My wife and I had an argument. It took me some time to realize that I had absolutely no idea what she was talking about. I know I’m a man and that is typically how we define normal, but his was different. I mean, I understood the words, even in proper order, but I couldn’t understand why she was so into this thing. Looking back, Scott was incredibly confused but didn’t know it because, work with me here, I was confused.
I have written on previous occasions (here, here, and here) about an accident of the neurological variety, just a few years ago. Blah blah blah, I sustained what, in layman’s language, would be dubbed a brain injury.
This sort of thing is a gift that keeps on giving and works its way out in several hemispheres (I know). I get confused. We are talking and suddenly I cannot remember what I was saying, perhaps even what we are doing. Empty space. Wait for it, there it comes… confusion. Something is wrong but it takes the requisite time until it dawns that my reality is off. Brief panic, then the gradual swim back up to the surface.
The specialist said I had a brain injury, though the diagnosis was nebulous; and like so many labels in my world, relatively unscientific. Most people have never imagined that their doctor is in the next room Googling what is wrong with them. I have literally seen this many times. Physicians who went to school 40 years ago probably know as much as someone who went to school 40 years ago; unless they constantly upgrade. Since that time in college, so long ago, the world of neurology, psychology, and even medicine radically transformed itself. I research every day and most of the time I still feel like I’m drowning in a sea of new information. Diagnoses are a bit like convictions; based on the best evidence available, but subject to change.
That label you have been wearing since grade 5, the one where that doctor told you that you were bipolar, well chances are it’s crapola. Labels are stupid unless helpful, and that one is thrown around far too often by people who should know better. I appreciate you telling me the list of things wrong with you on that first day we meet, but chances are we won’t talk about that very much, and several of these life sentences are garbage anyway. Most of us were diagnosed while we were still dumb-ass teenagers who were angry at the world, convinced they were omniscient, and carrying a chip on our shoulders the size of an elephant in the room. We actually believed that we would just die if that pimply faced loser we were dating paid attention to someone else. I don’t mean to demean a legitimate diagnosis, never that, but life is not static and it is far more complex, imaginably so, than can fit into a two-hour assessment. I have spent hours with teenagers who are presenting with symptoms born far more out of puberty and a pissed-off attitude than any psychological malady. They openly confess that they faked the behaviour or were in such a state of rage and angst that what that psychiatrist saw looked very little like the person they are. If you decide to label me for life based on how I acted in grade 10 than I’m screwed. Ask any of my friends from high school and they will describe a person I little resemble; with the obvious exception being I’m still very immature and have no plans of changing anytime soon.
If you look up brain injury on Wikipedia it will spew out something in the order of, “a brain injury is any injury to the brain”. That really helped, thanks Captain Obvious.
Some conditions do not go away and you are left holding a set of cards you never imagined possible. People with chronic physical conditions can tell you of the anger and the guilt and the shitty reality that it sucks to walk with a limp at my age. And like most people with chronic conditions, some of us are handed more than one cross to bear, once the party starts. Everyone who walks into my office knows there is something wrong with them. Diagnosis is one thing, treatment is another.
Defining oneself by the many labels we choose to button on does not necessarily increase the likelihood of authenticity in our lives. Knowing that you were diagnosed with depression at 16 may not be as helpful as it was advertised to be. It also doesn’t help to continue to beat yourself up for something over which you exercise little control. You can flagellate yourself until there is nothing left but emotional pulp, but that may not help you find contentment in this life. So many have convinced themselves that to even imagine they could live in a world with such cheesy concepts as contentment or happiness is unimaginable; and they are not interested in being disappointed one more stinking time. It is incredibly likely that you may end up bitter and sore if you don’t learn to hack your own dysfunction, and I am talking to myself here as well. At the end of the day it is up to me alone whether or not I fight back. I know you’re tired and don’t feel like it. Waiting until you feel like changing and are motivated to do the months and years of work with little or no short-term reward system is almost impossible when you are healthy, much less when you are chronically sore and hurting and tired. You are probably going to have to do something anyway.
But enough of this, I want to tell you about the empty space.
