Consider Sleep as a Symptom of Brain Health

English: Lou Ruvo Brain Institute

English: Lou Ruvo Brain Institute (Photo credit: Wikipedia)

When the brain gets sick, what does it look like?  Do we grow warts, or turn purple or loose our thumbs?  How does our brain say,

Help!

Through emotions and behaviors.  That’s how.

If we were an internist, a primary care physician, we would look at the vital signs.  We’d put our fingers on the wrist, count beats of the heart and breathing, and measure the pressure in the blood filled arteries.  This would tell us some of the story, the introduction to the body.

A church secretary came in complaining of indigestion times two weeks….

Or,

In a far off land, there once was a young maiden who by chance came to a magic filled glade…

Smile.

How does one do this in psychiatry though?  We start with the vital sign of SLEEP.

A farmer in the vast expanse of corn fields went each night to his bed with determination, gritted teeth and racing thoughts.  He worried over things that others thought were insignificant.  He ruminated and chewed over information.  Making decisions followed him around as if each were a crisis life balanced on.  The farmer was awake in the night for hours before his mind turned off.  And when he awakened, he was not refreshed….

Question:  Are you comfortable with considering sleep as a symptom of brain health?  When do you decide to look for medical reasons for poor sleep verses adjustment issues?  Please tell us your story.

Self-care tip:  Get to know your story to know better about your health.

Hatred and Brain Health

Hatred

Hatred (Photo credit: dton23)

Have you ever noticed that hating the person who hurt you is never enough?  The damage does not respond.  The edges do not come back together.  Hating them harder, hating them more effectively, with your voice, with your body, committing your talents toward their detriment, recruiting forces, community – this is not enough.  Finally, you grow plans from dragon teeth.  You wish them death and an after-life of repeating hateful deaths.  It is still not enough.  You are left with you.

When the extreme, when the hate that is to say, is not enough something is wrong.  But it’s not what you think.  The thing that is wrong is not that.

We could say you are a sinner.  We could say pray more.  We could say exercise, destress, do yoga, karate, eat less sugar and drink grass juice.  We could and perhaps we do.  But this time, please put that aside.  It is not disqualified.  It’s just not the bit we are going to talk about.  Don’t be mad at me.

The hate is in the brain.  The brain picked this to perseverate on and return to like the tongue over a canker.  Lick.  Ouch.  We don’t ask for these emotions.  We don’t ask for these behaviors.  They come, symptomatically telling us a story about our condition.  Hear the story?

It goes something like this.  We are persons who know enough to know that this is a feeling stronger than deserved. This is a response not entirely rational.  This is a behavior that we would choose not to do otherwise and nor would a friend of ours support.  Our mother would tell us, “No.”  We experience a whole body response that surprises some level of our awareness and that part stands by uncertainly with her fingers picking at her lip.

The story tells about the other times when we endured worse and responded without as much personalizing.  We remember that someone else we knew acted like this and we didn’t think much of it.  We thought they were “off.”  We realize that what we are experiencing might not have as much to do with the crime as we thought.  It might just be that we are not feeling and behaving well.  It might be our brain.

That darn double-crossing organ!  How is anyone supposed to trust themselves?  It’s tough but we have each other and we have our story and we have grass juice.  We have God.  We have medication.  We have ECT (electroconvulsive therapy.)  We have acupuncture, our support groups and DBT (dialectical behavioral therapy.)

Considering where emotions and behaviors come from is the bit that gives us a chance to find and be found by help.  Hate is a very strong emotion from the brain and it isn’t so friendly to Me.  If we can’t put it aside, consider the brain.

Self-Care Tip:  When emotions and behaviors come that you don’t want, and won’t go away even when you say, “Please,” consider your brain health.

Question:  What has helped you disentangle the effect from a cause that wasn’t really the cause?  

How do you allow for the biology of brain health when it comes to feelings so personal?  

How is considering the brain a friendly thing to Me?  Please tell us your story.

Guest Post by Michael Cornwall PhD – Bandaid Your Emotional Injury

The Brain Limbic System

Image via Wikipedia

The physical home of emotion – the limbic area, is located in the center-region of the brain. The limbic system consists of a series of interconnected structures that include the frontal area, the hippocampus, amygdala, hypothalamus (anterior thalamic nuclei), septum, limbic cortex and fornix.  It is believed that these structures support a variety of cognitive, emotive, behavioral and biological functions including emotional behavior and long-term memory often necessary for emotional behavior to occur.

