Tag: Trauma

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Emotional Work

Day 643 and Courage

My courage is uneven at the moment. I have a specific professional project that I am struggling to push myself on. I tell myself that it is something I want, but if the truism “having is evidence of wanting” is any indication, I am struggling to convince myself I really want it. Except I am fairly sure I do want it and I’m just scared.

I used to love it when people said no to me. I was the kind of “chip on my shoulder” young person that used a no to fuel myself. “I’ll show them” was somewhere between a mantra and a battle cry.

But now I find myself anxious to publicly go out and see just how many people will say no. I don’t know if I find it as motivating as I used to. I tell myself I don’t mind but perhaps some other unexamined element of reaction makes me afraid.

This could all be an elaborate ego protection ruse on my part. Maybe I still love the motivation that comes from no. Maybe I hate it. But I have not really done enough fucking around to find out yet to know one way or other.

My gut instinct is to simply declare in public my goals and a timeline to force myself into it. But then I’ve been working through my tendency to rely on willpower and force to motivate myself. Perhaps a big forcing function will simply send me back into my old coping mechanisms of addictive overwork.

I’ve always punished myself by doing things. If I am anxious I almost always find ways to kick a hornet’s nest to force an action rather than gentle build momentum.

Whatever I do I would prefer I do it with as much gentleness and respect for my inner child as possible. I am prone to abusing my inner child’s feelings by disregarding her fear or her desire to keep distance from the rest of the world. I deserve better than forcing misery onto my inner child.

Categories
Emotional Work

Day 635 and Wide Horizons

I am absolutely wiped at the moment as I rode a wave of enthusiasm all day. I felt focused, energetic and free of self doubt. I felt like my life was open to possibility.

Perhaps it’s the regular reminders of personal responsibility I get in therapy. Perhaps it’s it’s the sense of accomplishment I got from completing my wilderness medical incident certification last week. The case of the Yips that I felt a few days ago is swiftly resolving.

The strength in my marriage with Alex has always been our commitment to working through our emotional journeys together. He was able to be reassuring my through slow climb back from the depths of my health challenges. He helped me turn it into a source of strength. Next year will be ten years together and Alex really got the “in sickness” portion of the vows a little earlier than anticipated.

This is the first time in both of our lives we’ve ever truly been stable. And that’s a strange thought. That our lives have been so chaotic for so long. We finally have money and a home we own and good health and it’s all at the same time. All of the instability of startups and limited resources and bad health are over. And only really in the last six or seven weeks has that been true. As we just finally bought our first home. We moved to Montana in August.

We climbed through the aftermath of the Great Recession together, made our first angel investments together, raised venture capital together, and now finally thanks to the pandemic we’ve been able to secure a place to live and a wide horizon to plan how to use our resources and time. I am responsible for talking this blessing and letting it provide the foundation for our long term goals. Millennials might just accelerate in middle age just yet! I know it feels like I am.

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Preparedness Startups

Day 632 and The Yips

I think I might have a case of the yips. If you aren’t familiar with the term, it’s most commonly referred to as type of performance anxiety associated with experienced athletes. They suddenly find themselves unable follow through on techniques they otherwise know well.

Though as it turns out it’s not actually a form of anxiety at all, but rather a failure to consistently execute on muscle memory in experienced professionals which manifests as a loss of fine motor skills or a struggle to follow through on common chains of decision making, especially ones that are subconscious.

You might also associate it with analysis paralysis, a phenomenon in which someone has access to all relevant information but gets lost in decision making rather than simply acting on their reasonable informed instinct. One’s ability to simply execute what is in front of them is diminished not through lack of knowledge of experience but rather inaction.

I am an experienced startup operator. I am also a competent angel and early stage investor in private markets with a speciality in technology driven businesses. At this point, I’m not only well into my career with a number of concrete successes (I’ve built and sold companies) but I’ve also got generational memory from being the daughter of a startup operator. And yet I’m still nervous about swimming into the deep end of my investing career. I’ve got the the yips.

I hadn’t noticed that I had the yips till I came back from a wilderness medical incident technician certification course. I was doing a hands on course meant for front line first responders in rural and back country scenarios. It was heavy on scene and scenario execution so you could build muscle memory and quick response times.

