Friday, November 9, 2012

Bipolar Cycles & An Ongoing Process of Recovery

I return to Australia, after my Thai visa renewal is denied.
October 27th 2012: 9am, and I've arrived back in Sydney, fourteen hours after a very emotional farewell to my Thai partner of the past two and half years, and an abrupt end to my South East Asia sojourn.
As I waited inline at immigration the anxious butter-fly's in my stomach rose to higher flight, in respect for an increasingly imminent, family greeting.

"Stay grounded, resist replaying the scenes from the same arrival two years ago," I told myself. Considering how my oldest son James was waiting for me again, after agreeing to bail his father out of a self-imposed "fix," and fly me back to Australia. "No money, no home, no resources of a material kind, how could my children, not see me as having hit rock bottom?" I wondered, and would I get the chance to explain? Life is paradoxical, I thought, as I walked into the arrivals area carrying 15 less kilo's of luggage than I'd taken to Thailand almost three years before. Materially lighter, stripped of all possessions save for my precious laptop, six books and 20 kilo's of clothes. Objectively speaking, should I deny, my life appears to be going backwards? "Your a sad looser!" I probably would have told myself a decade ago, yet I feel more comfortable in my own skin than at any previous time in my life, ready, willing and able, to face the undoubted challenges to come.

I couldn't help a scenario running through my head though, as I pictured a coffee table family reunion, and some of the words we might, but probably won't, say to each other. "When you stop defending yourself against life, it tends to bring you the experiences you need to have," I pictured myself saying.

'Hi Dad,' James said, as he came up behind me, instantly relieving my concern that no one was here to greet me. Cordial greetings ensued, as I sat with James and Mathew, my two oldest sons, and talked about life in general, the catch-up family gossip, sport and the ever inflationary cost of living. "Five hundred dollars a week! For a one bedroom apartment!" I exclaimed, after Matthew filled me in on his new location, and I reminisced about life in Thailand were you could live comfortably for more than a month, with five hundred Aussie dollars. We talked real normal, in our usual social ritual of family "triangulation," the anxiety of an awkward situation relieved by speaking of neutral topics, unrelated to an obviously difficult, and emotional situation.

Homeless men gather outside the Matthew Talbot Hostel, Talbot Lane, Sydney.
'So what do you want to do?' James asked.
'Head for the homeless shelters,' I replied, adding that a search online had suggested it wise to get there as early as possible, to ensure a bed for the night. I needed to keep the tone positive, remembering the pain of his email comment, "its impossible for you to stay with any member of the family." Impossible?

So here I am, back in Australia and on face value alone, I would seem to be following a classic manic-depressive journey towards my demise? How could these circumstances possibly be described as a recovery in progress, I'm sure your thinking? How could this situation be described as life bringing me an experience I need to have? It sounds stupid and makes no objective sense, pure wishful thinking, even a delusional fantasy perhaps?

What does Recovery Look Like?

One of the most popular phrases in mental health is, "everyone's experience is different," and hopefully an explanation of my own "different" journey towards recovery, may help to enlighten the reader, on just how this seemingly desperate situation, is an experience I need to have. As I've written many times here on this blog, birth trauma seems to be the root cause of my bipolar type 1 disorder, with fearful avoidance, a life-long behavioral pattern. Two weeks after my return to Australia, I write this post in the very midst of my life-long fear, "the social group." And on face value alone, its a pretty scary group with which I now reside. Here, I can't avoid, can't rationalize any movement towards isolating myself, here I come face to face with implicit body memories of my father's violence, on a daily basis. Not that anyone is violent towards me, yet deep within there is an unconscious sense of threat, this group of men tweak's my nervous system.

'So how do you feel at the moment, in terms of mania or depression?' The psychiatrist asked me, towards the end of my first assessment session, six days after my arrival.

'There are no signs of mania, although there are depressive feelings and some suicidal ideation, but nothing I haven't dealt with before,' I responded, after already giving details of the self-regulation routine I'd developed in Thailand, after educating myself in Stephen Porges "The Polyvagal Theory" and coming to understand his term "neuroception," on a felt level of sensations within my body.

'You certainly seem to be managing an emotionally stressful situation pretty well at the moment, and I'm happy to let you self-manage considering your long experience and the fact that help is so readily at hand here,' he advised me as we arranged a weekly appointment, during my stay at the Talbot.

'Looking on the glass half full side of life, I'm certainly handling this crisis better than I would have done ten years ago, when I would have been well and truly under the blankets and drowning in depression by now,' I offered as a reflection on perspective.

