Moving forward with my own healing
On the list of physical issues that can result from trauma, fibromyalgia is one of the most common -- along with depression, anxiety, stomach issues, and chronic fatigue. I've long ignored the connection between my past experiences and fibromyalgia, but now I feel ready to take it on.
After resisting this for years, I want to try EMDR, for its potential to reduce my fibromyalgia symptoms.
When I made this decision, I thought it might be futile, as I assumed I wouldn't be able to find a practitioner. To my surprise, there are many, not far away! Not in our town or region, but in the closest more populous area. That's about three hours away, but doable.
(Funny how a three-hour drive now seems like no big deal! It helps that it's a beautiful drive through the woods, with mountain views -- not three hours on the 401 or I-95.)
Right now we are all on COVID-19 lock-down, but when the pandemic is over, I am going to contact some EMDR practitioners.
Below is a timeline of how my thoughts on this evolved. Please feel free to skip to the next section, called "The inevitable and useless thought".
EMDR and PTSD
For many years, I've considered myself done -- done with therapy, done with support groups, done with therapeutic activities like Model Mugging and public speaking. Done with dealing with the aftermath of being raped. Also done with resolving any childhood trauma, the result of growing up with a mentally ill, abusive parent. I've done a ton of work around this, and then drew a line under it.
The thought of venturing again into this territory -- sexual assault trauma -- just made me angry. Enough already! It was so long ago. How can it possibly still be affecting me?! I determined I was fully healed, and that was that.
And it probably could be that, for the rest of my life. But maybe I could do better. Maybe I could feel better.
In 2014, I went to France with my mother, and had a rare insight that led me to a huge revelation: PTSD is forever. It is a permanent condition. With work, you can learn how to manage it. But there is no post-PTSD. I believed I was no longer experiencing it -- but that was because I usually don't remember my night terrors. (Posts on this: here and here.)
In 2015, I saw a therapist for anxiety. I already had medication, and my doctor suggested using my employer's EAP to get some cognitive-behaviour therapy. I met a wonderful therapist, and had a few grueling (not CBT) sessions.
This therapist told me there is a strong link between trauma and fibromyalgia, and she suggested I try EMDR. That was the first time I heard of it. I wrote about this on my fibromyalgia blog: here.
In 2016, I read The Evil Hours, a social and cultural history of PTSD (review here). It's an excellent book, and made a big impression on me.
The author is dismissive, even contemptuous, towards EMDR. Whether or not that attitude is justified, I dropped the idea. The thought of doing any further work around trauma angered me. This book gave me permission, so to speak, to not go there.
In 2017, we visited our family in Oregon. (This is when the idea of moving west was born!) (And these are some of the people I would soon be visiting if we weren't under COVID-19 lock-down.) One of my nephews is a therapist, and a psychology professor. I asked him about EMDR. Turns out he is a qualified practitioner. He had some encouraging things to say that, in my mind, brought it back to the realm of the possible.
Also in 2017, we had two family weddings, plus another in 2018 -- which means more opportunities to see my nieces and nephews. At one of these, we were hanging out with a different nephew, who is a holistic medicine practitioner -- acupuncture and craniosacral work. He recommended The Body Keeps the Score.
In late 2018, we relocated from a sprawling suburb in southern Ontario to a remote region of Vancouver Island.
In 2020, I read the book.
Throughout, van der Kolk lists various physical conditions that are related to trauma -- and fibromyalgia always tops the list. (Other conditions are depression, anxiety, and fatigue.) There it was in black and white.
This must have come at just the right time, because all of a sudden, my resistance to the idea was gone. I'm ready to explore another path to healing.
Some other things I've written about my own PTSD:
the tyranny of the subconscious
my subconscious is an annoying bitch
i need a canada for my subconscious
The inevitable and useless thought
The Body Keeps the Score is full of brief references to many horrific forms of abuse. Compared to these, my own experience seems very small.
When I was part of a community of sexual assault and domestic violence survivors*, I frequently thought, What happened to me is nothing compared to what happened to them. I minimized my own trauma relative to someone else's. It's pretty common to do this.
I felt this again while reading The Body Keeps the Score, and you may experience the same feeling. But here's what I've learned.
Maybe what this person endured is objectively worse than what happened to you. Maybe it wasn't. But true or not, it's irrelevant.
Nothing is to be gained from these comparisons. No one is helped by them. No pain is alleviated. And many opportunities may be lost.
Here's the thing. Just as the trauma was not your choice, your brain and your body's reactions to it were not choices. Our brains' reaction to trauma is wholly involuntary.
You did not choose to have night terrors or panic attacks or hypervigilance, or any of the many physical responses to trauma. Your body responded automatically, from a deep, primitive part of the brain, the part that is programmed for your survival.
How you choose to deal with trauma, given enough support and resources, is a choice. But becoming traumatized and the subsequent changes in your brain are not a choice.
