Generalized Anxiety vs. PTSD Anxiety

I have devoted a lot of space on this blog to writing about PTSD, C+PTSD, and healing from trauma.  I’ve been honest about my own journey towards wholeness.  What I share here is an attempt to elucidate the emotional experience behind C+PTSD in specific the anxiety experience.

What I can say for certain about healing from C+PTSD is that it is like a disease that remits and exacerbates.  I can go a year and not devote any time to thinking about the man who abducted and trafficked me, my time in captivity with him, or the events that happened to me therein.  I rarely think of my father or stepmother.  My mother doesn’t come to mind much either in the context of her abusive behaviors.  The domestic violence I experienced in my former marriage is no longer foremost in my mind.  It’s not the people or specific events that dog me now.

So, what is left after you deal with the details and process the events? What is left after therapy because there is something left?

I’ve had a hard time defining the quality of what remains until a friend sent me a link to this article yesterday:

We Can’t Keep Treating Anxiety From Complex Trauma the Same Way We Treat Generalized Anxiety

Vicki Peterson, the author of this article, writes:

No one gets a prize for “worst” depression, anxiety, trauma or any other combination of terrible things to deal with, and no one should suffer alone. With that in mind, there is a difference between what someone who has Complex PTSD feels and what someone with generalized anxiety or mild to moderate depression feels.

For someone dealing with complex trauma, the anxiety they feel does not come from some mysterious unknown source or obsessing about what could happen. For many, the anxiety they feel is not rational. General anxiety can often be calmed with grounding techniques and reminders of what is real and true. Mindfulness techniques can help. Even when they feel disconnected, anxious people can often acknowledge they are loved and supported by others.

For those who have experienced trauma, anxiety comes from an automatic physiological response to what has actuallyalready happened. The brain and body have already lived through “worst case scenario” situations, know what it feels like and are hell-bent on never going back there again. The fight/flight/ freeze response goes into overdrive. It’s like living with a fire alarm that goes off at random intervals 24 hours a day. It is extremely difficult for the rational brain to be convinced “that won’t happen,” because it already knows that it has happened, and it was horrific.

Those living with generalized anxiety often live in fear of the future. Those with complex trauma fear the future because of the past.”

This is absolutely true, and most therapists don’t seem to have a clue that there is a difference.  Perhaps this will help someone reading this…

I live with a smoldering anxiety that never leaves me.  It peaks when I’m happy.  Oddly, it ebbs when I’m too busy to pay attention to what’s going on around me, and I suspect that trauma survivors try to stay so busy because it prevents them from feeling this particularistic type of anxiety.  When I’m struck with the evanescent beauty of a moment, fear creeps in like a thief and begins to steal my joy.  I do not know how to escape any of this.  It might be strange, but I’ve tried to make friends with it.  I’ve wanted to understand it in an effort to defuse it.

As Ms. Peterson has said, I don’t fear because I’m generally anxious.  I do not have an anxious personality.  I fear because of what I’ve known.  Because of my past experiences.  When the worst-case scenario has already happened to you, then who’s to say it won’t happen again? Yes, I’ve survived extreme sexual torture, a kidnapping, human trafficking, and years of abuse in my family of origin.  I was duped by my ex-husband for twenty years and sexually assaulted by him.  My former therapist told me that I could clearly survive anything.  My brain fears that I will have to do it again.  Over and over again.  This is the flavor of anxiety that belongs to trauma survivors.  This is the nature of PTSD and C+PTSD anxiety.

I do practice mindfulness, but becoming mindful does not shut down my anxiety.  It often only makes me more aware that I’m fearful and feeling helpless.  It can promote the very hypervigilance I’m seeking to escape.

The remedy for both anxiety and trauma is to pull one’s awareness back into the present. For a traumatized person who has experienced abuse, there are a variety of factors that make this difficult. First and foremost, a traumatized person must be living in a situation which is 100 percent safe before they can even begin to process the tsunami of anger, grief and despair that has been locked inside of them, causing their hypervigilance and other anxious symptoms. That usually means no one who abused them or enabled abuse in the past can be allowed to take up space in their life. It also means eliminating any other people who mirror the same abusive or enabling patterns.

