The First Rule of Fight Club

Well, are you still here? Hanging in? Not tired of this whole story yet?

Hmpf. That makes one of us. :/

My chats with Dr. Oz about the various parts in the mix are continuing, and this week we talked about what might be happening in my brain and body now that I've begun to make chinks in the wall large enough to let in the occasional spot of daylight.

In short: the increased demand for full lockdown. My brain is having none of it, giving in to the fog whenever possible, getting irritated at the smallest things, sending the signal over and over to stop, defend, protect, retreat.

Not doing this-- because I am making every effort not to do this-- results in irritation at best, and hopeless overwhelm at worst. Which, as a general way of going through the world, sucks big time.

In Crash Course: A Self-Healing Guide to Auto Accident Trauma and Recovery by Diane Poole Heller, PhD, I am told that this is normal:

"When you begin to work on your feeling of being frozen, you may have a fairly strong reaction. It's typical when freeze response begins to release that you will move into the fight-or-flight response. You may want to run or feel like hitting someone. You might feel violently angry toward the other driver. This violent or intense impulse is natural because of the amount of energy trapped in your nervous system....

Your cognitive brain will try to override your primitive brain. You may feel guilty about expressing anger. (Women tend to have more guilt feelings about anger than men do.) Anger is a natural part of the fight-or-flight response; part of the life-saving system built into our reptilian brain."

According to Heller, this is an important part of boundary-restoration that has to happen in order to process and integrate the traumatic event and release the trauma in the body.

Yeah, okay. I see that. It makes sense, although I'd prefer something a bit less visceral. A signed affidavit of release, perhaps. Or a designated trauma container I can just drop off at the nearest hazmat recycling center. That would be good. There's one not far from my house. I can go right now.

Come on. Please?

Well. Barring that, I guess it's back to boundary-restoration for me.

_____

Step one: anger.

This is much, much, much easier said than done.

I am not an angry person, am not comfortable with anger, and have never-- and I really do mean  never-- experienced a moment of anger about the accident or toward the drunk driver who caused it.

I remember people expecting it, watching for it, but I never had it. I never had much of anything by way of an emotional response, as you'll recall. And as time has passed, it certainly hasn't gotten easier to express anything like anger or sadness, fear or loss.

I mean, that's what PTSD is for, is it not? Insulating oneself from the emotional impact?

Dr. Oz brought this up a long time ago, this idea of having to go through the anger and sadness and mourning for what was lost on the highway that night, and while it does make sense to me, it felt so far away, back then, that it was almost laughable.

Not going to happen, I thought. Not me. Nope. Can't do it.

Well.

I still feel like that. On the other hand, it's beginning to dawn on me that the Big Moment I've been hoping for, the climactic breakdown that signals the beginning of the end of the recovery process, is probably down that road. 

Get to the anger, and you get to the rest of it. There's no way forward without going there. 

The difference now is that while I still don't feel  anger, I can sometimes see what it would take to incite it. I can sometimes get a glimpse of an other, an alternative reality in which the accident never happened and I went on to become someone different than who I am now.

I don't want to be someone different, mind you, and that's not really the point. The point is that I can sometimes see where I could grasp a sense of loss about it-- not the loss of any particular thing, but the loss of the possibility for anything other than this. The loss of authorship. The loss of unlimited potential.

Or, looking at it another way, I am sometimes-- more frequently, these days-- aware of how much time, so very much time, I have spent under the control of something other than my best self; my conscious brain; my emotional, feeling self. How much time I have spent in this half-life of mine, held back instead of leaping forward into the world.

My twenties. My thirties. Those decades are gone. I can't do them over. I don't get another crack at it. So much time, wasted. And the longer it takes me to get this stuff sorted, the more time I continue to waste on a life that is less than what it could be.

Lately, I can get pretty close to feeling that as the profound, irrevocable loss that it is.

It doesn't seem like it should take much to muster some anger over that.

_____

But here is where I run into trouble, and in more than one way.

First of all, Heller is right about women and anger, or at least, she's right about this woman. Anger doesn't sit well with me, never has, and after a lifetime of being conditioned away from it, I honestly wouldn't know how to go about it. What does anger look like? How does it feel? How might one find it and wield it with enough effectiveness for the task at hand?

