CBT Part III: Sleep Deprivation

This article has been the hardest of all to write. Not because the subject matter is particularly daunting, deep or traumatic. But because it is the first time I have had to overcome fatigue and bodily wariness in a long, long time. Normally I am straight on a computer after a CBT session, full of energy and a desire to share with the world the wonders of cognitive behavioural stuff! Today, I had to overcome a big barrier of fatigue just to be here writing this, and I can’t promise anything special.

My recent episode of sleep deprivations seems to come from two places. Firstly, A gradual build up of anxieties, natural to living in a busy, expensive, polluted city. Secondly a loud idiot next door who shouts and wails at random intervals into the early hours. And I guess there is ultimately my own anxious personality and thinking patterns which can turn problems into serious problems. This I discovered from today’s CBT.

Lets start with the shouting. At random intervals in the night, a man will shout. It won’t be massively loud, but loud enough to jar you, or awaken you. For me it feels like his voice has entered by body, my being is filled with his sound. It is the exact same wail every time, a supposedly songful sound, but in truth, a horrible, mechanical, repetitive, intrusive load of shite. I came to associate any noise he made with the possibility of a wail or shout, and this puts me into a downward spiral of hyper-vigilance, which prevents me from having decent rest and recovering.

I didn’t realize how much this was effecting me. On the first day it was a nuisance. On the second day it hampered my ability to fall asleep. On the third I bashed on the wall at midnight and came close to telling him to shut the fuck up. On the fourth there was no shouting, but my system was in constant vigiliance, and wouldn’t let me fall asleep easily. This causes feelings of frustration, which develop into rage, something highly unconducive to falling asleep. I was, and still am, catastrophizing about the effects of sleeplessness.

Today in therapy we discussed this and revealed I do have unrealistic expectations and standards. I always feel the need to be active, alert and at around 80-90% capacity. I know we can never be at 100%, but I am very wary of being weak and vulnerable, especially having lived in countless environments where appearing unaware can be dangerous. It might seem obvious that this is a vicious cycle – the more you want to make yourself capable, the more you fear incapability, the more prone you are to anxiety and thus incapability. My therapist was very good in challenging this through questioning, making me run through the evidence and realize the vicious cycle. (But I don’t think it is entirely bad to have such high standards. Human beings are hunters by evolution, it makes sense that we will want to be capable of reacting to threat or opportunity at every possible occasion.)

But with me there is an additional problem, and the heart of the problem. The formation of patterns. I have used patterns to some good effect, building up positive days and exploits to get me out of panic disorder. The downside is, one or two shit days and I fear a bad pattern forming. This rigid thinking really is a double-edged sword, and never far from a downward spiral. The challenge is to be more flexible, to accept more sad days as inevitable. This is not easy to do.

My mind is prone to catastrophizing and thinking the worst. This is why the nuisance of an inconsiderate idiot’s shouting can become something frightening and world-shaking. If I stop fearing the predicted outcome of losing sleep, my body should become less hyper-vigilant toward such disturbances. I don’t feel our session quite went into enough detail. How could it? One hour cannot cover a lifetime of being this way. But it has been very helpful, in hindsight. I am less afraid of sleep deprivation, and less prone to it.

There was also the factor of a build up of anxieties. We tend not to realize sometimes how anxiety gets us. It is like a shadowy assassin, slowly poisoning you drop by drop. For the considerate, this causes internal strife and restlessness. For the inconsiderate, this inspires the harming of others to regain a sense of control. I am sadly in the former category of person, and so the day-to-day banalities of life occasionally build up and make it difficult to function, even at 50% or so.

But its not only the cost of living and banal problems like that. The backdrop of an idiot sitting on America’s nuclear arsenal, catastrophic climate change threatening to wipe out everything that breathes, the dissolution of communities and the watered-down experience of Facebook and the like to replace it, new technologies falling into the hands of powerful capitalists; among a host of world events and tragedies, make anxiety quite a normal and relatively sensible state to be in. How we react to that anxiety is another matter entirely – with fear and paranoia, or the will to change things and become more harmonious. Or like myself, a mixture of the two. Nevertheless, I entirely understand why it is there.