Unfortunately for many, creating a 100 percent abuser-free environment is not possible, even for those who set up good boundaries and are wary of the signs. That means that being present in the moment for a complex trauma survivor is not fail-proof, especially in a stressful event. They can be triggered into an emotional flashback by anything in their present environment.

It is possible (and likely) that someone suffering from the effects of complex trauma is also feeling anxious and depressed, but there is a difference to the root cause. Many effective strategies that treat anxiety and depression don’t work for trauma survivors. Meditation and mindfulness techniques that make one more aware of their environment sometimes can produce an opposite effect on a trauma survivor.  Trauma survivors often don’t need more awareness. They need to feel safe and secure in spite of what their awareness is telling them.”

Feeling safe and secure, for me, is key.  Safety and security in my relationships and environment seem to be the cure.  I know why feelings of relief and happiness trigger feelings of fear and, sometimes, emotional flashbacks.  My father deliberately cultivated feelings of happiness and relief in me in order to overturn them and further engage in abuse.  He was a pathologically cold man.  My mother’s emotional and personality disorders caused constant instability in our family environment.  As soon as any sort of happiness was achieved, it vanished just as quickly due to her inability to maintain a consistent mood or affect.  She also attempted suicide numerous times.  As soon as any family member felt relief that she might be doing better, she would attempt suicide again or lash out in talionic rage against someone in the family.  Nothing in my family life was ever predictable.  We consistently waited for “the other shoe to drop”.  I grew up on edge.  If there were ever a moment of happiness, I knew that my mother would ruin it.  Or my father.  That has proven to be true over the years.

Consequently, when I feel this rising panic borne of this nebulous but constant fear that follows me everywhere, it isn’t generalized.  It is quite specific, and I find myself saying, “I can’t go back to that.  I can’t do that again.  I won’t do that again.”  And, I feel frozen and terrified as if an old enemy has found me.  I feel a strong urge to cut all ties and run away mixed with a terrible almost existential fear that I will live out my life completely alone.  And, yet, I know that this will all pass.  It is, as I said, like an exacerbation of an autoimmune disease–an autoimmune disease of the mind and soul.

With that said, what is to be done? Well, I have therapized, read, studied, and pursued many roads over the last twenty years in order to answer that very question, and I’ve had a fair amount of success.  For the survivor of trauma, however, consistently establishing safety and security in your myriad environments and relationships is the number one thing to do to defuse anxiety and flashbacks related to trauma.  This will always be the first and last step.  It is also the first question to ask when you feel that familiar fear rise: “Do I feel unsafe or insecure anywhere in my life or in any relationship?”

I hope that this has been helpful to you.  Ms. Peterson’s article has been very helpful and validating for me.

As always, keep going…

Shalom, MJ

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Healing Past Trauma in The Present

I have been trying to find an appropriate way to write about a particular “emotional” experience that I have endured for years.  I wouldn’t blog about this were it not for the fact that most survivors of trauma seem to experience something quite similar.  What is it?

It isn’t exactly the Foreshortened Future experience, and it isn’t the “catastrophizing” thought distortion either.  One could say that it is a combination of both.  It is somewhat unique unto itself.  Essentially, it is a fundamental feeling of dread that something terrible is going to happen.  It usually comes out of nowhere most often when nothing terribly stressful is happening and particularly when you’re feeling happy.  It almost feels like you’re being watched, but it’s not paranoia.  As if Life Itself is watching you.  Waiting to destroy your happiness.  To inflict something torturous and terrible on you.  It is the emotional experience of “the other shoe is going to drop” x 100.

It creates fear and panic.  An anxiety extraordinaire.  And no matter what I’ve done in terms of CBT, DBT, EMDR, and therapy, this flavor of terror has stubbornly stuck around.  I’ve grown so tired of it that I generally don’t discuss it when it strikes.  I live with it until it passes.  It is so familiar to me.  I cognize myself out of it, and my therapists praise me for that.  I don’t feel good about it.  I feel exhausted and somewhat defeated.  This just doesn’t feel good enough.

