What I do, is What I am… and is Who I am.

This past weekend was a busy one. It was busier than I expected, because a project I’ve been working on had a “pre-launch” on Saturday, and I had to join a conference call for a few hours, starting at 8:00… and then I was on-call for the rest of the day.

I also had errands to run, in advance of next week’s Thanksgiving vacation (which actually won’t be much of a vacation, because there will be so much travel, family stuff, and tiring activity). It’ll be good to be away from work, but the change in schedule brings its own stresses.

But all in all, things are good. I know that, even though it’s going to be challenging, I have the tools and the skills and the capacity to handle whatever comes my way. This is a huge change from before.  Monumental. And the fact that my last nasty concussion was at Thanksgiving in 2004 (13 years ago), always brings up the reminders of how my life was turned upside-down, starting around this time of year.

I’m managing all the different things I have to “juggle”. Getting errands done in advance. Doing up-front planning for when to travel and what to do along the way to keep from being destroyed by hours and hours in the car. Regular stops are called for. Stretching and exercises by both myself and my spouse. Taking our time, so we don’t suffer too intensely from the whole trip.

I’m actually pretty concerned about the physical effect this trip will have on us. We’re both in king of rough shape, physically. My spouse more than me. And it’s tough, because they’re not very active, to begin with, and that makes it harder for them to recover. Plus, the reactions of our families, when they see just how limited they are with their mobility. People can be both insensitive and cruel and alarmist. What’s needed, most of all, is for people to be strong and positive and supportive. Not despair and think all is lost from what really could be a temporary condition.

Time was, I was pretty crippled, myself. Intense chronic pain that seemed like it would never go away. A state of mind that was defeatist and full of despair. I’m not like that, anymore. And frankly, I think what I did has as much to do with it as anything that I thought or told myself

I’ve been thinking a lot about how I managed to put my life back together… how I managed to restore my Sense-of-Self. I had a lot of help from someone who talked sense into me each week. But I think even more than that, what brought me back was effort and action — consistent effort and action.

Taking action and then giving a lot of thought to the results… and then taking more action… that’s done wonders for restoring my sense of who I am, and getting me on solid ground again. The thing about TBI is that it takes away your sense of who you are — that unconscious, instinctive trust in yourself. And when that goes away, it makes life that much more stressful. Which means that you don’t learn as well as you could under less stressful conditions. And that means your recovery gets delayed. I know mine did. For years.

Because I didn’t recognize myself. I didn’t know who I was anymore. And I became unrecognizable to the people who used to be my friends.

But as I just got on with my life (kicking and screaming, the whole way), and I worked through one situation after another, I came to recognize myself again. Through repetition. Through keeping to a schedule. Through regulating myself with checklists and strategies that made repeat experiences possible and re-taught me to recognize myself.

I think rehab people vastly under-estimate the impact of that loss. And as a consequence, they (and we) lose valuable ground, without realizing it. Without ever understanding why.

After TBI, you have to re-discover who you are. People do that in different ways. For me, it came through action. Taking action. Again and again. And soldiering through the failures and frustrations to build up a better understanding of who I was, what I was about, and why things mattered to me.

Action, in addition to thought, brought me back.

But sometimes we get it backwards. I know I did, for years, up until the post-TBI symptoms were so bad, my life was about to implode. People still do it. All the time.

I was talking with a friend yesterday who’s been having a lot of trouble getting their life together. They said they wanted to understand the underlying nature of their confusion and lack of direction, in order to go in the right direction. I suggested that rather than trying to figure out the mental background of it, they simply move forward, take action, and do the things they want to do. If they wait around to understand what’s going on, they may never get started making the concrete, substantive changes they need to make, to get their life in order.

They’re in a state of “analysis paralysis”, in any case, so just about anything they do to move forward will be step in the right direction.

I’m not sure if that sank in with them, or even if it made any sense. But they seemed to get it.

And I hope they can take the steps they need to take.

Anyway, that’s on them. I have my own life to worry about. But I’m too busy doing things to worry much, these days.

Life awaits.

Onward.

Save

Walking on a different wild side

I’ve been daydreaming about chucking it all and hitting the road. I’ve managed to save up a nice little chunk of change, banking it for house repairs and emergency situations. I actually have enough for an honest-to-God emergency fund now, which hasn’t been the case for close to 10 years. It really takes the pressure off. At the same time, though, it also tempts me to do something rash — like taking my little commuter car (which just got a tune-up), filling up the gas tank, and driving, driving, driving…

But I know it would never work. Never, ever. And without a doubt, I’d end up worse off then, than I am now. No doubt.

Here’s the thing — I need a break from all the heavy-duty daily frustrations. It’s just getting to be too much, and I’m not making good choices about how to get that break. Some people smoke. Some people go on social media. I dance with danger and run the risk of getting injured all over again. It’s clear that I need to change things up and get my blood pumping on a regular basis. I need a positive and productive way to get that adrenaline pump that keeps me sane and channel the energy I have into something that helps me, not hurts me.

That all being said, I think the key for me is to step things up with my hopes and dreams. I have an “old” dream of having my own business doing consulting and training about an area of expertise I have. I know there’s a market for it, and I know others do well in that line of work, I’ve just never made good on it. I have wanted this so badly, on and off over the past years,and I’ve made some starts, here and there. But I’ve repeatedly given up on that dream over and over. I got overwhelmed or confused or just felt like I couldn’t do it. I knew in my mind that I could, but I lost courage and backed off and went back to doing what I had been doing before — holding down the fort with my 9-to-5 job and steady paycheck.

Now things are different, though. I don’t have a horrific commute anymore — if anything, it’s going to get shorter. And I’m becoming increasingly motivated to move forward, as I talk to people about my idea, and they get really excited about it. I have managed to find a job where every day I am in the midst of some very forward-thinking people who are also super supportive, and it’s really doing me a lot of good.

These two magic combinations — time to work on my ideas, and supportive people with vision — are helping me get past myself and re-start anew. I’ve started this idea so many times, I actually have a lot of knowledge about how to get off the ground. And I have enough professional connections, I can start putting myself out there — while still holding down the fort at work.

So, there is hope. And my goal is to earn enough on the side, to be able to afford some travel. That way I don’t have to drive off by myself — I can bring my spouse with me, and we can have a fabulous time. It’s a plan. It’s a bonafide plan.

And rather than wasting my time and energy and risking my neck on danger-seeking types of behavior, I’ll court danger in the form of chasing my dreams and having them come true. Putting my life in danger in questionable situations, and putting it all on the line for my dreams, are the same type of activity. The difference is, one of them will actually have something to show for my risk-taking. The first one… all I get is a system full of adrenaline, a brief burst of clarity, and the potential for things to go really, really wrong in an instant.

So, in a very real sense, my motto continues to be Onward!

After TBI you’re still human

And you still have the same types of interests and desires and needs that you had before your injury/-ies.

You want to be fully engaged. You want to be involved in your life. You want to have hopes and dreams and to follow those hopes and dreams.

Why should any of that change after TBI? Some days, it’s like the world just expects you to stop being interested in the things that mean the most to you — to anyone. Like it should be so easy to let go of the old ways that were so familiar and made you “you“. And you’re just expected to do it. To adjust. To deal with it and move on.

This is something I really struggle with on a regular basis. It’s bad enough that I have to deal with the confusion and disorientation and not feeling quite “here”, half the time. It’s bad enough that I have to think through every friggin’ thing that used to come so easily to me, lest I get hurt or screw something up. It’s bad enough that everything feels like such a CHORE, and even the fun things are hard for me to do, sometimes.

But through all this, I’m expected to do it without any recognition or support. That just sux.

Even my neuropsych isn’t much help to me in this respect, because comparatively speaking, I’m not nearly as “bad” as their other patients. I’m high-functioning. My IQ is still up there. I have a good job and a house and all the trappings of modern success. I’m in a stable marriage of 23 years. I have a bank account and a plan for how to live my life.

What could possibly be wrong?

