Neuroplasticity

Content Warning: Talk of triggers, trauma and abuse.

This week I was triggered, badly. It happened at work, which was kind of embarrassing. I’m always a little embarrassed when it happens, but at least if I’m just with my husband, he knows my history and understands what’s happening and can wait it out with me. At work, I try to put forward my confident, professional self, and the illusion is kind of shattered when you end up curled up on the floor shaking and crying (not an over-exaggeration).

This episode was a particularly bad one too. I have talked about my triggers and trauma responses before.  I had a tactile flashback in March that I shared here. This time it was more emotional than sensational. Even though I knew I wasn’t in any actual danger, I was completely overcome with the absolute terror that I used to live with daily. I don’t know how to properly explain this kind of fear to someone who’s never felt it. Physically, my body shook, I began to sweat, my heartbeat went through the roof, I couldn’t stop crying. Emotionally, I didn’t feel safe. No, it’s more extreme than that. I felt as though someone could burst through the door and end my life in a fit of rage and there was nothing I can do to stop it. This is the reality I lived with for a year; afraid to sleep because he might smother me, afraid to shower because he might drown me, afraid to blink or look away because he was a constant threat on my life, while simultaneously feeling as though I couldn’t live without him.

That was the emotion that I experienced with this trigger, I was petrified. But, because I wasn’t reliving a particular event, I was still mentally present. I was aware that I was at work and that I had been triggered and that I need to find a way to make myself feel safe. I removed myself from the situation and locked myself in the bathroom for while to get over the initial shock. When I felt a little better, I left the bathroom to return to work. My manager met me in the corridor and asked if I was okay, evidentally, I was not. Every time I thought I was okay, another wave crashed down on top of me. I ended up in the staff room, sitting on the floor between a sofa and coffee table, shaking and crying down the phone to my husband. I like small, compact spaces, close to the ground, where I can see the door. I’m sure I looked crazed, but I know what I need to do to look after myself, and I did it. I called my husband because he is grounding for me, he makes me feel safe. Ideally, I’d have him hold me tight until I calmed down, but in this situation talking to him on the phone was the best I could get. It helped a lot though and I returned to work not long after that.

My colleagues were all very kind and supportive, and respectful of my process, asking what I needed from them and then doing as I asked. I was very appreciative of that. Although I am embarrassed that they’ve seen me like that, I am sure they’re not judging me for it, they are good people.

So anyway, the episode took its toll physically and mentally. It is exhausting to feel that kind of intense emotion, even if it’s only briefly (I do have theories that my trauma contributed to my M.E, but more on that another time). As per usual, I began thinking of ways that I could improve myself. In terms of counselling, talking therapies, CBT etc., I think I have done as much as I can. The trauma occurred 6/7 years ago and I feel as though I have processed it as much as I am able. I am conscious and aware when I am triggered, my response is purely physical. It’s kind of like playing a horror game in VR, you know it can’t actually hurt you, you know it’s just a game, but it’s still scary as hell. The trauma lasted for 2 years and I was barely human by the time it was over, so I think it’s fair to assume that my brain was injured by it (MRI testing has proved that PTSD physically changes the structure of the brain). If this is the case, then I need a different kind of treatment that focuses not on my emotional responses, but on helping my brain to process the traumatic memories that it’s holding onto.

EMDR. Eye movement desensitization and reprocessing. The process of reliving your trauma (with a trained professional) while being bilaterally stimulated. This can be done by watching a moving finger, metronome, lights, or anything else. No one is exactly sure why it works, but they’ve been using it in PTSD patients since 1988 and many find it very helpful. The theory goes that during a traumatic event, you brain is incapable of storing memories properly. So when you are triggered by something relating to the trauma memory, your brain gets confused about when it happened and reacts as if it’s happening in the present. By stimulating both sides of the brain while recalling the trauma, you are able to keep one foot in the present moment and one foot in the past, allowing the brain to reorganise itself and file the memories away correctly. A study done in 2020 has shown that this kind of therapy increases connections in parts of the brain involved in multisensory integration, executive control, emotional processing, salience and memory.