In the midst of one of these unusual “anxiety attacks”, a friend suggested I try breathing essential oils.  There are some oils that are particularly good at crossing the blood-brain barrier and affecting the limbic system.  I had those oils on hand.  I gave it a shot, and it was effective.  I was pleasantly surprised.  She then suggested that I introduce some cognitions while smelling the oils the next time.  This experience felt very similar to EMDR using essential oils (and I do not recommend doing that if you have a lot of unresolved trauma because it was remarkably potent).

What came to mind, quite out of the blue, during that most particular feeling of dread was an ordeal from my time with trafficking.  It came so far out of left field that it stunned me.  I said out loud, “What does that have to do with anything?”

I’ll write about it here because I think that it is so important in terms of present experiences of trauma and anxiety that we can experience.  I did not receive any justice in terms of the legal system regarding my trafficking experience.  I got away and survived it.  The man who abducted me was never caught, but he knew where I lived.  And, he knew where I was going to go for college.  He made threats to find me and murder me when I was in the trafficking environment should I try to escape.  Law enforcement agents explained to me that should I see him, I was to notify them, but they admitted that I was vulnerable to “secondary contact”.   For at least two years, I lived with feelings of terror and dread that he would find me again.  I had nightmares.  I looked over my shoulder.  I checked and double-checked my car.  I wouldn’t go anywhere alone.  Whenever I relaxed enough to start to enjoy myself, I suddenly couldn’t because he might show up.  That might be the time that he would make good on his threats.  It probably took a full five years to stop looking over my shoulder and another ten to stop believing that, at some point, he was going to find me and kill me.  My heart still skips a beat today if I see someone who resembles him.

How does this connect to the present dreadful anxiety attacks? I suspect that what is happening today are actually the same feelings of dread that were related to the post-traumatic experience of leaving the trafficking environment, but they have lost their context.  Those feelings were never processed.  So, they continue to play out until they are processed.  I never talked about them.  There was no one to talk to during that time.  I just had to start college and pretend that none of it ever happened.  Those feelings are so strong today because I was in a marriage that triggered those feelings of dread and enlivened them.  They are now front and center.  They appear as an emotional flashback void of visual cues.  The way to deal with them properly is to go all the way back to their source, but, if you have profound trauma, do not do that alone.  You need the guidance and support of a trained clinician.

I am always fascinated by how we function.  Our brains seem to be fighting us, but they aren’t.  We just lack information.  What amazes me more is that when we’re finally able to listen and receive information, our brains speak to us.  When I finally sat down and asked, the memory came forward clearly.  I almost dismissed it because it made no sense to me.

I encourage you to take time out of your day or week to journal or pay attention to what your mind is offering.  Some of it is white noise and cognitive distortions, but not all of it.

And, if you really want to look into something interesting, then check this out:

Emotional Release with Essential Oils

 

 

Claude and Me

I don’t know about you, but I don’t like people knowing about my deeper, darker trauma history.  I don’t like people knowing that I ultimately ended my marriage because of domestic violence.  It goes without saying that I don’t like people knowing that I was trafficked when I was 18.  Yes, that was twentysomething years ago, but there are aspects of it that still feel like now.  That is how trauma works.  Unprocessed and maladaptively processed trauma remain in the “still happening” box in your brain.  This is why those memories pack such a punch when you recall them or re-experience them.  Your limbic system activates when you think about them.  You sweat.  You have gastrointestinal symptoms.  You might experience a migraine.  You might feel a sudden need to run.  Maybe you get belligerent.  Or, perhaps you lose your words–you can’t speak.  You can chalk that up to that very basic survival reaction called fight or flight (or freeze).  We can thank acetylcholine, a neurotransmitter, for a lot of those symptoms.  It’s all very real.  You are not making it up or wishing yourself ill.

Me? Sometimes, out of nowhere, I have a sudden urge to move house, leave town, and start over with a new identity.  I’ll panic and think, “People know too much about me.  I’m too vulnerable.  I must leave.  Must…run.”  I’ll want to cut off all relationships and flee.  I don’t do that, of course, but it happens from time to time.

I had that experience when I was in California.  I wanted to leave the country.  A gulag in Siberia started to sound pretty appealing to me.  Why?

