Month: March 2016

Brain Sculpting

 

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Did not do any EMDR yesterday as I was too exhausted still, a week after the previous session!

My wife was like this too, so very very tired until the day before the next session, the following week, so she was averaging one day in seven when she wasn’t knackered. It is hard work, I have to say, being this tired all the time.

I asked my therapist about this, she wasn’t sure why it is so tiring so we decided I would research it.

There is not much out there in the research about why EMDR is so tiring. Most research said EMDR was so much more rapid in getting positive treatment outcome than other “talk therapies”  so I guess there is a lot of soul surgery and healing which accounts for me being so tired.

I have had to put most of my life on hold which kinda annoys me. Part of my attachment disorder is always doing stuff to make myself feel better about my self. Much of my self esteem is attached be getting approval for being good at stuff, being talented.

I am often too busy being a human doing rather than a human being to quote one of my old counselers!

I buffer my sometimes fragile and sometimes low self esteem through various achievements such as research and running my own business.

Not being able to do this stuff to the same extent has been tough.

The last couple of days have been full of sadness and anger.

I am seeping out sadness from  my past and then being really angry about it.

It seems incredible I am healing stuff that has been eating away at my very soul for forty years!  It seems a colossal waste of time some days. Why so much suffering for so long?

I wish I had come across  EMDR decades ago. Maybe I wasn’t ready for it then?

Anyway I am full of grieving for a multitude of losses.

The loss of my mother who’s passing I have not really grieved in recovery, the loss a self defining part of me (now I gotta grow a new shell?) the losses that trauma, C-PTSD and my alcoholism and addictions have caused in my life, the loss of opportunity, choices such as having had a child with my wife as we kinda decided against this due to my rampant alcoholism,  addictions and at times chronic mental health.

I have to be careful of not slipping into shame and self pity. It is a balancing act, feeling the pain I have blocked out on one hand and not indulging in it on the other.

I have to be careful sadness does not slide into self pity. I have to remember I am not a normal person doing EMDR for PTSD related incidents. I am a chronic alcoholic in recovery who has to guard that the treatment of one disorder does not trigger off the other. Which is kinda why I am doing this treatment in the first place?

Equally I have to feel this stuff, the decades of pain, sadness, anger that I have numbed out, run away from. I have to fully experience and let it be part of me and who I am.

I have to let it be and not react. Instead of avoiding it, only for it to constantly seep through into my consciousness and trigger my emotionally overreactive behaviours.

I have still to get to the root of many of my behaviours, to the source of where they began.

I have hit a milestone moment for sure in therapy recently but there are other layers of this psyche onion to unpeel.

Many years of emotional pain seems to be seeping out, like a puss and I have to accept this, not run or avoid, as this has been my way of coping from the past, a maladpative coping mechanism.

I have also been grappling with my pride and shame.

I do not think I have been explaining fully enough the process of EMDR which is remiss of me and has made me feel a bit stupid.

Although I am fairly intelligent, I live in fear that my “stupidity” will be outed one day and every one will know the real me, the “not as bright as I would like to think I am” me. As my cleverness or otherwise is linked to my sense of self esteem, I feel pained when I do not research something properly. It feels like a self inflicted wound.

My sense of self is threatened even.

I have not described the process of reprocessing properly I believe.

When I had my major therapeutic breakthrough last week I did not clearly state that the reprocessing bit was when I acted as an adult to my childlike self, to my childlike sibling and then to my parents. I was in charge, in control with making things right, in consoling and comforting way to make sure everyone was okay, loved and comforted. This is what I mean by cognitively reprocessing the past.

I revisited a traumatic memory, the scene of a traumatic memory, I was desensitized to this memory to a large extent because I was acting doing the bi lateral stimulation, the watching of the therapist’s finger moving from left and right, left to right. This desensitization is supposed to happen as the amygdala, implicated in distress states,  is somehow calmed by this process so the brain and mind are not as distressed as normal, so the revisiting of a traumatic scene is not as usually distressing.

This allowed us to adaptively  reprocess this scene and traumatic experience on three levels. First we feel it on a physiological level, we become aware of our body sensations and where they are on the body and just observe them. Secondly we are aware of the emotions that accompany these sensations and the trauma experience.

