I hope you’ll read this riveting account of an acute anxiety attack and what happened to the person who was struck by this brain disorder since addiction is included. It is re-blogged here with the permission of the author.
FROM THE NEW YORK TIMES< OPINIONATOR SERIES ON ANXIETY JULY 15, 2012, 7:00 PM 1
Anxiety: We worry. A gallery of contributors count the ways.
Even if I live to be a thousand years old I won’t forget my first panic attack, that first surreal journey into the paranormal dimensions of my cerebral cortex. Decades later, the memory is all white heat and jagged edges. Psychologists call these acute anxiety episodes “little deaths,” but victims of them will tell you there is nothing little about them. Next to a panic attack, death, when it finally comes, will be skipping through tulips.
It was a sweltering July day in 1980 and I was sitting in a Manhattan restaurant a few blocks from the Plaza Hotel with 70 carats of emeralds in my pocket. The stones were fresh from the infamously lethal Muzo mine in Colombia, and as a favor to a good friend who had smuggled them into the country, I’d flown to New York the day before to meet with a gem dealer, the father of a college friend from Brooklyn who had “connections.” Drinks with friends until 3 a.m. the night before was not the best idea, and the pitcher of black coffee I poured down my throat in the Palm Room a few hours later flooded my central nervous system with Jamaican voodoo and high-voltage insults. So after a testy morning of bickering over occlusions and color and squinting through jewelers’ loupes, I was a little on edge when the gem dealer invited me to lunch.
I heard a muffled “linguine Alfredo,” and that’s when the film snapped.
I first noticed the seizures in my fingers when we were seated — bizarre, neurological twitches that made my digits dance like grasshoppers on the linen tablecloth. A tic in my left eye kept shuttering my vision. The dining room was jammed to the fleur-de-lis wallpaper with red-faced white guys in blue suits and harried looking waiters in penguin costumes. Not my crowd. I remember hearing a muffled “linguine Alfredo” and the clinking of glasses at another table, and then the film snaps. This, as I’ve come to think of it, was the moment my first life stopped, where the film broke and the reel spun around and around, flogging itself.
I couldn’t move. I was suddenly, inexplicably, paralyzed with anxiety. As researchers would learn years later when they peered into our brains with PET scans, the electrical messaging between the amygdala and the anterior cingulate in my brain had gone “Tilt!’” The sudden storm of impulses surging between these tiny glands lit up my central nervous system like a Christmas tree hit by lightning. A neurological journey measured in milliseconds launched me across a threshold wider than any ocean, from my happy-go-lucky, anything-goes carnival of a life to a place that was scarier than the hospital scene with Heath Ledger’s Joker playing Russian roulette.
The initial tremor of voltage wormed its way up the back of my neck in a vertiginous rush of heat. Before I could grab the table to steady myself, the snake uncoiled itself inside my head and struck my prefrontal cortex with a ferocity that made my heart pummel my ribs, trying to break out. In a flash, my arms and legs went numb from the elbows and knees down, a band of steel encircled my head, I trembled, sweat poured off my forehead, and the spinning behind my eyes was speeding up.
“Are you all right?” asked the dealer.
“Get me outta here.”
I couldn’t actually shape the word “dying” with my mouth, but that’s what I thought. That’s what I felt. This was it, the Joker, his hot tongue slobbering all over me. I reached for a glass of water but it flew out of my hand and shattered. I pushed back from the table and stood up and my friend caught me before my legs buckled. As we made our way to the door all I could think about was my wife and our 11-month-old son. They were so far away. I would never see them again; this was curtains.
What I couldn’t know at that moment was that I’d crossed a frontera, a border crossing separating my old life from the new, and there was no way back, any more than I could return to my mother’s womb or rewrite my genome. This was the new me, a verdict with no appeals, no chance at parole. My brain had betrayed me, and in this new life I would have to learn how to function in a suspended state between the deadening banality of the exterior world and the theater of the absurd that tormented me from within. I was now living with an intimate stranger, trapped, it seemed, between two profoundly distorted mirrors with no way out.
Once outside, I managed to get my bearings, but the storm raging at the center of my brain was getting worse. Panic deepened with each breath. The dealer took my pulse and blurted an expletive.
