zanzoken's journal

[zanzoken]

This is my journal.  I started it offline a few days ago but figured I might as well post here.  Others are welcome to comment as they see fit.

All the best to each and every one of you in your continued healing and recovery.

[zanzoken]

I started my journal using the ICD-11 definition of Complex PTSD as my frame of reference.  Though each of us has a unique trauma story that has affected us in an individualized way, having a framework through which to view and analyze my condition fits well with how my brain likes to organize and process information.

These definitions may not be exhaustive, but they are a good starting point, and I can fill in any other important details as I go along.

[zanzoken]

Post traumatic stress disorder

Post traumatic stress disorder (PTSD) may develop following exposure to an extremely threatening or horrific event or series of events. It is characterised by all of the following:

1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares. Re-experiencing may occur via one or multiple sensory modalities and is typically accompanied by strong or overwhelming emotions, particularly fear or horror, and strong physical sensations;

2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event(s); and

3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises.

The symptoms persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

[zanzoken]

Complex post traumatic stress disorder

Complex post traumatic stress disorder (Complex PTSD) is a disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g. torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse).

All diagnostic requirements for PTSD are met.

In addition, Complex PTSD is characterised by severe and persistent

1) problems in affect regulation;

2) beliefs about oneself as diminished, defeated or worthless, accompanied by feelings of shame, guilt or failure related to the traumatic event; and

3) difficulties in sustaining relationships and in feeling close to others.

These symptoms cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

[zanzoken]

What I am working on at the moment is to go through each of these six symptom classes, one by one, and journal on how they manifest in my own life.

This will help me create a record of how I feel in the present tense, and also highlight areas I need to focus on in my recovery work.

[zanzoken]

Re-experiencing past trauma in the present (RE)

Memories and Flashbacks

I don't know if I have flashbacks, per se.  What exactly constitutes a flashback?  I know that I have memories, some of which are extremely painful.   In fact, in recent years I have noticed that my mind often seems fixated on the past, more so than at any time before.  I'm often flooded by memories in a way that could be described as intrusive, involuntary, or reflexive. 

To give a rather innocuous example, my ex-girlfriend and I once took a vacation to the Grand Canyon, so anytime I see the Grand Canyon or someone mentions it or anything related to it, I immediately think of her and our trip and replay it in my mind in vivid detail.  Then I inevitably recall something painful about that relationship and how it all went wrong... almost as if the two are inextricably linked.

This happens with all kinds of topics, good memories and bad, extraordinary or mundane, with great frequency.  But is it appropriate to say those are flashbacks?  I'm not sure.  Regardless, it feels like my brain is clinging to the past, and old associations have a sort of timelessness to them, as if they are more recent than they actually are.

Nightmares

It's not uncommon for me to have dreams.  They are almost always distorted and nonsensical, and often painful or scary.  A few times I've had vivid dreams where I'm intimately involved with someone I know I shouldn't be (i.e. a good friend's wife).  I've also had a few dreams involving someone who, in the dream, I characterized as the Devil... when I woke up from those I recall feeling deeply distressed.

I also have a recurring dream that involves my teeth breaking and falling out.  There isn't any consistent context to it... it just starts with me noticing in the dream that one or a few of my teeth are loose, the way a child would experience tooth loss.  My teeth then start to fall out, or shatter and crumble, or I reach up to touch one and it pulls out effortlessly.  And in the dream I feel afraid and confused, because I know I am an adult and my teeth are supposed to be permanent. 

I had this dream for the first time many, many years ago, and I have lost count of how many times I have had it since.

[laurels]

Hi zanzoken, what a smart and self-aware way to organize your journal and healing journey, hopefully it will make things smoother and easier to go through. I'm getting inspired to investigate how I process information now.

And I've had the teeth-falling-out-of-my-mouth dream so many times myself! Sometimes it was scary in the dream, other times perfectly mundane/commonplace. I stopped having those dreams a while ago, I wonder what they could be connected to, how universal they are...

Best of luck on your methodical adventure!

[zanzoken]

Thank you, laurels.  I appreciate the kind words.  I am without a doubt a denizen of order... perhaps too much at times.  But in this case I hope it will prove to be an advantage in probing the nature of my condition.

That's interesting that you've had the same dream, and curious how yours have stopped.  In the current book I'm reading (it's The Body Keeps the Score, which I have come to believe is a seminal work in the trauma field) the author states that dreams are part of how our brain shapes and integrates memories.  Here's the relevant passage:

Today we know that both deep sleep and REM [rapid eye movement] sleep play important roles in how memories change over time.  The sleeping brain reshapes memory by increasing the imprint of emotionally relevant information while helping irrelevant material fade away...

