Sunday, March 6, 2011

Bipolar Affective Disorder Education

This page is guided by my need for self education and learning all that I can about my affective disorder, in a concerted effort to increase my self respect & self reliance, after experiences of shame & feelings of helplessness.

Over the coarse of a decade of training and reading dozens of books, I found my way to the science of human development, which has allowed me a clearer sense of myself beyond a focus on managing disease.

Slowly yet surely I found my way from author to author, sifting through the great and often confusing, information overload.

Where I'm coming from:
After 25 yrs of experiencing bipolar disorder, mostly off med's due to chronic issues with side effects, and with a growing exasperation at the lack of root cause information from mainstream medical science, which deals overwhelmingly with the management of bipolar affective disorder as a disease.

I took inspiration from men like Joseph Campbell who read his way through the great depression & came out of that period as a world expert on mythology, and Murry Bowen the father of Family Therapy who describes his furious reading & re-reading in his development of such concepts as the multi-generational transmission process of emotionality within the family, and from my childhood appreciation of Jesus readings of the Old Testament scriptures, perhaps his greatest lesson?

After reading through the history of societies reaction to madness & how we have struggled to manage it so far, such as the accidental discoveries of chemical effects like Lithium, I found myself reading all I could about the evolutionary development of the human brain & the triune model.

Surprisingly this led me into an appreciation of my autonomic nervous system, as an inseparable aspect of my affective experience, I have found that the reality of 'feedback' within complex, organic brain/body systems cannot be easily divided in their milli-second interactions and that our neuroscience knowledge is so new, we are yet to develop an adequate language for it. 

Our current, linguistic symbols of mental perception are overwhelmingly 'object' based, and break down when trying to visualize the electrochemical activity of the 100 billion neurons in the brain, such notions as "high roads & low roads" do not capture the processes of our internal reality, and are perhaps more to do with immediate, instinctive needs for comfort & ease?

I had craved a clearer and more complete picture in my minds eye, in order to sooth an instinctive & persistent agitation at not being able to identify the threat that so challenged my sense of being alive. Most people I know with an affective disorder speak of a sense of relief when first diagnosed, one friend claimed, "at last I've identified the beast," yet for so many, life on medication does not bring the significant & ongoing relief that identification may have promised.

What follows reflects my own attempt to further identify that beast within, a phrase with which I'm sure only fellow sufferer's may truly empathize.

Stephen Porges Polyvagal Theory has been the key to how I now regulate my affective disorder. His concept of neuroception augmented my reading of Allan Schore and the confusion surounding what exactly Affect Regulation means in terms of 'affective disorders.'

Silvan Tomkins is recognized as the father of Affect Theory by many and cautions us that there are only Nine Innate Affects and that these are the instinctual roots of all our complex emotions. Some use the term affect and emotion interchangeably, while my own reading has led me to link these nine innate affects with Porges triune nervous system.

Polyvagal Theory seems to fit seamlessly into Paul MacLean's - Triune Brain model, which describes the evolution of our human brain. Our experiences of affect/emotion and how we regulate our affective experience is dependent on both internal & external feedback processes which are overwhelmingly unconscious, and mediated by the brain and the autonomic (animal) nervous system.

We are all vaguely aware of instinctual, unconscious processes like our visual reading of body language, and a sixth sense awareness of things we cannot 'objectively' explain. Prior to reading current neuroscience, I had read many object oriented observations of human nature, and tried hard to accept notions of affective disorders as similar to any other biological disease, yet found these explanations more in tune with an immediate need of comfort and ease, than clear definitions of reality.

Slowly I have become more aware of my own instinctive resistance to self awareness in terms of real insight into the sensations of my affective experience, and I now fully accept Tomkins understanding of innate affects and the initial alarm cry of innate distress to the first sensations of life, as my unconscious aversion to any awareness which may arouse sensations beyond my habituated comfort-zone.

Such innate reactions have informed my sense of superiority as a human animal and is most likely the root of denial, a denial that had kept me from a full appreciation of my life. Focusing on the brain alone and notions of disease, did not bring me comfort and ease and had led me to feelings of resentment towards those who simply project their own unconscious needs. I needed and found a more holistic picture to identify the source of my internal threat, and found it within my trauma conditioned - autonomic nervous system.

The process of my ongoing education has changed my beliefs and therefore my affective experience of life in each new moment. It has been an evolving experience which has taken me away from an immediate need of quick relief, a wish for the perfect medication or bolt from the blue transformation.

At age 59 I wish I had not waited so long to begin this process of education and the growing resilience of my affective experience, as I learn through sensation awareness within my body, that I can manage my right brain regulation of affective states.

The Chaos, Chance & Circumstance in those early moments, days, months and first three years of my life, more than likely conditioned my autonomic nervous system and created my neuroception of life within my early developing right brain. Innate Fear through the experience of birth trauma seems to have initiated a process of affect dysregulation in the early maturation of my nervous system leading to a lifelong trait, a personality of avoidance.

My 1st episode of mania came with the sudden loss of my sole attachment figure, my wife, this seems to have triggered the need for a new dynamic within my nervous system, a need for open approach and not closed, self stimulated avoidance. Hence the seeming chaos of mania in an attempt to change an autonomic nervous system, hierarchically dominated by fear.

I believe that mania is an unconscious attempt to re-balance an autonomic nervous system initially energized by trauma, inline with Peter Levine's observations of trauma exit in the animal world of our mammalian cousins. Needing a somatic-experience approach for understanding, as the process is below the level of the mind and cannot be brought to awareness by thoughts alone.

Understanding what Stephen Porges means by neuroception is not an intellectual exercise, I read and re-read his thesis and slowly with day to day experience a felt sense of this autonomic mode of perception began to dawn on me. A century after Freud observed his patients and formulated his theory of the unconscious we are coming closer to defining the reality of its biological nature.

Stephen Porges, Allan N Schore and Peter Levine are the three authors who have most influenced my current ability to remain depression free and manage my affective experience within a normal range of arousal, Levine's notion of titration in experiencing body sensations, has allowed me to release the survival energies trapped within my autonomic nervous system orientation.

Finally, I am coming to know the joy of being comfortable in my own skin, confident in my evolved, instinctual ability to react to each new moment of time with the appropriate affective response, finding my way to Mihaly Csikszentmihalyi's concept of 'Flow' and optimal experience.

A last word here would be that I could have remained bound by the autonomic dominance hierarchy of group status & rank, remaining infantile in my subservience to others of superior formal education, "know you're place" as my grandfather often said. Yet we live in an age of more equal access to information, allowing the capacity to follow the inspiration of those gone before us, who were also well read.

John Chitty has perhaps the best education on the autonomic nervous system here on the internet, listen to him talk about the miracle hug of new born twins.


A link to some of the Books I've Read: