Tonight, I am about as alive as any person can be

I am wiped out. Tired from a day full of really good things, and tired just thinking about all that tomorrow will bring. My job is wiping me out. And that’s okay. Because I know it is, and I know it does, and it just means I have every right to go to bed early tonight.

The autumn night is humming with insects, the sing-song cadence of their sawing wings and their scraping legs a kind of tinnitus, the high pitch of life that is always there, even when it isn’t.

I am reading again. Travelogues by infamous writers. Accounts of Greece and Italy and France and beyond. Stories of New York and California. All of them inaccurate, all of them true, with the kind of truth you can only wring from someone who isn’t often studied in school.

School. Huh. I saw a bumper sticker on my way home tonight from my weekly neuropsych visit — Learning is natural. School is optional. And I read the words of individuals who turn their nose up at the academy.

I used to think I wanted to earn multiple degrees. Find a stable job teaching at a good school — not necessarily a famous one, but one where I could dig in and grow some roots, live the life of the mind and make a name for myself. A name for myself… as though my own name didn’t matter. As though I were like a tree falling in the forest who wouldn’t make a sound unless thousands upon thousands of others could hear me loud and clear.

A name for myself… I was blind and deaf and dumb, struggling to prove to myself that all the things that were “up” with me didn’t make me less of a person… and losing that battle daily. The one who needed most to hear my fall in the forest was me, but I was so busy trying to convince others, I hardly paid any mind to myself.

And all the while thinking “… this inner life, this secret place within, these thoughts of mine, these sensations and confusions and all of it… this is who I am. This is what I am. This is all I have to work with.”

Far from it, I know now. But when you’re 28, you’re so damned sure… and all the while, no one was listening. I thought – no, I knew. No one was listening.

Then I crossed the country. Twice. In a 14-foot rental truck. The second trip found me in a vehicle the same color and size as the truck that blew up the Federal Building in Oklahoma City, within a week after the attack. I got strange and wary looks on that trip. But I made it. I did my explaining whenever necessary. And I kept moving.

Keep moving… that seems to be the key to my live-liness. Not so much like a shark, as a small bird that must constantly eat to keep its energy up. I move with the cycles, picking up speed when the seasons change, so I can make a smooth transition into the next round of sun or rain or snow or wind or whatever.

And the night is my friend. Most of the time.

Tonight,  I am about as alive as any person can be. I ache like the dickens — I swam the other day, wearing an old suit because I misplaced my new one. The old one didn’t fit me well, but I swam anyway. The first time in months. Now my body aches, and my neck and back crack. Just as well. I needed a reminder that yes, I am here and yes, I am alive. Nothing like a little chilly water to wake up the senses. And remind me, there is more to life than warm weather. Warm water. Warm. Cold has a life of its own, and cold has its place, too.

Hungry does, too. And although I’ve eaten my dinner tonight, alone and on my own for the evening, I’m still hungry. Eager for something else. If I have some sense — and I believe I do — I’ll call it a night and make my way to bed, with a book to keep me company till sleep meets me, or my loved one gets home, whichever comes first.

Tonight, I am about as alive as any person can be. And I realize that I need to have people in my life who are as open to LIFE as I am… people who are as welcoming of the full range of human expression, as I am… people who are as undaunted, and as intentional as I am.  People who press out to the limits of what they are capable of, and find out what’s out there, who aren’t held back by what “should be” or “what is” — according to what others say.

This change in my needs for company has been in the making for the past year or so. It’s been stirring in earnest, for the past few months. And over the past weekend, when I saw a bunch of people I used to work with, I realized that the people I got along best with, were the ones who were the most comfortable with themselves, and the most comfortable with risk and reward. The kind of folks who wring what they can out of life — and themselves — and then come back for more. It’s not that they’re not afraid. Far from it. They simply have a tolerance for the experience of fear. And it’s not the ONLY thing they experience.

And they keep learning. I used to want to spend my life in school. Then I realized my life IS my school. I probably won’t be going after those degrees anytime soon. Life is much too interesting, to spend inside the walls of an institution, telling me what to think and say and how to act. The privileges of membership only compensate for so much.

I found this on YouTube tonight:

Scenes to live by.

Amen.

I’m tired.

Good night.

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…

Because rust never sleeps

 

Tea catastrophe averted

 

I got a good lesson this morning. I managed to sleep in  till 8:15, with my earplugs firmly wedged in my ears and extra curtains pulled across the windows to block out the light. Even the birds that fill the trees around my house, clamoring for attention from each other and battling for position at the bird feeder first thing in the morning didn’t wake me up, as they often do, ’round about 6 a.m.

I’ve been feeling progressively more under the weather over the past few days, with my balance getting worse and worse and the headache starting up again. Work has been really good – very rewarding and satisfying. But it’s taken a toll, and when I got up this morning — without doing my usual breathing exercise (I did that at 4 a.m. when I was trying to get back to sleep) — I was feeling wobbly and out of it. I had to lean against the walls as I walked to the bathroom, and while I brushed my teeth, I had to prop myself up with one hand firmly on the sink counter.

I managed to get downstairs in one piece, and I made my breakfast slowly, deliberately. I took my time with it, taking care to not move too quickly and put myself off balance. In the past, when I was still dealing with the early years after my last injury, being off balance would send me into a panic and it would throw me off for the whole day, even before the day began. But since I’ve been making important changes in my daily life — including regular exercise — the panic has subsided considerably, and I’ve learned how to handle the sense of teetering on the edge of collapse without having my psyche collapse, too.

And that’s important.

So, anyway, after I had my breakfast, I decided to spend my day reading and writing and checking in with myself. The weather has been pretty wet, lately, and I can’t do much outdoor work. Plus, I’m not feeling well, and I would love to just spend the day reading, studying, and writing. Taking it easy, instead of taking care of everybody else’s business. I put some water in the electric kettle and fixed myself some fruit with crackers and goat cheese and went up to my study to settle in.

After a little bit, I realized I’d forgotten my trusty writing cardigan, and I went back downstairs to get it from the kitchen. While standing in the kitchen, looking around to see if there was anything else I’d forgotten, I heard an odd hissing sound. I went over to the kitchen counter and found my tea mug with a dry tea bag in it, and beside it was the electric kettle, hissing away, nearly all the water boiled out of it.