So: we have a constitutional ineptitude with anger in general. Check. Awesome start.

Secondly, I don't really experience my life as a loss. I mean, I went to an outstanding college and graduate school and performed brilliantly; I live in one of the most beautiful areas of the country; I won the husband lottery and hit the adorable-child jackpot (and doubled down!); I have a great extended family and close relationships with my three sisters, who I cherish as best friends. I know and love a lot of cool, smart, interesting people and have done rewarding work and been recognized, on occasion, for my talents.

There's not much room for anger, here. I am not suffering, not really. I've taken the ball and run with it, as it were. As it turns out, I am just too optimistic to waste any time getting angry about anything, especially when that anger isn't going to change what's happened or do anything for anyone but me.

Hmmm. That was an interesting thing to have written: The anger is a waste of time if it isn't going to help anyone but me. Didn't know I thought that.

That's a real-time discovery of a flaw in the infrastructure, folks. Foundational beliefs like that are part of the reason that I was susceptible to PTSR. Low spots in the fortress walls where it's easy to mount an attack.

Huh.

Well, anyway, that brings us rather neatly to reason three that giving into anger is difficult:

If I did...

Considering all of this, considering everything, considering the enormous amount of evidence I've gathered about how much I've been impacted by this, how much has been restricted because of it, how deeply it has infiltrated every inch of my life, how profoundly it has controlled me for so long, if I were to give in to it and let the anger come...

If I did...

What if I couldn't make it stop?

_____

Hello Kate. Sherlock part here.

I wanted to take this opportunity to assert that this thing you're talking about here, this loss of control? THIS IS WHAT WE'VE BEEN WORKING SO HARD TO AVOID!

I mean, for god's sake, are you SERIOUS?! After ALL I'VE DONE FOR YOU?! You think it's been easy, holding this back? You think it's been easy to reroute your every instinct until your instincts supported my agenda on their own? 

You think I've spent the last 22 years holding your shit together just so you could pull it all apart now?! 

You are an idiot.

You are playing with fire, and make no mistake, you WILL get burned.

And if you think I'm giving up without a fight, you've got another thing coming.

_____

So... that keeps happening. Still, after all this time, I am engaged in a war against myself. 

The main difference, I guess, is that my internal enemies now have names. 

The unshakable optimist in me assures me that if we know what they're called, we can find out where they live; and if we find out where they live, we can plan a much more effective attack.

Good luck, idiots, sneers the Sherlock part.

Let's just all go back to our rooms and keep quiet and never bring this up again, whispers the frozen part.

Don't fight, says the Wise Adult. You've all been essential in getting us this far, and we're grateful for everything you've done. But I'm here now, I've got this, and I can take it from here. Your job is done. You can relax a little. I can assure you: everything will be fine.

My unshakable optimist tells me that if I keep putting words in the Wise Adult's mouth, she will begin to speak for herself.

The rest of me sides with Sherlock and Freezy. Shut up. Don't be an idiot. Let's just climb back into our insulated shell and leave well enough alone.

But that ship has sailed, hasn't it? Pandora's box has already been opened, whether I like it or not. So what's a little more? I can handle it.

If I say that often enough, how long do you think it'll be before I believe it? 

Optimist be damned: in the pool, mark me down for NO TIME SOON.

I Was A Teenage Grown-Up

Dr. Oz and I have been discussing something lately that is really hard to put into words. It's hard to hold in one place in my mind and get a good look at it, you know?

Or do you? Is this a PTSR thing, or a human thing? 

Well. It's about the different "parts" within the psyche of a PTSR sufferer-- parts that become distinct and isolated from each other in order to compartmentalize and cope with all the trauma-related symptoms and feelings.

I've talked about these parts before.

Mainly, what we're doing these days is trying to get the Wise Adult-- that part within that is compassionate, soothing, authoritative, non-judgmental... the part that is the kind, loving parent to the rest of you, basically-- to step forward and take over from the other parts that have, by necessity, been performing their recognizance missions and flash mobs and covert ops and diplomatic assignations over the past 20 years, just to keep things together under the onslaught.