Further Perspective:

In 2010 I went to Thailand with the rationalized intention of writing a book about my experience with mental illness. For well over a decade now, its been my dream to write about mental illness from the inside out, so to speak. In hindsight, the actual motivation was a re-writing of my experiential story. Not just the life-story I tell myself within my conscious mind, but within the unconsciously stimulated expectation, of my autonomic nervous system. After my involuntary hospitalization in 2007 and a subsequent depression, I committed myself to a process of self-discovery, in an authentic journey that will lead me wherever it may. So here I am, still in process and open to whatever this journey brings. Still learning and daily practicing a more embodied sense-of-self, to heal the trauma-trap of a flight into the mind, away from pain in my body.

A memory of my first attempts to write comes to mind here;

"‘Come on David,’ I hear myself say, ‘don’t stay in your head - feel it!’ Suddenly I drop to my knees as the old familiar shudder sends waves of unpleasant sensation down my spine. ‘My God!’ I shout out, feeling like I’m shrinking, like I’m dissolving into a pool of dirty water. I try to stay with the feelings, I want to know what this is once and for all, and an awful freeze sensation seizes my shoulders running down my spine. ‘How can this be protective,’ I shout out with this image of dirty water flooding my mind. I had thought I was over this stuff, it hasn’t happened for years now. A scene from my childhood came to mind, a scene of physical and emotional abuse that I could not escape. I’m not sure about the affect of the physical abuse, but the emotional abuse, the rage in his voice and the hate in his eyes; somehow they threatened me with annihilation more than his blows did. My innate animal instinct would have been to run back then or to show my own anger and rage, yet that would have enraged him even more, no flight, no fight and no escape so hence the first of my lifelong shudder reactions. What do you do when your nurturing protector is a predator? ‘Is this the seat of my defensive over reactivity towards people?’ I say out loud.This thought has come to mind before, although perhaps I have never allowed myself to feel the depth of sensation before, and right now I can’t believe how strong this shudder reaction is and the awful sensation of dissolving to water is quite frightening.

"Feigning death," I whisper to myself, remembering the evolution of the autonomic nervous system. This urge, this pulse of electrochemical energy, as neurons fire in my brain should follow it’s evolutionary path, as my nervous impulse is stimulated to produce freezing to the point of fainting. A vestige of millions of years old mammalian survival reflex, when faced with overwhelming mortal threat as mammals feign sudden death as the last resort to survival. We humans inherited the same nervous system capacities in the dual sympathetic and parasympathetic branches of our autonomic nervous system, also known as the stress response system. Human responses like fainting are vestiges of the earlier mammalian response of feigning death through a sudden and massive surge in the parasympathetic branch, acting as a brake on the heart after high sympathetic activity. The parasympathetic branch of the autonomic nervous system is known as the rest/digest or conservation/withdrawal branch compared to the sympathetic fight/flight aggression branch, and in situations of threat it plays a part in a freeze/fight/flight/fright sequence of possible survival reactions. Being scared stiff is actually an unconscious parasympathetic mediated “fright” response, probably designed by evolution to present your body as a non threat or as dead meat. There is footage on the internet of a guy who has fallen into a large hole in the ground, a hole he helped dig to trap a bear. We see him flailing away with a bamboo stick trying to fend of a curious bear and of coarse the bear just bats the stick away with effortless ease. Suddenly the guy drops to the bottom of the pit and lies there motionless, leaving the bear with no active object to attract innate interest and in a short while the bear turns and walks away. How did the guy know what to do to save himself? Perhaps his conscious mind didn’t but his body certainly did and as Jake Sully tells us in the movie Avatar “you have to trust your body to know what to do.” Written in May 2010.

Over a three year period in Thailand, where I found the time and space to read, write and re-experience myself, within a far less judgmental and stressful environment, self-knowledge and self-awareness has grown in a steady progression. So as I write this post some two weeks after returning to Australia, should I view my current circumstances as a regression, or part of a process? As the reader can see with the link to Understanding My Mental Illness Journey & Road to Recovery, my dream of writing a book is in progress, as my own understanding accepts a process that will probably take a decade to unfold, and produce the tangible results that will make sense to both myself, and my children.

What should I think about being here & how can it be an experience I need to have?
Three square meals per day and free accommodation until I find work and save enough money for a deposit on private accommodation.
As a society, we certainly do more to relieve an existential crisis than other societies, were family support takes its age-old place on the front line of human survival.
Thank God, it was not "impossible" for me to stay here.

