Thursday, July 14, 2011

Recovery In Progress -- My First NAMI Convention

Dr. Ken Duckworth's job at the Ask A Doctor about PTSD session was to make some opening remarks and then let people ask their questions.  He rattled off a list of treatments and said, The good news about PTSD is, we know what causes it -- trauma that was not able to be processed adequately.  The bad news is, the treatments just don't work so well.

Short and to the point.  Actually, I am not so negative (right this very minute, anyway) about treatment as Dr. Duckworth, because I am not looking for the magic med anymore.  I know about recovery.

Recovery is about collecting tools and pulling them out when the occasion requires.  I will illustrate.  But first the setting...

Last week I attended my first NAMI (National Alliance on Mental Illness) Convention in Chicago -- 2300+ people who have mental illnesses, family members, advocates, volunteers and caregivers, with a few scientists thrown in for good measure.  As a friend said to prepare me, A NAMI Convention has a certain kind of energy.  Yes, it does.

I have been to big conventions before, used to be a legislator (called Deputy) for the Episcopal Church, which gathers 8-10,000 or so Deputies, Bishops, exhibitors, visitors, volunteers and the like every three years.  I stopped doing that when I figured out that every three years General Convention tripped my hypomania and was followed hard on by a depressive episode.

So this was my largest gathering in some time, with plenaries, workshops, symposia, networking and ask-a-doctor sessions, drumming, theater, yoga and talent show, internet cafe and peer counselors, exhibitors, book sales and an information booth which was the best hidden spot of the whole damn Chicago Hilton.

You can expect a number of blogposts out of this event, including dueling comments between me and fellow blogger John McManamy.  Now that we have finally shared a beer, does that make us blogmates?  I began writing this piece in the hotel room, late after the last gasp, the rawest of my posts to come.

I knew it was a mistake to make Ask-The-Doctor-About-PTSD the last thing I attended.  It's just, that was the schedule.  Most helpful take-away: The brain is simply not designed to metabolize certain experiences.  PTSD is the result of incompletely metabolized traumas.  Bottom line, it is a normal response to an abnormal event or series of events.

The brain keeps trying to metabolize these unprocessed events/memories/emotions/bodily sensations.  They lurk beneath the surface, waiting for the next opportunity to emerge, when triggered by some reminder.


Oh, I was triggered, alright.  The last question of the day was about a particular symptom I don't talk about and religiously avoid.  I left the room reliving it, dizzy and disconnected.

Walking out, I heard the voice of my therapist, who once ended a session saying, The things we have talked about today probably have triggered your past traumas, and you will be dealing with the effects after you leave.  So how are you going to take care of yourself today?

Time to pull out that toolbox.

The Ask-A-Doctor doctor listed half a dozen treatment modalities for PTSD: meds, support groups, EMDR (Eye Movement Desensitization and Reprocessing), sleep regulation and aerobic exercise.  He mentioned Prazocin for nightmares.

First off, pop my anti-anxiety rescue med, put on my walking shoes and go get some aerobic exercise.  Work off that negative energy.

Just outside the door was Grant Park.  An art exhibit diverted me from my aerobics.  But art is good, very good.  Change the channel -- that's Cognitive Behavioral Therapy 101.


I stood still and drank in paintings inspired by water.  Not this painting, actually, which is exhibited just down the street.  But I thought of it.

Water is good.  It evens out the emotional turmoil. -- So says my other therapist, the one who does eastern-based energy work.  You see, when even the doctors acknowledge that western treatments (they don't call them western, because they don't speak of there being any other treatments) work poorly, I am not going to limit my tool box to only half the planet, especially not the more rigid half.

I spoke with the artist about perspective.  He paints on a flat surface, so doesn't think it matters which side is up.  I breathed into the here and now.  Thich Nhat Hanh taught me here and now.  But here and now is my worst subject.  And somebody interrupted to talk about showings and art business.  There were too many people -- had to reduce stimulation.


My energy therapist would recommend grounding.  I headed back to the gardens, flowers, trees, dirt, all good, all grounding.  Eating is good for grounding, too.  Maybe I should eat something.

From Alcoholics Anonymous: HALT = pay attention to when you are Hungry/Anxious/Lonely/Tired.  No, a martini is not in the recovery toolbox.

So I bought my inner child a strawberry ice cream -- a drippy cone instead of my usual adult cup.  Sugar isn't really the best choice, but it was red and a gift to my inner child.  Then I head off to find some meat.  Meat feeds the first chakra.  First chakra is about safety.  PTSD is about the amygdala is about safety is about the first chakra.

Still I was struggling.  I don't just have my own pain; I suck up the pain of every person with whom I have spent the last three days.  All those stories -- how can there be such a world?  How can I live in such a world?

