Archive for the ‘adult PTSD’ Category

I’ve just discovered my new bible–the book that explains me to me perfectly. Louis Tinnin, MD and Linda Gantt, PhD’s The Instinctual Trauma Response & Dual Brain Dynamics: A Guide for Trauma Therapy is THE book to read if you want to understand all types of early trauma: invasive medical procedures and infant surgery without anesthesia, sexual and physical abuse, abuse from foster care and orphanages, burns, rape, combat trauma, and captivity. The book discusses the authors’ understanding of how the brain copes with trauma, how the symptoms manifest, and how to best heal survivors of trauma. It  describes techniques and strategies in-depth and gives many excellent examples of cases in which people have successfully resolved their traumas. And, perhaps most importantly, the text is understandable to a lay person. I applaud them for this.

I feel immense gratitude, for this book has explained things to me that I have not been able to get a handle on no matter how I have tried. I’ve had SO many revelations and I’ve only read half the book. Here’s an example of a life experience that I’ve gotten a handle on: The difficulties I had learning to scuba dive were instantly clear to me. The book affirmed the fact that I was intubated without anesthesia before my infant surgery. That is, a breathing tube was forced into my throat while I was strapped down so that I could be breathed by a respirator. (Right now I am staring blankly out the window, slightly ‘frozen’ just thinking about it.) The scuba equipment replicated the respirator, sound included. I’ve always felt shame and disappointment about the fact that I could not become a scuba diver (especially since I was a marine biology major at a university in warm water Florida) and now, my experience is completely understandable. Post traumatic stress symptoms from the early trauma took over, a condition that I did not know I had at the time. Had I known, I would probably have been able to work through my reactions and soothe myself as I went along or even avoid certain reactions altogether.

Here’s a big excerpt from the book so that you get a flavor of the narrative and a glimpse into their approach. Go slowly. You’ll get it. They really do try to make it clear to a non-scientist type reader.

“Humans are double-minded. They have dual brains and dual minds. Yet, they do not know it. They have not known it since they first became toddlers using speech and verbal memory. That happens around age three when the two cerebral hemispheres begin  to exchange information across their maturing connection, the corpus callosum. When one hemisphere becomes dominant over the other, a compelling illusion of unity develops. This is when the individual acquires ‘I-ness”and begins life as a unitary agent in the world of verbal communication. The dominant hemisphere (usually the left) becomes the verbal brain, with a mind that operates by the logic of language and imposes a sense of self as unitary agent with willed action in linear time (past, present, future).

“Dominant verbal consciousness rarely yields to the nonverbal mind except during one’s instinctual response to trauma when cerebral dominance surrenders to nonverbal survival instincts. When the person recovers from the lapse of unity caused by trauma, the instinctual experience remains outside of verbal recall, unremembered in words but unforgettable in feelings and images. The nonverbal mind, unconstrained by narrative structure, remembers it all: the fear, the thwarted impulse to escape, the near-death experience of the freeze, the altered state of consciousness, the automatic obedience, and finally self-repair (as in animal wound-licking).

“We contend that it is nonverbal memory of the traumatic survival experience, held as unfinished and forever present but outside of verbal consciousness, that causes posttraumatic intrusive, avoidant, arousal, and dissociative symptoms. Understanding the brain dynamics of cerebral dominance, verbal and nonverbal thought and memory, and the interaction of verbal and nonverbal minds can lead to specific therapeutic measures for posttraumatic disorders” (Tinnin and Gantt 9).

Until we extract our trauma story from the right brain, post-traumatic stress often has its way with us. And if the trauma occurred before the age of three, then strategies other than verbal recall, such as drawing, must be employed. Stay tuned for more about this book. I’ll quote some of the case studies and share more of my impressions. In the meantime, you might want to go to the authors’ website for more information: www.traumatherapy.us or to Dr. Tinnin’s blog http://ltinnin.wordpress.com. Get ready to get clear.

