Book Review: Dark Apprentice

Wow, I really dislike Nikolai Fedorov.

I know this guy. He is the guy who smirks when they think you can’t see. He is the guy convinced of their own superiority.

From the first page to the last Nikolai, the main character, is both protagonist and antagonist in his own story. He undoes himself at every turn. And, by the end, he has learned absolutely nothing, grown not one hair, and is still the conniving creature he was at the beginning.

Some readers might argue that Nikolai did “change” by the final scene. Nope. Look again. The only change was that he moved his teacher from his mental list of adversaries to his list of allies.

That is not growth. That is merely rearranging his opinion on someone’s usefulness to him.

So, why did I stick with the novel to the end? Good question. I’ll admit – I put it down twice and walked away. I think the thing that drew me back was a simple need to finish the thing so I could get it out of my head. And, because I think I know what Nikolai is hiding under all that calculating cunning. So, back I went.

Allow me to insert a note here: My degrees are in Soviet and E. European studies. My mother is a survivor of WWII. I have spent many hours speaking with people about the sieges of Leningrad and of Stalingrad. I have a well developed idea of just how grim a childhood was in one of those, or other Nazi occupied areas of the Soviet Union.

It makes sense that Nikolai would see the world as one brutal conflict to win – at all cost. So, on one hand I despise what he is and, on the other, I can pity him.

The other major player in the story is the immortal mage Medea. She takes Nikolai as an apprentice against all her better instincts. She has his measure and yet still takes on a power seeking, lying, cheating psychopath.

Her decision is explained late in the story. My response to the revelation was — And your best solution was to teach him? Uhm. Yeah. Medea may be immortal, but I have serious problems with her judgement. This is not to say she is a paragon. She obviously still has a few problems of her own to work out.

As far as the technical side of things went, the writing was clear and the story moved along. But, the emotional depth of the characters left me wanting something more. I didn’t so much make an emotional connection with the characters as I had an emotional reaction to them.

So, would I call this my usual “brain popcorn”? No. It’s more like candy-corn, you either like it or loathe it. This is the first in a series – Will I read book #2? At this instant, I don’t know if I’m willing to allow Nikolai to take up any more of my time.

I received an advance review copy for free, and I am leaving this review voluntarily.

Book Review: Steady

Steady: A Guide to Better Mental Health Through and Beyond the Coronavirus Pandemic by Dr. Sarb Johal is one of those books I wish everyone would read.

80% of the people around the globe would find some idea or thought within these pages that would help explain the currently fluid world we find ourselves within. They would find an understanding professional who clearly lays out the current causes of anxiety at every level from personal to global.

Dr. Johal is imminently well qualified to write this touchstone for the world. He has worked with governments and international organizations, to develop psychosocial responses for over a decade. Among the crises he has helped guide populations through is the H1N1 pandemic.

He knows his stuff.

The prose is clear and approachable. The concepts are clearly presented and there is ample reference to resources for those, like myself, who are inclined to look at the nuts and bolts of research.

It is, overall, a calming and reassuring look at the changing social landscape caused by the COVID pandemic. Dr. Johal offers understanding and practical approaches to the mental stresses that it seems everyone is facing. He doesn’t offer rainbows, but he is offering umbrellas to help us make it through the current series of crises.

One thing I found of particular note is his refusal to advocate for the ‘normal’. Quite rightly Dr. Johal reminds the reader that every situation is fluid, even if it is familiar. He doesn’t give any promises, but he does make emerging from the pandemic seem possible.

— Oh, and that other 20% or so, those are the folks who live with long term trauma. And while we may know a good bit about anxiety and uncertainty, we would do well to read the book, too. Because, sometimes we need to remember that not everyone is as programmed to flourish in the shifting unknown.

(And no, I don’t know if it really is a 80/20 split – it’s a metaphor.)

I received an advance review copy for free, and I am leaving this review voluntarily.

Unpacking: COVID and ‘brain disease’

light blue one use medical protective masks

The headlines are terrifying.