Yeah, well, I’ll spare you the details. The bottom line is, half the time I feel like crap. I don’t feel like myself. I can’t recognize the person who’s walking around in my shoes, wearing my clothes, doing my job, driving my commuter car to and from work each day, running errands on the weekend. Who IS this person, and how did they get in my life?

Addressing this is so difficult for me. I rarely bring it up with my neuropsych, because they don’t really seem to think it’s that big of a deal, and they don’t seem to think it should impact me. After all, compared to their other patients, I’m doing grand.

Oh, except for flirting with danger on a regular basis, and being totally oblivious to what all could go wrong in an instant.

To be truthful, I have not discussed everything with my neuropsych that I could. Over the years, there have been a lot of things I haven’t brought up, because they are way too upsetting for me, and it’s more important to me that I have a regular conversation with a regular person and be able to relax, instead of plunging into that infinite, bottomless black abyss that takes me over when the emotions run too high. I have to stay functional. I have to hold my sh*t together. I can’t be sitting around spilling my guts, and then getting so freaked out and upset that I can’t even see or walk straight. My neuropsych has seen me overwrought a handful of times, and they don’t seem to understand what all is going on with me. They got exasperated, as though I were not trying.

So, I just don’t go there with them. I keep things positive and talk about the progress I’m making. I don’t have many words to explain the way it feels inside. Plus, when I get to their office, I’m ALL THERE, and nothing else outside the office exists. There are so many pieces of my life that feel like a shambles to me, even though on the surface they look good and they are holding, I don’t have much hope that a strong wind wouldn’t blow them all down. In all honesty, I’m not even sure how they’re holding together. They just are. I’m just lucky, in so many ways.

That, and people are so consumed with their own lives, they don’t notice the chinks in my armor.

It all just feels so precarious.

And it’s a strain. Because I want to have a life I can be proud of. I want a life I actually feel like I choose, and I’m involved in, not just one that other people tell me I should have, so I go ahead and go for it.

So much of my life has been about just getting by… because I was the only one who could see what kind of crap I had to deal with inside. And nobody seemed to take seriously the challenges I had to overcome on a regular basis.

Oh well. I’m still here, and I still have my hopes and dreams to follow. I’m still a human being with my fair share of challenges, and I can’t lose sight of that. It’s all a massive discovery process, and in the meantime I might just learn a useful thing or two.

So long as I don’t get myself killed, chasing danger and risk, to remind myself that I’m alive.

How I can get hurt – again and again

Yeah, I’m a bad-ass alright. Hopefully not a short-lived bad-ass.

I had an interesting conversation with my neuropsych yesterday. I have been wondering about some judgments I’ve made, in the past six months or so, which — at the time — seemed fine… but in retrospect were probably not that smart. At least, that’s what my neuropsych has told me.

About six months ago, I was offered a ride on the back of a motorcycle, and I took it. I had to get somewhere fast, and this rider offered me a lift through a shortcut they knew. This rider (I won’t call them a biker, because I think of Harley’s, and this individual was on a BMW) was a stranger to me, and I had no way of knowing how good a rider they were. I’ve ridden with really bad motorcycle drivers before, and I didn’t care to repeat the experience.

But this individual appeared to be competent, and I hopped on the bike behind them.

For the record, I don’t drive motorcycles — or usually ride them — because of balance issues and attention problems. I can get distracted and lose my presence of mind, which pretty much disqualifies me for driving a motorcycle. It’s a great way to get seriously injured… or killed.

Anyway, the shortcut worked, and I got where I was going in record time. But not before we’d pulled some really dangerous stunts — fitting the motorcycle through very tight spots that were borderline illegal, and weaving in and out of traffic at high speeds. The driver also ended up taking a wrong turn, and we ended up driving around a blind curve directly into oncoming traffic — and the bike stalled on a low barrier and couldn’t move forward or back.

So, I hopped off the back, and while the driver got the bike started, I heaved at the back of the bike and got it off the barrier.

Very exciting. And also very dangerous. And potentially fatal.

Once I got where I was going, I realized how close I’d come to something pretty terrible. And worse yet, I was far from home in a place I wasn’t familiar with, and I’m not sure how I would have gotten help if I needed it.

It all turned out okay, and it was a thrilling ride of my life. But it’s not the sort of thing I should have done at that time.

A few months later, I was traveling (again). Near the end of a really long and tiring drive, I ended up at a rest stop where I realized I was being watched by an individual who looked like trouble. I gave them a wide berth, but later they were joined by another individual who looked equally rough, and they tried to engage me in conversation. Rather than keeping my distance, I walked right up to them, shook their hands, and had an extended conversation with them. In the course of the conversation, one of them identified themself as a known criminal. I didn’t bat an eye, just finished the conversation, and they took off… as though they were up to no good and didn’t want to get caught.

In retrospect, I was setting myself up to get mugged. Big-time. I didn’t… and I actually had a really cool conversation with those two. But was it a good idea for me to interact with these two at a rest stop along an interstate? Doubtful.

Then, the other night, I was driving home from work, and I got caught in a torrential downpour, accompanied by close lightning strikes. I could not see the road. At all. I should have pulled over, but I kept going. I could have easily run into a tree — or run into someone else. I didn’t, but even as I was driving, thinking that I might want to pull over, the urge to keep going was even stronger… overpowering. I got home safe and sound, and after sitting in the car for 5 minutes, the downpour suddenly stopped. Everything was fine. But it might not have been.

On all three of these occasions, I was tired, and I was looking for a “hit” of adrenaline to perk me up. I needed a pump — a jolt — to get me going. It didn’t matter that I was putting myself in danger. The whole point was putting myself in danger. I needed to get my stress hormones going and get myself back online. I felt dull and foggy, and I needed a boost.

So, I put myself directly in harm’s way. It worked — I did get the pump and the jolt I needed. But had things gone differently, I might not have fared so well. For that matter, I might not even be here.

Riding motorcycles is something I should NEVER, EVER do. I know that. I have avoided them like the plague — like I avoid tall ladders. Talking to folks who obviously look like they’re up to no good, and going so far as to shake their hands and “hang out”, is not something I typically do, either. I know better. What’s more, driving my car through conditions when I can’t see more than a foot past the hood ornament… I know WAY better than that.

But reason failed me. In a very big way.

And that’s how I can get hurt – again and again. By actively seeking out danger that makes me feel alive… that makes me feel like myself again… that puts all the pain and confusion and frustration away, for even just a few minutes.

My life tends to feel like a jumbled-up mess of contradictions and conflicts, and it’s hard for me to get any peace. I live in a body whose biochemistry tells me things are WAY more extreme than they really are, and as a result, I usually end up on a roller-coaster of emotion. I know better… but my body doesn’t get it. And it wears me out. Mentally and cognitively, my brain loves to do its own thing and not stick with the program. I’ve been forgetting a lot of things, and I’ve been coming up short, now and then, with projects I’ve been working on… playing catch-up and all that. I keep cool and maintain calm on the outside, but inside it’s sometimes pretty chaotic and frustrating and a little bit terrifying now and then.

So on the inside, I’ve got all these experiences of chaos and confusion and frustration, while on the outside, everything is supposedly okay. I know I’m not the only one who has this — most people do, probably. That whole “living lives of quiet desperation” thing that a philosopher once talked about.

That tires me out. And the quickest and most reliable way I know to stay “with it” is to add a little danger to my life. Or a lot of danger.

Looking back, I can see how almost all of my injuries — even from fairly young — came from this danger-seeking streak of mine. I put myself in dangerous situations. I also pushed myself to unsafe levels of play in football and soccer games. I drove while I was tired, and I pushed myself to do things when I should have stopped and rested. I needed the pump, I needed the adrenaline. I needed the shot of instant clarity, in the midst of all the confusion and static in my head, that I just couldn’t sort through.

I didn’t have a death wish. I had a life wish. And the one way I could really truly live my life, was to push myself past a certain point, and get lifted up by the pump.

I know I need to change this sort of behavior. It’s caused problems for me before, in subtle ways, and it’s doing it again. I don’t want to stop being the person I am. I don’t want to cower in a corner, hiding from life. But I would like to live to see another day. I’ll have to figure out something better, for how to get what I need to be as alive as I can be.

