ramified mind: when you realize (part ii of ii)

3espi

Last time detailed the deepest dissociative experience I’ve had while also observing it. That was kind of cool. Why dissociative bliss is not a great choice was in the coming down experience.

When I left, I hadn’t completely grounded. It was noonish, and I hadn’t eaten yet. My blood sugar felt low (Ehrenreich is right, low blood sugar does contribute to dissociative states, but is not responsible for them) and I was still feeling not quite there. The blissful edge had worn off and the lack of grounding felt more irritating than anything, more or less like low blood sugar (hangry, in popular parlance). I walked home at a not-quick pace, trying to feel my feet with each step, replaying the morning in my mind. I should have taken the train. It’s faster and I didn’t need the vata-movement. But the dissociative state wasn’t letting go, and I walked. The scenic route. Once home, I realized I had only 10 minutes to ready for my workday before I had to leave for the hair appointment. Damn.

I ate a slice of peanut butter and banana toast, and then some cheese and hummus before I raced off to the appointment, walking again. I was still slightly dissociated and needed to eat more. If you have low blood sugar, perhaps you know that once it’s low, you can wander around trying to find something that seems good to eat for far too long. All possible choices are wildly irritating. I wished I had almond butter (awesome for both grounding and blood sugar regulation) and swore I should carry some with me at all times should this happen (ridiculous). Instead of marching to a store with fresh almond butter 3 blocks away, I took the train, 1 block away, up to work to find something there.

After a large sandwich I felt exactly the same. I taught and I felt better, if not normal, for exactly the duration of the classes. Then I went home and ate again. The low blood sugar was gone, but the irritated, low-blood-sugar feeling was not. Fuck.

The dissociative freeze response is meant to be a separate response from the flight or fight response. In the former, the bodymind realizes no escape, so slows and goes soft, preparing for the pain of attack. In the latter, when escape is a possibility, the body prepares to use all its resources to fight or run. The heart increases, digestion stops, we amp up. But in my experience, as a result of decades of hyperactive traumatic nervous system response, these two responses can mingle. It is really not good.

There is a tendency for clinicians to diagnose survivors as either dissociated (freeze response) or hyperaroused (flight or flight response), and it’s usually true that we tend toward one. But I’ve found that I experience both, triggered by different circumstances. Sudden movement or aggression I don’t expect and cannot control coming near me (e.g. an aggressive car in the crosswalk) or feeling trapped tends to trigger me into fight or flight. This has improved after emdr. But, almost exclusively, painful memories and emotions surfacing (flashbacks) send me into a dissociative response.

Dr. Bruce Perry pioneered the use of clonidine for hyper-aroused nervous systems (those stuck in fight or flight) and naloxone and naltrexone for the dissociated-freeze response. But what he found when dissociated patients went on these drugs is that they became irritable and anxious. Taking away their ability to float away when triggered forced them into fight or flight mode:

Ted took the medication for four weeks, during which he had no further fainting episodes. But because the drug blocked the opioid response that allowed Ted to dissociate, he now became very anxious when he faced new or stressful experiences. This is a common problem with many drugs in psychiatry, and in general medicine. A drug may be excellent at eliminating a particular symptom, but does not treat the whole person and deal with the full complexity of his problem, and therefore it may exacerbate other symptoms. In fact, we found that parents and teachers often thought that naltrexone “made the child worse” because rather than “spacing out” in response to perceived stress, many children began to have hyperarousal symptoms instead. These “fight-or-flight” reactions appeared far more disruptive to adults because the children now appeared more active, more defiant, and sometimes even aggressive. We could give clonidine to minimize hyper-arousal, but without helping the child learn alternative coping skills, the medication had no enduring effects. We ultimately decided that while there were certain cases in which naltrexone could be helpful, it had to be used with great care.

The Boy Who Was Raised as a Dog (p 192-193)

Like “You are not going to drug my baby” Mama P in the book (Chapter 4: Skin Hunger, another must read chapter about safe, predictable touch and consistent physical affection as integral in the healing of childhood neglect or abuse), I do not think pharmaceutics are an answer unless you absolutely need them to stabilize. They generally numb and cloak issues, rather than heal them.