The study behind the headlines was published in the Lancet on April 6, 2021 (yesterday, as of writing this)

I recommend you go read the study, but for a short recap I’m going to break it down here. The main take away point from the study is this:

The largest group of outcomes involving the brain from having COVID-19 are mental health issues.

And really, who could be surprised by that?

I’m in no way attempting to minimize the role of mental health. (Seriously, have you looked at the rest of this blog?) But, I did want to show the data behind those horrid headlines in the media.

Mental health is a serious matter, and the recent study demonstrates that the next wave to follow COVID-19 might be a series of mental health crises. I’m not the first person who has espoused this possibility. Nor, do I think I will be the last.

IF anything, this study has demonstrated that mental health is interwoven with physical health. The first order is to preserve life, but we must not abandon the fundamental human need to live.

The data below is taken from Table 2, of the study.
The table below shows the rates of each outcome for COVID-19 patients at the four levels of severity –
non-hospitalization, hospitalization, ICU admission, and delirium.
Additionally, the data is organized from most common to least common Based on the “No hospital” column.

Outcomeno
Hospital
hospitalICUDelerium
Mood, anxiety, or psychotic disorder (any) 23·59% 24·50% 27·78% 36·25%
Anxiety disorder (any) 17·51% 16·40%19·15%22·43%
Mood disorder (any)13·10% 14·69% 15·43% 22·52%
Mood, anxiety, or psychotic disorder (first)8·15%8·85% 12·68% 12·96%
Anxiety disorder (first)6·81% 6·91% 9·79%9·24%
Substance use disorder (any)5·87%8·56% 10·14% 11·85%
Insomnia (any) 5·16% 5·95% 7·50% 9·82%
Mood disorder (first)3·86% 4·49% 5·82% 8·07%
Nerve, nerve root, or plexus disorders2·69% 3·35% 4·24%4·69%
Insomnia (first)2·23%3·14% 4·24% 5·05%
Substance use disorder (first)1·74% 2·09% 3·15% 2·58%
Ischaemic stroke (any)1·33% 4·38% 6·92% 9·35%
Psychotic disorder (any)0·93%2·89% 2·77%7·00%
Dementia0·35%1·46%1·74%4·72%
Psychotic disorder (first)0·25%0·89%0·70%2·12%
Data are percentage at 6 months (95% CI)

All the other outcomes, which were all physiological, were under 0.50% Those include: Intracranial hemorrhage, Ischaemic stroke, Parkinsonism, Guillain-Barré syndrome, Myoneural junction or muscle disease, and Encephalitis.

If you go read the study, which I recommend you will see that it was well constructed and thorough. I have a small niggle with the combination of outcomes they chose to examine – but in the end the brain is all about chemistry, so I can’t really complain.

What is Complex-PTSD (CPTSD)

Definition of C-PTSD


Complex post – traumatic stress disorder
is a psychological disorder that can develop in response to prolonged, repeated experience of trauma in a context where the individual has little or no chance of escape.

Honestly, I can’t remember if these are my words or not. Please tell me if they are yours.

That is the clinical definition of Complex-PTSD. Other resources will explain C-PTSD as a form of PTSD that has other overlying factors. The two can be easily confused if you don’t start with the definition. The definition above holds some key phrases.

The first is “prolonged, repeated experience of trauma.” Most instances of PTSD are traced back to a single horrific event. Not so with C-PTSD. Someone who has this form of mental wound has experienced not one instance of trauma, but multiple instances, even possibly their entire life.

The second phrase to take note of is “little or no chance to escape”. I would add the words ‘over time’ to that phrase, because that is a key part of C-PTSD. Anyone who has suffered trauma was not in a situation to escape – but where PTSD is an instance, C-PTSD plays out over a long period of time. The person who is being traumatized has no means to escape their situation.

Persistent feelings of worthlessness or emptiness.
constant feelings of emptiness or hopelessness

There is another central issue when differentiating PTSD from C-PTSD and that is the mind that experiences the trauma. The initial group of the population where PTSD was observed was military veterans. In this group, the men and women were all over 18 years of age when they experienced trauma. This is important because most of their cerebral development was done. They knew who they were, and they knew who they wanted to return to being after the trauma. When we talk about C-PTSD the trauma can start as early as infancy. That is perhaps the most important difference. In PTSD the individual, usually an adult, has a point before the trauma to return to. People with C-PTSD have no previous to return to in many cases because they were shaped from their earliest moments by their traumatic environment.