In medical emergencies, especially in a wilderness context, you have limited resources and personnel. Acting swiftly with the knowledge and materials at hand is crucial. If you don’t take action, someone will die. Startups are famously resource constrained environments. Paul Graham of Y Combinator has an entire framework that assume you are default dead unless you take action to assure survival. This is as as applicable mindset for wilderness survival as it is for startups.

I had some sort of instinctual foresight that this wilderness medicine course would be useful not only practically in day to day life as someone who lives in Montana, but also as a mindset for my investing work on the chaotic thesis that the world is getting more complex. And that complexity has consequences for all of us.

The more chaotic the world, the harder it is to act with confidence as complexity builds.

Only by getting outside of my own skill set and professional world did I finally see how much I’m holding myself back from acting. Whether it is out of fear or analysis paralysis I do not know. But I do know that if one does not act the consequences can be dire. We are all default dead unless we make decisions to remain alive. There is no safety or progress to be found by staring at your problems and becoming overwhelmed by the challenge. If there is a cure for the yips it is to simply keep playing no matter how hard the game becomes.

Categories
Medical Preparedness

Day 629 and Working in Chaos

If you have been following along for the past couple of days you may have noticed I’m at a wilderness medical first responder course. I’ve been soaking up an inordinate amount of information. Part of the reason I am here is personal enrichment, but equally I am here because I’m working to understand chaos driven industries and the opportunities they present.

And the class is not disappointing. As we’ve have absorbed more skills and are moving further into the course, the chaos factor is being ramped up. The particularly enjoyable aspect of the specific course I am doing is that it is not just imparting book smarts. It’s designed to be much more hands on.

If it were a business school class they would probably refer to the methodology as case studies. But instead of ruminating on what you would do if you were management you are reacting as if you were the actual first responder on the scene. And the cases are getting more and more complex.

We started out with with the basics. We were deducing issues and imparting stabilizing treatments. But as we got more comfortable with figuring diagnostics and rendering basic aid the complexity ranked up. At the end of the day today we were presented with a car accident and four patients.

As we ran (literally) onto the scene we had to not only unravel what had happened but also treat several patients in varying degrees of distress. One of our patients didn’t make it. There was nothing we could have done. But we didn’t know that going into the scene. When we arrived we had no idea what happened and had to untangle the triage ourselves.

I was surprised at how challenging it was to leap into action. As the chaos of the accident presented itself our group of first responders had to decide on organizing ourselves and our resources. But the instinct is to simply begin rendering aid.

And that tension between acting and organizing in a crisis never goes away. You just get better trained at how to approach it. Working in the chaos is the job. I honestly thought I’d be better at it. Taking charge and working in uncertainty is something I enjoy. But as with any new skill, it takes work and practice. A certain amount of pressure is the only thing that teaches you how to work in chaos. And I’ve still got a long way to go.

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Aesthetics Community Preparedness

Day 628 and Intensity

If my brain is a sponge I think I’ve been sopping up more than I am designed to handle. But I am holding on and facing a lot of new information and acting on it quickly.

I’m at a wilderness medical first responder class. And I’m the odd duck out on the class. Everyone else is living with much harder realities than I do. They are the ones that fight our wars. Provide our security. Fight our fires. They keep up with where our most vulnerable live. It’s an on the margin make your best call world.

My body can feel that this reality is very different from what I live with and on different class and wealth bands. People that are more buffered from harsh realities often don’t want to face the costs of our lifestyles. But we are not in a morally neutral systems. And a lot of violence still happens on the margins.

I feel somewhat invigorated by the immediacy of decision making in these chaotic environments. If you are in a natural disaster like a wildfire your capacity to react calmly under extreme conditions is a given. So naturally we arm these people with more agency and skills as it’s a set of problems with a lot of nuance and grey areas too.

I am frankly exhausted even though I didn’t do anything that intense. I did some traumatic brain injury drills. And I worked on how to properly stint and secure broken bones if you are in the back country and need to hobble back in to society. I learned a lot about agency and context and the need for high emotional intelligence as you cope with those who are in need or duress.

I suppose with that in mind, it’s no surprise that I’d like to enjoy a good long night of sleep and a big breakfast in the morning. One has got to enjoy living when you have the chance.