You've known them in these posts as, among other things, Controlly Kate™, the Ministry of Vigilance™, and my adaptive, destructive ability to Keep A Lid On It™. Also as Sherlock, as closet walls, as my limbic system, frontal cortex, and lizard brain.

Their name is legion, apparently.

My first post about these parts was last November. That was the first time we talked about them this way, and when I first became aware of the importance of finding that Wise Adult and letting her start to wrest control away from the other parts, whose intentions are good but whose scope is limited and who have been keeping me in this constant state of fight-or-flight for two decades.

We've been talking about her ever since, but like all of the big moments in this recovery, it's taken a long time for me to get any useful perspective on the situation, and it will probably take another while before I am able to use that perspective in a way that instigates change. 

The Wise Adult's big moment hasn't happened yet, is what I'm saying.

But in these past couple of weeks, I think I've figured out why:

It's because I'm not her. She is not me. We are not... acquainted. 

I don't know where she lives or how she takes her coffee. I don't know how to contact her. I don't know what her voice sounds like, and wouldn't recognize it if I heard it. 

Dr. Oz says she's in there, and always has been, and that evidence of her work is present.

Look at me, having to rely on faith that this is true.

_____

The moment of realization happened a a few weeks back, when Dr. Oz was talking about the likelihood of there being a part of me who was frozen at 19, and who still hasn't moved past that age or the trauma that happened then, and who needs the wise adult to reach out to her and reassure her that it's over now, that we survived and moved on, and to help her to integrate with the rest of me and leave the past behind.

You know. A trivial, light-hearted conversation.

I've talked about that 19-year old before, and how my accident caused me to fail to fully launch as an adult, waiting, as I was, for the end, instead of creating a beginning for myself (I can't find the post to link to, but it's around here somewhere).

Dr. Oz has asked me, many times, who I am on the inside. How old am I? At what age does my consciousness rest?

I always say I don't know. I don't. Answering that question requires a higher level of security clearance than I have at the moment. No idea what's going on in there. Can't tell.

Couldn't tell. Can now.

Dr. Oz wasn't asking me that question in this conversation. She was talking about the Wise Adult and the 19-year old.

"Can you separate them?" she asked.

"I... don't know," I said, because I am super non-knowy in our sessions whenever we talk about stuff like this. I not only don't know, I don't even know where to look to figure it out. There's no there there. There is nothing. Empty space. Radio silence. I just don't know. Period.

"Try," she said.

"Okay. I think... I think I can do it. I think I'm doing it." Sure enough. As if to prove me wrong, part of me stepped back, it seemed, and waited for somebody to say something.

"So now, let the Wise Adult speak to the 19-year old. What does she say?"

WHOA. What the... wait a minute... did I just...

"I can't. I went with the 19-year old," I said.

"What?"

"I went with the 19-year old. You said to separate them, and I did, and I went with the 19-year old. Me. My... consciousness, I guess. The part that feels like me. I'm her. I'm the 19-year old, not the Wise Adult."

"Okay," said Dr. Oz. "That's okay."

"I don't know what the Wise Adult would say. I could say something, but I'd just be making it up. I am not her."

"You're blended with the 19 -year old. You can't separate yourself from her. That makes sense, doesn't it? You've stayed with her all this time, because she has needed you.

"The truth," said Dr. Oz, "is that we are actually all of these parts. They're all there, whether you are aware of them or not. You're just blended with some of them and dissociated from others. 

"Those are adaptive behaviors. You've blended with the Sherlock part because she has kept order for you during all this turmoil. You've blended with the Freeze part because bracing against what's coming has kept you alive in the past. But your Wise Adult is in there, too, even if you can't feel her."

Hmmm. Even as we are walking the very fine line between Weird Touchy-Feely Stuff Which I Am Willing To Afford The Benefit Of The Doubt and Weird Touchy-Feely Stuff Which I Find To Be Bullshit, I feel the instinctive huh of truth-acceptance.

Truth. This does feel like truth to me.

The other day, I was standing on my front porch, clattering through my house keys and preparing to open the door for my two little girls, momsy minivan parked in my driveway, dandelions blooming in my front lawn, and a teenage girl walked past on the sidewalk.

