Thursday, August 19, 2010

PTSD

Lately I've had occasion to ponder a lot on PTSD (post traumatic stress disorder). I know several people who suffer from it. Some IRL, one or two online. I could possibly even consider myself to have a little bit of it.

But I guess the odd thoughts I've been having is about its evolutionary course.

That might sound strange, but this is me we're talking about.

I've had a really raw couple of weeks. Something about my Mom's 20 year bone marrow transplant anniversary and a couple other significant events in lives of people I love dearly have brought my emotions dangerously close to the surface. I seem to always be on the verge of tears. And I'm not a person who cries often so we've been pondering tryin g to figure out what our issue is.

My first thought in this random jumble I'm going to try to bring into a coherent train is this:

Flash Bulb Memory.

This is a phenomenon in psychology. Basically attach an intense emotion - good or bad - to an event and you'll remember it for ever. Some argue this is why women have such good memories because for them everything is emotional. Think about the CLEAREST memories from your early childhood. There is almost always a strong emotion attached to that.

In terms of evolution this makes perfect sense. Odds are good if it scared the crap out of you or made you blissfully happy its a good survival practice to remember whatever it is clearly so that you can avoid/repeat the behavior as often as possible.

Now make that moment the most intensely negative experience of your whole life.

We'll break it down to monkeys.

Mr. Monkey is living in the jungle doing his monkey thing. Mr. Monkey has a near death experience with a jaguar and nearly gets ate, he's badly injured but he miraculously survives. Over the coming weeks and months Mr. Monkey now jumps at small noises. He has little monkey flash backs every time he sees anything that remotely reminds him of the jaguar. He has nightmares where he relives the moments that lead up to the attack.

What possible good could this torture do him? Well, the smart monkey option is to remember as clearly as possible what lead up to that attack so that he can avoid it in the future b/c the smart monkey goal is to avoid becoming jaguar lunch. Now he's hyper vigilant and you can be dang sure no jaguar is gonna get the jump on that monkey ever again.

... assuming of course he doesn't condition himself to ignore all the stuff that makes him jump b/c he's tired of being afraid and then he gets ate.

Well... here's where life gets complicated.

#1. We're not monkeys. Our traumas are not often jaguar attacks. PTSD is most commonly associated in the public mind with war veterans, but they're not the only ones that experience INTENSE emotional/physical trauma.

Human beings with our so superior intellects, have invented all sorts of ways we can torture and traumatize ourselves that don't leave a single exterior scar. But that makes them no less real.

I think that PTSD is essentially flash bulb memory. Except in this case the flash bulb was a super nova. The traumatic death of a loved one. The severe illness or injury of ourselves or people we care deeply about, a parent, sibling or child. The loss of some one you care deeply for. Years of abuse where the terror and fear burn a pattern of pain deep into the psyche.

I think that PTSD is infinitely more common than we think about it.

And whats amazing is how much it can surprise you. You can have a severely traumatic event. One you recognize as a trauma. And you move on you think you work through it. You do the best you can. And years later all of the sudden you completely and totally FREAK OUT and you're left shocked and gasping.

What on EARTH just happened? Why on earth did I just react like that? I'm past this. I'm fine now. I have 1 million reasons why this should not bother me. But suddenly its raw and its fresh and its stripped down to the open wound that was there all those years ago.

Maybe if you're lucky it doesn't hemorrhage like it did the first time. Maybe if you're lucky you can staunch the bleeding much faster than the first time. But all of the sudden you discover the wound you thought was fine is definitely not gone.

I think that just because you know something in your mind, this intense, super nova flash bulb memory has burned that thought into the very fibers of your being. Your body doesn't care that the mind knows that everything is just peachy now. Your body knows that "a broken heart" isn't just a metaphor. Your body knows that it can literally feel as though its heart as been torn from its chest and put in a blender and it does not want that to happen again.


And so in spite of your super intelligent, evolved brains protest your body is going to have a Grade A Freak Out. The right trigger got flipped and here you are back again. B/c after all the years of training your brain you discover the body wasn't paying attention to the lesson.

The good news is that  you can deprogram this reaction, mostly, over time. You learn to anticipate it. You learn whats going to cause the freak out. And while you can't help the initial response, that core emotional shock wave, what you can help is how you react to it. Do you feed it? Do you fuel it? Do you toss a couple sticks of TNT on top of your little glass vial of nitro glycerin?

Or do you call the bomb squad? Take deep breaths, focus on recognizing the reaction for what it is and then attempting to control your physiological response through various relaxation techniques. Eventually the body can be taught that A+B does NOT equal "End of the WORLD". Your brain knows that. It knows that A+B is cancelled out by F, G, and H which negate the effects of A+B, but thats not how your body thinks.

Your body is primal and its memory is event driven. As far as its concerned A+B = Worst Thing Ever. Therefore anything that reminds it at all of A+B will lead to MELT DOWN.

So the bad news is, odds are even with years of work, A+B is gonna make the body a little twitchy. You're gonna feel those over tones of grief and loss and mind numbing terror. BUT the good news is, that A+B doesn't have to ruin your life, your year, month or even a whole day. A+B can make you have a bad spell that you recenter for a bit and then you're fine.

Bastard thing of it is, you can go years with out A+B causing a problem and then it just goes and sneaks up on you and the body goes... "OH! OH! OH! Its A+B!!! Its been a LONG TIME but we remember THIS IS BAD!! AUUUUGGGHHHH!!!"

And then you're almost back to square one again. Some how its worse if you go a long time between exposures. The familiarity conditions the response and the brain can jump in and short circuit before the body gets into full blown melt down mode. But go a long time and the brain is a lazy slacker. If you don't use it you lose it. So A+B shows up and the brain is busy taking a snooze at the desk while the body, like the primal animal it is sniffs the wind, recognizes its old foe and with out the brain to enter the disarm sequence, launches back to its old programing and freaks out.

I may be talking in circles here but I need to.

I think I had some PTSD in response to my mothers leukemia when I was 8 years old. Someday I'll tell you the whole story. But now I'm starting to wonder if theres any correlation between a PTSD freak out I had at age 12 and the onset of my clinical depression.... I never noticed the time line similarities there but they are definitely there. And now that I'm reliving my memories, as we hit the 20 year mark, I find that familiar tension in my chest, my eyes threaten to tear up and I want to curl in a ball and weep for my terror for my Mommy....

Its been 20 years. I should be fine. But some how there I am all over again.

I dunno maybe its partially the anniversary. Maybe its reading somethings from friends dealing with their versions of the nightmare, maybe its conversations with people I love dearly having their own version of this hell. But its intense and I'm just trying to breathe through it....

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