How does one describe what isn’t? The other day I sought frantically for keys that were in my mouth. I know some of you forget things but I did it again a few days later. Lock the door and walk away and then realize you cannot remember locking the door. You may relate to forgetfulness but when a part of your brain is dead, sometimes your natural shortcomings become amplified. Forgetfulness isn’t really what we are here to talk about, however. A far more accurate description could be vast emptiness. In those moments of emerging consciousness I have endeavoured to document the feelings before I wake up from the dream and, like all dreams, the memories quickly fade. Even writing the words, “the memories quickly fade” cannot adequately describe the sensation of fighting to make sense of what is happening. The very nature of confusion and emptiness precludes the capacity for cognizant self-awareness. There is nothing to pin your consciousness on because reality is wrong, and that does not seem right. How do you wake up from the cheesy Matrix metaphor when you have no way of knowing you are not in the real world and the lady in the red dress is not really checking you out?
As a psychology geek I am not content to give in to such an interesting problem. I firmly believe this crap works so this is something to learn about and then figure out how to hack. Counseling may sound great in theory but if the tenets that professional spewed at you don’t work in the real world than why waste your time and often money? For this particular puzzle the key is awareness, and the earlier the better. Once I know I am out of my mind, the game is pretty much a clean-up. It took about a week to figure out what to do once I knew I was confused. There are any number of psychological tools available for this problem and I simply grabbed a few off the shelf and worked them until they worked. This is not the hard part, in spite of how long it has taken me to really work the program. Knowing how to work around this problem is one thing, persevering is another. The techniques are easy. Remembering to do them is hard. The person who becomes aware that they are unaware soon becomes aware. Say that one three times really fast.
The challenge is figuring out something that will help me float to the surface faster, and I do not find this easy to accomplish. Just like a seizure, there is an initial incident over which I exercise little control and less understanding. In the beginning, there is almost a state of wide-awake unconsciousness, and it is not realistic to spend too much time trying to fix this part. Besides, it’s over quite quickly. If you are a client of mine you know what I am doing here. The first thing you do in STOPP Therapy is identify that magic moment. You know the one. There is a brief piece of time when you realize something is wrong and you think you might remember what that was.
I tell the story of a friend of mine who was prone to panic attacks. She found herself in the fetal position at your local mall and decided to do everything in her power to never have to experience that freak show ever again. My clients all know this story. A second or two before everything went to crap her palms would start to sweat profusely. Few of us have the muscle memory to stop a panic attack one second before all hell breaks loose. This is not our magic moment. We eventually discovered that about five or ten seconds before her palms would perspire her forehead got sweaty. She does not have a problem with sweating. Bingo.
It is impossible to adequately describe what it feels like to discover you are delirious. To become an observer of your own craziness. You see what I did there? Dispassionate observation of oneself is another box cutter from the counseling toolbox; an intellectual and psychological out-of-body experience. There are thousands of people who practice these disciplines, along with mindfulness and spirituality and all manner of hippy experiences. Some become historians and philosophers and psychologists and Jedis. People begin to read or meditate or get in touch with their authentic self.
For this exercise my tool of choice is STOPP therapy with a smattering of Mindfulness and DBT. Concepts like Radical Acceptance.
The problem is, telling you what it is and telling you how to do it are two different things. Radical acceptance can’t really be completely explained. Why not? Because it’s something that is interior – it’s something that goes on inside yourself. But all of us have experienced radical acceptance so what I want you to do right now is to try to focus in on sometime in your life when you’ve actually accepted something, radically – completely and totally.
It is my firm conviction that those who spend the requisite time and energy in self-discovery find it was worth the ride. It is entirely possible to become much more intelligent and I watch it happen almost every day. The secret is figuring out what is really wrong with me, above all else. Everyone of us is a complex web of intricate identifiers, and to reduce the entirety of your amazing brain into a simple diagnosis for depression is incredibly naive and perhaps a tad bit arrogant.
I am layers of dysfunction, and wonder, and a myriad of inexplicable dimensions, and so are you. Learning to hack your own dysfunction is extremely complicated, contrary to those cute little posts on Facebook and the more we can do to honestly address our crazy is an enormously important and valuable journey.