We discussed these to understand the unprocessed feelings. Then we cognitively challenged these feelings. For example feeling guilty for doing something any child would have done or feeling guilty for something that was not one’s fault is achieved and the emotions are somehow quelled. Then cognitively we can think about what we would say or do in relation to this scenario, to the child or the others in the scene from the perspective of now as an adult.

I consoled my child, spoke to my mother and asked her to speak reassuringly and in a comforting way to my child, then I extended this invitation towards my sisters, then my father joined us and we were all consoled my older adult me, in a way no one was at the time of the trauma. This was in essence a cognitive reprocessing of the event.

The reprocessing means that this memory will now have a different  cognitive, emotional and physiological resonance for me from now on. It was lodged in more long term memory.

The memory is still there in a sense but it does not have the cognitive, emotional or physiological  charge as previously. Hence it does not have the same influence, impact or prompt to certain behaviours that it once had.

For me thus far, this desensitizing and reprocessing has altered a maladaptively processed memory in terms of physiology, emotion and cognition and made it adaptive i.e. it is processed in a way that can help me not cause further pain. The behaviours that now follow it are more likely to be adaptive and healthy.

Some researchers have suggested that the sate of consciousness that one goes into during bi lateral stimulation is akin to REM sleeping. Thus, as with REM sleeping, the brain is active in resolving conflict in the mind.

I will probably have to consolidate this experience again at a later date but have grown some sort of membrane over this painful gaping wound of a memory, this hole in the soul.

I feel differently about this now as a result. It affects me in a differently way to before.

Something changed, possibly for ever.

In terms of the Adaptive Information Processing Model, on which EMDR is based, in order for a memory or experience to be processed properly, according to this model, it has to be processed on these three levels of physiology, emotion and cognition.  I have taken a memory that was not processed in terms of body sensation which probably reflected a heightened stress chemical response, not processed it in terms of emotionally coming to terms with it and not processed properly in terms of my thinking about it, for example, I had not fully considered it’s repercussions from a cognitively perspective.

This third perspective was not missing from what I mentioned in earlier blogs, I simply discussed the two levels of physiology and emotion

That is my understanding of it in the present now anyhow. That may change.

I have come across a number of excellent papers on how EMDR works which I will either upload here on this blogsite or more likely on http://insidethealcoholicbrain.com/ as this therapeutic process is fairly amazing in that it seems to rapidly reorganise certain networks in the brain.

http://insidethealcoholicbrain.com/2016/03/11/adapting-the-maladaptive-how-emdr-reprocesses-the-past/

In fact it is like taking a new adaptive memory and inserting or stitching it in to where the maladaptive memory was or in more technical terms like delving into the coding script of memories and rewriting some of the code underlying these memories. Like removing by a massive defragging.

It is profound stuff either way.

Any way why so tired from EMDR? I think the answer lies in the fact that EMDR leads to this rapid neuroplastic reorganisation of the brain.

In simple words, these means that neural networks in the brain are quickly created, redirected to become more adaptive. For example one area implicated in PTSD is the hippocampus which plays a major role in memory (especially explicit, episodic memory) but also has a less known role in stress regulation.

It appears that even after only about 8 EMDR sessions that the hippocampal region of the brain can increase in volume by about 12%!

This is fairly rapid and immediate reorganising of neural networks to increase a role the hippocampus in explicit memory (perhaps as opposed to the implicit memory network of the dorsal striatum which is implicated in more automatic, reactive responding, or stimulus response activity, with distress often being the stimulus of emotionally overactive responding) and stress regulation.

If my brain is re-organising so rapidly in  a matter of weeks then the brain will be using up much energy, brain glucose,  in re-sculpting my my brain’s neural circuitry.

Which is kinda mind blowing.

Filling in the Hole In the Soul

 

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The Light at the End of the Tunnel is You!

Just got back from EMDR therapy and thought I would write this right away as I will be very tired over the next few days.

A fundamental difference between PTSD and Complex PTSD is that Complex PTSD also addresses the consequence and effects of emotion dysregulation (the impaired ability to process and regulate negative emotions ) and insecure attachment to a primary care giver.

PTSD can happen in those with secure attachment and adaptive emotion regulation abilities and often relates to specific events or a one off event.

Much of the therapeutic work that goes into PTSD is about reprocessing a particular trauma and the related or associated feelings of guilt, blame and fearful helplessness etc that can result from that moment of traumatic powerlessness over a particular re-experienced traumatic event.

