Impulse Control

“As for impulsiveness, a volume could be written about the disastrous consequences of this symptom. It has ruined many a business, many a marriage, and many a life.”

- Karl Menninger

Before I turned twenty-five I had:

  • Committed early to college to play lacrosse

  • Blew all of my money skydiving

  • Changed my major multiple times

  • Enlisted in the Marine Corps

  • Moved into an apartment without steady income

  • Attempted suicide three times

I was impulsive, and I was young. My prefrontal cortex was still developing.

In fact, some research indicates that, “the frontal lobes, home to key components of the neural circuitry underlying ‘executive functions’ such as planning, working memory, and impulse control, are among the last areas of the brain to mature; they may not be fully developed until halfway through the third decade of life” (Johnson, Blum, & Giedd).

Kids, I get to call them that now that I’m thirty, do not have the mental hardware to deeply consider anything beyond their immediate future.

Many adults look at the behavior of adolescents with bemused concern. Surprised at what we consider silly behavior, we ask: “don’t they think about the consequences?” They do! Just not like adults with fully developed frontal lobes.

impulse_hobbes.png

Kids, for the most part, have a dial-up connection to their impulse control center. Adults have a 4G connection. It is no wonder that young people will think through a decision, experience slow loading times, and decide to do what they want.

The lack of impulse control may be why we see that, “suicide is the 2nd leading cause of death in the world for those aged 15-24 years.”

15-24. Ages where a young person goes through at least three different learning environments, experiences vast changes to their bodies, simultaneously juggles youth and adult personas, and, as if to add more to their plate, every adult asks what they plan to do with the rest of their life.

Add in the potential for bullying, social isolation, poverty, physical and sexual abuse, mediocre parenting, poor parenting, or no parenting, and you can see that kids, despite our adult objections to the contrary, do not have it easy. To say otherwise demeans them, and calls into question the validity of our own growing pains.

Are you worried about your child, but do not know where to start? The American Foundation for Suicide Prevention has an excellent list of resources that will help: https://afsp.org/campaigns/talk-about-mental-health-awareness-month/teens-and-suicide-what-parents-should-know/

PANIC Attacks!

Not to be confused with worry or concern. Panic, is concentrated fear.

The symptoms can include some, or all, of the following:

managing-a-panic-attack.jpg
  • Palpitations, pounding heart, or accelerated heart rate

  • Sweating

  • Trembling or shaking

  • Sensations of shortness of breath or smothering

  • Feelings of choking

  • Chest pain or discomfort

  • Nausea or abdominal distress

  • Feeling dizzy, unsteady, light-headed, or faint

  • Chills or heat sensations

  • Paresthesia (numbness or tingling sensations)

  • Derealization (feelings of unreality) or depersonalization (being detached from oneself)

  • Fear of losing control or “going crazy”

  • Fear of dying

Panic attacks are extremely unpleasant and can be very frightening. As a result, people who experience repeated panic attacks often become very worried about having another attack and may make changes to their lifestyle so as to avoid having panic attacks. 

https://adaa.org/understanding-anxiety/panic-disorder-agoraphobia/symptoms

All of this sounds bad, but the symptoms and description of “extremely unpleasant’ and “very frightening” does not quite encapsulate what a panic attack truly feels like.

If you have never experienced a panic attack, I wish that you never do. But, you can imagine what one feels like.

Pretend that you are relaxing in front of the television, watching your favorite show; when all of a sudden, a 700 pound Siberian Tiger bursts into your living room. It roars, and your brain quickly realizes that you just got knocked down to the bottom of the food chain. The tiger sits back on it’s haunches, coiling it’s powerful rear legs, and then leaps across the room directly at you.

“I’m going to f____ you up.”

“I’m going to f____ you up.”

It’s mouth is wide open, large teeth clearly visible, and right before you realize you are about to die, the tiger vanishes into a wisp of smoke.

Then, a 700 pound Siberian Tiger bursts into your living room. Roars, leaps, is about to tear you about apart, and then it disappears.

Roar. Leap. Death. Fade.

Roar. Death. Fade.

Death. Fade.

Death. Death. Death. Death. Death.

