Persevering through Uncertainty, Hesitancy, and Doubt

Coming up on my three year anniversary for attending weekly therapy has been confronting to say the least. While I acknowledge immense improvement and growth, I also acknowledge cyclical behaviors and patterns that leave me feeling like I've made little progress.

I had ended my work day at the shop, in a ball on the floor, next to the embroidery machine, with my wife asking if I was going to be okay. I was spiraling, again. A familiar mixture of irritation, shame, anger, sadness, guilt, and confusion. The drive home was quiet. I matched the silence with shallow breathing as the tears rolled down my face. What I'm left with once I'm no longer spiraling and lashing out is equally overwhelming. Immense sadness, confusion, and grief overcome what moments before had me kicking a stack of cups across the room in rage. As the tears stopped, I once again found myself feeling like I had made no progress at all, and questioned if I need more support than what I've been allowing myself to receive.

For some time now, I've been filled with anxiety, self-doubt, paranoia, confusion, despair, shame, denial, and anger. Some days are much worse than others. Frequent unpredictable emotional and behavioral reactions with moments of complete shut down, disrupting daily activity and responsibilities. Some days are filled with playfulness, joyful singing, and a sense of pride and productivity, leaving me feeling like there's nothing wrong with me at all. But then I remember the bad days, and the cycles I've documented for years. The switches as I used to call them. Feeling absolutely out of control one day to completely level headed the next. Questioning how to move forward includes weighing all options and being open to whichever resources will be best suited for this time in my healing.

While I've spoken to my therapist in the past about the idea of being medicated, I've remained quite hesitant to actually do so. I've been determined to do the healing work without medication - to get to know myself and learn how to calm and manage myself without the aide of resources outside of myself. That mission has been extremely important to me since I began therapy. On day one of stepping foot into this stranger's office, I shared with her that I have always struggled with anxiety and depression, that I have a history of substance abuse, that I experienced a severe dissociative episode in 2017, and that it was all likely due to the traumas I've experienced but never spoken about. I told her that I mask, I numb, I run, and I avoid, but that I was ready to be honest with myself, share my traumas, and do the work to heal. I wanted to do all of that without a substance potentially altering my brain chemistry in any way. For the first time in my life, I wanted to allow myself to feel the things I had been working so hard to mask, numb, run from, and avoid. Three years later, while immensely proud of the progress I've made, I'm pretty exhausted to say the least. Going through these chaotic cycles has been incredibly difficult to manage, put words to, and learn from, which I realize is why I used to numb and self-medicate so heavily.

There was something about this last episode though that had me really questioning if I need the additional assistance of medication or something else to be less uncontrollably reactive while trying to execute daily tasks. Despite all the work I've done in therapy and through writing, the knowledge and skills I've learned are separate from me in moments of distress. I can't always seem to access them regardless of how mindful and aware I try to be.

Since I began therapy, I've purchased many books - some of which have helped me immensely while others have yet to be cracked open. One book in particular is referenced at some point during every support group meeting, and has been recommended to me by countless individuals. For years I've had the book, but have been hesitant to read it, as I knew it would be a lot to take in. Perhaps too confronting. Confrontation brings awareness. Awareness brings knowledge. Knowledge presents the call to action - the decision to absorb and utilize the knowledge or to deny and run from it. The book: The Body Keeps the Score by Bessel Van Der Kolk, M.D.

The Body Keeps the Score is the inspiring story of how a group of therapists and scientists— together with their courageous and memorable patients—has struggled to integrate recent advances in brain science, attachment research, and body awareness into treatments that can free trauma survivors from the tyranny of the past.

Exhausted and overwhelmed by the reality of the healing of trauma, questioning if I need to be medicated despite my hesitation, and feeling confused by the myriad of options before me, I grabbed the book off the shelf Saturday morning and finally cracked it open. A few days later, I just finished page 47 and have highlighted probably 38% of what I've read so far. Some parts have filled my eyes with tears, some have caused my heart to race and sweat to drip, some have made my jaw drop - all in awe of how my inner world and experience aligns with what is being explained through patient stories and science with eye opening empirical evidence.

In the first few pages, Van Der Kolk details the three avenues to potentially "palliate or even reverse the damage" resulted from trauma:

1) top down, by talking, (re-) connecting with others, and allowing ourselves to know and understand what is going on with us, while processing the memories of the trauma; 2) by taking medicines that shut down inappropriate alarm reactions, or by utilizing other technologies that change the way the brain organizes information, and 3) bottom up: by allowing the body to have experiences that deeply and viscerally contradict the helplessness, rage, or collapse that result from trauma.

These words struck me, as I knew I had been taking the first and third avenues for three years now through therapy, group, writing, and sharing. For nearly ten years, since I had last regularly taken an antipsychotic, I've been adamantly opposed to option two. Almost shaming myself for considering it, thinking that it would shut down my ability to feel and do the work necessary to heal. Being medicated can feel like constant numbing, which is my biggest fear. I'm starting to realize that while that can be true, medication can also provide the necessary boost in serotonin levels required to allow for less reactivity. The proper medication and dosage can help a person still feel the emotions without spiraling out of control, allowing coping skills and tools to be utilized in the moment as opposed to being separate from them until the moment has passed. Ideally this minimizes disruptive cycles, which can allow therapy focus to return to other needed areas rather than managing day to day struggles.

Normalizing prevents future shame.

I'm so thankful I decided to pick up this book and read the insightful words of a world renowned psychiatrist and trauma specialist, who acknowledges that most people require a combination of the three avenues to find healing. I'm eager to lean into, read about, and explore the second avenue more. First, I'll look into what all encompasses "other technologies that change the way the brain organizes information." Perhaps he's referencing biofeedback, which I have yet to explore and consider.

Van Der Kolk goes on to say:

I am continually impressed by how difficult it is for people who have gone through the unspeakable to convey the essence of their experience. It is so much easier for them to talk about what has been done to them - to tell a story of victimization and revenge - than to notice, feel, and put into words the reality of their internal experience.

Since I started therapy, it has been incredibly difficult to notice, feel, and put into words the reality of my experience, but damnit I'm proud of myself for every word I've spoken or written and have been brave enough to share. I'm proud of every penny I've spent out-of-pocket on therapy and resources to notice and name the experiences that have consumed me for so long. I'm proud of myself for every group session I've attended to find support and gain a sense of identity in a community that experiences similar battles. I'm proud of myself for considering all options, taking my time, and being honest with myself and others throughout the process. Living with trauma can feel extremely isolating and shameful. It can leave you feeling withdrawn, broken, and hopeless. The path to healing can seem impossible with no end in sight. The more I allow myself to learn, try and fail, and share throughout this process, the more in control I feel in the healing of trauma and the less I want to deny or run from it.

I've felt very hesitant about what steps to take next, but I'm already finding that this book is providing insight and inspiring confidence in moving forward. As I enter the next phase of my healing journey, I'm incredibly thankful for the endless invaluable resources that others make their life mission to share with the world.

Together we find healing; we find being well.

Wishing you strength and confidence as you persevere ♥️