Medication

My doctors have suggested that I go on medication. This suggestion was made previously but I refused. At the time, I was experiencing a strong impulse to self-destruction. I did not truly trust myself, or my ability to make decisions, and was concerned that any medication might further impair, or cloud, my mind. These events took place in the late spring of 2013.

In the spring of 2014, the situation is different. I still encounter mood swings. I still find myself entering depressive episodes. I still find myself wanting to retreat from the world. I still have thoughts of self destruction. I still ponder the question: is the new me the way I want to live out my life? According to actuarial tables, I have fourteen years worth of sunrises and sunsets ahead of me. Does my present quality of life make those days welcome?

In trying to answer this question, I have come to the following conclusions. These are not hard and fast, objective outcomes.  They are not final decisions. They are essays, attempts to gather my thoughts, to think things through on paper, and to see what is arrived at.

Medication – Change in Thought Style

I am not sure one can alter their thought style in the same way one alters one’s clothing fashions. I may be remiss in attempting to introduce a form of medical haute couture. But my sense is that my present day thought style is different from that of a year ago.

I am not sure what words to employ to characterize this difference. First, the difference is experiential in nature. It is my “sense of difference” rather than an objective measure. If one has experienced love then one understands immediately the failure of language to fully capture, or convey, the experience. I face a similar problem.

In 2013, I felt more overwhelmed by my thoughts, More driven by them. Perhaps more reckless and out of control. There was no fear but there was a sense of being out of touch, uncertain, confused. There was considerable experience of mistrust – mistrust of my own experience, mistrust of my perceptions, mistrust of my ability to engage in the common casual ordering of body and mind in the effortless way the uninjured so easily take for granted.

In 2014, I am less overwhelmed. There are still strong patterns of thoughts but I appear better able to surf these thought waves, to ride through the turbulence, to keep my head above water. There is less sense of being submerged, out of touch, the grasping for reality that was present in 2013.

I have more confidence in my ability to think things through. If it were possible to reduce everything in my life to a set of logical syllogisms then I would be able to operate quite happily, an imitation of Lieutenant Commander Data from Star Trek (I may mean Spock. I have no idea. I have enough trouble keeping track of my own life to worry about confusion between these characters).

Much of this confidence stems from the blog. I use the blog as external memory, as a form of “thought processor.” It forces me into an attempt to commit my thoughts, to fix them to the page, to make them discursive. I believe I am more successful in this than I was earlier and that the blog has been of significant benefit.

Medication – Self Destruction

In 2013 I experienced a strong wish to go to sleep and never wake up. This impulse was expressed in other forms. I feared medication would alter me in unknown ways, might leave me less able to avoid a destructive impulse. The medication itself might provide a means to the end.

Today, I continue to have down periods. I am not sure if these are less, or more, powerful than previously. There is a sense that these questions, questions Camus described as being central to the human experience, are by now routine, like a pair of worn shoes, well accustomed to the shape of my feet. There appears to be a quality of greater objectivity, more distance, less immediacy, less impulse. I seem better able to accommodate my deficits despite the fact that recognition of them remains a strong trigger for depressive episodes.

Medication – Self Perception

I remain concerned that through the use of mediation I might become less, rather than more, self-perceptive. I believe my ability to exercise logic, to analyze, and to write about my experience, has significant therapeutic value. Would medication impair these capacities?

If they were to be impaired, would I retain the capacity to notice?

This last item calls up memories of a stage in my accident recovery prior to the commencement of blogging. I would find myself sitting motionless, staring out into space, devoid of all thoughts and motivation. Acknowledging this vacant state as unhealthy was a key motive driving me to accept the difficulty of blogging. I am concerned medication may place me back in the twilight zone.

 

 

 

 

Feeling Very Uncomfortable

I have been trying to develop a better understanding of the blog software. As I do so, I rapidly become overwhelmed. I attempt to read the relevant technical material and it does not click. I study the same text again, and again, and it still does not take. I begin feeling very uncomfortable and I start to back away from the work I am attempting to perform.

This worries me.

In the past, in the info-tech sphere, I would totally devour technical information, readily grok it, and have no difficulty in moving forward with the implementation. This was true back when I was teaching myself a new programming language. It was true when learning a new software application. It was true when I worked for Gargantua in the global information factory. The customer wants support on some exotic new technology? No problem! I would just dive in and solve the issue.

Now I appear to become lost, or severely challenged, when making an equivalent attempt. I am trying to interact with one of the easiest to use, most widely adopted, open source software packages available. This is software with training wheels! It is software with all the sharp edges removed! Surrounded with lots of thick padding to protect the user from his own actions. Despite working on a platform with excellent ease of use, and a clear, straightforward UI, I continue to encounter problems. When I seek out additional technical resources, I encounter a similar set of problems. I have been working on these issues for several weeks now. And I acknowledge having made the same attempt months earlier, an attempt abandoned in frustration.

The software itself readily accommodates text input. Creating a blog post is not an issue. Making a post is a very straightforward task and amounts to little more than copying in some text, and pushing a button. Voila! All is done.

But I am attempting to dive deeper into the back end, to get under the hood, so to speak, and acquire a more comprehensive technical understanding. And, when I make this attempt, I quickly hit a wall. I become overwhelmed and discouraged; this is followed by an embarrassed retreat.

