I went to therapy on Tuesday with a migraine.
I have to pause for a moment and talk about migraines, pain, and trauma. Whenever I have mentioned the nightmare known as The Migraine on any blog, well-meaning people have offered helpful comments. I certainly want more good information particularly if I don’t have it, but it must be explained first that a migraine is not a headache (please bear with me as I will make a point). It’s a neurological event that, if left untreated, can leave lesions on the brain, thusly, leaving the brain vulnerable to a future ischemic attack. Who knew? I certainly didn’t. You can’t fool around if you have “chronic migraine” (15 or more attacks in a month). I am one of those people. A dark room, a few Excedrin for Migraine, and lavender oil don’t help me. Regretfully…
I began experiencing migraines after an auto collision, and these pain-mongering menaces arrived days later and never left.
They are the bane of my existence. I have tried everything known to, well, anyone for 13 years now and continue to pursue every avenue of treatment and prevention available from PT, diet therapy, pharmaceutical interventions to yoga, breathwork, chiropractic, aromatherapy, massage, acupuncture, myofascial release work, European herbal remedies…you name it. They don’t stop. Ever. They might abate for a while, but they always return. I was in the ER on Tuesday night for an infusion of the magic cocktail due to a migraine that lasted around 16 days. It sucked, and I felt very discouraged.
Once again, I was in therapy during this round in the ring with Mega Migraine, and my therapist, who has experience counseling people with chronic pain, tried to coach me through the pain suggesting different strategies. He also asked me carefully if past trauma played a role in the frequency of my migraines–a legitimate but admittedly tiresome question. At times, however, one starts to feel patronized. I did my best to answer his questions while I massaged
stabbed myself as if I had an ice pick trigger points and squinted at him possibly slurring my words.
This is where, I observe, that people with PTSD or past trauma might experience a defensive response (looking catatonic can be defensive in nature, I suppose). I do, at times, feel emotionally defended when people suggest that migraines or any other illness are psychosomatic if you’ve experienced trauma; that is an oversimplification as humans are far too complex. I didn’t, however, defend myself at all on Tuesday because I was in too much pain, and, for what it’s worth, I know the emotional stressors that trigger a migraine attack. I also know that a car crash has damaged the nerves in my neck (neuropathic pain), and I also have vasculitis in my CNS thanks to SLE (Lupus) not to mention genetics. These are three “quantitative” etiologies for these migraines that have nothing to do with PTSD or past trauma; so, I felt safe enough to address the more qualitative reasons.
For example, the sound of my mother’s voice will trigger a migraine in a certain part of my head–around the trigeminal nerve to be exact–in about five minutes. This is a primary reason I’m pursing EMDR. That is a classic trauma-based somatic response. I want that outta here! If one of my daughters becomes labile and needs to go to the Behavioral Health ER for something like suicidal ideation or a sudden onset of a mixed state, I will most likely experience a migraine within 12 hours after that. That is a classic stress trigger for me. My ex-husband’s antics will trigger a stress-related migraine particularly if it hurts one of my daughters in a meaningful way, but this does not mean that a migraine emerges out of the ether and descends upon me, the migraineur, in some sort of psychosomatic fog. Blood pressure, adrenaline, and cortisol most likely play a huge role in affecting the blood vessels in the brain thanks to the stress experienced from these events, thusly, causing a migraine. We are not machines even though Descartes would like to attribute such a description to humans.
Westerners can be quick to banish anything stress-related and almost act as if the resultant symptoms are not real. Stress causes heart attacks. That’s as real as it gets.
Look at the rise of hypertension and diabetes or even cancer. One can point at diet first, but what fuels the poor diet choices (leaving out low income and class issues)? Stress. Why, for example, won’t people give up their favorite foods loaded with salt, sugar, and unhealthy fats? Stress. People are often trying to mitigate stress using the closest thing at hand to do that–food products i.e. substances. The Big Three make us feel better for a time, and that’s real and measurable. Reduce stress and one observes a subsequent reduction in illness and its damaging effects on the body and mind. This is a known principle. Once stress is reduced, the automatic habits that go along with that stress tend to reduce as well i.e. emotional and/or stress eating, increased alcohol intake, increased caffeine intake, increased substance use for stress and emotional management. It’s tough, however, if the very things used for stress mitigation are themselves addictive which, alcohol and opiates aside, dairy and gluten are as their proteins occupy the opiate receptors in the human brain. That’s why it is such a pain in the ass to give them up. What’s more, the very things that ultimately exacerbate our stress levels and level our health surround us namely industrialized food products. Our biology works against us here.