Symptoms of PTSD and CPTSD

Complex PTSD builds on the already accepted symptoms associated with PTSD. So, while someone with PTSD will experience symptoms from the list on the left, someone with C-PTSD will experience symptoms from both lists.

PTSD

  • Memories of the trauma.
  • Flashbacks – Reliving the trauma.
  • Dreams or nightmares
  • Emotional or physical reactions to reminders
  • Trying to avoid thinking or talking about the event
  • Avoiding anything that reminds you of the event.
    Negative thoughts about damn near everything.
  • Hopelessness about the future
  • Memory problems
  • Difficulty maintaining close relationships
  • Feeling detached from family and friends
  • Depression
  • Feeling emotionally numb
    Being easily startled or frightened
  • Always being on alert
  • Self-destructive behavior
  • Trouble sleeping
  • Trouble concentrating
  • Irritability, angry outbursts or aggressive behavior
  • Overwhelming guilt or shame

CPTSD

  • difficulty controlling your emotions
  • feeling very angry or distrustful towards the world
  • constant feelings of emptiness or hopelessness
  • feeling as if you are permanently damaged or worthless
  • feeling as if you are completely different to other people
  • feeling like nobody can understand what happened
  • avoiding friendships and relationships, or finding them very difficult

dissociative symptoms 
depersonalisation or derealisation

physical symptoms: headaches, dizziness, chest pains and stomach aches

regular suicidal feelings.

This list is from mind.org.uk

Emotional Flashbacks vs. Flashbacks

You would think that there wouldn’t be a dividing line between these two terms. After all, both are moments when the brain is hijacked by the past and trauma is reexperienced. The difference lies in the brain. A flashback is a full sensory being there re-experiencing of the trauma. The person can see, feel, even smell and taste all the details of the event. Those details are stored in their memory. They reexperience every part of that trauma.

The concept of the emotional flashback extends this to include periods of early childhood where the ability of the brain to form, store and retrieve memories is still developing. Particularly in the area of the visual cortex. What that means is that the memories of the event are stored complete with all the associated emotions, but there is no visual context. So when you encounter something that triggers a memory of that trauma – you are instantly swept back to the emotions of that time. And, you have nothing to correlate it with.

This being flung into emotions that are overpowering, without knowing why, or being able to point to any specific memory is one of the most disorienting, and in my opinion frightening aspects of C-PTSD.

Core Beliefs of CPTSD

The manner in which the other major symptoms of C-PTSD can manifest are as varied as the people who suffer with this condition. One core belief that many people with C-PTSD have is that they are essentially fatally flawed. And because of their own brokenness, they are undeserving – of anything.

This is the core belief that tells us we are not worth ‘the bother’. This is the core belief that makes us accept the least. This is the core belief that makes it difficult, at the least, to face conflict. The script in our head says we are not worthy of our parents love, therefore we are not worthy. It is the core belief that we are worthless, completely without value.

CPTSD: Survival before growth

Most of the people with C-PTSD have created defenses to keep them safe from their early environments. Most of the people who live with C-PTSD are fiercely independent. We are also likely to be stoic. But many of these traits come from the need as a young child to be ‘easy’. Many people report a similar scenario of not asking for anything, because asking was dangerous. Others report that they abandoned things they enjoyed for the sake of peace. Many of the strategies we developed as children were not to explore our world, but instead to survive our world.

Where are we now

Post Traumatic Stress Disorder (PTSD) is more widely known in the public. Efforts to educate about this mental wound, typically found in soldiers but also victims of violence, have been ongoing since the 1980s. In contrast the study of C-PTSD is relatively new. So new, that it is not yet included in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

But, European sources are starting to recognize that C-PTSD is a disorder that should be recognized as a unique set of symptoms, behaviors and challenges. Hopefully, one day the DSM will follow.

There is a great deal more to convey but, for now, to sum it all up, Complex-PTSD is a bitch. Really.

