Archives for posts with tag: CBT

I’m sipping my coffee and ignoring (as much as I can) the chronic pain of my osteo-arthritis, which radiates upward from my spinal fusion, which was done years ago, when the state of the art was quite different than it is today. I knew then that my surgery was a new approach to the problem, and that some outcomes were unknown. The goal was to prevent me from ending up in a wheelchair partially paralyzed, and to allow me to continue to serve on active duty (Army). I guess for most values of success, my surgeries were a great success. I’m still walking. I did continue to serve (was even deployed to war in the 90s’), after a period of convalescent “retirement”, although I got “RIF’d” after that war (which broke my heart, but is an altogether unrelated story). So, generally, I’ve nothing to regret about that surgery if I’m just thinking about those details. But…

…There were consequences – of both the injury itself, and the surgeries that followed. The arthritis started to develop in my spine about 3 years after my surgeries. I didn’t understand why I was in so much pain all the time, and it took a rather stupid amount of time for that to be appropriately diagnosed; I was young. Medical bias being a real thing, many doctors were persistently just as “mystified” as I was. What could be causing my pain? How could I have arthritis at my young age? I still feel frustration and annoyance by that lack of curiosity, and lack of diagnostic skill (or persistance). Pain they could not feel themselves did not matter to them.

Then, there were the other things… the persistent chronic itch below my left shoulder blade, that I couldn’t quite reach and that scratching didn’t ease. A “phantom itch” that still bothers me occasionally (CBT really helped with that). A chronically cramped muscle down low on my back, on the left side of my body, most likely a result of the disturbed section of musculature attaching to my spine being put back “not quite in the right place” during my surgery (to make room for the hardware that was there for a year) and which healed into a new, less than ideal, location. This, too, still bothers me, often. Most of it I had to “figure out” in pieces, with limited help from too many doctors, and a lot of study. Sexual challenges (both neurological, and also to do with practical matters like lubrication) that were awkward to discuss were another thing; I was past 60 before a physician finally said, with some surprise, “of course that’s related to your spinal injury” after looking at my records, surgical reports, and images, and listening to me with great care. She seemed so matter-of-fact about it, I ended up enraged for days that no one else had said as much. I went through some shit over that issue with more than one lover, I can tell you. Turned out it wasn’t “my fault” or “a lack of desire”, or anything I could actually do much about; I have a spinal injury. Duh. I spent a few days moping around pretty pissed off about it.

What I thought I understood.

Why am I on about this, today? It’s to do with perspective and knowledge, and how those create our understanding (or don’t). I knew coming out of my surgery all those years ago that I had a permanent “30% stenosis”, and I felt that I understood what that meant. I mean, words having meaning, and I knew the meanings of the words…so… I understand? Don’t I? I thought I “got it”. My lack of real understanding was stunning, and it would be decades before that changed. It wasn’t actually a doctor that changed my understanding. It was math – and a moment at the dining room table with my Traveling Partner; a “lightbulb moment” to do with circles, that was completely unrelated to my spine, my injury, or my pain. lol (Pay attention in school, kids – math matters, and it’s useful stuff.) Something clicked.

What I hadn’t understood, in spite of seeing the images, reading the reports, and discussing with doctors, was what my stenosis meant in my case, specifically. For many years, I imagined 30% percent stenosis as a uniform 30% reduction in a circular area. (I felt pretty stupid when my understanding changed.) Firstly, the spinal canal as a “tubular structure” is not a beautifully perfect mathematical cylinder wherein a slice would appear circular. Not at all. It’s quite different than that. Also, and more importantly, my injury (which crushed two vertebrae, and broke off a spinous process which was then forced into my spinal canal by the impact and subsequently could not be removed) and the repair of that injury did not result in anything like a uniform reduction in area all the way around. Not even close.

Geometry for the win. lol

Reality doesn’t care what we believe. Our pain doesn’t care what we think we understand about our body. Reality is. Pain is. Conditions are what they are regardless of our understanding. So, for years I had struggled with symptoms that made no sense to me – because I so poorly understood my condition – and which I could then not clearly articulate to doctors, who may also not have understood my condition, because (let’s just be real about this, eh) doctors are also human and also have limitations to their own knowledge (and limitations on the amount of time they can spend reading patient histories with the care needed). I understand more/better now, but… I’m still limited by all the things I do not know. I still live within a reality that I perhaps only partially understand because of those limits.

