Here’s your memory training image for the day (sorry I have forgotten to include these in the past days)
So, I’m starting my new job tomorrow, taking it easy today, catching up on my rest, and not going too crazy with everything. I had some errands I intended to run, but I went to bed, instead.
Just as well. Those errands can wait.
I’m pretty excited about my new role, and I can’t wait to find out how it’s going to go.
I got myself some really nice, fresh food for dinner, and I’ll start cooking that up in a little bit. I need to get my things together — make sure I have clean socks, as well as a formal suit to wear. It’s my first day. I want to look my best. I’m sure it will prove to be a lot less formal than I’m dressing for, but I’ll just take off my jacket. Roll up my sleeves.
I’m trying to drink a lot of water, so I’m clear for tomorrow. The last few weeks were pretty action-packed, and I need to settle my system. Yesterday I ended up being pretty busy and active, which wasn’t my ideal. I really wanted to have yesterday off, but that’s not what happened. Oh, well. That’s what Sunday’s for, right?
I spent a lot of time, this afternoon, relaxing and stretching and breathing. I did that after my nap, while I was lying in my warm bed, feeling comfortable and easy. I am having more trouble with my upper back, shoulders, neck, and trapezius muscle. I’m really stiff and sore, and not feeling great. All that lifting and moving yesterday didn’t help. Oh, well. I stretched, rolled on a tennis ball to work out the knots, and I “breathed into it ” as my chiropractor tells me to do. In the end, I felt better than when I started, but it’s still tight and painful to move at times.
The main thing for me is to work on clearing out the stress sludge from my last job. Let by-gones be by-gones, and also help my body clear out the biochemical leftovers from all the ridiculous dramas and conflicts that people seemed to dream up to keep themselves entertained. It’s not a small thing, clearing out the sludge. We have to do it, in today’s world, because nobody else will do it for us. We live in very stressful times (especially as the new political season picks up), and our systems are deluged with all kinds of conflict and strife and perceived threats.
If we allow it to build up and stay there, it takes a toll. It puts additional stress on our systems, and it drags us down. I dunno about you, but I don’t need anything else dragging me down. Especially if I know how to clear it out.
So, I’m breathing – steady as she goes – count of 5 in… count of 5 out… nice and even, relaxing all the while. It balances my autonomic nervous system and gets me out of fight-flight mode. It backs down the stress response and makes it possible for me to clear my head, so I can think properly.
This is important. This is critical. I know how to do this, and I must do it. It’s no longer optional for me. Not just some interesting thing to try out, here and there, but a discipline I need to regularly do.
Like the image memory exercises.
Both help. In different ways. They really help.
And now, get your pencil and paper and draw the image you just looked at above. No peeking. It’s important to see where you come up short. If you succeed each and every time, you’ve learned nothing. Good luck.
Trauma from traumatic brain injury is about more than what caused the injury.
Life after TBI (or other brain injuries) is traumatic all around. And the stress of living with yourself after TBI, can be like a river cutting a canyon into the earth, one bad experience at a time.
If you really want to help, you have to factor in the stresses that come with TBI.
You need to understand how traumatic it is to deal with the changes of a brain injury — the changes to how you process information, how you react to that information, how you interact with others, and how that compares with who you knew yourself to be, before.
You also need to understand how traumatic those changes are — what a threat they pose to your identity, your sense of self.
You need to “get” that the trauma builds up and can overwhelm an already taxed system. And if it is not cleared by things like exercise, good nutrition, some sort of self-help routine like meditation or mindfulness, and regular interaction with strong social supports, it can — and will — erode a person’s ability to function over time.
The other thing it’s important to realize is that while the Grand Canyon may always be there, you don’t have to stay in the bottom. The effect of the damage is fixable — it’s even reversible. No matter how far down a person has gone, it is always possible to help them rise back up. They don’t have to stay at the bottom of that gulch. They can climb out of that canyon and find firm footing again.
The human system is built to rise from the ashes, to re-wire its circuits, and find ways to become fully human… even if your sense of human-ness seemed to be long gone.
I have been caught in my own canyons many times. And I have climbed out of them, repeatedly. I have rebuilt my system, seemingly from the ground up, many times over in the course of my 50 years on earth, and I know from personal experience how impossible it can feel.
I also know from personal experience, how possible it really is to get up and out of The Pit.
But before you can do that, you need to understand that what’s pulling you down is very, very real, and it needs to be accepted as “a thing” and addressed directly.