If I don’t manage to figure that out, all bets are off.

What our denial is costing us

It’s not like we can’t see the signs

I’ve been thinking a lot about The Crash Reel, lately, especially thinking about the parents of Kevin Pearce and how they handled his accident and brain injury and recovery. One of the things that stands out in sharp relief for me is how silent his mother is, as she watches her son suffer and struggle. When he’s sitting with the doctor, telling him about how he thinks he should just go out and start snowboarding again… when he announces at a family dinner that he’s looking forward to getting back on the snow… his mother is silent. Sitting quietly in pain, having aged a great deal over the past year, and not speaking up on camera to set him straight.

I know it’s heresy to be critical of parents — especially those who have children who are struggling with a disability or recovery of some kind. It is a parent’s worst nightmare to see their beloved child injured so horribly, even killed. At the same time, parents are one of the most available lines of defense against action sports TBI, and when they don’t step in to stop dangerous behavior, I really feel for the kids who end up suffering as a result.

The kids literally do not know better. Their brains have not properly developed enough to be able to make good decisions. And parents who just leave all the decisions up to them may actually be inviting danger and disaster into their families.

On the other hand, no parent can own or control their child forever, and accidents do happen, no matter what sport you play. Even if you’re not playing a sport, accidents happen. TBI happens. No amount of good parenting will erase that chance 100%.

There are many other pieces to the TBI puzzle, especially when action sports are considered. There’s the X-Games atmosphere of daredevil stunts, the constant push to exceed your (and others’) limits, the steady pump of adrenaline that makes us feel alive — and makes some of us feel like we’re human again.

That adrenaline pump, the flow of dopamine when you accomplish something fantastic, the numbing of pain that all the fight-flight stress hormones make possible… it’s not just an addiction, which people simply dismiss. For some of us, it’s a non-negotiable part of who we are, and without it we are just shells of who we know ourselves to be.

I spent the last week deliberately resting, and man, at some times it was hell. Boring. Dull. Dampened. Blah. Booooorrrrinnnngggg.  I knew I needed to rest. I knew I needed to catch up on my sleep, and it was all good, when I finally got to a place where I actually felt rested. But that persistent sense of being so dull and dim and low-level was extremely difficult to take. And I’m not even an extreme sports athlete.

Imagine how it must feel for someone to go from the thrill and elation of successfully completing a difficult ride down the slopes… to being laid up, forced to rest and recuperate and “take it easy”. Yeah, sheer hell.

It’s the denial of this part of our lives that is the most dangerous, I think. Because we deny that we need that rush, the challenges that test our limits in real life, we don’t get the stimulation we genuinely need, and we live lives that are far less … alive … than they should be. We try to reduce danger at every turn, avoiding uncomfortable situations and everyday challenges, in hopes of having some sense of security. But in the process, we starve our systems of the important challenges and tests that make us more of who we are. We stunt our growth, and we know it harms us. But we are still so convinced that somehow, some way, we can be safe and secure.

In a way, our hunger for safety and security is the worst thing we could possibly indulge. It makes us less than who we could be, and it denies us the necessary genuine risk that fine-tunes our systems and makes us better at being who we are.

But we can’t be deprived forever. As I said, part of us knows the constant risk avoidance is not doing us any favors. So, we seek out artificial challenges that we think we can control ourselves — like extreme sports, velocity sports, collision sports. The worst is when we ask others to vicariously seek out those challenges for us — NFL football players, extreme athletes, and all sorts of danger-seekers we reward with adulation and praise for doing things we could never do ourselves — and which might actually permanently maim or kill them, right before our voyeuristic eyes.

We need action. We need excitement. We need risk. There’s no point in denying it. Our brains and bodies are finely tuned to handle risk and excitement, and if we can’t get it in a healthy way, we will get it in an unhealthy way.

So why not exercise and develop that part of ourselves — safely?

When I say “safely”, I mean without putting our lives and limbs in direct danger — within the context of our everyday lives, taking on challenges that others so frequently flee. Countless “dangerous” situations present themselves to us each day, which we could pursue, and make our lives better in the process. Things like

  • Speaking up and telling the truth about what’s going on around us.
  • Refusing to play along when a bully shows up and demands that you join in their “game” of ridiculing or bullying others.
  • Taking a long, hard look at yourself and admitting what’s really there — and taking steps to address the things you’re not so happy about.
  • Following your dreams, once and for all, and damn the torpedoes or what anyone else has to say about it.

Those are just a few examples of the real risks in life, and those are the ones that get lost in the shuffle. I’ve been seeing a lot of trailers for the “Secret Life of Walter Mitty” movie, lately, and just from what I’ve seen, it seems like old Walter is doing just what I’ve described — replacing the challenges and dangers and risks of everyday life with extreme situations that give him that necessary pump of adrenaline and dopamine that makes him fully human. Fortunately or unfortunately, I suspect the movie concludes with him coming out safe and sound, with no TBIs or other disasters ripping his life apart. Yet more denial? {sigh}

The Walter Mitty story seems not so far removed from the story of sheltered kids taking up extreme sports to supply their brains and bodies with the biochemical pump they need to develop properly. Of course — full disclosure — I haven’t seen the movie yet, so it may turn out to be a good one. I do know the original story behind the movie, so I can speak to it a bit. I’ll have to check out the movie for sure — but on DVD later. I’m not going into a movie theater filled with people who are talking and texting and coughing all over me.

Anyway, that’s my little discourse on denial and its role in producing one TBI after another. We are all culpable, when it comes to cases like Kevin Pearce

  • those who let him take up extreme sports,
  • those who encouraged him,
  • those who rewarded him,
  • those who profited from him,
  • those who continue to urge him back on the slopes to do yet more dangerous stunts,
  • and those who sit by quietly not speaking up when the danger is so apparent, so obvious.

The crazy thing is, this keeps happening every single day, and yet we sit by silently and say and do nothing about it.

Makes no sense. I think we all need to get our heads examined.

Change it up

How easy it is, to fall into a rut.

Day in and day out, I have pretty much the same routine, and part of me likes it. I get up, I exercise, I have my breakfast, I go to work, I come home, make supper, watch some television or read or do some work, and then I go to bed. In between, I may stretch or take a walk or do some sort of additional exercise. I’ll also check my email periodically and have a cup of coffee and a snack in the afternoon to keep me going.

Each day, it’s pretty much the same. Even on the weekends, my routine doesn’t change much. It’s great for keeping myself on track with a consistent, reliable schedule. And it makes me quite reliable, as well. I often have so much going on in my life, I don’t have a lot of leeway to stray from my path. That makes me a valuable employee, a responsible spouse, and a solid community member.

It also represents a bit of a change from how I used to live my life, when each day was a new form of improvisation, and I really didn’t have much routine at all. When I was much younger, I drifted from job to job, relationship to relationship, state to state, country to country, residence to residence, a bohemian vagabond who was more interested in the experience of living, than actually accomplishing anything.

Then I got all respectable and what-not. I got a real job. I settled down with a partner. I had responsibilities. And I changed how I did things, becoming responsible to a fault — rigid and regimented and not very flexible at all.

I went from one extreme to another. It wasn’t all bad. It made a lot possible for me that had eluded me for years — a steady income, a (somewhat) predictable career path, respect from people around me, a higher standard of living.

But I’m starting to feel antsy again. Sometimes it’s nice to change things up a little bit, and I’m beginning to feel the pull of change. I guess working in technology for the past 20 years, I’ve sort of become dependent on constant change — I expect it, I’ve acclimated to it, as things are never static for long in the technology field.

The trick now is to introduce some change into my life that doesn’t derail everything I’ve accomplished. My job history is dotted with relatively brief (12-18 months) positions that focused on one thing, then I “traded up’ to something else. I’m not sure I want to do that. I need a change. I crave a change. But I need to find somewhere to have healthy change — not destructive change.

In the past, I’ve been all too quick to just cut and run, when things got too familiar, or too comfortable, or downright easy. I need things to be challenging, and it’s always been tough to find regular challenge that can last. Especially when I’m working in environments that are geared towards standardizing everything and making things as predictable and as “safe” as possible.