It doesn't matter if someone else thinks your experience isn't awful enough to give you PTSD.
Actually, it doesn't even matter if you think it is!
Those are judgments, and the deep, emotional brain is not subject to judgments. It just is.
At some point, I made a decision to let go of the comparisons and the judgment. I can look back to an event decades ago, through the distance of time and all the protective barriers of my rational mind, and think, That shouldn't still be bothering me. It was the worst thing that ever happened to me, but come on, it's been nearly 40 years. Enough already!
But that's my conscious mind speaking, separated from the trauma by time, language, culture, and all the layers of my rational self. When the trauma speaks, that's when I wake up screaming.
In order to heal -- in order to give ourselves the space in which the possibility of healing exists -- we must release ourselves from these judgments. Because even when they are true, they're irrelevant.
Think the thought. Feel the feeling. Put it aside. Carry on.
-- I'm always a proponent of using medication like SSRIs to treat anxiety and depression, and always encourage people to at least try meds. Despite the fact that the drugs enrich the disgustingly corrupt pharmaceutical industry, I have seen meds save relationships, and save lives. The Body Keeps the Score taught me about the limits of medications. I understood that these medications may be over-prescribed, but I didn't understand either the extent or the dangers of this, as I do now.
-- Similarly, I'm always a proponent of talk therapy. When I used to do public speaking about my recovery from sexual assault, I always credited talk therapy as a way to release the poison. The Body Keeps the Score taught me about the limits of talk therapy to effect PTSD and other trauma reactions. Trauma -- especially the sustained traumas of child abuse and neglect -- occurs in a place in the brain where there is no language, a place before language. Survivors of childhood trauma often cannot process talk therapy, because they cannot access their memories in words.
Trauma often blocks memory. When it is remembered, it is recalled in disconnected bits and pieces. Adults who experience trauma can use language to weave together a narrative about their trauma, but that story is a reflection trauma -- not the trauma itself.
I might not be explaining this well. Van der Kolk touches on this again and again, with both the clinical observations and the neuroscience to back it up.
-- Some of the studies that are used to test various neuroscience theories are fascinating. Here's one small example.
Alexander McFarlane is studying how exposure to combat changes previously normal brains. The Australian Department of Defence asked his research group to measure the effects of deployment to combat duty in Iraq and Afghanistan on mental and biological functioning, including brain-wave patterns. In the initial phase McFarlane and his colleagues measured the qEEG in 179 combat troops four months prior to and four months after each successive deployment to the Middle East.-- One of healing pathways van der Kolk writes about is the use of therapeutic theatre. One project he mentions is "Theatre of War", which uses the tragedies of Ancient Greece to help give language and healing to PTSD sufferers. This reminded me that I once had a strong interest in the history of theatre, now long forgotten in the annals of Things That I Used to Know.
They found that the total number of months in combat over a three-year period was associated with a progressive decrease in alpha power at the back of the brain. This area, which monitors the state of the body and regulates such elementary processes as sleep and hunger, ordinarily has the highest level of alpha waves of any region in the brain, particularly when people close their eyes.
As we have seen, alpha is associated with relaxation. The decrease in alpha power in these soldiers represents a state of persistent agitation. At the same time the brain waves at the front of the brain, which normally have high levels of beta, show a progressive slowing with each deployment. The soldiers gradually develop frontal-lobe activity that resembles that of children with ADHD, which interferes with their executive functioning and capacity of focused attention.
The net effect is that arousal, which is supposed to provide us with the energy needed to engage in day-to-day tasks, no longer helps these soldiers to focus on ordinary tasks. It simply makes them agitated and restless. At this stage of McFarlane's study, it is too early to know if any of these soldiers will develop PTSD, and only time will tell to what degree these brains will readjust to the pace of civilian life.
Further info on Theatre of War:
How Ancient Greek Tragedies Can Help Veterans Deal with PTSD, written by a veteran who initially dismissed the idea of this as total bullshit (vice.com)
Theatre of War: Sophocles' Message for American Veterans (The New Yorker)
On YouTube: 36 minutes, more than an hour -- and incredible, five minutes with the creator of the program here.
-- Reading about neurofeedback was super interesting. In this process, a person learns to control the functioning of different areas of their brain! The results of the studies are quite amazing. It's been especially useful treating ADD and ADHD. It is generally not covered by insurance, and so, rarely used.
* When I did training with a rape-crisis centre, and later, with this sexual violence intervention program, I met many survivors and listened to their stories. Many of them had been victims of child sexual assault -- incest. This is much more common than most people realize. And it is seldom a one-time event. It's often something endured repeatedly for years. Child sexual abuse is a root cause of much substance abuse, self-harm, eating disorders, high-risk sexual behaviour, suicide attempts, inability to maintain relationships, and untold mental illness.