Now, the way the kettle has always worked in the past, is that when it gets low on water or reaches a certain temperature, it shuts off. This time, it did not shut off. So, I did. And when I looked closely at the heating element, it was showing signs of rust — perhaps from the intense oxidation from the coils evaporating off the water?

I kind of went into a tailspin about this. Yes, I know my alarm was disproportionate to the situation, but I got seriously upset by this and I started to beat myself up over having put water on and then walked away. I won’t write all the things that went through my head, because they are not the kinds of things I care to archive for posterity. Suffice it to say, for a few minutes this morning, I was not my best friend.

But then I realized I was pretty off the charts with my distress — how much would a replacement kettle cost? not very much, really — and it was more about me being absentminded and not paying close enough attention … no to mention feeling ill and “off” this morning. So I was wasting a lot of precious time getting bent out of shape over this. It’s turned out to be a beautiful fall day, and I have given myself permission to take time off to take care of myself. Why should I waste my time and energy beating myself up over a simple case of absent-mindedness that really anybody could have done, too?

Okay, so I established that it wasn’t worth wrecking myself over this oversight. And I realized that this electric kettle is not going to automatically turn off whenever it’s low on water, as I assumed. I would just get in the habit of A) putting more water in the kettle and B) not leaving the kitchen till it’s done heating the water, which takes all of maybe 30-60 seconds. Simple solution, right?

Well, what came up next was the burning question (and yes, I realize this sounds a bit neurotic, but I am not feeling well this morning) about what to do with the “extra” water that I wasn’t using for my tea? See, when I pour water in, I pour exactly as much as I need, so when it’s hot, I don’t have to check the level of liquid in my mug. I just know that I have exactly as much water as I need. If I heat more than I need, what will I do with the extra?

This was the hotly burning question in my fuzzy brain this morning (in the moment it seemed extremely important). I was all up in my head about the evils of waste and getting frantic about not having the exact amount of water I needed in the kettle, and having to gauge how much I was pouring in… and so on.

Ugh.

Then it occurred to me that having the extra water would come in handy for clearing the drain. I’ve been having some problems with the kitchen sink drain getting sluggish. My fix for it is to pour boiling hot water down, and that often works. So, this “problem” is actually no problem at all — in fact, it solves some problems, namely:

  • I need to slow down more in the morning, and this will help me do it.
  • I need to heat more water in the kettle, so it doesn’t fry the coils, and this will let me do that.
  • I need to periodically clear the drain with boiling water, and this will let me clear it daily, so the buildup doesn’t accumulate and become a bigger problem down the line.

So, there’s really no problem at all. Not anymore. But this morning, for about 15 minutes, I was going into a tailspin that threatened to wreck my entire day and set me down a spiraling path of upset — at the innocent electric kettle and at myself for getting so bent out of shape.

The electric kettle is forgiven, and so am I. I know full well that I am off balance, not feeling well, and I am spending an awful lot of cognitive energy just trying to keep myself vertical and not get hurt. I can cut myself a break, and just get on with my day and my recovery from the past week+ of hectic activity.

I’d better cut myself a break. Because rust never sleeps.

Neil Young reminds me of that constantly, while I’m driving to and from work. For some reason, radio stations in my area keep playing his music, and “rust never sleeps” is often what I hear him singing about. My, my,  hey, hey… It’s better to burn out, than to fade away… And this gets me thinking. Especially in the autumn, when the effusive growth of summer is giving way to frosts and withering and deadening, and the cycle of life turns to a cycle of death, my thoughts become, well, a little maudlin. The change of the season gets me to wondering “what’s it all about?” and “is this all there is?” and all manner of existentially angst-y ruminations. And my brain starts to perseverate and lock onto misperceptions and misconceptions and any number of irregular reasons to doubt my ability to live effectively in the world.

Some days, I suspect it’s due to the way my life turned in the course of my concussion-punctuated years. Each injury left a mark on me — a “ding” or two or three in the fuselage of my vehicle that didn’t exactly ground me, but kept me from achieving the heights I might otherwise have reached. I don’t want to blame the brain injuries for my ills — certainly, they have played a part, but they’re not the only reason I’ve had difficulties.

More than the traumatic brain injuries, in fact, I believe that the aftermath, the reactions, the later reactions of others and myself (which were based largely on ignorance about what brain injury does to the personality) and the meanings I gave to those reactions, had the biggest impact. And the time when I was actually recovering from the physical effects, I was sinking into a psychological morass of confusion, dread, insecurity, and the conviction that this temporary situation was permanent, totally screwed me up. After my injuries, my neuroplastic, adaptable brain was on the mend and finding new ways of doing the things I wanted to do, but because those new ways were different from the old ways — and therefore threatening and alarming to me — I discounted them and told myself they were WRONG and I should not be doing things the way I was doing them.

I had it in my head that the roundabout way I learned was Wrong.

I had it in my head that the way I communicated with people was Wrong.

I had it in my head that the way I structured my daily life — much more downtime than most people I knew — was Wrong.

I had it in my head that the choices I made about my social life — who I would and would not interact with — were Wrong.

I had it in my head that the choices I made about my domestic life — not having children and not officially getting married until 15 years into the settled, intricately entwined relationship — were Wrong.

Now, to be fair, there was an awful lot of social pressure to adhere to certain ways of doing things, so I had plenty of reinforcement for judging myself and my choices. And the rigidity of my upbringing didn’t help. But I suspect that the rigidity of my parents and wider social circles wasn’t the only reason I was so locked in, and so quick to judge myself. Indeed, I believe that the head injuries I sustained as a young kid (when I was about 4, then again when I was 7 and 8 ) predisposed me to an intense rigidity that locked out any alternatives to routines or “standard issue” behaviors.

The Brain Injury Association of New York State has a great little tutorial on Flexibility Versus Rigidity In Thinking And Behavior that I really like. (They’ve got a bunch of great material there, especially for teachers and parents of brain-injured kids.)

Here’s a snippet from the tutorial:

WHY IS RIGIDITY/INFLEXIBILITY IMPORTANT FOR SOME STUDENTS AFTER TBI?

Students with TBI or other neurological conditions sometimes demonstrate extreme forms of rigidity or inflexibility. Rigidity/inflexibility is often associated with damage to the frontal lobes, the most common site of injury in TBI. Therefore, some degree of inflexibility is common in students with TBI. This may manifest itself as difficulty (1) making transitions during the school day (e.g., from lunch or gym back to classroom work), (2) tolerating changes in schedules or everyday routines, (3) adjusting to changes in staff, (4) ending an intense emotional feeling, and the like. In extreme cases, a transition as apparently simple as from sitting to standing may be difficult and cause stress.

