anti anxiety

“With the ideal comes the actual 

like two arrows in mid-air ..they meet” ~ Sandokai 

What does this have to say about stress and anxiety ..? The odds of events meeting our ideals are about as likely as two arrows meeting in mid-air. At the local-level, what we think people should do or say is an ideal ..what follows is the actual. Like arrows in mid-air, they seldom meet. At the neural-level, when events don’t meet our expectations, an orienting response is triggered. Pupils dilate ..light intensifies ..sounds get amp’d ..muscle tone increases ..acetylcholine is released .. blood vessels constrict and blood pressure rises ..all in a fraction of an instance. The orienting response is meant to be transitory. It should subside once dissimilarities are found to be non-threatening. But when the incidence of dissimilarity occurs too often, and the orienting response doesn’t get a chance to recover ..it becomes chronic. You experience a constant sense of vigilance both mentally and viscerally, which is similar to what someone with PTSD suffers. It takes a toll. There are many reasons for experiencing a higher incidence of dissimilarity. I have a theory that highlights one possibility: memory becomes scripted with age and repetition [link]. Many of our old views of the world simply don’t match present-day reality anymore. However, we persist. This leads to a false sense of knowing and anticipating what comes next. However, what comes next is never certain ..only imagined. Anticipation-fueled imagination is a vicious cycle that leads to more frequent experiences of dissimilarity between the imagined and the actual. I believe it results in the chronic anxiety and pervasive feeling of dissatisfaction I often see in people my age.

Psych unit

“Locked inside your head do you realize the things you say never make sense? We can sit here awhile but we don't know the half of it in your defense.” KT Tuntall

Group therapy: Rose is a recent arrival. She says she’s here because she lost her cat, which she repeatedly refers to as a ‘jaguar’. “It kept me safe” she says “..nobody fucks with you when you gotta’ jaguar.” I look at Dr Russell. He says counselors had to coax her out of room 20 at the Eagle Inn because she had rendered it toxic ..a rotten mix of soiled blankets, month-old McDonalds wrappers and fuming litter boxes. Another new admit is Jeffrey. He was sent here after leaving a handwritten note at the police station, which read: “Listen, I got 20 CIA agents protecting me where I live” and demanded a ‘monogamous pretty’ woman be delivered immediately.

Psych unit

“A horse at my window ..a voice singing in my head. Reality beckons but I will stay here instead. In delirium people are free to see what they want to see. And I am not alone. In the darkness I have a thousand friends. And the music plays and it never ends. And the midnight owl comes to fly with me. And I feel and hear what I cannot see.” ~ Emilie Autumn

Group therapy: Florence pulls at a mop of tangled red hair. Says she thought the spirits that possessed her had disappeared. But they showed up again last night, clawing at her soul. Someone told me she suffers chronic heartache (!?) Robbie needs more medz to think clearly in class. Reasonable request. Stacy, clearly the worst off, hunkers in the corner weeping ..saying her husband (who is deceased) gave her another round of beatings last night. Her head is bandaged and her face is black and blue. Startled, I look at Dr Russell. He says this cycle of recrimination has been going on for years. Some patients appear to have already left the world. The techs brought them in ..they look inanimate. “They’ve escaped their tyranny” the doctor likes to say. I tell him I feel out of my depth. He’s says that’s a good first step. I stare at a chart of the brain on the wall. “Don’t get fooled into thinking that’s any use” he says. Robbie tells me that talking about her problems has helped as much as any anti-depressant a doctor prescribed. “When I speak out, say what’s inside ..they appear to understand and give me direction on what to do.” Makes me think how much better girls are at expressing what’s inside. “So, the people here are pretty helpful ..?” I ask. “No, I mean the Angels ..!!” she shouts incredulously. Dr Russell says you gotta’ treat them for what they believe ails them. “Doesn’t that just reinforce their beliefs ..?” I ask, thinking back to a class in abnormal psych. “Some of these patients were incoherent when I got here” he says. Like they’re making sense now, I think. But who am I to say.

Nomad

Frank is a nomadic dumpster diver. He’s frequently blitzed on meth and it shows. His eyes bulge and quiver. and his hands shake.  “Why do you do it ..?” I ask. One voice tells him it’s his reward for two tours of duty ..says it’s OK ..it’s just a phase (he was never around the stuff before). A second voice tells him he needs something to obliterate the first one when it starts sounding like bullshit. He tried taking courses at the city college but discussions in his political science class left him feeling conflicted between the patriotism he felt going in and the alienation he feels now. “Nobody gives a shit around here.” He’d leave campus pissed ..go back to his tent in a field near the airport and watch planes fly away ..imagining himself flying away someday too. Reminded me of a song that used to go through my head when I was on the road:

“This old airport’s got me down / it’s no earthly good to me / I’m stuck here on the ground, as cold and drunk as I can be / You can't jump a jet plane like you can a freight train / So I best be on my way in the early mornin’ rain.”