“Can you walk? I know a doctor up the street.”
Somehow, we got there. The next two hours are phantom memories. My heart was beating so fast — 220 beats a minute according to the doctor — that very little oxygen was getting to my brain. The doctor, an elderly German with kind eyes and soft, thick hands, laid me out on a bed in his office, covered me with blankets, gave me a shot of a barbiturate, and I was gone. When I came around a little while later, he said, “You have experienced an acute anxiety attack. I think you’re going to be fine, now, but I want you to take one of these if it ever happens again.”
I took the small vial of pills, thanked him profusely, and got up and left.
Thus began my descent into the world of acronyms (EEGs, EKGs, G.A.D.’s, LMNOPs), bewildered doctors, frustrated psychologists, and a three-ring circus of pharmaceutical adventures. Years later, after my second stint in a clinical study on depression and anxiety at the University of Arizona Medical Center, I made a T-shirt that read, “Lab Rat.”
I flew home to Montana with a vial of Valium, a few emeralds and a rationalized story that I had “gotten a bad oyster.” I wanted more than anything to believe that story, but it was only a matter of time before the hair-trigger in my amygdala wasted that fantasy.
The second time the Joker struck was on a snowy evening the following November as I was rocking my son to sleep. The attack was ruthless, without warning, another world-class humdinger of a meltdown. “This is not good,” I told myself as I waited for the doctor in the emergency room, “this will not end well.”
The attacks came in shorter intervals over the next few years, and I soon learned that I knew more about acute anxiety than most of the doctors treating me. Tests revealed nothing abnormal. Their bewilderment was palpable. My refrain, “There has to be an organic source to this,” fell on deaf ears and glazed eyes as they scribbled out yet another prescription. Even 25 years ago, before PET scans and other imaging break-throughs, the inner workings of the human brain were an enigma to medical science. My doctors didn’t know that their best efforts to control the beast in my head were making the beast more and more uncontrollable.
Desperate, I threw myself into my work. Photojournalism forced me to break through the gravitational field pulling me inward, to turn outward and engage the world through the viewfinder. That hope, like so many others, was in vain. Nothing worked. Then one winter evening, a neighbor, a minister’s wife, knocked on our door. I cracked it open a few inches and saw her kind, gentle smile. “I think I know how you’re suffering, and I think this might help,” she said. She slipped a blue clothbound book through the slot: “Peace From Nervous Suffering,” by Dr. Claire Weekes. “This is for you. I have my own copy.” I read it cover to cover, that night, and then I curled up around that book and wept. Finally, someone understood my living hell. I wasn’t alone.
As a journalist I covered wars, presidential campaigns, natural disasters, you name it, all with the Joker on my back and that book in my camera bag. Claire Weekes went everywhere I went. She was a brave and brilliant pioneer in the field of emotional brain physiology, and her fearless insights and calm compassion gave me a fighting chance against the black pit of despair, a place to plant my feet on solid ground when the world all around me was heaving with madness and dissolution. But she, alone, could not stop the attacks. They kept coming, those E-tickets on the Anxiety Express, with varying intensity and varying frequency. You haven’t explored the farthest reaches of the existentially surreal until you’ve had a grand mal panic attack during an 8.2 earthquake in a war zone in the middle of the night. Alone, in a foreign country. Peak experience.
Read previous contributions to this series.
Inevitably, the 10-year-long addiction to Valium led to intense medical detox, including a course of Dilantin to stop the seizures, and a year of mind-bending withdrawals from the benzodiazepine curse. Then came the terror of confronting the world metal-on-metal, without a buffer. This was yet another new frontera, the border crossing into my third life. If you survive this last crossing, you’ll always have something to laugh at, yourself, and an experience so absurd in its comedic/tragic dimensions that the only possible venue for objective reflection is in the funhouse mirror of the everyday.
I survived. The Thorazine, imipramine, benzodiazepines, opiates and rivers of alcohol, the serotonin reuptake inhibitors, the uppers and downers, inners, outers, laughers and screamers, are all markers of a distant past. I haven’t had a panic attack in many years, but there’s always tomorrow, or tonight, or 10 minutes from now. Ruthless, unprovoked, no warning.