Question of interest for book on CPTSD

Hi folks.

I have a question for my readers – Would you be interested in a book about the journey of recovery from Complex-PTSD?

What I have in mind is an exploration of the healing process from three distinct perspectives. The view of the person trying to overcome CPTSD would be one. I have a therapist who is willing to work with my to provide the therapeutic aspects that are encountered and how to work through them. And I have a person who is willing to author at least a part of the ‘how to support someone’ in recovery.

If you have some interest or ideas, please share them in the comments.

Thanks.

A little victory over C-PTSD

selective focus photography of assorted color stars

I didn’t have a migraine last night.
Read that sentence again because I’m going to explain WHY? that is a big deal. Ready?

One of the symptoms of my Complex PTSD, since I was 12 perhaps, has been debilitating blinding headaches. I could expect expect 3-4 nights out of the year that I would spend sleeping on the bathroom floor. The tile floor was cool and I could close the door and be alone with my pain. Pain that was so bad I saw auras, I suffered muscle contractions that twisted me involuntarily, I would bang my head on the walls to find some focus away from the lancing pain through my skull. The pain was so severe there was the added insult of nausea and puking.

When my parents finally witnessed one these headaches, (huh, I can’t remember how that happened), they took me to the doctor. A neurologist. There was a long day of many tests. At the end of the appointment, the doctor sent my parents home with the knowledge that there was nothing physically wrong with me.

In retrospect, I think I really hate that he did that. Because, of course, for my parents if there was nothing physically wrong then there was nothing to treat. End of story.

Only it wasn’t. I have spent another forty years living in fear of one of these ‘headaches’. For a long time, I had no idea of where these came from and what triggered them. In my 20s when I was in grad-school the general practitioner I was seeing prescribed massage for me as a way to lower my anxiety. Best three months I had experienced in a long time. And that lead me to one of the ways to alleviate these events, touch. A person who would hold me as I writhed, or better before it got that bad. could usually halt or at least soften the episode.

I knew nothing of the sympathetic nervous system or the role it plays in cptsd. This was, like so many of the coping mechanisms we find hard won out of brutal experience. After nearly a decade in and out of therapy I put another pair of pieces together. I found I could predict when I might experience a headache. That knowledge allowed me to attempt to stop it.

Not all of those attempts were wisely chosen. Most of the time I cut to let my demons out. Only once or twice did I turn to alcohol. I still can’t stand the smell of most alcohol. Never chose drugs because my central need is to be able to control myself. With alcohol and drugs I might have been able to stop the pain or blunt it, but I would lose control and that wasn’t acceptable. So I chose to bleed instead. Most of the time it worked. But, not always.

The trigger I found that most commonly lead to this reaction was a case where I felt I had failed or where I had been rejected. If you have cptsd you’ll understand how fundamental those triggers are and how far ripples can travel even decades later.

Over time I discovered the most effective method for me to handle an event that might trigger one of these episodes was to talk to myself. Yeup, I still think it sounds corny – and I know it works. As I started to learn about cptsd, the sympathetic nervous system, triggers, dissociation, integrated family systems I was learning how to better manage those events in my life that at one time would have produced a migraine. (Technically I don’t know if it was migraine, but you get the idea, right?)

I am making progress. Huzzah!

Yesterday one of those events of life happened that would have had me out of commission on the bathroom floor last night. But, it didn’t. I processed that F*er. Ok, probably still processing it, but the major danger of having a reaction headache as some type of punishment that my psyche thinks I believe is low. Perhaps, I would even go so far as to say – very low.

And that feels like a miracle. Feels like. I know it isn’t. The ability to deal with yesterday’s ‘thunk’ was decades of practice and finally understanding my brain.

So here is to recovery and the many little victories it brings.
May you have many, many little victories.

Book Review: Wild Things Will Roam

Wild Things Will Roam, the debut novel by K.M. West, is a post-apocalyptic gore fest with a soul. The surprises don’t stop there.

The concept that the things that go bump in the night are still with us is reframed. The beasties are wearing new fangs in the wilds left behind by the destruction of our familiar order. The idea is handled so skillfully that the reader is left wondering what might already be staring back from the dark.