What if then one has done everything one can, but the stress cannot be reduced?
Isn’t that the magic question though? I can’t control my children or my ex-husband. You can’t make an infant sleep through the night nor can you control another person’s behaviors or driving habits, and it’s these very things that potentially exacerbate myriad illnesses in us if we are already under internal pressure–how other people’s choices affect our lives.
Enter The Buffer.
What is The Buffer?
Well, we are supposed to have natural buffers in our lives that help support us in ways that our proxy support systems– Fat, Sugar, Salt, Caffeine, Entertainment, Substances, and other things–do. The emotional soothing and regulation that we get from these sources are supposed to be provided to us from something else. Like what?
Let me introduce you to Rat Park. What is Rat Park?
“The Rat Park Experiment aimed to prove that psychology – a person’s mental, emotional, and psychosocial states – was the greatest cause of addiction, not the drug itself. Prior to Alexander’s experiment, addiction studies using lab rats did not alter the rat’s environment. Scientists placed rats in tiny, isolated cages and starved them for hours on end. The “Skinner Boxes” the rats lived in 24/7 allowed no room for movement and no interaction with other rats.
Using the Skinner Boxes, scientists hooked rats up to various drugs using intravenous needles implanted in their jugular veins. The rats could choose to inject themselves with the drug by pushing a lever in the cage. Scientists studied drug addiction this way, using heroin, amphetamine, morphine, and cocaine. Typically, the rats would press the lever often enough to consume large doses of the drugs. The studies thus concluded that the drugs were irresistibly addicting by their specific properties.
However, rats by nature are social, industrious creatures that thrive on contact and communication with other rats. Putting a rat in solitary confinement does the same thing as to a human, it drives them insane. If prisoners in solitary confinement had the option to take mind-numbing narcotics, they likely would. The Skinner Box studies also made it incredibly easy for rats to take the drugs, and it offered no alternatives. The need for a different type of study was clear, and Alexander and his colleagues stepped up to the plate.”
Are you curious yet?
“The goal of Bruce Alexander’s Experiment was to prove that drugs do not cause addiction, but that a person’s living condition does. He wanted to refute other studies that connected opiate addiction in laboratory rats to addictive properties within the drug itself. Alexander constructed Rat Park with wheels and balls for play, plenty of food and mating space, and 16-20 rats of both sexes mingling with one another. He tested a variety of theories using different experiments with Rat Park to show that the rat’s environment played the largest part in whether a rat became addicted to opiates or not.
In the experiment, the social rats had the choice to drink fluids from one of two dispensers. One had plain tap water, and the other had a morphine solution. The scientists ran a variety of experiments to test the rats’ willingness to consume the morphine solution compared to rats in solitary confinement. They found that:
- The caged rats ingested much larger doses of the morphine solution – about 19 times more than Rat Park rats in one of the experiments.
- The Rat Park rats consistently resisted the morphine water, preferring plain water.
- Even rats in cages that were fed nothing but morphine water for 57 days chose plain water when moved to Rat Park, voluntarily going through withdrawal.
- No matter what they tried, Alexander and his team produced nothing that resembled addiction in rats that were housed in Rat Park.
Based on the study, the team concluded that drugs themselves do not cause addictions. Rather, a person’s environment feeds an addiction. Feelings of isolation, loneliness, hopelessness, and lack of control based on unsatisfactory living conditions make a person dependent on substances. Under normal living conditions, people can resist drug and alcohol addiction…
Today, psychologists and substance abuse experts acknowledge the fact that drug and alcohol addiction involves transmitters within the brain. Certain chemicals latch on to different receptors in the brain, altering the way users think and feel. The user becomes addicted to the high he or she experiences while on the substance, and soon has to use it all the time to cope with other feelings. The more neuroscience discovers about addictions and the brain, the more physicians can find solutions to treat addictions.
What scientists today realize is that addiction is as mental as it is physical. Humans do not have to be physically isolated, like the rats in the Skinner Boxes, to become addicted to substances. Emotional isolation is enough to produce the same affects. Humans cope with their feelings of dislocation with drugs and alcohol, finding an “escape” or a way to smother the pain. A human’s cage may be invisible, but it is no less there.” (online source)
Many people have written about Rat Park. My takeaway is this: In order to heal and progress in a meaningful way we must build a buffer. We must emerge from our human cages with as much dedicated effort as possible and do something different than we’ve been doing.