These worries are definitely harming natural, harmonious functioning. Not only in me, but in so many citizens of the ‘so-called’ first world. This includes that most natural and essential, but mysterious, phenomena that is sleep. Sadly, I can’t think of a way around this off the top of my head. Maybe to paraphrase Alain De Botton and to see the odd night of insomnia as a creative gift to be cherished. And to realize that normality isn’t quite so normal, and lots of people have trouble sleeping. This doesn’t give me much solace. If I could sleep eight hours a night without disturbance for the rest of my life, I would.

Learning what I have about my own need for patterns and rigid routines, challenging negative thoughts by seeking evidence, practicing breathing exercises and progressive muscle relaxation, I should have a decent night’s kip tonight, and be back up to a decent level of running, without fatigue tomorrow. I at least can write a half-way decent article three days into moderate sleep deprivation! I venture to say then that it isn’t quite as bad as anxiety has made it out to be, (even though it is far from ideal). As with all things in life, the breaking of the pattern has made me realize the pattern. Perhaps this is the key to changing it, and perhaps something better will actually emerge from it. I don’t know, lets see.

 

 

 

 

CBT Part II – Testing a theory

I have just come back from another great session, which ended in a real climax of excitement! Its all happening in the NHS mental health support team!

We covered some exposure exercises, to simulate the feelings associated with a panic attack. It is important to familiarize yourself with these sensations, so as not to fear them. Once in an anxious situation, anxiety tends to peak and then starts to drop. So-called coping strategies prevent the natural decline of anxiety, and prevent the subconscious from ever properly learning that a dreaded situation (such as getting on a bus!), is actually not all that dangerous after all, and there is nothing to be anxious about.

By trying to avoid bodily sensations associated with anxiety, we lend them a power they do not deserve. I call this ‘mythologizing anxious sensations’, something which feeds into the cycle of avoidance and furthers fear. Eventually anxiety becomes a general dread which you will dedicate the whole of your life to avoiding! The short-term cure, avoidance, is worse than the disease. And those who say that time heals all ills have obviously never recovered from a panic disorder before! Time will not heal this.
I must now expose myself to these situations and bodily sensations. This will let the natural course of things play itself out, and the subconscious can learn once and for all that there is nothing to fear. Likewise, I will stop fearing the sensations in my own body, which I have already done much to achieve.

This is all made much easier by going into what I am really anxious about, which my therapist helped me with by proposing a theory. Before we get to the theory, we need to examine my true fears.

Today I boiled down my fears of a panic attack to two things: i) fear of embarassment, not being helped and public humiliation. ii) Fear of bodily weakness after a panic attack, losing my independence, being dependent without a trustful support network.
So we proposed two theories. Lets start with Theory A. This states that if I have a panic attack people will laugh, think I’m weak, and might film it on their phones. The evidence from this comes from seeing lots of humiliating incidents at school and the general shittiness of certain human beings. If theory A is true, then a panic attack would be rather devastating, and the best thing to do is to avoid panic attacks at all costs and restrict my freedom. On recollection, I believe this theory to be about 20% true. In other words, its a load of anxiety-induced shite.

So lets move onto the (infinitely more plausible) Theory B! This states the problem is worry that other people will judge me, be humiliating and unhelpful. But the evidence is against it: I would definitely help others if they needed it. Some people will always want to be helpful, even heroic in such situations. And some people have similar problems with anxiety and depression, so can actually be understanding. If Theory B is true, I need to try to think more realistically and positively about things, and dispel the power of the panic attack. This is as far as I got in working things out. My therapist took the next step.
She gave me an analogy which really helped explain what we had to do to truly see the theory through. Imagine an apprentice on his first day at a building site. The workers on the site put up a wall and tell him to hold it up, or else it will fall down! He spends the whole day standing there, holding up this wall, getting tired and uncomfortable. As night falls, his bosses tell him he has to stay there all night. Well, this just won’t do. So what does the apprentice do, now that he is in doubt about the worth of holding up the wall? He can gradually release his hold on the wall, he can release his support and slowly step away. But will this do? What if there is a gust of wind or something? To truly see if the wall is sturdy, he will have to give it a darn good push!

Ultimately, a theory needs to be tested. ‘If panic attack then people will be helpful, and there will be no harm’ is the crux of the more plausible theory. So lets just say that we might end up doing some field research soon!
I am most excited about the opportunity.
p.s. Get CBT if you can, its great. Just be prepared to look deep inside yourself and realize what needs to change inside you.

 

The power of CBT – Part I

So I have started CBT proper. So far, so good. In summary, here is what I have learnt after my first session.

Short-term coping strategies prevent long-term healing.

My short term strategies to deal with panic disorder, such as carrying medication, not straying far from home and avoiding long journeys, means that I am not getting a chance to ‘update’ my thinking. I am not challenging my catastrophic misinterpretations. By not testing them, they are given immense power by the imagination. Until I put yourself into the situation I dread, I cannot come to realize that it is nothing to be feared.

What is it I have been dreading? Firstly, fear itself. The dread of dread – a wholly pointless, but understanable, fear. Another thing I dread is shame. I have carried with me a long standing prejudice that panic, being different, being perceived as ill, is a weakness and shameful. This fear of not being able to cope, of humiliation in a public place is so powerful that, even though it is a myth, I am avoiding going into the situation. I have coped with some of the hardest shit you can imagine, time and time again. And when I have really needed help, I have almost always received it from friends and trusted people. But even so, I have a belief that I can’t cope, can’t rely on people, and need to hide from shame.

Well its time to test those beliefs and update my false perceptions!

It is illusion that keeps us most powerfully chained, hidden in fear. Truth must be allowed to prevail.

There is no shame on panicking in public transport and asking for help. Think – if someone was having an episode of panic opposite you on a bus, would you do everything in your power to help that person, show them compassion and strive to understand their situation? I would! I would go out of my way for a stranger, and try and be useful in helping them. There would be no judgement in my heart for such a person.

So why am I so hard on myself, and why can’t I turn that compassion inwards? Because I have these impossible fucking standards and expectations which find their root in having to be ‘perfect’ to avoid abuse – standards and expectations that need to be ‘updated’ (to say the least!) And why am I so doubtful of others, and so untrusting? Perhaps because I never allow myself to be put into a situation where I might have to trust people.

In some respects this is wise – caution is there for a reason. I have had a fucking hard life , especially emotionally. It has not been easy to trust people. But to lose your trust in humanity is the absolute worse thing you can do. Without being naïve, one must have a general faith in humanity in order to live at all. Without that faith, we become as hermits – paranoid, isolated, self-serving, self-confirming. It is a deeply sad, and retarding state to be in.

CBT is giving me the courage to challenge my negative thought patterns, going deeper beneath them, rooting out the hidden shame beneath the surface.

It is also showing me in detail that the fight or flight response is not something to be feared, and that bodily sensations should not be misinterpreted as danger signals (at least when there is no danger around!) It is opening my eyes to the truth.

I strongly recommend that anyone who has anxiety problems seeks out cognitive behavioural therapy. It is not designed to go deep into your emotional world – psychotherapy is there for that. But challenging our thinking patterns and changing our behaviours is just as important as the deep emotional shit, make no bones about it.

The price of being sensate

So the price of being sensate to the world, and expecting to be treated with love and respect, is often to absorb a lot of pain and be easily hurt by others. The higher your entitlement to basic dignity and respect, the more easily it can be tarnished. 
 
Not that anything can change in me at least, but it is a heavy price, which needs a lot of consolation and connection to maintain. It is a heavy price I must constantly re-evaluate every time pain is absorbed into my very being.
 
Where are these safe havens we can go to, where we can be ourselves in all of our vulnerability and as our true selves? Where are these doorways out of the capitalist world, where you need only wear a mask if you choose to?
 
Isn’t it time to melt the charade of individualist non-life and form one, great community?
 

They hurt people

It is impossible to escape the news, as much as I find it necessary in my current condition. It feeds anxiety, sensationalistic violence and ‘unprecedented’ tragedy, every day.

