Wednesday, December 26, 2012

A Lonely Birthday & Other Physiological States?

Wanphen, in Thai dress, for a traditional dance festival, with her old falang.
December 27th 2012: Happy Birthday! I said to myself, as dawn crept into another lonely room.

Memories of Laos and Thailand came to mind, as a normal morning state of low metabolic resources, threatened a meloncholic yearning, I could easily work into a sense of depression.

"A Physiological State?"

"The depressive urge is not really psychological, after all," I told myself.

I must admit the urge to dwell in that low metabolic resources (see: Mental Illness - Its Metabolic Energy Shifts? state was tempting. Knowing I could easily fill it up with thoughts of loss and separation, decades of depressive thinking could have swamped my mind, as my low physiological state, "toned" my head space. Yet whatever it is that I've learned during my three year sojourn in Thailand, is holding fast, despite my current circumstances. Almost as if this trail by existential circumstance, is an affirmation exercise. Not an affirmation of mind, like some mystical chanting or the visual imaging of new age philosophy, not a triumph of mindful ascension, as 2012 slips towards history.

As I write, its 3pm, here in Sydney Australia, midday in Thailand where Miss Wanphen will be working in the three storey shop/house we shared till October 26th. Leaving her behind to arrive here, courtesy of my oldest child, on the 27th, by coincidence? Dates are meaningless though, aren't they? Coincdence is never meaningful? My questions fueled by melancholy, or this reasonable, "loneliness is such a sad affair," sang Bette Midler. "Will there be any contact from anyone," is a question I'm prompted to ask myself, as I wonder what to write here? Still! At 3pm in Sydney, here at the Matthew Talbot, its hard to ignore the proximity of my oldest child, probably three streets away right now, if he's at home? Yet of coarse, I'm guilty as sin, when it comes to ignoring birthday's, and playing this isolation game.

Sadly, there have been decades of this self-obsorbed obsession by now, the why, why, why of having bipolar disorder, and the even tougher to deal with, failure of one hopeful medication trail, after another. This personal quest to understand it from the "inside out," damming me to exclusion rather than inclusion, as the prophetic words of 2007, come back to huant me once again;

4/8 Martin Place. Mortdale. Sydney. NSW. Australia
Your all mind and no heart!'

I shouted at him before storming out the door of our pokey two bedroom apartment, here in the Sydney suburb of Mortdale.

Groaning in frustration I stomped down the stairs to the ground floor, slamming the entrance door to our three storey apartment behind me, knowing the pain in the ass reverberation it would cause within this cheap brick, concrete and tile building.

“They don’t want to know, nobody wants to know!” I told myself as I walked across the carpark at the rear of the building.

Pity! I’d felt the manic energy subsiding before his brother told me about the paranormal séance.

‘Someone came up to him and put a card in his hand saying something about a message from Pa, and that someone in the family needed counseling.’

After weeks of mania and those dream-like states of mind common to the experience of bipolar type 1 disorder, more evidence of paranormal communication? Was this contact from my dead Father-in-law more proof of the special cosmic connection, I’d been demanding for two full weeks? It had been another one of those spiritual ecstasy days too, wondering around in a bliss-like trance, finding self-referencing associations for my unique sensitivity to the cosmos, everywhere. It was Easter Monday, April 9th 2007, a month after another relationship loss had triggered a steady rise into a full blown mania. This mania was different to previous experiences too. Although, as most psychiatrists would no doubt suggest, a typical loss of objective insight would cause me to write that?

Yet consider this episode came after twenty seven years experience, mostly self-managed due to medication side effects and intolerance. Consider also, that I hadn’t taken any psychotropic medications for at least four years and had coped increasingly well, gaining more self-esteem and improving my education by training to become a therapist. “You sure you have a mental illness? - You always seem so reasonable and well grounded to the rest of us,” a fellow student once said, during our two years of group therapy together. “Yeah, but you haven’t seen the inside of my head,” I’d replied with typical self-depreciating humor. “Neither has anyone else!” Our supervisor exclaimed with the kind of knowing look, that epitomizes a currently increasing concern about the still unproven nature of any mental illness, as a distinct and verifiable disease." An excerpt from First of Four, Six Week Psychoses

Does anyone, really want to know, about the physiological states of mental illness? Most people assume its all mental? Its about a failure of cognition, all about the brain in the head, as we collectively ignore most of its physiological aspects, and the unspoken voice of the body? Yet it not through the ascension assumptions of my wistful head, that I now manage a day like this, a day would have definately triggered a depression, before 2007. Especially considering where I'm living, I would have withdrawn, gone into hiding, isolation the safest place to be, when one is suffering from "The Trauma Trap," of a denied physiological rsponse? (see: Madness & the Chaotic Energies of The Trauma Trap? )

A trail, by existential circumstance?

