Posts Tagged ‘Anger’

Day 2: Life in the TBI Desert

I am up too soon. Like a person lost in the desert who is given a single, precious bottle of water each day, I have to ration my brain energy. I am up too soon.

In the desert that is my mind, my day yesterday was one of gazing about at the bewilderment of the changed landscape. The flood has come and gone. The waters pushed on – dissipating somewhere beyond knowledge.

This flood caught me utterly off guard. It has been years since that happened. For the last four years, I “shut down,” which causes the deluge to simply bounce off me, rather than gather into a violent burst, coalescing it’s rage like a key that unleashes mine.

Factors of a raging Brain Flood
I’ve debated how much detail to go into. I think the details are important for people who genuinely want to understand what brain injury is, so I’ve decided to share some of the underbelly of what life in the desert of brain injury is like.

I often “short circuit” and then shut down when the light flicker or one of our children rushes toward me in glee, waving their creation and love in front of me. In general. That’s one factor storm. What hit me two days ago was multiple factors and before I even realized they had gathered into a threatening cloud, I was awash and being bashed about in their agitator.

Factor 1: I ate bread with potato starch. One slice. It tasted off to me. I should have stopped, but I’d forgotten. This typically takes me a day or two of recovery.

Factor 2: getting “got” by multiple simple things more often throughout the day. This wore my capacity down even further.

Factor 3: An ongoing family challenge escalated due to outside factors.

Factor 4: I don’t even know what it was. It hit and the wash of released adrenaline erased it from the meager landscape of my memory. I was lost to the flood and it was all I could do to make sure the flood never went close to my family.

Life in the TBI desert is different from life anywhere else. The challenges I and other survivors face in our own deserts are experienced by others and they do not even notice it. Just like city dwellers turn on the tap without thinking about it, non-brain injured people filter out the constant barrage of sensory deluge without even realizing it’s raining, let alone flooding.

Recovering from Adrenaline
Recovering from adrenaline when you live in a desert mind teaches me how the earth feels as her tectonic plates grate against each other. WIth the rush of adrenaline and other things released by the flood in my neuro-canyons, the bones of my head and neck collapse upon themselves, forced together by the rush of tension in their surrounding muscles.

I’ve learned to relax them as soon as possible. How? My blood.

I enter the hyperbaric chamber, forcing greater concentrations of oxygen and carbon dioxide into my blood using specific breathing techniques so I do not cause another flood, this time of too much oxygen because over oxygenated blood oddly makes the oxygen inaccessible to my cells. The hyperbaric chamber takes me down to 3000 feet elevation and I breath using the Buteyko Method, to maximize the scrubbing bubble power of my blood. My blood scours my cells for any remaining residue of the flood. THe oxygen scrubs, and the antioxidents and other goodness from my specific diet reach out and grab whatever toxins they see, like a crew of volunteers devoting their Saturday to clearing up roadside trash.

That helps feed the muscles my blood can reach. But what of those constricted muscles? Blood can’t flow freely through constricted areas. How do they get the scrubbing bubbles? I dangle upside-down for several minutes several times a day in an inversion table. This helps stretch out my collapsed bones in my neck and skull. Blood pours into my brain, washing it clean, feeding it. And the tectaunic plates of my skull begin to draw apart, though they give sharp pains of protest as their muscles let go. It is the pain of progress and recovery — oddly welcome

I am up too soon. I do not know what price I will pay. Will I be able to run today? Such questions are the norm following a raging flood of adrenaline. Sometimes I go for days of mornings when I’m up at 2am, crash by 4am, and that’s my day. The rest is, well, rest.

Other times, it looks the same at this point, but the only price I pay is going to bed at 5 or 6 pm instead of 7 or 8 pm. Perhaps this will be one of those days. I hope and pray as I dangle from my inversion table and lay in the hyperbaric chamber.

I do not have enough brain energy to navigate around the newly carved landscape of my mind. Not today. I crashed and work up at 7:30am. No running today. I was up too soon. Perhaps tomorrow.

Create a Safe Haven: Tour of My TBI Sanctuary

One key aspect of brain injury recovery is having a place that is a sanctuary away from the noise and chaos of the outside world, and even from family.

The trick is to learn what overwhelms your brain and do all you can to limit those things in your controled space.

How do you set one up? Pick a room that is quiet. You may want to use weather stripping to sound dampen the doors, and even consider replacing hollow doors with solid ones.

Keep it visually simple, take steps to regulate temperature year round. Wear a hat or sunglasses if direct light bothers you. Use ear plugs to help block out even more sound.

Set up your sanctuary so you can create things, watch TV, read, write, paint — do whatever various life therapies you do.

Do you have a sanctuary? How have you set yours up? What have you found that works for you? Share your wisdom and experience in the comments!