The news is a narrative, and a sorrowful one. The mind, wishing to predict the future, looks to the past, and projects it outwards. We watch the news, then, to be safe, to gather memories from society’s great ocean.

As with most anxious thoughts and dispositions, there is exaggeration and skewed perception. The news, like an anxious mind, focusses on danger, terror and harm.

But the news only tells of ‘cinematic’ harm, massive harm, sellable harm. The news about the millions of people, elderly, with disabilities, poverty-stricken, living in absolute psychic squalor is few and far between. These drawn out sufferings, if added together in some utilitarian calculus, would far outweigh the pain of war and terror.

This is in the billions: the exploited and the starved. The objectified and the enslaved. Billions, everywhere. Not only overseas, in distant lands and different narratives, but here. Your own elected officials will harm people in your own life time in your own country. This is real and it is happening.

Slaves all to ‘progress’, more aptly described as fear of stillness and re-evaluation. The juggernaught carries on, humanity is swept away. Chugging oil in its engine, it breathes out thick clouds of noxious smoke.

Fortunately, it will slow and eventually grind to a halt. There is much cause for optimism as humanity evolves, and I have no doubt we can grow from our pain, if we finally learn from it.

The antidote to anxiety does not lie in the cause of anxiety. One that takes cannot give, one that silences cannot implore, one that demeans cannot exalt. We must look beyond the societies around us for answers. We must plumb the depths of our histories, reaching back to stone circles and we must dream to the future where things improve and technology is used for the common good. We must dare to imagine something beyond capitalism, or amoral systems which can never provide for the most important thing of all. Human, plant and animal wellbeing, safety, encouragement and happiness.

They harm people every day, but you never hear about it in the news. Well, you can hear about it here. Now that we have these shared nodes of consciousness, let us expand until we reach critical mass. Let us undo these shackles of thought and throw off the heavy weights of despondency. Evolution is unstoppable, be part of it, and make sure you are evolving mankind in the right way.

It is possible. It is only the part of the mind that builds predictions based on anxiety that says it is not. That is a worm of the mind, planted by those who harm people.

Loss (the instability of consciousness)

Imagine sitting in a chair that is hard and uncomfortable. No matter how you wriggle, you always end up with an ache somewhere. The top of the chair digs in to your back, so you hunch further down into it, but that only makes things worse in the long run. So you go back to how you were at first, having forgotten the feeling of a wooden bar against the top of your spine. You turn sideways, but now your neck is cranked at an awkward angle and in futility you begin to massage your shoulders. So you hunch down.

This is what my consciousness feels like inside my head. Disjointed, disorientated, confused. Uncomfortable with itself, it struggles between uncomfortable places.

I believe this is for two reasons, both metaphysical and intellectual: the first is that I have not accepted that there is no centre, that consciousness is intrinsically afloat on a stormy sea, and the second is that change and loss is the nature of all things.

I will focus on the second. Everything comes from something and dissolves back into that something. Change is a blessing when you are in pain, for it won’t be forever. But it is not a nice though to think that what is familiar to you, people and places, will someday cease to exist. This is especially true when we have a strong sense of memory and the places that made us happy.

Good days are the ones we want to hold on to, but inevitably they come and go. And when we really think about it, we were never truly in control of the millions of factors which fed into those good days. Indeed, that is what made them good!

So longing to recreate them is futile. What has been has been. Things are gained and lost. People in our lives also; found and lost.

Trying to predict every factor that feeds into this impossibly complex ‘equation’ that is life / lyfe – such a thing cannot be done. And is not desirable – imagine how terribly contrived it would be if everything fit your dreams to perfection and was entirely of your creation; there would be no other autonomous people, just you directing everything.

Yet insecurity and instability are frightening, so it is understandable that we want a foundation of control. We could talk about balance here, but I feel that will be naive. What balance? What sense of control?

None of us will ever be given one for long. Consciousness, echoing the nature of all-things as transient and permeable and centre-less, cannot sustain itself forever. It evolves by virtue of what it is.