…And reality doesn’t care at all what I understand…

Our perspective and our knowledge limit our understanding – but reality goes on being real, regardless of what we think we know or how we think we understand the world around us.

I breathe, exhale, and relax. Living with the pain is pretty much a requirement. There is no option to live without it, at least not now, not really. I do my best. Maybe that reality will change at some point in the future? Technology changes. Medical progress is made. I’ve learned to practice fairly skillful pain management in the meantime. I’m not complaining, not really. Good self-care and skillful pain management may not add up to a “cure for pain” – but it does help.

I sip my coffee thinking about my Traveling Partner, his injury, his surgery, his progress… he’s come so far, so fast, relatively speaking (although I know it doesn’t feel that way to him). We both deal with pain, and I don’t personally see a future where that’s not a thing we deal with, each having our own experience, each doing our best. I feel fortunate to have a better understanding of my injury than I once did. I’m grateful for a conversation at the dining room table about math and circles and ratios and areas, and grateful for a partnership that understands pain and makes room for love anyway. Grateful for love. Things could be worse.

I look out the window. My mind wanders away from the pain I’m in – probably a change for the better. It doesn’t do to dwell on the pain. Don’t get me started about this fucking headache. I sigh quietly and glance at my calendar, and the clock. It’s time to begin again.

The work week finally ended. I got home tired and uninspired about home cooking, late in the afternoon. I wasn’t hungry, just thirsty and fatigued. My Traveling Partner had put in a full day in his shop machining parts to upgrade the lathe. He had overlooked having lunch. I made him a hearty sandwich and then put my feet up for a little while, taking the break I should have taken earlier in the day.

I never did feel like cooking a proper meal, and never had much of an appetite. I ordered pizza, instead of fussing. I did remember, at some point, that my beloved had asked me if I’d make banana bread with the last two bananas, so I did that. It turned out splendidly well. I used the Better Homes & Gardens recipe, with a bit more salt than it calls for, and being generous with the walnuts. I chuckled to myself about how often it has turned out that my Dad’s “secret family recipes” have been from that cookbook. It was definitely worth the effort. The pizza was good, too. It was a simple, quiet evening.

Simple joy.

This morning I woke from a sound sleep feeling rested, got up and started the morning. I’m sitting at the trailhead, waiting for enough daylight to see the trail on this rainy, muddy, morning and hoping for a break in the rain. The dense clouds overhead seem to tear themselves apart, a jagged gap opening to reveal the blue-gray sky of daybreak beyond. I lace up my boots.

I’m grateful for the simple joys in life. I’m grateful for these quiet morning moments of solitude and reflection. I’ve got a few days off work coming up, and I’m grateful for that too. I’m tired, and I am finding it harder these days to manage my pain; a couple days of leisure and creative time will do me good. I run my fingers through my hair, enjoying the softness of it, and watch the clouds moving away toward the horizon. No colorful sunrise this morning, but many beautiful shades of blue and gray and lovely soft shadows. I’m content with the morning as it is. It’s enough. The pain is a small detail, inconsequential compared to the beauty of the morning, just a thing to be endured.

Finding joy in a moment.

A soft rain starts and stops, again and again. That won’t stop me, either. Like the pain, it is a small detail; I grab my rain poncho from my gear tote.

I sit awhile longer with my thoughts, savoring the moment before I begin again.

This morning is cold and foggy. I slept in (for some values of “sleeping in”), and still arrived at my selected trailhead well before dawn. This trail is lit for much of the distance I walk, but beyond the vineyard, near the river, I still needed my headlamp. I’ve been, and returned, and it is still quite dark, though there is a hint of daybreak on the horizon. It’s not yet visible from the lit area of the trail, or the parking lot. The new artificial lights are much too bright.

A walk through winter fog.

The morning is foggier than I expected, and somewhat warmer (still quite cold, near freezing). The fog makes everything seem quieter and more mysterious in the darkness. I see the headlights of workers arriving to a nearby construction sight, filtered through the fog, before I hear the sounds of their pick-up trucks. I’m okay with that. The dance of the lights over irregular pavement is fascinating, and I don’t care for the noise at all. I walked and watched with wonder, alone with my thoughts.

The Author arrives later this morning. 10:30 or so, though I’m not certain whether that means to the house or at the airport. I didn’t ask for clarification – I guess I’ll know soon enough. lol I’m excited about this visit from a dear long-time friend. It happens too rarely. I think of other far away friends and wonder whether to plan a trip to see some of them in the summer? I wonder whether my Traveling Partner will be up to being without me for a week…or in shape to go with me?

