Hail

I self-soothed myself through the hailstorm last night, which, given my heightened nighttime anxiety and PTSD, I consider a notable win. I woke suddenly as it pelleted on the roof and ricocheted off the air conditioner jutting out from the window. The pinging and clanging was jarring and so unfamiliar that I was unable to categorize the noise as a weather-related anomaly, let alone specifically identify it as hail. I tucked into a ball, hugging my knees to my chest and listened. My frantic mind feared combat, an attack from an enemy, some sort of dangerous monstrosity. My muscles tightened and the inside of my closed eyelids flashed a fury of alarming reds and oranges as if staring into the rotating siren light of an emergency response vehicle. I fought the panic by trying to conjure up peaceful images and relax my muscles with each successive exhalation, employing progressive muscle relaxation techniques I’ve been practicing every morning. The sounds only got more disruptive and bewildering and although I was able to harness my worries and prevent continued escalation, I remained engrossed in concern, perched on the precipitous of sympathetic fight-or-flight.

One issue with auditory processing attributable to SPD is a pervasive difficulty in locating the origin of a sound. I can hear everything just fine; in fact, I have an extremely keen sense of hearing, but I often am unable to identify what the noise is or even what direction it’s coming from. This greatly complicates my ability identify and classify the sound, which heightens my anxiety because it’s not clearly evident if it’s innocuous or dangerous. (When in doubt, my brain errs on the side of caution and assumes danger.)

Last night, as the erratic banging continued, I pulled out my phone to try and put on a calming video for more engaging distraction. I noticed the alert on my weather app and quickly discovered that we were amid a hailstorm. Crisis averted.

I am much too light of a sleeper to sink back into sleep while the racket continued, so I relaxed and watched my show until the torrent was over and the more gentle rain lulled me back to sleep. A year ago, this type of unprecedented and unusual calamity would have sent me into an inconsolable tailspin. Even if I had rationally deduced the cause of the noise was innocuous as hail, it would have been nearly impossible to quell the initial panic and calm myself back to sleep. The hopes for additional rest would have been abandoned with the first weakening pitter-patter. The remaining hours of night would have been spent remembering the jarring noise, the resultant uneasiness, and the range of possible (and impossible) dangerous sources that could have generated such terror.

But not last night! Last night was evidence of my improved self-control, command over my previously-unbridled anxiety, and coping tools to manage startling situations.

Stunned into Silence

My selective mutism completely overtook me yesterday. I went several hours without the ability to speak. The little voice I was eventually able to conjure up was so feeble and small, it was like a hushed mother trying not to wake the baby in her arms. This time, it wasn’t directly tied to a medical appointment, although I did have one later in the day that I seemed nervous about. For this reason, I’m not sure that it was entirely separate and more likely, my tension and anxiety in anticipation of the appointment played a role. Still, it typically hasn’t been the case that I lose my voice prior to an appointment. Instead, I’m usually quite chatty until I enter the waiting room, and effectively smothered like a fire extinguished by a woolen blanket. 

The precipitating event yesterday seemed to be an emotional explosion in the morning. After trying repeatedly and unsuccessfully to reach Ben via his phone, I panicked that something was wrong with him and adrenaline coursed through every last millimeter of vasculature in my body. This call was already one fueled by stress because I was having debilitating dizzy spells and so I was contacting him for support. When he didn’t answer after many, many attempts, my irrational brain immediately jumped to worst case scenario stuff (car accident, bad fall, etc.) and skipped all of the more likely and less dire potential causes for his lack of reachability. (He just inadvertently fell asleep.) In fact, these sorts of realistic possibilities were not even considered for a fleeting moment; my trauma brain took over and immediately assumed the worst and only the worst.

It wasn’t until early this morning that I was able to connect the dots and make sense of that. I remember exchanging a couple of really helpful emails with one of my sisters last year about PTSD and emotional fallout from traumatic events. I had reached out to her for advice about my problems with PTSD after the attack because she had survived a bike accident years earlier, and while quite different in nature, still certainly a traumatic event to overcome. I correctly figured that she might have some tips or at least solidarity with some of the emotional demons I was facing. She told me that she had very little PTSD and was pretty much over it now but that she still would get incredibly mad at her own husband when he was unreachable, even though she couldn’t draw any connections between not being able to communicate with him and her accident. As I lay on the rug this morning thinking about things like I do every morning, trying to meditate and relax, my sister’s words suddenly helped me understand what went on with much more clarity.

Not only do I hate not being able to reach Ben if I feel like I need him, but it instantly transports me back to the first moments after I getting up from my attack because after I attended to my immediate physical problems, I sought out my phone, which had been tried from my hands and flung behind the couch, to call Ben. I called. No answer. I called. No answer. Then he texted to remind me that he was out to lunch with friends and he would contact me when he got back to the office. Instead of asserting the urgency and severity of my needs, I just felt rejected and alone. Of course, had I told him that I just got brutally attacked and raped, he would’ve been home or at the nearest hospital to meet me, as soon as the first available cab could wiz him there. I blame the complete shock I was in, the searing pain, the greatest depths of fear and disgust I had ever experienced on my inability to voice my needs. My therapist has since told me that this is a fairly normal post-traumatic response. I simply wrote back “fine,” and by the time he did call me back, I was completely consumed by silence. I just texted back that I no longer want to talk, which was technically a lie because I did want to talk but I was entirely unable to. It’s fair to say I went into a hibernation of sorts after that. I completely disconnected in all sorts of ways from him and everyone else in my life at that time for several days. Needless to say, I have more than just anxiety at face value when I can’t reach Ben when I don’t feel well; it’s inseparable from the horrific memories surrounding that dreadful day. 

Anyway, after I was finally able to wake him with call after call, I exploded at him in a tirade of tears and shouts about how he terrified me and I thought something happened to him; although unfair and irrational, I spoke the truth and my feelings were deeply seeded and real. 

The entire outburst lasted all but a couple of minutes, but it relegated me to that of a meek nonverbal mouse for six hours. I felt like an outline of a human form, one that could be blown into scattered fragments like a summer dandelion puff. Even when I walked the dog, my thoughts were just mouthed in inaudible configurations of the words I intended to say and my muscles felt melted along my bones like the feeling that only comes after being physically spent at the end of a hard race. 