The story is written with a crystal clear prose that doesn’t hamper the reader’s experience. The style allows the characters to shine and the story to move forward unimpeded. In short, it was a pleasure to read. A genuine surprise is waiting in West’s fluid and graceful prose even while walking the reader through the horrors of Hell.

The horrors of Hell, it is. The landscape drawn by West is far from benign. Readers who have a history of trauma might want to bear this in mind. The story is a frightening look into what lies under the thin veneer of civilization. It explores not only the world post disaster but also the consequences when that protection from the wild within our own nature is broken.

Cover of the novel Wild Things Will Roam
To Purchase a copy from Amazon

Within this brutal landscape the story follows the struggles of a small group of people thrown together by happenstance – or is it fate?

That is the question that challenges one of the characters, Liv, throughout the story. How much of our action is self-determined versus what our circumstances lead us toward?

While Liv struggles with the concepts of something beyond the seen, others in the group offer varying levels of acceptance with the unknown. Liv’s guardian, Carian starts the novel as aware of the unseen. Lash, a protector and guardian, takes the presence of an infinite plan for granted – perhaps he even sees it as his due. Ander, the younger brother to Lash, is so steeped in the ideas of some overarching other that he is often lost beyond the borders of reality. This causes him to act as something of a lightning rod between what is and what will.

But the question remains at the end, as we see everyone’s sense of the world has changed, is Ander led or deluded? What of his vision is true and what of it fantasy? It looks like we will have to wait for the next book in the series to find the answer.

I would consider buying the hardcover to have it on my library shelves. In a day of electronic consumption this says more of how I feel about this work than all the analysis I can offer.

Off the rails

Complex Post Traumatic Stress Disorder is a bitch.
I was trying for something more academic sounding, but let’s face it, I’m not on that plane today. Nope, today is one of those days where I’m just trying to figure out where I put my sh*t. Or, more accurately, where I lost it.

I know when. That much I am certain of. But, where all my bits scattered to after that I have no bloody idea. I’m off the rails, ground to a halt and trying to find a way to right myself and start moving again.

I hate this.

And yet, I know this process very well. This is a cornerstone of my CPTSD. This cycle repeats itself ad nauseum. Every time through this process these days I’m better at being able to identify which part of the cycle I am in. That, although it sounds trivial is a huge step.

It used to be that I didn’t know what was happening. My CPTSD manifests in many ways. The aspect being activated here is my emotional dysregulation. The cycle goes something like this.

Phase 1:
Calm, cool, collected. Moving forward with life tasks and goals.
Small emotional moments are managed by either listening to the emotion or ignoring.
The sum of the emotion is no change in my equilibrium.

Phase 2:
An event of intense emotion.
The event can be almost anything and can trigger almost any emotion possible. The track-record is more to the negative, but positive emotional events have also kicked the cycle into motion.
In the event there is a sharp dichotomy about expressing or not expressing what I am feeling. More often than not I fall to the side of repression. Which, as loved ones have told me, can feel deceptively normal – or intensely dangerous. I’ll admit, from the inside I can’t tell the difference.
On the upside, I am at least getting better at acknowledging that I am feeling ‘something’. Even if I cannot always identify the emotion, these days I am at least aware that I am feeling. It may sound inconsequential, but for someone who has lived with emotional paralysis for 40+ years, this is a huge step.

Phase 3:
Working my way out of ‘the moment.’ Because of the confusion surrounding my emotions, their muted state and sometimes just the delay in determining what is happening, the ‘moment’ of emotion can last. It is like sitting down and teasing apart lines of rope that have been coated in tar. Laboriously I peel apart the strands of what I am thinking from what I am feeling. At the end of the process I need to sit with that feeling and try to not only understand it in a rational manner, but to also process it at an emotional level. That processing is another intense period of labor as the creaking and stunted machinery of my inner emotional self is prodded into motion.
Previous patterns of attempting to ignore or stuff the feelings away results in anger, depression and intense self-loathing. Enough of that and I will begin to start longing for ‘out’.
So, these days I work through it. Believe me when I call it work. It is.