Desert Floods Shed Light on Brain Injury

The river at the bottom of Canyon de Chelly flows gently, offering life, yet the canyon only exists because of her raging floods carving out the landscape

In the latter half of his book “The Secret Knowledge of Water,” Craig Childs objectively, scientifically, and poetically describes his years of experience studying floods in the desert Southwest.

People who have lived in the desert, he explains, know that the desert is designed for one thing: to carry water. Vast amounts of it in a very short time.

Unimaginable under the baking blue skies often even minutes before it happens, vast, concentrated storms gather rapidly and unload water that falls in poolfulls rather than rain drops.

He described one flood that tore through a Utah town, putting it under feet of torrential, raging water. He could tell most people weren’t from around here because they said things after like “I thought this was the desert.”

Intentionally placing himself at the gathering place of tributary canyons beneath the watershed of a current storm in the Grand Canyon, describes the sensory onslaught of the flood as he stands on a small ledge a few feet above it, witnessing its deluge unfold all around him, as waterfalls toss cottonwoods and 40 ton boulders around him into the cacophony that will continue down canyon, eventually to the Colorado River. He might as well be describing what life is like with brain injury in a world full of stimulation, in which the flood of sound, light, motion, smells, tastes, thoughts, and touch tries to fit down steep, narrow, clogged neuro-canyons of my mind.

It was as if the scaffolding of the planet was coming down, the bolts and metal sleeves of time and phsical structures snapping apart, planks caving in. Wind sheeted up from the canyon floor, propelling mud and mist straight up the wall and against my face, through my soaked clothes.

You could not shout over this sound. It was like gritting teeth and clenching fists. It was the sound angels make as their wings are torn off. Occasionally a single sound stood out: the smack of a boulder, or the sucking of a thousand gallons of water finding a new path. Most individual sounds were felt only through my feet or up the bones of my arms. Breaking boulder made sharp clacks. The low-pitched sounds were those of larger rocks, and when I heard these I backed against the wall in case the earth should split open here. It is simply not possible to stand limp before something like this. The muscles in my neck stood out.

I have often though tat trapped on a shelf in a flood, a person could go insane, waiting for the flood to lift and take the ledge…

… It became difficult to carry a thought for more than a couple of seconds. My senses jerked back and forth as if I were being dragged.
-Craig Childs, The Secret Knowledge of Water, “Fear of God”

I could be reading a description of the experience I have walking through our sleepy mountain town in winter. Change boulders and cottonwoods and waterfalls to wind chimes, passing cars and trucks, and people waving hello.

As epic as they seem from within their throughs, they are a common occurrence. Their raging abnormality is, in such a landscape of the desert and the TBI brain, normal.

In such a flood, gathered atop a ledge surrounded by steep canyon walls being epically reshaped by water’s rage, a person could hardly be blamed for entering a rage themselves simply to handle the onslaught. Raging screams swallowed by bashing boulders. Fists pounded into walls a mile thick. Shrieking and howling. Now, imagine that person surrounded by a crowd of people, none of whom see the flood. The flood is in the neurons of the person’s head, smashing it’s way through their neuro-canyons, unseen and unheard by any but them. For everyone else, it is clear blue skies, normal, quiet life. There is no onslaught. Just a crazy person pounding walls screaming as if the world has come unhinged.

Brain injury is a flood in the desert that swallows one person, surrounding them with an experience only they have. Yet they appear untouched to those around them.

How much more like a desert flood is brain injury?

Like those who do not live in the desert have a hard time imagining floods in places that have not seen water in several years, it is hard to imagine life with a brain that cannot handle light, sound, smells, tastes, and touch that seems insignificant.

In the face of such ignorance, people who talk of floods seem crazy, as if they are blowing things out of proportion, possibly simply desperate for attention. They desperately seek solace by making those who speek of floods psychologically unstable, as people unwilling to work in a perfectly workable environment (What?! How?! We’re in the middle of a flood! When it subsides, there will be another!) Crazy.

TBI Anger and Rage: What it is and what to do about it

Raw, Primal Protective Reflex
TBI anger is unlike any other kind of anger. It taps into our primal instinct to protect ourselves, like any wounded, cornered animal, with a burst of adrenaline. This is the source of the raw, primal strength, energy, focus, and coordination. Once it hits, it can not be stopped, only redirected in a safe direction.

Why does Primal Rage Happen in TBIers?
It’s a primal response we have to protect us from sabertooth tigers and other immediate physical threats. For most of us, those do not regularly exist in our world, but our biology interprets the onslaught of overwhelming input on our brain as an imminent threat. Our biological reaction kicks in, releasing adrenaline. But there is no immediate physical threat. So we often (and very wrongly) assume those around us must be the imminent threat. This is why some TBIers are verbally or even physically violent to those who love them. The truth is there is no threat. The “threat” is damaged neural connections inside our brain that make it so we can’t handle input from our own senses.