It is NOT essential for you, the reader, to know the names and functions of these structures – although it could benefit you.  Knowing that there are anatomical, electro-bio-chemical and hormonal correlations between your emotions and your brain is, however, critical to improving your emotional intelligence. Although you may decide not to know these structures, you will have to remember, at minimum, where your emotions live.

Your emotions live in your head.

More specifically, your emotions are an expression of your thoughts.

Without thought, you would have no emotion.

If you wish to change your emotion, you will have to change your thinking.

The limbic neighborhood, when in balance, can be described as resting.  While at rest, however, it can be instantaneously energized by thought and perception in an all-out effort to protect the body from real or perceived harm or the threat of harm. The stress response will cooperate with your thinking and automatically release neurochemicals and hormones into the bloodstream that are intent on providing the fuel you will need to protect yourself  from real or perceived threat. You can expect a sudden increase in heart rate, perspiration, flushing of the skin, hair standing on end, etc. All designed by Nature to give you the strength, energy and focus to run away very quickly, fight very bravely or just to freeze, motionless, in the hopes you will appear unthreatening to your attacker.

Let’s find a more familiar image to understand this phenomenon.

Imagine that you have a paper cut.

Blood flows from the cut, no matter how much you are against that from happening.

It is an automatic response to injury.

You can commit to do something about the cut by attending to it. You might wash it, put it in your mouth or cover it with a Band-Aid (or plaster).  Your effort to stop the bleeding will likely shorten the time the wound is active and susceptible to infection. While attending to the cut, you commit to memory how the accident occurred and tell yourself how to avoid similar injuries in the future. Injury and trauma are, in many ways, opportunities for learning.

But how does cutting your finger and attending to it compare to the expression and remediation of emotion?

Your perception of an event as threatening or dangerous is like injuring the nuclei of your brain.  Your thoughts activate a response in the brain that starts an automatic flow of neurochemicals and hormones into the bloodstream. These hormones and neurochemicals:

  1. Increase heart rate and blood pressure;
  2. Dilate the pupils;
  3. Constrict the veins in skin and send more blood to major muscle groups;
  4. Increase blood-glucose levels;
  5. Tense up the muscles that have been energized by adrenaline and glucose;
  6. Relax smooth muscles in order to allow more oxygen into the lungs;
  7. Shuts down the digestion and immune system to allow more energy for emergency functions; and
  8. Improves the ability to focus on the task of determining the location of the threat and how to respond to it.

Much like cutting your finger, there is an automatic flow of neurochemicals and hormones into the bloodstream that happens without your consent.  Similar to tending a paper cut, you can be a passive observer or you can actively respond by providing wound care.

You can put a Band-Aid on your emotional injury.

Here I will provide you with some self-care techniques and suggestions.

First, it should be noted that if the injury to the emotional areas of your brain were visible – if the flow of neurochemicals and hormones rushing here and there inside your head could be observed, rather than having it all happen deep inside your skull, you may be more active in responding to it, without all this comparison to a paper cut.

Instead, we will just have to imagine and increase our awareness of the phenomenon.

Wounds inflicted by thought require as much attention and enthusiasm for treatment as an injury to skin or bone.  We might imagine the paradigm from the following perspective:

  1. An Event Occurs: “You did a horrible job!”
  2. An Injury Results from Thinking About the Event: “You have no right to talk to me like that! I am a good employee.  I am a good person. I should be treated better.  It is awful that you are treating me this way.  I need your approval in order to be happy in my life.”
  3. An Automatic Protective Response Results from Thinking:   Your threatening thoughts instigate the flow of neurochemicals and hormones into your bloodstream, causing your body to go into a protective mode (a stress response).  These chemical will flow for some period of time specific to you.  The longer you ruminate about your perceived threat, however, the longer the chemicals will remain flowing through your bloodstream. It could be minutes, months or even years (chronic stress).  If you do not tend to the wound, you will be susceptible to infection, fatigue and a continued loss of homeostasis and likely reopen the wound each and every time you encounter the same or a similar misfortune.
  4. Attention to Thinking: “I am not in dangerI am viewing this situation as threatening. I don’t have to view the situation as threatening.  I can view it as unfortunate. It is unfortunate that I am being talked to this way.  It is regrettable that I am being criticized this way.  I am being treated badly and that is difficult, but it is not awful. I can stand it and I will.  I can express my concerns.  I have a right to ask for respect, but I have no right to get it. I don’t need approval in order to be happy in my life.  It would be nice to have approval, but it certainly isn’t a necessary element of my continued happiness.”
  5. Interfering with the Flow of Neurochemicals and Hormones: Using more rational thought is the essential part of attending to the emotional wound.  It is also the first step toward improving emotional intelligence.
  6. The fact that the hormones and neurochemicals are already in your bloodstream will present some problem.  Although you may be thinking more rationally, your physical body will need time to readjust and return to balance.
  7. Be assured that these hormones and neurochemicals will dissipate, if you stop them from flowing using more rational thought.
  8. Your new thinking will eventually win over the process and you will be free of these toxic substances.  At least until you encounter misfortune, again – something you can certainly expect.
  9. To encourage the return to balance, you may breathe deeply, stimulating your vagus nerves.
  10. Breathing deeply (through your mouth, into the pit of the stomach and out your mouth) sends a message to the brain that all is well and that it is safe for the body to return to balance.

The next time you encounter some perceived danger or harm, try these techniques and suggestions.  How did it work for you?  Would it help to keep the suggestions in your purse or wallet, for when you find yourself in the middle of misfortune and want a quick guide?

Michael Cornwall, PhD  is an author, lecturer, clinical supervisor, educator and child behavior therapist in private practice.  In our community, you may know him as the author of blog, Emotional Intelligence Theory.

(502) 564-4321 x 2008

Pay a dollar

Repost from July 29, 2010.

We all have a number of our own eddies, currents that spiral behaviors. Assuming that when those are friendly behaviors, then like “casting your bread upon the water” you’re bound to see something nice coming back your way. Some people say these patterns come from neurological loops, grooves in your brain like indian trails. When you go back down over your same footsteps 100 more times, you now have an open path without resistance, easy to travel. That is how the connections – neurological, electrical, chemical, are all biased in our brains.  Adaptability to stress, in part, means that your pattern of coping is on a path that serves you well when you need it to.

Come on, though! Who spends even five minutes talking about good behavior? What we do ruminate over, is why we keep doing what we don’t want to do. …Such as screaming at the kids when what we really want to do is to grow up and practice the good skills we’ve read about in all those parenting books!

Why is it so hard to stop?  Why are we “triggered” so easily?  Grooves, my friend.  Grooves.  Any day we can list off several seemingly unrelated events – but our reaction is all too familiar.  It feels like getting sucked into a tornado with a word spout, as if today turns you round and round the same way you did the day before.  Inevitable self loathing follows, which can set off more self-destructive behavior.  The cycle goes on.

When you feel trapped by your own self, get friendly by remembering this.  You’re mistaken.  You’re talking about a groove, not a vampire.  It’s not hopeless.  Not much more, not much less than what it is.  A groove can be abandoned.  New paths can be made and when the stressor hits next time, you will have a longer moment to decide on which behavior to play.  You will have a choice and you will realize more often that you are not trapped by what you thought; you are not hopeless and ugly.

For example, now when I yell at my kids, regardless, I pay a dollar to the family money jar.  Anyone can call me on it.  That’s my effort to steer clear of the “yelling-groove.”  The innumerable reasons for righteous anger, took me on miserable trips.  Round and round.  Yelling equaled me jamming myself all over again.  That’s right.  Who did it to me?  Me.  Now that’s not too friendly.  So something’s got to change.

It may be something different for you, but if you end up hating yourself in the end, it couldn’t have been good.

Self Care tip #5: You are not trapped. Pay a dollar. Be a friend to yourself.

Questions:  What has helped you abandon old grooves and make new ones?  When you don’t feel hopeful, how do you recognize that even though you feel that way about yourself, there is hope and the feeling is deceiving?  Please tell us your story.

Seeing Your Brain As The Place Emotions and Behaviors Come from is Terrifying

Terror

Image by pablokdc via Flickr

Where do emotions and behaviors come from?

Now think about it and answer your true beliefs.

I was speaking with a wonderful physician the other day to whom I asked this question, (let’s call her Doctora.)

