Recently in Pain Category
In what was a very healing and important post for me, see Blending, the subject of headaches came up in the comment discussion. Someone asked if it was a common issue for people who struggle with dissociative identities, and others chimed in saying it was. So, I thought it would be worthwhile to talk directly about the issue. To be honest, it is not high on my list of symptoms I have to worry about, but as I have thought about it, it has shed light on some other issues for me.
Probably it is not high on my list because I do not consider my pain to be all that bad. This is ironic, because I know full well that pain, whether it is in my body or head or neck or throat, can be absolutely debilitating. Headaches tend to be the most frequent source of pain, but also the least disabling. Body memory pain with its associated flashbacks, by contrast, can have me writhing on the floor and crying like a baby.
My personal take on headaches, for those of us with any chronic dissociative issues, is that they are related to degrees of switching states. There are switches that we flow into and are kind on our system, and these do not usually generate headaches. These, for me, are switches that takes place when we, for example, end up being more playful or funny with our children. As such, they are not really full blown switches, though they can be, but more usually are more of the blending type I talked about in the post I referenced at the top.
But, most switches are highly stressful. And headaches are clearly linked to stress. Psychologically, I label these headaches as switching headaches. The medical language would be tension headaches. The pain can be severe. Sometimes I just go right to medication, depending on what is going on, I will take as a first line, the variant of Fioricet without the caffeine. And try some techniques like guided relaxation and a heating pad on my neck to relax the muscles.
There appear, to me, to definitely be degrees of pain. If the internal stress is bad enough, it feels as though my whole body collapses, and this leads to what I think are migraines. These are the times when I cannot see well, become nauseous, cannot think at all, and the head pain is a different league. These can last a day or more for me. I have heard from others that migraines can last a week or longer. Thankfully, that has not been my experience. I usually can get by with medicating the pain, and forcing myself to sleep. That usually means I take a cocktail of Percocet, Flexeril, and Klonopin.
As I have healed, I have found that these really bad states happen less and less. This leads me to the interesting piece. What is interesting, for me, about all of this is that there are things I can do to solve these pain states without any medication at all, and quickly. I am just not that good at doing this yet, but I am getting better. There have been many times I have ended up in a really bad switch state and in bad headache pain (which is usually accompanied by other somatic body memory pain, like neck or throat pain) and ended up phoning "My Healing Guide." She almost always tries to help me get grounded, and there is always resistance. The miracle is that getting grounded works and solves the pain. And often the solving of the pain happens as quickly as the switch itself.
Now one could look at that data in a couple of ways. One could say that the pain is contained in a part (or parts) of me, and that my getting grounded as me, Paul, still could keep the pain in the part, with the part suffering. I do not subscribe to that theory. I think that becoming grounded helps the whole system, and parts of the system become more at peace (sort of like what I was trying to get at in the "Blending" piece).
In Self Assessment, Part Deux, I talked about how disengaged I felt in the hospital. I had been trying to do what I knew always works. But something was holding me back. I was not making progress.
I found out I am physically sick.
I have known I had been running a low-grade temperature since the beginning of the month. And I have felt achy and run down. Up until this past week, I attributed it all to what was going on mentally. But my symptoms worsened and my temperature went up to over 102F a few days ago. What little energy I did have went away completely and I found myself practically unable to do anything except sleep.
What I want to bring up here is the question: How do we attend to our mental wellbeing when we are physically sick?
My own current situation has increased my appreciation for how truly difficult it is. Paying attention internally when one is severely dissociative is a hard enough task even under the best of circumstances. For me, I have noticed that because of being sick, there is an expected hunkering down of sorts, which means my internal awareness is reduced. My internal parts do not operate in the same way as they do normally. I am not sure how exactly this is all happening. It is as if my system does not have enough total energy for parts to be as active and accessible as they are normally.
The best I can do is be as gentle as possible with myself. And to be "on call" when I feel better so that I can cultivate the internal awareness I know is necessary for "normal" living. For me, that time will come when I am out of the hospital. I see no point staying here any longer if all I am able to do is be physically sick.
I find myself also thinking about those who struggle with chronic physical problems. I have a better understanding of how difficult a road it is for them. I find myself asking how they navigate the rough waters of healing?
Then I started asking how I would be able to attend to my mental wellbeing if I still had current depression or anxiety or suicidality? The reality is I do not have any of those symptoms in any kind of ongoing way anymore. I realize this makes things so much easier. I realize this also means I would not be where I am in my healing. This site would not exist, at least in the manner that it does; its content, messages, and focus would be far different.
Because I know what it is like to struggle with these debilitating issues and deal with ongoing dissociation and trauma difficulties, I try to bring that perspective to my writings here. My being physically sick, helps me appreciate that for many, a lot of what I write here may seem out of reach (or that I am out of touch).
I write to show that while the healing journey can be painfully long, healing is very possible. Anyone can heal. Do not let anyone, including yourself, tell you you cannot. As I have said before, one of my main mantras is: Anything is possible. I believe those words.
To say that I have not been very engaged here in the hospital would be a major understatement. Yes, I did 10 pieces of art over the weekend and had shift in acceptance Monday evening. But that was ephemeral. There has been one distraction after another since coming here, all meant, I think, to deflect against dealing with specific memories.