Categories
Medical Preparedness

Day 627 and First Responder

My hands are stained blood red. Despite a good scrubbing, my cuticles definitely show that I spent time packing wounds today. Ok, fake wounds. And it’s fake blood. I am taking a wilderness medical incident certification course. And it is very hands on. Literally.

A firefighter packing compressed gauze into a femoral artery simulator

I got the opportunity to take a spot in a course that one of my friends teaches. I’ve got so much exposure to medicine after the last several years of health challenges that I’ve been yearning to upgrade my knowledge to something more practical than my own personal biohacking. So when Tom offered up a spot in his medical incident certification course for wilderness response, I said you know what fuck it I’m going to do it.

And I’m so glad I did. Not because I anticipate needing to apply a tourniquet in the back country of Montana. Or that I’ll be faced with packing a groin wound to stop someone from bleeding out when they are hours away from the hospital. Though I am glad I now know how. But because I think hands on experience with a rougher world is experience I need to do my job investing in an increasingly complex, chaotic and unstable world.

I was absolutely enthralled by the first day. It was me and a bunch of other much more experienced EMTs, paramedics and wildfire fighters. I also met a number of extremely savvy folks who special in fire and emergency incident response.

I was very much thrown into the deep end of first responder world and I’m not ashamed to say I “died” on the very first scenario test as I’ve got no idea what I’m doing. But I’m soaking up as much information as I can as fast as I can. Though not quite as fast as arterial blood gushes. Yet. Ask me on Friday if I’ve improved.

I couldn’t tell you precisely why I think this kind of hands on exposure to emergency response is so crucial but something deep in my gut says that I cannot possibly invest in a changing world without having some on the ground exposure.

The folks who are fighting our worst wildfires and responding to our most intense natural disasters know something visceral about chaos and the fragility of modernity that the rest of us do a lot to suppress.

Just casual conversations as we went through lessons and practice opened up my mind to new areas of opportunity. I found half a dozen blind spots I didn’t know I had. The world is much more chaotic than the media and our social channels let on. But it’s also possible to tackle them head on. We are not helpless. And it’s not hopeless. And I’m feeling fully empowered to deepen my relationship to chaos as I learn just when and where I have more agency.

Categories
Aesthetics Biohacking

Day 624 and Goblin Mode

A trigger warning for folks. This post contains discussions of poor eating habits, food trauma and possible eating disorders.

As much as I like being a bit of a loner, I am often comically inept at having to take care of myself. My husband has been busy with work and I have been left to my own devices to manage cooking this week. Let’s just say it went a bit poorly. Or at least it was comical. My husband is practically a chef and I can barely microwave a hot pocket.

I’m exactly the sort of person that Soylent, the tech bro reinvents NutriSlim beverage, was designed to appeal to. I am easily overwhelmed by the thought of even basic cooking. I’m extremely picky about texture, smells and presentation (thanks autism). And if I’m really honest I just don’t want to eat anything that isn’t perfect. So if it’s not exactly what I want, I might has well have a nutritional slurry. I hate to waste calories in unappealing food so I’d rather get in my macronutrients and vitamins.

I’m embarrassed to say that I did exactly that for a few meals this week. I tossed 2 scoops of protein powder, a scoop of vitamin mix, and some GI stomach support into a glass of water and called that dinner. Even lower rent than a packaged shake but probably healthier. I got 35 grams of protein out of this bad boy.

A protein slurry in water.

I realize this sounds like I’ve got an eating disorder. And maybe I do. Before anyone has a clue that I might be autistic I had some knock down drag out battle of wills with doctors.

One of the defining traumas of my childhood was my pediatrician telling my mother I needed to eat more dairy. I hated the stuff and refused milk & yogurt as small child. My doctor’s solution (and I am not making this up sadly) was to not allow me any food till I ate dairy

Julie Fredrickson from Day 368 Eating Disorder Season

That story doesn’t end well. I didn’t eat the dairy. I passed out. Starving kids into compliance is perhaps a bad idea. But it did leave me with a sense of comfort and control with fasting. If I cannot eat for any reason I know I will be able to manage feelings of hunger. So not a total loss.

I have enjoyed some of this feral goblin mode stuff but I’m glad that Alex is back at his cooking now that the week is over and it’s Friday. Pulled pork is definitely better than nutritional slurry. Well, sometimes slurry has its place.