Phase 4:
The aftermath of one of these events is all encompassing. Every system of myself suffers under the impact of such an event. Physically there might be muscle spasms, stomach upset, migraines, exhaustion. Emotionally the rawness caused by this unprepared for intensity leaves me in one of two states; hyper-aroused or depressed. Periods of hyper-arousal are followed by emotional numbness.
There is another feature in all this backwash. The question inevitably comes up of “Why am I doing this again?” Why am I spending time and effort and money on trying to connect with these emotions when I was doing well-enough as an automaton?
All those storylines where an android wants to ‘become a real boy’ – wow, I’m pretty sure I could talk them out of it. Because, seriously – why am I doing this?

Phase 5:
Recovering my balance.
Much as I wish that recovery from such an event was as simple as recognizing that I am in the midst of one, it isn’t. Recovery takes time. Time to process the emotions. Time to process the event that caused it. Time to herd the physical and mental processes back on-line. Time to pour it all out onto a page in an effort to move past the wreckage. Time to reflect, but not to fall into an old pattern of over analysis.

That is where I am, right now.

I’m trying to feel my jaw unknot. I’m coaxing my shoulders to relax. Telling my stomach that this too shall pass and to try to stop cannibalizing itself. Above all reminding myself to breathe.

I will end with a couple of quotes from Winston Churchill:
First “When going through Hell, keep walking,” and the second – “Success is never permanent, and failure is not fatal.”

So – here’s me, walking.

Book Review: The Sons of Mil

The Sons of Mil
L.M. Riviere

If you are a fan of epics, Celtic myth, or simply good storytelling, The Sons of Mil, L.M. Riviere’s debut novel is a welcome outing. From a diverse group of characters, the author weaves a tale of complex politics, the brutal conditions in fictional Innisfail, treachery, and a quest for redemption. The story opens with an act of opportunism and pride that heralds disaster. The killing of a white stag, an animal sacred to the Sidhe, establishes the theme of bearing the consequences of actions driven by pride. The opening also establishes the tension between the Sidhe and the human, Milesian, population.

From there we follow Ben Maeden, one of the hunters on the ill-fated trespass, as he is forced to abandon his home for his failures to protect another hunter. With a series of encounters, we learn more and more of Ben’s history as the layers of his disguise are literally and figuratively stripped away.

Ben’s central relationship forms with a young woman, Una. Una is a pawn who is both powerful and powerless. She makes for an interesting counterpoint to Ben’s discoveries about himself as she joins him on his journey.

Innisfail is fleshed out from the bones of Celtic mythology. If the reader is enchanted by the stories of the Sidhe, the Ard Ri, and Tara, they won’t be disappointed with a stroll through this detailed and complex world.

The storytelling is fast-paced and moves along well. The only place I found myself wanting faster development was in the characters themselves. But, there is a delicate ballet of revealing and concealing at play between the two main actors which would be spoiled by rushing it.

Only one point feels misplaced in the story. There are repeated references to ‘the Transition.’ Those references hint at a time before Innisfail. The setup makes me wonder if we are somehow sitting in a fantasy story set on top of a dystopian future base. If this is the case, it would make the scientific terms that arise in the prose and the conversation easier to accept. This one piece of the story is like a pulled stitch on a sweater. It needs to be smoothed into place.

Like many first novels in a series, and there is more I hear, The Sons of Mil is overfilled with leads to develop. They are tempting, but at the same time, it leaves the story with a somewhat unresolved feeling to the ending. Lots of little ‘what ifs’ are left lurking in the reader’s mind. But, there is a wee point of great satisfaction as we see how Ben Maeden has broken free of his past.

For my brother

Duane Robert Stewart
October 16, 1964 – January 18, 2021

My brother died today and I wept for him, for us.
For all the warm words we never exchanged,
For all the jealousy we held for each other,
For all the times pain was our only contact,
For the words of hurt,
For the thefts,
For the bruises,
For the silence,
And for the little boy
At the bottom of the stairs
Who screamed in panic
As I fled upward
And father raged below.
You deserved better,
And so did I.