Avoiding the trauma aspects of traumatic brain injury is a mistake. But it’s also reversible. And you have to do it in the right way, in the right sequence, with much sensitivity and intuition, not to mention common sense.
More on this later. Must get to work. But this is important. For all of us.
The Concussion Blog posted a great video a little while back explaining concussion
One of the things they talk about in the video is how the “sucker punch” can do you more harm than a hit you can brace for. A sucker punch doesn’t let you get ready to get hit. You just get hit.
The same kind of thing happens with your life after TBI – you have all these “sucker punch” experiences, where you get hit with all kinds of unexpected circumstances, because you think things are going to go one way — based on your prior experience and brain training — but they go completely different, because of your brain being a bit “re-adjusted”. Things that “should” be easy, turn out to be hard. And you can end up in a state of panic and confusion on a regular basis.
This is a problem for a number of reasons.
First, it sucks. It’s unpleasant, it’s irritating, and it can be distressing in the moment when it happens. Your best-laid plans fall apart. Your plans and expectations don’t pan out. And you don’t always know why.
Second, it makes you doubt yourself. One mistake is a mistake. Two are a possible coincidence. Three are a pattern. Four can make you start to second-guess yourself from every angle. And when this happens to you, day in and day out, the cumulative effect is… well… not good.
Third, it hampers your ability to learn new things and re-train your brain. See, the thing with TBI is you have to retrain your brain and learn new things and restructure the way your brain works. When you are stressed and defensive and confused, it is harder to learn. It is harder to acquire new skills. It is harder to re-train your brain’s connections in the way you want them to be trained. Stress seriously impedes our ability to learn new things — and that’s exactly what you need to be doing after TBI — learning new things.
Fourth, it can trigger a case of PTSD. Not many people out there seem to be paying much attention to this. They seem to think that PTSD and TBI have different causes. But TBI, with its recurring “micro-traumas” can build up a real stockpile of stress and stress hormones and ultimately cause full-blown PTSD to emerge. This is just common sense. When you understand the nature of PTSD as a mental and physical response to unresolved mental and physical traumas, and you understand that TBI can be an ongoing source of traumas that never get cleared out, in part because nobody’s paying any attention and taking them seriously… well, then you’ve got a problem.
What to do? Learn ways to clear out the traumas on a regular basis — physically first, then mentally. Find ways to get your body to clear out the “sludge” that comes from shock and surprise and stress — including exercise, meditation, breathing exercises, rest and relaxation — so that your body isn’t hijacking your brain’s attempts to right itself. If you can find someone to talk to about your situations, who can help you feel supported by someone in your corner, that can help, too. The main thing is figuring out ways to clear out the after-effects of all those little unpleasant shocks and surprises that cross your path on a regular basis.
Speaking of clearing that stuff out, it’s time for my walk. I have about 36 hours left in this vacation, and I’m going to make the most of it.
I found an interesting article today — about a Marine who did something about the isolation that veterans go through when returning with injuries – especially TBI.
“They train together. They fight together. So if wounded, why shouldn’t they go through recovery together? This was the question that Lt. Col. Tim Maxwell asked about his fellow marines being discharged from the hospital and left alone to recover from injuries of war.
“When you’re in the hospital, you are with other wounded warriors. But once you are out of the hospital, it’s tough,” explains Maxwell.
He should know. While on his sixth combat deployment, Maxwell sustained a severe traumatic brain injury (TBI) during a mortar attack in Iraq. When he awoke a month later at the Bethesda Naval Medical Center, doctors didn’t think he would survive. The
shrapnel that penetrated his skull inflicted severe damage to his brain, impairing his vision and leaving him unable to talk or walk.”
This is the kind of news I love to read – the kind of forward thinking that comes from within the ranks of TBI survivors. I understand that Lt. Col. Tim Maxwell is now retired, but I believe Maxwell Hall is still going.
And I have to wonder if these things are still going on, if they are still holding up under present circumstances, or if the resources and halls and support networks are able to stand on their own, after their founders retire or just can’t do it anymore. I wonder if the “superfriends” ever get replaced when the original members bow out or fade away. Of course, in the comics, none of the Superfriends die or are destroyed. I think… But in real life, does that really happen?
I suppose in a way we are all on our own, and we all have to take it upon ourselves to take steps to get better, when we get hurt or injured. But what about those who just cannot find it in themselves to do that? What about those whose brains are damaged in ways that keep them from even wanting to get better… or that keep them from even realizing they need to improve?