When I paid my 10 bucks a few years ago to see “Batman: The Dark Knight,” one glance at the hideous feral leer of Heath Ledger’s Joker took me right back to that July day in New York City. Ledger was a brilliant, once-in-a-generation talent beset by the emotional anarchy of acute anxiety and one or more of its sinister first cousins; depression, insomnia, isolation, mania, personality disintegration and O.C.D., and that’s just the front row in the family portrait of demons. By the time the film was released, Ledger had already fallen into the abyss with the help of a cocktail of prescribed remedies, but of this I am certain. His Joker was no illusion, no dark fantasy of his imagination. His Joker, whom he described as a “psychopathic, mass-murdering, schizophrenic clown with zero empathy,” was the real deal, the mocking personification of the intimate beast trapped between two mirrors in both of our heads. When Jack Nicholson — who played the Joker in 1989 — was informed of Ledger’s death, he cryptically told reporters: “Well, I warned him.”
It’s a shame that our six degrees of separation could not be narrowed to one. Maybe, just maybe, I could have thrown that young man a life ring on a stormy night. Maybe I could have slipped a blue clothbound book through a crack in his door and somehow made a difference. And maybe not. We’ll never know. The Joker got there first.
(Anxiety welcomes submissions at firstname.lastname@example.org.)
Paul VanDevelder is a photojournalist, filmmaker and screenwriter, and the author of “Coyote Warrior: One Man, Three Tribes, and the Trial that Forged a Nation” and “Savages and Scoundrels: The Untold Story of America’s Road to Empire Through Indian Territory.”
There have been many grieving parents and loved ones who have commented on my post about Philip Seymour Hoffman. My heart aches for them.
While watching a documentary the other day about the spiritual teacher Ram Dass, approximately 13 minutes in, parents from Ashland, Oregon tell of the loss of their 11 yr. old daughter. The mother then reads a letter they received from their friend Ram Dass. I was so moved by the letter that I stopped the film and copied the it word for word (errors in punctuation are mine).. I share it here in hopes that his words also touch the hearts of those who are grieving and have shared their experiences with us all.
Here is the letter in its entirety:
From the 2001 documentary, FIERCE GRACE, about the western Hindu teacher Ram Dass (formerly Harvard professor Richard Alpert, PhD).
Steve and Anita,
Rachel finished her brief work on earth and left the stage in a manner that leaves those of us left behind with a cry of agony in our hearts as the fragile threads of faith are dealt with so violently.
Is anyone strong enough to stay conscious through such teachings as you are receiving? Probably very few, and even they would only have a whisper of equanimity and spacious peace midst the screaming trumpets of their rage, grief, horror, and desolation.
I cannot assuage your pain with any words, nor should I, for your pain is Rachel’s legacy to you. Not that she or I would inflict such pain by choice, but there it is. And it must burn its purifying way to completion.
You may emerge from this ordeal more dead than alive, for something within you dies when you bear the unbearable. And it is only in that dark night of the soul that you are prepared to see as God sees, and to love as God loves.
Now is the time to let your grief find expression. No false strength. Now is the time to sit quietly and speak to Rachel and thank her for being with you these few years and to encourage her to go on with her work, knowing that you will grow in compassion and wisdom from this experience.
In my heart I know that you and she will meet again and again and recognize the many ways in which you have known each other. And when you meet, you will in a flash know what now it is not given to you to know, why this had to be the way it was. Your rational minds cannot understand what has happened. But your hearts, if you can keep them open to God, with find their own intuitive way.
Rachel came through you to do her work on earth, which included her manner of death. Now her soul is free and the love that you can share with her is invulnerable to the winds of changing time and space. In that deep love include me too.
So much love,
Below is the link to an essay by a professional writer who is oh-so-much-more eloquent and concise in his description of the experience of craving and choice in the life of an addict in recovery. I think he nailed it.
Congratulations to Tina Turner, who got married yesterday, apparently while I was writing this post : ) Little did I know that my blog title would come to me on a special day in her life. I admire her greatly. And I am certain that she knows all to well ‘what love has to do with it’ as well as what I learned about trust only this week. I pray that she and her new husband know only happiness together!
And now about trust…..