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A scar is a reminder that something happened to you, something that was likely painful. And sometimes, as in my case, the scar is ugly and ragged, something I learned to be ashamed of. But today, I feel differently. I feel lucky to have a scar–a mark that actually pinpoints the location of the early torture and pain. My brother Wayne was not so lucky. My brother had no scar from his early hospitalizations, but he had the unresolved trauma and the post-traumatic stress. Trouble is, he didn’t know.

my brother

My brother, who died in 2010, had anger issues all his life.  He could go into a blinding rage in zero to .1 of a second flat. I once watched him chase down the driver who cut in front of our car, pull out a tire iron, and threaten the man with a beating. During a knock down drag out fight when we were teenagers, he threw me into a window so hard I felt the glass bend–pure luck that I didn’t crash through. He broke my mother’s wrist when, angry about something or other she’d done or said, he whammed the book he was holding down onto her arm as she was washing dishes. (It was an accident; he’d meant to hit the counter.) There are many other instances. His rages were felt by all who knew him. And while he was so much more than his rages, of course, they were a defining factor for him.

Where did this anger come from?  I was a very angry girl and young woman, but I took it out on myself. I cut myself, pulled out my hair, scratched into my skin, burned myself, and tried to kill myself a few times, once very seriously. I now understand these actions–symptoms of post-traumatic stress disorder (PTSD) from unresolved early medical trauma. That’s why I think my brother had it, too.

My brother was very sick when he was four or five. The doctors thought he had leukemia and, my mother told me, conducted so many tests she joked that she kept the hospital funded for a year. He spent several weeks in the hospital. My mother was distraught, thinking she might lose him. After all the tests proved negative, the doctors realized that he had a severe allergy to cow’s milk. My mother used to say that he was raised by a goat.

He was also hospitalized in the intensive care unit as a newborn. My mother gave birth to him in the backseat of the Ford as my father raced to the hospital. Unfortunately, my father had stored car radiators or batteries back there and somehow, he had ingested fluid from one of these types of car parts. He was put into an incubator as soon as he arrived at the hospital. So twice in his very early life, he was hospitalized, isolated from my mother, and subjected to many procedures and tests, some of which I’m sure were quite traumatic. (Back then, medicine believed that babies did not feel pain and, therefore, did not generally use anesthesia or manage pain. Please see two previous posts from Feb. 10 and Feb. 25 for more information about this.)

My brother died in pain. He had a major heart attack. For the few years before he died, he was very stressed and often scared that he would lose his home. He had lost his job several months before his death. He had no health insurance and constantly worried over the mounting bills and debt. He’d had many high paying jobs in his life as a mechanical engineer and businessman, but in the financial meltdown, he really crashed. After he died, I learned that he’d spent a lot of time in his last few years making bullets and storing ammo in his garage. He was frightened. He was armed. He was defended.

I believe that he had post-traumatic stress like I do. I believe that many of his personality “traits” were actually “states” of PTSD. I think his rage was a lifelong consequence of unresolved and untreated trauma due to invasive medical procedures at the beginning of his life. He had no scar to point to and say, aha, here’s the origin, here’s the wound. My mother had told him of his severe sickness as a baby and young boy, but whenever she brought it up, he silenced her. He did not want to be portrayed as a weakling. He was not vulnerable. His trials were over. And no scar reminded him of the pain and suffering.

So while I have cussed and groaned over the fact that I have an unsightly scar at the center of my body, it reminds me of why I suffer the symptoms that I do. It helps me have compassion for myself and remember that my personality quirks are not always me but symptoms of PTSD. (It’s a relief to know there’s a reason for some of the crazy ways I’ve acted in my life.) It helps me explain myself to myself. Since my brother had no battle scars to show for his warrior wounds, his wounds were invisible. Perhaps a scar would have helped my brother explain himself to himself. Perhaps not.

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I painted this self-portrait when I was 25 years old and very depressed, can you tell? I was so down, lost, and  unaware one drizzly, chilly east bay morning that I left a pillow over the heating duct in the floor after I turned on the heat, which started a fire in my apartment. I crawled under the cloud of living room smoke to the safety of the porch while the fire engine arrived.