Even this article has no coherent central theme, just fragmented paragraphs loosely linked together. That is more profound then you may think, if you can work your head around it.

Holding on is anxiety, letting go is anxiety!

Perhaps this universe was made as some kind of joke, one that we human beings, limited in power and perception, can never truly see the funny side of. The joke is really cruel because we have the infinite abilities of thought and imagination, without the inner-strength to truly make sense of this great something (which doesn’t have much of a meaning anyway), we are beholden to. Sometimes it is funny, at least when people take it a bit too seriously and fight to hold on to their illusion. But largely it is tragic, and it is only in being together that we can survive in such a universe for long.

God has been taken away from us and there is nothing to take His place. Well, except for the microorganisms which feed on the bloated corpses of the fallen perhaps.

Ha ha.

 

Pain and self-growth

At first I was afraid of the pain. It makes sense. Caution is wise when something new is upon you. And patience too. To be unsure, to wait it out, to dip a toe in the black pool and have a safe space to recoil. All of these are wise decisions.

Yet the day will come when the passage of time has done all of the healing it can. Time alone does not heal all wounds, and anyone who tells you it does is a fool. Once you have something of a stable foundation again, the days and days waiting for inner-pain to go away become wasted opportunities to get back onto your feet. You cannot know when you are ready to go back out (though your body will give you indicators, or guesses). So you will just have to try it for yourself, to trust your defences and trust that you can take what comes and have the self-love and inner-strength to make it. Do not go it if you are not ready, but do not stagnate it you are.

Wait and you will wait forever.

The world is full of suffering. There is no denying it, and anyone sensitive to it will feel it. Pain is unavoidable and inevitable. Thus, one way or another, the time will come when you will fall into a spiral of pain which dominates your consciousness. It is not a ‘mental’ thing – it will permeate all aspects of your body and mind. It will come when it comes, and you will not be able to just will it away.

I would rather face those days of reckoning as one who is trained to face my fears, then one who hides behind shields of repression, or naive hope in the passing of days. And so I did.

When the pain came and took over my body I could not turn it away, and why should it leave on my account? Does it not have an equal right to express itself through the human corpus? Is it not also a part of me? When the pain came and took over my body I stopped resisting it and accepted its presence. I went deeper into it, explored it, and this hurried its course toward resolution.

The black pool is there, waiting for you. Ignore it and you will see it in dark dreams. Dive into it and you will come to know it wholly.

It will return again, the pain is recurring. There is no end point of healing and no end point of anything. But when the inevitable returns again, you can become more and more adept at dealing with it. I have no ultimate choice in what I feel and when I feel – I do not think anyone has that much freedom. But when the storm comes I will ride through to its eye, through to the other side.

Face things, do not let them linger. Confront and challenge things; at your own pace, but swiftly enough to not lose your social life, hope and ambition to them. Human beings evolved on the plains to hunt in packs. They did not evolve in arm chairs and in front of laptop screens to wait and rot.

You were born to hunt, to be an element in nature, so go and hunt. Only, this hunt is not for some animal, it is a quest into yourself for truth, for what truly happened, and the path to changing yourself. I have changed so much since the pain came and I learnt to hunt so much for the better.

When something inside screams, listen. The longer you leave it, the worse your demons will grow…

My lived experience of anxiety

To overcome anxiety and panic, come to understand it. Anxiety is there for a reason – to protect us from danger. The aim is not to completely get rid of anxiety, but turn the volume down on it when it gets out of hand. Anxious feelings themselves are not dangerous, and cannot lead to any serious harm.

And do not worry – you will not have panic attacks forever! They are going to go. Mine have gone from bad to bearable in four or five months.

Here is a description of my lived experience of anxiety and agoraphobia.

Sometimes when I go out, it feels like something is pulling the hair right at the back of my skull. I can describe it as a constant tugging. I know it is a false warning, but it is nonetheless powerfully there. Describing it seems to rob it of its power. Imitating this feeling at home, literally tugging the back of my hair, makes me realize that sensations are just that – sensations. What they mean depends on the importance we give them. Nonetheless, they are frightening at first. Gradually, you kind-of just get used to them.