Homelessness & Medicated Mental Anguish?
Upset for a couple of days now, he's been "acting out," his Mental Torment, Otherwise known as Mental Illness?

Early last week though, his head was mostly grasped firmly between his hands, in that common symbol of defeat, and despair, the homeless and mentally ill, so often share?

'So why is he ranting and raving now?' Asked a homeless brother, as we sat down to lunch today. Funny! The homeless men here use Brother, rather than the Aussie vanacular, "G,Day. Mate!" All Brothers & Mates here.

'They need to give him more, freaking medication!' Said another brother, from across the dinning hall table. We all burst out laughing at the pun. 'freaking medication - Get it?' Said our self-anointed lunch time jester, emploring more laughter.
From depressed despair, to agitated mania in a week?
Ah! The magic of those medication pills?

Its funny in a macabre sort of way? Black humor, allowing us to cling to threads of sanity, so daily challenged, by living in these often difficult, existential circumstances?

'Existential circumstances! - Yeah, yeah, I met his brother, the other day. Existential Angst, is his name, and he wears a freaking face, like bloody red thunder!' Said, you know who, from across the dinning hall table. As we laughed, the supervisors gather around our "acting out" brother, and usher him towards the exit.( please see >> Mental Illness & The Face - - Heart Connection? )

'Go for a walk,' they tell him repeatedly, although camly and firmly. He knows the rules too. If he escalates this "acting out" into physical actions towards another brother, or staff member, his walk outside to calm down, will become a search for other accomadation.

Its depressingly familiar, this cycle of medication madness. A merry-go-round of "Antidepresent-Induced Mental, Behavioral, and Cerebral Abnormalities:" as chapter 7 of Dr Peter Breggin's book "BRAIN-DISABALING TREATMENTS in PSYCHIATRY" points out? Please consider;

"Many of the adverse psychiatric reactions produced by the newer antidepressants can be viewed as occurring along a continuum of activation or stimulation, culminating in mania or psychosis. In addition these drugs can produce a blunting or lobotomy-like deactivation in the form of an apathy syndrome, especially after longer periods of use.

All antidepressants cause mania, and mania is an acknowledged adverse effect in the FDA-approved label of all antidepressants. As noted in chapter 6--and now built into the FDA--approved labels for antidepressants-- mania is the extreme expression of drug induced over stimulation that includes insomnia, anxiety, agitation, irritability, hostility and aggression, emotional liability, akathisia, and hypomania and mania. It can lead to crashing into depression and suicidality.

At one end of the continuum, the individual becomes mildly irritable, a little emotionally labile, or slightly agitated. At the other end of the continuum, the individual becomes classically manic, at times perpetuating violence or crashing into depression and suicidality. On occassion an individual will traverse the whole continuum; starting with irritability or insomnia, for example, and ending up in a manic state. At other times the individual will experience only one of the drug-induced stimulant symptoms, such as agitation, akathisia, or hostility.

SSRI labels tend to organized in ways calculated to avoid any implication that the medication can cause a pattern of overstimulation, but detailed analyses of the labels disclose that these drugs do in fact produce a continuum of stimulation."

As I watch our homeless brother departing the dinning hall, I'm reminded of my week in an acute care ward, back in 2007. Arnie, not his real name, had been admitted (involuntarily) for suicidal depression and had spent the first day "acting out" his rageful anger, at his forced detention. By the time I left the ward, five days later, he was manically euphoric, expressing his undying love for all and sundry, volumiously singing, praise be the lord, night and day. (see: Sectioned on The Road to Redemption)

Only last night, the police and an ambalance where here, to visit this, at times, epitome of existential madness?
Mind you, I haven't heard of any suicde attempts, so far this week? Perhaps the worst week of the year, for the lost, lonely and isolated? Perhaps I'm digressing here though? Rambling, instead of writing well and delivering the promise, implied in my title? Please consider;

A Physiological Foundation - My New Realization?

‘That first time, back in 1980, it felt like the real you had come out, then everyone wanted you to go back into your shell again,’ my best from 1980 told me in 2010.

‘People see it as a breakdown, its so disruptive to the old personality, the personality they’ve become adjusted to, but that old personality was habitually defensive and I needed a breakthrough experience to change an unconscious pattern of avoidance behavior,’ I replied.

Its more physiological, than psychological. That’s my breakthrough realization, thanks to Stephen Porges groundbreaking discovery of a polyvagal regulation of the human heart, and our energized states of body-mind. Learning to accept and let go my habitual defenses, of tense body posture and a sense of self awareness to fixed within my head, has been key to a healthy transformation. A re-orientation towards healthy growth and maturity, which mother nature had always intended. A healthier organism, of body, mind and soul thanks to my five year trial of redemption, my sojourn to forgiveness, for the willful sacrifice of my destined first child, my lost daughter. There is now a solid move away from the shadow of negative orientation towards life, a shadow unconsciously orchestrated by unfortunate life experience. A shadow which became an unconscious, self-fulfilling reality of behavioral reenactment patterns.