I sit quietly with my thoughts. The sky is beginning to be a hue of deep gray-blue, visibly no longer “night”. A new day. There are things to do, and a visit with a friend to look forward to. I consider getting a coffee somewhere nearby, but I am just as content to sit here, watching the sky slowly lighten as dawn unfolds. G’damn, sometimes I am such a simple and easily satisfied creature. I chuckle quietly to myself. I’m okay with it.

A new day begins.

… It’s time to begin again.

It’s raining at the trailhead. Still dark, too. I decide to give it a few minutes. Maybe the rain will stop? I’m here earlier than I planned, anyway. My wakeful Traveling Partner woke me early with his wakefulness, and rather than keep him awake once I was awake, I dressed and made coffee and slipped away into the predawn drizzle.

… Now I wait…

We chat online for a few minutes, before my beloved returns to bed, and hopefully to sleep. The morning is quiet and calm. The rain is misty and not enough to prevent me from walking. The morning is a pleasantly mild one, the temperature a relatively comfortable 42°F. I had dressed for freezing weather; I’m definitely comfortable. The misty droplets covering the windshield glitter like scattered gems as passing headlights sweep over them from the nearby highway. Pretty.

… Nice morning…

The holiday shopping is done. Too late to change any of that now, although there are still packages arriving and gifts to wrap. There are still holiday sweets to buy for stockings and groceries to buy for holiday meals. So much yet be to do, but things also feel somehow “done”. Ready. There’s a plan in place and that’s enough. I feel content and mostly comfortable. The only discomfort I do have is purely physical and there’s nothing much to do about that besides taking care of myself properly. I double-check my shopping list to confirm I’d added capsaicin patches; they help some and I’m nearly out.

This is all such mundane stuff, isn’t it? It’s also enough. More than enough maybe; I feel fortunate. I do work at it – at the contentment and the quiet joy. I work at embracing sufficiency (chasing excess has only ever hurt me). I work at achieving and maintaining perspective. I work at non-attachment and at not taking shit personally. There are verbs involved, and practice, and my results vary – but over time I find myself quietly calm, contented, and joyful so much more often, I might even say these feelings have become characteristic of my day-to-day experience. That’s a pretty profound change from chaos, misery, and madness. There are few manic highs, these days. Abysmal dark lows are also very very rare. Mostly, things are pleasantly… ordinary. I don’t need the excitement of a rollercoaster ride in my emotional life. lol

… I sit quietly sipping my coffee, not quite waiting for the sun, just waiting…

My results will definitely vary. This is a very human experience. Moments are moments, and some of them are difficult. I’m okay. I’m here, now. I breathe, exhale, and relax. Practicing the practices. Beginning again.

Trigger warning: domestic violence.

Yesterday was weird and difficult, although I never figured out why I was so fragile and irritable (yesterday). I definitely was, though, and it was definitely me. My Traveling Partner had helped set up the day so I could paint, or decorate the tree, but my irritability quickly made painting unlikely; I don’t like the work I produce from that headspace. Then, after another load of Thanksgiving dishes were done (almost finished with all that!), we started discussing the Giftmas plan, and the placement of the tree (conveniently already in the car), and realized the one we have has too big a “footprint” and doesn’t give my partner enough room to get around (a temporary condition, but a thing we’ve got to account for this year).

We measured. We talked. We shopped (online – no way was I eager to go out into the world the Friday after Thanksgiving). We finally found a tree that met our shared needs well. Later we figured out a better place for it, too. Somehow, as successful as all that was, it didn’t improve my irritability, which continued to lurk in the background. Sure enough, I eventually lost my temper, and it was predictably enough over feeling both micromanaged and also unsupported. Rough. I’m not even sure I was “wrong”, though I definitely did an absolutely crappy job of communicating my feelings and my needs, before, during, and after. Shit.

(It wasn’t about any of that.)

We got past it. I never did stop feeling irritable, but I succeeded (if it can be called a success) in keeping it to myself for the rest of the evening. It sucked, and somehow I still have yet more dishes to do.  My Traveling Partner suggested I ask the Anxious Adventurer for help with the dishes. Honestly, while I’d love the help (and appreciate it any time he does the dishes), what I want is for him to do the dishes because they need to be done, and he lives here, and he’s part of the family, and it matters for our shared quality of life, and he’s a responsible fucking adult. I don’t want to have to ask. I loathe the assumption that it’s somehow “my job”. I’m neither his mother, nor am I the g’damned maid. But that feels like a discussion for another time, and I squelch it, again, and let it go.