... Dreams keep replaying, recombining, and reintegrating pieces of old memories for months and even years.  They constantly update the subterranean realities that determine what our waking minds pay attention to.

Perhaps your dream was an artifact of something your brain was trying to work through, and it eventually succeeded... so now you don't have the dream anymore.  That's just speculation, of course, but it's interesting to consider.

[laurels]

If that is the case, then I really can't tell you what, if anything, I was trying to consciously work on! It's been a while since I've had them. I know this series of dreams completely replaced a previous series of sort of stress-dreams ("need to go somewhere urgently but I don't know how to drive").  But I've stopped having both, so they can go away without you completely identifying the source. It would be very interesting if you ever uncover yours.

[Not Alone]

I've had the "teeth falling out" dream several times too. Interestingly, when I was listening to the radio recently, they were discussing that type of dream. According to whatever research they were looking at, it is a fairly common dream.

[zanzoken]

Thank you, notalone, for sharing.  It's interesting that so many people have the same dream. 

I did some googling and it looks like this has been researched to some degree, and they found these dreams to be more related to dental issues than psychological ones.  I have always grinded my teeth in my sleep and have had teeth chip off and break in real life too, so that probably explains it.

[zanzoken]

Avoidance of traumatic triggers (AV)

I don't really know if I get triggered by certain things.  Rather, it seems like avoidance manifests in my life as a sort of default state of mind.  I can spend hours upon hours on mindless empty pursuits such as playing video games, watching TV or Youtube, or browsing and posting on internet forums or social media.  It's not that I necessarily get a lot of joy out of these things, but more that they provide a sense of comfort and relief from my constantly churning and racing thoughts and emotions. 

On the other hand, I find it very difficult to maintain any level of focus or consistency in the important areas of my life.  I can usually manage short, discrete tasks (for example, doing laundry or keeping the house clean) but I struggle immensely with longer-term goals that have no immediate payoff (like going to the gym).  I have a tendency to put things off, come up with rationalizations for why I can't do things, or get overwhelmed by negative emotions.  This has affected me severely in areas like my career, relationships, and personal care (diet and exercise).

Trying to confront my mental health issues directly often brings these sensations to the forefront.  If I sit down to read, journal, or meditate, my brain often feels like it would rather be anywhere else.  I get distracted very easily... in fact, as I write this, I am having to constantly fight the urge for my attention to divert.  Another frequent occurrence is I get struck with an overwhelming sense of exhaustion and emotional fatigue, usually to a point where I feel like I have no choice but to go lie down and rest.

[zanzoken]

Persistent sense of threat (SOT)

Hypervigilance

I feel like my brain is always switched on.  It's like a neverending loop of perceiving and analyzing everything I come into contact with.  In some ways it is a good thing.  I feel safer having high spatial awareness, and it's exceedingly rare for me to forget, lose, or overlook things.  But it is also distracting and exhausting. 

For example, I went to the park yesterday to read, but I couldn't bring myself to feel safe enough to relax and focus on my book.  There were too many people and sounds.

However even when I am in a safe place with fewer irritants, such as being at home, I still find it hard to just feel calm.  My mind still races, recalling the past or visualizing the future, relentlessly scrutinizing inside and out.  Even in complete stillness the hamster wheel rarely stops turning.

Heightened startle response

I have a difficult time with certain external stimuli.  Bright lights make me uncomfortable, particularly if they are very white or garishly colored.  I feel the calmest around warmer tones, earth tones, or pastels.

Sounds are even worse.  Loud noises heighten my sense of unease, even making me angry sometimes.  The worst by far is dogs barking.  My ex-girlfriend and I adopted two dogs together and one of them would bark every time it heard a noise outside our apartment, which was often.  It would also bark at me every time I entered our home, which was unsettling and stressful for me.  I avoid dogs as much as possible now.

I generally have a low tolerance for chaotic places and situations and I make it a point to avoid them whenever possible.

[CactusFlower]

Zanzoken, I totally resonate with what you say about sound. Overstimulation has always bugged me, but I thought it was just the Fibro and being "sensitive" before. I can't stand restaurants with ambient tvs or music often because between that noise, the normal noises of the place, and all the people talking, I can't clearly hear whomever I'm with and it starts to exhaust and irritate me. Crowds are bad too, but a part of that is only being 5 feet tall. Can't see over everyone AND can't hear? Nope outa there. I personally think it contributes to the hypervigilance, because we're also then looking for ways to escape that as well as everything else. Hugs

[zanzoken]

Thank you CactusFlower for your reply.  I'm sorry you deal with many of the same challenges with regard to overstimulation.  I agree with your comment about hypervigilance too.  I know I expend a nontrivial amount of mental energy every day trying to avoid situations where I fear I will be overwhelmed.