I suck at safe. It’s just not me. But being a danger-seeking adventurer doesn’t go over that well in the corporate world.

I need change, and I need it on a regular basis. But I’m also realistic. Looking at my life, I don’t really want to get rid of my routine — it makes my daily life possible in ways that a hectic, constantly changing and shifting series of distractions can never do. But I do want to change some things about my routine. Like the exercise I do, first thing. For about a year, I did the same exercises — lifting free weights in the same kinds of sets, in the same sequence — and I never deviated from that.

Which is fine. If that’s all I wanted to do. But I found that it had all become quite rote and, well, boring. And it wasn’t waking me up quite the way it used to. I guess I’d gotten too acclimated, and I didn’t actually need to work at it anymore — which is the whole point of my exercises, first thing — to work out and wake myself up in the process.

So, I switched up the weights I was using and went heavier. I also changed the number of repetitions in each set.

I also moved away from doing ONLY weights, and I started doing more full-range movement, to strengthen and stretch more of me, not just isolated muscle groups. I started doing a bit of yoga, following along with some videos I found.

The overall results have been good, I’m happy to report.I feel more awake and more “with it,” thanks to this shift in how I’m starting my day. I feel more energized, actually, with these small alterations in my routine. I still have the structure of the routine to get me into my day, but I have some leeway in the midst of it all to perk things up a bit. I can have the best of both worlds – a regular routine that gets me into the day, along with some variety to keep me interested and engaged.

The same thing holds true for my work at my day job. I’ve pretty much “got it down,” after nearly a year of some pretty arduous efforts. Now I need to keep with it and build on what I’ve got, rather than running off to find some other way to keep my attention trained on what it is I’m doing. I need to watch my energy, that’s for sure, and not wear myself out. But I also need to keep active and not let myself fall into the trap of getting bored… and then getting in trouble.

It sounds odd to hear myself saying this. At my age, one would think I have more sense and more stability than to be debating this, but it’s a lifelong habit of cutting and running that I have to overcome. It’s taken me three years of regular rehab — talking with someone who understands my cognitive issues within the context of my history of TBIs — but I’m finally at the point where I realize that I don’t have to completely trash my life, in order to stay engaged.

Actually, on a deeper level there’s something important going on — I’m finally at the point where I (at long last) realize that I’ve been trashing my life to stay engaged, all along. I never realized that, till I learned about how TBI and neurology affect attention and distraction and resistance to interference, that seeking out drama and “refreshed” situations (read, new jobs, new friends, new homes, new… everything) was my way of keeping myself alive and involved in my life.

It’s not that I deliberately want to sabotage myself, or that I don’t think I deserve to have success in the long term. People have told me that story about myself for as long as I can remember. They’ve told me the following:

  • You’re a quitter.
  • You don’t have what it takes to get the job done.
  • You’re not up to the task – it’s too hard for you.
  • You’re trying to sabotage yourself/the group/the job for some deep-seated psychological reason.
  • You don’t think you deserve success.
  • You just can’t.

In fact, the exact opposite was true in many cases.

  • I wasn’t a quitter – I had a really hard time holding my attention on tasks that were easy, and I didn’t know I had that problem, so I could never address it.
  • I did have what it takes to get the job done – in fact, I had more than enough, but the easier the task got, the harder it was for me to concentrate.
  • I was up to the task – it was actually too easy for me.
  • I wasn’t trying to sabotage yourself/the group/the job for some deep-seated psychological reason – it was a neurological and physiological combination of compromised attention, susceptibility to distraction, and anxiety that set in when things started to go wrong.
  • I didn’t start out thinking I didn’t deserve success – but after so many failures and aborted attempts, I started to believe it.
  • I could — I just couldn’t see what my issues were, so I couldn’t deal with them.

As a matter of fact, many of the “decisions” I have made to either “give up” or “start fresh” were not conscious decisions at all. They were impulses driven by a serious need for alertness and attention — which was physiologically compromised by my neurology, and which I could only get back through changing up things, when they got familiar and comfortable and I was approaching mastery.

The easier things got for me, the less I paid attention, and then things started to fall apart. When things started to fall apart, I would get anxious, wondering why the hell things were starting to go south — and that anxiety and worry would further encroach on my already limited attentional capacity. I would start making choices that stressed me out, and because I thrive on a moderate dose of stress hormones, I would keep that up, gradually exhausting myself and burning myself out and endangering my working relationships.

The downward cycle would commence. And keep going. Until I was out looking for another job.

I would go looking for something else that wasn’t familiar — I’d wander off in search of more excitement that didn’t involve the situation I was fleeing. I told myself I wanted another adventure. It wasn’t that I needed to trash my life — I just couldn’t think as well as I wanted to, anymore, in those old familiar surroundings. I couldn’t function as well as I desired, and that made me very anxious and complicated everything all the more.

In a way, the easier things got for me, the harder it was for me to stay.

So, I didn’t.

Now, here I am at a job I really like, with people I really like, in an industry that’s actually stable and growing. I’ve got it really good. They like me, too. There’s absolutely no reason I should leave. So, I need to find ways to keep myself alert and engaged and attentive. Focused. Intact.

My TBIs have trashed my life often enough in the past. Time to change things up. For the better.

When getting hurt feels good

Hurt doesn't always hurt

I’m back from vacation, and I’m already starting to feel over-taxed. Time to get out in front of what I’m doing and take command of my days, my time, my energy. Most important of all,  I need to not get down on myself, thinking there’s something wrong with me, because I can’t “keep up” with everything going on. I have more stringent definitions of what “keeping up” is all about, anyway, so I need to give myself a break and be a bit easier on myself.

I’m doing great. I really am. I’ve been getting great reviews at work, and I have a really good feeling about this year. We’re already through the first quarter, and we’re moving on. Just gotta keep moving on…

One thing I noticed – again – is that I tend to push myself harder than I should. It’s partly because I have high standards, it’s partly because I have this perpetual sense that I’m falling behind, and it’s partly because I really dig the feeling of pushing myself really hard — even to the point where I’m hurting myself. I’ll stay up too late, take on too many tasks, drive myself onward-onward and feel the effects of it, day in and day out, till I crash. But I won’t stop.

I did this when I was younger, too. When I played sports, I would just push myself and push myself and push myself, playing through many injuries, including head injuries. It didn’t help that I had pre-existing concussions by the time I got to high school and started playing organized sports. I think, in fact, it contributed to my willingness/eagerness to play through injuries. Definitely, having the prior concussions contributed to the impact of the ones I sustained in high school. They made the actual injuries worse, and they made my responses to them less intelligent and more stubborn and non-compliant.

Why?

Am I innately self-destructive? No, I’m not.

Do I want to hurt myself? Did I have a deathwish, back when I was younger? No, that’s not it.

Do I disrespect myself and think poorly of myself, so I have to be punished for some terrible thing I think I”ve done? Sometimes I feel that way, but not all the time.

So, why do I do it? Why do I push myself hard (and crash hard, too) when I know it has a negative effect on me and my world.

Because as much as I intellectually know it bodes ill for the rest of my life, the simple fact is, it feels really good to push through, to play through, to keep going.

This comes back, yet again to the energy/focus/analgesic stress idea that’s been on my mind a lot, over the past years. It has to do with the calming effects of stress hormones, the way they help block out all extraneous details and simplify things for me. It has to do with the pain-deadening effects of the biochemical cascade that comes online when you’re in high-pressure, dangerous, high-stress situations. It has to do with the rush and the chill that comes from extreme living.

It has to do with pain and trouble introducing a relief of some kind, and how I instinctively seek that out.

It’s not that I want to harm myself with stress and pain. I actually want to help myself. Because the pain and fatigue and confusion of so many stimuli coming up — when I’m fatigued, I become even more sensitive, and my hearing, sense of smell and touch, and eyesight all become amplified, picking up every little thing. It’s painful and confusing, and I just want it to stop.

So, I push myself. I push myself through the work I’m doing. I push myself to get up earlier, to stay up later, to take on more tasks, and I overwhelm myself.