A Paradigm Shift in Understanding Mental Health:

“The theory proposes that physiological state limits the range of behavior and psychological experience. In this context, the evolution of the nervous system determines the range of emotional expression, quality of communication, and the ability to regulate bodily and behavioral state.” _The Polyvagal Theory. For perhaps the most comprehensive video presentation of the theory and its understanding of emotional development, watch Stephen Porges presenatation at a Columbia University Grand Rounds event here." An excerpt from: Born to Psychosis an online memoir of my experience.

"Physiological state limits the range of behavior and psychological experience."
Hence: "The depressive urge is not really psychological, after all," I told myself.
I must admit the urge to dwell in that low metabolic resources state was tempting. Knowing I could easily fill it up with thoughts of loss and separation, decades of depressive thinking could have swamped my mind, as my low physiological state, "toned" my head space."

So this morning, instead of following the kind of habitually negative thought patterns my low physiological state was unconsciously stimulating, I understood that my mind only maintains or amplifys a primary process? Over the last three years of learning about how my body/brain works, and learning how to assimulate this knowledge, using a sensate awareness, described many times on this blog. I now seem to be proving, at least to myself that Stephen Porges statement above, has led to a paradigm shift in my mental health. Told repeatedly that with my diagnosis of bipolar type 1 disorder, a lifetime of medication compliance, was the only way I could expect to manage my condition. By 7.30am, after breakfast, with two cups of coffee, my physiological state, held more metabolic resources and was stimulating a more positive "tone" in my head space. So no depression today, despite the challenging existential circumstances, that surround me thanks to all the reading and the experiential understanding from my three year sojourn.

A Memory of Laos:

Long Night of The Soul - An Invitation to Depression

May 8th 2012:

A no thrills hotel room in Laos, 2am and the mechanical hum of an old pedestal fan accompanies a grinding ache in my stomach, thoughts of defeat and a fraudulent sense of self won‘t stop buzzing around my head.

Almost two and a half years into my self discovery sojourn here in South East Asia, I fear I’m running out of time with dwindling finances and visa restrictions, becoming pressing concerns.

“I’m just kidding myself that I understand anything about the processes involved in mental illness. The fantasy of writing a book just rationalizes a life’s unconscious default pattern of withdrawal and isolation.

Follow my heart notions are a mania fueled romantic joke, leading me to ruination not salvation.” After five years with no return to a cyclic pattern of depression and no need for medications of any kind, I’m feeling the old familiar sensations of defeat and collapse here. There‘s a pressured sense of doom inside my head, as a continual loop of disaster thoughts hold my mind in a vice like grip of driven compulsion. “It’s a physiological state and my mind is amplifying it,” I tell myself. “Then face it and stop running away from it, the negative thoughts are stimulated by a core feeling, its innate fear-terror.”

I turn onto my stomach and adopt my mind-less meditation routine, a practice that has worked really well for dissolving the racing thoughts and energies of bipolar disorder’s mania. If the mind is dependent on physiological state as the polyvagal theory indicates, then changing this physiological state should work just as well for this dreadfully negative state of mind. I focus on the felt sense of my flesh on the mattress sheet, feeling the sensation of my internal organs and the knot of painful tension just below my rib cage. I follow Peter Levine’s advice and try to feel into this pain sensation, staying with it and noticing any subtle shifts. Yet I can’t seem to get into my body now, stuck fast in my head as each attempt to experience the felt sensation is blocked by an instant rush of thoughts. Curiously, thoughts and image memories of the same painful gut spring to mind, a forty year old memory of fear and avoidance, the same knotted tension in the same place, just below my rib cage.

“A body memory, the place I’m always running away from, always avoiding,” I tell myself. A whole slew of thoughts about trauma and how we normally think in terms of external, causal events, runs through my mind. “Yet its an internal process, my brain stem and my nervous system with their electro-chemical stimulation are the actuality of post traumatic experience.” A familiar shudder runs straight down my spine now, as if making a comment on this thoughtful interpretation, “a conversation with my unconscious self, perhaps?” I try again to just feel into the knotted tension in my stomach, and let all awareness reside there, and again there is an instantaneous surge of thinking. This time self recriminations about wasting time, letting months drift away instead of writing. “Self revelation is an organic process, there is no clockwork timetable involved,” some part of me kindly advises.

