Saturday, June 28, 2014

Sometimes Your Brain Thinks Thoughts

The brain is a truly complex and amazing organ. It does some pretty unbelievable things that we never have to think about, like regulating the pace of our breathing, our heartbeat, some reflexes, vasomotor activity, plus the obvious stuff like generating our emotions and thoughts. The brain, in conjunction with the nervous systems, reaches out to tell our organs what to do, and to make our bodies move around. Our brain allows us to see, to hear, and to feel. Our brain is so sophisticated that it does what no other parallel processing computing device has ever been able to replicate: it allows us to have consciousness.

Kinda makes it sad that the machines are wasting our potential by using us as batteries, right?

I joke, of course. This isn't the Matrix. Whatever you do, don't take the red pill.

Sometimes, our brains think thoughts. If you think about it, we're thinking thoughts all the time, possibly as an outcome of linguistic capability (it might also be the other way around but, really, who cares). It seems obvious that we think thoughts when we're trying to solve a problem, or planning, or listening, or having a conversation, or learning. We think little thoughts all the time as we ask ourselves questions like, I wonder if I'm hungry? What should I have for dinner? We think little thoughts as we keep up a running commentary on things going on around us. Our brain thinks little thoughts to remind us of things, sometimes by interrupting something else that we're doing to tell us something completely different, like if we're doing the dishes and our brain tells us that we have to go to the drugstore tomorrow and buy more cottonballs.

We think thoughts so often that most of the time we don't even notice them; they're part of the background noise of being human. We take them for granted. In retrospect, part of what I find most terrifying about severe acute depression is the moments where the pain gives way to a nothingness where there are no thoughts. People tell me later that it's like I've frozen staring off into space. Subjectively it feels like time has stopped and then picked back up again, except that it turns out there was a gap with nothing in it. I'm lucky that this tends to last only moments at a time. But the idea that it might be possible for my brain to stop thinking thoughts, even temporarily, is chilling.

But I digress.

Sometimes I have thoughts that I don't feel like I'm in control of. Sometimes these thoughts follow moods, but sometimes they just float into my mind like a passing breeze with no obvious genesis.

I wish I was dead.

I should jump in front of that metro.

I want to stick a carving knife into my wrist and pull it up to my elbow.

Do the thoughts bother me? Yes. Partly because anything I don't control bothers me, and I hate not being in control of my own mind. Partly because the thoughts are scary and bad, and I'm afraid that if they start to hound me I'll end up being powerless against them. Partly because it divides my attention away from other things, like data entry, or looking at pictures of cats, or obsessively replaying my rapes in my mind.

I talked a little bit about the hurting-myself thoughts with my first psychologist, whom I will henceforth refer to as Dr. Radio, because he had the best voice I've ever heard in my life. I could listen to him for hours, even if he were just reading copyright information, because the sound of his voice was so relaxing. Anyways.

When I started to get more depressed in the Fall, one of the things that happened is these thoughts about suicide and self-harm reappeared. I was terrified: I hadn't had these thoughts for years. I wasn't suicidal at all since 2006. I hadn't harmed myself at all since 2009, and not seriously since 2006. When these thoughts came back, I felt scared. I also felt like I'd failed. I felt like I was failing God, Who had given me the miracle of healing me from these ideas. I felt like I was failing myself. I fought against the thoughts for months, by the winter for most of the day, constantly. Both the feelings and the thoughts were painful and overwhelming. I was scared I'd have the thoughts forever, and I was scared because I both did and didn't want to do what they were telling me. I knew that at one point I wouldn't be able to stand the thoughts any more and would give in just to get a moment's peace.

When I was released from the hospital in March, I'd had weeks to think about it, and I knew something would have to change in the way I was dealing with the thoughts, especially since my mood was still pretty low. In a way I was also better off than before I went in, thought-wise, because trying to kill myself did work in the sense that it released a lot of the pressure. It was like taking a cork off a bottle of champagne: Ahhhhhh. Suddenly not so crammed-in and tight-feeling, crushed, unable to breathe. I think that's what they call catharsis.

Over the years, I'd taken steps to try and mitigate the potential impact of the thoughts. I don't keep Tylenol in the house because acetaminophen is shockingly hepatotoxic (that shit will destroy your liver). I don't have a gun, and wouldn't have a gun, because shooting yourself in the head is very bad. I keep stainless-steel blades specifically for self-harm because I can sterilize them with alcohol and, at the very least, avoid cutting myself with anything stupid like a rusty nail or a broken bottle I found in the street. At times, I've had my prescription medication locked up so it was inaccessible and gotten it dispensed weekly.

