“In response to the trauma itself, and in coping with the dread that persisted long afterward, these patients had learned to shut down the brain areas that transmit the visceral feelings and emotions that accompany and define terror. Yet in everyday life, those same brain areas are responsible for registering the entire range of emotions and sensations that form the foundation of our self-awareness, our sense of who we are. What we witnessed here was a tragic adaptation: In an effort to shut off terrifying sensations, they also deadened their capacity to feel fully alive.”
Bessel van der Kolk, The Body Keeps The Score, p.94
I kind of feel like I have lost myself. Like all this work in therapy on dismantling negative beliefs and delving into the parts of me that feel like a dark abyss make me feel like I don’t know who I am. I guess if I’ve dissociated or hidden parts of myself from myself for years maybe I never knew who I really was. I was always just a shell of myself- what others dictated of me.
My time these days consists of working, spending time with my wife, and going to various medical professional appointments. There was a 2 week (10 days M-F) period when I had 11 appointments while clocking 68 hours at work. And yet all of these appointments were necessary. Two of these appointments were at the Treatment Resistant Department at Emory (http://www.psychiatry.emory.edu/programs/trd.html). Because medication and talk therapy are not significantly improving (or fast enough) my depression symptoms, my psychiatrist referred me to the TRD team. These two appointments were two and three hours long involving a psychiatrist, a psychologist, and several computerized assessments. After my appointments the team concluded that TMS (Transcranial magnetic stimulation) and possibly switching up my medication cocktail (yet again) were the best course of treatment for my particular situation. Right now I am waiting on hearing back from Emory to see what my insurance benefits will cover for TMS. If everything works out I will be going to an hour long appointment five days a week for six weeks having a coil deliver a magnet pulse on the surface of my head. (http://news.emory.edu/stories/2016/06/hspub_epstein_tms_for_depression/campus.html)
I am hoping I am able to do this and that it might deliver some results. I am not putting all my eggs in this basket and will continue to go to therapy twice a week as I have been.
In January we added a stimulant to my medication cocktail. This addition has been somewhat helpful, but I can’t figure out if the benefits outweigh the side effects. The medication decisions lately seem to revolve around whether I can tolerate certain side effects and nixing other medications which have side effects I have deemed deal breakers. Right now deal breakers for me are weight gain and lethargy (I don’t need any more help feeling tired!). Vyvanse, the stimulant I am taking, has definitely helped me to cope better with everyday life. It’s less effort to get out of bed, I’ve been actually cooking dinner, and I can manage a dog walk 1-3 times a week. I have even been to the gym once to lift weights! This is a huge difference from the previous 4-5 months. Headaches, an even drier mouth, more shakiness, jitteriness, and a brain fog in the afternoon are what come with the benefits. I can’t decide if the jitteriness is increased anxiety or just extra energy I am not used to having- maybe both.
Another fun thing that’s been becoming increasingly painful and ever present is pain in my lower abdomen/pelvic region. I have been assessed by my pcp, my gyno and will be going to the urologist this coming Monday. So far all the diagnostic testing shows that I don’t have anything wrong with me. The gyno thinks that if I am cleared by the urologist I might be having symptoms of endometriosis and she will put me on birth control (more pills yipee!). I have noticed that the pain gets worse when I am more emotionally dysregulated which means it could have an emotional component. After finishing The Body Keeps The Score, by Bessel van der Kolk I understand how trauma has contributed to my chronic pain issues. I do want to get completely checked out first before we determine that this is mostly trauma related. The TRD clinic did comprehensive bloodwork and urinalysis tests when I was there. The tests concluded that I have an abnormally high blood sedimentation rate and a high C-reactive Protein level. These tests basically just mean that I am having body inflammation. It does not determine, why, where, or how.
Along with the pelvic pain comes increasingly more vivid and painful flashbacks. They seem to trigger each other. That’s also fabulous. Van der Kolk states, “Trauma victims cannot recover until they become familiar with and befriend the sensations in their bodies….Noticing sensations for the first time can be quite distressing, and it may precipitate flashbacks in which people curl up or assume defensive postures. These are somatic reenactments of the undigested trauma and most likely represent the postures they assumed when the trauma occurred” (p.102, 103). I was totally weirded out in therapy last week when I curled up like a child and hid my face from my therapist. This action was involuntary and I just found myself just going along with what my body wanted me to do.
I have had friends ask me if I think all of this is necessary and if drudging up the past is just making things worse. I have wondered the same thing, but both my therapist and van der Kolk (among many other professionals) have said that “In order to regain control over yourself, you need to revisit the trauma: Sooner or later you need to confront what has happened to you…” (van der Kolk, p.206). It’s like the saying, “the only way out is through.” Going through this recovery/process is probably the hardest thing I have ever done, but I know that not dealing with the trauma for more than three decades has brought me harm and strife.
The Body Keeps the Score is probably the most life changing book I have read to date. It’s crazy how I can relate and see myself in almost every chapter of van der Kolk’s book. It has really helped me to understand why I cannot readily identify emotions or know what I am experiencing/ feeling- there is a name for that, it’s called Alexithymia! I need facts and information in order to make sense of myself and seeing it in written form really brings it home.
If everything falls into place, I plan to write and keep a daily journal about the TMS treatment. The psychiatrist at the TRD clinic also recommended that I use the hour during TMS to do some sort of meditation or relaxation techniques to make double use of that time.