And I actually caught myself thinking, I wonder if she thinks I'm cool? I mean, look at me, I have my own place! This whole house is MINE! No parents around to thwart my plans! I'm totally in charge! See these kids? MINE! They have to do what I say! Because I'm the mom! I get to do whatever I want!

Okay, I'm paraphrasing.

Ahem. Sort of.

But yeah, that's the gist of what I was thinking. As if she and I were peers. As if I were pulling off some sort of major scam, and had tricked my way into this adult life, even though I was not, in fact, an adult at all. 

That reaction felt as organic to me as breathing. I realized in an instant that this is where I live, in my consciousness, most of the time.

This goes beyond "late bloomer" status. I am forty-one years old, for god's sake. I am middle-aged. I have lived more of my life since the accident than I did before it. I have been an adult, responsible for myself and others, for a very long time.

There's a difference between being youthful and being inappropriately immature and undeveloped. I am no longer sure where I fall on that spectrum, but it sure as hell ain't where I thought.

_____

So that's what I'm thinking about now. That 19-year old, and why she's still hanging around, and what she needs from me to get on with things and start launching herself for real.

The Wise Adult needs to be involved in this process, I realize. Which means I need to locate her.

"Are you ever aware of her?" asked Dr. Oz. "Is there ever a time where you know she's there?"

I thought about that for a while. "I see the results of her influence, mostly. My academic work, my marriage, my children. She did that."

Dr. Oz nodded. And waited.

"She got me here to you, too," I said. "She knew I needed to get a handle on this recovery."

"Anything else?" 

"In this room," I said. "I hear myself saying things in this room and have no idea where they came from or how I came up with them. It's like they come from someone else. Someone who is looking at the big picture and making connections. They come to me out of nowhere when I'm in here, and a lot of the time they disappear again when I leave."

"So she sees the big picture," said Dr. Oz. "She makes the connections. She's facilitating the healing, even though you aren't fully in touch with her."

Huh. 

"Yes," I said, and then remembered the other time when things come to me from nowhere and facilitate my healing. The other area in my life where I find myself saying things I can't believe I ever came up with, don't remember thinking, don't recognize as mine once I've said them and yet hold to tightly as my talisman, leading me along the road and protecting my journey.

"The blog," I said suddenly. "The Wise Adult writes my blog."

_____

And so, since we're all meeting each other anew every time we sit down together, and since some of us are only recently aware of who is actually at the table, I'd like to take this opportunity to introduce us to... myself.

A part of myself. Who's been sitting here, patiently, waiting to be acknowledged, all this time. I can't see her clearly if I look straight at her, but if I relax and let the conversation flow of its own accord, I can sense her in my peripheral vision.

It's a soothing presence. And it's enough to be getting on with, for now.

So: 

Hello. I am the Wise Adult. I'm here now. I wasn't here before, back then, a long time ago, when something terrible happened. 

But I am here now, and I'm not going to leave you. I will stay with you and help you through whatever comes. You don't have to be afraid, you don't have to run away, you don't have to protect yourself behind the walls anymore.

I know what to do. I have always known. And I'm going to keep trying to do it, until one day, you'll realize we're in this together, and you'll finally let go and let me take over. 

It's what I'm here for. I promise: you can trust me. And won't it be great when you do?

After all, I hear you want to live.

Sounds great. I'm in. When do we start?

Trials Without Tribulations! Yippee!

Check me out: I've been chosen to participate in a clinical trial for a new migraine medication!

I'm not allowed to tell you anything about the trial while it's happening-- it's a double-blind study, so no data relevant to the study can be posted on social media in order to maintain the integrity of the trial.

So fancy! Ha ha.

But I can tell you this: it's a prophylactic medication, so if it works, it will prevent migraines from starting, rather than treating them once they begin. And I'll be involved with the study over the next seven months. And I have a 50/50 chance of receiving the drug vs the placebo, but won't know which I got until the trial is over.

So wish me luck, friends. I want that drug like burning.

That does mean, however, that I won't be able to post anything about my migraine status over the next seven months. I thought I'd rather tell you this was happening now and have you know why I was keeping mum about it in the future, than just never say anything or tell you I wasn't having migraines but lie about the reason. Because lame.