As I came out of the dissociated response that day, I moved into fight or flight. I felt irritated and easily triggered, while still slightly dissociated. How this is possible, I do not know, but it was my experience. I went into a quiet rage for hours over a report about white European UN peacekeepers sodomizing young boys—children—they were allegedly protecting. The UN monitored the crimes and allowed them to continue. (!) They punished not the child molesters but the one man with a conscience, the sole person who had the decency to take issue outside the UN so that the raping of children by their “humanitarian” protectors might be stopped. How is this not worthy of rage?

Why are we all not in a rage? What? Who? Where? Ohhh, uncomfortable. Ah, wait, what was that? I think my facebook beeped. (More on this sort of rage next time.)

It took almost three days from that practice for my system to normalize.

What helped? A foot massage. Grounding foods. Time with friends. Practicing. Teaching. Familiarity. Calming touch. Kindness. Consistency. Love. Talking with my shrink about what he said that angered me and about my dissociated and hyper-aroused responses. Being heard, understood and respected. Specifics aside, this is what not only trauma survivors need, but what everyone needs in our anxious age, in our own unique formula. We have to map out ways to get these things (and, if and when we can, give them) consistently, so we can choose grounding and feeling what comes up when triggered, instead of dissociating.

Because as Kole beautifully illustrated in her comment on the last post, dissociating isn’t harmless. It’s not just the crash but the avoidance of ourselves that is the problem. We need to figure out how we can feel safe enough to feel what comes up and create the environment for that in advance. This can be hard, as trauma survivors often unconsciously seek scenarios and relationships that recreate the trauma—maybe because it’s the closest we got to love and affection, or maybe because we hope and aim to have some control this time around, to recreate the scenario as something we have power to change and effect.

Trauma is partially defined as having no control over oneself in a threatening situation. Some theories suggest a person will recreate their trauma in hopes of reenacting it with control and change of outcome. This was successfully navigated by little Sandy in the harrowing story of “For Your Own Good” (Chapter 2, TBWWRAAD). How likely it is one can find a safe, non-clinical venue for this sort of work is a big question though. Is it even appropriate or healthy to elicit outside of a clinical situation? Probably not.

Next time, more from the rage notebook.

2 Responses to “ramified mind: when you realize (part ii of ii)”

  1. Kole says:

    Thanks for the shout out in this excellent post!
    Agitation and irritation seems like it goes hand in hand with dissociation for me. It’s almost like my body never learned how to self-regulate. I recommend reading Bessel Van Der Kolk’s masterpiece of a book The Body Keeps The Score. It’s extremely helpful, yet draining because it demands me to face a lot of truth, truth that I normally dissociate from. Look forward to next post!

  2. anastasia says:

    Thanks for your comment! I really appreciate hearing from someone else who experiences all this. When I’ve discussed it with the few other survivors I know who are doing this sort of work, I’ve gotten a slightly condescending “flashbacks? dissociation? Yes, you are still healing, I am past all that” sort of response, instead of a real conversation about how they experienced this and how they passed through it.

    So I’m glad to hear that’s your experience, too. Though it’s (aggravation/dissociation) usually talked about as separate, no? In van der Kolk as well. Yes, that’s an excellent book. I think replaces Herman’s Trauma & Recovery as the new authority. My copy below (I seldom buy books, but got this when the library copy was due.) :)

    bvdk

    I talk about van der Kolk in these posts (I’d love your thoughts on Trigger Mind and post-Trigger Mind) and Herman in these.

    As an aside, Bruce Perry’s (TBWWRAAD above) book on empathy is pretty dreadful, distorting research and making all sorts of far-fetched claims about human nature based on conjecture and assumptions that behaviors that are culturally learned are inherently biological, offering absurd claims in lieu of evidence. Worth a miss unless you can handle that sort of thing.

     

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