Related but not identical to inflexibility is the phenomenon of perseveration. Perseveration is a possible result of neurologic impairment and is characterized by continuation of the same behavior or thought or words or emotions after the reason for the behavior, thought, word, or emotion has passed or the thought or behavior is no longer appropriate to the situation. . For example, a student may remain focused on a given emotional behavior state long after the reason for that state has been forgotten.

This pretty much describes me when I was a kid, though today I’d have to say that emotional rigidity and perseveration is much more of an issue than cognitive. Cognitively, I can move on. But emotionally, I’m still stuck. I think that getting out in the world and holding down jobs and having gotten positive reinforcement in work environments has helped me cognitively. I’ve been able to really reap great rewards from using my head, and that’s encouraged flexibility and creativity. Emotionally, though, I get jammed up and stuck. That’s where I get rusty — stuck in place and wedged into an old pattern that doesn’t serve me or the people around me.

No, rust never sleeps. So, what do I do? Do I drive myself onward-onward-onward, in hopes of burning out before I fade away? Do I race at top speed through life and damn the torpedoes?

Um… No. Racing around and pushing myself are the very things that encourage rust. Like the super-heated coils in electric kettle caused the metal to rust, so does my super-heated life cause my system to lock up and show signs of wear. Maybe not in Neil Young’s case, but in my case, pushing for burnout is a sure route to rust. And I don’t have all the time in the world — I’m not getting any younger, and my window of non-fatigued time is significantly less than most people’s I know — so I just don’t have a lot of time to spare, cleaning up after myself when I crash and burn.

That’s no way to live.

What to do?

This is the eternal question, and it keeps coming around with me, no matter how much time I put between myself and my injuries. My first TBI probably happened when I was about 4 years old. And there were two more when I was 7 and 8 years old. More came over the years, including sports concussions and car accident mTBIs, for a total of at least nine separate instances of head injuries that involved some level of disruption of consciousness, followed by cognitive, behavioral, and physical problems.  I never got help for any of them, until about 3 years ago — just a lot of headaches (literally and figuratively) — and only in the past 3 years have I started to systematically and mindfully approach my issues with a focused desire to overcome them.

I’ve learned a lot about how to deal with the basic things — get my exercise regularly, eat right, get enough sleep, and check in with my neuropsych on a regular basis. But as the basic issues get resolved, the “higher level” questions emerge — as in, how to make the most of what life I have left, so that I can have the best life possible, whenever possible?

Ironically, the answer to this question has gone hand-in-hand with the answers to my most basic human needs. The answer is to just slow down and pay attention. For someone who is as driven as I am, it’s a tall order, and not that easy to do. But you know what? When I not only slow down but also pay very close attention to what I’m doing with myself and my life and my choices, many of my TBI related issues resolve.

When I slow down and pay attention to my physical fitness, my joint pain and headaches subside considerably.

When I slow down and pay attention to what people are saying to me, the problems I have with understanding and following clear up considerably.

When I quit going 150 miles per hour through every single day and pay attention to what I eat and how rested I am, my need to pump myself full of adrenaline and push past all sensible limits becomes far less pronounced.

Now, slowing down and paying attention is the sort of thing I’ve had to learn from scratch. A big driver behind my rushing is a constant low-level panic that simmers in my gut, day in and day out. It’s that constant restlessness, the constant agitation that comes with TBI. It’s my brain working overtime trying to find its way through the tangled networks that have developed over the years. It’s my body’s reaction to the intense energy needs of my very-active brain, and the low fatigue threshold I have.

Slowing down and paying attention has been closely connected with my exercise routine, taking the edge off my stress, finding outlets for the nervous energy, and clearing out the biochemical sludge that builds up after countless experiences of surprise/shock/dismay/confusion that come at me in the course of each day, when the things I expect to happen … just don’t… and I need to immediately adjust and move in a different direction to get where I’m going.

That surprise/shock/dismay/confusion is an ongoing situation for me, and it may never change. I may find myself spending the rest of my life realizing I was all wrong about something and needing to find another way to think/act/be. But at least I have my exercise to help me clear out the chemistry of those micro-traumas. And I have an understanding of that bio-cognitive action that lets me cut myself a break and not get all bent out of shape — for extended periods of time — over things that are either directly attributable to my brain having gotten a bit banged up over the years… or are long since over and done.

But even if I do spend the rest of my born days troubleshooting these kinds of cycles of pseudo-drama, I always have my fall-back, my comfort in the midst of the storms — the knowledge that slowing down and paying close attention to what’s going on around me, with heightened awareness and intense curiosity, can and will pull me out of my funks, can and will restore me to some sense of myself, can and will connect me to my life once more, in ways that running around at top speed never can and never will.

Rust may never sleep, but I don’t need to run from it. Ultimately, it’s not the quantity of life that staves off the debilitating freeze, the rust. It’s the quality. Cooling the hot elements, adding more water than I “need”, and just sticking with my life in all its aspects till I find some peace, some resolution, and I can make my tea… that’s what does it for me.

Now, what can I pay attention to next?

Be very, very careful

 

Warning Will Robinson!

 

Not long ago, one of my readers posted a comment about how important it is to be careful, so you don’t sustain a brain injury. Those words (at least, the gist of them, as I’ve since forgotten exactly how they said it) have stayed with me over the past day or so.

I have been working overtime a lot, having taken on a lot more responsibility that is a pretty big deal. And I have not been eating quite as well as I should be. I’ve been hitting the vending machines regularly — not insanely, chowing down on Skittles and Pop Tarts and Swedish Fish and all manner of sugar and chocolate. But I have been eating a chocolate bar a day, along with my beloved peanut M&Ms that keep me going (I need the protein).

At the time when I’ve been needing more sleep, I’ve been getting less. The Headache is back — not headaches but Headache — the long-lasting, perpetual one that doesn’t have any breaks and just keeps going to the point where I barely even notice it anymore. Except when I do. I’ve started to get the tactile sensitivity —  my clothes are hurting me — and light sensitivity and noise sensitivity. I’m kind of wired, as I’m sure you can tell. And in fact, it doesn’t take a whole lot to get me wired, so I’m feeling the burn, right about now.