Obviously, these are attempts to control my environment rather than attempts to regulate the thoughts. Leaving St. Mary's, I knew it wouldn't be good enough because it manifestly hadn't been good enough.

The main thing I decided I would do is that I wouldn't chase the thoughts. It's natural, when you have a thought, to have the corresponding emotions. When a thought is powerful, either in the force of its suggestion or the tenor of its emotional implication, it's easy to get trapped in a cycle of thoughts. One thought follows another in an endless train, pulling along emotions that fuel the thoughts running on and on, a conflagration running like wildfire through the kindling of your mind.

You chase the thoughts, following them, fueling them and, ultimately, allowing them to burn uncontrolled. If you ever do stumble across a wildfire - which I sincerely hope you don't - the way to put it out is really to have it run into barren ground where there's nothing to burn. Chasing a difficult thought around is like throwing barns at a fire while you run away, hoping that it will eat the barns instead of you, all the while making it bigger and angrier and more uncontrollable.

Stop. Take a breath. Acknowledge that you're having a thought. I am having a thought. Okay.

Then let it go. You don't have to hold onto it. You don't have to dwell on it, or try to puzzle out what it means, or let it fill you up. It's just a thing that's happening, and it passes.

Talking about the thoughts with Dr. Radio, we discussed the ways that I felt badly about myself for having the thoughts. I felt like I was a sick person, a weak person, like I wasn't ever going to get better. I felt abnormal. These thoughts, these are illness. But he pointed out that, in reality, people with psychopathology and people without psychopathology both have random thoughts like, I wonder what would happen if I stabbed that person, or, I wonder what would happen if I jumped in front of that train. The research supports the fact that everyone is having these stray thoughts. The difference is what people with mental illness say to themselves about themselves because of the thoughts.

I have a thought about killing myself, and I tell myself that I am sick, that I am a bad person, that I am not capable of getting better, and that I am afraid I won't be able to resist the thoughts. So what I have to learn is not to judge or label myself because of the thoughts. Essentially, this involves noticing that a single thought is actually triggering an entire thought-sequence about yourself that really has nothing to do with the original thought and everything to do with your self-conception. So when my thought-train starts up, I take notice, stop, take a step back, and remind myself that the thought doesn't mean any of the things I'm saying to myself about myself, because the thought is just a thought. It takes a lot of time, and a lot of work, to interrupt thought patterns, but I'm sticking it out.

Recently, after rTMS, I've been feeling a lot better and doing the thought-work is easier, but I'm still having the thoughts sometimes, out of nowhere. It doesn't bother me as much as it used to. I do feel disappointed sometimes that they're not completely and miraculously gone, but then I remind myself that it takes a long time to undo thought patterns. Thoughts, like flowing water, carve grooves in the mind so that future thoughts more easily follow the same path. It's not easy to change the course of a river, and it's not easy to change thoughts, either. You definitely end up with two competing thoughts at once where you're telling yourself, gently, that you're wrong. So, at least while you're relearning, what you're having is not so much different thoughts as more thoughts, as you pile new thoughts on top of the old ones to divert them. I had to decide to be patient with myself.

Talking about my thoughts with my new psychologist, she mentioned that I didn't seem very distressed by the fact that I was having them, so I told her what Dr. Radio had told me and how I was trying to learn not to judge myself. She suggested that I take it one step further and, instead of saying to myself, 'I am having thoughts,' to say, 'My brain is having a thought.' This makes sense on multiple levels: it creates more distance between you and the thought by decoupling it from a sense of personal agency; it creates a gap between the thought and the emotional reaction by framing the experience in the most objective way possible; and it interrupts the thought-pattern by adding a new thought about the thought, namely that you are not the same as your thoughts. This last idea is actually pretty radical - the suggestion that you and your thoughts are not identical, or that you, as a person with personal worth and value, are not made out of your thoughts.

So, if you're looking to change the way your thoughts are running around in your head, I hope you find my tips helpful:

Don't chase the thoughts.
Don't judge yourself for the thoughts.
Be patient with yourself as you learn a new way.
Remember that the thoughts are not you, and don't define you, and will never define you. The thoughts are something that is happening, and that you are living with, and that are giving you an opportunity to change. 

If all else fails, just turn yourself over and look for the little button that you can poke with a pen to force a system reset.

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