Head trauma

Shrapnel from an IED went rattling around his skull ..and for the next 12 hours Paul thought the enemy had captured him. He couldn’t recognize faces or uniforms ..orders sounded foreign ..and foreign sounded menacing. He had to be restrained to keep from picking up a rifle and shooting members of his own platoon. Stateside, his comprehension has returned but he gets lost mid-sentence while talking. He struggles to remember where he left off. When prompting doesn’t work, I tell him to take his time ..just keep talking ..even if it’s something different ..whatever comes up. He manages to tell me what’s happening: “The words coming out of my mouth aren’t matching the ones in my head.” Then he starts crying. Something that never happened back there. Now he says even AT&T commercials make him cry ..he doesn’t know why. “The civilian world is pretty fucking surreal” he says. I imagine two different narratives ..one playing inside his head and another playing on the outside. He was a high school honor student ..but the VA says he was bi-polar when he enlisted and wasn’t traumatized by combat. It’s a catch 22 ..except they’re saying is you have to be crazy to want get in as opposed to being sane if you want to get out. I documented his symptoms ..got statements from his family physician (who says he was never bi-polar) .. attached copies of his high school records and got him a disability designation that entitles him to see a VA psychiatrist.

PTSD

The military is known for instilling leadership and teamwork ability ..skills that battle conditions can quickly take away. According to a Rand study, nearly one third of all returning troops suffer from some form of post-traumatic stress (PTSD) or traumatic brain injury. Some of them show up at student services where I see them. James was part of a tank crew. On a hot day in Iraq ..they left the hatch open. That’s when a grenade blast slammed his head against an iron plate. At home, he enrolled in college using his GI benefits. However, crowded classrooms make him feel trapped and panicky. When he tries to contain these feelings, he finds he can’t make sense out of what the instructors are saying. Answering a question is like trying to find the answer to a riddle. He mumbles and strains to put together a coherent sentence ..and hopes he’s somewhere in the ballpark. I referred him to the VA for therapy. A short time later he quit school and went looking for a job. He hoped the skills they taught him in the service would help. Unfortunately, many employers told him they couldn’t accommodate time off for therapy. When I talked to him about it, he said he didn’t think that was the real reason. “They hire the disabled all the time.” He says “Guys that need just as much time off as I do.” “No, it’s more like they’re afraid I’ll go postal or something. Head-cases make them nervous.”

Dear John

Eric received a Dear John letter just before shipping stateside. It has made civilian life hell. Much more painful than anything he experienced in Afghanistan. He tells me she was everything he was living for over there. Now he’s reminded of her everywhere he goes, like ..the clubs ..city streets ..friend’s houses. He describes it as “..receiving an jolt of electricity around every turn.” Classes are torture, he can’t concentrate and I get the impression that student services are wasted on him. I’m out of my league. I see signs of depression. He has difficulty sleeping and concentrating .. the pain is like, everywhere he goes .. and he’s beginning to withdraw. I’m going to have to refer him to VA and hope that they don’t drug him into oblivion. I’m not unfamiliar with the pain of being dumped, however, so I try to convince him that it doesn’t last ..the shocks will begin to fizzle-out and his memory will begin to clear-out. But he’s not paying attention ..it’s not what he wants to hear. I try to imagine what it’s like. I picture him getting hit in the head (or punched in the stomach) with a baseball bat every time he goes through a door. Now he doesn’t open many. He doesn’t leave his room much either.

Drop in the ocean

The broken BP rig is leaking about 8,820 tons of crude oil into the Gulf every day. It is sickening the ocean and killing marine life. Believe me, I grieve. However, what worries me even more is what we don’t see. A little over half that amount gets burned and released as auto emissions into the skies of Los Angeles every day. That’s somewhere in the vicinity of 4,740 tons of hydrocarbons a day. It is sickening the air we breathe and causing debilitating respiratory problems. Sustained exposure to hydrocarbons compromises the body’s defense system resulting in ailments such as chronic bronchitis and pneumonia. If you don’t believe me, check out an emergency room in L.A on a smoggy summer day. What is even more insidious is what crosses the mother’s placenta, and gets absorbed by the human fetus. Toxins related to hydrocarbons are known to impair prenatal development. This accounts for a higher incidence of developmental disorders such as autism, attention-deficit and dyslexia. Sometimes impairment doesn’t show up until later in life when it becomes visible as signs of depression or schizophrenia. I believe the human suffering caused by addiction to fossil fuel is immeasurable. It makes the Gulf oil spill seem like a drop in the ocean.

