Waking in the Middle of the Night

As the last wisps of a dream fade, you come to, and there’s no sign of dawn. The clock on your nightstand reads 3:14 AM, a time with no meaning aside from its proximity to the advancing morning. Occasional traffic noises, footsteps, and dog barks are the only indicators of civilization; the solitude feels like you might as well be on the Moon.

Waking up in the middle of the night and not being able to fall back asleep is a very common type of insomnia. This is known as sleep maintenance insomnia. Its better-known cousin, wherein you are unable to fall asleep when you first go to bed is known as sleep initiation (or onset) insomnia.

Broken sleep isn’t just a matter of losing time spent sleeping. Sleep is like a song, with a beginning, middle, and end, and it plays on a loop throughout the night. Missing part of the song means missing an important part of sleep (most often stage 4, the deepest non-REM sleep stage, or REM sleep itself, in which you dream).

Sleep experts recommend getting out of bed briefly when you can’t fall back asleep after 10-20 minutes. This is to make sure your subconscious continues to associate your bed and bedroom with sleeping. While you’re up, find a soothing activity that will coax your body out of alertness: read a simple book, listen to gentle music or an audiobook, or sit or lie quietly in another room with low lighting. If you choose not to do any activity, let your thoughts come and go, trying not to give any of them much focus. This can be helpful during the day as well, to calm the mind and reduce anxiety that may cause moments of unwanted alertness.

Manifestation

It is maddening when something harms you but no one can see it. Pain is often invisible: what you struggle with on the inside may not show up on the outside. Mental pain, emotional pain, is among the most grueling, because it does not call to others for help the same way that physical pain does. Sympathy and aid come naturally when you see someone who has a bandage or a cough. Saying that you are not feeling well with nothing to point at is immensely frustrating.

Anxiety and depression are like icebergs. They show a little bit above the surface but are much, much bigger underneath. The palpitating electric dread of anxiety may be only hinted at in keeping the eyes away and a quivering tone. Depression is even better at hiding itself; the hollowed-out sense of self is quiet by nature.

What does it look like when someone is in distress? How many times have you been able to spot it in someone when they were hiding it well? It can be hard to do, as we are all trained to hide our feelings and our pain. This article describes what depression looks like in others in detail. It can be helpful to consider when you are going through it yourself. You may have more allies than you realize.

Depression and Support

In his book The Noonday Demon, Andrew Solomon compares depression to a rusting iron frame of a building. Gradually over time, the structure’s support weakens, the solid metal turning into powder. The building may look okay from the outside, but it is in danger of collapsing from within. Eventually, that happens: one essential part can maintain no longer, and a chain reaction wherein each strut that relied upon another loses its bulwark and the floors fall one into another.

Depression has a way of sneaking up on you in the same way. It seems like things are fine, particularly to other people, but something is deeply wrong. It frustrates because you can’t put your finger on it; like the rusting frame, the emotional framework is covered up by personality, thoughts, beliefs, goals, and ideals. Despite its hidden nature, you know it’s there, because you can feel its influence. You have to exert more energy in holding yourself up, you have to adjust for the lack of balance in your feelings. It takes strength to put on a face around others, it takes endurance to work towards feeling better, even at the smallest things. What replenishes the person next to you feels empty.

This kind of emotional decay takes more than one thing to overcome. It may not be clear as to what will help right now, what the answer may be, but like a reinforced structure it is important to be propped up on more than one side. When someone comes to me asking for help from depression, I always consider multiple ways we can work to overcome it. Exercise is a simple and powerful option, often recommended by physicians. Finding a set of friends who you want to share both your time and your self with is key. Hobbies are valuable, as is taking in other people’s creativity through stories and music and also creating and expressing yourself. None of any of these suggestions are enough on their own to take hold of depression, but in conjunction they can provide a framework of support. It is entirely okay to rely on one of them from time to time, to make life just about one small thing; this is the nature of life. Having a collection to choose from allows for you to move from one to the next as you need, when you need to.

Conflict

Virginia Satir was one of the most celebrated pioneers in therapy and also one of the most compassionate souls who ever lived. Satir had a kindly grandmotherly demeanor, and could disarm the most jaded person with her gentleness and insight. I’ll never forget the moment in a video I saw some years ago when a sulky 15-year-old boy broke into a reluctant grin after Satir unraveled and soothed the anger in his family (the teen was the five-member family’s reason for going to therapy, and clearly not thrilled about it). Everything in his face said, “Alright lady, you got me."