First, there was the not eating and drinking, which I truly thought was going to take me over, and has not gone away completely by any means. Then there have been troubles with an increasing fever for a week; for me, all physical ailments are a distraction! And yesterday, I deliberately allowed the comments on my last post, a mistake on my part, to distract me for most of the afternoon and evening.
But, in the midst of all of this was the sole group I have been to, I think, since I have been here. Well, it was a combination deal of talk-based self-assessment followed by art therapy self assessment. So, two groups really.
Back in May, I posted Self Assessment, where we used art therapy in group to "represent body sensations, thoughts and emotions contained in a circle." Yesterday we repeated that directive.
I have said before that I believe art therapy is one of the mental health community's greatest inventions for trauma healing. And while I have done many art pieces over the years, I never attempted anything with such vigor as in this piece. I started with the circle, the black circle. Then I put the typical angry colors of red and black to represent surging emotions (a whole host of them) and body sensations (physical pain).
I put gray in there to represent me, the responsible adult (or "coach" if you will) of all of me. I have recently been asked to put myself in artwork. But I did not ever have a color. I chose gray a couple months ago, and it made its way into this image. All the while, I was going back and forth between laying down the interior colors and angrily making the black circle thicker and thicker.
I have heard artists talk about getting into their work and using the medium as a conduit for emotions, and have seen this in movies. That has never really been an experience I have much had, until yesterday. I can certainly say that I have the experience quite often when performing on the piano. I absolutely find it thrilling!
The second part of the assessment was to draw healing colors outside of the circle. The healing colors that are very specific to me are purple, pink and brown. During this whole process, which took only about 15 minutes, I was using the oil pastels so hard that I broke several. Then I immediately grabbed the bits and smashed them into the paper. And, as usual with oil pastels, I used my fingers to blend all the colors. My hands were completely covered in color when I was done.
I think this is the first art piece I have done where I have completely filled the page with color. It was very important for me to do that. I do not know why it was important and do not know what that means.
I rather like the result. And maybe I am more engaged than I think.
In Blending, I talked about how I navigated through Halloween and a short hospital stay which led to increasing my level of acceptance. I almost never leave the hospital so quickly. And probably for good reason. I ended up back inpatient in exactly a week.
What I believed was acceptance was more a mirage. I asked to leave based on what was really only a minute amount of internal communication. It was not enough to leave here confidently. But I did anyway.
While I did well for several days, everything collapsed in a matter of hours. The memories that came to the fore on Halloween, the ones I thought were attended to, came rushing back with a force greater than I could have ever imagined.
As I wrote in the earlier posts, I had been trying to do the work I knew I needed to as an outpatient, but just today I realized why that is so hard. Being a Dad, husband, and working has to be protected on the "outside." This means simply that I am not that willing to allow myself to be vulnerable as an outpatient. While normally this is a good boundary, it can get in the way when a step forward in healing work needs to be done.
This is why I have always used the hospital to help me with these big pieces of work. My time in the hospital has been hard. This is more normal for me here. Physical pain ramps up. I get memory flooding. I lose time. I have difficulty maintaining control. I get little to no night sleep (or sleep all the time).
Stopping eating and drinking, an old coping strategy, seemed like the only way out. The only way to control things. After several days, today I made the decision to begin eating and drinking again. The cost was just too high. And, deep inside, I knew I was just postponing facing things.
Over the weekend, I did a good deal of art. I made 10 important pieces (one of them is shown above). Today with "My Healing Guide," I tried to make sense of them and put them into context. As I did, everything kind of started to fall into place. I saw the 10 art pieces as telling a story. A story I could never tell with words alone. And a story I could never tell outpatient.
We went through the images quickly because we were short on time. And she clearly tried to help me move towards a place of acceptance. This was truly hard for me. It has not been at all easy to accept that some of the abuse was at the hands of multiple bad people (or "organized torture" to use my doctor's words that sent me over the edge on Friday). While, I have always known bits and pieces of these memories since the early 90s, it was always much easier for me to cast them aside. To say that I make them up. To deny.
But one of the biggest lessons I have learned over the past couple years of healing is that to deny sets up massive internal conflicts, and leads to self-abuse that recreates it all. So, really the only path to healing is to accept the truths we hold inside. Today I was telling myself that I would not be going through so much internal struggle and pain and self-abuse if there was not truth to the memories which have haunted me for years.
This afternoon, I did not go to any groups. Instead, I stayed in a sort of sleep-awake state. Processing. I was getting titrated memories and there was some kind of communication going on internally. Most of it was about acceptance. It was interesting that I was not flooded with memories. I cannot even say for sure what the images were. But I am certain I was trying to put everything in its place.
Normally, when I make this kind of progress like today, I say I have done enough in the hospital and start to advocate to leave. But I do not have the sense I am over any hump. As soon as I moved towards acceptance, and started taking in liquids again, the physical pain came back. I will give myself more time here. And I am not certain where this stay will take me. So much has happened already in such a short time.
What I will work on now is to be gentle with myself. To continue to try to eat and drink enough. To accept as much as I can. To not push the memories away, but to contain them safely. I will continue to express myself through art and writing in my journals.
I also know I need to find a way to talk about the overwhelming material outside of the hospital. I know how to do a lot of things. But this is one skill I have not quite mastered. The question for me is: How do I handle the responsibilities of life while at the same time make progress on what is held in parts of me and needs to be addressed and healed?