How to Handle TBI Anger
First, it’s important to know that typical anger management techniques do not work. They fail to recognize that the anger happens because of damage to the brain.

Second, trying to reason with someone in a TBI rage only makes it worse. Why? Because in their focused “fight or flight” state, you are standing against them and are thus mistaken for the immediate threat. Not accurate, but still what happens.

There is, however, hope.

First: Make sure everyone is safe
If the TBI anger bursts get physically directed at people, get immediate help until the survivor learns to direct their rage in a safe direction. If you feel like you are in danger, you are. Getting safe may just be the motivation your TBIer needs to learn how to address their rage

Second: Create a Sanctuary
A sanctuary is a room set up to minimize the stimulation on the survivor. Mine has a sound dampening door, increased sound proofing between me and the rest of our home, and is where I do most of my writing and other creating.

Sanctuary is where I go to recover when TBI rage hits.

Third: Learn to Direct your Anger Safely
This is challenging, but as we’ll see it cooperates with our natural biology

Pay attention to what it feels like immediately before an anger burst. When you feel it coming on, drop everything you are doing and get to your sanctuary as safely and quickly as you can. Do not engage the people or animals around you or who happen to be in your way. If you must hit something, hit a wall or slam a door. Doing these things gives your adrenaline somewhere to go. when you get to your sanctuary, crash and recover.

Why this works: This is your fight or flight response you’re experiencing. It either wants to fight the immediate danger, or flee to safety. Your sanctuary is safety, so its natural to direct your rage toward safety and away for harming others. Trying to stop the rage (you, or those around you) only makes it worse.

This is something you can learn to do fairly quickly. It is also the stepping stone toward learning the next step, which can take years to learn. In the meantime, whenever your rage hits, directing it’s purpose toward getting you to safety will keep you and those you love safe.

Forth: Learn to “Shut Down” rather than Rage
If the last step was hard, this one is even harder. The previous step at least had biology on it’s side

Once it starts, there is no stopping a TBI rage other then letting it run its course. I know. I tried for years. THe trick is to stop it BEFORE it starts.

We only get one shot at this with each anger burst. The window of opportunity to stop the rage is when I know it’s coming but before it arrives. Typically this is far less than a second.

Remember how step three above was a stepping stone to this step? Learning what it feels like immediately before the rage burst is key.

That feeling of impending rage is my “trigger” to shut down. Like a robot. whatever I’m doing, I simply slump to the floor and turn off. I do not move until help comes to help me to my sanctuary.

Doing this is a pure act of the will. Nothing in our biology tells us it’s good to shut down in the face of danger. But the benefits of doing so are numerous.

First I don’t verbally or physically threaten anyone when I’m shut down. I’m a completely non-threatening lump on the floor.

I’ve taken years to reach the point I can feel it and choose to “shut down” rather than let the rage hit. This takes a lot of work and effort to learn what it feels like immediately before the rage, and choose to make that a trigger that always, without question, causes me to shut down. If I think about it, it fails. And sometimes the rage is too fast for me. But for the most part I am able to now shut down.

Why is “shutting down” better than a rage? First, rage doesn’t benefit anyone. Second, the rage never happens. The adreniline is never released. I don’t have any burst of energy to deal with, no “crash” after the adreniline wears off, and no 2-3 days or more of recovery from the rage itself (let alone whatever overstimulation caused it). My muscles do not constrict, lmiting blood flow to my brain, causing more things to overcome to recover.

Shutting down is the right thing to strive for. It’s also amazing hard. It took me years to reach the point that it is my natural response to impending rage. As soon as I feel my brain getting overwhelmed, I shut down. I do not think about it because if I do, it’s too late, and I’m back to fleeing to my sanctuary in a rage. Hard as it is, shutting down is well worth learning.

What is your experience with TBI rage? How have you handled it? What have your found works for you or your survivor? Use the comments to share your experience and wisdom.

TBI Anger Bursts

Anger bursts. Rage. Tantrums. Call them what you will, they seem to appear out of nowhere and rip the reins of control away. We find ourselves doing and saying things we would not choose to do or say.

TBI anger bursts are a very different animal from the anger traditional “anger management” techniques know and understand. In short, traditional anger management techniques do not work with TBI anger. Which begs the question: What is TBI anger?

TBI anger bursts result from the brain feeling so under attack by the world around it that it triggers the primal rage in self defense. To the outside world, it looks like nothing has happened, and like the brain injury survivor is bursting into a rage for no reason.