I’ve been aware of EMDR for a while but am naturally skeptical of treatments that don’t have scientifically demonstrated, repeatable results. All of the evidence that this works, is anecdotal. But at this point, what do I have to lose? I texted an old counsellor of mine (who said to text any time if I needed help after our formal sessions ended) and asked if she knew someone or somewhere she could refer me to. As it turns out, the faction that she works for (who I have used several times in the past) do use this kind therapy. She said I may have to do some trauma counselling first, I guess to prove that I have PTSD and that I’ve exhausted other treatment options, but I’m okay with that. From my experience they’ve always been quite receptive when I’ve told them “this is what’s wrong with me, this is what I’ve tried, these treatments work, these ones don’t, this is what I’d like from you”. I’m sure it’s easier than trying to figure out how to help those who don’t know what’s wrong with them or what to do about it.

I’m going to call on Friday and see what they can do. I booked the day off work so I could have a ‘health’ day and I reckon this falls into that category. I’m excited, I like to work on my mental health and the idea of being free from flashbacks and nightmares is exilerating. He’s taken enough from me already, time to let it go.

Depersonalization and Derealization

My mental health has taken a hit recently. Unfortunately, I am person who will struggle with my mental health all my life. In the beginning, it was difficult to accept that I would never be ‘cured’ but, now I have, I am able to work on levelling out my peaks and troughs, while taking comfort in the knowledge that when I am down, I will come back up. In a way, this acceptance has helped me manage my chronic illness too, but that’s not the point of this post.

Today I want to talk about, not what caused this bought of depression, not how I’m managing it, but how I experience it. Today, I want to talk to you about dissociation.

When a brain is exposed to prolonged, sustained trauma, it will often learn to dissociate as a coping mechanism. That is, it will remove your consciousness from your body, from the time and place where you are, and give you an alternate reality to focus on so that you don’t have to endure what is happening to you.

For those of us with CPTSD (Complex Post Traumatic Stress Disorder), even after the trauma has passed, the brain can continue to employ this technique to every day stressors. This can be a blessing and a curse. It means that when traumatic events do occur, we are better equipped to deal with them than the average person. We are often calm in high-stress situations because we are able to emotionally and mentally remove ourselves from it. But it can also caused severe mental illnesses such as DID, OSDD, sociopathy, psychopathy, psychosis and others. In me, it has distorted my sense of reality. The more stressed or anxious I am, the more I dissociate, so I struggle to remember some of the biggest moments in my life, like my wedding and my graduation.

Before I was able to name my problems, I always knew that I had difficulty distinguishing the difference between truth and lies. And not just the lies that others told me, but the ones I told myself too.

When I was a child I had imaginary friends who I sometimes forgot weren’t real people. Sometimes I even heard them speak to me. It didn’t help that my real friends and I would talk about them as if they existed in the world, but nobody else ever got confused like I did.

When I was a teenager I was a pathological liar (I’m sure I’ll get into the reasons for that in another post some day). In order to make my lies believable, I would envision the made-up scenario in my head. I would submerge myself in every detail so that if I was ever quizzed or questioned about it I would be able to give accurate, consistent information. However, the more I told a lie the more I began to believe that it was real. There were a couple of times when I was presented with witnesses and hard evidence that a thing had not in fact occurred, and I flat-out could not believe it.

As a young adult I became fascinated by conspiracy theories and repeated to myself the mantra “question everything”. I became paranoid about everyone and everything I thought I knew. During this time I was also romantically involved with an abusive narcissist, and by the end of the relationship I genuinely believed that he could read my mind.

When that relationship ended I tried to commit suicide by overdose. The drugs made me dizzy, hazy, and sleepy. For about year after that, I was convinced I had actually died from the overdose and that everything I was experiencing from that point onward, was some form of afterlife.

There was a time where I hadn’t slept in several days and my skin was itchy. I thought that if I cut my skin open then the itch would be able to escape and I would feel better.

Often I recall things, and I’m not sure if they actually happened or if I dreamed it. I have been wrong in both directions too (thinking something did happen but it turned out to be a dream, and thinking I dreamed something that turned out to have actually happened).

The pandemic has been the definition of a stressful/traumatic experience for everyone. When it first began, I basically ignored it, thinking of it like another swine flu that is blown up by the media but will ultimately not effect my life in any real way. When lockdown began, that was when I realised my own vulnerability and the immensity of the destruction this virus could cause. That was when I started to flip-flop between “this can’t be real. It’s not really happening” to “this is the most important event of my lifetime and everything that happens now will effect our lives and the lives of generations to come.”