So: expect no public updates from me about the existence/quality of my migraines. It's a little tricky, just because they've been so implicated in this work and this blog and in my mental and physical health in general, but I'll find a way to write around that topic for a while.

I will probably mention the trial now and then, just because it's really interesting to be taking part in something like this, and the doctor in charge was really intrigued by my particular set of symptoms and circumstances and was excited to have me on board, and because there are so few ways to feel like one has any agency with regard to chronic illness that it's just awesome to think I could be part of the solution not just for myself but for others.

And being part of the solution, not just for myself but for others, is my new thing. 

_____

Update: remember my "Please Don't Help My Kids" article that went viral a few months ago? Well, it's apparently having a little resurgence. They've changed their interface over there, so my stats aren't showing up properly and I can't tell what my "share" count is at the moment, but I'm told it's going nuts again, which always brings a bunch of new readers to this blog (hello, and welcome!) and also reminds me that I need to write a few more posts there, because I have more to say.

Never in my life did I imagine I'd write something that would be viewed by so many people, world-wide! Based on the numbers I've seen from the Patch, and from Facebook and Tumblr and Pinterest (OMG, it's everywhere!), it has to have been seen by several million people by now.

In a way, I wish I'd known this would happen before I'd posted it, because I would have made a few edits. 

Then again, if I had known, I never would have had the courage to post it at all. So. There's that.

The universe knows I need a few lessons in living my life less cautiously, and just jumping in whether I've tested the waters or not. And thus, it has provided.

Thanks, universe! You have my permission to continue with this trial. Just don't tell me about it beforehand, or I will mess it right up.

_____

In other news, I am hard at work painting and organizing my new house (sometimes more in theory than in fact, but still: a lot of energy being expended in that direction). We're settling in and figuring out all the quirks, of which there are many. We haven't yet reached the tipping point, where things work more for us than against us, but I think we're getting there.

And room by room, organization is emerging.

Helpful in this process is my new-found focus on rerouting my triggered behavior. Frustration and overwhelm are more easily kept at bay when you know they're caused by phantoms.

Or at least, they will be. When I get used to it.

It's a step forward, though. It's enough to be getting on with. 

Agency: the answer to everything.

Art, Books, and Patrick Stewart

The other day, I came across a story about an art program for veterans with TBIs and PTSD/PTSR at the National Intrepid Center for Excellence (NICOE) at the Walter Reed National Military Medical Center in Bethesda, Maryland.

Fascinating.

And also: revealing. I looked at the slideshow of some of the art pieces created there, and I recognize so much in them. Enough that most of the time, the description is unnecessary. 

An example of the art works produced at NICOE. Click the image above to see the story.

The effects of PTSR are universal, regardless of the cause. As I've learned from reading Peter Levine and Diane Poole Heller, trauma isn't in the event, it's in the body's response to the event. This is why people can be traumatized by so many different kinds of things, and why people are affected differently and to different degrees, and why it can be so very difficult to know when you are suffering from PTSR.

And because I subscribe to the belief that PTSR is, at least in part, a shame disorder, I think it's important to emphasize this point; trauma is not in the event, it's in the body, because it's very easy for people to think that they shouldn't be affected, or that their pain isn't as "real" as the pain of others, because they didn't experience the same kind of traumatizing event.

For example: I belong to a PTSD group on Facebook, and recently saw a post by a man who was in a horrific car accident three years ago, in which he lost a leg. He was describing the fits of uncontrollable rage he was experiencing, including violent episodes that left him afraid for his own safety and the safety of others, and then he said this:

"I tried going to a PTSD support group, but everyone else there was a veteran, and I felt like I was insulting them by being there. They've been through so much, and I don't feel like I have a right to say I'm suffering the way they are."

This man is a paraplegic. He had a part of his body literally ripped away from him. And he doesn't feel he has a right to seek help for his pain because it didn't happen to him in Afghanistan.

I see this happening the other way around, too: veterans returning home with TBIs and PTSR, and struggling to assimilate back into civilian culture, or to cope with the feelings of fear and isolation that they don't understand and are ashamed to admit to their families and friends. 

There is no understanding of this condition in the general population. There is no support that isn't stigmatized in ways large and small. There is a psychological barrier that prevents so many PTSR sufferers from seeking help, and it's so incredibly frustrating and demoralizing to someone like me, who has experienced some of the healing that is available to us now.