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I have been mulling this issue over to get a better fix on it.

I do not believe this is due to any further deterioration in my abilities. I think it has something to do with the level of complexity involved. I have the sense that I am able to operate in a few limited areas. Within those specific contexts, I am able to perform to a reasonable standard. When I seek to extend my operational boundaries beyond a narrow comfort zone, I easily become overwhelmed.

At some level there has been an improvement. One example is found in writing. I am able to hammer out a decent batch of prose. In some instances, I surprise myself by the quality of what I have written; I have not previously engaged in producing this form of written material. I believe I can detect an improvement in my skills from the first few months of the blog, up to today.

My photography has also improved, but for a different reason. With photography, I abandoned some sophisticated techniques. These techniques were not required to produce images for the web. With photography, the improvement has come from a relaxation of standards, or from embracing standards appropriate to the output medium.

Both writing and photography are long term skill sets. If my understanding of brain injury is correct, then well adapted procedural skills are rarely impacted by brain injury.

I am going to let this issue sit for a while, and see if I develop any further insight.

 

 

 

 

Agency

When I commenced drafting the text that ended up as a four part post ( see  Laughing with Dr. D  –  The Shock of Unknowing –  Dendritic Forest –  Clouseau and the Maggots ), I experienced a shift in mood. The act of writing generated a sense of calm. I also felt motivated. I wanted to investigate my behaviour, examine it thoroughly, understand it completely. The intensity of my response, and the degree to which I worked to spotlight the issues, struck me as borderline symptomatic of OCD, or some other form of quiet mania. What follows is the result of my investigation.

Sense of self is intimately connected to an awareness of one’s personal ability to influence the surrounding environment. If it is possible for the individual to manifest a change in the external environment then there must exist an actor capable of initiating the observed change.

Conventional wisdom has it that René Descartes asserted “I think therefore I am.” I am not a big fan of Descartes and have not read deeply in his works. My memory of my studies suggests Descartes actually asserted “I doubt therefore I am.”

We are connected to the physical world through various sense mechanisms. We know from experience that these mechanisms are fallible, that it is possible for us to confuse a coil of rope with the form of a snake, and envisage a threat were none exists. We fool ourselves all the time. It may be argued that mutual self deception is required for relationships to work, for organizations to function, for civilizational processes to proceed. It is not difficult to go on the web and find people casting doubt on everything from the work of Darwin, the scientific study of climate change, free trade, contemporary monetary policy, or the facts surrounding the events of 9/11. It is possible to cast doubt on every aspect of our experience. We have institutionalized this skepticism in the form of science.

The one aspect of life that we cannot doubt is the existence of doubt itself. For doubt to be present there must exist some capacity to experience the world in different ways, to envisage an alternate construction of the facts. If this alternate facticity exists, it must reside in some entity, it must spring from somewhere. Descartes proposed that thought processes were contained within something we call “mind,” an entity responsible for the generation of meta-data concerning sensory epiphenomena. Something flashes by us in a blur of colour and sound, our senses perceive it, our mind processes the sense data, catalogues it, and labels it, and we become conscious of having just seen a bird.

Of course, it may not have been a bird. It may have been a kite falling from the sky. That same kite which now lays at our feet in a tangle of wreck.

If our mental processes were fully congruent with the facts of our environment then there would be no room for doubt, no opportunity to second guess. We should never mistake a coil of rope for a snake. Or a falling kite for a bird. We would be at one with our world, in perfect union with our surroundings. From the perspective of Descartes, our world, every aspect of it, was the creation of a munificent God, a transcendent being who not only created all that stands before us, he also endowed us with the sensory capacity to perceive his prefect creation in order that we might give thanks for his generosity.

The fact of our ability to doubt, to question our own sense perceptions, to generate alternate conceptions of reality (God is truly a She) serves to support the assertion that there exists an “I,” an autonomous individual capable of performing the required thought operations. However this same capacity for reason compels us to the possibility that our entire deductive chain is in error and we have mistakenly given credence to entities which do not in fact exist. There may be no “mind,” and there may be no “I.” Gilbert Ryle, in The Concept of Mind, affords the best means to unpack the first assertion. Any valid Buddhist text will quickly unpack the second.

A closer approximation of what occurs in the creation of the self is likely to be found in the assertion “I initiate change therefore there must exist an actor to be recognized as me.” I cannot remember my studies of Piaget and infant psychology but I believe that an infant will, at an early age, come to recognize his / her agency and this constitutes a seminal event in provoking the self awareness which is later identified as the self.

In the case of my injury, the most debilitating effects are due to the impaired exercise of agency which results in a deprecated sense of the self.

This thesis serves to explain why my acknowledgement of my deficits was found to be so crippling. I was no longer as capable as I once was. I was forced to acknowledge this impairment. As the deficits made themselves manifest they served to undermine the sense of self which had been established over the prior 60 odd years.

I continued to rely on sensory evidence exactly as I had learned to do from infancy. But, subsequent to the accident, this sensory evidence was frequently wrong, or incorrect, or failed in some way to remain congruent with physical reality. I have absolute certainty I parked my car at this exact location. But, when I return to the same precise spot, I find the car has vanished. This disappearance posed a philosophical problem that I was then forced to solve. It was extremely disquieting to learn that my innate life-long capacity to process sensory evidence was no longer to be trusted. That I was no longer to be trusted.