I picked up my whole personal Book of Traumas, the traumas that never got resolved, that get retriggered today when I try to resolve them in therapy, the distrust I try to pretend does not exist toward the people who try to help me but they end up retriggering the traumas I can't resolve because they never seem to address that they are retriggering them and my retriggered shame prevents me from telling them and I truly believe the result will be retrauma anyway.

There are exceptions to that negative thought.  List the exceptions -- Cognitive Behavioral Therapy 102.  But how do I know who is for real...?

So I head back to the convention, walk over the train tracks.  And there is another trigger, another overpass, another trip to Chicago, another episode, another long time ago.  How quickly is that train traveling?  How far away?  How fast does a body fall that far?  How to time the collision of the two?  Velocity problems were the one thing that defeated me in high school math.

But I am not in the right spot anyway.  Geometry I got.  I need to be right -- there -- where -- a woman is pushing a baby stroller.

Oh.  Okay.  Not tonight.  I have an Iron Rule.  In a world filled with trauma, to the extent that it lies within my power, I will not cause trauma.  A two-year-old is sitting where my demon would call me.  The two-year-old wins.

God bless the internet that led me to David Conroy some years ago.  The first sentence of his book Out of the Nightmare brought sense out of the chaos that compounded the pain of my suicidal symptoms.  Suicide is not chosen; it happens when pain exceeds resources for coping with pain.

Tonight my pain was painful.  But I have survived worse, much worse.  And tonight my resources are many.  Tonight the thought was more than a mosquito, but it wasn't a tiger.  I do not underestimate the lethality of this disease.  One in five people with bipolar II do not survive it.  Tonight, I am still of the four.

I know people freak out over the suicidal ideation part of mental illnesses.  I apologize to my friends for causing them pain by bringing up the subject -- even though my need to protect you from this pain adds to my own.  I try not to bring it up, except with people who know what I am talking about.  But this is one of the tools in the Recovery Toolbox.  Those who do know what I am talking about need this tool.  And this post is for us.

Ironically, the state of the art treatment for people who have a lot of suicidal ideation and behavior, people with a diagnosis of Borderline Personality Disorder, is Dialactical Behavioral Therapy, radical acceptance.  Starting, not ending, but starting with acceptance even of that symptom that freaks out so many of you.

Yes, sometimes I have those thoughts.  They are well-worn grooves in my neurological pathways.  Any number of things will trip the cascade that leads there, including things you might not imagine, a cold sunny day, my doctor suggesting a new medication, an overpass.  These are not reasons.  Suicide is not about reasons.  These are triggers of neurological pathways that have a current of their own.

It is what it is.  Those five words sum up Dialectical Behavioral Therapy, an offshoot of CBT.  They were the chorus sung by one of the players in the lunchtime drama troupe.  Saturday night, I repeated them to myself.  Often when that thought appears, somewhere between a mosquito and a tiger, I say, There it is again.  That's all.  Mindfulness.  The thought doesn't have to freak me out, doesn't have to freak you out.  It is what it is.  Move on.


As I crossed the overpass, I felt a draw, a pull toward the hotel.  It was an energy, a spiritual energy on the side of life, two thousand people in that building, rooting for me, for my life, for one another, for you.  One of them even blowing a didgeridoo, accompanied by a flute, to be followed later by another who whistled Somewhere Over The Rainbow, all spiritual energy on the side of life.

The wisdom is ancient.  Two are better than one, because they have a good reward for their toil.  For if they fall, one will lift up the other; but woe to one who is alone and falls and does not have another to help.  Again, if two lie together, they keep warm; but how can one keep warm alone?  And though one might prevail against another, two will withstand one.  A threefold cord is not quickly broken.  [Ecclesiastes 4:9-12, New Revised Standard Version]

So that is my first report of my first NAMI Convention, the most confusing and most compassionate experience I have ever had with 2300 people.


(Find your local NAMI Chapter here.)

photo of toolbox by Per Erik Strandberg and used under the Creative CommonsAttribution-Share Alike 2.5 Generic license
General Convention Seal for the Episcopal Church in public domain
Olaus Magnus's Sea Orm, 1555 in public domain
Water Lilies by Claude Monet, 1906, in public domain
photo of Grant Park in Chicago by Alan Scott Walker and used under the Creative CommonsAttribution-Share Alike 2.5 Generic license
root chakra by Muladhara Chakra and used under the Creative CommonsAttribution-Share Alike 2.5 Generic license
photo of Chicago Orange Line by Daniel Schwen and used under the Creative Commons Attribution-Share Alike 2.5 Generic license
photo of Coal Creek Falls by Walter Siegmund and used under the Creative CommonsAttribution-Share Alike 2.5 Generic license
fresco at the Karlskirche in Vienna by Johann Michael Rottmayr, in public domain
book covers by amazon.com

1 comment:

  1. Hey, Blogmate. It was great to finally meet you at the NAMI convention. So much to write about. Looking forward to duelling blogs. :)

    ReplyDelete