C-PTSD is more complex in it’s treatment as the trauma meshes with wider issues,  in my case, of emotion processing deficits (like alexithymia) and as a result emotion dysregulation.

We need to identify emotions in order to process then cognitively as feelings – we need to find words to put to the emotions before they become feelings – before we can properly regulate or control these feelings and whatever action we take in relation to these feelings will be the direct result of how these emotions are represented in our brain and mind.

If we have difficulty with representing these emotions as feelings then it is because the emotions are not labelled accurately (i.e. remain undifferentiated from other emotions) and do not become specifically represented in our brain and mind as particular and distinct feelings.

If we are not fully aware, cognitively, of emotions then we do not represent them as feelings to act on but act on these undifferentiated emotion states via impulsive and compulsive behaviours as if they are distress states. We act in relation to undifferentiated emotions as if they are distressing, like an emotional white noise.

I often act in an emotionally and experientially avoidant way. Most of my life I have avoided my emotions via maladaptive impulsive/compulsive behaviours.

I need to know my feelings in order to “self soothe” but as I could not “read” my  feelings my attempts at self soothing have normally been external to me in the form of susbtance use and abuse or in behaviours like gambling

The problem of “self soothing” thus is a legacy of emotion dysregulation but it is also a legacy of insecure attachment to my mother which resulted in an avoidant attachment style which can become disorganised when distressed.

This attachment style, I realised today, deep in my mind during bi-lateral stimulation, is partly  because I never learned to self soothe.

I was never taught it from my primary care giver and she did not appear to be able to do it either.

I never learnt to process and regulate emotions from my primary care giver either. So when I,  today, was attempting to  to investigate the horror of that fearful helplessness of watching my mother attempt a “cry for help” suicide attempt by trying to force pills down her throat I did not expect to suddenly understand the interlinking connection between all these things.

I expected to return to the horror of this most distressing scenario. I didn’t return to the horror emotionally but I did return to the scene and saw and felt that it was definitely a cry for help and not a serious attempt to kill herself – not completely otherwise she would not have made such a drama and spectacle out of it and had an audience to observe it.

I saw doubt in her eye, and shock at our reactions, a sudden realisation of “what the hell” am I doing here?

However, as she slumped to the floor, she, to my memory anyway, said it was all too much, that she wanted to die that she had had enough.

To us fearful children this  meant she had had enough of everything including us. That we were not enough, not good enough or not reason enough to keep her from wanting to die.

When asked to describe how I felt, I, to my surprise, had this massive feeling of a huge hole in my soul, as if someone had blasted the biggest hole in my chest with a double barrel  shot gun.

A hole that my alcoholism, addictive behaviours and traumatized self seeped from.

I was asked to act as an adult in this scene and immediately consoled the younger me, then my mother.

I asked mum to reassure the younger me that it was nothing to do with him/me, that she loved me. She did so.

Slowly but surely over ten minutes my younger me became united to my mother and then my sisters, and then my father. We all at on the bathroom floor, in the sunlight, holding each other and reassuring each other of our love for each other and that things would be alright.

My mother told me how she struggled on afterwards, through years of addiction and mental health problems, out of her love for me and my sisters. That this was not my fault, that I was not bad and it was not my fault – she was ill and couldn’t help it just like I could not prevent my own addictive illness.

It was the way it was. The way it is. We had to accept this.

Imperceptibly I could feel a membrane stretching and growing across my chest, over the circled edges of my hole in the soul.  Like a healing.

It is a start, a great start.

The inner child stuff I have often I have thought  a useful idea but not a reality until I married this psychological idea to something  called the resonance circuit in neuroscience. It is the emotional circuit in the brain through which the effects of insecure attachment resonate decades later.

It is like a frequency via which trauma and insecure attachment vibrates when distress in our everyday live strikes this fear circuitry. It may be as real as any neural circuitry in the brain.

Today I felt for the first time at a profound level that this resonance circuit is how the inner child communicates his distress. It is still  a “live ” part of me. A part that requires me to soothe it. To have compassion for.

I suddenly realised this is what healthy people do, they look after themselves, they self soothe. It is a part of emotion regulation.

They do so by having a compassion for their own suffering. They put their emotions and then their feelings first.

Today I experienced the benefits of self soothing, of realising that emotions were not to be avoided but discussed, shared and clarified and that I could eventually have a secure attachment with myself.

This is the main awakening. That the most important relationship is the one I have with myself.