Panic attacks are the psychological equivalent of this imagined scenario. You constantly ride the edge between life and death, almost 100% certain that you will die. That your death will be both agonizing and slow.

What would you do if a massive tiger leap at you right now? Fighting it is useless. You have no chance of running away. All you can do, is be frozen in place while you get yourself right with your maker.

See how horrifying that is? It is no wonder that a panic attack can be debilitating in the moment, but the effects can linger.

Say the tiger vanishes and does not reappear. Your mind is ready for it to pop back into existence to end yours. But it does not. Tentatively, you stand up, arms in front of your torso to give your vulnerable belly some measure of protection.

Imagine your mind on fire.

Imagine your mind on fire.

Your senses are heightened, blood is pounding, and fear compels you to either sprint or freeze.

At that point, you don’t think that you have to pick up your kids from school later that day. You aren’t worried about that staff meeting at 2pm.

Your brain is on overdrive, trying to find the TIGER THAT WILL KILL YOU!

It takes some time to come down from that state.

In my experience, there is no immediate “snapping out” of a panic attack. You need to let it run its course. It will be awful, but, I promise you, it will end. You will be okay.

Life in a Psychiatric Hospital - Part 2

Routine.

Visit any psychiatric ward, anywhere in the country, and you will find a daily routine that the caretakers follow. Why is routine important? Why are vitals taken each morning? Why are meals served at the exact same times? Why are groups part of every day?

Because in the throes of withdrawal or with someone not long after a suicide attempt - the mind is shattered.

USS Constellation  - I run by it most mornings.

USS Constellation - I run by it most mornings.

Imagine your mind as a ship. You are the captain of the ship, but you are also every officer, every deckhand, and even every piece of wood and rope that make up the ship. Then a storm comes, the ship/you runs aground, and splinters into pieces. You reach out and grab hold of a floating plank, where you desperately try to keep your head above water in the heaving seas.

You become the captain of a wood plank, floating alone in the chaotic abyss.

Routine is the starting process for rebuilding a ship. You don’t throw wood and nails into a dry dock and expect a ship to come together without a plan. Nor should you expect that to happen with your mind.

Most hospitals follow a routine:

Vitals are taken every day so the nursing staff and doctors can notice any significant changes in a person’s physical health.

Vitals are taken every day so the nursing staff and doctors can notice any significant changes in a person’s physical health.

  • Morning

    • Wake up, vitals, meds

    • Breakfast

    • Group session

  • Afternoon

    • Lunch

    • Group session

    • Break

  • Evening

    • Group session

    • Dinner

    • Meds

The routine is dull, uninteresting, and unexciting - by design!

Imagine you’re desperately gripping your wooden plank, and, by some miracle, a party cruise liner breaks over the horizon. You are rescued and immediately thrown into a world of bright lights, loud noises, curious food, and you haven’t a clue what the destination is. You’re grateful to be out of the water, certainly, but you have a whole new host of issues to navigate.

Now imagine you are saved by the Coast Guard. Everyone is wearing the same uniform, everyone fits into a particular role, everyone is calm in the face of danger. A medic checks you out, you’re given a blanket and a cup of coco, and told where you will be taken to next. You’re just as grateful to be out of the water as you were in the first scenario, but all of your issues are taken care of for you.

That is the magic of routine. It gives a mind in chaos something to hold onto. Something that makes sense. Something that can be counted on.

That is where recovery can begin.


A GIGANTIC thank you to the following people for breaking my $1,000 goal for the Baltimore Out of the Darkness Walk!

  • Collette Dixon

  • Roger and Margo Coleman

  • Lou and Mary Jo Corsetti

  • Caitlin Corsetti

  • James Hunt

  • Samantha Perrine

  • The Smith Family

  • Natalie Wills

  • Kate and Mark Bernal

  • Andi O’Connor

  • The Assaf Family

  • Kevin Greene

  • The Arney Family

  • Jim Fiora

  • Cara Morris

The Mental Dictator

Consider the following by Thanatologist, Dr. Sneidman

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Every single instance of suicide is an action by the dictator or emperor in your mind. But in every case of suicide, the person is getting bad advice from a part of that mind, the inner chamber of councilors, who are temporarily in a panicked state and in no position to serve in the person’s best long-range interests.