I had a startling insight the other day. Startling not because of any brilliance on my part, but because of how surprised I am that I have lived all of these years not understanding something so basic and important.
If you have a history of secure and fulfilling relationships you already know what trust has to do with it so you can skip this. However, if you or anyone you care about has difficulty creating safe, stable, and fulfilling intimate relationships then you might want to read on.
Here’s the context:
Five months ago my second husband announced without warning that our marriage was over and he also refused to talk about it saying, “I don’t do forensics.” It was his analytic way of saying to the woman who made his dinner and shared his bed the night before, “You’re dead to me.” I didn’t know that I was married to a mafioso. I was about to find out.
He really meant it. He didn’t talk to me anymore. He didn’t move out either. So after 5 really awful, silent days of grieving in a small house with my husband unwilling to be in the same room with me or speak to me, I left.
He still won’t communicate. He won’t answer an email of any kind. All communications have to go through lawyers. Seriously, Tony Soprano on his worst day would have shown me more mercy.
Results are that I’ve been left to figure out what went wrong with my 18 month long second marriage by myself. In the ‘shock and awe’ of his departure strategy I couldn’t understand anything about our relationship. And I really, really want to understand what happened because I really, really don’t want to go through anything this painful again, ever.
And now about that insight:
The other day I was musing over one of the 6 disagreements my husband and I had during our short marriage. Yes, I counted because there were so few of them, they were easy to track. It was during this moment of contemplation that I met my inner mechanic.
I didn’t know I had an inner mechanic. But there he was, a kind, pragmatic, gentle masculine energy–like Mark Harmon on NCIS, on any cowboy good guy in a western. He lifted up the “hood” and looked into my heart and said, “Well, there’s your trouble.” And in one thought all the pieces of the puzzle fell into place.
My inner mechanic said, “You don’t trust him.”
In that instant I remembered the moment when my trust in my husband was broken, about 9 months into the marriage. He had humiliated and disrespected me in public in front of my friends. And every 3-4 months he would repeat this behavior. Over time he expanded the audience of my embarrassment to include his adult children. I realized in this flash of memory that not only did I not trust him, but also that I had been completely unaware that my trust in him was gone.
HOW COULD I HAVE NOT KNOWN THAT?! Who doesn’t know that they can’t trust their spouse? And how could I have had such enormous feelings of love for him throughout our short marriage (18 months) when I didn’t trust him?
This insight left me “speechless,” even my mind shut up.
I can feel love and take loving actions, but I don’t know, at my age and after all of my training and experiences, that without trust in my husband that there will never be intimacy between us. Wow. If I was missing a leg, would I fail to notice it? I am a relatively smart person with a supposedly high emotional IQ. I am still stunned at the level of my unconsciousness.
Space and time prohibit the full explanation of how my deep state of cluelessness came to be my modus operandi since….well, forever. But I suspect I am not the only one who is willing to love people they can’t trust.
Turns out that loving feelings and loving actions are separate from being able to trust someone. Seems obvious to me now, but I hadn’t ever stop to think about it until now.
I suspect that there are lots and lots of couples out there who love each other but no longer trust each other. I’m thinking that there are lots of marriage counselors getting paid to try and patch that problem up while not being able to articulate the core question, “do you trust her/him not to hurt you?”
So what does trust got to do with it? Why isn’t love enough to make a marriage work?
Here’s what I have figured out so far. Feel free to add to this. I want to learn all that I can.
1) If I can’t trust him to avoid hurting me, then I won’t be vulnerable with him. I’ll keep my emotional distance instinctively–meaning whether I am conscious of keeping my distance or not.
Check. I did begin to withdraw after he repeated his public display of disdain for me. And while I made every attempt to communicate with him about my hurt feelings, forgive him, and remain kind and loving, I had instinctively and unconsciously drawn an emotional line in the sand that I didn’t cross again. The problem is that you can’t make a marriage work with distance between you.
2) If I can’t be vulnerable with him, I can’t really be myself with him. I’ll give him the parts of me that I think he likes best because I want to feel love from him.
Check. I began to avoid giving him any news that I thought would be stressful to him. I began adjusting myself to think about what he would like before I did things. What I wanted was to feel more love from him. It didn’t occur to me that I was afraid of him getting upset with me.