By mid afternoon, I was able coax out a small voice, which was a relief because I rarely feel unable to speak for so long. I think it’s an emotional issue more so than a physical one, my autism therapist says these sorts of “shutdowns” can happen.

Even though I’m often upset and juggling a lot of demanding issues, I rarely lose my cool. I’m one of the least confrontational people I know and almost always internalize fear, anger, hurt, or overwhelm instead of letting it surge out. This unfamiliarity adds to my discomfort and shock when it does escape in a demonstrable way. I thrive on stability and predictability, and any sort of fitful anger or hysteria uproots my feeling of control, even if it is a farce in reality and unhealthy to bottle up. 

The most difficult part of the experience was explaining myself to Ben. Although I don’t concede that my exaggerated response to not reaching him was justified, I do now acknowledge why I have this post-traumatic reaction. My sister is one of the most even-keeled and logical people I know, so if even she has had similar irrational behavior, it further provides me understanding of my own panic.

The mutism must be the way my mind recoils in an attempt to restore equanimity after an emotional torrent like the echoes of deafening silence after a massive explosion. It’s an uncomfortable place because I’m the silence, I cannot express my thoughts or needs. In the silence, my brain runs discounted showings of the memories of the attack, flooding “TV screens” in my mind with simultaneous screenings of lived trauma. The verbal silence seemingly opens a permissive and inviting gate for the memories I try to suppress to air on full blast enshrouding me in the disgusting fearful garb that cloaked my entire conscious and unconscious mind post-attack. Why can’t I burn these memories and watch them rise in lofts of ash far up into the sky? Why can’t I always operate with self-control, logic, patience, and calm? When will my resilience become foolproof and my strength no longer be an act? I can’t answer these questions and I’m guessing that the answer may not be what I hope it to be, that’s why it’s more productive to focus on what I can change and the progress I have made. Yesterday’s outburst was not progress but unpacking its roots was a substantial step forward. Before today, I had no concrete grasp on what was precipitating such unduly magnified reactions. I speak frequently of wanting all of this PTSD stuff to vanish, and I do, but I’m sure there are invaluable lessons and some purpose that I am deriving from this place of pain and this space in my life. I will do my best to trust in the process of my healing, the outward expansion and inward growth that I will glean, and hope that each experience and tribulation is like a crucial piece of the foundation or scaffold from which my “building” as a human becomes better, stronger, and more useful to those around me. 

Small Victory

I had a medical appointment victory yesterday, which was especially welcome after a stumble on Wednesday, where, Ben accompanied me to my appointment, but I still left feeling overwhelmed and had a post-appointment stress meltdown in the car.

Yesterday, I not only went alone, but I saw a new doctor at a further hospital (I hate driving, so this was a triumph in and of itself), stuck out the hour-long wait for my behind-schedule appointment (all while getting a worse SPD- and anxiety-induced headache), and then talked to the new doctor. He even said I was “amazingly self-expressive and precise” in my ability to discuss my problems. What are the chances?!

After initially getting off to my typical monosyllabic I-forget-why-I’m-here/I’m-too-overwhelmed-to-talk start, I pulled out my phone and showed him what I had written down: “I am on the autism spectrum and I get a little nervous and shy but I’m really glad to be meeting with you because I have not been feeling well.” Following this line, I had written a list of my current symptoms. Thankfully, he also had my hefty medical records, which he had taken the time to review before I even entered the room; I guess this is why this guy is worth the drive and the wait! Upon reading my prompt, he immediately said he’d start with the talking and when I was ready to respond, I could jump right in.

His method worked fantastically. At first, we sort of briefly addressed the pertinent highlights in my chart: I confirmed them with a nod, and then verbal affirmations, and after a few minutes, with coherent elaboration and explanation where warranted. Before I knew it, I was discussing my current problems in language that made sense to me. He chuckled as he took notes while I spoke. At first it bothered me and then I asked him what was so funny, to which he replied, “You describe things in a unique way and very directly. You admit a lot of things people won’t and it’s refreshing how candid you are.” He apologized for laughing and said he wasn’t trying to laugh at me. I assured him now that I knew why he was laughing, I wasn’t at all offended and to “laugh away because I’m a bit of a weirdo and have no problem admitting my weaknesses.” That seemed to seal the deal in assuring my comfort with him and after that, we had a fluid conversation and I even allowed him to examine me—a process that is usually like wrestling an uncooperative toddler into a snowsuit because I don’t like to be touched.

This doctor not only had fabulous bedside manner and admirable patience, but he was also bright and action-oriented. Too many times it seems like doctors just shuttle me from specialist to specialist or test to test without actually interpreting anything or making a treatment plan besides either taking the “wait and see” approach or the “go elsewhere” one. Although this doctor is sending me for more tests and referring me to two other specialists, he gave me two diagnoses after reviewing the tests I’ve already had and will follow up with me in three weeks after the other information is received to complete the necessary picture for a treatment plan.

All in all, I’m really glad that my phone prompting approach worked and that this doctor had the tools and time to work within my needs. I’m also proud of myself for sticking out the wait because I got paid back in dividends with quality care. Prior to the appointment, as I waited in the loud and stressful waiting room minute after minute beyond my scheduled appointment time, I texted with Ben about how desperately I wanted to leave and I told him I was planning to shortly. After I was weighed and the doctor was entering my information, I texted Ben, “Ugh, just now getting in.” Of course, as the doctor was scrolling on my phone to review my notes, the text alert from Ben saying, “finally!” flashed on the phone’s screen. The doctor said, “someone named Ben just gave you an enthusiastic ‘finally’!” I said, “That’s my husband’s response after I complained sorely about how I wanted to bag this whole thing because I was tired of waiting.”

He laughed. I laughed.

As I left, I emphatically thanked him for helping me and I said, “I’m not pandering to you but something in me knew you’d be worth the wait!”

I do think I fell into the hands of a competent and compassionate provider but I also think my phone strategy and my bravery helped me in this interaction. I left feeling completely exhausted—even more so than usual after an appointment—but instead of being frustrated, more anxious, and confused, I felt informed, confident, and proud.

 

Am I Safe? Are You Harmless?