 

Trying to Find the Horror

 

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In most traumatic events there is an accompanying feeling of terrified helplessness. Whether it’s a soldier looking on helplessly as his fellow soldier gets killed or a fireman seeing person burn in a fire, just out of reach or someone looking on as a loved one tries to kill herself.

There is that feeling of falling into an abyss.  A moment of true wordless horror. This the moment of trauma that leads to a life of post trauma, to PTSD.

A moment that is so unbelievably bad and terrifying, that the brain and heart struggles to comprehend the extent of it, fails to process the magnitude of it, fails to lodge the event in their long term memory and script of their life. Instead it makes you roam your life like an emotional Steppenwolf, scared to ever return to the warm of common humanity.

It is like an explosion that detonates in the brain and blows holes in stress systems and lives on in fragmented, fractured memory and in heightened fearful emotional responses to the world which are somehow not explainable. They require post hoc and retrospective explanation because they seem inordinately over reactive to events that prompt them.

This event will haunt the future and appear to  live on in one’s very bones. It has not been exorcised so lives on as a neural ghost haunting one’s reactions to people, places and things.

I know what my explosion is but not the intimate details. I have asked one of my sisters to help me piece together the broken pieces and scattered  debris of my memories of the event but she has struggled to.

First she was sure she was right in describing it a certain way and now has changed her mind to describe it a different way. With a different sequence of events and characters. It has been frustrating not being able to transport oneself back in time and simply look at a previous event in one’s life but there are so many self defense mechanisms making that process extremely difficult.

Either way, we are still not convinced about the aftermath of the event. We seem to be looked at a charcoal penciled sketching of pictures of the past which often get scrubbed out and started over. We have tried desperately, for hours this weekend, to piece and glue our scraps of memory together to make a bigger, more fuller picture, like a collective collage.  We might do this for weeks and still not get a definitive picture and memory of what truly happened.

I spent a few years, many moons ago, trying to write fiction. In fact I wrote about my family and this incident but purely, I believed, from my imagination but mixed with some historical signposts. Looking back, this writing from the heart may be more accurate that our attempts to rescramble our collective memories?

I and my sister have been trying to get to the moment of horror. To look at it again as adults not children, traumatized children.

We are convinced that it happened only once, thank God but that it has had major consequence and repercussions on all my sisters and I.

It would not be outlandish to suggest that all our lives took a major redirection that day. I, when talking to my sisters, see now that the huge similarities we seen to have are all because we are traumatized by the same event. We have post trauma personalities.

How we reacted to the same trauma seems to have frozen us into certain personalities.

My sister who ran for help is still running, in her personal life she continues to trust no one.

My eldest sisters still pretends, that it did not happen  as she may have dissociated from the actual event when it was happening – not wishing to believe that it  could be happening.

My third sister still bristles with anger and hostility at my “scary monster” of a mother who scared the life out of her children over forty years ago by attempting to swallow a phial of pills.

I am not sure what tablets she tried to kill herself with or if she even consciously tried to kill herself but to her assembled children that is what it looked like and that is what it felt like.

It is hard to describe what this level of rejection  and devastation felt  like. I will try to explore it again tomorrow in my next EMDR sessions.

The problems with asking a sister to help you remember is that you not only view the same scene differently, depending on gender, emotional loyalities, age etc but that the effects the traumatic incident had on you still affects how you recall it.

For example, my sister who ran to get help, talks about the event in a skimming, superficial, running through it type of way. She still doesn’t want to delve deeper into it as it is still  too scary. She is still running with the ten year old shaky, adrenaline fueled legs that took her to my uncle’s house to get help, not knowing how bad her mother was and whether something monumentally terrible had and was occurring.

I was left with my mother after she had taken the pills, slumped on the bathroom floor, without an adult to tell me things were going to be okay?  God knows the feelings I had, being so helpless? The despair I must have gone through in this few minutes between my mother throwing the pills down her throat and my sister returning with help? It must have felt a bit longer than eternity?

I will find out more no doubt tomorrow

Interestingly I would say decades later that one of my major weaknesses in life is my ability to tolerate uncertainty about future events and to handle distress adaptively.

It has been the greatest issue in my recovery, it is tempting to speculate that this behavioural response started as the consequence of not knowing the future prospects for my strewn mother, lying with tablets dribbling out her mouth on the bathroom floor?