06 Oct 06

Psycotherapy With Dr O’Malley (6)Dr. O. pondered my homework: a journal of anxious/abnormal thoughts that documented the roars of F-16s making me antsy, frantic activity in the chow hall making me paranoid, grief over my grandmothers death.

“The grief,” Dr O said, “and guilt over your grandmother is perfectly normal. Her death is reality. But your hypervigilence with the F-16s in the chow hall is something we need to work on.”
“I realise how daft those thoughts are immediately after thinking them, but it all happens so fast.”
“You need to breath normally in those situations to calm the cascade of chemicals. You need to be able to appreciate and evaluate reality. There are habitual criminals who are incapable of being anxious in crowds.”
“Like psychopaths?”
“Yes. You need to desensitise yourself, and regain control. Instead of being hypervigilent, you need to be in a state of mind where you can evaluate things. If the F-16s catch you by surprise, breath. I had the same reaction when someone dropped a bucket by me once. Pay attention to visual clues instead of overinterpretating things.”
“Another thing that got me going was reading about a bomb going off on a plane and the jet oil burning people’s flesh, bits of the plane dismembering people, and them falling to earth. I’ve got a thing about planes.”
“With explosions at altitude you immediately lose consciousness. The shock wave knocks you senseless. It’s surprising how fragile the brain is. Troops in Iraq who survive IED attacks are tore up physically and they suffer heavy physical trauma to the brain. When the IED goes off, the survivors know nothing other than waking up in Walter Reed.”
“I had some head trauma that made me pass out once. I was jumped by four lads who repeatedly kicked me in the head, back in England when I was about twenty. A point came when I could no longer feel the kicks. I went warm, and passed out.”
“Have you suffered any other head trauma?”
“A speaker fell on my head from a third story window in Liverpool.”
“Did it knock you out?”
“No, the wood broke in half.”
“The break probably dissipated the force.”
“I’ve been in around half a dozen car crashes. In one we knocked down a brick wall, bounced, ended up with the car lopsided up a hedgerow. I’ve also had multiple airbags smash me in the face. Could these accidents have affected my personality?”
“You shouldn’t be too concerned about them. You’re not showing any signs of the subtle problems one would expect. We should be more concerned with your anxious thoughts.”
“Do I need to learn to accept anxious thoughts?”
“No. Learn to look at them: yes. Learn to build them up: no. In a dark room, the presence of objects may seem dangerous, but when you turn the light on you see the safety of chairs, lamps, and small shelves. The eight-foot ogre is suddenly a small spider. When you perceive reality, breath and push back the fear response. Comfort yourself as if you are a little kid. Calm your system down. You need to perceive reality because when you hit the streets you’ll need realistic aims of who you are, what you’re doing, and where you’re going. In the prison environment it’s realistic to be mentally prepared for fights, but you don’t have to be hypervigilent. Just be prepared to get out of the way if something’s going down. There’s an atmosphere you can usually pick up on when something is going to happen in here. I’m sure that you can interpret ate that by now.”
“Yeah. You can usually tell if something is about to happen. When there was an all-out race riot at Towers, I eventually got up the stairs, and stayed in my cell.”
“And that was a realistic plan. If you go around panicked all the time, you’ll crash. With all the people on the roads in tonnes of steel going 40 to 60 mph, who are just as big idiot drivers as I am, I drive defensively. Vigilant but not hypervigilant. I assume that the other person is going to do something. I keep my distance from the car in front of me. I check my rear-view mirror. I don’t tailgate. I do whatever I can to minimize the force of impact. That’s my realistic plan. Try to go about realistically.”
“I will.”
“For homework I’d like you to document yourself talking to yourself in relation to how you justify or criticize your past actions. And to compare and contrast what you are thinking and feeling with your present expectations.”
“OK. Thanks.”

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