Look at my CV, and you’d think I’m well-educated. Despite a poor-performing school, I came away with a string of A*s at GCSE. I ticked off 5 As at A-level, a First in my undergraduate degree, a Distinction in my Masters, and then a doctorate. These are all things it was worth working for, and which it is worth having. Each progressively took me the step along the road to the next, and when I became seriously ill and my life fell apart, it was the benefits associated with the job I’d gained through all those qualifications that paid for the medical care that began my cure. (Now I can no longer get health insurance, it is the salary from that ‘high-flying’ job that allows me to pay my medical bills directly. The NHS does not cover long-term individual therapy; welcome to the prioritisation of the physically ill.)
Skills learned through the taking of all of those qualifications have also benefited me over the past years of illness. My logical, analytical training is strong, and that enabled me to form hypotheses about what was happening in my brain and body that I could trade back and forth with my psychiatrist, and which gave me a story I could follow about what was going on. I read extremely fast and can assimilate vast amounts of information, so was able to digest every book that anyone recommended as I searched for parallels to what I was feeling and how I was behaving and what the solutions were. My training in literature – my more than 10,000 hours of taking apart verbal works of art – kicked in automatically as I started to write, and so though I have written very little ‘training fiction’, I have nonetheless published a literary novel which is getting wonderful reviews.
Despite all of that, it is what I hadn’t learned that has preoccupied me over the last few years. Perhaps that is inevitable: in my way of seeing things, a breakdown is not merely a random medical event that can be treated and cured by means of a chemical intervention. It is instead the consequence of long-ingrained habits of responding to the world ‘wrongly’, or ‘mal-adaptively’, or (my preferred term) ‘unhelpfully’. (It can also be caused by trauma in the present – a car accident, for example, or the death of a child. But, as I understand the literature, those who find themselves unable to assimilate what has happened and to move on usually have underlying weaknesses that pre-date that catalysing incident. This applies even to soldiers with war-induced PTSD.)
I went into my breakdown with a collection of unhelpful patterns in my brain, in my thoughts, and in my behaviour. They may or may not have caused the breakdown; but once the breakdown hit, they certainly slowed my return to health.
Here are a few of the things I had never learned:
How to regulate my freeze response
We all have the freeze response in us; it is the nervous system’s final layer of protection against harm, the backup beyond fight/flight; it is the body’s attempt to feign death. Most people when threatened default to fight/flight first and can therefore act to protect themselves. For some reason I do not: my default is directly to freeze. This is something that unconsciously I have always been aware of. I mused every so often in the past on what would happen if I was, say, attacked in the street. I knew that I would go limp, that I would be physically incapable of screaming for help. I also remembered that as a teenager I’d spent many hours close to unconscious in the medical room at school, and that that was psychological in origin. The medical term, I now know, is dissociation, and it is the most extreme form of the freeze response.
When my breakdown hit, I fell automatically into this response again and again. Despite my best efforts I was unable to form words or move my body, even to avoid ambulances being called. It happened despite me being in the safe environment of the hospital. Once in that state I couldn’t get out and it lasted for hours or even days. My nervous system, once triggered, was unable to regulate itself at this most basic level.
How to ground myself
My nervous system is also over-active; it kicks in and freezes under circumstances most people would not find threatening. To deal with that, I needed when I noticed dissociation beginning to be able to reverse the process. The opposite of dissociation is presence, the ability to register and react to the brain impulses that allow us to hear, see, feel our environment in the present. Grounding ourselves is the ability to register those brain impulses: I can tell as I write this that my feet are on grass; I can hear birdsong and some men playing volleyball; I can smell barbecue smoke. (I am on a campsite in France.) With concentration, I can nowadays progressively register my environment even when my freeze response is activated. That in turn calms my nervous system down: I have learned to ground myself.
How to feel emotion
I knew what emotions were; I had read about them in books. And I assumed that everyone’s experience was like mine, that these forces of passion, of grief, of joy, or even of sadness, were theoretical, that they were a fictional trope, created to flesh out stories. Except for a flash of joy the day of my wedding, I hadn’t felt them, and I’d never told anyone I hadn’t felt them so had no-one else’s experience to go by. But with the stabilisation of my nervous system, emotions began to emerge. One moment from 18 months ago: I was watching La Traviata on stage. I’ve known the opera from early childhood, have always known Violetta appears to revive and then dies and the curtain comes down. But this time it was different. Feeling the music, absorbing the story, I sobbed through the final scenes, hoping desperately that the piece would end differently. It didn’t and I was devastated. Welcome to the existence of emotion.
How to know what I wanted
Without emotions I had no idea what I wanted. I largely chose friends who had strong views, and I did what they suggested. I was rarely the one to choose where to go, what to eat, who to see. Anything was fine, and I was content to fit in. That has also changed. It hasn’t always been convenient.
How to have energy without relying on adrenalin or alcohol
Without likes or dislikes, or an awareness of what was going on inside, I didn’t have impulses to do anything in particular. And yet I was terrified of laziness and failure. I was also, in retrospect, trying to keep moving in order to block out the past. As a fourteen year-old I had been told that I was extremely driven, which was absolutely correct. That drive led me to achieve a lot. But what onlookers saw as my vast energy (the mountaineering, the marathons, the work pattern) came from adrenalin and a fear of failure. My dance-all-night social energy came from alcohol. Without the more subtle input of emotion I was effectively relying on drugs to survive my life.
That connection with other human beings is not only beneficial but essential
Here’s a consequence of years of being bullied: learning that people are not to be trusted. As time went on I stopped being bullied, but I never unlearned my distrust. Always defensive in relationships, I made very restricted connections with others. Given that I didn’t have emotional responses, I didn’t feel lonely; solitude was easy for me. It was only when my emotions ‘woke up’, when my brain became quiet enough that I was able to feel emotion, that I discovered what loneliness was. It both is and is not an improvement to be able to feel.
Those are some examples. That is all. But they are examples on a bigger theme: they all relate to non-intellectual capabilities. I had a doctorate in seventeenth-century English, had taught at Oxford University, had a job in an intellectually elite company; but my nervous system was unregulated, which blocked out the ability to feel emotion, which reduced my ability to be connected to other people, to objects, to the world.
If you’d told me all of that pre-breakdown, I’m not sure I would have cared. In my world-view, humans were largely intellectual beings, ruled, at their best, by the consciousness that sits in the pre-frontal cortex. I didn’t know anything about other structures in the brain and the role they play. I certainly wasn’t able to tune into them. I didn’t know that felt awareness of the physical, the emotional and, for want of a better word, the spiritual (if you prefer, a sense of ‘connectedness’) is essential to our survival.
It is not advanced knowledge that has helped me get well. My lessons are to do with the most primitive of brain structures and functions (the over-activation of the freeze response). Some apply also to the slightly more modern limbic brain (everything to do with emotion).
Critically, these lessons have been non-cognitive. They have not been about ‘Kate’ learning intellectually how those processes work. They have been instead about Kate’s body and brain practising and practising self-regulation until eventually that regulation became their default mode.
The tools for those lessons have not been books, but therapy focussed specifically on nervous system regulation, supplemented by yoga, chi kung, mindfulness and connection with consistently reliable people. Those are all things I wouldn’t have seen value in a few years ago.
So, if I ask myself what is worth learning now, what I wish I’d learned earlier in life, it is absolutely not more of the intellectual. It is the non-cognitive that interests me most, and that will continue to bring me back to health. That is where my learning was stunted. The intellectual, at this stage, is a dose of amusement on the side.
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