Tag: "PTSD"

The "Weakened Identity"

The “Weakened Identity”

(Click here if you missed Part 3.)

Bob is a Vietnam Veteran.  I was his psychiatrist.  We met weekly for a few years at the trauma clinic at a VA Medical Center.  Bob is a good family man that anyone would be happy to know.  But, he suffers still with the symptoms of Post Traumatic Stress Disorder, (PTSD).

This post is not about PTSD.  Most of us will never face what Bob had to.  His case illustrates, however, in the extreme the features of a “Weakened Identity” that the rest of us may exprience to a much less intense degree.  The sharp relief of his exprience can inform our own much less intense one.  His growth is also an example of a pathway from unsuccessful to successful suffering and the “Compassionate Identity.”   We’ll use Bob’s case to go over some of the brain science and psychology that define a Weakened Identity and how these relate to the anatomy of both extremism and civility.

Bob had been very idealistic as a teen-ager.  He enlisted in the Marines at 18 to give himself to a cause he felt was worth fightng for: liberty and the defeat of oppression in the world.  He was stationed along the border with North Vietnam in Quang Tri in the  “I Corp” region of South Vietnam.

If your life depended on it, could you read what is in these eyes?

He recalled to me one of several terrible episodes in which, while on patrol, a woman approached his fireteam carrying a bundle that looked like it might be a baby.  But, the men had heard that other units had suffered serious casualties in similar situations when the bundles turned out to be AK-47s or plastic explosives.  Knowing this he and other men in his unit had been forced into an impossible dilemma.   After repeated calls to the woman to back away from the men, they felt they had no choice but to shoot her.  Whether she was carrying a weapon or not, the fact that he was in the position to even have to consider shooting a woman brought home to him that it was not so easy to tell himself he was fighting for liberty and to end oppression in the world.  The world was nowhere near as black and white as he had thought.  There were difficult decisions that had to be made in life.  In his case, a wrong decsion resulted in someone being dead.

Bob is not an evil man.  He is not a weak man.  Far from it.  He is a very decent man that you would be proud to know.  He has been through the most wrenching of human experiences: war.  No one told him that, in the 20th Century, 90% of casualties of war are civilians.  He did not expect to be in the position to have to kill civilians.  This devastated him.

After this horrific event, he wondered if there could be any good in the world.  Could there be a loving God who would allow such a thing to happen?  He wondered if he had been kidding himself all along believing that there could be good in the world.  Or, at the very least, if there was good in the world, he felt he certainly had nothing to do with it.   He felt that he had no right to strive for anything good in his life, if there actually was anything good to strive for.

This caused him to feel alone and uncomfortable around other people.  It was as if he was putting on aires pretending to be interested in what people’s lives were about.  Nothing held any real worth to him.  He felt that the things that he experienced most strongly in his life were overpowering feelings like despair and guilt, not to mention the horror he felt when memories of his experience haunted him at night.

How could he share what was most real to him with another?  He thought he was doomed to be alone in the world as no one would ever want to know of the internal world in which he lived.  How could he share with someone else feelings that were so overwhelming to him and so negative, feelings  for which he often couldn’t find words?

All of this left him emotionally exhausted.  Without anything good he could believe in, he couldn’t develop any meaningful goals for his life.  Without a valued goal, he had no reason to be motivated.  Without motivation, he could not develop new skills to create a sense of competence in life.  His sense of worth as a man was devastated as a result.

Bob felt as if he had no center in his life.  Adrift, he wondered what would become of him.  His life was characterized by despair and isolation.  This is the part of the experience of many who have suffered a severe trauma and developed the symptoms of PTSD.  A lesser version of this is also common to many people without PTSD who feel confused about the suffering in their life.

Bob’s experience is an extreme.  It is something to keep in mind when an opportunity to be a friend to a veteran arises in your life.  But, what Bob experienced in capital letters, many of us experience in smaller measure.

This sense of feeling diminished as a person I call a “Weakened Identity.”  One if its chief characteristics is a difficulty identifying with a goal in life.  The weight of a previous experience has shaken one’s sense of value in the goals by which one might have directed one’s life.  Bob’s idea he was fighting for freedom and human dignity were shattered by his own bitter experience.  This collapse of his life’s goal was, for Bob, a collapse of the world view that gave him meaning and purpose.  With a collapse of his sense of purpose, there followed a paralyzing loss of motivation.    Without motivation to strive for a goal, there was no impetus to compel him to develop new skills, to venture to enter relationships and explore deeper levels of intimacy and trust.  His personal growth was stalled.

Control of our lives should come from our thinking cortex, not our lower brain structures.

An underlying fear and anxiety are two of the other key features of a Weakened Identity.  Fear is the arousal we experience from the survival emotion that is directed at a particular threat.  Anxiety is that same arousal but without a clear threat.  These survival states become filters of perception that cause to see the world in a way that maintains their existence.  Fear begets our tendency to create reasons to stay afraid and to see the world as a frightening place.  When anxious, we tend to see the world as anxiety provoking.  Over time, these unregulated “hyperarousal states” paralyze our capacity to grow.

