Content warning: this post discusses suicide and Electro Convulsive Therapy.
Structure warning: I am writing with my editing and self-censorship blinkers off – paragraphs, sentences and arguments may be imprecise.
I started this post just after I was released from a five week psychiatric admission that included 12 sessions of Electro Convulsive Therapy. It was my first course of ECT. Writing this has been hard. My first draft was messy, my latest draft is still messy, and the ECT brain keeps dropping in random memories and links – I’m honouring the brain and leaving these droppings, but where necessary I’ve put them in brackets and italics.
I am a mentally ill person in NSW, Australia. We have ‘free’ universal health care. I have, however, been privileged to receive seventeen years’ worth of high-end ‘private’ psychiatric care as a bulk-billed aka ‘free’ patient, but until now all hospitalisations had been in public hospitals. The ECT happened in a private hospital paid for my workers compensation. I’m still reeling at the difference and have much more to write on the subject.
I am also an early career academic researcher, writer and critical thinker. I have been teaching casually at University of Wollongong since 2011. You can prove I exist here.
Electro Convulsive Therapy used to terrify me and saying yes to the therapy was difficult. During ECT, a patient is put under a general anaesthetic before an electric current is run through specific parts of the brain. When I went in for my first session, the psychiatrist conducting the therapy asked me why I was getting ECT. He was a small bearded man who I’d never met, but was about to consensually electrocute me and I saw no reason to sugar coat it.
‘It’s to short circuit my brain, stop the constant urges to kill myself.’
I might have imagined it, but I remember his eyes getting sad before he told me I’d be okay.
I was okay. The ECT cut off those constant suicidal urges and helped me find a way to think without them constantly being present. I got ‘safe enough’ to be allowed out of hospital and go home. I’m still thinking about suicide but it’s not the ever-present back-up plan it was prior to hospital.
But it also did something interesting to my critical thinking brain. One of the side effects of ECT is issues with memory, which for me has mostly exhibited as ‘losing words’. I sometimes cycle through four or five words (particularly nouns) before finding the ‘correct’ descriptor. It’s also led to me thinking in some new and interesting ways and making links I never saw before.
During my last hospitalisation (public hospital in January 2018), I was the quintessential academic wanker who read Foucault in the madhouse, so you just know I was already thinking hard before the zapping.
During/after the ECT, thing started to get interesting in my head. And that’s what you’re reading now. I’ve had some new ideas I’ve never though before and suspect that the stepping stones of getting ‘really well’ from my complex Post Traumatic Stress Disorder are hidden in what follows.
When I’m teaching critical theory at University, I like to ‘play’ with ideas. I’ve realised that pretty much any idea can be discussed, if we use the term ‘hypothetically speaking’ to bounce theory balls from court to court. Ideas that can seem revolting and dangerous, can be made palatable by hypotheticals and my students seemed to love the idea that we can ‘make up’ ideas and links and still be doing critical theory.
Everything that follows this is written from a hypothetical viewpoint because I’m not a clinical/forensic/whatever psychiatrist.
Thank you for getting this far through my rant, now it’s going to get a bit amorphous and technical. Brace yourself for my new ideas.
New idea one: Trauma is a fungus
Anyone who’s lived through trauma knows that it does something to your body. All the pain, reactivity, anger and sadness that’s been rotting on the inside had to get out somehow. It gets out by jumping into the flesh and rewiring the brain on its way. Complex Post Traumatic Stress Disorder, or PTSD that came from lots of traumas, has only recently made its way into common discourse, but it can be understood in some ways by looking at how the brain exhibits and processes trauma.
PTSD is characterized by specific symptoms, including intrusive thoughts, hyperarousal, flashbacks, nightmares, and sleep disturbances, changes in memory and concentration, and startle responses. Symptoms of PTSD are hypothesized to represent the behavioral manifestation of stress-induced changes in brain structure and function. Stress results in acute and chronic changes in neurochemical systems and specific brain regions, which result in longterm changes in brain “circuits,” involved in the stress response.
The changes that Bremner describes here vary depending on your age when experiencing the trauma, with children (obviously) being most susceptible to trauma-induced brain changes.
So, to put it simply, messages of fear and terror enter the body via ears, eyes and other sense organs, are processed by your cerebellum and then converted into symptoms that start in the brain and work their way out into the rest of your flesh.
During this process, something happens that changes how the body responds to future traumas.
In a typical non-PTSD body, the three ‘stress hormones’ work as a team to get you through stressful situations. Adrenaline and Norepinephrine, the arousal hormones, respond to messages transmitted by elevated Cortisol, helping us to make the ‘fight/flight’ (or ‘flop’) decision in the face of dangers.
Since we all know that adrenaline and norepinephrine are responsible for memory formation and arousal, not having enough cortisol to completely bring down the sympathetic nervous system, at the time when it is very important for a person to calm down, may partially explain the formation of traumatic memory or generalized triggers.
The PTSD body usually shows lower than average levels of cortisol, which means we’re facing ‘fight or flight’ situations without the full spectrum of chemical responses. This lower rate of the magic stress hormone means that new traumas find it easier to get a toe in and enact even more brain changes.
So new traumas set off old traumatic responses, playing on the altered levels of stress hormones in the PTSD body to trigger off new sites of trauma and make new neural pathways that reinforce the traumatic responses.
All of which reminded my ECT brain of nothing more than a mushroom spore rain.
As I’m privileged to not live a lifestyle that offers ready excuses for fight or flight, I’m able to step back and see the hows and wheres of my own trauma responses. They map all the traumas in my flesh — from my mother monster, through the sexual assaults, domestic violence, and recent workplace harassment — and as the map expands, the neural links defining my reactions strengthen.
So it’s kinda like we’ve got a big mushroom crop of trauma spreading out through our flesh.
This was the first idea. It hit me pretty hard. I could’t imagine a way to repurpose this idea for my recovery but the ECT brain kept throwing up strange connections.
(ECT Brain — Old idea, am I remembering it right? Deluze and Guitar-guy aka D&G? That we can map our cultural texts and responses by linking knowledge and ideas using structures similar to the growth patterns of mushrooms and ginger? Filtering thirteen years of critical theory through the ECT Brain is an ongoing source of amusement and amusement.)
Assuming that I’m on the right path (is there ever any other option?), I’m going to make some broad assumptions about trauma, using ‘made up ideas’.
At this stage, we believe the following:
- The body’s responses to trauma can be imagined as a fungus sporing in the flesh and brain,
And it turns out that all this thinking is hard work. I’m going to post this now, because otherwise I’ll hide it forever.
Turning ‘trauma’ into ‘armour’: part 2 – the sclerotium is coming soon
Part 2 will look at how fungi can be hardened and solidified in response to environmental factors. Part 3 will explore how we can imagine therapy as a laser beam. I’m not even kidding.
If this has been a hard read for you, then please talk to your support network.
Stay safe. You are stronger than you think.