It all started with this guy…

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Claude the Albino Alligator

I didn’t know that his name was Claude until I started writing this post! That somehow makes this seem funny in a sinister Loony Toons sort of way.  So, I had just walked into the California Academy of Science.  I saw a lot of people gathered around a large open air exhibit.

“Ooooh, what’s that?” I thought.

I sauntered over, and that’s when I saw him.

Claude.  A very large alligator.

An alligator!

I am extremely afraid of alligators.  It all began when I was a very small child.  I was convinced that a gator was living under my bed, and this seemed perfectly reasonable to me because there was a bayou directly behind my house.  Sometimes alligators would emerge from their natural habitat and awkwardly drag themselves down my residential street.  So, every night I had to be careful not to let any of my extremities fall over the edge of my bed lest that under-the-bed-alligator bite them clean off!

Fast forward to my 18th year.  Was I over my fear of alligators? I liked to think that I was, but I wasn’t.  I was fascinated by them, but I maintained a strong fear of them.  It remained visceral for me.  I left Texas after I graduated from high school, and I figured that I left alligators behind for good.

I was wrong.

Human trafficking for the purposes of sex work is talked about today.  Shows like NCIS, Law&Order:SVU, and Criminal Minds use the topic in their plot lines.  The most accurate on-screen portrayals of an abduction and sex/human trafficking scenarios that I’ve seen are represented in the movie Taken.  The auction at the end? Those are very real.  The buyers? Real.  Girls being closed up in rooms, drugged, and raped? Real.  That was very close to my experiences in the early 90’s.  Not much has changed.  What is not discussed or used as fodder for entertainment is the torture aspect of trafficking.  Torture is a very important part of human trafficking because psychologically “breaking” an abductee is important in order to gain compliance and destroy hope.  My perpetrator used alligators.

Alligators.

Do you remember that scene from Raiders of the Lost Ark in which Indy opens up the ancient Egyptian crypt where the ark of the covenant has been hidden for millennia only to discover that the entirety of the interior is creeping and crawling with snakes–his greatest fear?

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That was me.  “Alligators.  Why’d it have to be alligators.”  In retrospect, my perpetrator was a lot like one of those unintelligent Bond villains thinking up creative ways to torture and kill people.  Instead of using something reliable like a gun or knife, he had to try to be showy and egomaniacal and threaten me with being eaten alive by alligators.

Until a year ago, I never talked about the alligators.  I survived the experience and compartmentalized that particular aspect of my time in captivity.  Until last Sunday, I have not come face to face with another alligator since I was 18.

So, how did I do upon meeting Claude?

I froze.  I started sweating.  My stomach clenched.  I almost started crying.  I had no thoughts.  It was entirely a limbic response.  Pure trauma.  So, I decided to just stand there among all the strangers oohing and aahing over this white, prehistoric reptile and let it flow while I told myself the truth.

“I am okay.  I am safe.  That alligator is not going to eat me.  There is no perpetrator here now who is going to throw me down there.  I will never be thrown to alligators.  An alligator does not live under my bed or behind my house or anywhere near where I live.  I am no longer being threatened.  I can look at this alligator and know that I am safe at the same time.”

And then I moved on with the rest of my day.  That was it.  No one knew what I was experiencing.  Just me.

What is the point of sharing this?

Well, the longer that I engage in the healing work (and it’s been a lifetime work at this point), the more that I realize that I have to be my own biggest support.  I have to be my biggest fan.  I am not trying to say that we become self-reliant Teddy Roosevelts who white-knuckle it on the open tundras of life’s hardships.  What I am saying is that we must learn to coach ourselves through the unexpected scenarios that trigger us because sometimes very powerful healing opportunities arise at inopportune times, and we have to take hold of them quickly.  Sometimes our allies are not around, or they are wrapped up in their own healing work.  We must experience and know our strength, and we do have it.

It isn’t romantic.  It will look nothing like it does in the movies.  The theme from Chariots of Fire will not start playing.  No one will high-five you or lift you up on their shoulders.  Most people won’t even know just how hard you’re working.  Just you.  You will probably be judged.  At some point, you’ll feel like a total failure.  You’ll become disillusioned with yourself and life in general.  It will feel like you’re working twice as hard as everyone else just to be average.  Sometimes you might feel like an outcast.  Like you don’t belong anywhere.  You’ll feel ontologically different, and that creates a devouring kind of loneliness that can almost make you feel cold inside.

