Wednesday, November 7, 2012

trauma in the body

I'm not always particularly humble. Yesterday I was reading a book my therapist gave me The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment. It has been on my to-read list for a while but I haven't spent money on books in a bit. Sometimes when I read books I think, "God damn I am a lot smarter than I thought."

Specifically the author was writing about the introduction of the idea of short term/long term memory. It came into understanding in the 1980's and wasn't widely accepted until 1994. I clearly remember explaining my dog bite using this language when I was about six, so 1987.

Someone asked me if I could remember the dog bite and I said, "No--when you get that kind of scared, so scared that you think you will die then you stop being able to remember because your long-term memory isn't working right then." I remember that the person looked at me like I was crazy but didn't say anything--I was just some kid. I was completely right.

Reading this book feels like independent verification of the things I have been variously researching on my own. I'm appreciating what she has to say. I would give almost anything to get a brain scan of my hippocampus. I would really like to know what size it is. I would be very curious what my body's ability to produce cortisol looks like.

Page 7: "Somatic disturbance is at the core of PTSD. People who suffer from it are plagued with many of the same frightening body symptoms that are characteristic of ANS (autonomic nervous system) hyperarousal experienced during a traumatic incident: accelerated heart rate, cold sweating, rapid breathing, heart palpitations, hypervigilance, and hyperstartle response (jumpiness). When chronic, these symptoms lead to sleep disturbances, loss of appetite [side note--the anniversary of my father's death has caused such anxiety that I don't eat for a month and lose about ten pounds every October], sexual dysfunction, and difficulties in concentrating, which are further hallmarks of PTSD. DSM-IV acknowledges that symptoms of PTSD can be incited by external as well as internal reminders of traumatic event, cautioning us that somatic symptoms, alone, can trigger a PTSD reaction. PTSD can be a very vicious circle."

Yup. That's me. That's what I am just supposed to "get over". If you startle me I am very likely to jump multiple feet away and scream at the same time. it has always been true. People like to fuck with me because they think it is funny that I get so scared.

Randomly: I have often wondered if some of the people in my life do not in fact have ADD, ADHD but if instead they have PTSD and they just don't deal with it properly. It's interesting how many "adult ADD sufferers" often talk about similar symptoms to me. I don't have ADD. My attention abilities are freakish. Except when I'm having panic issues.

This book also neatly explains triggers and why I don't want people to care about my triggers. There are two "kinds" of memory: implicit and explicit. Implicit is for things like riding a bike and driving a car. You just have to learn the muscle memory. Explicit memory is for things like following a recipe. There is a very specific list of things to remember in order.

Pavlov trained his dog to salivate at the sound of a bell--a conditioned response (CS). If someone is raped by a person wearing a red shirt and then later (irrationally, but that is how CS works) red shirts may be frightening. It being frightening would be a "trigger". It triggered your bodies instinctive memory of what happened to you.

I can't expect everyone in the world to stop wearing red shirts. She (Babette Rothschild is her name, by the way) explained that you can get secondary conditioned responses as well. If you go out in public and have a panic attack while walking past a shelf of red fabric because it reminds of the shirt... that's starting to migrate out. She theorizes that these kinds of progressions are how many people end up agoraphobic. You have more and more negative responses to going out that are further and further removed from the trauma. I agree with that.

It's not like I actually worry about being thrown out of the homeschooling group. I simply have a lot of overlapping and layered triggers that cause me to be afraid when I am there. Some days being there is too hard because my body is overwhelmed by being scared.

When I use the spoon theory this is how I use it for me. Not every day but certainly many days I decide whether or not I can handle the stress of working in the front yard where I will have to deal with talking to people who walk by. That's pretty limited. I feel ashamed of myself but I have to manage it.