false memory

I ask Randy how things went at the V.A. He describes his visit in full detail. When I follow up, they tell me he never arrived. I tell them there must be a mistake. They check again and tell me there’s no mistake. I’m like, wtf is going on here. I ask to see his counselor. The counselor tells me about a condition they frequently see called ‘false memory syndrome’ He goes “It’s where you remember things that you planned to do as though you actually did them.” But I go, this was way too elaborate .. I mean, he told me what he had for lunch .. the ride over .. what they talked about in the car, etc.. His counselor goes, “Yeah ..he’s afraid of missing something so he conjures them up. It’s a coping strategy and should go away pretty soon” I’m dumbfounded. He goes on to explain “You’ve heard of the belief where, if you think about something, it can be the same as doing it ..? The book of Matthew says anyone who even looks at a woman with lust in his eye has already committed adultery. Well, consider this an extension of that ..where thinking about something can lead to the mistaken belief that it must have happened.” I try to put it in words I can understand “Sounds something like virtual reality ..(?)” “You could say that” Now I’m driving home, going ..OK, did that just happen, or do I only think it happened ..? Now I’m wondering how many things I’ve accomplished that never got beyond the planning stage.

Aftermath

“What happened ..?”
“You were hit by an IED, dude.”
“No, that was somebody else ..”
“You’re good man, you still got your feet.”
“Where are you ..?”
“Checking your pupils.”
“Where am I ..?”
“On a berm.”
“How did I get here ..?”
“You were blown here ..you’re lucky.”
“Where is here ..I don’t remember ..I can’t see.”
“Don’t worry, it’s temporary ..you’ll see fine in just a moment.”

Back in the States, Johnny has lapses in consciousness where he tells me he leaves his body .. travels back to Iraq and becomes someone else ..just before they get hit by an IED. Each time, he says ..the same conversation takes place. I ask the VA about this and they tell me it’s a documented condition called ‘disassociative fugue’. I tell them it sounds frighteningly supernatural to me. They say it will go away soon.

Antidepressants

I think I like this guy! He certainly makes a convincing argument. He's saying that medication for depression (SSRIs, MAOIs and Tricyclics) may actually be turning single/acute episodes of depression into chronic conditions. I wonder what this means for children who are medicated for, what may only turn out to be, a rough period of adolescence ..that they would eventually outgrow.

Ramón

After his 2nd tour of duty, Ramón’s world was a fuzzier place. Milkier too ..until he got the cataracts removed. The ground feels spongy when he walks because of the loss of sensation in his lower legs. I have a theory that says: what the body can’t feel, the mind fills in ..and sometimes with bizarre effect. For Ramón, it can make a dusty street feel like a rocky stream .. or level ground feel like an uphill slope. He says he’s learned to look for visual confirmation, but sometimes his eyes deceive him. He went to an optometrist but couldn’t pass the eye exam. He says he could see the letters clearly enough, but they would rapidly morph into other letters. For instance, an ‘M’ would become an ‘N’ then a ‘U’ then an ‘O’. When he mentioned this to the eye doctor ..she let him take the test over a few times. Ramón learned that if he blurted out the first letter he saw, he did much better. Out on the street however, phone numbers dissolve before he has a chance to repeat them. He can’t remember things he just read because when he gets to the end of a sentence, he’s forgotten the beginning. Now whole movies fade away by the time they reach the end, which he says is cool ..he can watch them over and over again as though he were watching them for the first time. I’d say the things that tethered him to mother earth have slackened a little, which accounts for the sliding sensation he gets in the pit of his stomach, the one he says feels like his car is skidding off the road even when he’s sitting at his desk.

Footnote: Music that used to annoy him ..dissonant-sounding jazz from performers like Coltrane or Björk ..now appeals to him. I put on the Beatles Revolution number 9 ..which sounds like a loop of recorded chaos and impromptu screaming. He was delighted. Then I put on a track of improvised rock recorded at a Grateful Dead concert. He said it sounded natural to him, like riding in the back of a truck on a winding road through the woods. This leads me to another theory ..when the mind adjusts to blur ..it can also make a melody out of noise.