I need to explain though, the “this can’t be real. It’s not really happening” thoughts are not the general disbelief that everyone feels in these kinds of situations. The kind where they don’t want it to be real but ultimately they know it is. This is the kind of disbelief where I am questioning my own existence and the existence of the world around me.

The first time I saw people wearing masks out in public, I thought that it was a simulation. I thought they were holographic projections of what a futuristic world could look like. When I went outside during the first lockdown, the streets were abandoned. There was no traffic and no people walking around. I thought I was in a post-apocalyptic film or game, I kept waiting for something to happen, but nothing did.

I’m not completely detached from reality though. If I was, I wouldn’t be able to communicate these things to you. It’s like I have a split brain and while one part believes that nothing is real, the other part is well aware of what is actually happening. It’s difficult to explain the disjointed feeling of unreal and real at the same time.

Here’s an example from the other day: I saw an electric scooter abandoned in the middle of a green area between roads. I saw it there a few days in a row and it became part of the scenery, so I stopped noticing it. The next time I saw it, it was laying on its side, on the verge of the green rather than in the centre. The most obvious explanation for this is that somebody moved it. Maybe they used it and returned it to a slightly different place. Maybe it was in their way so they pushed it to one side. Maybe some kids were messing about and it got shoved a little way away. However the exact movement came about, it was most likely a person that caused it to move. But I didn’t see that happen. From my perspective, it was in one place, then it was in a different place. So what if it disappeared for a day or two, then on its reappearance, it misjudged the time and speed of its arrival and ended up in the wrong place? What if it teleported to somewhere else entirely and when it tried to come back it got it’s co-ordinates wrong and missed it’s spot by a few feet? You see, even though it’s highly unlikely that this is what happened, I didn’t see it, so I don’t know for sure. I can’t know for sure, so in my mind any of these scenarios are equally possible.

It’s like man landing on the moon. We know that’s probably what happened, but we didn’t see it happen ourselves, so how can we know for sure that it actually did?

My most recent dissociative thought was that I was a game character that was stuck in first-person mode. I found it irritating and wanted to switch to third-person so I could see where I was going better. I know I’m not a character in a game, but if I was, would I know?

For a long time I thought (because my psychiatrist told me) that it was caused by my having an “overactive imagination”. But I’ve been thinking about this recently, and I believe it’s actually because people close to me have been fucking with my sense of reality all my life.

It started with my Mother. With things as small as “you did ask for a cup of tea, I wouldn’t have made you one if you hadn’t”, all the way to keeping the details of my Father’s illness a secret. I knew they were going to hospitals a lot and I knew he was in pain all the time, but they never told us what was going on. Maybe they were trying to protect us, or maybe they are terrified of being vulnerable in front of us. Either way, the outcome was the same. I have many memories of my childhood that my Mother completely denies happened, but I know that they did because my brothers can confirm them.

Then came a whole series of people who would tell me one thing, then do something else. My first boyfriend who said he loved me, then hit me. My school friends who said that we would all go to Sixth Form together, then left me on my own and went off to college together instead. The narssacist who lied about pretty much everything and made everything my fault some how. My best friend in the whole world, who I’d known and loved for 10 years who told me that no matter what his new girlfriend did or said, he would never lose me from his life because I was too important to him, who then ghosted me at the worst time in my life (I only knew he wasn’t dead because his Mum would have told me if he was). The girlfriend who played the domestic abuse victim who was actually an abuser herself. The boyfriend who told me he loved me, then took it back the next day. Everybody I ever trusted, lied to me. Is it really any wonder that I don’t know what’s real and what’s not?

My husband knows how important open honesty is to me. In our marriage hard truths are a sign of love and respect, even if they hurt us both, because it’s a demonstration of trust. Promises are a rare thing between us, because we won’t make one that we can’t be certain we’ll keep. All too often people will say things like “I promise I will always love you/will always be here/will never hurt you/will keep you safe” but people change and no-one has that much control over life.

I am a scientist and I believe that empirical evidence can prove or disprove the existence of something. I am religious and spiritual, and I know that there are some things in this world that we cannot explain, but that doesn’t make them any less real. I am a fiction writer and I spend a lot of time “off with the fairies” imagining made up people and places and events. I am a philosopher and continue to “question everything” in order to find deeper meaning. I am a survivor of trauma and abuse, I know that sometimes things that you didn’t believe would ever happen, do happen. I am neurodivergent and the world is not how I was taught it should be. I also have minor prosopagnosia (face blindness) so strangers all look like generic NPCs to me. All of these things effect how I experience the world around me, and inside of me. Sometimes I wonder how many other people experience the world like I do.