When I was a child I would stop going to school when the stress got too bad. It didn't matter if I missed a few weeks. A few weeks meaning up to three months. We would always be moving soon and I would just start over again in a new place and it doesn't matter that I've been hiding in my house for two straight months because I can't interact with other people without crying. This has simply always been my life. When I dated Tom I had long periods where I left the house to go to the grocery store and school and other than that I didn't leave the house without him. Noah doesn't want to do the same kind of role. This is complicated.

It is probably "for the best" that Noah doesn't want to continue to support my bad but semi-functional coping method. I have to develop new ones now. I'm not doing very well. This too shall pass.

I'm ready for a different brain cycle.

I think this is normal, but I pretty much always have a soundtrack to my life playing in my head. I was talking to Noah last night while brushing my teeth. I was looking at myself in the mirror and I started hearing the song from RENT "Will I". On one hand I feel like a co-opting piece of shit. I don't have HIV/AIDS. I am not going to die from a wasting disease.

I do worry about losing my dignity. I feel like my link to the world is tenuous at best. I worry about not being able to be calm enough to be treated like a human being. I worry about being treated like an animal again. I do not enjoy being treated like an out-of-control wild animal. Sometimes I feel like I would do anything, trade anything for a chance at having a body that reacted normally to the world. I want to stop feeling so afraid that I need to fight for my life.

I don't want people to "learn my triggers" and avoid them. I want to not have them. I feel like most people say, "you triggered me" and mean "you made me feel bad/anxious therefore you are bad". No, that's not what triggers mean. I go through the world terrified because I have so many specific references to traumatic life experiences. I would like to have fewer. I really would.

I'm working on it..

4 comments:

  1. As far as relating to "Will I"....

    I often relate the the song "Lovely Ladies" from Les Miserables. Which I feel TERRIBLE about, since it is a song about being forced into prostitution, and that's a pretty far cry from my life. But there is a bit at the end: "C'mon Captain, you can wear your shoes/don't it make a change to have a girl who can't refuse/Easy money, lyin' on a bed/Better that they never see the hate that's in your head/Don't they know they're making love to one already dead?" And for some reason, even though I have not ever been in a situation where I have had to sell myself, I still relate.

    Judith Herman write a book in 1992 called Trauma and Recovery. I think I've probably mentioned it before, but I'm gonna plug it again. :-) Her theory is that "regular" PTSD is one thing, but there is also complex PTSD, which stems from situations of repeated, ongoing abuse or terror.
    YMMV as far as your opinion of her work but here's a couple excerpts:

    "In general, the diagnostic categories of the existing psychiatric canon are simply not designed for survivors of extreme situations and do not fit them well. The persistent anxiety, phobias, and panic of survivors are not the same as ordinary anxiety disorders. The somatic symptoms are not the same as ordinary psychosomatic disorders."

    And:

    "Even the diagnosis of 'post-traumatic stress disorder,' as it is presently defined, does not fit accurately enough. The existing criteria for this disorder are derived mainly from survivors of circumscribed traumatic events. They are based on prototypes of combat, disaster, and rape. In survivors of prolonged, repeated trauma, the symptom picture is often far more complex."

    Also:

    "...adult survivors who have escaped from the abusive situation continue to view themselves with contempt and to take upon themselves the shame and guilt of their abusers. The profound sense of inner badness becomes the core around which the abused child's identity is formed, and it persists into adult life."

    She's also written about recovery, in the same book - that's the second half. But I felt like those bits, from the first section, were somewhat more relevant today. Also, I lacked the energy to look things up all morning.

    I can really relate to not leaving the house as well. I have only just started leaving my house on my own (aside from going to class and medical/therapy appointments), and only to go to a very few, specific, "safe," places. It's hard. I go to class, I church. I've started going to a few church related functions. It's hard.

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    1. And, uh, sorry for writing a novel in your journal! Guess I had more to say than I thought....

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  2. Stanford is doing some PTSD studies... You might be able to get scans done for science!

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    1. I actually went to them and asked. I was told that my trauma is too complex for them to study. I refrained from telling them that their science is pathetic.

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