I respect Doctora for her character, personality, standard of medical practice and interpersonal beauty. She is a bulldog in the operating room. When patients need studies done that insurances won’t pay for, she tears barriers to treatment apart with vicious tools of rightness. And she cares.  She sits.  She asks.  And she cares.  She sees the person in the paper gown, each one for the person she knows them to be and the person yet unknown.

I admire Doctora greatly not only for these qualities but also because it gets personal.  I, who have my own special practice of medicine, cannot do her’s.

When just a green bumbler in medical school, there was a fateful day when I shadowed another great artist of medical care into a locker room.  I suited up in that blue sack they call scrubs.  I put little blue sacks over my tennis shoes too.

Do you know why there are blue sacks on the surgeon’s shoes?  So that when wet things come out of the human body and fall onto their feet, their toes won’t feel squishy. Yep. That’s what was going through my mind as I scrubbed my hands, each finger and each finger nail the ten minutes it takes to reach what is considered clean.

Surgery in progress, the color red mixed with a smell and monstrous sensual force that clobbered me to the ground.  I swooned, gagged and promptly ended my surgical career.

There is nothing more irritating to a surgeon than someone who doesn’t appreciate the “fun” of “cutting.” Yes. I irritated this mentor and others too I’m afraid.

This doesn’t keep me unfortunately from pleasuring in telling people, “I am licensed to do surgery.”  I am you know.  Any Jane with a medical license can pick a scalpel up and bring back the dark ages, or contemporary, depending on who holds the license.  I’m irritating to my mentors, remember.  It reminds me how anyone can go online and pay to become a marriage registrar, i.e. perform a marriage ceremony for couples.  My brother did that twenty years ago and has yet to perform the marriage ceremony for a willing couple.  For real judges and clergy, this might be irritating too and that makes me a little happy as well.

Anywho, Doctora and I were rolling with the injustices haranguing us in the practice of medicine, both from the angle of the physician and the patient. I was pumping her up for being the cutting-wonder who she was and she was dutifully marveling at my jabber-mouth work that she would, “never be able to do in a million years.”  Somehow this brought us round to how our culture avoids embracing the biological paradigm of anything inside our skull but is so willing to celebrate it for any other part of our human bodies.

Where do emotions and behaviors come from?

Doctora answered me with a frozen breath. Then after I soiled the air with a lot of jabbering and she was finally able to speak, she said,

I would just be horrified if my brain got sick!

I wondered if it was scary enough to clobber her to the ground, but I do agree.  Terrifying.  Don’t you think?

Question:  Is that why hardly anyone can speak about the brain being human and largely responsible for where our emotions and behaviors come from? How has this played into your experience of self-care?  Please tell me your story.

Self-Care Tip – Go to the fear that keeps you from embracing your biology to gain more freedom.

Say Yes to Medication And No To Drugs

Please don’t call them drugs.

Image via Wikipedia

Today I spent eight hours in the company of many neuroscientists.  Smart folk.  People I look up to, want to emulate and learn from.  It was an honor.  We covered different stimulating topics about serving our patients, diagnosing better and the development of our field of practice.  We connected collegially, ate too much chocolate, exchanged cards and talked about each other’s families.  I hope to meet them again soon at future related conferences and continue learning from their experiences and study.

The one thing I do not like about any of these meetings however, is hearing people who know better (if they thought about it) naming our good medications “drugs.”

Drugs.  Yuck.  What do you think of when you hear that word?  I think of stigma, addiction, substance abuse, ruined families, fathers who do not come home, needle marks or powder on mirrors, low-living, illegal behavior, dealers, hepatitis and so much more – very little of which is good.  Drugs.  I cannot number how many patients I have spent oodles amount of time on talking them away from the stigma attached to medications because they thought of them as “drugs.”  Blah.  It is not anyone’s fault but we can start over when ever we want to, so let us.  It is time.

Who thinks of anything that actually improves us when thinking of drugs?  Who thinks of life-saving remedies, disease cures, hope, ability to feel pleasure again, forgotten shame, ability to hold a job, restful sleep, speaking well in public, desire to live restored or a mother who no longer wants to drown her baby?  Do you think of that when you hear drugs?

Let’s get together on this and forget the word that carries so much loaded negative meaning.  It is a disservice to ourselves – physician, scientist, grocer, student, surviving family of a suicide victim, newborn baby, patient and all of us who have any connection whatsoever to disease and treatment.