(It wasn’t about that either.)

I left the house early, this morning, and noticed the neighbors had taken their trash cans to the curb, so I put ours out too. (Sometimes it’s hard to figure out holiday trash pickup.)

I had the highway to myself on the way to the trailhead, which felt like a luxury, and my latent irritability began to dissolve. It got me thinking about what life would be like entirely alone. An interesting thought exercise… We are social creatures by nature. We form families, tribes, communities, and societies. We gather in groups and build cities. We distribute labor for sustained efficiency. A solitary human being alone in the world would be at much greater risk. How would one human being be able to know enough? To do enough? A primitive life would probably be the best one human being could do alone, and without the shared skills and effort of a group, the risk of some small misadventure becoming a fatality is pretty significant. Bitten by a snake or a dog in our modern social connected world? Go to a hospital or call 911, or rely on bystanders for aid. You’ll likely survive. Alone in a solitary world, you’re probably more likely to die. We rely on each other so much. Even our precious solitude and solitary experiences are supported in some way by the fact that other people exist. Think about it awhile. Solo hike through the wilderness? Okay – how about the car that got you to the trailhead? The gear and provisions you carry? Or what about being “magically alone” in some great beautiful library? Who wrote the books? Where does the light to read by come from? What will you eat and drink?

I drive on thinking about interdependence, interconnectedness, and my fondness for solitude in spite of how much I truly rely on others. Eventually my thoughts bring me again and again to the safety and risk reduction inherent in family… and how damaging the trauma of domestic violence really is. That damage lasts. Is that what all of this has been? My PTSD? It’s the fucking dishes triggering me?? G’damn it.

It’s been many decades since I lived in terror within my home environment – that’s the nightmare of domestic violence; home is not safe. (It wasn’t then, it is now.) My brain and chemistry were altered by those experiences, perhaps permanently. I still sometimes struggle to feel safe in the one context where my safety should feel most secure, at home with my family. I still have nightmares. I still deal with the chaos and damage. I still bear the emotional and physical scars of that violence, although it was more than 30 years ago. I still lose my shit over the fucking dishes in the sink out of a fear of harm I don’t even detect because it has become part of the noise in the background of my consciousness. Nearly a lifetime between me and that nightmare, and I still deal with the damage done, and still crave the seeming safety of solitude. Worse, I’m aware that my broken brain and lingering chaos and damage inflict new wounds on those dear to me now. That’s shitty – and seeking solitude doesn’t prevent it, or heal the damage done.

… Dishes in the sink still cause me intense stress and a fear reaction that hides in the background of my consciousness…

G’damn, fuck that violent psychopath and the damage he’s done. Sometimes it’s hard to forgive and move on. I earnestly hope he rots in his own vision of hell for an eternity that the human mind can’t fathom. I hope he gains real understanding of the damage he did and has to live with the awareness of it until his dying day, with regret that never eases, and guilt like an itch he can’t scratch.

… And I hope I learn to forgive myself for how hard it is to heal, and the damage I’ve done to everyone who has ever loved me since then. I know it’s a lot. Every now and then it takes me by surprise and I have to face it all over again. Healing takes time and it’s a long journey. It can feel too long, sometimes. I sigh quietly. I breathe, exhale, and relax. My Traveling Partner is right; it’s important to be vulnerable, to trust, to communicate. If I don’t say how some of these experiences affect me the way they do, I just look like a headcase and hurt the people around me needlessly. They aren’t mind readers. They weren’t there then.

… And I’m not there, then, now. I’m here, and I’m safe, and it’s okay to trust love and feel safe at home. It just needs more practice. I’ve got to begin again.

I walk down the trail thinking about how safe I am at home with my Traveling Partner. I think about his enduring love and patience. I think about how much he cares and how horrified he is, himself, over what I’ve been through – and how angry. I let myself take comfort in his anger at the man (men) who mistreated me and did so much damage. I let myself feel wrapped in the protection and safety of his love. I think about our cozy home together. The charm of the holidays. Who we are together when my chaos and damage don’t rise to the surface. I breathe, exhale, and relax. I keep walking. It’s a journey. The journey is the destination. Ancient pain and trauma are in the past. Love is now. I’m okay now.

We become what we practice.