The outside world, however, can not see that while the survivor looks like they are on planet Earth experiencing the same things as everyone else, in reality they are on planet TBI. Planet TBI had different laws of physics. On planet TBI light, sound, smell, touch, indeed any sensory input is a weapon. So while it may look as if I’m suddenly angry because the sky is blue, in actuality my brain feels like it’s cornered and under fire because there is a loud rumbling trash truck outside lobbing sound bombs into the middle of my head. Seeing no way out, my primal instinct kicks in, and I respond as a wounded animal — lashing out at anything close. Typically those who care for me are closest.

Real, Physical Danger
Brain Injury anger bursts can be dangerous to both the survivor and those around them. Unchecked and allowed to run rampant, they make the TBI survivor a danger to themselves and others. If you are a caregiver and do not feel safe because your survivor can not direct their anger in a safe direction when it hits, GET OUT. Get safe. Seek help.

If you are the survivor and you are placing others or yourself in physical danger because of your anger bursts, get help. Find ways to safely direct your anger. Find ways to stop it before it happens. The suggestions below may be helpful. The safety of those you love (including yourself), depends on you doing what seems impossible. Through grace and faith in God, all things are possible and you can do this, but it won’t be easy.

Foul Language
When an anger burst hits me, I instantly have a mouth that would turn the most seasoned sailor green. In that moment of rage, I’m too blindly stupid to know it’s my TBI I’m angery with, not the people around me. My dear, blessed wife has endured a lot of horrific things said about her. Thankfully she knows I’m really talking to my TBI, not her. But I know it still hurts her. We’ve worked hard so our children know I’m mad at my TBI, not them or their Mama. This is the reason I’ve worked so hard to find ways to avoid anger bursts in the first place. If you choose not to, you will likely lose those who love and support you, as they will be forced to protect themselves by not being around you.

How to Address TBI Anger Bursts
There are several steps you can take to minimize the anger, direct it in a safe direction, and (eventually) prevent it from occurring. These took me multiple years to learn and impliment well, and I still occasionally fail and have an anger burst — but I even then, I am able to direct it safely toward the inanimate.

1. Create a Sanctuary.
A sanctuary is a place that is yours, where you control the environment as much as possible and needed. It is the place you go to recover when your brain gets overloaded. It is the place you go to work, think, and concentrate on activities that you can’t do with distractions.

See a detailed article on creating a sanctuary here. [LINK]
Learn about creating a portable sanctuary when you’re out and about here. [LINK]

2. Learn to get yourself to your sanctuary safely when anger burst strikes
Your sanctuary is where you go as quickly as possible when you feel the potential for an anger burst, or get caught off guard and have one hit. If that happens, you one goal is to get safely (for you and those around you) to your sanctuary and begin recovering.

3. Learn to recognize the “weather pattern”
Anger Bursts are a lot like thunder storms. They can strike fast, unexpectedly, contain damaging winds and lightening strikes and tornados, leaving a path a destruction in their wake before they dissipate like they never existed.

Like thunder stormes, anger bursts happen under certain, very predictable conditions. Learn to recognize these conditions and what they are for you, and you know when you need to get yourself to your sanctuary BEFORE the anger burst happens.

Keep notes in your journal about what is happening around you when an anger burst happens. What did you feel like immediately before? As a possible way to help you get started, here’s what I look for to issue myself an “anger burst warning” and get to my sanctuary:
— I feel brain fatigue. This by itself is enough for me to need time to recover in my sanctuary. Pushing it at all at such times only invites trouble.
— External chaos. More than one conversation, flashing light, loud noise, someone smoking a cigarette or wearing perfume. These all rapidly create brain fatigue and thus the need for my self removal to my sanctuary.

4. Learn to “Shut Down” when your fuse is suddenly short.
If your anger bursts are at all like mine, when they strike, it’s all you can do to remove yourself safely to your sanctuary. Along the way a door gets slammed, a wall bashed. It’s uncontrolled rage pointed in the safest direction possible. If only there was a way to “cut it off at the pass”! There is, but it is hard. It’s the hardest thing I’ve learned since becoming brain bludgeoned.

In the moments before my rage hits, when something “short circuited” me out of the blue, or I was pushing it to be where I was out in public, I’ve learned to see that my fuse is short and burning. I simply turn myself off. I literally go limp, slumping down wherever I am. On the floor, in a chair, wherever. Then I wait. Generally I’m with someone who knows and understands my disability (typically my wife). They see what’s going on and come help me get to my sanctuary (portable or permanent).

In the event no one is there, or well meaning passers by try and help (but only make things worse by adding stimulation), I have to slowly work (and direct them to help me if needed), to get to a temporary place where I can recover at least enough to call someone who knows how to help me.

5. Over time, as you find things that help increase the stability of your brain energy, these bursts of anger will become less frequent. Combined with your ever expanding knowledge of how to forecast the weather, and life will be much simpler and easier.

Deacon Patrick’s Round the World Progress

Deacon Patrick's Round the World Progress