He's gone

“He’s just not the same anymore” his mother says “Does he ever talk about it ..?” I ask “The only thing he ever mentioned was the time he had to retrieve his friend’s body from a supply truck that exploded. It was too gruesome for me ..he’s just not the same anymore.” He can sit at a crowded table with friends and just smile and not say anything for hours. His prior relationships have ended and he can’t remember most of the people he went to high school with. “He isn’t who he was when he went in” a former girlfriend tells me. He can’t drive ..traffic laws and street signs elude him. It scared her to death one night when he drove for miles and did not stop for a single red light. Later on I find out he didn’t really learn to drive until he was in Iraq, and that was mostly on unmarked desert roads. He’s not aware of it when he hits curbs on both side of a residential street. He misses other customary signs of danger as well. He’ll blindly walk across a busy boulevard to reach a starbucks and meet friends. I’m reminded of a line from a book by John Irving and tell him to keep passing the open windows.

Fear incorporated

Presented to the

Seminar in Neuroscience

“Anxiety is a thin stream of fear trickling through the mind. If encouraged, it cuts a channel into which all other thoughts are drained.” Arthur Somers Roche

Anxiety is a feeling of dread or apprehension that occurs for no apparent reason. It is distinguished from fear because it occurs in situations where there are no outward signs of eminent danger. It becomes debilitating when it grows out-of-proportion to ordinary events in life. Anxiety is deceptive. First it focuses attention, and then it clamps the brain into rigidity by obsessively replaying past traumas.  Read more ~> [ link ]

“O.K.
Just a little pinprick.
There'll be no more aaaaaaaaah!
But you may feel a little sick.
Can you stand up?
I do believe it's working, good.
That'll keep you going through the show
Come on it's time to go”

Drifters

I work for student services at a local college. Most of the kids that come in here have legitimate learning problems. However, we frequently get kids with problems that lay elsewhere. Those are the ones I see. For some of them, it may be their last contact with mainstream society. They talk about life on the road as if it were religion ..and then disappear. I understand the appeal ..I love the outdoors too ..but sleeping on solid ground for too many days can be rough ..not to mention city streets can be dangerous. However, talking to them, I get the impression that life on the road feels less threatening than an adult-life filled with obligations, sadistic bosses and debt-collectors. Periodically they try re-entry. Haley’s father wired her money so she could enroll in college courses. She tells me her problems started in high school. She felt so angry that she’d cut herself .. medicate herself ..and lash out at practically everyone in sight. She wasn’t making friends. At age 16, they diagnosed her with ‘borderline personality disorder’ ..whatever the fuck that means. However, she found a cure of her own: drop out of a school ..run away from home ..leave the pills behind ..hop a train for the west coast ..and don’t stop moving. She’s been riding trains since 2006. Now, I have a theory. We’re all born with a mixture of genes from our ancestral past (if you believe in that sort of thing). Some may get more genes from our ‘rooted’ ancestors (like farming tribes) while others get a higher proportion from our nomadic ancestors ..those whose survival depended on moving from place to place. For these kids, stability is threatening ..home feels like a cage ..and city streets make them feel claustrophobic. I’ve learned that there is no ‘talking cure’ ..no amount of reasoned-speech will overcome it and I cannot offer any recommendations for it. I think there will always be a segment of humanity that prefers a nomadic lifestyle. Some may work out an accommodation (like foreign service reps, traveling salesmen or covert polygamists) while others remain in perpetual orbit.

Bex

Bexi’s grades tanked ~ her sophomore year is over and she’s sitting slouched and expressionless ~ she says she feels ‘a bit off’ ~ her mother says she doesn’t know what to do ~ she tried taking her to the hospital (?) ~ but the hospital said they needed family therapy ~ family therapy wound up causing more grief ~ mainly because her mum had to take time off of work ~ which I’m sure made Bexi feel even worse ~ probably why she’s feeling ‘a bit off’ ~ I suppose I would feel the same way ~ her mother is talking, but I tune her out and focus gently on Bexi ~ I sense discomfort ~ she doesn’t like attention ~ now I sense a shift ~ she’s pissed ~ her mum is talking about all of those ‘private family matters’ Bexi brought up during counseling ~ and how she really ripped into her for it afterwards ~ so now I think that ‘counseling’ must sound more like ‘punishment’ to Bexi ~ and her mother is using it as a threat ~ funny, in my day it was reform school.