3) If I can’t be myself with him, I can’t keep my connection with him strong, no matter how much I love him.
Check. Everything makes more sense in hindsight. I remember feeling more and more like I was doing something wrong, but I couldn’t figure out what is was during the last 6 months of our marriage. It took effort for me to try and get on the same page as my husband. We spent time together and talked a lot about a lot of things, but not so much about our feelings.
I wanted to do more things together as a couple–date type of activities and I couldn’t get his interest in them. He certainly didn’t initiate anything. At the time I passed this off to his busy work schedule. And so I tried just leaning into whatever was going on with him and work and his grandkids as a way of connecting with him but it didn’t work very well.
Now I know why. It wasn’t mutual. He wasn’t trying to connect with me. And if he had tried, he would have met that line in the sand I had unconsciously drawn and kept moving each time he berated me in front of friends or family.
4) If my connection to him isn’t strong then I can’t experience intimacy with him.
Check. About the time I started adjusting myself to please him (see #2), our intimate life began to feel strained to me. It wasn’t effortless anymore. I began having problems with thinking too much. It never crossed my mind that there were emotional issues in the marriage. I thought that our honeymoon phase was coming to a close as it does for every couple. And I blamed myself for my difficulties with responding to him physically.
It makes sense now. If I can’t be myself with my clothes on, I’m not going to be able to be myself with them off. I loved him and I wanted to be with him but my protective emotional distance and my increased need to please him took me away from the moment, a real deterrent to enjoying what marriage has to offer.
While a satisfying sex life isn’t the only component of connection in couples, sex is the canary in the coal mine of true connection in a relationship. If your sex life starts to sputter, something is wrong in the trust/vulnerability/connection department and your relationship is in danger. Partners who are connected can have medically induced sexual dysfunction and still have a satisfying sex life. This is fact. But when the connection between couples becomes weakened, their sex life stalls out.
5) And without intimacy I will not know love. I can have a relationship. I can love him, but I will not feel loved. And when I love but don’t feel loved, I suffer because I am not that much of a saint to be able to be a wife to a husband with whom I can’t have a connection.
Check. By the third time he “made a joke” at my expense in front of family and friends I was not feeling loved or respected. And by the fourth time he utterly failed to protect me or my feelings, dismissed me for being upset at all, and looked at me with a kind of contempt I’ve never seen before, I exploded in tears and yelled at him for not loving me.
And then I recovered. We spoke about things. That is, I spoke about things. He listened. I felt heard. I took responsibility for holding in feelings and then exploding. I apologized. We seemed to get back on track. I did notice a few days later he had not apologized for failing to look out for my well-being, dismissing me, and being insensitive. There was so much unpacking to do after the move across the country I decided that I would ask him about that later.
One instance every 3-4 months isn’t enough to send me to a divorce lawyer. I’m a traditional gal. I like to keep my commitments. And for whatever reasons, I loved this man with my whole heart. And he said he loved me and he showed that he loved me with the exception of those 5 or 6 moments of hostility. My thought was that we’re doing alright for older newlyweds with emotional baggage from our first marriages. And like most of us who end up loving spouses we can’t trust, I had enough optimism for the both of us that time would allow us to work things out.
Now I know that I was headed for increased suffering if our marriage had continued. I know that a pattern of disrespect and hostility only increases in frequency over time. So every 3 months would have turned into every month and then every week pretty quickly.
So, I figured out what went wrong in my short marriage without my husband’s help. But he had already done enough. My husband did me the biggest favor he could have ever done. He left me.
The rationalizations of a married woman who loves her husband are powerful things. They will keep her in a relationship that is unhappy and unloving, sometimes for life.
My inner mechanic taught me in an instant that if I want a true marriage I need to be able to trust my husband not to hurt me in any way.
And that’s what trust has to do with it.
“Connection is the energy created between people when they feel seen, heard, and valued–when they can give and receive without judgement.” Bene Brown, PHD, LMSW
Socializing is really difficult for me sometimes. Now is one of those times. I have the skills. I don’t mind the mild anxiety (what should I say? did I say too much?did I leave too early? did I stay too long?….) that comes with the activity. It’s just that talking is draining these days. I feel overwhelmed and exhausted by the experience.