On the bright side, I am functional. I’m able to do my work and get things done and interact with people at work. But that’s a downside, too. Because when I get like this, I tend to push myself and go faster than I should. And when that happens, I can get hurt. I’ve fallen down stairs a number of times in the past six months, because I was in a hurry. Nothing bad enough to injure me, but enough to rattle me.

I must be very, very careful. Especially because the BIGGEST symptom I’m having, which I neglected to mention above, is the vertigo. Dizziness. Crazy spinning head and the inability to turn quickly in any one direction, without my head going haywire. I am so dizzy,  I have to keep my back absolutely ramrod straight, or I start to lose my balance. Standing at the tops of stairs is interesting, too. And I have to hold onto walls as I walk along, or I tend to wobble and stagger like I’m drunk.

This sucks.

I can’t even close my eyes without the room spinning, and I have felt like I was going to throw up for three days running. Fortunately, I’m able to keep it together reasonably well with a discretion that masks my issues. Nobody needs to know that I’m as badly off as I am. Nobody needs to know that I’m about to heave all over my office. Nice for them. Not so nice for me.

Yes, this sucks.

But you know what? It’s all in the line of duty, and it’s all for a good cause, and I get to lay low this weekend. I don’t have any pressing activities I must do. I can lay low and be ill and take care of myself at my own pace. My spouse has a bunch of commitments over the weekend, so again I’ll have the place to myself for most of the coming two days. So I can roll myself up in my blankets, pull the blinds, and just hibernate in my cave.  Drink hot tea — the nasty cold season tea I can’t drink with anyone around, it smells so awful — and read a book. I never did finish The Bourne Identity. I got it it out of the library again a week ago, so I can spend my time catching up (and seeing how much I remember from before).

All in all, I feel physically awful, but I’m still bright-eyed and bushy-tailed. I’m so tired I’m literally falling over, but it’s a good tired that comes from having spent so many, many hours doing work I love in an environment where I’m actually able to do it.

Yeah, baby.

But I have to be careful. Seriously. I need to watch myself, make sure I don’t fall, make sure I take care of myself better this weekend, and get some recovery under my belt. I can’t continue on at this pace — must take some downtime. And be very, very careful, as I’m moving about.

Times like this, I’m reminded of how head-injured folks — especially athletes — so often re-injure themselves.

We tend to have have crappy risk assessment skills after we get hurt.

We also tend to over-estimate our ability to navigate challenging situations.

And all too often we feel like we have something to prove, so we push ourselves even harder than most — even with diminished co-ordination and balance.

These things I know. These things I know about myself. As euphoric as I am about this new job and all the great potential for it, I still know that I am running a risk every time I push myself, and I am running a risk every time I don’t take it easier than I am. I know that I am in danger of being injured — as anyone is who’s overtired and tremendously off-balance and walking up and down stairs, driving in heavy traffic, and generally going about their business in environments where you can slip and fall and get hurt.

I must be very, very careful. And so I shall.

Addressing the trauma in traumatic brain injury

Source: Scott Butner

As I’ve been exploring the landscape of my head injuries over the past few years, one aspect of my life experience has consistently come to the fore — trauma… and its long-term effects on lives of both survivors and the ones they love and live/work with on a daily basis.

It’s almost a total fluke that trauma should even have this on my radar. But over the years, I’ve befriended — and been befriended by — a number of psychotherapists and counselors, most of whom specialize in trauma. In retrospect, I suspect that many of them have assumed that my difficulties were due to past traumatic episodes — rough childhood, misspent youth, etc. In fact, one of them has flatly denied that my issues could be due to TBI, and they became more and more insistent about me getting a therapist, which was probably the worst thing I’ve ever done, in retrospect. (This friend’s denial is a topic for another post — it’s quite interesting, “clinically” speaking.)

Now, I have to say that after more than 10 years of being around these friends of mine, I get a little tired of every ill known to humanity being ascribed to after-effects of trauma. When I talk about experiences I’ve had and people I’ve encountered who have annoyed me or done some seriously sick stuff, I’ve often heard the refrain, “Oh, they’re a trauma survivor, so they’re dissociating/being triggered/experiencing kindling/re-enacting their past traumas.”

There’s not much room for just being an asshole. For some of my friends, it’s all about the trauma. And in an attempt to better understand what it is they’re talking about, I’ve attended some trauma workshops, as well as read some books. I’ve got Peter Levine on my bookshelf, along with Belleruth Naparstek. And now I’m reading Robert Scaer, M.D.’s  book The Body Bears the Burden, which explains (from a neurologist’s point of view) the effects of trauma on both the body and mind of someone who’s gone through awful experiences — and those whose experiences don’t seem that terrible, compared to, say, Pakistan’s flooding or suicide bombings in Kabul.

The DSM-IV defines a “traumatic stressor” as:

[an stressor] involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate

The part that interests me is the “direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity”. The other parts are just as significant, but I’m not going to speak to them at this time.

When it comes to mild traumatic brain injury, I think sometimes the severity of the experience tends to get downplayed. After all, the injury is mild, right? Well, interestingly, mTBI survivors apparently can show more disruptive symptoms of traumatization after the fact, than survivors of more severe injuries. And these long-term effects  can wreak havoc in the lives of survivors, as well as their immediate circle.

Problems such as fatigue, emotional volatility (emotional lability), rage, agitation, irritability, insomnia, sleep deprivation, anger, temper flares, temper tantrum, anxiety, fear, panic, risk-taking, danger-seeking, not to mention all the crisis and drama that can accompany hormonal spikes during times of stress, certainly don’t make things any easier. If anything, they complicate recovery by flooding the system with stress hormones which interfere with your ability to learn from your experiences. So, at the time when you’re having to get a new grip on your newly changed life with its “new normal,” the biochemical processes going on behind the scenes may be getting in the way.

How maddening is that? At just the time when you need your brain to be able to recover, it’s busy cranking out all sorts of interesting concoctions that specifically get in the way of your recovery.

Because (I believe) there is unresolved and un-dealt-with trauma wreaking havoc behind the scenes.

Trauma in mild traumatic brain injuries is particularly tricky. After all, the injury itself may not have been that dramatic — something gets dropped on your head, or you get in a fender-bender, or you slip and fall down and clunk your head on something. You get up again, walk away from the scene… maybe pay a visit to the emergency dept of your local hospital, get scanned, and you get a “clean” bill of health (and maybe a few pointers on what to watch out for to make sure you don’t have more serious issues later on). Then you’re expected to get on with your life.