This is what healing from trauma feels like.  I describe it as such because I have found that when I discover that my experience is common, then I am consoled.  I am not alone.  Maybe I am okay, and in that sense of being potentially okay I find momentum to keep going.

This is why I will always say, “Keep going.  Never give up.”  It gets easier, and it gets better.  There are bad days, but there are good days, too.  And, at some point, the good outnumber the bad, and life starts to feel worthwhile again.  Even when you’re facing down your fears.

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Look how big he is! 

Keep climbing.  Keep going.  Shalom…

 

The Great California Shenanigan

I returned from my two-week romp through Northern California Monday night with my three hyper-sensitive daughters in tow.  My phrasing might make it sound like I have ten daughters seven of whom have little to no requirement of my presence.  Well, that’s not true.  I have four daughters the oldest of whom will be a senior in college this year.  She had the presence of mind to stay home.  Actually, she had to work.

I feel as if I have returned home a shell of a person.  Do I say this with humor? Yes.  Do I admit this honestly? Mmm…yes.  I prepared them for this trip.  I explained all the ground rules.  I drew diagrams.  I asked them to draw on their reservoir of manners and social skills which runs deep and wide.  I quizzed them on responses to possible scenarios.  I had it locked down not to mention they had been on a trip before.  We are not feral people. None of this was new.

When we entered the airport, I began to experience a subtle but very real feeling of dread.  Our last trip to California was trying.  To be honest, everyone behaved like assholes except for my youngest daughter who is on the autism spectrum.  She managed herself like a champ! “Surely, that won’t happen again,” I naively thought to myself as the TSA was patting me down.

But, a conspiracy was brewing, and my 16 year-old was no doubt thinking something like this…

And shenaniganate she did! It started when we arrived and didn’t end for 15 days! I parented more in two weeks than I do in six months.  I overcompensated, deflected in gardens, ran interference in restaurants, pulled aside and coached in museums, flat out disciplined in quiet corners of conservatories, had in-depth discussions privately, validated, encouraged, pulled out DBT self-soothing techniques, and then took ten-minute baths to cry just to excrete all the stress hormones coursing through my body.  By the 13th day, I was so amped up and anxious myself that I freely admit to feeling like this about my own child…

When we walked into our house at nearly midnight, I didn’t fall asleep until after 4 AM.  I’m still emotionally spent from the trip and feel like I might burst into tears at any moment.  For me, it was a bit nightmarish.  I am not wont to take her anywhere ever again.

In the middle of all of her missteps, shenanigans, and displays of teenage angst all of which I had zero control over, I felt a very familiar feeling creep in.  I started walking on eggshells.  My daughter’s behavior was offensive to our host.  There was no getting around it.  She was politely asked to stop engaging in certain behaviors, and, “forgetting” herself, she would continue to do those very things.  Being very sensitive to changes in mood and atmosphere, I discerned our host’s frustration as soon as he felt it, and I almost couldn’t bear it.  It made me feel ill.  So, I did what years of living within abusive environments have trained me to do; I began to attempt to minimize our environmental impact.  I cleaned up every single thing that I could.  I made beds.  I cleaned up dishes.  I cleaned up the kitchen and countertops.  I wanted there to be little to no evidence that we were there.  I removed the girls from the environment for long periods of time in hopes that our absence would lessen the emotional load.

Does this sound familiar to any of you? If you make yourself invisible then perhaps you won’t cause any sort of negative impact on the environment or those within it.  If you can anticipate the outcomes, then you can run interference in order to prevent negative outcomes.  I grew up doing this in order to mitigate suffering.

I knew I was doing this, but I didn’t know what else to do.  No matter what I said to my daughter or how I tried to influence her, she refused to stop engaging in the very behaviors that were causing the problems.  I eventually concluded that we would have to deal with this once we left California.  I was stuck.  We were all stuck, and I felt trapped.  My two other daughters were feeling it, too, and they were frustrated with their sister.  I didn’t know what to expect from moment to moment, and I was starting to feel an overwhelming sense of anxiety.  I couldn’t anticipate anyone’s responses.  That type of uncertainty causes terrible suffering in me.