Some of the quotes below, taken from the article “The Long Life of Early Pain” published in On the BrainThe Harvard Mahoney Neuroscience Institute Letter Winter 2011, Vol. 17, No. 1 explain why, as a survivor of infant surgery,  I was in such pain.

Scan 2

It was a centuries-old notion that had profound ramifications for medicine: Infants, especially those born prematurely, felt little or no pain. As recently as the late 1970s, physicians in the United States and other countries used pain-killing medications on infants only sparingly; the common practice was to provide infants with a sucrose solution to quiet and soothe. . . . Few researchers had challenged the premise that infants did not respond physiologically–or neurologically–to surgical incursions (1).

A pivotal study in 1987 by Paul Hickey, MD, . . . and Kanwaljeet Anand, MD, PhD . . . showed not only that babies exhibited stress responses to invasive procedures, but that these troubling, even dangerous, responses were reduced when anesthesia was used (1).

Medical professionals began noting an array of psychological and psychosomatic troubles linked with the experience of pain or impending pain in adolescents and adults who, as infants, had undergone surgery without anesthesia (2). 

According to Frederick J. Stoddard Jr., MD, . . . early-life traumatic stress and untreated pain may seriously affect a child’s development, contributing to lifelong emotional disorders, including anxiety and depression, learning disabilities, and other problems in growth and development (3).

Although studies have documented post-traumatic stress disorder (PTSD) in survivors of child abuse, few have looked for a connection between the disorder and early-life surgical pain. PTSD, a severe anxiety disorder that can develop after exposure to a psychologically traumatizing event, often overwhelms an individual’s ability to cope (3).

Need I say more?

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I am psyched. I gave my first talk out in the world beyond the classrooms of The College of Alameda and it was thrilling. Eight women from the Women’s Motivational Meetup in Sacramento, hosted by Griffin Toffler, gave me their attention, listened to my lecture, and participated in a writing exercise at the library in Fair Oaks. Afterward, I felt so happy because I was doing what I felt I was put here on earth to do—tell my story, invite others to find out what’s holding them back, and share some tools that might help them to break through to their power.

Two major points keep surfacing when I think of what I want to discuss in this first post of the new year: belief and post-traumatic stress (PTSD). At age fifty, from my exploration in writing about my infant surgery, I learned that I was living my life from a false premise—I was broken and incapable of being fixed. This thought or wrong belief about myself sabotaged me at every turn. It had been unconscious all my life, operating below the radar, and so this lack of belief in my strength and power undermined me mercilessly. It’s difficult to write about this even now; grief surfaces, sadness. How painful it is to accept that I believed this about myself and acted from this false and destructive premise.

Writing about my infant surgery also helped me realize that I had post-traumatic stress disorder (PTSD) and had had it all my life since the operation for pyloric stenosis at 26 days old. Amazing!  I sensed that I might have it, my lover hinted that I might, but I was too frightened to investigate this possibility. In doing research for the memoir I was writing, I learned about the history of infant surgery and anesthesia, the nature of trauma, and the condition called PTSD. I read many books and scientific articles, which helped me realize what had happened to me. My hypervigilance, exaggerated startle response, re-enactments, difficulty sleeping, jaw pain, panic attacks, depression, anxiety, suicidal ideation, self-harming, eating disorders, and delinquent behavior as a teen were all explained by this syndrome. What a relief to finally be able to identify these symptoms and pinpoint a cause. And what a relief to know that these expressions of myself aren’t really me; they are actually due to a condition that is caused by unresolved trauma.

So here’s what I wanted the group of women at the library to know or get support for knowing—that it is possible to ReStory Your Life. It is possible to identify a deeply held belief or set of beliefs that might be holding you back. Talking is often not the best way to discover it. Through writing, artwork, and/or somatic work, allow yourself to learn what belief is obstructing you from being all that you know yourself to be. This idea was never yours in the first place. Work with this misperception to understand it and then change it. You are a most profound and beautiful soul. You are a creation of the universe. What is your real belief about yourself? Discover it. Find freedom after trauma.