But inside your skull, something else is happening. Some of the fragile connections in your brain have been sheared or severed or frayed, and your brain isn’t able to communicate with itself like it used to. On a fundamental, profound level, your very existence has been threatened — only nobody can see it. Even you can’t see it very well, because your brain is either still bathed in the stress hormones designed to keep you from feeling a bunch of pain (and thus preventing you from fleeing an immediate threat), or it’s just not making the connections it “should” in order to give you — the resident owner — a clear picture of what’s going on. Or it could be both things going on.

In some cases, from what I’ve read in Dr. Scaer’s book, the onset of problems can be delayed by hours, even days. So, right after the accident/event, you’re walking around looking fine, seeming to be fine… maybe you’re a little shaken up, but that’s to be expected.  But then you start to slip away… decline… feel the effects of what was supposed to be a mild event that had no serious immediate effects you. In your system, hidden from view, the process of gradual (and possibly debilitating) problems has begun.

This process is utterly maddening. Everyone around you, who was worried for your safety, just wants to be relieved that you’re okay. But all of a sudden, you’re acting strangely, you don’t seem like yourself, and you’re complaining all the time. The complaints don’t get better over time, either. They get worse. And for no apparent reason. People think you’re looking for attention, that you’re trying to “milk” your accident for all it’s worth. They just want you to get back to being your old self. But you’re doing the exact opposite.

And the pressure to return to normal builds, even as your system is being eroded by the biochemical havoc of trauma that was introduced to your system which has not been cleared — it hasn’t even been recognized. How can you clear away what you can’t see/hear/detect?

Indeed, the most insidious and problematic manifestations of trauma take root when the person having the experience is taken by surprise. Studies have shown that bracing for impact limits the impact, but being blindsided makes it worse. And it makes the experience as a whole worse. The body detects this threat to its safety and existence — all of a sudden out of nowhere — and it unleashes myriad biochemical substances for us to deal with it — including endogenous opioids designed to numb the pain of injury. Animals in the wild which are being chased by predators, when there is no way to escape, will often fall down as though dead, their bodies full of chemical substances that will both numb the pain of being devoured and turn them into “dead” prey which might discourage a predator from actually killing them.

The same biochemical process is in place with human beings. After all, once upon a time, we were hunted as prey by animals larger than us. Indeed, we still are, in some cases — the predators happen to be other people, more often than not. In times of combat and assault, when all escape routes have been blocked off and we believe (on some level) that we’re done for, our brains and bodies do their natural thing — they bathe us in substances to protect us from feeling that knife going through our lung or feeling that bullet smash through muscle and bone.

Our brains and bodies are doing their utmost to protect us as best we can. But our minds tend to interpret the experience differently.

In the case of animals who freeze and then survive the assault, they shake themselves, go through a series of shuddering/jerking motions, do heavy, deep breathing, and then pick themselves up and get on with their lives. In the case of humans who freeze and then survive the assault, we tell ourselves we were wusses for freezing the way we did, and we plunge into cycles of self-doubt and conflict, feeling like we failed — when we were simply being the biological creatures we are designed to be.

And the self-perpetuating downward spiral of the PTSD loop starts. Where it stops, is anybody’s guess.

Therapies which have been successful in freeing people from that negative feedback loop are those which engage the body to discharge the sudden burst of biochemical self-protection, and get the autonomic nervous system back into balance. In the completion of the fight-flight-freeze cycle, the body is allowed to return to its most effective ways of working. And we can get on with our lives.

Here’s where the problem starts with mTBI. (Note, I’m not a doctor or certified health professional — this is just my belief system about how our systems interact with the world around us.) If the injury is “mild” then what’s the big deal? Why should we even need to complete the fight-flight-freeze cycle? Wasn’t the injury itself mild? We just got clunked on the head. Big deal, right?

Hardly. I think with mild traumatic brain injury, there may be another aspect of it that comes into play. With “mild” injuries (not that any brain injury is ever mild, mind you), the brain itself perceives the threat on a basic, biological level. It knows something’s wrong, and it kicks into overdrive, trying to right what’s wrong.

I suspect this is why people who have sustained concussions or mTBIs are so prone to denying that there’s anything wrong. Our brains are so busy trying to right their internal systems, that they fail to communicate with the rest of the world — that includes our conscious mind.

Based on what’s happened to me, what I’ve observed, and what I’ve read, here’s the cycle that I believe gets set up:

  1. An individual experiences a sudden, unexpected impact or injury, which injures their brain. This can be a fender-bender, a tackle or collision in a sports game, getting cold-cocked by an attacker, or having something fall on/hit their head.
  2. Fragile connections in their brain are frayed, sheared, or destroyed completely… or all three.  On the surface, they seem to be fine. The injury doesn’t look like that big of a deal. It’s just a bump on the head or a hard hit or a bit of soreness or being dazed after the fact.
  3. The body interprets the impact as a threat to the system, and it unleashes a biochemical cascade of hormones and other neurochemicals which narrow the focus, numb the system to pain, and shunt energy away from “extraneous” body functions.
  4. The injured person’s brain senses something is amiss, and it works like crazy trying to sort out what just happened. The whole body-brain connection needs to be tested to make sure everything is still online, so the system can correct itself as need be. Any outside talk or input is dismissed and rejected — “Are you alright?” isn’t a sign of concern, it’s an intrusion into the vital process of the brain checking through the bodily system for problems. And the brain is so focused on its internal process, that it “forgets” to tell the rest of the world what’s going on. There is no full communication loop with the brain — it’s in damage assessment mode, and it blocks out any input as well as refuses to provide output.
  5. The impacted individual wanders around in a bit of a daze, then they appear to recover, and they get on with the rest of their activities. They drive on in the car, they get up off the bench and go back in the game, they pick themself up off the pavement, or they go back to work.
  6. In the course of going about their business — both immediately and over the course of the coming days and weeks — their brain is having trouble figuring out how to do the things it used to do so effortlessly. The old connections have been disrupted, as though a massive storm had torn through a region, torn up trees, unleashed flash floods, and made many of the old roadways either treacherous or impassable.
  7. The brain senses something is amiss — the inability to do things it used to do before is intensely distressing, and it doesn’t understand why things aren’t working. This confusion represents a “threat to one’s physical integrity” and the body reacts as though its very existence were being threatened. The cascade of stress hormones and fight-flight-freeze substances wash through, and the sympathetic nervous system is activated.
  8. Unfortunately, the incidents of confusion and disorientation and disrupted functioning aren’t intermittent. They can be regularly occurring — as well as unexpected. Time after time, the brain is surprised by its sudden (and unexplained) inability to do what it’s always done. Surprise sharpens the experience, making it both more intense and more indelible in the body and brain.
  9. The brain/mind interprets these inabilities as a problem with the self, and a chain reaction of personal recrimination starts up, which assigns more meaning to the events, which triggers further releases of adrenaline and cortisol into the system when the amygdala is tweaked by this interpretation.
  10. When cortisol and adrenaline are released, higher reasoning is impaired, and lessons which might be learned from trial-and-error are not retained. One misstep after another occurs… one screw-up after another… confusion compounding confusion… anxiety heightening anxiety. What was originally “just a bump on the head” elaborates into a full-scale debilitating condition which becomes more and more entrenched over the ensuing months, even years.
  11. Social pressure doesn’t help at all. Impairments to speech understanding (that happened to me) aren’t interpreted as symptoms of brain injury, rather as laziness or stupidity. Sensitivity to light or sound, which foster distractability and make holding a conversation difficult are not perceived, but the results — wandering attention and apparent oblivion to what others are saying — are obvious (and not at all appreciated).  Social pressure leads to increased stress, which in turn triggers the release of more chemicals that prevent the injured person from effectively learning new patterns and building new pathways in their brain.
  12. The brain is still trying to sort out what’s going on, and it’s not very communicative, either with others or with the “resident” in this body. It gets wrapped up in the drama of flawed interpretations of what’s going on, the crisis of stories it’s invented about what’s going on around it, and the increasing struggle to make sense of anything.
  13. Time passes, and things just seem to get worse. Self-esteem plunges, and resilience declines. Self-recrimination builds, and difficulties at work and at home erode the ecosystem of the impacted individual. Jobs are lost, relationships fail, and money seems to fly away for no apparent reason.
  14. If they’re lucky, the impacted individual can find help from a competent neuropsychologist, counselor, or neurologist — or even friends who are up to the task of helping them get back from the brink. If they’re like all too many traumatic brain injury survivors, they cannot get the help they need, and they end up becoming permanently unemployed (or sporadically employed), with no savings or source of income, no social support network, and no justification for going on disability or collecting insurance payouts.
  15. Muddling through, maybe they make it, maybe they don’t. Ultimately, many end up on the streets, in jail for behavior problems, or on medication for psychological disorders that mimic brain injury after-effects and carry lasting side-effects. And unfortunately, a number eventually commit suicide, hastening the process that an oblivious, uneducated society and tough-it-out culture sets in motion.

As you can see — assuming this progression is at least somewhat accurate (and I believe it is) — the impact of a head injury need not be severe, in order to lead to severe consequences.

To fully understand the pervasive effects of mild traumatic brain injury, you need to look at multiple systems — from the brain’s inner workings, to the autonomic nervous system, to the demands of adult living or childhood development, to the expectations of one’s surrounding social milieu. With mild TBI, it’s never just one issue that sends you down the dark road — it’s a million little, subtle, interrelated issues that combine to create a recipe for disaster that, like bread dough sitting near a hot wood stove, will inevitably begin to rise and expand.

Trauma and the body’s internal responses to perceived threat and our interpretation of those threats, is like yeast added to a sugar-water-flour mix of our injury. With enough heat and time, it’s going to double, triple, even quadruple (and more) the issues that initially come with mild traumatic brain injury. Unfortunately, it appears that our systems are designed to work that way, and unless we can figure out alternative ways to address the issues, we’re in for a rough ride… till we can find help, sort things out, or end up incarcerated or dead.

What strategies and approaches we can hope to employ in this trickiest of situations — which might actually work — is a topic for another post.

Concussion stampede

Source: t3rmin4t0r

Football season is picking up, and with it comes a spate of stories about professional players suffering concussions… then we have stories about student athletes suffering concussions… head injuries on the rise… mild traumatic brain injuries increasing… trips to the ER… stories from individuals talking about either their own or their kids’ head injuries…

You’d think all the world were sustaining traumatic brain injuries.

Then again, maybe we are. I mean, look at the stats:

  • 5.3 Million Americans are currently disabled by a traumatic brain injury
  • 1.5 Million Americans suffer a traumatic brain injury each year
  • 80,000 Americans sustain long-term disability from TBI each year
  • Every 21 Seconds, someone in the U.S. suffers a traumatic brain injury

Source: Neurology Now, Sept/Oct 2006

That’s an awful lot of traumatic brain injuries (which include concussions — don’t let the semantics confuse you). And that was back in 2006 — who knows where we stand now.

That’s an awful lot of people — and only in this country, we’re not talking the rest of the world — getting “dinged”, or worse, and suffering long-term because of it. Crazy. When will this madness stop?

Or will it? I’m not sure it ever will — as far as I’m concerned, head injury is about as endemic to the human condition as promiscuous sex and violent crime. As damaging (and as interrelated) as they may be, and as much as we may try to reduce the incidence, the fact remains that they continue to happen.

It is so very hard to have a healthy perspective on this head injury situation. On the one hand, you don’t want to overreact, but on the other hand, you don’t want to under-state the significance of head injury. It’s serious business. People get badly hurt — even when they don’t look like they’re injured. And they suffer for a long, long time. Some people never rebound. They get lost in the crowd, fall between the cracks, and fade away into their own private hell.

And our culture just keeps churning them out — especially in the sports arena. Between professional football and student sports and cage matches and mixed-martial-arts fighting and extreme sports and the heavy-duty ‘roids folks are on (including student athletes) and the popular fascination with hard hits and rough pastimes… it’s just one big head injury circus waiting to entertain all the folks sitting home on the couch with a cold beer, waiting for the blood to start flowing.

I’m a bit punchy tonight, I’ll admit. But buried deep inside this thought process, there’s a rhyme and a reason. More and more awareness is coming out about brain injuries and the long-term effects of head trauma. More and more players are agreeing to donate their brains to research. More and more air time is given to concussion and who’s on the disabled list this week, thanks to post-concussive syndrome symptoms. More and more stories of chronic traumatic encephalitis are coming out, and more and more tales of soldiers getting hammered by IEDs and other blasts are making the news.