Some of the nicest people I know have reached out to me in the aftermath of the emotional and financial tornado that mowed down my life and I can’t connect right now. I don’t mean to be rude, mean, or indifferent. I just don’t have it in me to talk.
This is where I wish I could have gotten away with telling everyone that my husband had died after spending all of our money. If I was a poor widow no one would be expecting me to return calls or go out to social events yet. But memories and empathy are in short supply these days and apparently the rest and recover period has expired for women whose husbands walk out on them after 18 months and take all the money.
It’s hard to be upset with anyone–that takes too much energy also. Everyone’s got her/his own troubles to manage. Also, I know I make people feel better about their own lives when they can get me to talk about what is going on in mine. By comparison their stress isn’t so bad. (It’s a tough job being at the top of the life stressor heap, but somebody’s got to do it.) So I can’t blame them for wanting to “check in” on me from time to time.
I sound like I’m depressed. Yep. I am. Gratefully, it’s not the ‘can’t get out of bed or brush my teeth’ variety. It’s the ‘my life just blew up and I’m overwhelmed’ type of depression. And what I’ve learned is that I am newly sensitive to my own energy level, especially if it dips too low. Life is difficult enough at the moment. I don’t want to let myself get to the ‘can’t get out of bed’ place.
Talking drains my energy. Especially talking about him, what he did, what he’s done to me recently, and what he might do when it’s time to go to court. And if I try to answer the question, “what are you going to do now?” you can be certain it will need to be followed by a long nap because I have no reasonable ideas about where to go from here.
All of this reminded me of an old saying that my mother and grandmother used to repeat, “If you can’t say anything nice, don’t say anything at all.”
I can tell you everything you need to know about my family by saying this: there wasn’t a lot of talking in my house.
This was crazy-making to us kids because you couldn’t figure out what was wrong all the time and you couldn’t predict when the next unsettling event was going to take place. We might as well have been living on a chicken farm for all the eggshells we walked on.
Predictably, I started talking when I left home to go to college. I don’t think I ever stopped. This too has had its problems, but they were not nearly as difficult or as stressful as living with the quiet and courteous hostility that I grew up with.
Hmmm…quiet, courteous, and hostile. I guess that’s who my husband really was. After all my experience in my family with that style of non-communication I am surprised that I didn’t pick up on it in him. My family never walked out on me though. Maybe the kind of hostility that makes someone treat you really well up until the moment they leave you is a different kind of rage. Or maybe hostility is just so familiar to me that I didn’t take notice of it. Something like the odor in your house after you cook a favorite family meal….only a guest who hadn’t eaten that meal before would notice the smell. I wonder, what does rage smell like? Garlic? Cauliflower? Tomato sauce? Liver and onions? Burnt popcorn?
Curiously, I am invoking the right to “not say anything at all” precisely because I can’t “say anything nice” at the moment. Am I reverting? Nah. (At least that’s what I’m telling myself. So please, don’t argue with me. Thanks.)
I think, I hope I’ve come full circle. I’m not pretending I’m not angry. I’m not repressing or suppressing my anger only to have it exert itself in other ways or all at once. I’m not “saying anything at all” because talking about the devastation my personal tornado has caused makes me feel depleted and upset. It hurts me. Having the experience of being a victim is draining. I can’t afford the energy loss if I want to stay up and out of bed.
My dear family tried their best but we missed the point. “Don’t say anything at all” is not for the purpose of being courteous, it is to allow you to express your anger appropriately, make adjustments in your life as needed, and then transcend the negativity. “Don’t say anything at all” is a way to power up out of being a victim.
Conversely, unless you’re trying to sort things out and create solutions for yourself, talking about the awful things that life throws at you, telling that story over and over again, keeps you in the victim spot. And it can do so permanently, if you let it. I, for one, do not want to become the docent of the ruins of my own life, recounting the stories of what once was my life and how the tornado called Bob came through and destroyed it all. I’ll end up being a personal archeological site: uncomfortable, dusty, and boring.
Perhaps I’ll take up storytelling again when I can link my losses to what I can create in their aftermath. But for now, I’m not saying anything.