On purpose.

Not because I want to hurt myself, but because I want to help myself. And the stress hormones do just that. The adrenaline I get pumping, the intense focus I bring, the ability to shut everything out, just to focus on one individual task or experience at a time… it gives me a huge amount of relief. Relief from the aches and pains and sore tightness in my joints and muscles. Relief from the fog that sets in from having so many responsibilities going on that I lose track of. Relief from my insecurities about being able to get anything done at all.

Just relief.

And that’s a problem. It’s always been a problem, for as long as I can remember. As far as I’m concerned, this need — real, physical, logistical (NOT psychological) need — to plunge into stressful situations — has been at the root of many of my issues over the years. I can very easily see how it has fed my behavior issues, my distractability, my inability to complete things, my restlessness and inability to stay the course over so many years before I got started with rehab. Contrary to what many psychologists will say, I’m convinced (from my own personal experience) that it’s NOT a psychological choice to “sabotage” myself — that’s not it at all. It’s a real physical, logistical need that’s borne of neurological conditions, not psychological ones.

And to think that for so many years, I was convinced that there was something wrong with my psychology, that I was suffering from low self-esteem, that I was self-destructive, that I was somehow psychologically impaired, when all along, there were fundamental underlying neurological and biochemical reasons for my behavior and choices.

It makes me a little nuts, to think of all the years I spent feeling psychologically impaired because of misunderstood neurological conditions. But at least I’m aware of the true nature of my issues now. And that’s half the battle, right there.

If I can get some rest, step back, take another look at how I’m living my life, and make some choices that I want to make about how I want to live my life, rather than having them be made for me by reflex or reaction, drive by others’ agendas, that will be good. I’m doing that now. I’m looking at my pain levels, my sleeping issues (I’ve started lying down on the couch earlier in the evening and just going to sleep for a while when I’m tired, so I’m less exhausted when I actually go to bed – and I can actually GET to bed), my daily routine… I’m looking at it all.

Vacation was good, but it didn’t solve everything. But at least it gave me a little more rest and some distance to contemplate what it is I’m doing with myself and why/how I want to do it all.

Which is good.

Getting hurt isn’t the only thing that feels good. Sometimes getting things right feels pretty awesome, too.

I just need to make a point of focusing on that.

And find yet more replacements for the kinds of activities that give me that huge rush — the rush I don’t just crave, but can’t live without.

TBI SoS – Restoring a Sense of Self after Traumatic Brain Injury – The Things We Do for Our Selves

This is the fifth part in a multi-part exploration of sense of self and how it’s affected by traumatic brain injury. Read the other sections here.

Note: I am currently writing a full-length work on Restoring a Sense Of Self after TBI, and I am posting the sections here as I write them (click here to go there now).

The Things We Do for Our Selves

Okay, down to brass tacks. I’ve talked a bit about the abstract, theoretical reasons why Self Matters to TBI survivors. I’ve talked about how it’s critical to have, so that we can continue the work of our recovery, and just living our day-to-day lives. I’ve talked about how we need it, to be part of a community and share our lives with the people we love and need.

Now I want to to talk about the importance of restoring strong sense of self in terms of the negative impact it can have on us, when we don’t have a strong sense — and the not-so-great things we’ll do to strengthen it. And I want to talk about it in terms of physiology, as well as psychology. The physical aspects of a disrupted sense of self are, I believe, key contributors to mood disorders, behavior problems, poor choice-making, and the kinds of risk-taking activities that can not only get us in trouble socially, but can get us brain-injured all over again. I would even go so far as to say that a damaged sense of self is one of the prime motivators that compels injured folks to engage in activities which almost guaranteed to injure them all over again. And if people tasked (officially or informally) with responding to head injuries/concussions — such as coaches, athletic trainers, teachers, doctors, family members, co-workers and employers — don’t address these core issues, the chances of the brain-injured individual putting themself in harm’s way can be pretty high.

See, here’s the thing…  Let’s take a student athlete for example — a junior in high school on the football team. (I’ll call him Junior.) Suppose Junior has been having a difficult time — in school and in life. Like most kids, he’s a bit confused about life. His body is going through changes, and socially he feels inept. He’s had a couple of girlfriends, but he can’t seem to keep them for long. His friends all seem to have girlfriends, and he’s worried about his sexuality. The last thing he wants, is to be “queer” but girls don’t seem very interested in him, and it always feels like such an obstacle course, anytime he has to interact with them.

He’s a good football player, a really capable offensive guard on first string, but it’s the quarterback, tight end, and the wide receiver who get all the attention and glory. His dad isn’t around much, and when he is around, he’s pretty rough on Junior, who gets good grades — but his dad hardly notices. His football coach is the closest thing to a real “Dad” he has, and he really seems to care about Junior and how he’s doing in school and on the gridiron. The trainer and everybody else on the team are like extended family, and the only time he really feels like “himself” is when he’s playing football, practicing, spending time with the team. When football is out of season, there’s not much left for him to do. He’s got a job as a night manager at a local department store, and he’s active in local charity work, but there’s nothing like the feeling of being part of the team. He and his football buddies hang out in the off-season, working out at the gym and following the NFL season all winter long.

Then one day Junior gets hurt in a critical game. A teammate’s knee catches him on the temple, and he goes down briefly. Everything goes a little dim and quiet, then “the lights come back on” and he sees his buddies standing over him, asking him if he’s okay. They seem genuinely concerned — but more about continuing the game. Not wanting to be a wuss and let his team down, Junior jumps up, says he’s okay, tightens his chinstrap, and jogs back to the huddle. He sorta kinda hears what the next play is, but when he’s getting set to go, he’s not really sure what he’s supposed to do, exactly.

So, he just does his thing, blocking and tackling. When the ball changes hands and he heads off the field, the coach and trainer look at him strangely, like there’s something wrong with him. But he gets a drink of Gatorade and sits down, like there’s nothing wrong. When it’s time to get back in the game, he jumps up and hustles out on the field ahead of everyone.

But he’s still not playing 100%. It’s becoming more and more apparent. His reaction time is slowed, he’s clumsy and misses blocks and tackles, and he has a few more hard falls that leave him dizzy and disoriented when he gets up. Junior struggles to understand what’s being said in the huddle, and if he didn’t have other players around him to cue off of, he’d have no idea what to do with himself out there. He’s bound and determined to stay in the game, however. It’s who he is. It’s what he does. He might not be the biggest star on the team, but he’s an integral part of the offense, and he can’t let his team down.

Next time the ball changes hands and he heads to the sidelines, he can see his coach and trainers looking at him with real concern. The trainer comes over and asks him a few questions. When he replies, the trainer tells him he’s got to sit out the rest of the game. They didn’t see him get hit, but he sure as hell acting like he got his bell rung, and he’s not 100%. He’s done a good job, the trainer tells him, but he’s got to sit out the rest of the game.

Junior is devastated. The men he looks up to, who are just about the only reliable father figures in his life, are doubting his ability to play. He’s letting them down. His teammates ask him how he’s doing, when they hear he’s benched, and he shrugs it off and tells them that somebody else needs a chance to get in the game. Watching from the sidelines, as his team advances down the field to win, he cheers along with the rest of the team and celebrates their victory. But he’s not feeling completely “there” and the celebration feels weirdly remote to him.

In the locker room afterwards, he finds that the lights overhead and the loud echoes of cheering, roughhousing teammates are more than he can take. He puts a towel over his head and tries to shut his ears, but he can’t get away from the lights and the noise. The trainer comes over and tells him he needs to see a doctor, because he might have had a concussion. Then the trainer calls his mom to warn her. His dad isn’t home — he’s traveling for business. And instead of being one of the jubilant players who helped his team to victory, he’s now a mama’s boy who’s pushed to the margins and can’t be part of the celebration.

The only good thing about this, is that his dad isn’t around to give him shit about being getting hurt and being a wuss who couldn’t suck it up.

The doctor visit results in the worst news possible : CONCUSSION. “Probably a mild one,” his doctor says, but Junior wonders what’s so mild about this killer headache, confusion, fatigue, and inability to deal with light and noise. The doctor prescribes complete rest for a week — no television, no reading, no activity of ANY kind, including physical activity. Definitely no football. Not till his symptoms clear.