Why do I call it a buffer? That’s what my neurologist called it, and it struck a chord. She had prescribed five medications for me to take in order to prevent constant migraine pain. Five. It’s ridiculous. When I asked her why so many she said, “These medications are your buffer. Your life is so stressful. You have nothing in your life properly supporting you right now. Until you have real buffers in place like people you can count on consistently to alleviate some of your intense stress like your sick kids and abusive husband, you need the medication. Otherwise, you won’t be functional because your brain is just too irritable. Your circumstances have to change, and the meds are bridging the gap for you until they do.” Well, that’s a lousy answer, but is that not a true answer for so many of us? Who is absorbing the stresses and inequities of our situations? Us. Our bodies. Our minds. Our spirits. We are caged in circumstances that we did not entirely choose.
Psychologist Adi Jaffe states:
“To make matters more complicated, we know that biological influences related to genetic differences, neonatal (birth-related) circumstances and early nutrition can alter brain mechanisms and make people more, or less, susceptible to the effects of trauma. For instance, we now know that early life trauma alters the function of the Hypothelamic-pituitary-adrenal axis, making individuals who have been exposed to trauma at an early age far more susceptible to stress, anxiety and substance use; or that hypoxia during delivery (certainly a form of trauma) can increase the chances of mental health defects later in life. Like the Rat Heaven experiment, it should be somewhat obvious that without these early traumas, the individuals in question (those who struggle with addiction) would experience less “need” for heavy-duty coping strategies like, let’s say, opiates. So biology is important here at least in this regard.
So trauma and stress are not at all objective truths but rather individually determined patterns of influence. I am fully on board with making sure that the treatment system we use does not exacerbate the problems that stress and trauma bring about (so no shaming, breaking-down, or expulsion of clients for their struggles), but I think that the picture this TED talk and the related book presents is far too simplified to be as helpful as we want it to be. I believe that more focus should be given to improved prevention efforts in order to reduce the likelihood of these early traumas and therefore of later drug seeking experience in the first place. I also know that significant efforts are already being put into this sort of work through a multitude of social-services organizations and government agencies. Needless to say, the demand for drug use has not abated despite these efforts. It’s been happening for at least 8000 years already and I’m thinking it’s here to stay.” (Adi Jaffe)
Where does this leave me? What is my point? It’s not as if we can suddenly jump from our circumstantial cages and swan dive into a metaphorical Rat Park as lovely as that would be, but can we migrate to such a place given the chance to make small, meaningful changes consistently? Is that possible? I think so.
Well, that’s what I’ve been trying to do for the past 13 years. The reason that I know it’s been 13 years is that the very auto accident that resulted in my now ever-present migraines occurred two weeks after I ended my relationship with my father–my primary abuser. That was a monumental choice in my life, and, while I did not know it at the time, it set me on a course of recovery. The trajectory of my life changed in that moment. A few years later, I ended my relationship with my mother, my secondary abuser. And, a year and half ago, I ended my marriage. I finally climbed out of that cage. No more abuse. From anyone.
Was it hard? Excruciating. It is hard for me to describe the emotional suffering and turmoil I experienced last year. The pain and grief were nothing if not backbreaking. I think I wept more last year than I have in my entire life, and it wasn’t because I missed my ex-husband. It was simply an overflow of pain, grief, loneliness, fear, and existential alienation that I was forced to set aside in order to survive. I had pretended to be fine for so long that when it came time to be truthful with myself, it became a reckoning. I spent many sleepless nights sobbing. I can barely write about it even now. I felt like I was somehow vomiting forth my viscera through my tears, but, I think, it all had to go. Years and years of absorbing the inequities, the emotional and physical abuse, and believing that in order for others to be happy I had to diminish had to be sucked from me as a poison. And do you know what has happened? Unbelievably, my Lupus blood panel is now normal. For the first time since my diagnosis, I am in remission.
My neurologist also wants to look at reducing those medications. I am getting better.
I enrolled in grad school.
And…ahem…I met someone, y’all.
Yes. This is hard. I have never lied on this blog about the inordinate difficulty involved in turning your life around. BUT…it is possible. And that is what I have always wanted to know. I never cared if creating a life worth living was hard. I only wanted to know if it was a possibility for me.
Is it possible? Yes, it is.
So, excuse my language, but fuck hard. Do what is possible because, while it might seem impossible, it’s not.
You can do this. Keep going.