And what about those who go back to lives after their injuries, surrounded by people who neither know – nor care to learn – about what TBI / concussion can do to a person, and who just can’t bring themselves to help.
Yesterday I spent much of the day with a friend who has been through some serious sh*t and could relate to some of the difficulties I have, now and then, with fatigue and light/sound sensitivity. All through their growing-up years, they were in and out of trouble, in and out of institutions, so when I talk about having a tough time at this or that, they seem to get it. And they don’t judge.
I don’t know how much they know about my TBI history – I’ve never brought it up, but my spouse may have mentioned it in past years when I was having a much more difficult time than I’m having now. I just don’t have the heart to bring it up in person. Whenever I try to discuss it with people who didn’t know before, they usually either make some blanket statement about how “smart” I am and how it’s just not possible that I could have any brain issues… or they back away from me, become distant, don’t bother with me the same way the did before. So, I haven’t said anything about it, specifically.
But that didn’t actually matter yesterday, because I could talk about the difficulties I have with getting tired and then having everything crash in on me… or losing my cool and freaking out… or whatever various difficulties come up in the course of my everyday thanks to TBI stuff. I could talk about these things not as TBI-related, specifically, but just generally in my life. The “why” about it didn’t matter as much as the “what” — in other words, I could just discuss the issues without getting into the root causes, and get some feedback about what to do.
And that’s the thing that I have learned will help me, when I need feedback or support — not getting specifically into the TBI-nature of my issues, but just talking about them as I experience them. So long as I don’t go down the road of “I was brain-injured in 2004, and nothing has been the same since”, and I talk about the things that happening with me just for what they are, I can actually get some useful feedback from people.
It’s the “brain injury” thing that keeps me cut off from the rest of the world. It’s the root cause that is the problem with people, I have found. But when I don’t get into the causes, and I stick with the end result that I need to manage, people can actually hear me and help me out. Or at least not push me till I’m crazy.
And it’s funny – when I first learned about TBI and finally had an explanation for why I was so screwed up and everything was falling to pieces around me, it was like I was finally free. And I thought that telling others and educating them would help them the way it had helped me. But all it did was freak them out. They just couldn’t deal. And everything got lonely really quick. Then I got to a point where I made peace with this loneliness and just focused on my own TBI recovery, understanding how it affected me, and getting a handle on what I really wanted to change in my life. Then I got to a point where I was less focused on the brain aspects and more concerned with the end results and managing them, getting them better. And now I’m at a point where I am mainly interested in having the best life possible, without making everything that goes wrong about my brain’s problems, and making it more about getting on with my life, picking myself up after I fall… and being able to talk to people about my issues in ways that they can hear and support – instead of getting all freaked out about it.
That’s how I get my support, these days. I’m still learning the best way of doing these things, and I still don’t have a lot of friends I can actually talk to about what I’m experiencing. But at least I’ve learned a thing or two in the past four years.
Actually, you know what…? I’m really tired and foggy. I’m really struggling to put words together, right now, and my head feels like it’s packed over-full of cotton. I have been at this computer for the past 2 hours, reading and writing, and I need a break. So, I’m going to pick myself up, change my clothes, then get out and walk in the woods for a while… and be quiet and settled and not worry about much of anything.
And that, my friends, is probably the best support I can give myself today.
This is a continuation of the discussion about PTSD from TBI – Exploring some possibilities.
The next factor in the development of PTSD, according to Belleruth Naparstek, is societal context — what the culture you belong to believes — and communicates to the survivor — about the source of your trauma. “The meaning and significance assigned to a traumatic event by the larger culture makes a difference in its impact.” (Invisible Heroes, p. 52)
In an example she cites, Finnish veterans of WWII showed extremely low incidences of PTSD — the war was seen as important, the fighting spirit of the veterans was celebrated, and overall there was a relatively high sense of subjective well-being, despite disabling health issues. The sacrifices of the soldiers were celebrated by the society — in sharp contrast to American veterans of the Korean War and the Viet Nam War, whose PTSD rates were as high as 30%.
Now, when it comes to TBI, so little is actually known about it in the general populace, and there are so many misconceptions about what causes it, what it means, and where it can lead, that it’s pretty difficult sometimes to ascribe any meaning to it at all. On top of that, when you get into labeling TBI’s as “mild” or “moderate” or “slight” you not only skew the facts of the situation (every brain injury is a serious matter, not to be taken lightly) but you also diminish the significance of it.