Junior sits it out. He stays home from school, chafing under the change to his daily routine and the loss of his friends around him. Some of his teammates come over to the house to visit, but he’s so tired, he can’t spend much time with them. His symptoms don’t seem to be going away, no matter how much he rests. He’s going out of his mind, climbing out of his skin, and he can’t seem to get his bearings. He feels slow and stupid. Dense. Retarded.

He’s not himself, and the tenuous hold he had on his evolving identity, is slowly slipping away. His friend are all busy doing what they do, and his team has moved on to post-season play, with a chance at the championship. He tries to adjust to things, tries to stay positive and up-beat, but without football and without being part of his team as an active member, he feels like he’s been set adrift on a raft in a vast sea, as all the other boats sail right past him and leave him in the dust.

Junior starts hanging around with the wrong crowd. They’re the pot-heads and partiers who hang out after school at a playground not far from his house. He’s not going to football practice, and his buddies don’t know what to do with him, but he needs some sort of social interaction. Those “losers” he used to laugh at are now the only people who actually make time for him. When he’s hanging around with them, nobody cares if he’s stupid or slow. All that matters is that he drinks and smokes pot and hangs out with them.

That’s easy enough to do. And his new friends realize that this clean-cut football player dude would probably do a pretty good job of getting hold of some beer for them on the weekends. He looks respectable, and with a fake id, he could probably pass for 21, if the light in the bar is dark enough and his id is good enough. They hook him up with a fake id, and drive him out to a bar a few towns over. They drop him off and tell him they’ll circle the block and pick up him up with the sixpack of beer he’s supposed to buy.

Junior takes a deep breath and steps into the bar. It’s smoky and dark and he’s never done this before. He’s also scared shitless, as he approaches the bar, and when he produces his id, his hands are shaking a little from all the adrenaline in his system. As he fakes his way through purchasing “a six” suddenly all the fogginess disappears. As the adrenaline rushes through his veins, he feels a clarity and a focus that he hasn’t felt in months. Suddenly, all of his senses are ON. He’s not dense, and he’s not retarded. He finds himself actually able to carry on a conversation with the man behind the counter, who is clearly skeptical about his age, but begrudgingly sells him a six-pack.

Feigning nonchalance, Junior tucks the six under his arm and saunters out to the street, where his friends are just now coming by to pick him up. Beneath his casual veneer, he’s feeling more alive than he can remember feeling in a very long time.

Jubilation! He did it! They drink the six-pack while driving around on back roads, and for the first time in a long time, Junior feels like he actually achieved something useful. He’s part of a team again, and the adrenaline rush, the focus, the intensity of it all… well, it feels a little like old times. Except this time, it’s real-life, not just on a football field.

This time, too, the payoff is a buzz from the beer, on top of the adrenaline — and by the time his buddies drop him off at home, he’s feeling more normal than he has in a long, long time. In real time, it’s only been a few months of feeling “off”; in teen years, it’s been half a lifetime.

But now he’s back.

You can probably imagine the continuing scenario. Junior’s initial success at buying beer for his buddies continues. He hones his technique, learns the best places to buy booze, and he pushes the envelope, working his way up to buying cases. When the local bar owners catch on and stop selling to him, he finds older guys who will buy for him, and they exchange money and goods at the back loading dock at his work. The thrill of buying from someone else hardly does it for him, however, so he takes up reselling to others, playing middle-man in an informal network of underage drinkers. He expands ihs business into drugs, including some pot and some speed, but he steers clear of the really hard stuff.

With the extra money he makes, he buys himself a nice, fast car, and he starts to rack up speeding tickets. The only thing that keeps him from losing the car is his graduation and moving out of his parents’ house to go to a college (that he barely got into) several states away. His grades never did recover fully after he was benched, and he never did get back into football. His symptoms just lasted too long, and by the time they subsided, he was too entrenched in the party life to give a shit about football or any of those jocks he used to hang out with. He got a new life — one that was almost as full of comaraderie and excitement as his football life — but that got him money and, in some ways, more thrills.

In college, the drinking and drug scene is much more pronounced, but enforcement is a lot more regular, so the thrill of peddling controlled substances disappears. If nothing else, Junior is practical. Plus, he meets up with some guys who are into extreme sports — bungie jumping, rock climbing, backwoods mountain biking, windsurfing, waterskiing, and even skydiving. He gets active again, gets back in shape, and has a new bunch of friends who like to party as much as they like to push the envelope with extreme sports. Once again, he’s part of a team, part of a cohesive bunch of compadres who — much more than was ever true in high school — rely on each other intensely, sometimes for life and death.

Junior does okay in school. Not stellar, but not flunking out. He’s sure he’ll graduate and be able to get on with his life.

The only problem is, he keeps getting hurt. Not big injuries, mind you, but little things. Little stupid things. Like wiping out during waterskiing and messing up his neck and back. Like getting dumped off his board while windsurfing. Like taking some spills while mountain biking and falling a few times while rock climbing. His buddies tease him about it, and he fights like crazy to get back after the injuries. But each time, it feels like a little more of him goes missing. He has a hard time concentrating. He has trouble with lights and noise. He loses his temper a lot. He can’t seem to hold his liquor like he used to. He gets in fights, too. His buddies stay pretty steady with him, they watch his back, and he does manage to keep up. But still, something just doesn’t feel right.

So, he pushes even harder, putting himself in more and more dangerous circumstances to get that rush, that focus, that intensity that keeps him PRESENT as nothing else can. When he’s dull and dense, he feels so stupid, so useless, and he hates feeling that way. That’s not him. It’s not who he is. But when he’s standing at the open door of the airplane with his parachute strapped on, looking down at the earth below… well, it’s magic. And as he’s hurtling through the air, finally — at last — he feels like himself again.

From here, the story could go in just about any direction. Junior could be killed in an accident. Or he could be arrested for assault or manslaughter, repeat the offenses while drunk or high, and spend much of his life in prison. He could experience a religious conversion and turn his life around with the help of his church. He could meet a good woman who gets him back on track. He could find work as a stuntman and do well for himself. Or he could end up unemployable and on the streets with a drug/drinking problem and dementia from all the hits he’s taken.

Anything is possible. Any outcome — good or bad — is as likely as any other. But even knowing he could “fix” the problems to some extent won’t change the fact that losing his connection to his emerging identity when he was in high school scrwed him up. It took him on a detour that separated him from the things that mattered most to him — the things that helped him define who and what he was. And the only way out of that detour, was a massive adrenaline rush that blocked out all the confusion, sharpened his senses and made him feel like he was back.

See, here’s the thing — traumatic brain injury, concussion, head injury, whatever you want to call it, can cause the processing in your brain to slow significantly. And you may not even realize it, a lot of the time. When I had my neuropsych eval and the results for my processing came back signfiicantly slower than I thought they “should be” it was pretty devastating to me. BUT it suddenly made a lot of things make sense. Especially when I looked at how I got myself back to feeling “up to speed”.

Like Junior, I was hurt in a high school football episode (though mine was a lot more informal). I was also hurt in a soccer game. For all I know, I could have been hurt playing baseball, too — I just don’t remember any specific instances. And I spent a whole lot of time over the years looking for ways to pump up my adrenaline and feel like I was up to speed again. Slowing down when you want to go faster can be devastating for a teenager, and the last thing you can do is ask for help because you don’t want to look bad or seem “retarded.” I also spent a lot of time with the party crowd, driving back roads on many a night, looking for booze and smoking weed. Did I like the people I was partying with? Not always. But they accepted me for who I was, and they also stuck together when we were out on beer runs. We had that comaraderie I missed when I was out of sports. I managed to keep myself in games, even after I got hurt (people didn’t know much about concussion back then), but when the seasons were over, and the teams had all dispersed, who was I and what did I have to live for? I wasn’t entirely sure.