From time to time this dissociation can cause an existential crisis in me, but I am aware when that is occurring and can take the time and space to reconcile this. For the rest of the time, as long as I’m rational and not a danger to myself or others, does any of it really matter?

You Don’t Have to do Anything

In this Covid-19 pandemic that we are all currently living in, there seems to have arisen a new social pressure to be productive and achieve. There’s a lot of emphasis of what new skills you will have acquired once the lockdown is lifted. What renovations you will have made to your life and your home. I have seen and heard many people say something similar to “You finally have the time to do all of those things you always said you never had the time for”, and while this may be essentially true, there is no reason why you should now be obligated to do those things.

The thing that these people are overlooking, is that this situation is unprecedented for most of us, and that what we are actually living through a massive shared trauma. For these people, their go-to coping mechanism is to keep busy so that they don’t have to sit with, and acknowledge their feelings about what is going on around them. These people will likely find that eventually they will run out of things to keep themselves busy, or that their thoughts will overpower their actions so that their ‘keeping busy’ tasks are no longer able to distract them. These people are often in denial about their true feelings, and their underlying insecurity requires them to validate their avoidance coping mechanism by shaming others into doing the same things as them.

A common feeling that is shared by many of us right now, is one of helplessness or uselessness. There is nothing we can do and nothing that can be done for us. We have no control over the virus or how our governments choose to react to it. Sometimes, these feelings can bleed into our other activities and soon we find ourselves thinking, what’s the point in doing anything if there’s nothing we can do. This apathy can quickly spiral into depression where we find ourselves wanting to do something but feeling too miserable and down-trodden to act on it. This then circles back to our original feelings of helplessness and uselessness.

Anybody who has suffered with depression before will recognise this kind of cycle, and if you’ve been lucky enough to get help, you’ll have your own coping mechanisms to dig your way out or to manage your feelings. But for a lot of people, this will be a new sensation.

For people who have never had to deal with this kind of depression and isolation, it can be terrifying not knowing what to do. Desperate to connect with people and know that they are not alone, these people go to social media where they are bombarded with all of the things that the “productive” people are accomplishing. They are asked “What have you been up to?” “What have you done?” and suddenly they feel like they have to justify themselves and defend their lack of activity. This will send them down one of two paths. Either they will force themselves to be productive, even though their heart isn’t in it, or the feelings of shame will confirm for them that there is something wrong with them and that they are lazy, useless and wasting precious time etc.

The first outcome will lead to frustration, exhaustion, possibly anger, and no task attempted will be given full attention or dedication and so won’t live up to the standards that the person is now expecting of themselves. This will eventually lead them to thoughts such as “I can’t do anything right even when I try” and a return to depression. The second option reduces self-worth and increases anxiety and depression as well as isolating them further by making them believe that they are the only people feeling this way. These feelings could easily lead to self-neglect or self-harm very quickly.

Depression is not an easy thing to overcome, especially if it’s your first time fighting with the beast, and I’m not going to pretend that I have an answer for you on how to break out of the cycle I described earlier. Honestly, the reason I’m talking about it in the first place is because I am stuck in it myself. But from my experience and knowledge I can present to you these thoughts and observations. I hope that when you read them, you believe them and that they can bring you at least a little relief if not show you the path out.

• Processing trauma takes time and energy and is a different process for all of us.
• This is something that has never happened to us before so there is no correct or incorrect way of dealing with it.
• Just because a lot of people are doing something, does not mean that you should be doing it too or that it is the right thing to do.
•  Acknowledging your feelings is the first step to accepting them.
• You are the authority on yourself. Trust yourself, believe in yourself, focus on yourself. Don’t worry about anyone else. Their opinions can’t hurt you.

What and Why?

Last night I felt a rush of very strong emotions. My partner was away for the night and I was alone in the house overnight (apart from the cat) for the first time since we started living together.

