Saturday, March 29, 2014

We All Have Reasons For Moving

I've been thinking about how difficult it can be to figure out how and when to move forward. How to figure out when moving is what you should be doing but aren't. And if it's because you're stalling or because you still have more to do where you are. Or if it's because you don't actually know what moving looks like so wouldn't know it even if you were doing it by accident.

There come times, in this work, where the next move gets handed to me and it's very clear and it just happens because the handing was the thing and then it's done and there I am, somewhere new. 

And then there are times where the preparation for the next move gets handed to me and seems obvious that the next move is one I'll be needing to make on my own recognizance. 

That one. That's the one I'm trying to do right now.

I hate that one.

I've been handed a bunch of awareness. Awareness of when I'm triggered, and even why and how a lot of the time. And what I need to do for the next move is get a handle on that in my body. 

DO something with it other than just react, react.

Or, you know, pop a lorazepam,

I've done the observing thing. Oh look, there's me, triggered. Yep. That's me, triggered all right. Triggered as all hell. Skin crawling, patience gone, feeling like I want to crawl into a cave and wait it out. I AM TRIGGERED AND I KNOW IT. Situation noted.

I was talking with Dr. Oz about this the other night, and I told her I thought it was time to add a new step to this. I was very good at noticing it. So then what?

"Maybe it's time for some self-talk, then," said Dr. Oz. "Have the Rational Adult step in and talk to that triggered part, and remind her that she's here in the present, she's safe, she's alive, she's okay."

I must have had that Oh jesus parts talking to each other again you've got to be kidding me expression on my face-- I didn't mean to but I can't seem to help it-- because then she said, "Or maybe you do some daily journaling about it. What happens when you get triggered? What are the triggers? What happens in your body? Where do you feel it? What makes it stop? Just doing some writing like this will help you to be mindful about it and keep it grounded in the present, in reality."

Well. Yeah. It would also keep me from just glossing over the noticing part. Instead of Yep, there it is, I'd have to do something more like: 

I notice that I get triggered when I feel defensive, and I feel defensive when I feel overwhelmed by having to hold too many plans or commitments in my head at one time, or when someone tells me what to do. Either something I already knew to do and was doing or was planning to and just hadn't communicated yet because I don't communicate well, or something I should have known to do but didn't because I am not on top of my game.

Both make me extremely defensive because both make me ashamed of the way I conduct myself. And shame = trigger.

And trigger = crawling skin, short temper, restricted breath, high anxiety, panic, hot/cold flashes, a need to escape and lock down, shut down, soothe, soothe, soothe and equalize.

Yeah. That. Daily journaling done for today.

So, back to moving. I was thinking about how difficult it can be for me to move into a new way of being during all of this. How high the bar seems, how overwhelming it feels to think of adding another box to the checklist. I feel like I can only manage a small number of things at once, and adding more to the list will upset the balance irrevocably.

But I need to add a few, and now: care for my back. Yoga. Exercise. Neuro-feedback for the anxiety.

It's hard to feel like I can add these things smoothly into my day, even though I know there is time for them. I find it extremely difficult to see the ease in transitions between one thing and another. Everything feels too big for its time slot, too urgent, too difficult, too overwhelming. It's like my scale is broken and I can't properly size anything.

Intellectually, I totally get it. But my body is triggered over this right now. I'm refusing to let it escape. The med roller coaster has helped to gain back 25 pounds of the 35 I'd lost and kept off for more than a year. I'm switching to a new med with no association with weight gain, and I'm getting back on the weight loss and exercise horse, and I'm losing those 25 pounds again.

And the other 35 I'd wanted to lose right behind them.

But at the moment, sitting down on the floor and stretching sends me into my frozen cave, because it somehow feels too big and scary for my schedule.

What. The FUCK.

You know, it helps to write it down like this because I can see how ridiculous that is.

Okay, Journaliing for today, part II, done.