Now, over the years after high school, I did manage to get on with my life. I went to college (had four years, but didn’t manage to graduate), and I went on to find jobs and build a life I could be proud of. But that nagging sense of having lost part of myself never truly went away. And after each successive injury — the car accidents and the falls — I felt like I lost a little more of myself. I would build back… but then I’d get hurt again.

And to compensate, to make up for things and develop some sense of myself as a unique individual, I worked my ass off in just about every area of my life. I also got in the habit of pushing the envelope — taking risks, courting danger, doing things that no sane person would do (like buying a one-way ticket to Europe without any clue how I would get back). I went head-to-head with the law. I got myself in trouble (restraining order and all).  I ran around with edgy people who could have gotten me killed.

Those risk-taking, danger-seeking activities made me feel so ALIVE. So together. So with it. When I was high on adrenaline, hopped up on stress hormones, all the pains and distractions of my life disappeared. They just faded away, blocked out by the biochemistry in my brain and body. Going head-to-head with a crazy dude who lived in my apartment building might have been stupid, dangerous, and self-destructive, but when I was doing it, I felt so… “normal”. I actually felt like myself. And as bone-headed as it was to start shouting at a police officer, when I was yelling, I felt more like myself than I had in weeks.

Those kinds of activities, lame-brained as they were, offered me something that no amount of good sense could — a biochemical pump that got my brain moving at a rate of speed that made me feel like a regular person. When I wasn’t pushing the envelope, I felt so dumb, so dense, so useless. I often still do.

But as helpful as these adrenaline-producing activities hav been, they have also stressed and fatigued me and set me up, biochemically, for a TBI-induced case of PTSD that’s far less “serious” than, say, a case induced by war or other violent trauma, but still had an impact. Years and years of working-working-working to get myself pumped and moving at a speed that makes me comfortable, jammed my sympathetic nervous system in permanent high gear, like a runaway Prius, to the point where up until a few years ago, the idea of relaxing was so foreign to me, I had decided that there was no good reason for me to bother with doing that.

And I’ve had to train myself to relax. Seriously.

In terms of my overall life, I have to say that TBI and PTSD have walked hand-in-hand, and my constantly revved state contributed directly to my fall in 2004, which nearly derailed my life and cost me everything. Jammed in permanent high gear (in part because of lacking a clear sense of who I was and what place I have in the world), I was overly tired and not paying attention when I was standing at the top of those stairs. Down I went. BANG-BANG-BANG went my head. And my life turned to shit.

Had I not been injured in high school, would I have made it through in one piece? Who can say? I’d already had several concussions prior to high school, and I had already developed a lot of difficulties with behavior and choice-making. Hell, I was getting in TBI-related trouble when I was 12. So, I can’t lay it all at the feet of the sports concussions. But I suspect that if I hadn’t had those injuries and hadn’t lost touch (in the off-season) with the identity that sports gave me, I might have had a fighting chance to get myself on the good foot and form a better foundation for the rest of my life.

Obviously, there’s no way to tell how things might have gone. But we sure as hell can see how things CAN go, after a traumatic brain injury. It’s never too late to turn things around, but losing your sense of self can certainly do a job on a young — or older — brain and send you down a path that it would be better if you avoided.

This ends the fifth part in a multi-part exploration of sense of self and how it’s affected by traumatic brain injury. Read the other sections here. More to come…

Extreme Sports… Extreme Living… Extreme Dying

I’ve been thinking a lot about extreme sports and TBI, of late. Just this past week, Nodar Kumaritashvili, a Georgian luger, died on the Whistler track in Vancouver during an Olympic training run. I watched a graphic video of it on CBSnews.com, and it’s pretty wrenching. He lost his sled in a turn, flew off, and went into a pole.

I have heard it said that he was relativley inexperienced. I have also read that he told his father he was terrified of the track. And I’ve read discussion and debates about how lugers and other winter athletes know the risks, but they choose to focus on the goals, the rewards, the prizes that come from winning. If they give into fear or they hesitate, all may be lost.

At the same time, I’ve been reading a bit about Kevin Pearce, the snowboarder who sustained a traumatic brain injury on a halfpipe during a training run. ESPN’s headline seemed to downplay the injury — Pearce hurts head training on halfpipe. Other news told a more sobering story — critical condition… moved to a brain injury hospital in Denver, where he’s making better progress than expected, actually walking and responding.

Only folks who understand the impact of TBI — more than what many folks think of as “just a concussion”… more than “just” a bump on the head — will fully appreciate how much progress Pearce actually is making. Most folks may very well wonder what the big deal is. If Pearce is doing that well, yes, he is making amazing progress. It probably helps that he’s an athlete.

Over the past holidays, one of my nephews had a fall from about 6 feet up. He landed hard and was addled afterwards. I wasn’t there to see it happen. And everyone else who was there just let it slide. According to my nephew, he’s had about 12 concussions. He’s into extreme sports. He skateboards and is an all-out outdoor enthusiast. He’s a great kid — kind and soft-spoken and quite polite. His mom has done a great job with him, I have to say.

But I worry about him. I wonder about him. He’s fine now, but what about in the future?

I look back on myself at his age — 13 and rarin’ to go. Immortal, as far as I was concerned. Untroubled by hard falls and spills and being knocked silly, every now and then. I played hard and fast, and I didn’t follow instructions about being careful. That was for sissies. Wusses. I had a game to play, a goal to reach, and nothing — no timidity, no fear, no trepidation, no namby-pamby wuss — was going to hold me back.

And I think about the concussion prevention/management legislation that’s been proposed in multiple states — some of it requiring medical clearance before kids who have head injuries are allowed to play agan. I wonder what kind of an impact that’s going to have at all — if it may in fact cause more dangerous cases to go unnoticed. I can tell you from personal experience that when I was a kid,  if I thought I was going to be told to sit out a game I wanted with all my might to play, I either lied through my teeth to convice my coach that I was okay. If, that is, I even realized that I was having problems. A lot of times, I didn’t. Or, if I did, I ignored it and played through.

It’s really, really hard to explain what it’s like to get your bell rung in a game, and not be able to think well enough to protect yourself from further injury. It’s like, you know there’s something up, but you keep going, keep playing, keep pressing on. You don’t want anything to stop you, and sometimes the more your bell is run, the harder you push through.

You should sit down. You should rest. Part of you knows that. But there’s this other part that’s very go-go-go that gets jammed in gear and you can’t disengage. Even when there’s this little voice in the back of your head telling you that you need to take a break… that something’s not right… your coordination is off… you don’t have the same control you did, just a few minutes ago… still, you’re jammed in gear, and like the jammed accelerators in pre-recall cars, accidents can happen as a result. More accidents. Just when you least need them.

It’s a tricky, tricky thing, trying to stay safe when you’re just trying to play and have a good time. The Olympic athletes who sustain injuries (or are killed) during training runs… some folks would consider them foolhardy and blind to do the things they do. But when you’ve been pushing the limits, going faster, farther, higher, for years on end, you sharpen your taste for breaking records, pushing past limits…. and with each successive broken record, the bar is set higher. And higher. And higher.

It’s a wonder anyone survives at all, quite frankly.

But here’s the thing — all those stress hormones pumping through the body, all that adrenaline running in your veins, all the hype and pump and competition… they literally change you. They change your brain, they change your body. Just ask people with PTSD — a super-extreme version of what happens to you over years and years of intense extreme sports experiences. Your brain gets used to the pump. It craves it, actually. And if you’ve been marinating in that hormonal soup long enough — and have gotten plenty of rewards from pushing past your limits — pushing through till you’re breaking through becomes very much a part of your person.

And without it, you’re lost.

Literally. It’s not just some psychological “addiction” to the thrill that’s at work. It’s a fundamental, integral part of who and what you are — a piece of your puzzle that has to be fitted into place, in order for you to feel even remotely human. Someone who is at their best when they are pushing the envelope is going to continue to seek out those situations where they can push through, because they want to be at their best. Especially when they are an athlete — and a world class one at that. We athletes want to be the best we can be. We want to perform well. We need it. We crave it. We must have it. If we can’t get it, then who are we? Just another schmoe sitting in a cubicle, answering phones, or wearing an apron and telling people where they can find the plumbing supplies.

