How to get my brain working again — this was the question.
In December 2006, I had closed my private practice after becoming traumatised by 20 years of work as a clinical and forensic psychologist. I was plagued by nightmares, irritability and hypervigilance; my relationships with my family were fracturing. In an effort to get well, I’d undertaken psychotherapy with a clinical psychologist who’d diagnosed post-traumatic stress disorder and major depression. I took St John’s wort, a herbal remedy proven to be of value for moderate depression.
In late 2008, just when it felt that I was getting better and I might return to some kind of work, the global financial crisis struck. Our savings had been exhausted and we were unable to make repayments on our property loans. Creditors threatened us with litigation and my trauma symptoms returned — worse than before.
In July 2009, I found myself in the emergency room of our local hospital, not knowing how I got there, why I was there or even that I was the patient. I was suffering amnesia and confusion. Because of my recent mental illness, doctors thought I’d had a mental breakdown and I was sent to a psychiatric clinic. Three weeks after my initial admission, however, a brain MRI revealed that I’d had a stroke due to an infarct in my left posterior cerebral artery. The stroke diagnosis was a relief of sorts because it explained my impaired vision, memory problems, inability to sustain everyday conversations and inexhaustible need for sleep. It also meant that returning to work was unrealistic.
Fortunately, I was curious about neuroscience, and I learnt that I could rewire my brain to achieve cognitive rehabilitation and emotional healing. To improve my auditory processing, verbal memory and capacity to stay on track with a task, I began daily training on my home computer using Posit Science’s Brain Fitness program. This took me through six exercises building basic auditory skills for speech (pitch and phonemes), then components of speech (syllables and sentences) and, finally, comprehension (narratives). After several months, I noticed a stark improvement in my ability to sustain a conversation and remember what people told me.
I learnt that ruminating thoughts, those that play over and over in the mind in depression, and trauma memories, such as in post-traumatic stress, can get “stuck” in the brain’s right prefrontal cortex (PFC), so they’re not fully processed by the left PFC. The prefrontal cortex, left and right, is located directly behind the forehead and the eyes and is highly developed in humans.
In a healthy functioning brain, the left and right PFCs are equally active: life experiences in their sensory and emotional form in the right cerebral hemisphere tread a pathway through the right PFC to the left PFC, where meaning is created. Here, the experiences are sorted and connected with older memories and words attached, making the experiences consciously available. In my case, I surmised, the right PFC was dominating the left PFC, this imbalance causing the replay of nightmares, irritability and feelings of dread.
But the left PFC cannot be activated through chemical means; I had to find other ways of doing this if I was going to recover. One way was through narrative writing: writing about trauma memories and how they were affecting me in the present. I drew on the writing exercises devised by James Pennebaker, a psychologist who has researched the value of expressive writing for emotional healing.
Why had I, a highly trained mental health professional, become so affected by the stories of my clients? In answering this question, I found myself writing about my childhood, my parents and later-life events that had shaped the person I became. Perhaps I’d pursued some of the work I had as a way of seeking my parents’ approval? But my life-writing also revealed that I’d made many considered decisions and it had been my capacity for empathy and a desire to help others that had actually damaged me.
Neuroscience told me that mindfulness meditation changes the function and structure of the brain in ways that enable greater emotion regulation: the ability to manage emotions so they don’t overwhelm. I developed a morning practice of focused meditation and mindful awareness so I carried a mindful attitude with me throughout the day. Previously, my traumatised mind had created “the dread”: a fear that would overtake me at any time. With mindfulness, I began to see it for what it was: a toothless tiger; a false belief that my fear was proof of a threat when there was no threat at all. Now I could tell the dread that it was overreacting, thereby soothing it; I was building alternate neural pathways and quieting overactive ones.
Physical exercise cements neuroplastic change by increasing blood flow to the brain and increased production of brain derived neurotropic factor, a neuron-building protein. I did a lot of swimming. I also ensured I had good nutrition, engaged in music-making, got extra sleep and took fish oil and vitamin supplements.
Throughout my recovery, from 2006 to 2011, I was drawn to those who’d had their brain go on them in some way or been through a deep emotional crisis. They had an intuitive appreciation of what I was experiencing while accepting me as I was. I sought out compassionate people, some of whom were health professionals, others not.
Now, when I look back, I feel that the compassion of others was a healing force in itself. And as my sense of failure, shame and self-criticism fell away, I experienced self-acceptance: a kindness, a sense of common humanity — we are all in this together. That’s when I realised: self-compassion is the ultimate destination.
David Roland’s book How I Rescued My Brain: A psychologist’s remarkable recovery from stroke and trauma is available from Scribe. To find out more about David, visit his website.