Categories
Chronic Disease

Day 621 and Pain’s Anxiety

Before I was diagnosed with my spinal condition ankylosing spondylitis, I didn’t really understand that I was in pain. I know that sounds weird, but I just knows I felt like shit. I hadn’t yet pinpoint the origins of the crisis in my own body. I was a stranger to myself.

Back then getting a diagnosis involved a lot of questions about my mental health. Are you anxious? Would you consider taking an anxiety medication just to see if it help? Are you sure it’s not all in your head? No doctor I’m not sure of anything that’s why I’m asking you.

The thing is I did feel anxious. My central nervous system was in a perpetual state of fight or flight from the pain. I had tachycardia. I was twitchy. I wasn’t a sleeping well. I didn’t want to be touched. It hurt too much. I was exhausted all the time and felt overwhelmed that no one seemed to know what was wrong with me. I’m lucky no one asked me if I was depressed or I might have been put on Prozac.

I’m one of the lucky ones. My chronic disease has a simple blood panel and physical exam to diagnose it. It only took me a few specialists to get to a rheumatologist.

I fear I would have been given an anxiety diagnosis and told it was all in my head if I’d had something more complex. But thankfully we untangled that any anxiety or depression I felt was simply a function of being in an inflammatory condition so acute every movement was painful. You’d have a racing heart and a fear of movement or touch too if everything was painful to the touch

The thing is I am scared of my pain. I do regularly get caught in fight or flight fear responses if the pain appears and I’m not prepared for it. I am militant about certain aspects of self care and my biohacking as I fear flares. I fear the drugs that are required when it isn’t controlled. It makes me anxious to need drugs at all to control my symptoms. Especially in America where a war on drugs has made it hard to need anything stronger than Advil.

Everything about pain and it’s treatment is anxiety inducing in America. And that’s a hard comorbidity to live with in a disease. As if pain wasn’t enough, the latent fear that you might not be believed lingers.

Categories
Chronic Disease Politics

Day 618 and Personal Politics

I hesitate to share too much detail about this but, I’m an opioid user.

Actually I’m not hesitant to share that at all, it’s in fact the core salient point I want to make today. I have a chronic disease and sometimes, blessedly more and more infrequently, it can only be effectively treated with pain medication.

Why am I talking about this? And in public no less? Because unless powerful people that have a degree of social, personal and political capital discuss things we deem unsavory we never make any damn progress on humanizing our inhumane responses. And our response to the opioid epidemic is inhumane.

The backlash to the crisis, a mash up of intense scrutiny, government intervention and rigid rules, has now reached a point where it is doing as much harm as the original crisis of overprescribing. And I hope my personal story allows you to see why.

My spinal condition (ankylosing spondylitis) can be so debilitating that the only way I can get out of bed to accomplish basic tasks is by taking a mild opioid called Tramadol. It’s not in the same category as OxyContin or Percocet but it’s not risk free either.

I’m lucky that my condition is relatively well controlled. I don’t need pain medicine all the time and I work very hard on alternative treatments in the hopes that I won’t need it at all in the future. I spent a small fortune making sure I don’t need a core useful medicine. Let that sink in.

I’m not an addict. I am monitored by a team of professionals. Every step of the way is in fact monitored extensively by state and federal systems along with massive insurance and hospital system oversight. It’s the closest I’ve come to experiencing the Panopticon. It’s life altering in its scope. My entire life by necessity has to revolve around when the system deems it safe for me to get a prescription. Not when my doctor thinks I need it. When Uncle Sam does.

I fucking hate relying on something so dangerous and so demonized but also so regulated. I hate that my entire private medical life is so closely monitored by the state. I hate all of it. But, on very bad days, the choice is immobilization or Tramadol. And I’m not at all ashamed to say I pick Tramadol. I want to be a working productive member of society and that’s hard to do when you are unable to move from the pain.

There is no grace in suffering but what it teaches us. And I’ve learned we use pain as a cudgel to control people in our society. That it is so effective is why I am both a libertarian and fiercely against the carceral state. One day it might be you suffering and you won’t deserve it either. And I pray that you will be shown grace in your personal circumstances.