And when the injury happens as part of a freak accident, like something falling on your head, or you falling down a flight of stairs… that makes it even worse.
So, all the upheaval you’re experiencing, all the ups and downs, the confusion, the cognitive processing issues, the light and noise sensitivities… well, it doesn’t mean all that much, really. And society doesn’t have much use for you, when you’re unable (they think unwilling) to “get your act together”. As Belleruth Naparstek puts it, “… the significance that the larger community attaches to the traumatic catalyst has the power to cushion or exacerbate PTSD symptoms.” And all too often, no significance is (or ever can be) attached to the injury, leaving TBI survivors open to post-traumatic stress, which gradually builds over time.
This is a continuation of the discussion about PTSD from TBI – Exploring some possibilities.
So far, we’ve looked at how TBI directly contributes to PTSD through proximity, duration, extent of brutality, betrayal, and threat of dying. In all cases, the big way TBI contributes to these factors is through the skewed perception it can create, causing us to perceive “threat” where there is none, as well as amplifying our emotional and physiological reactions to events. There’s nothing like a hyper-activated amygdala pushing the brain’s automatic fight-flight response, to make everyone’s day that much more “interesting”.
And now we come to an area that has particularly strong implications for TBI survivors — perpetrating violence. As Belleruth Naparstek points out in Invisible Heroes (p. 51), we don’t normally think of folks who perpetrate violence as the ones affected by post-traumatic stress. It’s the victims after all, who bear the brunt of it. Right?
Not so fast. Post-traumatic stress which manifests in “more violent outbursts and greater severity of intrusive symptoms, as well as a greater sense of alarm, alienation, survivor guilt, and a sense of disintegration” is prevalent among those who cause harm to others. It’s a subject I’ve written about before in Putting my soul back together, one act at a time, in September of last year, and it remains a serious concern of mine.
See, TBI is all too often accompanied by anger issues. Outbursts. Meltdowns. And violence. I myself have been plagued by violent temper outbursts and extreme mood swings that shook me like a terrier shakes a rat… and I couldn’t do a thing about them. For someone who has long been known as an even-keeled sort of person who can be relied on to stay calm in stressful situations, it was a terrible blow to me to watch myself (like a train wreck) blowing up at people over what I logically knew was a small thing, but which seemed like the end of the world to my frayed wiring.
It was so distressing and so shocking to me, that I rarely brought it up with my neuropsych, and then I played it down because I couldn’t stand having someone know about what was going on inside of me. It was almost too much to take. My sense of honor, my sense of dignity, my sense of propriety, and my feelings for those I loved and cared about and worked with went right out the window without me having any understanding or control over things… and then I had to deal with the aftermath.
And the more I blew up, the more things I threw, the more I melted down, the more intrusive the memories of those times became, and the more I felt like I was in the grip of it all.
It’s no friggin’ fun watching yourself dissolve before your very eyes, and that’s exactly how it felt. Which added a sense of impending destruction/death to the whole experience.
The crazy eff’ed-up thing about TBI is that it can turn even the most mild-mannered individual into a raving lunatic, and it can cause them to do things they would never, ever choose to do on their own. It can turn even the most mellow individual into a violent perpetrator. I’m not trying to scare anyone, but at the same time, this is the dark side of TBI that people don’t like to talk about. And the toll it takes is something that really needs to be looked at.
Now, I don’t want to say that everyone who does violence to others is not in control of their behavior. Some people very much are. But with TBI, the right combination of fatigue, malaise, agitation, restlessness, and anxiety-producing sense of lost control, that nastly little switch can get flipped and you can find yourself becoming a stark raving lunatic over the stupidest little sh*t.
This is not to say that it has to — or should — stay that way. If we can see (or are informed) that our behavior is unacceptable, it’s our responsibility to fix it and make sure it doesn’t happen again. But all too often — especially at the start of your recovery — a lot of incidents can happen that result in feelings or experiences of violence.
And that takes a toll.
It takes a toll because you see and hear yourself doing these things, and it takes a toll because you may not be able to do anything about it, until you gain understanding and self-awareness, which can take months, if not years.
In the meantime, you’re racking up some serious mileage in the PTSD department. And ultimately that’s got to be dealt with constructively, or it can — and will — drag you down in the long run.