Moving. I wanted to talk about this because it made me think of my favorite Mark Strand poem:
Keeping Things Whole
           In a field
           I am the absence
           of field.
This is
always the case.
Wherever I am
I am what is missing.
When I walk
I part the air
and always
the air moves in
to fill the spaces
where my body's been.
We all have reasons
for moving.
I move
to keep things whole. 

Saturday, March 22, 2014


In my last post, I was feeling really muddled and scattered and like I was just hanging on by a thread: the result of being on the wrong medication and struggling to control the automatic response of my PTSR brain to flee the scene when faced with triggering thoughts.

I kept having the image of myself-- my essential, conscious, "self" self-- as a kite, trailing along behind my robot body, unable to get back in and just be there and think stuff. There were moments where the thought-avoidance would get so bad that I couldn't focus on anything at all, not even the most mundane of things.

It's incredibly annoying and frightening when that happens. I know you'll understand just how annoying and frightening it eventually became when I tell you that it actually... drove me... to try...


I know.

I mean, just a little. Just for a minute. Here and there. Just to get the goddamn self back into the goddamn body.

I'd think, Okay, okay, this is ridiculous, stop, I am right here, I am waaa---





What else? What were the other tricks? Oh, right:


(That last thing is actually really weird-but-true. It helps more quickly and viscerally than just about anything else. I think I've mentioned it here before, but I'll plug it again as a great technique for bringing yourself out of a triggered state. 

Why it works: when the brain goes into fight-or-flight mode, it shuts down all unnecessary bodily functions in order to mobilize to escape threat. Blood rushes from the areas of the brain that record time and memories and into the limbs for more efficient movement--and really crappy conversation-tracking-- and the saliva center shuts down completely, because who needs saliva when there's running to be done?

So if you start making a pool of saliva in your mouth-- for reals, no joke-- it shocks your lizard brain into retreat. It helps, somehow, to flip the switch and bring the other systems back online again. For those of you who get triggered out there, I give you this simple, DIY gift. Try it. You'll like it.)

So... yeah. I did that. A lot. And tried to hang on once I got back in. But it was exhausting and annoying and mostly I was just tired and irritated and sick of being both.

As far as full-time jobs go, this one blows.

I much prefer my other full-time jobs: raising my two glorious daughters and the creative work that results in the writing for this blog and other projects and the visual and architectural art and work and restoration that is slowly (very slowly) transforming our house and garden into an awesome place to live.

Which brings me back to the first thing I said in last week's post, about my medication still being off.

I went to see Psychopharm (I just love saying it, I can't help it), and told her the amitripltyline just wasn't cutting it, and that I was somehow feeling worse on 50mg than I had on 25mg, even though 25mg still hadn't been enough of what I needed.

I've LOVED the extra migraine prophylaxis effects of the amitriptyline-- I've been having 2-4 very mild migraine attempts each month since I started with it, as opposed to the 10-12 pretty solid migraine days per month on just the topomax alone, and the 25 horrible days per month I was having before I started taking preventative meds last september.

But Psychopharm said she wanted to switch me away from amitriptyline to Effexor, which functions more like Cymbalta, which, as you might remember, I had a bit of trouble disengaging with a few months ago, but which, aside from the ugly withdrawal thing at the end and some unfortunate... um... ph imbalance trouble in the ladyparts area that caused me chronic urinary tract infections (because, you know, that's a totally reasonable side effect to expect from an antidepressant, am I right? O.o)... it was actually pretty good at what it was supposed to be doing for me.

So she had me cut back to 25mg of amitriptyline. And then my husband suggested that I wait to do this next Big Med Switch until my sister and her husband, who are staying with us for a few months, get back from their honeymoon in Paris next week (swoon), since he has to travel a lot for business over the next few weeks and we never know how difficult the switch is going to be for me and it would be nice to do it with some support if I can.

Good idea.

So I stuck with the 25mg past the three days I was supposed to and I didn't make the switch.

It's been almost two weeks now, and I have to say... I feel pretty damn good.