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One can always be more free. As the year comes to an end and 2013 is upon us, it’s a good time to let go of things one doesn’t want to bring into the new era.

As a baby, I got wired for trauma. Being operated on at 26 days old for pyloric stenosis, a blockage in the stomach, set the stage. As a baby, my belly was cut open and part of my stomach actually drawn out of my body to fix the problem. In many ways, I am still frozen, holding my body rigidly as I cope with a trauma that occurred 60 years ago. Amazing!  It’s called PTSD (post-traumatic stress disorder).

So earlier this morning, I was sitting in bed with my legs extended, preparing for meditation. I settled in, covering myself with a blanket, allowing my body to sink into the earth and be held as I listened for my heartbeat and tuned into my breath. I realized though that my face was stuck as if it was frozen from the cheekbones up, including my nose. My lips were pulled back and my nose and brow were literally numb. I was smiling a weird lips-pressed-together-and-pulled-back type of smile, more like a snarl, and breathing as shallowly as possible.

What was going on?  I tracked the tension in the rest of my body–my shoulders, hips, chest–and realized that I was straining against something. Flash! In all likelihood, I was straining against whatever hospitals use to tie down infants who are going to be operated on. Back then, my head was secured to the table and here I was in 2012 still fighting to free myself.

Often in my morning meditation, I’m so busy dealing with the somatic repercussions of infant surgery that it’s a challenge to allow a meditative state to kick in. Some days, I simply deal with what I call somatic freeze and other times, I break through to information that my higher self has to offer.

One way I work with this rigid state is to allow my breath into the frozen area. I don’t forcefully bring breath in by taking a deep breath but simply allow my natural breath to return. I invite a quiet breath movement. In this process, I actually began to feel my nose and to exercise face muscles that I didn’t even know were there.

Another strategy to cope with PTSD freeze is imagery. During my meditation, a liberating fantasy brought excitement and a feeling of power.

I am a baby strapped to a gurney before surgery, wanting to escape. I rise and break the bands holding my head, shoulders, hips, and feet and grab the surgeon’s scalpel. It becomes a sword. I’m standing on the gurney now, a super-powered baby swinging her sword, daring anyone to approach. Oh, what fun!  I love watching their shocked and frightened faces. They run out of the operating room and I smash up the place. Oh, more fun!  

So am I suffering from frozen rage?  Am I stuck in that moment of facing my own mortality and being unable to do anything to save myself?  Yes!

I may have been given a local anesthetic before the surgery. I may have had no anesthesia but received instead a paralyzing drug. In this case, I would have been awake but incapable of fighting. Still I would have tried to be free. Certainly, my nervous system cried out, escape! Perhaps before being administered general anesthesia, I fought against being tied down. Since I had been starving for weeks and weighed only four pounds, I was pretty weak. I doubt though that I was fully anesthetized; the level of tension and stress in my body suggests I wasn’t.

My body has been engaged in a lifelong fight with itself and for the last 10 years, through meditation and Middendorf Breathwork, I’ve been finding freedom from this struggle. I am discovering my power. I am learning that more freedom is always possible. For 2013, I am getting a new face–less startle, more real. More truly me.

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I was going to write about re-enactment, a psychological byproduct of trauma from exposure to danger, but I can’t stop thinking about the shooting at Sandy Hook school.  In articles in Huffington PostSFGate, and New York Times Online, I look for pieces in which a more in-depth understanding of the psychology of the shooter Adam Lanza is revealed, but all I ever see is the tired phrase “personality disorder” as if that explains anything.

In other articles, he’s referred to as autistic or Asperger’s. In one article, a high school classmate remembered Adam as a weird kid who ducked in and out of class, carrying a black attaché case. Someone else mentioned that he was ‘one of the Goths’. I just want to know why a kid whose suffering was clear to everyone wasn’t helped. How do kids become such loners?  Why does everyone know that Adam Lanza was different or “socially awkward” or “painfully shy” and obviously needed guidance or friendship but was just left to ‘go his own way’?  And why was an adult who was head of the high school technology club to which Adam Lanza belonged charged with watching out for the boy because he couldn’t feel pain?