But still we parade on like it’s all good fun — or at least the kind of thing that we should take in stride. You get hit, you go down, you wobble around when you get up, and nobody thinks anything of it, should you keep yourself in play. You get dinged, you drop to the ground, you get up dimmer and slower than you were before, and the game goes on. You get blindsided on the ice, you land hard and have to be carted off on a backboard, and when you’re not back playing in two weeks, the world starts to forget about you. If you do manage to come back (before all the symptoms have really cleared), you’re lauded as a brave soul.

And we think it’s fine.

Why even bother with all the pres and all the stories? Our culture loves its hard hits and its blindside tackles. We love to watch people get the crap pummeled out of them every Monday night. We love to watch our heroes go down, and get up and continue to play, no matter what. We get all hopped up on adrenaline and drama, get high off our bodies’ stress response hormones, and we worship the ground the most risk-taking, danger-seeking players walk on. We love our heroes, and we expect everything of them — except basic human vulnerability, and simple biological susceptibility.

It’s football season, and student athletics are swinging into high gear.

Concussion anyone?

Oh, take two — they’re small.

A million little hits

Source: photolib.noaa.go

Somebody needs to do a study on the cumulative biochemical impact of constantly finding out you screwed up. I’m serious about this – especially for new mTBI survivors. And long-term survivors, as well.

See, here’s the thing – stress impacts thinking. Cortisol mucks with your thought process. Stress hormones block out complex reasoning abilities, in favor of pure fight-flight-freeze reactions. And the long-term effects of high levels of stress hormones do have a cognitive impact.

So, after you sustain a TBI, and you’re in that initial phase of cluelessness, where you are so positive that you’re fine and everyone else is screwed up… and you keep undertaking things that seem perfectly reasonable to you, but aren’t exactly good ideas… and you keep bumping up against your new limitations (I won’t say “newfound” because it takes a while to find them)… all the while, you’re getting hit with these little “micro-blasts” of stress. The plans you make don’t work out. The relationships you depend on start to erode. Your behavior becomes not only mysteriously different, but also uncontrollable and unmanageable, and every time you turn around, something else is getting screwed up. You weren’t expecting it at all. It’s a shock — to your self and to your system.

Lots of false starts, lots of botched attempts, lots of pissed off people… and all the while, the cumulative effect of your body’s stress response to these “micro-traumas” is building up. The really messed-up thing is, that when you’re freshly injured, the experiences you have can take on vast proportions, and every little thing can seem like a monumental event. Which makes your reaction to them that much more extreme — a lot more stress hormones get released into your system that might otherwise, if you had a sense of perspective that was proportional to the actual events of your life.

But no, when you’re freshly injured, EVERYTHING can seem like a

Big Deal.

Of course, you have no reason to clear out the biochemical sludge with something like exercise or mindfulness meditation or anything like that, because either your brain is telling you that it’s much more pleasant to sit around and watch television, and/or you’re so exhausted from the stresses of daily living that making additional efforts or changes is out of the question, and/or you’ve got a lot of pain, and/or you don’t have access to the equipment or a support system or good guidance for how to start with something like that.

You’re off in your own private Idaho — no, wait, your own private hell — of watching your life fall apart for no reason that you or anyone else can discern.

After all, it was just a little bump on the head, right?

People have been puzzling for some time about the connection between TBI and PTSD, as though they are two entirely different and distinct conditions. I can tell you from personal experience that traumatic brain injury, even mild head injury, can and does result in post-traumatic stress disorder. Because even though the build-up of stress hormones is gradual and incremental, it still happens. And unless and until you figure out a way to clear out the biochemical sludge of one alarming stress response (no matter how small) after another, you’re going to have a heck of a time clearing your mind to the degree you need to clear it.

Being a mild traumatic brain injury survivor (I’m actually thriving, not just surviving), and having experienced what my neuropsych has called a “phenomenal” recovery, I can personally attest to the importance of exercise and good nutrition in helping the brain recover. I can’t even begin to tell you how “gunked up” I was, when I first showed up for my neuropsych testing. I was a wreck. Just a walking series of screw-ups waiting to happen. I bounced from job to job, just dropped out of a couple, made really bad choices about my money and my career and my home and my relationship, and to those who were watching, I was indeed teetering on the brink.

Now, I’ve been extraordinarily blessed to have connected with a neuropsych who firmly believes (after 25 years of working in TBI rehabilitation and 30 years in neuroscience) that recovery is possible, even probable, and that there is hope of some kind for even the most intractable cases. But even they weren’t expecting me to do as well as I have.

Especially in the last year, I’ve made some pretty great progress, and it coincides with my starting to exercise each morning. I don’t do a lot, most days — just get my heart rate up for 15-20 minutes, then stretch, then do some light strengthening exercises. The main thing is that I get my heart and respiration rates up, and that I jump-start my system. This is something that anyone can do — and you don’t need special equipment to do it. We all have bodies, and most of us are able to exercise them enough to get our heart rate and breathing up.

This is key. I can’t say it enough — to help clear out the buildup of stress hormones in the body which can impair thinking and make the aftermath of an mTBI even more challenging than it is already, exercise helps like nothing else.

What’s more, it oxygenates the brain and it stimulates the parts of the brain that learn and heal. How amazing is that? Very, very cool. Even after a long period of difficulty, as the folks at the Concussion  Clinic at the University at Buffalo have found, regular exercise can clear away “stuck” difficulties of post-concussive syndrome. One of their study participants even got back to a way of being that was better than he was before his six concussions or so — according to his mother.

Why does this work? How does it work? There are lots of possible explanations, but at the core — for me — it’s about giving your body the ability to deal with the constant onslaught of surprise and alarm and reaction to situations which emerge (often blindsiding you) in situations where you thought you were fine. For me, it’s very much about giving your body the ability to return to balance, to homeostasis, so it can just get on with living life. It’s about clearing out the cortisol, the adrenaline, the noradrenaline, and the handful of other biochemical substances that our brains normally secrete in order to help us deal with emergencies. Humans don’t have the same ability as animals, to clear this stuff out. Rabbits and antelope will shiver violently and shake and run around to clear out their biochemical “load”, but humans just end up hanging onto it, for better or for worse.

But, you may say, having things turn out differently than you expected isn’t such a big deal. Why would that be so stressful?