I've been here in the past to fix the broken elevator and reacted to the sights, sounds and smells of this place with a fearful and ignorant sense of judgment. A fearful need to feel strong and superior, in judging other people as lesser than, as loser's, the lowest of the low. "I must be ok, because I'm so obviously better than you," in that endless status competition we call civil society. A sense of judgment securing my deep need for a sense of security. My ego's endless drive to feel certain, to feel safe, while remaining cut-off from an internal sense of security. My need projected onto objects, like a better car, a bigger house and bank account, unaware that I was treating these human souls I once viewed as pitiful, as nothing more than objects. I'm sure I remember something from Christian Sunday School about Mosses and advise about NOT worshiping false idols/objects? So here I am, testing my new self-regulation and appreciation for life, and the sanctity of the human soul, and coping pretty well with my "existential crisis," so far.

In my self-imposed quest to learn more about my "mental illness," is this a new cycle, in my ongoing recovery process. Do I really have a brain disease, or was I suffering from a profound dis-ease for decades? As Paris Williams points out so well in Brain Disease or Existential Crisis?;

"In spite of over a hundred years of research and many billions of dollars spent, we still have no clear evidence that schizophrenia and other related psychotic disorders are the result of a diseased brain. Considering the famous PET scan and MRI scan images of “schizophrenic” brains and the regular press releases of the latest discoveries of one particular abnormal brain feature or another, this statement is likely to come as a surprise to some, and disregarded as absurdity by others. And yet, anyone who takes a close look at the actual research will simply not be able to honestly say otherwise. And not only does the brain disease theory remain unsubstantiated, it has been directly countered by very robust findings within the recovery research, it has demonstrated itself to be particularly harmful to those so diagnosed (often leading to a self-fulfilling prophecy), and it is highly profitable to the pharmaceutical and psychiatric industries (which likely plays a major role in why it has remained so deeply entrenched in society for so many years, in spite of our inability to validate it)." _Paris Williams.

A Brain Disease in Mental Illness? or Existential Crisis?

In past visits here I was suffering from that most common form of ignorance "ignore-it," not relevant to my needs, my life. Looking back with hindsight from years of experience since, it was more a physiological reaction, a shying away from the sights, sounds and smells of reality, that stimulate internal discomfort and distress. An instinctive judgment (valence) of avoidance, in my unconscious need to maintain an established homeostasis (comfort-zone), no matter how uncomfortable that internal zone was. It seems to be a tendency we all have, to look away from heightened distress in others, instinctively avoiding the contagious affect of our primitive emotions, in the sensory nature of being human, beneath our "I think therefore I am," constant rationalizations of our unconscious motivations. In my current existential crisis, the challenge is a matter of coping and to what extent I've managed to bring a previously unconscious sense of fear, into more conscious awareness. Have I really managed to become more aware of an internalized sense of threat, that once drove my motivation (movement), in habitual avoidance patterns of behavior? Am I coming to understand that its the world within, and internal body sensations that spooks me, moves me, and not the world "out there?" Is mental illness, nature acting out, just like normality, in our denial of our evolved nature?

The Hidden Motivation of Acting Crazy?

"Yesterday, All my troubles seemed so far away.....Now I need a place to hide away......Oh, I believe in yesterday." It was a good day, yesterday, I'd got my first payment from centrelink and had money in my bank account for the first time in nearly a year. Coming back to the the Talbot, I turned the corner at the top of the lane and there she was, back against the wall, her head in her hands and holding a riotous conversation inside her mind, and spoken out-loud. The giggles and bursts of laughter suggested it was fantasy conversation with family members or close friends, perhaps a ex-lover? A remembrance?
It reminded me of my own tendency to hold imaginary conversations with important others in my life, whenever I was in unfamiliar circumstances, like a foreign country and culture.

It reminded me of walking along Beach Road in Pattaya, Thailand, and seeing the same unconsciously stimulated "attachment fantasy" as a traumatized woman sought to hold onto a semblance of normality, in the face of internal sensations which threaten to destroy the conscious sense-of-self, we hold so dear. As I'd moved passed this heartbreaking sight of a brutalized woman so desperately trying to support herself, three of my more Neanderthal male counterparts, walked past her from the opposite direction. "Crazy fucking bitch!" I heard them pronounce, as I carried on, feeling helpless. What could I say? What crazy looks like, and what crazy really is, are not the same, as we continue to learn more about its unconscious stimulation?

Here in Talbot Lane, there are signs of human attachment loss and its stimulation of addiction behaviors, reminding me of comments I've made on, in my ongoing process of deepening my self-awareness and self-understanding. Consider;

"Social Bonds, Loss, Loneliness & Addiction:

“I Sing the Body Electric” I have perceived that to be with those I like is enough. To stop in company with the rest at evening is enough. To be surrounded by beautiful, curious, breathing, laughing flesh is enough.