Yesterday, at urgent care, I had my first trauma-related mini panic attack in a long time. It used to be a disturbingly frequent problem but with therapy, time, and courage, I’ve started regaining trust in men. I’m now able to make a critical distinction: not all men are likely perpetrators of rape or attack. Most men, like most women, are good people trying their best to lead honorable and meaningful lives (or at least not criminal ones). My attacker was the exception to the rule, not the rule itself. After the attack, I feared every man, even ones I knew (except a handful of close friends or relatives). As such, any time I was in close proximity to a man, especially in secluded or isolated environments, I’d panic. My brain would flood with worries: would he touch me, hurt me, have a knife or weapon on his person, hate me for some unknown reason or have some other motive? Was he getting too close to my body? Was there an exit close by? Physical symptoms would mount just as rapidly in tandem with my spiraling thoughts, racing heart, dizziness, a feeling of facial flushing then rapid draining of color, whispers of nausea building to overwhelming sickness. Worse, as if erasing the months passed since the trauma, I’d feel physical reminders of the wounds I had suffered, as if still etched in gaping scabs and swollen bruises on my skin. Even when I’d have flashbacks while doing everyday activities like driving, sitting in class, or grocery shopping, I’d re-feel pain from the injuries I suffered during the attack sort of like when you see a graphic scene in a movie or real life when someone incurs a serious injury and for a fleeting second, you grab that same body part on your own body as if recoiling in reactive pain and verifying your body is fine.

Anyway, for the first year after the attack, any encounter with an unfamiliar man catapulted me into panic or flashbacks. The reaction was so automatic and so dramatic that I found it very limiting. I never wanted to find myself in a situation where I’d be one-in-one with a man or the only woman in a group. So, I stayed home. I avoided asking my male professors in my graduate program any questions during their office hours or while my peers were filing out of class, even if I was clueless about assignments or concepts. Email was my only vehicle of communication. I couldn’t risk it. (Surprisingly, a number of my professors turned out to be instrumental in helping me defeat this crippling anxiety by, of course, being so friendly and harmless.)

Eventually, I got over it by slowly loosening my grasp and gradually letting the fear slip away, by taking small, manageable steps at first, restoring some confidence, amassing successfully safe interactions, and continually trying to expand the “risks” I took to conquer more and more normal situations.

Yesterday, my encounter with the x-ray tech caused all the anxious feelings to flood back in and swell to a critical mass in my brain. With the door shut behind me, I felt mildly nervous, but with all my injuries in the past couple of years, it was certainly not my first time post-attack in a closed room with a male technician; I can think of at least five this year already! Perhaps it was slightly more anxiety-provoking because I had on a gown with no pants or underwear. I don’t know if this is inappropriate to admit or helpful to those with SPD but I can’t wear underwear. I’ve tried every kind imaginable and nothing is comfortable. Like socks, something seamless may first seem tolerable, but then suddenly, it becomes a screaming impossibility to handle. I’ve been known to stop dead in my tracks while out and about and frantically rip my shoes off to peel away my socks when the sensory threshold is surpassed. I rarely see it coming, but even in January, among the icy sidewalks carved into knee-high banks of snow, I’d plop right down and remove my boots to free my feet from a sock: trudging back home with cold, wet feet was still preferable to suffering the offending sock. I imagine this same solution for uncomfortable underwear is beyond socially acceptability, so it’s better to start with nothing! Luckily, the types of pants and shorts I wear and of comfortable fabrics and loosely-fitting designs (though they leave much to be desired in terms of fashion!).

All this is to say that I ended up on the x-ray table with no pants or underwear. A thin, gauzy white gown was my only shield. I lay there, staring up into the machine’s camera arm, my own arms folded over my chest as instructed waiting. Tim, the technician, tinkered on the computer to enter my demographics. With the light out, my heartbeat starting accelerating; first, it was hardly noticeable, but with my hands over my chest, I quickly realized that it was not only beating quickly, it was also pounding, visually displacing my hands up and down with each beat. Relax, I told myself. When Tim emerged from the small closet containing his desk and computer, my ears started ringing and I became dizzy. “Are you OK?” He asked. I nodded yes, unable to speak, but my spooked eyes were a tell that I was lying. “You are very crooked on the table,” he commented. “Can you straighten yourself out?” As I have terrible kinesthetic awareness and body position sense, I am never surprised to hear this and have received similar instructions almost every time I’m at an appointment. I tried my best to align my body on the table. He started gently pushing my shoulders and straightening my neck and then my feet to position me appropriately for the picture. Like a reflex or the pop of a Jack-in-the-box, my limbs recoiled into a tight tuck position over my trunk to avoid his touch. “You’re fine! I’m just getting your spine lined up here. Don’t worry I’ve done this for years!”

I pleaded with my mind to relax. I didn’t want to feel afraid of him, and logically, I knew that he was totally harmless. In fact, I felt guilty even having unintentional anxieties about the situation. We tried again to situate my body as well as possible and then he swung the overhead camera into its designated location. He reached over me to palpate my iliac crests in tandem to verify proper positioning and a level pelvis. This is it, I thought. I squeezed my eyes as if to will myself out of the situation and transport myself to safety. But, I was safe. Just as he should be and just as he should have clearly seemed, Tim was a harmless healthcare worker trying to do his job in providing necessary medical images for my care. He retreated to his computer command station, told me to hold my breath and not move, and snapped an image. As he repositioned me for the next series, I was visibly more relaxed, and a wave of relief came over me, not just because nothing had happened and I knew that I was safe, but because ultimately, I knew the whole time that I was in good hands but my anxious reaction seemed entirely out of my control. I was embarrassed by it the moment it began stewing, and struck by how unfamiliar the reaction had become to me—a testament to the vast improvements I’ve made over the past two years. What was once as natural and automatic as turning my head when someone says my name has gradually become a faint memory, an abandoned instinct like a long-forgotten nickname whose familiarity only resurfaces years later when you hear it again.

It’s easy to feel displeased with my behavior/reaction during the imaging because it feels like I must’ve taken steps back. I’m hoping it makes sense to simply blame it on the stress and frequency of my recent medical appointments. I also choose, in this situation, to recognize the progress I have made. The encounter served as a helpful reminder of how far I’ve come, how unfamiliar and removed I felt from those once-pervasive worries, and how naturally and normally I now face everyday situations without the looming fears of getting victimized by every passing man.

