7.30.2007

the tyranny of the subconscious

Two nights ago, I did a stupid thing. I read about something very disturbing right before going to bed.

Allan, D and I had been talking about trying to keep what we know about players' personal lives out of our enjoyment of sports. D mentioned Michael Vick. I had heard about it, but hadn't read any details. D said the details were too horrible to talk about.

I decided it was one of those things I had to know, even though knowing would upset me. So I read about it. That's OK. But anyone with sleep issues should know better than to do that before bed.

I woke up at 2:00 a.m., crying.

In my dream, we were at the vet's office where we had Buster put down. I saw our last moments with him, the same as they occurred. But in the dream, after we left the room, the doctor injected Buster with another drug that revived him. He wasn't really dead. Then Buster was taken to a pit where other dogs would attack him. (That is likely what happened to him in real life, and why our boy had so many problems.)

But that wasn't the worst part.

In the dream, Buster thought we let that happen to him. He thought we tricked him into going to the vet's office, then betrayed and abandoned him. That was the worst part.

At 2:00 a.m., this felt so real. My chest hurt like my heart was being crushed.

It was a while before my mind swam back up to full consciousness and I was able to convince myself this hadn't really happened.

* * * *

In some cultures, dreams are visitations from the spirit world, or travel to other dimensions or states of consciousness. One of my nephews studies depth psychology, an offshoot of Jungian thought that says a person cannot truly know themselves unless they understand their dreams.

I never wanted to examine my dreams. There have been times in my life when my greatest wish was for dreamless sleep. But I'm fascinated by how our minds are at work even when we're not conscious of it.

When I have a writing problem that I can't solve, staring at the computer screen and trying to force an answer will never work. The best thing to do, I've finally learned, is to get up and go do something else. When I'm being smart, I go for a swim. In the pool, or later, relaxing with a cup of tea, the answer comes to me.

That means my mind is working on the problem even when I'm not aware of it. I remember learning about this "Ah-ha Experience" in my own psychology classes in university. The human mind is so amazing.

* * * *

But the workings of my subconscious mind have been more curse than blessing. Anyone who has lived through post-traumatic stress syndrome will know what I mean.

After I was raped, I used to wake up in terror, every night, at the exact same time. Over time, and with a lot of help, this happened less frequently. Sometimes it wouldn't happen for months, and I would think it had stopped altogether. Then it would happen again.

I've been told it's very difficult to wake me up when I'm experiencing this. Whatever is being said to try to rouse me gets incorporated into the dream. So if someone is saying, "It's ok, you're ok, you're safe," then someone in the dream is saying this, while they assault or torture me.

In the dream I hear screaming, coming from a distance, and I try to move towards it. But I'm immobilized; I can't move. I know to be safe I must get to that screaming, but I can't. Finally the screaming gets louder and helps me wrench free. It's the sound of my own voice. My own screaming wakes me up.

After one of these incidents, I'm exhausted the whole next day, sometimes for several days. My concentration is low, I feel stressed, wrung out. Years after I was raped, it was still happening - only once in a while, but never stopping altogether. I would wonder, when will this cease? I am over it. I am healed. So when will this terror be flushed from my brain?

About ten years ago, I was quietly celebrating inside that I no longer had these night terrors. Years had passed - including the anniversary of the incident itself, formerly a difficult time for me - without an incident. In my public speaking - on "survivor panels" to help medical students, police, or other populations learn about rape and domestic violence, and for outreach to other possible survivors - I would say that it no longer happened at all.

Then I had another. This time I was angry. Enough already!

Years passed again. Surely that was the last one.

But no.

Within the last six months (I know because we lived in this house), it happened again. I didn't remember it upon waking, I just didn't feel well. Then later in the morning, it came back to me. I asked Allan, did something happen last night? Did I wake up?

Enough already!

All the work I've done - the therapy, the activism - all the time that has passed - more than two decades, for godsake! - and this shit is still in there?? Leave me alone already! I am healed, I am whole, I'm more than fine, I'm great. The rape is just part of my life's landscape, and has been for so many years. It's the worst thing that ever happened to me (and I hope it always will be), but that's all it is - something that happened to me. It was one incident, one night, and it was more than 20 years ago! Why, why, why can't this part of my consciousness get past it?

* * * *

In 2001, I started having minor anxiety attacks. Not full-blown panic as I've seen some people experience, but frightening little incidents of racing heartbeat, shallow breathing, anxiety and fear. I would think something terrible was about to happen to me. It mostly happened in the morning, upon waking. It seemed unconnected to anything going on in my life.

My own doctor thought it might be purely physical, an irregular heartbeat, the adrenaline surge that happens in the morning (when most heart attacks occur). But I wasn't being fully honest with her. The incidents were coming during the day, too.