When I think about the chain of events, I guess it really started that afternoon when I abandoned my plans to get some work done that evening. Then on the way home I decided to order in junk food in stead of making myself a good dinner. Then I wouldn’t make myself a drink even though I was thirsty. I put on a film but divided my attention with games on my phone so I wasn’t fully enjoying either activity. I put off doing chores that I said I would do, claiming I was too tired and I’d do it later. When the film had finished and I didn’t know what to do next, that’s when the wave hit me.

It began with a tight anxiety in my chest, then I started to cry and I held the cat on my lap, even though he clearly didn’t want to be there, and began begging him not to leave me. I let him go after a couple of minutes because he wasn’t happy being held, but that made me cry harder. I felt desperately lonely. My partner wasn’t easily contacted and I’d also been hoping to hear from someone that I haven’t in a long time but they never responded to my message. I was chatting to one friend online but that contact wasn’t filling the need I had. I remember having the thought “I wish I was somebodies everything.”

My practice when I get uncontrollable feelings like this is to ask myself what exactly it is I’m feeling and why I am feeling it. More specifically, where are those feelings coming from? What triggered them in that moment and what is the underlying psychology that caused this response to that trigger. In the moment I tried to ask these questions but the feeling was too overwhelming and all I could come up with is “I’m just a depressed person. This is my default setting.” This is an old habitual response, something I told myself for years to excuse my behaviour and avoid dealing with my issues. I recognised that then and told myself that it probably wasn’t true but my mind refused to entertain any other idea, so I employed distraction techniques until I was tired enough to sleep reasoning that it could be stress related.

This morning I still feel the residue of last night’s experience but I have a clearer head so I can analyse it more carefully.

Anyone who knows me knows that I have a strong fear of abandonment. This is a learned behaviour. As I eluded to in my earlier posts, I have always been a vulnerable person and as such I would cling to others for support. I have had a number of people in my life whom I loved and trusted and who promised that they would always be there for me. However, when I became difficult, needy or combative, I discovered that those promises were conditional and more often than not those people would disappear without a trace. This inevitably left me feeling unwanted, lied to, betrayed, vulnerable, created ideas about my own lack of value and triggered unhealthy behaviours such as pushing people away when they are present and clinging to them when they are distant. I also formed unhealthy relationships with people who were emotionally unavailable and then tried to manipulate them into fulfilling my needs. Then, of course, when those relationships don’t work out it feeds into the ideas about my self worth and how no one can be trusted.

I also felt and feel extremely unloved and unwanted by my family who were also emotionally reserved. My family dynamics are complicated and not something that I will delve into here but suffice it to say that I was a child who needed a lot of attention and desired clear and obvious affection, but those needs were never met. My memories of my childhood are almost exclusively negative. This is not to say that there were no good times, only that the mind clings to memories that have the most emotional impact and for me very few of the good times were good enough to leave lasting impressions. I also wish to mention that I no longer harbour any ill will towards my parents for their failings. I have held a grudge for a very long time, even entering adulthood and being able to reflect and understand that they did the best they could in a difficult situation, I couldn’t let go of the anger and grief of never feeling loved. It is only since starting this journey that I have been able to look at my parents as people who were also conditioned by the world and their experiences and who were ignorant to the harm they were doing. I can’t be angry at them anymore than I could be angry at a child for doing or saying something hurtful, they don’t mean to, they just don’t know any better. But, nevertheless, trauma and conditioning from your childhood is some of the hardest to overcome so those feelings of being unloved and unwanted are like thin scars on my soul and it doesn’t take much to open them up again, and when they do I bleed heavily.

Understanding my psychological history makes it easier for me to forgive myself for having moments like this one. I don’t remember a precise trigger, it could have been building for a while with stress, lack of sleep, the moon phase, stories I tell myself about how the world should be, but it definitely wasn’t just because ‘this is how I am’. It happens, I recognise why it has happened, I forgive myself for reacting that way and I try to spot the signs before it happens next time. I know that the best way for me to keep my mental health on track is to make plans and stick with them, and yet on this occasion I abandoned one plan after another. I also know that waiting to hear from people can trigger my fear on abandonment, so I should send a message then make myself busy so I’m not consumed by the waiting. I didn’t do that either. I know that I gain more pleasure and distraction from games than film and yet I chose to not fully engage in either. All of these things are tools that I could have implemented to get me back on track but sometimes, in these moments, you can think of nothing but what you are feeling.

Sometimes all you can do is ride it out. And that’s okay. Wait for the storm to pass then reflect, forgive, and try again.