It still doesn't do much for the anxiety-- I think there's still something missing from the cocktail-- but I like this 25mg of amitriptyline so much that when I go in for my checkup with Psychopharm on Tuesday, I'm going to tell her that rather than throwing out the baby with the bath water, I'd like to try adding something to this mix instead.

The Effexor can't be taken with this. But maybe there's something that can that will provide the promising features of Effexor; most notably the "lift" of energy that I am sorely missing, and the anxiety relief as well.

Anyway, wish me luck. While I'm still on the merry-go-round, this is the first time I've felt like I've had a sense of where I was and what I wanted. I've felt at the mercy of Psychopharm and her whims until now. Now I'd like to have a say in the matter. 

So I'm going to give a bit of pushback: I've found something that works in ways that are very important to me. Now find me something to fill in the gaps. It may not be possible, but let's at least try that first.

Huh. Would you look at me, standing my ground and demanding stuff. It's like Invasion of the Body Snatchers around here! These drugs might be working better than I thought! ;)

Sunday, March 9, 2014

What It's Like In Here

Things have been difficult lately.

The medication problem still hasn't been sorted out-- I've got a doctor appointment on Tuesday to discuss a new approach. Ugh.

But I've also been working on being more engaged-- with people, with the present, with the moment-- and it's leaving me triggered and scattered and struggling to focus.

The opposite of engaged, really.

This is something that's going to take a lot of practice. It is not something I'm used to doing. But as I push myself to do it, I'm getting a glimpse of the gymnastics my brain is willing to do to keep me from doing it.

I was struggling to describe what it feels like to Dr. Oz the other night, and she seemed to know what I meant and was able to give me the language to use to describe it to you. I hope this makes sense:

It's as if my brain is refusing me access. It won't allow me to think about certain things-- why I disengage, how I do it, how to slow my automatic responses down and stay with the moment. I can't even hold these thoughts in my head for a moment, let alone put in any time thinking about them. I try, and my brain skips right off the surface like a stone on the surface of a pond.

It won't let me go there.

That sounds crazy, doesn't it? Not being allowed to think certain types of thoughts, or have certain types of inner dialogue, because your own brain refuses to let you get a grip on the idea for more than a second?

I can describe it to you like this, but I can't actually do it. It's like I try to reach for the thought and it disappears before I can wrap my hand around it. 

What's more, I've learned this week, if I try to push the matter and keep bringing myself back to it, my brain starts to go into "don't go there" overdrive, and I get pushed further and further from what feels like my intellectual center and more to the outer surface of my consciousness. 

Meaning: I become unable to concentrate on anything. 

It's the strangest feeling, to feel locked out of my own brain. I feel like I can't think about anything for more than a few seconds, like my thoughts are so scattered that I can't gather them back together again.

Disengage, my brain seems to be telling me. DISENGAGE!

And it's true: the only way to stop this scattering process is to find something innocuous to distract me from what I'm trying to do and lull me into complacency. 

Facebook. Fan fiction. Stupid TV.

Instantly calming, soothing, and clear in a way that my thoughts refuse to be.

Escapism at its finest.

"You're being triggered," said Dr. Oz, "and you're going into the fight-or-flight response. Your brain is switching off the processes it deems unnecessary, and throwing you into flight mode. You feel like you can't focus because your lizard brain has taken over and is pushing you away from what it sees as the source of the threat."


That makes sense. I mean, it works as an explanation for what this is. It feels true, to the extent that I can hold the damn concept in my head for a moment and judge its validity.

It sounds true. Let's say it that way. It sounds true.

What I don't get is why I can't stop it from happening. This is MY BRAIN we're talking about. It's not like I'm trying to have a conversation with someone else and can't express my thoughts coherently. 

I'm only trying to hold a thought in my own fucking brain for a few minutes and have a dialogue with myself,  and it's still impossible.

To feel out of control of your own brain, not just on an unconscious level (which, lord knows, I am quite used to by now), but on a fully conscious one?