There are structures deep in our brain that are the engines of these unthinking survival emotions.  One of them is called the “amygdala.”  Among other things, the amygdala is like a switchboard relay station for survival emotions like fear and anger.  When the amygdala is activated, it completely takes over control of the the way the brain processes information.  It colors our experience with strong survival emotions like fear and anger.

Remember that song, “When you’re similing?” My Mom used to sing it to me.  The song tells us that when you smile, the whole world smiles with you.  When your laughing, the sun come shining through.  But, when you’re crying, you bring on the rain.  Neurologically, when you experience a strong emotion, that emotion becomes the filter for all of your thinking.  So, if you are sad, everything you experience is processed as proof of why you should be sad.  If you are angry, whatever the person you’re speaking to says is processed as proof of how evil they are.  Ever been on a laughing jag?  Every stupid thing is hilarious.  The more stupid, the funnier.  Every strong emotion becomes a filter for all of our experience.  So, we stop experiencing the world for what it is, and instead, see the world through the filter of our emotions, which reinforce themselves by making all of our thoughts justify them.

Louis Armstrong did a great version of “When you’re smiling!”

Emotions also act like the topics in a file cabinet for our memory.  When you are sad, everything you experience is filed as a memory for “sad.” We remember something much more clearly if it is associated with an emotion.  It’s a positive feedback loop.  You feel an emotion.  The emotion colors all your experience to justify that emotion.  Your memories are then laid down in the brain with that emotion attached as a kind of memory jogger.  If you feel that emotion again, the memories associated with it return.  If you remember something, the emotion it is filed under comes back, too.  Again, emotions reinforce themselves.   Sadness will produce more sadness; fear, more fear; anger, more anger; love, more love, etc.

This neurological wiring of our brain makes sense if you are running from or trying to fight a lion that wants to eat you.  In order to stay alive, you need to remain very motivated and focused on how everything might be a potential threat.  Your strong emotions of fear or anger keep your motivation up and focused on the threat.  But, if you are trying to make a marriage work and raise kids, keep a job and have friends, this mechanism is destructive.  We need another mechanism.  If we are not aware that we need to turn off our survival mechanisms, we may be perpetually surprised as to why our life is not working.  It’s a matter of over-active and unchecked survival emotions getting in the way.

When we are able to make a choice to calm our emotions, the cortex begins to exert a braking influence on the amygdala.  We can choose to calm down, to quiet our fear and extinguish our anger.  This choice is the key.  The survival mechanisms of the brain, fear and anger, are in their full glory and ready to go right from birth.

A choice is like a push-up. The more you exercise a particular choice, the more the neural circuits that support that choice are strengthened.

But, our higher cortical reasoning requires exercise.  These higher cortical functions are not fully developed at birth. The pieces are there at birth, but they are not in working order at birth.  They require the exercise of choice to bring them into their full expression.  The more we use them, the more they become our ‘default” way of operating.  Each choice reinforces the neural networks that support that choice.

If we choose one way of being, the neural networks associated with that choice are strengthened.  The neural networks of those choices we don’t make become weakened.  In the same way a muscle gets bigger and better coordinated with exercise, neural circuits that we choose to use become more robust with each choice.   Our “natural” fear and anger come spontaneously, without thinking, without a choice.  If we let them reign unchecked, they only get stronger.

We have other categories of emotions as well, feelings, like calm, compassion and empathy.   In times of stress, these emotions that connect us to others may not arise spontaneously.  We may have to resist our angry and fearful emotions with thoughts that allow for bonding emotions to arise.  This requires the exercise of choice.  If we don’t practice through the exercise of choice, these bonding emotions do not develop.  In fact, they may feel unnatural and foreign.  The higher cortical functions that allow for reciprocal living with others, our civilized self, are only possible to sustain when we quiet our survival emotions of fear and anger and practice these bonding emotions.  These higher cortical functions are like gems in a mine.  We may be sitting on top of a mine filled with gems, but decide that making the effort to dig for these gems is unnatural and too much trouble.  We are poorer as a result in the quality of our relationships and the problems we create for ourselves and others through the fearful and angry responses we bring to our lives.

What has been said here about our instinctual survival responses and emotions applies to habits of thinking, feeling and behaving.   These habits are our biases.  You can think of “bias” as habitual neural patterns in the brain that wire our thinking, feeling and behaving that are reinforced by continual use.  These become our default neural patterns.  We think they are the “truth” because they seem so very natural, spontaneous and obvious to us.  But, they are really only our habitual ways to think, feel and act.  Anger and fear come naturally, for instance.  But, they persist in our character because we refuse to choose to change them.  The Compassionate Identity, which embodies the sum of all the gems we possess of higher cortical civilizing functions, is only possible with choice, repeated choice in spite of natural feelings of fear or anger.