Her self-portrait ~ submitted with permission

More Victors

In my estimation, there are probably thousands more soldiers, like Victor, returning from Iraq with mental conditions that are too subtle to detect without long-term evaluation. I know that when the brain takes a hit ..the first thing to go is attention. The second is impulse-control. It looks to me like these two things are causing Victor’s problems. Much of the surface area of the brain is dedicated to reducing ‘out-of-scope’ activity ..allowing us to focus, and act, on what’s relevant. Anything that impairs this action can leave us open to signals that disrupt conscious experience. This may account for the way Victor misperceives his parents, cars and carbonation. Symptoms like these may not appear for months after a soldier returns home. What often brings them to the attention of health care providers are complaints from family and friends who say they are no longer following the ‘script’ of the wholesome teenager they once knew ..growing up in the sheltered community of Santa Barbara. Or, worse ..they’re not following the script of the ‘noble young man’ returning from war ..which is complete bullshit because there’s nothing in the background of a teenager growing up in Santa Barbara ..or Nebraska for that matter ..that will ever prepare them to counter the horrors of war and it’s aftermath. The long-term consequences of our policies in Iraq ..and the ‘stop-gap’ policy of recruitment ..will be felt by this generation of Americans for a long time to come.

Victor's war

Victor returned from Iraq last fall after suffering a ‘head trauma’. He was knocked unconscious by the shock of a roadside bomb while on patrol. At first he seemed OK ..just a ruptured eardrum and a little blurring in his left eye. His parents were relieved. He was an honors student in high school. However, after returning to college ..he couldn’t keep up with his studies. He claims he can’t remember a thing he reads. But tests found that he’s not having problems remembering ..he’s having problems concentrating. He can’t tune-in long enough to finish a sentence without being distracted ..either by noise from another room ..or conversations he had earlier that day. He’s acquired some form of adult ADD. He’s also having problems at home. He used to be a pretty easy-going guy ..but now he ‘flies off the handle’ easily. He can’t even tolerate his parents asking him how his day went ..sounds like an interrogation ..so he’s doesn’t answer anymore. He quit going to school ..and won’t go anywhere by car ..he says it looks like other drivers are trying to ram him. He also avoids beer and other carbonated beverages because the fizzy noise they make sounds like bullets whizzing by. He’s getting more heavily into drugs.

Micro business

Shaun is the 23-year-old son of a friend of mine. He’s also an entrepreneur with a plan. He wants to sublet his one-bedroom apartment to two-or-more students ..for a modest profit ..then move ..rent ..and sublet again. It’s a ‘micro business’ he says “ ..start small ..create a stream of income with every move ..until, who knows ..maybe one day I’ll work my way up to like ..dormitories.” Before long, he says, he’ll have enough money for a place of his own. Well, I have to give him credit ..he would be filling a need ..we have a large population of students ..and a shortage of housing.

“Aren’t landlords already doing this kind of thing in Isla Vista ..?” I ask.

“Yeah, but I’m looking at the Mission district .. places like that ..who wants to live in a student ghetto like IV."

(Other students, I say to myself) “You’re going to have to stay one step ahead of the wrecking ball ..the only affordable rents in districts like that are in buildings about to be torn down.” (I don’t have to remind him that he lives in an apartment that was converted from a hospital ..and is scheduled to be torn down).

“But, don’t you see uncle Lee ..that’s where the opportunity lies, they all have to go through the permit process ...which can take years ..in the meantime, I’m providing income for the owner ..and living quarters for students .. it’s a win-win situation .. do you know what the dropout rate is around here ..? Shit, I’ll probably be able to rent the same place two or three times before the wrecking ball arrives."

“Sounds like a black-market ..do you suppose real estate offices are doing that already ..part of their ‘property management’ division ..have you considered working for them ..?”

“I’m not talking about work, uncle Lee ..I’m going to ‘manage’. I’ll hire people to do the work.”

Roxy

There’s a tattoo, in gothic script, written across Roxy’s left wrist ..the name of someone who gave her a set of Dale Carnegie books as a gift. Roxy promotes late night raves ..drives a delivery truck ..and practices Thai kickboxing at a nearby gym. She dreams of becoming pro someday. I admire her single mindedness ..and believe she might just make it. Her mother was a gypsy ..going wherever circumstances led ..her father was sitting at a bus stop in Arizona one day heading for Hollywood ..Roxy never knew him. She and her mother wound up living in places like Italy, California, Maryland and Colorado. She stopped moving long enough to finish high school ..then college. So she’s articulate as well as well-ripped. Tonight she’s scheduled to fight in an amateur bout at the Upland Indoor Sports Arena. “I understand that it's a performance,” she says. “I consider myself a full-contact actress.” Her trainer Chris Reilly, a former pro kickboxer and marital arts expert tells her that the fight is in her head ..you win by letting your opponent to lose theirs. She tries a flying kick, which doesn’t land. Her opponent, a more experienced boxer, delivers a volley of punches that crumples her ..2:46 minutes into the first round. The fight is over. She’s been knocked out. Doctors rush into the cage ..blood trickles from her temple. I’ve never been around the sport ..I don’t know what to say ..the best I can come up with is: “Hey, once in a while ..I have a bad day at the office.”