That feels... crazy.

Words disappearing before my eyes. Disappearing from my own mouth. Disappearing from the theater of the brain. The inner lizard (as I've begun to see the amygdala-- a green, sleeping dragon within) throwing up obstacle after obstacle, force field after force field, until I sound my own retreat and give up the fight.

I step back from the work-- because that's what this is, it's the work that I need to do in order to get to the next phase of recovery-- and I look for what is soothing instead.

Don't push, I decide. Just float.

It so much easier just to float.

All of this, as you might imagine, makes me feel farther than ever from getting to the bottom of this thing.

I've torn down plenty of walls along this journey, but right now I'm bashing my head against a big one and I see no way in.

Is awareness enough? If I'm aware of this phenomenon and keep chipping away at it, will I gain access at some point?

Will the right medication help? Will I find a drug that will help me to hold my focus and actually have these conversations with myself, so I can get some of this work done?

Is it the medication that is causing this disconnect in the first place?

I don't trust my brain chemistry. I don't know what's working and what's not, in there. I don't know which reactions are true and which are affected by too much of this chemical or too little of that.

IT'S NOT RIGHT IN HERE, is what I'm saying.

I'm sort of afraid to post this one, because I don't know if what I've said makes any sense.

This makes sense, though: the things I usually choose to to to distract myself from the discomfort and exhaustion of trying to find a way in-- the mindless, soothing things that make me disengage further from the moment or the person or the presence of mind I seek-- aren't helping to reduce my anxiety or strengthen me for the next battle.

Mindless reading, Facebooking, TV-watching... those things aren't fortifying. They're not recharging my batteries, the way I've let myself believe they were. 

In fact, they tend to make everything worse, because then not only do I still have the original problem, but now I've managed to create new ones by insulating myself from reality and letting everything else slide, too.

The truth of the matter is that my brain gets recharged by creativity, thought, and action, just like everyone else's, and if I'm not engaging in others, I'm not engaging in any of those things, either.

So I end up taxed, unfulfilled, exhausted, and no closer to a refueled tank than I was before.

I've been thinking, all this time, that disengaging was the only way I could recharge.

Turns out, disengaging is just as much a drain on my resources as fighting. 

What I thought was a refuge from the battle has been a battle in its own right, and I never understood that until now.


I used to have a post-it note on my computer screen, years ago, that said, "THE OPPOSITE OF "STRESS" IS NOT "NOTHING."

Because that was my counter-weight for the stresses in my life: come home, shut down, disengage, retreat.

It didn't help me. I couldn't figure out why.

And then I noticed that there were times when I felt recharged. After I'd engaged creatively with something. Written something, made something, done something productive and satisfying. I began to push myself to choose those things, rather than continue my trajectory of permanent retreat.

It's time to choose that again.

The opposite of stress is not nothing. Stop turning off completely in response to threat. Turn instead to creative work, and come back stronger than before.

Hard to do in the moment, when things are as they are right now, but worth the challenge, in the end.

Does this all come down to breaking a habit? Instead of choosing the easy path to the couch, choosing the more difficult path to the creative spark?

It might. It might just be habit. And breaking the habit might just be as simple as repeatedly forcing myself to choose a new reaction.

Has this made sense to anyone? I'm not sure I can rewrite it any more clearly than this, right now. Does anybody else have stuff like this happen, where you can't get close to an idea in your head without being forced into distraction mode?

Well. Incoherent as this post may be, I guess it's a faithful representation of where I am in my head: locked out of the part that knows how to make sense of things.

I've done my best. I'd love to hear your comments if you think you can tackle what I'm trying to say here and shed some light on it for the rest of us.

Apropos of nothing, I thought I'd let you know that I just applied for the Amtrak Residency for Writers program, which grants up to 24 writers a 2-5 day round-trip "residency" with their own private sleeping car, desk, and inspiration from the changing scenery out the window. Just because.

Cool idea. Wish me luck!