There were other thoughts too, about futility and how nobody really wants to know about non-conscious self-awareness, how group harmony is maintained by a shared “I think therefore I am” preferred awareness. Although accompanied by a twin awareness that writing a book was always a metaphor for re-writing the narrative of my cognitive sense of self. “Different experiences to change old habitual patterns, is how your re-writing that narrative,“ I advise myself. “Raising to conscious awareness a re-conditioning of my nervous systems unconscious expectations about scenarios of survival? This sight, this scene, and an unconscious reaction within?” For a full minute I focus on trying to just observe the process, the effort to sense into the pain area and the instantaneous flight into thoughts. “Try to catch the gap between the spark and the flame of thought,” I tell myself. “Its not a bloody spark, its an instinctual reaction, a recoil, a cut-off from pain’s felt awareness and it’s the theme, the motif force of my whole freaking life.” I despair that I’ll ever break it down into what it actually is, that I’ll ever be able to articulate it to myself, let alone anyone else. All my thoughts seem to do is rationalize away from a core sense of self that my conscious mind either can’t or doesn’t want to know about. I persevere with the attempts to stay with the felt sensation of tension in my stomach though, just as my mentor advises in his book “In an Unspoken Voice.”

“In particular, you will begin to notice what various sensations (i.e., tensions, contractions, aches, pains, etc,) tend to emerge in sequences or in groups. For example, you may notice that a “knot” in the belly or tightening of the anus is associated with a suppression or holding of breath.”(Levine, 2010.)

As I continue to practice what has become so effective in letting go of the surging energies of excitement in mania’s manic mood swings, I’m mortified by how difficult its proving to let go the bipolar opposite of what is beginning to feel like a fall into depression. God knows I‘ve been here before and I‘m getting really scared that I can‘t resist the collapse, scared that I won‘t cope with this first overwhelmingly negative state for five years. So many memories of feeling just like this and helplessly drowning in depression. “How have I become so immersed in this state of fear?” I ask myself. As awareness of tension expands across my whole body, aware too, of “holding myself in,” of shallow breath and the stiff posture of awkwardly positioned limbs. A flashbulb memory of holding myself like this as a child comes to mind, “this is how I got myself to sleep at night.” Fear driven immobilization the experts now call it, or “tonic immobility,” an unconscious response hardwired as a mammalian survival trick, although a paradoxical trap for human beings. “This is what came from a three day birth ordeal, brutal forceps delivery and the immediate isolation of a mechanical crib. This is my default response to life, an existential crisis which has always been the ghost in my internal machine.”

“Our nervous system assesses threat in two basic ways. First of all, we use our external sense organs to discern and evaluate threat in the external environment. We also asses threat directly from the state of our viscera and our muscles-our internal sense organs. If our muscles are tense, we unconsciously interpret these tensions as foretelling the existence of danger, even when none actually exists.” (Levine, 2010).

Again I try to bring all awareness into the felt sense of pain, suddenly my eyes open and I become aware of the tension that had been unconsciously held there, along with the corresponding release of pain in my stomach. There is also a frizz of warm sensation in my feet as blood circulation flows more freely there. “A whole brain/body systemic reaction,” I say to myself, suddenly remembering a trick I was taught by an Alexander Technique therapist. I turn over onto my back and focus my eyes on the light switch by the bathroom door, some six yards away. I concentrate on widening my peripheral vision either side of the switch, and hey presto, a spontaneous release of stomach tension. “I think you have an exaggerated startle reflex,” the therapist had told me, explaining that it fitted perfectly with my suspicions about birth trauma. “Its more common than is realized, with people learning to adapt to a rather rigid posture and inhibited responses,” he’d said. “All the world’s a stage,” comes to mind as I turn back onto my stomach and continue to dissolve this physiological state of fear.

This time when I feel into tension in my stomach I’m equally aware of the tension around my eyes, which now feels like I’m forcing them shut. Holding an awareness of both eye socket and stomach tension, I feel a warm tingling in my feet and fingertips too, as a spontaneous deep breath overcomes me. My nervous system is coming back into balance now, as I de-arouse this unconsciously stimulated, whole body state of fearful rigidity. As I continue to relax into my body and gain a more mind-less state of embodied awareness, I remember how years ago I would have gotten stuck in that pressurized compulsive thinking, maintaining and amplifying this fearful state all the way into that avoidance of life we call depression. Yet just as now happens when I’m too excited and worry about escalating into a manic mood state, I begin to drift back down into my body with a mind-less muscular relaxation. The unconsciously stimulated physical tensions of fear, dissolving, as sleep, per chance to dream, overcomes my “I think therefore I am,” all too self-conscious mind." An excerpt from: Born to Psychosis an online memoir of my experience.

So despite a lonely birthday, with no contact from ex-lovers or blood relations, there is no invitation to depression today. Perhaps I really have learned something about mental illness, from the inside-out?

What do you think?