I had a consultation with a psychiatrist who I really liked. To my surprise, she asked if I had ever had post-traumatic stress. I told her I had been raped, and she just asked a few simple questions to get the basic picture. She also asked briefly and pointedly about my childhood, and zeroed in on whatever fear and anxiety I had growing up.

Then she probed my current life. I didn't think I had anything to tell. But to my amazement, I ended up briefly relating "The Finger" incident. That's our shorthand for a series of events in which an incompetent dog trainer set us up for disaster, leading Buster to attack another dog. The other dog sustained minor injuries to its ear; Allan was hurt trying to separate the dogs, and spent five days in the hospital, having part of his finger re-attached. Buster - calm and sedate afterwards, with blood all over his face - was never the same.

The Finger occurred when we, with the "trainer," were walking Buster in our neighbourhood and he slipped out of his collar. After, I was terrified to walk him. The five days when Allan was in the hospital were incredibly scary for me. (Worse for him, certainly.)

Somehow the psychiatrist easily pulled all this out and brought it together. "There you go," she said. "That's likely the source of your anxiety."

She talked to me about anxiety, and post-traumatic stress. She said that the brains of people who have had post-traumatic stress syndrome react differently to anxiety and fear. The ultra-high levels of adrenaline pumped into the system during trauma permanently change the body's sensitivity to fear, anxiety and acute stress. She told me that if we saw a CT scan of my brain when I'm frightened, compared to the brain of a person who had never been traumatized, we would see a difference, whether or not I was aware of feeling anxious.

The session was a bit scary, but wonderfully insightful. She wrote a prescription (Klonopin to the rescue), and made some recommendations on how best to use it. She also gave me a few names of therapists, in case I wanted to continue. I didn't. I understand it as well as I want to. I don't want to explore any further. I just want to sleep through the night.

* * * *

Trauma is an over-used word. Like so many words in our world - hero, tragedy, awesome - its meaning has been ruined by overexposure. But trauma exists, and long after it's over, it exists still.

I imagine a many-tentacled creature burrowing deep into our minds, lying dormant, perfectly camouflaged. Until something - the tiniest of catalysts, minor, unnoticed in our waking life - taps its shoulder.

14 comments:

M@ said...

Thanks for all this. I've been talking to a lot of people suffering from PTSD lately, and this gives some insight into what they're talking about.

One thing I notice is that when I try to describe the experiences to others, they don't really get what the big deal is. It's part of the problem in general society: PTSD just isn't recognized. But as you say, it's a fundamental and permanent change to the brain chemistry.

At least post-traumatic stress is more widely recognized these days, even if it hasn't penetrated the public consciousness. The Canadian military now provides mandatory counselling for all soldiers serving overseas (before and after their trip) and openly discuss the symptoms and effects of combat stress. A bit of a change from the early 90s, when soldiers were told "well, you've been away for a few months, so take it easy on your wife the first time you have sex." Yugoslavia veterans are only in the last few years getting in contact with each other and forming small, informal support groups.

One thing I'm wondering about is the varying degrees of PTSD, and how that's dealt with in the current treatment strategies. There are traumas like rape or torture that are obviously at the top of the list; then trauma related to physical injury; then life-threatening situations; then being in high-stress environments for an extended period.

I often hear things like "well, obviously I don't have PTSD... but I was severely depressed for my first six months back in Canada" or "but my temper is really short" or "but I just can't stand to see food wasted / laziness / etc". These things from people who, for example, served in Haiti or in Rwanda during the genocide. There's no doubt in my mind that these are lower-grade versions of PTSD, but unless the symptoms are such that the sufferer can't function in society, they just aren't recognized as a problem -- especially by the person suffering.

(Your post came along at just the right time for me -- this stuff has obviously been on my mind lately.)

L-girl said...

One thing I notice is that when I try to describe the experiences to others, they don't really get what the big deal is.

I'm curious, what is it they don't get? Why the stuff still bothers the person, or what the symptoms are, or... something else?

At least post-traumatic stress is more widely recognized these days, even if it hasn't penetrated the public consciousness.

I think it has. I see a great deal of awareness of it, at least I did in the US, in relation to domestic violence, child abuse, veterans, rape survivors, etc.

There's no doubt in my mind that these are lower-grade versions of PTSD, but unless the symptoms are such that the sufferer can't function in society, they just aren't recognized as a problem -- especially by the person suffering.

Maybe this is why I use the expression "post-traumatic stress syndrome" instead of "disorder". For me personally, I never felt I had a disorder, as these feelings and symptoms have not interfered with my life. (That is, after the initial recovery period - but during that period, the symptoms are a normal reaction to trauma, not a disorder.)

What you're talking about could also be seen as depression brought on by the high level of stress.