Sick

Something has been off in my body for the past 24, 48, 72 hours. I don’t feel well, though it’s fairly non-specific and generalized: malaise, aches, heaviness and swelling in my joints, unrelenting headache, throbbing muscles scattered throughout my body, and vague nausea. This type of mild sickness is unfortunately fairly common for me, but that doesn’t make it any less disruptive or any easier to get through. It is often accompanied by a low-grade fever and dizziness, but so far, I’ve been spared of those symptoms in this current bout (although the magnitude of the body aches and headache seem to be proportionately worse to compensate!).

Besides the discomfort of coping with the symptoms of feeling unwell (the throbbing joint and muscle pain is the most bothersome problem), I have to combat the sensory symptoms, which are always exacerbated with this sort of illness. In fact, sometimes it is unclear whether I have an actual virus or biological underpinning to feeling sick, or if it’s a product of sensory processing disorder, PTSD, autism overload, or a combination thereof. I have reason for my suspicion as I always seem to get this concoction of symptoms after being in overstimulating environments, experiencing triggering or anxiety-provoking events, or socially stressful and overwhelming situations. It’s plausible that these psychological or emotional stressors do lower my immunity, leaving me susceptible for viral or bacterial invasion of some sort, but the typical timing of events makes that unlikely, as it occurs immediately afterward. The only difference is that these bouts last for several days with no respite, whereas unadulterated sensory overload or emotional fatigue can often be resolved with a long afternoon and full night of rehab and relaxation.

Whatever the cause, when I am sick, my auditory and tactile defensiveness are the most affected: countless tiny sounds—ones even I can normally tolerate—are excruciating. For example, I usually enjoy the sound of birds sweetly singing, but I can’t handle it today. I have noise-canceling hunting headphones, but I can still hear them through those, plus wearing them seems to turn the amplifier on my own physiologic sounds, turning the volume up on my heartbeat, the fluid rushing through my ears, and the normal whisper of my relaxed breath nearly bellows in this internal cocoon. I seem to be able to discern every square millimeter of skin and each individual hair’s slight position change when I move. I can’t allow any part of my body to touch another (like the side of one foot lying adjacent to the other) without triggering a cascade of overloading signals to my brain and bothering not just the skin of the offending parts, but my headache as well. Nothing I’ve tried (ibuprofen, ice, heat, lying down like a pancake, a dark room, a pillow over my head, the headphones, Benadryl, drinking water or tea, etc.) has helped to reset my threshold or reduce the sensory discomfort because it’s not really the illness symptoms that are bothering me so greatly; it’s the sensory issues screaming out with reckless abandon. It is hard to distract myself and divert my attention to something fun or engaging because if it alleviates one symptom, it aggregates another. For example, littering bags of frozen peas on all of the swollen joints around my body lessens the inflammation and provides temporary pain relief, but it irritates my sensitive skin so much that it feels like needles are being plunged into the surrounding tissues. Moreover, I seem to be unable to push through the fatigue into any reasonable level of productivity.

I am not pleased that this is a litany of complaints and negativity, but it is my reality, and it’s not productive nor honest to pretend that everything is fine when it’s not. I strive to be more positive but to maintain the integrity of this blog, I also share my tribulations and moments of mental weakness.

I’ve been here many times before; in fact, it happens nearly weekly, though normally for a truncated duration compared to this current affliction. Time is the only agent of improvement. The sole “solution” is patience and trying to stay calm. And so I wait, testing my inner strength to stay distracted and calm, exercising my resilience and physical tolerance, and stretching my hope that it’ll subside in the coming days.

Blood Work

I can’t stand getting my blood drawn. This phobia does not extend to needles in general, as I don’t mind shots, but getting a lab slip for blood work is a doomsday sentence for me. This is more unfortunate for my circumstances than for the average person, because my health conditions necessitate frequent routine draws. I’ve trained myself out of my fear of flying, fear of men post-attack, and other phobias over my life, but this one seems impossible to conquer.

This fear confuses me. I’ve tried to analyze it, somewhat unsuccessfully, because there are still gaps in my understanding. For example, I’m not directly afraid of anything specific about the process of blood work. In contrast, when I was afraid of flying, I was terrified that the plane would blow up in a fury of flames at take off as it built up speed. I could also explicitly point to anxiety that turbulence was “abnormal” and the plane was going to lose its lift and plummet. I reasoned my way out if these through research, which was one step that helped me conquer the gripping phobia I had. I can’t identify a cognitive (even if flawed) reason for my blood draw issue. I’m not afraid of anything bad happening: I don’t think I’ll bleed out, I don’t think the phlebotomist will damage my body in some way. Sure, it hurts, but I’ve faced many significantly more painful situations, so I don’t think it’s that. I have had several bad experiences (passing out and hitting my head because they sent me on my way too quickly, waking up another time after fainting and not understanding where I was and then panicking, and incompetent nurses or techs that had to stick me several times when they themselves panicked due to an issue with the stick, but again, nothing Earth-shattering compared to other actual traumas I’ve faced. I think part of my anxiety is that I do feel sick and lightheaded with bloodwork, but I think some of that is physiological (as I’m chronically anemic and hypotensive so I do get weakened), but it’s undoubtedly also the anxiety feeding into the physiological anxiety reaction in a chicken-and-egg self-fulfilling prophecy. The more worked up I get, the worse I start to feel, and that in turn, makes me feel more uneasy and panicked. Ever since my attack, the number-one trigger that sends me into a PTSD bout is not feeling well or, more precisely, experiencing unaccustomed or unwarranted feelings in my body. I haven’t really divulged the details of my attack here yet because it hasn’t seemed necessary and it’s quite upsetting and emotionally shaking for me to actually think about it in a detailed way. Instead, when I say “my attack,” it couches the severity of the trauma into an emotionally safer package for me. One that has become such a habitual term that I can sort of displace myself or disengage from the feelings around that day. Just saying “attack”, doesn’t fully conjure up the utterly devastating and heinous acts I survived. I’ve recently been starting targeted trauma therapy though and my therapist thinks I would benefit from talking more explicitly about what happened, as a way to get some of terrifying memories that monopolize my brain. I do occasionally talk about it in detail with my mom or Ben, but even with them, it’s generally just mentioned in passing using the globalized “attack” terminology. Anyway, I’m leading myself quite a distance from my intended topic, and thus is more of a post for another day because I’d like to continue to evaluate my lab work phobia, but the point of my digression was to confess that my physical feelings of “unwellness” fuel my PTSD because I was so severely injured during the attack that I was genuinely worried I was going to die. Unfortunately (for once), this wasn’t even all inflated by my anxiety. Anyway, I think consequently, as I kind of was operating in survival mode for the first few days afterward, stunned pretty much into silence, not working or really doing anything, I just had me and my body and it didn’t feel right and I felt unsure if I was actually going to still make it through. Even though the acuteness of the trauma was over, I felt broken in so many ways and there was no clear path, however distant, to my guaranteed recovery. Over the first few days, I started healing physically but deteriorating emotionally. I’d check my own pulse periodically to see if my heart was still beating. While thankfully I’ve never come even within earshot of that sort of physical and mental trauma since, it takes a much smaller stimulus now to shove me back into that am-I-really-going-to-be-ok? place. Although I’m countless levels tougher than I ever was before, I’m a baby when it comes to triggering feelings.

