Physical Aggression, because while aggression can be a big problem post-TBI, it can take several forms. It can manifest as verbal aggression or physical aggression, but in either case it’s problematic. For everyone.

In my case, verbal aggression has often escalated into some sort of physical aggression — I haven’t struck anyone in recent memory, but I have thrown things (occasionally at someone), and I’ve broken things as well.

It happened a lot when I was a kid, too. I would just get more and more wired and wound up, and then I’d just lose it. Flip out on my siblings. Or one of the neighborhood kids. I didn’t just get time-outs, either. I was considered a menace by my neighbors — a real problem.

The net result? My family has always been a bit afraid of me, and they’re often on edge around me, when they sense my temper heating up.

My spouse is also afraid of me, on and off, and I’ve had to work pretty hard at not losing my cool, so they could start to feel comfortable around me again. The problem is, it only takes one or two episodes of me losing my cool, to trash all the progress I’ve made.

Back to square one all over again.

Or at least, that’s how it feels.

“On the inside,” it can be confusing and frustrating, as I often can’t tell that I’m getting edgy. All I know is, something doesn’t feel right when I’m having a conversation/discussion. It doesn’t feel “fluid” and I try harder to get my point across, the less effective I feel, and the more frustrated I become. And the edgier I get. And the more on-edge others around me get.

I don’t know if it’s a TBI thing or what, that I can’t tell when I’m getting edgy. I generally have difficulty figuring out what my emotions are, anyway. I usually feel like I’m happy, but sometimes I’m sad and I don’t realize it. Anger and fear both confuse me. For some reason, I just don’t “get” them, and I have to take others’ words for it, when they tell me I’m angry or sad. One of the confusing things is that I tend to tear-up over stupid little things. Frustration makes me look like I’m crying, which maybe I am, but it’s not the same kind of crying that comes from being sad.

It’s confusing. Which is frustrating. And anxiety-producing. And it just sets me off at times, especially when I feel like people are condescending to me or treating me wrong.

Verbal aggression is a bigger issue with me, I think, than physical — primarily because I’ve learned how to hold myself back with the physical expression. I’ve gotten into a lot of trouble over the course of my life for beating on people, so lessons learned. Still and all, sometimes it does come up and I walk a very fine line between “getting in touch with my feelings” and getting carried away by them.

It’s funny – my spouse used to lecture me about not being in touch with my feelings, like that was a bad thing. But you know what? Not being in touch with my feelings and being somewhat numbed out towards them makes it a whole lot easier for me to not get sucked down into the whirlpool of emotion. I’ve had shrinks lecture me about not being in touch with my feelings, too, as though experiencing all those emotions was actually going to help me. Frankly, with the emotional volatility that comes over me, everyone is better off if I’m completely out of touch with my inner world.

I’m sure there are people who will split hairs and tell me about how being in touch with my feelings isn’t the same thing as letting them run my life, but you know what? I’m not sure that’s accurate. Frankly, I was much more functional, aggression-wise, when I wasn’t “checking in” to see what was happening in my heart and soul.

Paying a lot of attention to what goes on in my inner landscape frankly makes me nervous and agitated — it changes very quickly, from time to time, which gets confusing and frustrating and pretty tiring, actually. So, I’d just as soon not do it.

What does this have to do with aggression? Well, if I can keep some distance between my head and heart and mouth, I’m far less likely to snap at people. I’m far less likely to get aggressive and go after people. If I can literally disregard what’s going on inside me, it actually helps me keep my cool. It’s when I start “getting in touch with my needs” that all hell breaks loose.

I start to feel slighted. Or overlooked. Or dismissed. Or ignored.

I start to feel sensitive. And raw. And vulnerable. Which I hate. And I start to feel like I need to defend myself from things and people who aren’t really out to get me — they just seem like they are.

Of course, my shrink friends love to tell me how I just haven’t processed it all enough, but you know what? Traumatic brain injury has a way of really mucking with your emotions and your interpretation of them, so what am I supposed to do — process a never-ending stream of constantly changing tsunami-like emotions? Please. No matter how much I may process them, they’ll never make sense, because they come from nowhere for no good reason, and they return to nowhere just like that. What a waste of time it is for me to process all that.