I do agree that the whole syndrome is often unrecognized, even by the peson experiencing it. Sometimes having someone else (a professional) name the experience can be very liberating. "So I'm not going crazy...?"

Your post came along at just the right time for me

I'm glad to be able to help.

I often think about the differences between one-time trauma and repeated trauma. I've known many survivors who grew up with sexual abuse as part of their daily lives, or were repeatedly assaulted by their partners. (I sometimes felt silly that my one-time event was still an issue.) I always wondered, and marveled, at how they coped.

James said...

I imagine a many-tentacled creature burrowing deep into our minds, lying dormant, perfectly camouflaged.

Except it's not some external creature burrowing in; it's an integral part of our minds, burrowing up and out, like a psychological cancer.

L-girl said...

Except it's not some external creature burrowing in; it's an integral part of our minds, burrowing up and out, like a psychological cancer.

Huh. That's a different way for me to visualize it. Because trauma itself was an external event, I think of the residual effects as an outside force, not something inside me. But of course this is inside me.

Your metaphor is similar to one I always use. I think of the effects of trauma as a poison running through the veins. Talking about the experience (or the effects of it) releases the poison.

People are afraid to talk about trauma because they fear it will overwhelm them, wipe them out. But when they finally do start talking about it, the poison can finally be released.

There are lots of ways to cover up the effects of the poison or to try to deaden the pain, but to my knowledge, only one way to purge it.

M@ said...

I'm curious, what is it they don't get?

Pretty much why the stuff is still a problem. If the person wasn't themselves attacked or hurt or whatever, or if no one was hurt or killed, what's the big deal? To me, it seems like a huge lack of empathy -- it isn't even easy, for me, to deal with hearing these stories, much less living them. Hopefully more people will feel like me when they read the book...

I think it has. I see a great deal of awareness of it, at least I did in the US, in relation to domestic violence, child abuse, veterans, rape survivors, etc.

I hope you're right. (One side issue is that many Vietnam veterans are being stripped of their PTSD disability status as the US military tries to clamp down on expenses. I was furious to hear a rep try to defend this policy. One of the reasons I'm so interested in the subject is that veterans will need the support long after -- sometimes not until long after -- those magnets are taken off the many cars they're on.)

Maybe this is why I use the expression "post-traumatic stress syndrome" instead of "disorder". For me personally, I never felt I had a disorder, as these feelings and symptoms have not interfered with my life.

Yeah, I realise the terminology I'm using is inadequate in a lot of ways. Is PTSS a common term? It seems more apt, more general. "Disorder", of course, is not a derogatory term in the psychological usage, but it certainly carries baggage with it that seems to me to say that it's the sufferer's fault. That's a problem underlying many of the stigmas regarding mental health in our society, of course.

David Cho said...

Wow, that is one scary dream about Buster.

I still dream about my mother a lot. And when I do, it takes me a while to realize that I was dreaming, and she is not alive, just as it took you awhile to realize that what was happening with Buster was not real.

This kind of stuff seems just to vast and beyond scope even to start thinking about.

L-girl said...

Wow, that is one scary dream about Buster.

I knew you would understand and leave a comment. It was very upsetting.

I still dream about my mother a lot. And when I do, it takes me a while to realize that I was dreaming, and she is not alive, just as it took you awhile to realize that what was happening with Buster was not real.

Thanks for sharing that. I frequently have dreams that when I wake up, I'm not sure what reality is. I wonder how common that is.

This kind of stuff seems just to vast and beyond scope even to start thinking about

Quick, run away! :)

I feel the same way. For me, it's enough to acknowledge it and marvel at it. I don't try to understand it.

L-girl said...

To me, it seems like a huge lack of empathy

Enormously insensitive.

Hopefully more people will feel like me when they read the book...

Your book is bound to increase people's understanding. Very cool.

One side issue is that many Vietnam veterans are being stripped of their PTSD disability status as the US military tries to clamp down on expenses.

Lordy. Just look at that phrase: "the US military tries to clamp down on expenses". After all, how will shareholders profit from multi-million dollar no-bid contracts if they treat every soldier who's screaming at night dreaming of car bombs?

Yeah, I realise the terminology I'm using is inadequate in a lot of ways.

But it's not you. It's the terminology.

Is PTSS a common term?

Among certain people. :) I do think the term PTSD is over-used. But not in the context we're talking about.

I agree w/ you about the medical terminology. It's useful, but it has its limits.

M@ said...

I agree w/ you about the medical terminology. It's useful, but it has its limits.

One of my interviewees, who had a very strong French accent, referred to it as "the post-traumatics", as in "I didn't really have the post-traumatics". I have to say I like that.

Scott M. said...

I'm happy to say that most people understand the flashbacks and/or upset episodes I had (and increasingly rarely have) after witnessing the subway hit a person who was not intending to commit suicide.