Still, I don’t know that any of that necessarily plays any more than a correlation role in my blood draw anxiety. I don’t think it’s a cause. The one piece that I do think must have some effect on the phobia is that after I lay on the floor post-attack, I was bleeding profusely and I was fighting to maintain consciousness while my body seemed to want to pass out. I was alone, except for my dog, and my phone had been ripped from my hand and thrown behind the couch, so I was pretty removed from life lines. I was too shaken to scream. I knew if I succumbed to the faint, I could potentially bleed out eventually and part of me, in that moment, was okay with that, as I saw no possible way I’d be able to pick myself up literally and figuratively after this and pull together some semblance of dignity and strength to move on. I actually credit my dog for convincing the piece of me that was willing to fight to prevail. She came slinking out of the corner where she had been hovering by the door around the turn in our hallway, out of sight. Slowly, I heard her nails ticking on the floor toward me. She was crouched and sling-backed and the hair on the back of her neck was raised. Even though he was gone and had slammed the door in front of her, she wore every color of fear. As she got within arm’s length of my body, she stopped and looked at me as if seeking approval to enter the invisible outline around me. I stared back at her, barely recognizing her for a minute. I remember thinking in my head, “wait, who’s that?” Unable to lift my heavy head yet, I simply tapped my own finger on the floor. She could read me. Come. She gingerly came forward and sniffed me. Then, in Gross Comet fashion, tried to start licking blood on the floor. That was the moment that finally I cried. It’s also the moment I decided I needed to find a way to get up, and while I’ll detail that struggle another day, I do think she played an instrumental role in me fighting my body’s protective urge to pass out and helped me save myself. Now, I think I’m particularly conditioned to fear even whispers of lightheadedness and fainting. I can’t stand that feeling. I want to be as far from it as possible because it immediately puts me back into that very worst of all my catalogued memories (and I have a very detailed and vast collection stuffed in my brain). It becomes so real; it’s as if I’m transported back to that wooden floor, plastered in terror, deciding what to do, realizing with each passing moment that I was one breath further from the person I had always been and one more into one that was frighteningly foreign: a life I didn’t know I could or wanted to bear.

I do genuinely want to rid myself of this fear. On Friday, I had to get blood work for my preoperative appointment to fix a bone in my foot. To try to quell the anxiety before it had time or momentum to build, I tried employing all sorts of relaxation and distraction techniques prior to arriving: mindfulness meditation, listening to music, deep breathing, talking on the phone, playing games, progressive muscle relaxation, even bribing myself with the promise of a reward on my Amazon wish list for getting through it. Nothing really worked. My heart was thumping and I was overheating just waiting to be called in. I tried talking to the old lady sitting next to me, something wildly outside of my comfort zone, but my brain just kept honing back in on blood work. When the nurse calmed me in, I gave a sheepish smile and tried to walk bravely over to the table. My eyelids filled will tears. They filled to their capacity before the volume exceeded the force from the surface tension holding them in. They rolled onto the paper pillow and spread like cracked eggs. She asked me my name and my voice cracked, the lump lodged in my throat hindering the ease of my most familiar word. I just swallowed. I couldn’t speak. She then looked up from her clipboard and noticed how I’d quickly melted into an emotional heap, entering the room as a young woman and now a small frightened child. She even commented I was smaller than but reminded her of her nine-year-old daughter.

Eventually, I was able to find my voice and string together enough coherent language to answer her questions and assure her I was fine, just scared of lab work. And so we began. I wish I could say it went well, but this blog is all about honesty and my reality, in all its highs and lows, mistakes and weaknesses. It did not go well and I was not the brave solider I fully intended to be. I’m unparalleled in my ability to imitate and emulate behaviors and personas in most cases (in fact, it’s one of my qualities that helps me camouflage amongst neurotypicals and evade diagnosis for so long), yet I was entirely unsuccessful in terms of willing myself to act unphased by the draw. I cried and cried. To my credit (if I can even say that in this case), they did have to get three nurses and try the stick three times because my veins kept rolling, but I still should have played a more stoic role. After the first puncture, the nurse panicked and called another over for an assist. The superior said, “oh, it rolled…no problem.”

They continued to try to rectify the draw and since I don’t look, I envisioned the worm-flipping feeling in my forearm to be part of the sample collection process. It was incredibly uncomfortable and interspersed with sharp transient flashes of pain. Then, it stopped. I felt the needle recede from my skin and the gauze applied with heavy pressure. “All done,” she said. “That was terrible,” I cried, but breathed a sigh of relief that it was behind me.