As I sit here this morning looking at my shenaniganating daughter, this is how I feel…

I feel profound frustration with her, and I feel almost 100% depletion.  I don’t know how to restore myself.  My host has reassured me that he had a positive experience, but I don’t remember the past two weeks positively.  I remember spending the past two weeks overcompensating for my daughter as well as trying to reach her in a cognitive sense.  Can she practice perspective taking? Will she try to remember to respect the environment? Please…pleaseplease

Raising humans to be good humans is hard.  That is no joke.

So, what do I bring to the table aside from snarky bird pictures that capture my existential and experiential state brilliantly?

  1. As I watched my daughter play the role of Teenage Asshat Extraordinaire with the aplomb of Meryl Streep, I remembered just how hard it was being 16.  Sixteen sucked.  Being the parent of a sixteen-year old sucks, too, and I realized once again that compassion is hard.  Compassion is not for the faint of heart.  It is not a romantic thing even though there is this inspirational notion out there that would convince us of that.  Nope.  Offering mercy to those whom we are currently experiencing as the least deserving of it is when compassion becomes the hardest because that is the moment when you must restrain your judgment.  Using judgment is a great way to cope with emotional distress, but suspending that, entering into perspective taking, setting aside our immediate needs and our beliefs that those needs trump everything else while offering mercy can be the the hardest choice to make.  And yet this is the moment when authentic compassion becomes possible.  This is probably the moment when compassion becomes the most necessary because compassion might be the one thing that changes a gridlocked situation.  Not force but mercy.
  2. I observed that I am all too sensitive to environments wherein there is any sort of emotional negativity or intensity particularly if I have no control.  If I have no way of escaping that environment, then my distress tolerance decreases rapidly.  I will immediately use old coping strategies to cope or survive in such an environment, and this makes me vulnerable to stress-related health issues as well as issues with self-advocacy.  I do not know if this will ever change.  It may be a tendency that I have, and I have to be aware of it.  If I am around people who do not contain well, then I am doubly  affected.  I observed that.  This may be a common trait in people with longterm PTSD.  A return to hypervigilance.  I don’t say this with a lack of hope, but I do think that self-awareness of one’s tendencies is important.

School is starting next week.  I am exhausted.  I feel the need to sleep for a thousand years, but I am determined to regain my composure and find my way back to myself…

What I find interesting about this situation is the idea of perception.  My host’s perception is so different from mine.  My perception could very well be distorted, but, then again, I am the parent.  I was the one standing in between my daughter and everyone else.  I was trying to absorb as much of her negativity as possible in order to ease the stress.  There has to be a way to ground yourself in order to let that negativity go.

In the meantime, life progresses, and, once again, I will let a troubled bird have the last word…

 

I have to laugh a little.  We might have had a very pleasant trip had shit not gotten real, and, in many ways, we did have an exceedingly good time.  There was just one little bird who kept interrupting the flow of fun with her antics.  Sometimes shit happens, and then…we go home.  And, life goes on.  Shit gets real in my house a lot, but maybe that’s okay.

To see more of these delightfully troubled birds, visit The Mincing Mockingbird.

 

 

The Trust Fall

I’ve written here before that I have migraines–chronic migraines.  Whenever a therapist gets wind of that, they always make some version of this face:

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“Oh boy! Somatic symptoms…”

Last week, I was doing the deep dive into some very old “stuff” with my therapist.  I leaned over and started rubbing my head which caused him to blurt out, “Are you getting a migraine?”

I wanted to say this…

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“For the love of God, no, no, and more no! Big barrel of nope!”

Instead I just politely said, “No, I’m just scratching an itch.  I’m fine.”  I really was fine.  I don’t know if you ever feel like this, but the experience of having a clinician or even a friend causally link physical symptoms like chronic migraines or autoimmune diseases to past trauma grates on me.  It has happened so many times over the years that I have developed a maladaptive coping strategy of hiding any and all symptomology in order to avoid oncoming interrogation and analysis.  Does stress trigger a migraine? Sometimes.  Alas, correlation is not causation.  Many other things do as well like aged cheese, sleep deprivation, and MSG.