It’s not that the athletes (and other high-performers) of the world can’t deal with regular life. We just operate at a different level. And to get to that level, you need an element of risk to sharpen the senses. You need a bit of an edge. And if you don’t have it… can’t get it… then it’s not just your performance that suffers. It’s your very self, your very core, your very interior person, that suffers, as well.

It’s not just thrills we seek. It’s not just mindless risk that we’re addicted to. Those of us who are peak performers — whether athletes or stock brokers or CEOs or award-winning writers, scientists… whatevers — need a little extra something to stay on top. We needed it to get there, and we continue to need it to stay there. To do anything less than push past our personal best, is to fail to be the persons we are. Some of us turn to drugs. Some of us turn to foolhardy decisions. Some of us turn to adultery with easily recognized flings. Some of us bungee jump. But the need and the drive is the same — seeking the edge, so we can find ourselves. So we can be ourselves. So we can be more of who we have become over time, over years of progressively more advanced tests, and progressively higher risks.

Deathwish? No.

Lifewish – yes.

Now, I know my psychotherapist friends would argue this point with me. BUt you know what, none of them are — or ever have been — athletes. They are not particularly active, to begin with. Understanding what would cause someone to lie down on a small sled and hurtle downhill at 95 mph with just a helmet to protect them… or what would induce someone to snowboard high in the air and do flips and twists… well, that takes a certain kind of experience. Physical experience. Physically extreme experience. Now, I’ve never been attracted to extreme sports that involved fast speeds and heights (my balance has never been good enough for me to go there), but I do know what it’s like to push myself as hard as I could go for 3.2 miles… or around a track 8 times… or down the final stretch of an 800 meter race… or down a runway with a javelin in my hand. I do know what it’s like to practice in all kinds of weather and push through, no matter what. I also know what it’s like to lay it all on the line, time and time again… to reap the rewards of success… and to suck up the dregs of failure and start all over again — next time working all the harder.

It’s not about some psychological death wish. It’s not about having no sense of imminent danger. It’s not about any conscious thought process, other than focus on the end-goal, the prize, the medal, the reward. On some level, it’s not even a mental process at all. It’s a physical, spiritual, metaphysical process to which the mind must be subservient. And as such, there will always — for some of us — be an element of terrible risk… risk of immediate death or eventual debilitation.

And until people figure out how to get that “high” (that insulting slight of a term for what is a complex process) from a safe and secure place, there will always be mortal danger for the best of the best. We don’t just like that pump; we need it. We must have that rush that gets you thinking better, cogitating more clearly, and feeling like you’re alive again. Until people acknowledge this as a valid human need and figure out how to help us get it without putting our necks on the line, the only way to get that will be through more risk, chancier actions, and increasingly dire danger.

After all, if you can’t live fully without that biochemical pump, and you can’t stand how you feel without it, the prospect of being hurt — or dying — while marinating in that soup of fully alert humanity, probably seems worth the risk.

A Perilous Relief: Bliss From Within – The Glory of Endogenous Opioids

For better or for worse, I tend to have pretty high stress levels. It comes from an eventful past, as well as a busy present, and the intense drive to realize my deepest desires for my future. Certainly, it’s not much fun having to constantly “quality control” my thoughts and my actions, so I don’t get myself in trouble over post-traumatic stress that has nothing to do with what’s really going on around me. I certainly don’t want my energy and attention to get pulled down by old stuff that still makes me jump when an unidentified figure appears out of the corner of my eye. And it’s no fun “melting down”

But being highly stressed isn’t as bad as it might sound. In fact, there is a side to my typically high levels of stress that feeds me. And I love it. After years of being down on myself for being “over-stressed,” I’ve come to terms with that shadow side of myself. And I’ve learned to love my stress.

Here’s why:

In addition to these classic “fight-or-flight” responses to get you going, the little almond-shaped gland in the brain, the amygdala, triggers the brain to release endogenous opioids (opium-like chemicals that originate in your own system) which help your system function adequately in high-demand situations.

These endogenous opioids are a built-in part of our naturally functioning system and they are ever-available in varying quantities. Endogenous literally means “from inside”. And endogenous opioids are magic opium-like potions our systems create on their own (it’s been discovered that the human body actually produces morphine in small amounts). Yes, Virginia, there is a way to get high on your own steam, as the biochemicals our brains produce are of the same type as the illegal, intensely addictive stuff you can buy in a plastic baggie from some sleaze who will take sex as payment for the goods instead of money. They’re just a little different, so they match our body chemistry better. And they aren’t usually available to our bodies through our brains in the intense concentrations that leave overdosed junkies dead on the street.

In particular, these internal substances can have a hypoalgesic or analgesic (pain reducing) effect on the body, which helps you deal instinctively with whatever threat is in front of you, without having to deal with pain, as well. I’ve read that endogenous opioids serve to suppress the “lick response” in injured animals, so they can escape. (An animal, when injured, will instinctively stop to lick itself and tend to its wounds, but if it’s been injured by a predator this instinctual response makes it easy prey for its hungry attacker. By suppressing the pain – and the lick response – this natural impulse lets the animal ignore its wounds and focus on escaping to live to see another day.)

The same holds true with us humans. Imagine how short-lived we would be in crisis situations, if we were distracted by pain and other heightened sensations. We’d be too busy going “Ow! Ow! Ow!” and checking to see what bone we broke or what piece of flesh we tore, to get out of the way of the oncoming rockslide, tidal wave, or speeding bus, or haul ourselves out a burning car and run to safety before the gas tank explodes. The adrenaline rush and sudden biochemical cascade of pain-numbing opioids makes it possible for us to do important things like rescue each other, even when the rescuer is injured… to pull ourselves from danger, even if we’ve been hurt… and do things that would be utterly impossible, if we had to deal – for real — with intense pain. Endogenous opioids may well have been what let that tech guy save himself from dying on an ill-fated hike through the California wilderness by hacking his arm off below the elbow with a pocket knife.

Now, these endogenous opioids are truly wonderful things. Among them are Endorphin, Enkephalin, and Dynorphin. More research keeps trickling in about these substances — and others like them. It seems implausible that we could know so little about these important biochemicals until recently, but some of these have only been identified and studied since the mid-1990’s. And by the time I write (and you read) this, much more will probably be known about these substances, and how they interact with our sensitive systems.

It’s my understanding that the reason that artificial opiates work is because they are so much like the opioids we produce in our own bodies. Like a copy of a master key fitting into a lock, artificial/man-made opiates “open the same doors” that our own bodies normally have closed… and then open, when properly prompted by our biochemical “keys”. If you consider how strongly heroin and morphine can affect the human system, and if you consider that the only reason they work is ‘cause they mimic the qualities of opioids we already have in our own brains/brains, you can begin to understand just how powerful our own biochemical systems intrinsically are.

Yes, these endogenous opioids have the same sort of effect on us as opiates. They cut pain. They give us a euphoric feeling. They help clear our minds. They do amazing things to make life worth living. Lenny Bruce, the heroin addict, said of his addiction, “… it’s like kissing God.” If you consider that endogenous opioids can work the magic of relieving/inhibiting pain, imparting euphoria, and making us think better, it explains how human beings can sometimes perform at super-human levels irrespective of pain, danger, stress, or other normally stymieing influences (like, for example, the voice in their head urging them (in vain) to keep a low profile).

These magic potentialities we have in our brains have recently been getting more “air time” from scientists like Irving Biederman, who studies perceptual and cognitive pleasure. According to Dr. Biederman, we’re not only wired to survive — we’re wired to enjoy ourselves in the process. A lot. Things like learning new things, encountering novel situations, looking at innovative art, “tickle” the parts of our brains that release endogenous opioids into our systems.

So, under the worst and the best of circumstances, endogenous opioids are about as close to a gift from God as you can get. Not only do they buffer our bodies from the ill effects of extreme duress, but they also reward certain kinds of behavior (learning, in particular) with a pure shot of unbridled joy.

Kind of makes it all worthwhile, doesn’t it?

A Perilous Relief – Table of Contents

Technorati Tags:
, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,