Trust me, when you’ve sunk a whole lot of time and effort into something and your self-image and survival (i.e., job) depend on things going the way you planned… and then things turn out to be screwed up in a way you hadn’t anticipated, and everyone is all worked up and pissed off and gunning for you ’cause you wrecked things (again), it does produce an extreme reaction. Especially in someone who has to contend with the extreme emotions and volatility, uncontrollable anger, rage, inexplicable confusion, and all that crazy anxiety and agitation that go hand-in-hand with traumatic brain injury. Even folks with “mild” injuries have these kinds of issues, and it can exacerbate and compound matters to no end.

Ultimately, if it builds up enough (and let’s not forget the embarrassment and shame and confusion that can be socially isolating), it can all become utterly debilitating. Disabling. And all because our  bodies haven’t had a chance to recover adequately from all these little incremental alarms, shocks, and other reasons to get pumped full of adrenaline and cortisol.

So, it’s important to not gloss over the effect of those million little hits. Inside our bodies and inside our minds, they do add up. And as our bodies accumulate the sludge of fight-flight-freeze, our minds are affected. Fortunately, there is a way to deal with it — exercise. Vigorous to a degree that gets your heart and respiration rate up.

Don’t have access to a gym? So what? Take the stairs instead of the elevator. Don’t have a set of weights? Big deal. Carry around some heavy stuff in your home. Don’t have an exercise bike? Do some knee bends, jumping jacks, and run in place. Swing your arms around. Stretch and move. Just get going — enough to get your heart rate up and create a noticeable difference in your body.

Now, I’m not saying it can fix things overnight. It’s taken me a year of consistent effort and commitment to get to this point, and when I started out, it was about the last thing I wanted to “have” to do each morning. But I wasn’t making the kind of headway I wanted to in my recovery, and the doctors were starting to talk about putting me on meds for my attention and mood issues. Given the choice between pharmacopia and 15 minutes of exercise each morning, I went with the latter. I’ve done the drug thing before, and it just made my life that much worse. I can’t go back there again. I just can’t.

So, I started getting my butt out of bed, and am I ever glad I did. I’ve read about biochemical stresses and PTSD in the past, and I’ve read about how animals can clear out the “soup” but humans can’t. But until I started exercising and got clearer as a result, the full impact of what I’d read didn’t sink in.

Now it’s sunk in, and it makes total sense. TBI can very much lead to PTSD — by right of the constant barrage of surprise and alarm and shock (not to mention our tendency to over-react to the unexpected or unfortunate events in our lives) which bombards us with stress hormones that don’t automatically clear themselves out of our sensitive systems. Given that TBI survivors’ systems tend to be even more sensitive after our injuries, it’s all the more reason to get up and get moving.

If you’re still sitting down while reading this, please get up off your butt and move. Your brain — and your life — will thank you for it.

Being better than that

Source: u m a m i

Well, this has been a mixed week. On the one hand, I’ve been settling in more and more at work, taking on more projects and getting synched up with my team and the larger department.

I’m making good progress, and it feels great.

On the other hand, I’ve been very erratic at home, perhaps because of the pressure I’m feeling about this new job, making sure I don’t screw up, and keeping my facts straight. I’ve noticed a few times, already, that I’ve gotten facts and figures turned around — not for lack of trying… I was really trying to get it right — and now those incidents are looming large in my head, taking up space and making me feel like crap.

Which hasn’t been helping at home. I’ve been volatile and cranky and have blown up a few times over the past week. And my spouse is only too happy to spend most of the day away from me today. They’ve got a job they’re doing later today, so they get to be with their “posse” while I spend some quiet time at home getting my act together, catching up with myself, moving at my own pace, etc.

Some good has actually come out of this fairly challenging week. Both of us have been looking at our behavior and our parts in the fights and squabbles, and we’re both taking responsibility for our less-than-helpful habits. Both of us know it takes two to tangle, and we both know that we’re each as high-strung as the other, at times. We both have our issues, and at least we’re both willing to take steps to do something about our behavior.

And we’ve been deliberately mindful of our interactions, in the aftermath of the electrical storms. We’re both making an extra effort to be responsible and not fly off the handle over every little thing. Unlike times in the past, this week, we’ve been able to rebound and treat each other with dignity and respectful consideration, which is really the cornerstone of any healthy relationship, whatever its nature.

Bottom line is, we know we’re both better than how we’ve been acting. We’re not total jerks, but we do really good impressions of them at times 😉 The thing to remember, is that what we do and what we say is not who we are. We’re much better than that. And we know it.

I guess that’s the main thing — knowing who you are and realizing that you’re capable of a lot more (and better things) than you are currently engaged in. There are all sorts of strategies one can apply to motivate oneself to better behavior  — thinking about what’s in it for you, if you do such-and-such… thinking about how you want your life to be and deciding if what you’re doing now is going to help you get there… having compassion for those you’re dealing with and being willing to extend them the respect they deserve.

Those are all great, and they work for a lot of people. But in my case, that’s a lot more thinking and a lot more abstract than I care to get on a regular basis. For me, it boils down to What sort of person am I… really? And would that sort of person be doing this sort of thing at this point in time? What kind of character do I have, and what principles matter most to me in life? Am I acting in a way that honors those principles and is a true reflection of my character — or the character I seek to develop.

Now, I know that the whole “character” discussion is not something people often talk about. But it matters to me. It matters a whole lot to me. What other people do and how they behave is one thing. It’s not my concern. But how I act and what I do, is my concern. It’s a big one, too. Maybe I’m old-fashioned, maybe I’m just a throwback to the last century when these things mattered a whole lot more than they do now. But the bottom line is, character matters. My character matters. And when I keep that uppermost in my mind, it keeps me out of the mire.

Another thing that keeps me out of the muck of self-destructive behaviors, is realizing that as important as character is to me, my brain has been jumbled up enough to want to go off and do its own thing. And it’s up to my mind to keep my brain from derailing my life.

I share Dan Siegel’s belief that the main is a guiding force that directs energy and information throughout the system, and the brain is the organ that generates and conducts energy and information.  Brain and mind are not the same. Character and behavior are not necessarily equivalent. They are connected, but behavior can go off the rails temporarily without making a permanent statement about my underlying character.

No matter what I do, no matter how badly things go for me, no matter how many things I confuse or how often facts get turned around, the bottom line is, I’m a good person who wants to do right. If I weren’t… if I were a total jerk and a-hole, the problems I have wouldn’t even bother me. I’d just go on with my life, as though none of it mattered.

But it does matter to me. And I know I can do better. So long as I keep trying, I always have the opportunity to show — yet again — that I am better than the things that try to bring me down.

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