If we make the choice to calm our survival emotions, the amygdala will let go of our thinking and allow us to think creatively without reverting to biases in our thinking, feeling and behavior.  The vast potential of our cortext is then opened through this exercise of will.   The neural networks we liberate, if exercised over and over by repeated choices to calm fear and anger, will result in a personality style like that of  Dr. Ruhe‘s mentioned in the previous post.  The discipline of his repeated choices led to a character that eventually found the pull of fear and anger virtually extinguished.  His mental capacities, as a result, flourished in a lifetime of productive creativity that was directed towards service to others.

If we neglect this choice, the neural circuits of our survival emotions only strengten their grip on our thinking and problem solving.  We become the prisoners of the grip of our own amygdala.  But now, instead of it enhancing our survival, it is the cause of our estrangement from others and the undermining of our integrity.

The confidence to exercise will is exactly what the person struggling with a Weakened Identity lacks.  A general tone of anxiety can predominate this person’s thoughts, feelings and actions.  Preoccupations with real and imagined threats grip the mind.  A general feeling of worry and fear of bad consequences plague the assessment of every situation and paralyize decision making.   Planning becomes difficult.   One’s actions might be ineffective as an over-aroused brain pushes us into poorly thought through desperate activity that misses the mark that was intended.   A form of some or all of these dilemmas are present in a Weakened Identity.

Rekindling the resolve to make different choices is the way out of this dilemma.  The final posts of this series deal with how that can be done.  The Unity Project is a methodology to do this with kids.

Spinning wheels.

Our thinking can turn this ineffective emotional and mental spinning of wheels into a false virtue and cause us to devalue anyone who acts with certainty.  We can consider them to be dangerous unthinking zealots.  The very idea of certainty itself becomes entirely suspect.  We see this on the Left politcally, when there is an accusation of extremism levied against anyone with a conviction.  There is an important distinction between a moral conviction and blind zealotry.  This distinction is sometimes lost to the person with a Weakened Identity.  Just as the desire to carefully consider options and question what appears to be certain can wrongly be seen as moral weakness by a person with a Rigid Identity.

There is real wisdom in the hesitation in the Weakened Identity.  Questioning certainty is fundamental to reciprocal relationships and innovation.  In the Weakened Identity, however, we see this questioning in its paralyzing extreme.  In excess, these important strengths lead to a paralysis of motivation and a lack of clarity about noble goals in life.  With nothing to hold as a worthy goal and no sense of capacity to reach for anything noble, nihilism and self indulgence become two extreme back-waters of the Weakened Identity.

These points became the themes of my work with Bob.  Helping him restore a capacity to choose.  They were small choices at first, exercising new neural circuits and dealing with the awkwardness of developing new habits.  We dealt with coping with the anxiety caused by the attempt to make new kinds of decisions; how to tolerate anxiety and ambuity without falling into fear and despair.  We explored new ways of seeing himself that did not stem from highly charged impressions taken on during the worst part of his life.  We worked toward a balance between assertion and tact, resolve and reflection.  He still deals with symptoms of PTSD.  But, he has a roadmap out of his paralysis, a map he uses daily to exercise his will to grow in humility and wisdom.  On balance, Bob is successfully meeting the challenges of his suffering.

I should say that the constructs of a Weakened Identity and a Rigid Identity are my own abbreviations for complex styles of personality with many features.  It is hard to find a person who is exclusively one or the other.  In fact, the two tend to reinforce each other.  More on that in my upcoming book.  I also must point out that a Weakened Identity is not a pathology.  It is an abbreviation for a style of approach to one’s struggles in life.  It is helpful also in that it provides a way to think about how fear influences our social life, especially in contrast to a Rigid Identity.

Next, we’ll take a look at the Rigid Identity, how it is constructed and operates.  It’s destructive elements and the seeds of strength it contains that can be helpful in a Compassionate Identity.

In Part 5: Extremism to Civility: “The Rigid Identity” we’ll get at the roots of extremism that come from a Rigid Identity.  Then, we can move into what liberates our greatest potential: our “Compassionate Identity.”  We’ll cover that in the 7 subsequent posts.

Please post this to your own blog or Facebook page!  Follow my posts by clicking the RSS Feed above.  Let me know what you think, comment below!

All Rights Reserved, John Woodall, MD, Copyright, 2011.

So much ground to cover.

So much ground to cover.

Athena grips a Titan by the hair.

I owe most of what I have learned about trauma and the resilient strengths that develop as a result of working to recover and grow from trauma, from veterans.  We all owe great debts of gratitude to the sacrifices they make for the country.  But on a deeper level, there is much to learn about the human soul from the struggle of those who have borne the battle.

I’ll post soon on why I chose this picture from the frieze of the Pergamon.  That’s Athena gripping a Titan by the hair, much like war seizes the soldier.  More on that later.

Let’s begin here with your questions and ideas for topics.  Feel free to post ideas, questions, experiences or insights about your experience as a veteran and we’ll go from there.  In the meantime, these videos will be helpful.

John

This one is key and moves beyond the others:

Becoming Free

This is of central importance:

A Compassionate Identity

Made for the Unity Project, this one introduces some fundamental ideas:

Form the Bowl