vendredi 3 mai 2019
PTSD Is Like Being Caught in a Battle Between My Brain and Body
The following is an excerpt from What a Body Remembers: A Memoir of Sexual Assault and Its Aftermath, available for preorder now.
Almost daily I go for a run. Nothing crazy, just four miles. It's how I break up my day. Running brings a brief calm, quiets the incessant chatter of my mind. Running, if I'm honest, is my only source of pleasure.
On these little jogs I wear my tattered Cal Bears cap, the navy blue worn and faded, the thread of the gold scripted Cal loose and frayed. At least once a week it earns a shout out from some passerby of "Go Bears!" Because that's what one Cal Bear says to another Bear by way of greeting. Usually I forget I'm wearing the cap and as my brain fumbles, I've already passed the person before I can muster a meek "Go Bears" in return. If my husband is with me, a man who spent the period that made up my college years playing bass in heavy metal bands on Sunset Boulevard in Los Angeles, he will cringe with embarrassment over the nerdiness of this exchange.
Today I am alone and I try to be conscious, to connect with my surroundings, to feel a gratitude I rarely register anymore. I follow the winding concrete paths of Balboa Park, trying to focus on beauty. Sun filtering through trees bending in the breeze. Black crows cawing. Happy dogs trotting along on flex-leashes. I am trying simply, desperately, to be present in my own life.
Running along, the ball of my foot rolls over concrete in rhythmic steps and sweat soaks the nape of my neck, wetting the edges of my tattered cap. I pass the Parks & Rec men, waving as I always do, envying them for their jobs. Maybe not a lot of money but a steady paycheck, minimal hassles, a good night's sleep, and a tidy pension from the city after thirty years. Not bad.
Panic flutters in my chest and my mind fights.
The path twists and I reach the place where I am all alone in the thick nest of trees where the grass flanking the path becomes invisible, covered in fragrant beds of pine needles. All around me is silence. I focus on my connection with the path beneath my feet, rolling forward, shifting my weight from foot to foot, grounding me to the earth, repeating in a tempo that feels like a song.
The breeze startles the leaves and I search side to side, making sure I am still alone.
Then another sound intrudes. Ten yards behind, the taps of another's jogging footsteps, pace steady, growing louder as they near. A runner's breath exhales in beats matching the sound of shoes hitting concrete.
Panic flutters in my chest and my mind fights. My brain knows with near certainty that this person means me no harm. It's a runner. In a park. Just like me. But my body refuses to listen and as it takes control, I am seized.
Something inside begins to choke me, squeezing my lungs. The ground beneath turns unsteady, the horizon starts to swim and the tingling, visceral as nails scraping chalkboard, starts at the base of my spine. It begins slowly, above the tail bone, a tornado of nerve endings rippling, rushing up the base, swelling at the middle of my back. Like a shiver of a tambourine, it rattles, transmitting a message from the deepest place, tumbling into a spasm of panic, meaning spilling across flesh. I own you, it says.
The tornado keeps rushing, rolling, all the way to the base of my sweating skull where it pulses. A surge sends pinpricks to my hands and I can no longer fight the urge to swing around, to set eyes upon the person making the footsteps sound, to make eye contact, to satisfy my body, to calm this storm.
As I relent, permitting my head to whip around, I strain to appear casual, knowing I have failed miserably the moment I see the look on the other runner's face. He's a twenty-something man with a buzz cut, sweating in his Navy cadet uniform of blue shorts and a t-shirt. He raises a palm in apology, "Sorry to frighten you, ma'am," he says, then continues past, giving the crazy panicked lady a wide berth. And it's only as he runs on ahead in front of me that the air begins its return to my lungs.
The ball of a foot colliding with concrete, a simple slapping sound. How can that evoke fear? How can something that happened so long ago hold so much power? And how can it wield that power after lying dormant for so many years? Every day pieces of memory fade away and die. But not this. It's an involuntary memory, a madeleine of terror, an ingrained sensation of before and after.
It makes no sense. In nearly fifty years on this planet I have heard footsteps slapping pavement behind me - What? A million times? Only once has that sound led to terror. Once. That night is just something that happened, something to catalog as I tally the unexpected things I've experienced in this life: sitting in a Manhattan conference room preparing to take a deposition, then watching a plane fly into the World Trade Center. The betrayal of a spouse. Losing a home and life savings. A car accident unfolding in slow motion, a crash certain to have killed me if a city light pole had been situated only seven inches farther east.
There is something unique about the sound of footsteps. His were the slap of rubber soled tennis shoes hitting concrete as he jogged along the sidewalk toward the entrance to my building, inscribing a message into the ground, like writing one's name in wet concrete. Perhaps it's his own special way of reminding me, of promising he'll always be with me, even if it seems he has disappeared for some years. Could I have known I would never forget? That he would arrive again and again at times of his own choosing, forever lodged inside my body? Each time it happens my body speaks to me, telling me the shadows of my past have not disappeared. Our lives intersected so briefly, but he has stayed with me. His footsteps inhabit my body. How do I get them to stop?
For years it came and went and I dismissed it as a minor annoyance. But as the triggers keep coming, triggers that attack when I'm at my weakest, I start to think. What if I'm missing something? Missing a piece to the story of my own life? What if that incident had transformed me even if I've refused to allow myself to believe it? If this still happens thirty years after the fact, what if my body is in revolt? What if it's responding because I insisted on blocking the trauma, refused to allow myself to process the impact of my assault, betrayed myself by lying, by insisting I was fine. Maybe the more we try to forget the wounds of the past, the tighter they grip us. Perhaps my body is shirking my mind's refusal to do something with these memories. Perhaps it's time for the mind to finally come around.
In 1984, the term "post-traumatic stress disorder" or "PTSD" was not in common use. It first appeared in the DSM-III in 1980 and its definition was limited. In 2014 it's everywhere, a label for veterans of yet another war, for the millions of people in this world who have suffered disaster.
The American Psychiatric Association defines PTSD as a reaction to an extreme traumatic event. Primary symptoms include increased arousal in the form of insomnia, impaired concentration, or persistent hypervigilance. Factors that predict development of PTSD include personality traits of high neuroticism and poor self-confidence. Another factor is family characteristics and yet another is the environment for recovery. Lack of support from family, friends, and community can make a victim feel alone and helpless. There is also considerable impact where a victim is disbelieved and where there is "secondary victimization" such as where the police or lawyers or jurors or prosecutors or an entire criminal justice system make a victim feel like a chump.
Psychologists say that when people live through trauma, the memories get connected in their minds with what they saw, heard, smelled, or felt at the time. Anxiety and fear become linked to sensations that occurred during the event. These sensations become cues that evoke anxiety when they are experienced again later, bringing the memories and emotions flooding back.
In other words, the texture of memory is smooth, slippery.
A traumatic event is not remembered and categorized in a person's past in the same way as other life events. Instead, trauma continues to invade the senses and a person experiencing PTSD will relive the life-threatening experience, reacting in both body and mind as though the traumatic event is still occurring. In other words, the past makes the present ache.
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