I'm so glad to hear about programs like the one at NICOE and the Walter Reed National Military Medical Center. I want to learn more about them and what they're doing. We need more of them, and we need to work harder to remove the stigma from this condition so that not only will more people have access to help, but more of them will be willing to seek it out when they need it.

So this is beginning to become a mission of mine: to do what I can to help veterans and other fellow sufferers of TBIs and PTSR. This blog is for me, sure, but I would never have started it if helping myself were my only goal. It's a platform, and I am a teacher, and I began writing about my experiences in the hopes that others would read them and be inspired to find healing themselves.

And by all accounts, in my tiny little world, it's been working.

I want it to work better, and for more people.

I've said from the beginning that I wanted to turn this blog into a book, and that I wanted to find ways to connect people who might be helped by it to my story. I've reached the point where I'd like to start trying to make that happen.

I don't know how.

I have some ideas. I joined that Facebook page, for example, so that I could post links to my blog and offer words of support and encouragement to the people who post. I try to do that regularly. There are other forums I can join and link to as I try to build a network. 

Of course, I have a natural aversion to self-promotion and I always feel uncomfortable with leaving my link when someone is sharing their painful experience, but I know it's the only way to get it out there, and I also truly believe that my story can help others if they choose to read it. So I've been pushing myself to leave that link. 

I'm ready to push myself some more.

I sometimes check my blog counter to see where my readers are coming from-- I can see the most recent 20 IP addresses to visit, when I check-- and I've been encouraged by a few visits in recent months from IP addresses located on US military bases, the Department of Justice in Washington DC, and-- most exciting to me-- a US army base in Afghanistan.

I want to be a resource for people who don't know what is happening to them or how to find help. I want to show them that they're not imagining things, and that it won't just "go away," and that it isn't a weakness to be hidden, and most importantly, that there is healing to be found.

And that they deserve it. 

So, although my time for writing and focusing on this blog is limited, I'm on a new mission to build a better network. I want to make a difference. I want this to mean something. I want to share what I've learned with others so that they can find their own path out of the darkness.

The other goal is to turn this blog into a book. I don't know what that would look like or how to go about doing it, but I want to do it. And it's time to start figuring that out.

So I'm starting with you, my readers. There are a lot of you out there now, from all corners of the world, and I would love to hear your ideas for how to turn this blog into a book, or how to get my story out to more people who need to hear it.

Can you help me?

You can leave suggestions in the comments, or you can email me here. I am hoping that in the collective wisdom of the little community we've created here, we can find new ways to make an impact. You've believed in me all this time, and I believe in you, too.

_____

Two other items of interest before I go:

First, I saw this video of Patrick Stewart answering a question about the work in his life he is most proud of, in which he talks about his fight to end domestic abuse and the roots of that fight in his own childhood experience. 

Or he starts there, at least. Then his answer takes a turn I didn't expect but find, as you'll see if you watch this, amazing and personally relevant:

So many lives, so many families destroyed by the effects of PTSR. I have so much respect for Patrick Stewart for the remarkable generosity of spirit that allowed him to understand this about his father after all this time, and to forgive him and show such compassion for him in the best way he possibly could have: by helping others who suffer in the same way so that no more lives are lost to this terrible condition.

Wow.

_____

The other thing is just a funny little random coincidence that occurred to me as I was writing this piece that I thought you might like to hear. 

I grabbed that story about NICOE and Walter Reed National Military Medical Center last week and have been thinking about it ever since, and before I sat down to write this piece and did a little research, I didn't realize that I'd actually known that famous facility by another name for my entire life.

I always knew it simply as the Bethesda Naval Hospital. 

Until today, I didn't know this was the same place that would house groundbreaking research facilities established by the Department of Defense for the evaluation, treatment, and education of service members and their families who are touched by the same condition that would affect my life so profoundly. 

I didn't know I would someday share its goal to reach past the walls of PTSR and help to truly  bring our servicemen and women home and leave the horror and trauma of war behind them.

All I knew about the Bethesda Naval Hospital was this: 

Forty-one years ago, I was born there.