As I sat there trying to get ease my heart rate back down, I started thinking about some of my challenges and wondering if the sensory issues play a role in my body’s repulsion to the whole blood drawing experience. The textured astringent wipe that is intended to sterilize the skin creates a toe-curling offensive friction on my sensitive inner arm skin as it’s vigorously rubbed back and forth. The rubber band tourniquet similarly irritates my skin, and though I don’t necessarily have a low pain tolerance per se, it feels like I can discriminate each individual cell layer that the needle penetrates and a searingly hot wave floods my whole body even when my antecubital space is touched gently or lovingly. SPD can transpose even soft touches to razor-blade like stabs. Somewhere in my mental survey of sensory insults, I’m brought back into awareness of the pre-op room and the nurses. “Ok, let’s try this again,” she says. “WHAT?” I exclaimed, “you said we were done!” “Oh no, honey. I just meant we were done trying to fix it.” Cue the waterworks. I freaked out. Like a petulant child, I started sobbing. “You said we were finished!” Needless to say, it was two more sticks until we were done, but I survived. I’m not proud of my behavior; far from it, I was filled with shame. As I hobbled on my crutches to the car, I vowed to myself to further research how to overcome this phobia.

I have. Extensively. But nothing has really resonated with me. Even the act of writing this post has made the multifactorial nature of this phobia more apparent to me. I did notice that Autism Speaks (which has its own pros and cons) has a comprehensive downloadable toolkit for parents to exercise with their autistic child prior to bloodwork. Unfortunately, even though I can be quite child-like in many regards, this is definitely geared toward a significantly younger demographic and therefore not useful for me. (If you are reading this and are parent of a young child, you may find it to be a helpful resource.) Becoming aware of the toolkit and assessing the amount of effort that must have gone into it did encourage me to imagine that there may be truth to my sensory processing issues exacerbating the experience for me. I know that the site they always collect from has some of the thinnest and most sensitive skin on my whole body so the cleansing with the alcoholic prep pad alone sends my system into overdrive before we’ve even begun, but I’ve been surprised how many phlebotomists seem reluctant or unwilling to try another site. They are the experts, so I am sure there is a valid justification for this (though I don’t know what), but the least offensive procedure I had was at the Celiac Disease Research Center at Columbia Presbyterian and they didn’t even ask-they just used my hand. It was more seamless and less excruciatingly stressful for me, by far. Who knows. I’m not a very adamant self-advocate when it comes to medical appointments, so perhaps I am less assertive and demonstrative of my self-informed position to adequately request the procedure modifications that would be most helpful for me. I’m working on my medical-appointment imposed unintentional and involuntary selective mutism. Clearly, I’m also working on trying to understand remedy my various challenges, though it’s not a quick nor easy process. At least I have my enjoyment for research and analysis on my side and plenty of opportunities to practice. For the record, I was too disappointed in my “performance” at this last blood draw to warrant getting the foxtail I want on Amazon, so hopefully the longer that carrot dangles in front of me, the more I’ll want to deserve it. (At the same time, part of my ADHD seems to be incredibly focused but short-lived interest in any one thing, so I’m not confident that won’t need updating as well). With my surgery pushed a few weeks back, I can guarantee there will be several updates to that wish list, more reasons I’ve uncovered for my anxiety, and hopefully a bevy of additional resources or facts to pacify (or at least inform) my problem.

Strength Training

I have been lifting weights again and strength training for exactly two months. Although this has nothing to do with autism, when I started my blog, I decided not to put constraints on myself regarding what I needed to think about or write about. This blog tends to be a space where I can simply mull over and express some of the many thoughts and experiences that confuse, frustrate, excite, scare, or otherwise impact me. As mentioned, strength training also has been a big bear I wanted to retackle, after going cold turkey post-attack for a couple years. Once a huge part of my identity and an integral source of joy in my life, it became one of many things I could no longer face. Except for running, I became a voyeur of the fitness world, as the mere thought of strength training made my stomach flip.

Not anymore. I’ve been training. I wouldn’t necessarily classify this training by tacking on any adjectives like “hard” or “serious,” because I’ve tried to take a low-key approach (and I have a broken foot!), but I would say my practice has been dedicated, courageous, and empowering. And fun. For as much as I’ve been trying to hold my ground above the depression abyss, any little source of happiness must be coveted like prized possession. Plus, it’s been effective. I’m actually back up to all of my old benchmarks and lifting at least as much—and in some cases even more—weight than in my prime strength training days in NYC as a full-time trainer. I never thought I’d get my body back up to that level of physical strength because it just hasn’t seemed as resilient anymore and I’ve had so many health problems, not to mention I was basically working out all day then through my job. 

It’s interesting because I have also mentioned that I avoid looking in the mirror. While I’ve gotten better and continue my daily practice of positive self-talk, this is just to the reflection of my face. My body is a different story: I don’t look at it. Until very recently, the weather had been cold enough that I was always bundled up anyway, so I never even really “accidentally” saw it. Sometimes I feel like this is actually healthier than it sounds for me personally, because I’ve hated my body unwaveringly for so long that it can be more beneficial to ignore its appearance altogether than risk critiquing it and hating it. I hope this is not the case for most people. I even shower in the dark. 

With all that said, I’ve looked at my arms lately. In fact, I not only looked casually at them, I decided to flex them. Boy there’s a lot of muscle trapped in a little arm! My scrawny atrophied arms of the past couple of years have reverted back to my healthy and muscular arms of my younger twenties. I’m not sure how it makes me feel, maybe surprised, maybe partly (ashamedly) nervous that my attacker’s words will ring true (that having muscles and a strong body made me attractive, and thus a target). Most of the time, my logical brain assures me this is not true, but I still have to fend off the occasional worries. The good news is that I’m not repulsed by my changing appearance, so that’s a start. I hope that confidence finds her way to quietly seep in, gathering a groundswell presence while I’m busy focusing on other things, until one day, she is big and loud enough for me to notice her secure hold in my mind. From there, she can slowly open the gates for the self-hatred, fear, and trauma to begin to recede and my mind, heart, and body will start finding more peace.

Is the Sinkhole Inevitable?

I’m in a tough place today and there’s not really any specific reason or excuse for it. I suffer from chronic clinical depression. Most days, I’m actually “fine” because I’ve become so accustomed to the depressed feeling that the bar against which I compare my emotional state has been permanently lowered. On these days, I grind through the motions, keeping busy with work and daily obligations, peppered with (hopefully) some leisure activities to lift my spirits. Other days, like today, for no obvious reason, I’m not fine. Everything feels like an emotionally draining chore and my resilience seems completely dried up. On these types of days, I may even cry with just the slightest frustration or discomfort because I’m in a perpetual state of straddling the precarious threshold between holding it together and completely falling apart.