They may be a little confused at the time though are understanding after I explain. I recall seeing "Titantic" with my grandmother and was horrified when a person hit their head on a fixed aluminum table while the ship was vertical and the sound effects man got the noise of the subway hitting the young man on the platform. In fact, just writing about it now I'm getting upset.

Anyway, I had to get up and leave the theatre and came back a bit later. I have been fortunate that everyone I've ever talked to about that has been supportive. I don't know how I would react if someone tried to make light of it or ridicule me.

May you have better dreams from now on, Laura.

L-girl said...

Thank you, Scott.

What a terrible thing to have seen. I'm glad to know people in your life were supportive. It's a horrible thing when they're not. (I'm glad to say I have been very lucky in that regard too.)

Interesting how a sound brought it back to you. As you may know, for many people the sense of smell is a huge trigger. I once almost vomited on the NYC subway after a man squeezed by me and I smelled something that brought back the assault. It was completely involuntary and instantaneous.

May I ask how long ago this happened? How long was it before the flashbacks/upset started to subside? If you don't feel like saying, please just ignore.

L-girl said...

(I'm glad to say I have been very lucky in that regard too.)

With the large exception of my father, who was extremely loving and supportive for exactly one week.

Ah well.

Scott M. said...

Well, today I had a bit of an episode, but hey. As you mentioned, better to talk about it.

I was sitting in the front of the subway coming home from work (Eglinton to St. Clair) when the train rounded the bend into Davisville. Being a trainspotter, I was looking out the front window. A person on the platform, who looked like me but 5 years later, was bent down to (likely) spit on the tracks and didn't hear the subway. The driver didn't stop more suddenly nor did he honk his horn and I don't blame him, I didn't even realize that he was in the path of the train. Then the train hit him. He was dead on impact.

The next four hours I was walking around like a zombie, in shock. I left my name with the TTC collector as a witness and went home.

At about 8:30 it hit me. I called everyone I knew, no one was home. I finally got my sister who I was mostly estranged from. She came over and comforted me. I didn't sleep that night.

The next day the TTC and Toronto Police called and they wanted to run through the accident. My boss didn't care that it happened (now that I'm remembering I do remember some not supportive people) and I had to go to work. The next day the TTC and Police arranged to pick me up and run an out-of-service train on the same route so I could explain what happened. Up until that point I had been crying many times each day.

I managed to get through the demo, and, at the end, turned to the TTC lawyer and asked if there is someone I can talk to at the TTC about the incident as I was having problems with it. He was rude and fluffed me off, but the cop was really considerate and offered to have the Toronto Police Victim Services call. They were awesome, I could call anytime and they would call every day at bedtime and make sure I was OK.

It took me about 2 weeks after the incident before I could go through a day without getting upset about it. It didn't help that it was in the news all the time and the reporting was horribly inaccurate. After that it was every few days for the next month, then once every couple of weeks. It took me three months or so before I'd ride the subway again (I know, it was stupid to not ride, but I didn't feel good about it).

After about a month on the subway I noticed I didn't get upset anymore. It was about a month after that I saw Titanic with my grandmother.

About another 3 months after Titanic, I was driving home on the 404 going 100km/h in really busy traffic when it hit me again, almost full force. I don't know why. I forgot what I was doing for a few seconds and almost caused a crash. I got over to the side of the road barely containing myself and sat there, crying, for a half an hour.

Since then no other periods of upset have been that severe, and they've been getting fewer and further between. The incident was 12 years ago, and for the last 5 or 6 years I've only gotten upset about it about once a year, at almost random times.

I know it sounds crazy, but I don’t actually want to forget completely. I’m glad I remember and I’m glad I still get upset. That somehow seems wrong, but there you go.

L-girl said...

I know it sounds crazy, but I don’t actually want to forget completely. I’m glad I remember and I’m glad I still get upset. That somehow seems wrong, but there you go.

Not crazy at all - in fact, totally normal and understandable. That will probably fade in time. But when it's ready to, it will.

Thanks for sharing the story, Scott.

Hooray for Victims Services! I used to volunteer at a group like that, although mine was specific to sexual assault and domestic violence. I'm always so glad to hear that similar agencies or organizations are out there doing that work.

That incident you describe while driving, that kind of thing is, to me, the scariest part of post-traumatic stress. It's called "disassociating". You lose a little bit of time because your mind can't stand to be where it is.

In extreme cases, that's how multiple personalities form - the mind goes away for long periods of time, and "someone else" who can handle the horror takes over and lets the "real" person rest.

That happens when people have to live with constant terror, like a child who is sexually abused on a regular basis in his/her own home.

But anyway, I have found that disassociating very frightening.

Well, hey, thanks for sharing. Many people don't realize how witnessing violence affects us. I'm sure your experience has made you very sensitive to that.