I do not ask anymore delight, I swim in it, as in a sea. There is something in staying close to men and women and looking on them, and in the contact and odor of them, that pleases the soul well.

All things please the soul, but these please the soul well.” _Walt Whitman.

One of the great mysteries of psychology is the nature of the “something” that Walt Whitman extols in his masterpiece “I Sing the Body Electric.” That subtle feeling of social presence is almost undetectable, until it is gone. We often take such feelings, like air itself, for granted. But we should not, for when this feeling of normalcy is suddenly disrupted by the undesired loss of a lover, or the unexpected death of a loved one, we find ourselves plunged into one of deepest and most troubling emotional pains of which we, as social creatures, are capable.

In everyday language, this feeling is called sorrow or grief, and can verge on panic in its most intense form. At a less acute but more persistent level, the same essential feeling is called loneliness or sadness. This psychic pain informs us of the importance of those we have lost. This type of psychic pain probably emerges from a brain emotional system that evolved early in the mammalian line to inform individuals about the status of their social environment and to help create our social bonds.

Neuroscience is struggling to come to terms with the nature of such intrinsic brain processes, and it is becoming clear that several ancient emotional systems control our social inclinations. In the coarse of brain evolution, the systems that mediate separation distress emerged, in part, from preexisting pain circuits.

It is now widely accepted that all mammals inherit psycho-behavioral systems to mediate social bonding as well as various other social emotions, ranging from intense attraction to separation induced despair. There is good reason to believe that neuro-chemistry’s that specifically inhibit the separation-distress or panic system also contribute substantially to the processes which create social attachments and dependencies–processes that tonically sustain emotional equilibrium and promote mental and physical health.

The brain contains a least one integrated emotional system that mediates the formation of social attachments. The affective components of this system are “dichotomous–behaviors” with feelings of separation distress on one hand, and those of social reward or contact comfort on the other. Existing data suggests that arousal within this system is controlled by multiple sensory perceptual inputs, and that the evolutionary roots of the system go back to more primitive mechanisms, such as those elaborating place attachments in reptiles, the basic affective mechanisms of pain, and fundamental creature comfort of thermo-regulation.

To be alone and lonely, to be without nurturance or a consistent source of erotic gratification, are among the worst and most common place emotional pains humans must endure. Love is, in part, the neuro-chemically based positive feeling which negates the pain of isolation. Brain opioids were the first neuro-chemistries discovered to powerfully reduce separation-distress. As predicted by an opiate theory of social attachment, drugs like morphine are powerful alleviators of the psychic pain induced by grief and loneliness.

Opiate addiction, may emerge largely because individuals who cannot find the needed satisfactions of social attachment in their lives, are tempted to induce the stimulation of internal opioid systems by a pharmacological means, usually leading to a further increase in social isolation. The French artist Jean Cocteau recollects how opium liberated him “from visits and people sitting around in circles.” _Jaak Panksepp.

Excerpts from, “Affective Neuroscience: The Foundations of Human and Animal Emotions.” by Jaak Panksepp.

Just how far “off base” is our everyday language when it comes to understanding our internal nature, and the real source of our motivations? I mean, "an opiate theory of social attachment," who talks about this internal, chemical motivation in our everyday conversations? Who is that self-aware, that they know much about their internal makeup anyway? Be rational, be objective, we are urged when we become over-emotional, yet there are no "objects" inside us, where internal reality is overwhelmingly, chemical. Our internal reality where all our perceptions are created.

As Panksepp explains how human bonding is foundationally mediated by the primitive brain systems of pain, panic and separation-distress alleviation, he notes how fear overrides the urge to relieve separation-distress. As a primitive survival protection against predator detection, the fear system will automatically override separation-distress, which perhaps explains a hidden aspect of social bonding difficulties for those with childhood abuse histories.

To what degree is an innate, predator fear system, triggered by the social environment, and its forest of faces? What part does innate fear play in “dichotomous–behaviors,” as addictions promote isolation and separation from “social attachments and dependencies. Processes that tonically sustain emotional equilibrium and promote mental and physical health.”

Panksepp, points us towards internal systems, as the hidden stimulation of human behaviors with an explanation of addiction as a behavior seeking to stimulate an internal chemical system. Such observations on the “organic” nature of human motivation/behavior, may lead us to question ourselves about the hidden aspects of our self-stimulating belief systems?

Do we need to consciously re-define stimulation/motivation, in the light of rapidly increasing revelations about the hidden nature, of human behavior?

What does recovery look like? Is it measured by an obvious absence of crisis? Can acting crazy, really be understood by external observation, by diagnosis? Are we really, only just beginning to explore the internal world within, when it comes to understanding mental illness, and an ongoing process of recovery?

What do you think?