The thing for me is not so much processing my aggressive impulses, as it is recognizing and managing them up front. Once I get going, things pretty much go to hell, so it’s on me to manage the situations that give rise to aggression: fatigue, frustration, and feeling defensive. If I can just stay rested and keep my frustration levels down and take time to ask what the hell is going on before I jump to conclusions and start in on people, it goes a long way towards keeping me out of trouble.

But it’s never easy. Oh, no.

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Good reading

I’ve just “re-discovered” Give Back, Inc., the organization/group that helps traumatic brain injury survivors get their lives back with self-therapy.

Their mission says:

GiveBack, Inc. is a recovery group for traumatic brain injury (TBI). Its purpose is not to help survivors to accept new lives that offer them limited options, but rather to help recoverers to deal with their deficits, improve their functioning, become active, and regain self-control of their lives.

I originally encountered them as Give Back Orlando, but the website has since disappeared, and it seems they’ve moved their operations to LA, as well as online. There is a Traumatic Brain Injury Support Group online that features regular postings from Dr. Larry Schutz, the founding director of this great organization.

I’ve been reading some of the articles about TBI and recovery and the different systems available to people. What I really respect about what I see, is that it’s based on many years of experience — both good and bad — and there’s still a perspective and a commitment to rehab and recovery, despite all the roadblocks in the way.

It’s safe to say that I would not be nearly as well-off as I am today, had I not come across Give Back. There was just the right amount of information for me, about just the right subjects, and I had room to move and develop my own self-therapy program based largely on what they outlined and suggested. And the changes to their suggested approach which I made to the recovery program I’ve been on didn’t negate the good their approaches offered. Obviously, everyone is different, and some of the suggestions just sounded hair-brained to me. But overall, the advice was sound, and I was under no obligation to do things exactly the way they said I should.

I’m really glad I came back to Give Back. Going along in my everyday life, it’s easy to forget about the things I need to do, to stay functional. And with the successes I’ve had, it’s easy (and tempting) to dismiss my difficulties and downplay them, thinking, “Well, I’m glad that’s over!”

But it’s not over. Brain injury is never over. The attention issues, the short-term memory issues, the fatigue and physical issues, as well as the processing speed issues may be mitigated by my coping mechanisms and compensatory techniques, but they aren’t going away. And if I don’t stay vigilant with them, they can rear their ugly heads and make my life a lot more “interesting” than need be.

The fact of the matter is, I have developed a lot of ways to deal with my issues. But if I don’t use them, I can get into trouble real quick.

So, I need to keep it green. I need to remember how close to the edge I was, when I first embarked on my recovery. I also need to remember that there ARE areas where I still have issues, and while my coping mechanisms may be great in most cases, they are not always second-nature, and I really have to work at them. I have to remember to do them.

And I have to keep in mind that when it comes to TBI, I may be a whole lot more functional now than I was three years ago, but I can easily go back to being non-functional with almost no effort at all. All I need to do is stop interacting with people when they talk to me, tell myself that I understand everything I think I do and not double-check, never write anything down, expect to keep everything in my head, and eat crappy food, drink too much coffee and soda, and stay up till all hours snacking and surfing the channels. I could also quit exercising each morning and stop paying attention to what’s going on around me. That’s a great way to go back to the way things were.

But if I keep my wits about me, stay mindful and pay attention to what’s going on, eat right and exercise each day, and I interact with the world and ask plenty of questions so I’m sure that I’m clear (even if I do feel like it makes me look stupid), I can stay on track. I just need to remember to do it.

And that’s where Give Back helps. Not only because of the forums they have there and the self-therapy materials they offer, but also because of the articles by Larry Schutz (I’ve been a fan of his work for some time, and that hasn’t changed). It’s so important for me to remind myself of where I come from, what I’m dealing with, and where I can end up, if I’m not careful.

I may move past the basic problems, and I may have my coping mechanisms in place, but if I don’t stay vigilant and keep up the level of effort required, I could end up like so many other TBI survivors — doing well initially, then slipping into long-term disability that I can never seem to shake loose.