But I’m lucky. I’ve got other pharmaceuticals, like biologic injections which treat inflammatory conditions, that I can rely on. I’ve got THC and CBD for their anti-inflammatory properties. I’ve got good old fashioned steroids like Prednisone. Which interestingly, my physicians universally believe is more dangerous than my Tramadol usage and did actually require an extended titration down as I was physically dependent on it, as your body stops producing the necessary hormones. They’d rather I use Tramadol for flares.

But you notice the government isn’t up in your face with a massive publicity campaign showing cops busting down Prednisone rings. There are no political advertisements showing how an opponent supports big steroid. Even though if you saw Donald Trump after he got Dexamethasone during his fight with Covid it was pretty clear he felt pretty good. Steroids have gotten me far more fucked up and also higher than any opioid ever has. But no massive surveillance program has ever come down on anyone for anti-inflammatory drugs.

Because that would be fucking ridiculous even though it’s just as addictive in driving physical dependencies , just as debilitating and depending on your body chemistry, just as “fun” as narcotics. Fun fact about me, I don’t have whatever chemical makeup that allows an opioid to give me a high. Which as I’ve learned is a saving grace. Not everyone does. That’s kind of the rub. The risk profile on opioids is a bit worse because some pharmaceutical executives lied about the percentages of people who get addicted. Or who found it’s side effects pleasurable in the absence of symptoms. They did not lie about the benefit of not being in pain.

And that ought to give you a good sense of the problem at hand. The iron law of prohibition strikes again. A massive bureaucracy imposing a fix that intervened in crude and inflexible ways is causing more suffering than it fixes. It wasn’t the intent but it is the outcome.

The iron law of prohibition is a term coined by Richard Cowan in 1986 which posits that as law enforcement becomes more intense, the potency of prohibited substances increases. Cowan put it this way: “the harder the enforcement, the harder the drugs.”

Because doctors were lied to about the risk profile of certain types of opioids in the first place, the backlash is now as bad as the original sin the pharmaceutical companies committed.

Regular law abiding people are getting fucked in their treatment plans because hard enforcement is making it harder to get the low dose drugs. We treat Tramadol users with arthritis with the same tools as as criminals addicted to illegal fentanyl. I know shocker that the American federal government can be as evil as Purdue.

But also historically you know it’s true. And now a huge portion of normal people like me, who just want the benefits of not being in constant pain, are being turned into an over surveilled over controlled population. And I’m not saying there are no risks. But who do you want deciding that? A doctor who knows you well? Or the government? Yeah I’d pick the doctor too.

Categories
Internet Culture

Day 614 and Cuckservative

At the risk of scandalizing any of my relatives, I learned about a sexual kink today called cuckholding. I was not, sadly, enjoying kink SubReddits. I learned about this term from a bunch of Trump acolytes. Apparently cuckholding means watching another man have sex with your partner (usually wife). So now you know.

For those that are not terminally online, the context is that in a lot of right coded spaces terms like cucking, beta cucking, and cuckservative get used to describe humiliation but also insufficient purity to the cause. The cause usually being some Platonic ideal of conservatism right up until it becomes indistinguishable from authoritarianism.

Now I’d not given a lot of thought to the term and it’s apparent intense fascination to conservatism men. But it keeps showing up in even ancillary spaces like gun culture and even Wall Street Bets. Every humiliation is cucking. Every instance of not holding perfectly pure in-group signifiers and adherence is cucking. The beta cuck is in a an internal battle with the alpha Chad. And frankly it got so prevalent I finally had a “lady doth protest too much” moment and asked wtf is the obsession with cucking.

Can anyone explain to me why the right is so obsessed with cucking?

I honestly didn’t expect to learn as much as I did about the anxieties of our age, the particular traumas of living with ego preservation needs from our childhood, and the sheer raging reaction formation that is American masculinity. Honestly I’m starting to spend a little more time there than feel safe.

I quite feel don’t feel up for analyzing the whole mess of reactions but it largely seems to boil down to a Slate or Salon article said this was the hot liberal fetish. This got percolated through forums culture and whipped into a frenzy by Trump meme magic. But because the internet gives you brain worms this turned into an actual thing people got sexually turned onto and now it’s maybe impossible to untangle what is fetish and what is meme. But there is definitely some wild sexual politics around power and property in America and who counts as a full person with agency. I’m including some screen shots for posterity as it might be helpful for later research as I fear this will end up being useful as some internet ethnography.