Drugs.  I think of First Lady Nancy Reagan‘s famous campaign in the 80’s, “Just Say No!”  That is not what we want to say or hear when we write or receive a prescription to treat and to heal what can be healed from a debilitating disease.  Just say yes, please.

Medication.  Not drugs.  A word does matter.  A word carries emotion on it like the smell of cookies baking in the oven or the toilet that was not flushed.  A word can start a war or inspire forgiveness.  Words matter.  Words can be part of what helps us be better friends to ourselves.  Why not use them to our advantage?  Let us change our culture and decrease stigma with this simple word – “medication.”

Maybe when I am able to get together with my colleagues again, maybe next year even, we will be using the word “medication.”  Maybe it will be because of the shift in culture people like you and I can start now.

Self-Care Tip:  Please forget about the misunderstood word, “drugs,” and say yes to medication.  Be a friend to yourself.

Questions:  What do you think of when you hear “drug?”  vs. “medication?”  Is there a difference to you?  To you think it would matter to culture and your “Me” if we used “medication” to refer to prescription therapies?  If so, how?  Please tell me your story.

Related Articles:

Fears of Addiction To Medications For Brain Illness

 

Are You Empowered to Start Everything and End Everything With Me?

Yesterdays blog-post brought a few neighborly questions for us to follow-up with.

One is regarding emotions from bluebee.  Is jealousy medical?  Followed by, What part of emotion is under our control?  Indeed.

Second, Sarah quietly slipped the question under our door of how to respond to emotions and behaviors that come from brain illness.  How?  Indeed.

Third, Carl banged a little louder when asking, what keeps him in a relationship with someone who is maltreating him verses leaving?  Indeed.

There is a nice flow to these.  They are leading into the next and circle back.  Emotions and behaviors come from the brain, much which is out of our control and some of which is.  The choice to engage in the life of the ill is like any other choice.  Our own.  If it matters to us if the way the brain is working in the “other” is in their control or not, we can spend more time trying to sus that out.  I’m not sure myself when I get it good from someone mean, but it has become easier to take care of my junk rather than there’s.  For that, I will say a million thanks.  If I’m getting yelled at, I do the checks on myself – anxiety? fear? anger? fatigue? shaking? dizzy? tone of my voice? do I know what this person is yelling about? (most often it has nothing to do with Me), empathy? empowerment? You’ve told me that you are growing in similar refreshing ways.

Face Down w/Laundry and Gwen Stefani

Image by NCM3 via Flickr

I’ve seen this play out a little in my children.  My daughters and son are supposed to do the laundry every morning before they play.  I don’t know how many years now, but their arguments haven’t changed.

I’m doing this all by myself.  No one is helping me!

Mom!  He’s just laying on top of the clothes!  

Mom!  …

These questions above…;

  • where emotions and behaviors come from,
  • control over biological symptoms,
  • do I respond to others with brain illness
  • or do I walk away

These questions don’t mean much if we don’t find where our empowerment comes from.  Me.  Everything starts and ends with Me.

I’m ill for reasons I have nothing to do with, yet I will be accountable for myself and how I affect others.

I feel emotions I didn’t ask for, behaving ways that I am a spectator to rather than a whole person, yet I will do what I can to gain health.  In that, I have control.

I surrender what I don’t control to my Higher Power.  I take medication.  I exercise, guard my sleep hygiene and get regular sleep, eat responsibly, gather and engage community, attend therapy groups and/or individual, I try while at the same time I let go, I love my flaws as I love my perfections, I try to develop my natural genius, try as often as I can to pour any energies I have in that direction as I know I will heal faster, enjoy life more and be more successful at all my efforts when I do.

It reminds me of that saying, that if I have success, it is from standing on the shoulders of giant midgets.  We are all flawed.  We are all wonderful.  We are supported by others who also are full of flawed perfections.

Do I have control?  You bet.  …And no way.  Always, there are both.

Do I talk when someone is mistreating me? or mistreating themselves by neglecting their own self-care? by letting their illnesses shape their lives?  Do I walk away as that may be what my self-care demands.

Everything starts and ends with me.  There are a lot of stops along the way with other forces, but empowerment is mine.  Indeed.  That’s what I hope my kids will learn when doing the laundry.