Then it is time to reach outside your own imperial head and seek more qualified and measured advice from other voices, who out of their loyalty to your larger social self, will throw in on the side of life, and - to use a Japanese image - will urge the chrysanthemum, not the sword.

- Edwin Shneidman

I cannot stress enough how important it is for me to externalize my depression. It is incredibly difficult to fight yourself AND depression. Imagine sparring yourself while depression wraps around your body and taunts you like Venom.

venom_quote.png

The whole time you can’t hit yourself because you know yourself too well, and the depression just laughs and laughs.

It’s exhausting, infuriating, and, despite the massive amount of energy you put into fighting, ultimately ineffective.

As Shneidman alludes to, I consider my depression a unique entity within my mind. Something that may be a part of me, but is definitely separate from what I consider to be ME.

This mindset lets me attack thoughts and feelings that arise from my mental dictator. What depressives have in common is our relative inability to recognize when our dictator is taking greater control over territory within our mind.

Fortunately, all great generals have advisors. AND that is where I missed the mark for so many years.

When I was younger I did not consider that others might notice the hostile takeover of my mental dictator before I did. So I modified the advice of Sun Tzu:

Be extremely subtle, even to the point of formlessness. Be extremely mysterious, even to the point of soundlessness. Thereby you can be the director of the opponent's fate.

My enemy is within me. It knows what I know. It feels what I feel. It has one hell of an advantage over me, but it only has that advantage over me. Because of this, it is incredibly weak to my family, friends, therapists, and coworkers.

I cannot recognize that I am about to be depressed due to my depression. It’s a weird blind spot. I only realize it when I am much deeper in the hole than I care to be. So I outsourced identifying the problem to the people that care about me.

Here’s what I do when the dictator begins a new attack:

  1. I say less and less (very subtle, often displays as never answering my phone).

  2. I stop shaving.

  3. I start showing up to things later and later.

  4. When asked, “how are you?” I reply: “I’m okay”, or “I’m alright”.

  5. I decline plans at the last minute.

There are other behaviors, sure. But these are the ones that are more easily identified by other people.

So, if you see me exhibit one or more of these behaviors - do me a favor, and ask me if I’m really doing okay.

Treat Your Thoughts as Honored Guests

I read this poem in the waiting room of a yoga studio in San Antonio, TX. I was fortunate that the hotel hosting a NASO Officiating Conference was located by a quality studio and a tremendous food truck park.

I was struck by Rumi’s idea of treating every thought as an honored guest. Happy, bad, good, evil, inspiring, depressing - the thought does not matter according to Rumi. What matters is your reaction to the thought.

This is not an easy idea to accept, and it is an even harder one to put into daily practice. I don’t think this way all the time, but I am getting better at recognizing my reaction to the thoughts that arrive at my mind’s door. And I try to be a good host.

This being human is a guest house.

Every morning a new arrival.

A joy, a depression, a meanness,

some momentary awareness comes

as an unexpected visitor.

Welcome and entertain them all!

Even if they are a crowd of sorrows,

who violently sweep your house

empty of its furniture,

still, treat each guest honorably.

He may be clearing you out

for some new delight.

The dark thought, the shame, the malice.

meet them at the door laughing and invite them in.

Be grateful for whatever comes.

because each has been sent

as a guide from beyond.

Jalal al-Din Rumi,

translation by Coleman Barks

Stillness

Feel your emotions. Live true your passions. Keep still your mind.
- Geoffrey Gluckman

Among my stillness was a pounding heart.
- Shannon Thompson

Time passes so fast. Make time to be still.
- Lailah Akita

Listen to the murmur of the water and you'll hear Mother Nature.
Listen to the stillness beneath,
And there you'll find God.
- Donald Hicks

Only your surface is disturbed;
in your deepness there is stillness and total tranquility.
- Bryant McGill

Movement is freedom of the body; stillness, of the mind.
- Marty Rubin

Aspire to be like Mt. Fuji, with such a broad and solid foundation that the strongest earthquake cannot move you, and so tall that the greatest enterprises of common men seem insignificant from your lofty perspective. With your mind as high as Mt. Fuji you can see all things clearly. And you can see all the forces that shape events; not just the things happening near to you.
- Miyamoto Musashi