On days like today, I feel deep and genuine loneliness. I am alone all day every weekday, but even if I was blessed with company today, I’d likely still feel loneliness in my heart. That’s one of the challenges of true clinical depression—it can be virtually impossible to ease the suffer during a low because the real things I’m depressed about are just that: they are real, they are heavy, and they are virtually impossible to change. Add those factors to a neurochemistry that predisposes me to emotional lows, and it’s more of a mystery as to why I (thankfully) have mostly “fine” days versus the more occasional bad days. (For the record, I’ve been doing therapy for several years and still actively do so and I don’t respond well to anti-depressants so I steer clear of those.)

Why is today worse than usual? Like I said, it’s unclear. The weather is awful and I’m in a lot of physical pain, so those two variables don’t lend themselves to the easiest of days, but honestly, I’m in pain most days and New England weather often graces us with less-than-ideal and erratic conditions. It’s probably somewhat of a chicken-and-egg situation. The more depressed I feel, the more I become aware of the reasons behind my depression and my powerlessness (coupled with impatience in some instances) to improve these. For example, when I’m really down, it helps me to get outside and run or take a walk with Comet. Right now, it’s pouring rain and I am on crutches so this is not going to happen. That makes me feel more trapped and takes away one of the few effective coping mechanisms I have. The frequency and severity of PTSD flashbacks is significantly magnified when I feel trapped and depressed. There’s an exponential relationship between the number of flashbacks I have in a day and my depressed mood, so as they come with increasing frequency on days like today, the emotional pain I feel skyrockets. It’s pretty impossible to have a good day when your brain will not bring you peace from violent memories. I think my PTSD has been particularly bad lately because of my broken foot. It just so happens that when I was attacked, I was also in a boot with a broken foot. The injury did not contribute to the traumatic event but my brain still relates “broken foot” with “attack” because in the weeks following the attack while I was healing, I was also painfully aware of my foot situation because again, it limited how well I felt I could cope. Now when my body sees “boot” it thinks, “attack.” (Pavlov was onto something…)

I’m depressed about things other than the attack and its aftermath (the ways it still affects me today), the foot, and the weather, but the other stuff feels even less topical and more stubborn or impossible to change. For instance, I’m upset that I have all the sensory processing challenges with autism because they are so limiting. Even with dedicated OT (occupational therapy), these aren’t going to go away. I can’t change my neurology. There’s an actual issue in my brain. The only thing that I can control is my attitude toward the issue and that forces me to abdicate the captain’s chair from which I’m a lot more comfortable. It puts me in more in the passenger’s seat: a less powerful, more hands-off role, with significant limitations in my ability to effectuate change. I’m not steering the ship and it’s not going where I want it to, yet I’m told to just take out my camera and enjoy the view. Sure, a bunch of pictures of glacial bays may be pretty, but if I actually want to be sailing by a coral reef, there’s only so much satisfaction that icy vistas will give me. One of the autistic brain’s modus operandi is ruminating on something and not being flexible to change course or stop fixating. When my brain decides or wants something, it’s all in and there’s virtually no way to convince it otherwise. This isn’t always a negative trait; in fact, I’m sure it’s helped me remain steadfast in many pursuits and goals, but such inflexibility can also be frustrating and annoying (to others for sure, but to me as well!). Even when I want to change course or focus or let go of something, I often can’t and no amount of logical or emotional convincing or targeted strategies will convince the rest of my brain otherwise. Of note, partly due to this reason, I find it nearly impossible for me to transition and switch tasks. Even if I physically move on to the next thing on my agenda, nine or more times out of ten, my brain is still analyzing, cogitating, and deliberating on my last task. I am much more productive if I only take on one or two things per day and do each for an extended bout of time because I don’t waste time trying to wrangle my brain to shift gears and catch up with the new activity.

*          *          *          *          *

Well, this post has been marinating for several days. I’m not doing any better. I’m findings myself clawing at the falling rubble at the edge of the cliff as a dangle and fight the to stay on the solid land above the abyss, above the sinkhole of deep depression below. I’ve been down there so many times and it is barren, dark, cold, and scary. It’s not where I want to be and it’s even harder to climb back out than it is to cling on and try to grab any solid rocks I can find, even though this position is also terrifying and exhausting. I’m trying to distract myself and also dedicate my energy to preventing the fall. Hopefully instead of avoiding writing as I have been for a few days, I will embrace it as a tool to help hold me up where the beauty, the light, and the stability reside. I’m surrounded by goodness when I am brave enough and strong enough to see it, so hopefully admitting my current struggle will help me face the pain and this problem and fight back with the tenacity and resolute that seems hardwired in my steadfast and stubborn ASD brain.

Mirror

Here’s a secret I haven’t told anyone: After I got attacked, I refused to look in a mirror—clothed or naked—for about two years. I’m finally now working on it.

Unfortunately, I also seem to have an internal dialogue that believes that somehow my opinion doesn’t matter as much as someone else’s. I think that’s the predominant mindset of someone, like me, with low self-esteem (and boy, is that hard to change!).

Recently, I’ve started doing an admittedly embarrassing exercise to combat these issues. I hate the phrase. “killing two birds with one stone;” I prefer, “getting two for the price of one.”

When I go downstairs in the morning, it’s totally dark and still. It’s usually approaching 4:00am and the house has just a slight hum from the fan. I turn on the bathroom light and look in the mirror at my face. Out loud I say, “I am brave.”

In the moment, it doesn’t feel cheesy. Of course, documenting it in writing exposes me in a way that makes it sound beyond lame, but I’m admitting it because it’s something I need to do for myself. I try to make eye contact with my own reflected eyes and hold it for 2-3 seconds. This may sound trivial and easy, but I struggle with eye contact in general and have to make a very conscious, and often uncomfortable, effort to do so. It seems equally hard, if not harder, to hold eyes with myself. After the two years of feeling utter disgust and repulsion with my own body and employing a concerted effort to always avert my eyes to prevent myself from the disgrace of my own skin, it’s incredibly daunting and foreign to simply look at my face. If 2-3 seconds is all I can handle now, it’s still a big step, and I will recognize that.