Another question I have is, was Adam on medication?  If so, how long?  What are the side effects of these medications?  At what age was he medicated?  What part did a drug play in Adam Lanza’s behavior?

I remember the rage I felt at age thirteen and at twenty-two. I didn’t know how to cope with it and acted out. The school psychologist was worthless; in fact, he exacerbated the situation and increased my rage. The principal of the grade school acted like a bad cop in his dealings with children, further enraging me. When I was twenty-two, the counselor at the college I attended was a Freudian analyst who frightened me. Many times, we are having problems that our parents can’t solve. Sometimes, our family is the problem. We look to society and its institutions for help. Where was the help for Adam?

What do children do with their anger?  Are they given tools to cope and understand themselves?  Is there a space for mental health training in schools?  Was Adam Lanza filled with uncontrollable rage?  Perhaps he had experienced some early trauma that he was unconsciously acting out on?  Maybe re-enactment is a relevant topic of discussion after all. Adam could have been “re-creat[ing] the moment of terror, . . . in an attempt to undo the tragic moment . . . commonly, traumatized people find themselves reenacting some aspect of the trauma scene in disguised form, without realizing what they are doing” (Herman 39-40). Was Adam suffering from undiagnosed post-traumatic stress?

Obviously, the situation is complex and all I have are questions and more questions. I am waiting for an article that honors the complexity of the human condition in its attempt to provide answers. In the meantime, I am praying that our society moves forward and changes in some big, brave ways in response to this enormous tragedy.

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Last Thursday, a dermatologist cut out a melanoma on the back of my leg just below my calf. It was a slow spreading kind and since I caught it early, I am told that it hasn’t metastasized. That’s the good news. I didn’t think the surgery and recovery were going to be a big deal. But I got twenty stitches instead of the projected seven, and I have to spend two weeks with my leg up on a pillow. And yes, it hurts when I walk. A much bigger deal than I thought it would be.

Here’s the part though that I want to discuss. As I lay down on the table while the doctor suited up, I had an experience that helped me understand how I coped with my infant surgery. The journal entry that I wrote shortly after the surgery explains it best.

What a gift that I was only given a local and so was conscious and aware of my body’s response to being cut. The old somatic pattern came raging back. When I lay down for the surgery, my jaw went through a series of unlockings–spasms of about twenty shakes until it settled down. In order for my jaw to relax, my bottom and top teeth could not be aligned; I had to let my bottom jaw slide out to the left.

My jaw spasmed once more–shudders of many shakes–and settled back down. The only way I was comfortable during the skin surgery was to let my bottom jaw slide left a half-inch, which made an awkward fit for my teeth.  Also when I lay down for the skin surgery, my right scapula (shoulder-blade) locked–a terrific force that gripped. I was eventually able to relax it.

All my life, my jaw has been misaligned due to gritting my teeth from the infant surgery. My teeth and jaw absorbed the pain. Gritting nightly stayed with me since that time. The pain must have been extraordinary to tense me up like that, to burn it into my brain, to create such an entrenched pattern. My gums weakened and made me susceptible to gum disease. As I got older, my molars became brittle and cracked. All my molars are crowned. And the scapula lock dates back to the early crisis as well. 

In my life, when I lay down for sleep, my body  goes into lockdown unconsciously. My jaw clenches and my right shoulder-blade locks, which has me breathing in a way that minimizes breath movement in the area of my infant incision. I became aware of this pattern years ago in my study of Middendorf Breath Work, which has helped me become aware of my outdated  somatic patterns and move beyond them.

I have come full circle: incision then, incision now. Let me move into a new future–no more cutting. Let my somatic pattern be released once and for all. Let me find a new way to hold my body in trust and in freedom. Let the old electricity and the old alarms be just that–old. Let me release the trauma buried so deeply in my body and brain. Let me be trauma free. Freedom calls.

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