Hiding one’s physical symptoms is not a good idea.  I freely admit this.  Pretending to be fine when you’re not isn’t a great approach in the long run.  I tell myself that I do it in order not to stress everyone around me.  I believe that my symptoms cause people more stress and worry.  My kids, however, are older now.  They know when something is off, and they know when I’m faking it.  It has been suggested to me that I stop hiding my symptoms and begin being truthful.

Well, that sucks.  You mean I have to start being truthful about how I feel physically?

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WHUT?! NO!!

So, what am I not being honest about here? I have a complicated health history that makes even the most steely physician cry.  This is why many people like to blame it on past trauma.  My past trauma is extreme.  All the more reason to play that card, but it would be premature and lazy to do that.

Two weeks ago I was diagnosed with a blood disorder.  A really annoying blood disorder.  This blood disorder, however, explains a lot of my other autoimmune conditions quite nicely.  In fact, it could be the reason I have the other issues.  In other words, all my autoimmune diagnoses might be manifestations of this singular blood disorder diagnosis, and, from a diagnostic perspective, that’s pretty cool.  It could also explain my long list of allergies.  Imagine that.  One diagnosis explaining almost everything that is wrong with me–including the migraines.  It’s almost miraculous in terms of a diagnosis.  The treatment? Management.  Not cool.  High dose medications that control certain cells in my body.  That’s okay, I guess.

What’s the downside? Some of these medications just happen to lower the seizure threshold.  That’s totally fine if you don’t have a seizure disorder, but I do.  I’ve been seizure-free for 16 years.  What happened this week? I had a seizure thanks to all those medications.  What did I try to do? Hide it.  Was that a bad idea? Apparently.

My daughters were very upset with me.  Someone close to me explained to me why I needed to start including people in on these types of events.  Honestly, I’d rather go into my room, get it over with, and come out.  That is what I’ve always done in the past.  A question was asked of me, “Were you conditioned to do that?”

Well, my mother was not helpful, and my ex-husband always bailed when I was ill.  I learned to handle all kinds of health issues alone–even seizures.  This has become normal to me.  Is it normal? For me? Yes.  Is it normal? I did not want to answer.

Okay.  Would I want someone to have a seizure by themselves? Of course not.  There are myriad reasons why they should not.  I have a friend with a seizure disorder.  I have stayed with her during her preictal, ictal, and postictal times.  It would be wrong–almost immoral–to abandon her.

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“I have backed myself into the logical corner…”

There cannot be two sets of rules–one set applying to me and the second applying to others.  We treat others as we treat ourselves.  I have to give up this maladaptive coping strategy, and I feel suddenly very exposed and vulnerable.  I do not want to broadcast or share my physical symptoms.  Have a seizure? In front of people? 

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Can’t we say I did and then..not?

I guess not.

My boyfriend suggested that I treat it as a trust fall.  Trust fall?! Oh god…

He’s right.  I find certain things relatively easy, but this isn’t.  Telling people that I’m actually really sick and need legitimate help puts me in a very vulnerable position, and I hate feeling vulnerable in that way.  But, this is how we heal.  It’s how we allow people to get close to us.  I want to run off and be sick alone.  Like wild animals do.  They do it to preserve themselves.  That’s probably why I do it, but I don’t think I need to do that anymore.

I will say this.  Life provides us with many opportunities to heal–even when we are sick.

Just stay present.  You’ll see.

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If a cat can do it, then so can I.

The Buffer and Rat Park

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.

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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.

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MJ in therapy…

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.

How? 

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.

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It’s true. Aaaaaanyway….

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.

Core Beliefs and Double Distortions

I paused writing about therapy because I wasn’t sure where to start.  I wish I could have filmed one session.  It was that good.  Alas, I will start where I stopped–core beliefs.

Between the breath work and the core beliefs work, recovery is moving very quickly.  I am sprinting to keep up.  I can tell that there is a change because my mind is quiet.  I don’t feel anxious and afraid all the time anymore.  The PTSD symptoms are calming down.  My pre-fontal cortex is back online which is allowing my executive function to reboot.  I can make decisions under pressure and remember them! This is all the neuroscience behind what happens to your brain during a PTSD flare.  It’s fascinating.