When I fear that I am exerting myself too much or someone walking down the street could be a threat, my heart feels like it is not there! I can only describe it like that. It is like my heart moves up and right across my chest, vanishing into a portal. This is certainly the most bizarre feeling. A tenseness in the diaphragm often comes up when I go out walking alone. The chest area has a strong significance for me. At the moment I am experiencing shortness of breath, especially in closed spaces outside. I know it is not dangerous (perhaps light hyperventilation) and it is kept at a low level. But it is uncomfortable, and makes me more prone to stress.

Another lived experience is like feeling a nebula softly exploding and dissipating in my frontal lobes. It could also be described as someone pressing down again my forehead. I don’t know why this one comes up – it hasn’t for a while.

My least favourite experience at the moment is the lightness in the knees, as if the ground is pulling away from me. My head simultaneously feels a dizziness, like a spiralling. I get thoughts like ‘I’m going to fall’ or ‘Have I gone too far’? Often this experience Is caused by anticipating it, leading to a self-fulfilling spiral. But it never gets too bad. I am on top of the dizziness, because I know that when we are in fight or flight mode, the last thing we are going to do is be clumsy and fall. Also, by imitating this feeling at home by deliberately spinning round (not too much!) I am robbing dizziness of its fear-association.

One thing I do at the moment is to have safety behaviours and items. For instance, I am conscious when I leave the house that I should have my keys, meds or phone in my pockets. When walking along the street alone I tend to hold on to these things in my pockets. When I let go of them and walk more ‘normally’, it decreases my sense of anxiety. In short, I am aware that these safety items and behaviours reinforce anxiety – I only need to remember all the times I used to go out without them! I am experimenting with going out without having my phone, or meds. So far, nothing catastrophic has happened as a result. Gradual exposure to anxiety is the way to gradually reduce it, and for me it is working.

Generally my sense of dread is felt in the knees and chest. It feels like something really bad is going to happen, and that I have strayed too far from home. I only real feel a major fear in my head on a particularly bad day. After a particularly bad mood, or conflict, or any gushing of volatile emotion, I can feel quite a lot of dread and anxiety on my first venture outside.

My anxiety is also linked to the weather – dark and cold and dreary makes it worse, sunlight and softness and warmth can almost completely nullify it at times. This is why it is important to warm up before going, and not to push yourself too far at first! I am slowly getting used to colder and harsher weather, although going out at night alone I have not much experimented with. I have had strong anxieties about going out at night for at least a decade. Now is the time to deal with that fear.

These are all uncomfortable experiences. There are also positive and encouraging experiences on my journeys. Sudden bursts of strength, energy and confidence usually follow my realization that ‘I am actually at peak speed and strength! Anxiety is only uncomfortable now because it is not the right time for fight or flight.’ These confidences are sometimes linked to specific areas (crossing at a certain traffic light for instance, or going up a certain part of a hill). I try to remember that even positive associations are based the subconscious. When I really delve into the causes of anxiety, and sometimes get angry inside myself for injustices I have suffered, I feel stronger and less anxious. Expression of something hitherto unexpressed seems to lower my anxiety. But the rules of society and masculinity are still strong even in my ‘rebellious’ mind. They force me into the ‘psyche’ of citizen, and so I have not yet learnt to transcend these expectations and thus greatly lower my anxiety levels.

These are some of my lived experiences of anxiety and how I strive to overcome them. What is your lived experience of anxiety?

Time and Trauma

Does trauma heal with time, or does time just make you feel cheated for longer?

The natural healing systems of the body can clearly get it wrong with anxiety, which is an over-active sense of alarm leading to the degrading of normal function. Waiting for these negative learned behaviours to change themselves is not going to work.

The mind can race ahead of the body, or think itself separate – a folly. But it can also correct its course, for the mind too is of nature, and we are possessed of some wisdom. Altering the mind’s course to reduce anxiety will help trauma heal.

But how long will  this take? I cannot know. And what will healing look like? I do not know. All I can know is whether or not I am on the path to healing and whether I wish to get better, or remain forever broken.