The first day I did this, I didn’t even use the light, just the glow from my phone. I simply looked in the mirror for a second and said nothing. Then I walked away in shame and got on with my day.

After a few days, I mouthed the word “hi” to my reflected self and thought nothing of it. As I approached the living room to see my dog I thought, why did I just say hi? Then I realized: it was the first time I was re-affirming myself as someone that matters, as a person to respect, as someone to greet. It was like an introduction to or a formal acknowledgement of this person I’ve become since literally picking myself off the floor after my attack.

So then, I had a few days of mouthing “hi,” which slowly progressed to a whisper. One day, a “good morning,” then: “you are brave.” On that morning, I stared back for a second, trying to lock eyes in the mirror. I wondered, when I’m talking to my mirrored self, should it be you are brave or I am brave?

I walked away, worrying that any over-analysis would make me too self-conscious and drop the practice all together.

I fluctuate now. I’d like to say: “I am brave” but mirrors have always been weird to me (is this an ASD thing?). Either way, I’m hoping this practice will translate into an increased comfort in looking at my own face or body and slightly better self-esteem and confidence. I have a long way to go but I think this blog coincides with my self re-introduction and both are small steps toward validating my existence, my strength, and my ability to contribute something meaningful to some piece of this world.

 

Lifting

This is a tough one for me to write so I’m not sure if I will stay on topic or even get through it because I’ve started and abandoned it several times over the last few weeks. I think my best bet is just to try to remain direct and speak straight from the heart. Someday, hopefully, I’ll look back on these entries with little to no critical lens and just be glad that I documented some of my thoughts, challenges, and triumphs.

I’m putting the meat of this entry into that last bucket: I’ve finally started lifting weights again. It’s only been a couple of weeks so far, but I’m confident that I’m back into a habit that will stick. For anyone that knew me as a young adult, this probably comes as a shock. I’ve always loved working out, especially running. While I certainly have not abandoned the running and it continues to be a big part of my life, strength training has completely ceased for about 3 years. I can’t think of something more ironic (and shameful!) than a personal trainer refusing to lift or spend time in a gym. In fact, my previous blog was entirely fitness-based and a place where I shared exercise tips, information, and motivation for my clients and friends. Removing my content and deleting my site was just surface stuff; I also stopped my fitness routine outside of quite a few weekly road miles.

Why?

I don’t have a reason that likely makes sense to anyone but myself (and in hindsight, it makes little sense to me too) but it’s my reason so I’m going to own it and share it: I felt like strength training played a role in my attack and I thought that by stopping such activity, I would be safer and avoid another rape. My opinion is that some sexual assaults or violent traumas make us do things that don’t make much logical sense and that have certain faulty thought patterns and decision-making processes behind them. Trauma seems to aim its tranquilizing dart at some sort of rational thinking center in our brains, muting their normally helpful messages. Things that may make sense to a healthy person or even to that same person pre-trauma, no longer seem like the best course of action and instead, “fear-brain” is born and all she does is recognize rather noxious stimuli as anxiety-riddled situations and the only message she gives, she screams, and that is that everything is scary and you are hurting, you are broken, and you are at fault. Therapy alone doesn’t tame her. Support from family and friends can quiet, but not silence, her wrath. Time and unduly caution can take her dictatorship down a peg, but doesn’t get her to abdicate the throne. I can’t speak with authority on what does; unfortunately, I’m not there yet.

She still breathes when I breathe, she still regularly plays violent flashbacks of that morning no matter how many new memories I create, she still makes my heartbeat triple when I hear someone at the door and makes my ears ring as I fight passing out when someone surprises me from behind. And she still does her best with her domineering nature to prevent me from feeling “normal” and free.

As incorrect as the logic may be, I became afraid to work out because I didn’t want to get raped again. I knew the man that attacked me. In fact, I’ve heard this is often the case and in one survivor support group I was in, all but one of us did. How creepy is that? I think at least some of those other women didn’t choose to let that person into their life initially. It’s not their fault at all. It may have been a family member, a babysitter, a parent’s boyfriend, etc. Me? It was my choice. This person was someone I talked to at the gym, someone I worked out with, someone I gave fitness advice to, someone who told me I was attractive because I was strong and lifted. And there you have it.

While I thought nothing of that comment at the time and completely dismissed it, it clearly worked its grubby little hands into my subconscious. Once the acute aftermath of the trauma had subsided and I was pretending to go on about my life, that little message would not stand to be silenced. All of these months later, I still have been heeding to her crippling advice. I have not lifted a weight, not done a push-up, and denied myself from the strength training I enjoy in the hopes that my weakness will make me ugly (I should say uglier since I’ve never felt pretty), and protect me in the ways my muscles and strength did not the day I was so horrifically attacked. I think that’s another reason that lifting (and even personal training) has been so unappealing to me since that day. I felt like a fraud. I had this self-image that I was a strong, fit young woman certainly able to defend her body. But I wasn’t. When I needed to call upon my strength, it failed me. He did pull a knife on me, so “logical brain” says I couldn’t have defended myself because I couldn’t try, but “trauma brain” tells me I did try and I failed hard. I can’t say that she’s right because I couldn’t fight back, either from paralyzingly fear, shock, or the drawn knife blade but part of me still listens to her and hates my body for letting me down. That part has gotten its time in the sun for too long. And so, I choose to be courageous. I choose to lift.

While my emotional and mental strength has grown since that day, my body has weakened. I am nowhere near my old benchmarks, which is humbling and somewhat humiliating, to say the least, but I’m doing it, I’m loving it, and I’m taking back control.

I wish I could say that conquering this milestone has put evil “trauma brain” to rest and extinguished her fire. It hasn’t. It’s barely just the start. I’ve been working hard in therapy for a couple of years now to shake her but she’s clinging on. Hopefully, this step is one of many and someday, she’ll fade out like the last candle on the cake that stubbornly keeps flickering back up with each blow, finally ceasing in a silent little curl of gray smoke, carried upward and blending into the clouds like a tiny whisper of powerless vapor.