How does this recovery manifest in real time? For me, as the healing quickens, the blind spots are revealed.  What do I mean? Here is an example:

My daughters and I joke around with each other a lot.  My youngest daughter is very irreverent, and sometimes she can take a joke a little too far.  She is on the autism spectrum, however, and that’s not unusual.  She’s learning social skills like everyone else.  Well, we were out at one of my other daughter’s choir concerts, and my daughter very saucily joked, “Don’t make that face! Never make that face!” She then pulled a rather ugly face and guffawed.  I suddenly felt sucker punched.  It came out of nowhere.  I almost burst into tears.  In the previous moment, I was sound.  In the next, I was about to weep.

What happened? A blind spot was discovered.  A core belief rooted in trauma, and I had no idea it was there.  As I sat in the concert working quickly to contain myself, I heard this thought pass through my head, “What if they’re right?”

“Oh my gosh, I know what this is about,” I heard myself think.

I’ve already explained that my father and his wife were cruel people.  When I was young, my father used to videotape me without my knowledge.  Then, when friends or my stepmother’s family came to their house, he would put the videotapes on for their viewing, and his wife would announce with sadistic glee, “Everyone, let’s watch these videotapes of MJ!” I was forced to sit in front of everyone while my stepmother in particular made fun of me.  She mocked my walk, my posture, my face, my teeth, my body, my hair, and everything she could find to scrutinize.  It was an exercise in humiliation and shame.  I developed social anxiety to the point of near agoraphobia when I was younger because of this.

My mother did similar things except without the video camera.  She just got off on criticism.  When she was bored, she would stare at me and begin pointing out my “flaws” be it my haircut, hair color, clothing, skin, nails, my laugh, my accent, handwriting, mood.  You name it.  My mother would find it and use it against me in some way.  Her point? Complete and utter decimation.  By the time I was 18, my self-esteem was obliterated.

In college, when I received the letter inviting me to join the competition for the Rhodes Scholarship, I recall thinking, “This must be a mistake.  Aren’t I too stupid for this?” It did not matter how well I did.  It did not matter how many dates I went on.  It did not matter who complimented me or how sincere they were.  In my mind, my parents were probably right.  I had grown up hearing that I was worthless in every sense of the word.

Well, I don’t believe that any of this is true now, but some tiny, hidden part of me fears that it might be; and, that’s what my daughter’s joke landed on.

So, I told my therapist about my intense reaction.  How surprised I was.  I didn’t want to talk about it which surprised me even more because I will usually want to talk about everything.  He leaned forward as he always does when he’s onto something:

“This is very interesting.  Do you see how this core belief is constructed? You have a double distortion here.”

A double distortion? Tell me more please!

“The first distortion is: ‘I have to pretend to be perfect,’ or ‘I have to hide my flaws behind trying harder,’ and that is a lie because you are not inherently flawed.”

I am not inherently flawed.  YOU are not inherently flawed.

“The second distortion is: ‘What if they are right about me?’ This double construction depends on the existence of both distorted core beliefs.  Take one down, you take them both down.  If you do not believe that you are inherently flawed, then there is nothing left to fear in terms of these people being right about you.  They are, in every way, wrong and were always wrong.”

Wow.  What a gift.  I left his office feeling lighter.  I thought I really understood the core belief dynamic, but there is so much to it.  Some of our core beliefs are predicated or dependent upon something foundational much like an “If…, then…” statement.

“If I am fundamentally flawed, then…”

But, if you are not fundamentally flawed (or fill in the blank with something else), then what might be true? What might the possibilities truly be?

It’s a very positive line of thinking as we close out 2016.  Doors open when we ask big questions.  Shalom…

The Door by Adrienne Rich

Either you will
go through this door
or you will not go through.

If you go through
there is always the risk
of remembering your name.

Things look at you doubly
and you must look back
and let them happen.

If you do not go through
it is possible
to live worthily

to maintain your attitudes
to hold your position
to die bravely

but much will blind you,
much will evade you,
at what cost who knows?

The door itself
makes no promises.
It is only a door.