Satir pointed out in her book Peoplemaking that everyone has a default attitude they fall back on when they face conflict with someone: accusational, distracting, intellectualizing, or disconnected. None of these ways of dealing with conflict work out particularly well; they aren’t meant to truly resolve the conflict, they only dial down its influence over us, push it away for the moment so we can do other things. This is true even for the aggressive, accusational reactions: they’re explosive but shielded, striking out in hope that the other person will submit without retaliation (and to just shove harder if there is aggression, locking things down in the familiarity of verbal battle).

Conflict is unavoidable. It must exist even in the closest relationships, with lovers, spouses, and family; in fact, it is more likely to happen then. Conflict means you and someone else are in each other’s business, and frustrated as hell. It is going to happen, and we deal with it regularly, continually, by trying to avoid it, distracting away from it, or attacking the other person as a way to keep yourself out of harm.

The alternative to attacking or avoiding while in conflict is to be sincere about how you are feeling, to be open to the other person’s feelings, and to tell them what you need while also respecting their needs. Much easier said than done, I know. This is where courage comes into play: being real with someone even when you don't expect them to be real back. The power of this position is that even if they don't respond in kind, you have kept your own integrity, you own honesty.

Pausing

Sometimes the best action is to do nothing.

When you are feeling anxious, overwhelmed, depressed, or empty, try taking a moment to pause. Simply stop doing anything and notice what you are feeling. Frustrated: you want to go back to what you were doing. I feel frustrated. Angry. I feel angry. Sad. I feel sad.

The feelings come. Notice them, let them be there. Release the urge to do anything.

Pausing is extremely difficult. The mere attempt can be hard - you simply don’t want to pause. Once you have paused, it can be hard to stay with it. Thoughts and judgements come back at a blistering pace, demanding and demanding and demanding action, any action. Once you have paused and remained paused, noticing your feelings, the shift from one feeling to another can throw you off balance. Feelings you didn’t know were there make themselves visible. Maybe they are completely new ones. I am feeling this. And that. And this too.

The mind is like a waterfall: there is a constant, never-ending gushing flow. It is very difficult to resist its force. Trying to resist will wear you out quickly, and the flow of water never ceases. Unlike a real waterfall, however, the waterfall of the mind will not harm you. There may be pain there, but noticing pain, acknowledging it, and allowing it, is not the same as being harmed. The pain was just there, and by noticing and accepting it, you give it the chance to be released, to flow on its way.

Social Energy

There is incredible pressure to show energy and motivation most of the time. Presenting yourself as happy and easy to engage is social currency - the more you do so, the more you connect with people.

But sometimes you need to connect when you don’t feel happy, when you don’t have that bit of currency to offer. There’s nothing strange about this, this is just the way us humans are wired; we need people. You can fake it, which works sometimes, to a point. But you have to sacrifice being real to do so. It is deeply frustrating.

Who you are around makes a big, big difference. Of course people who irritate you will drain your energy quickly, but even folks who are just fine might not alchemize with you, turning attempts at conversation into a slog. You may find someone who “gets” you in a strange context - they could be a co-worker you only spoke to a few times before, or a person you strike up a conversation with on a bus. You may find yourself clicking with someone unexpected after feeling out of touch with someone you’re very close to: you just had a fight with your S.O., or your best friend hasn’t been returning your texts.

These moments cannot be farmed, but they do thrive in a certain soil. The common way of dealing with low energy - trying to pretend - often hurts more than it helps. Doing the opposite can be very powerful: being as real as is socially allowed. What’s more, you can extend an invitation for the other person to be real with you. Oftentimes everyone is just doing what they believe everyone else expects of them, making what’s real invisible.

Beating Yourself Up

I once heard someone say, “I beat myself up about beating myself up.” I related right away. There’s no forbidden territory to the inner bully, the part of yourself that mocks you scathingly one minute and scolds you condescendingly the next. It will even attack you for listening to its attacks. A big revelation for me was the realization that my own inner bully was me - I was attacking myself. Right afterwards I got on my case for that.

Fighting the bully feels good sometimes, but it’s as close as you can get to fighting your own shadow - it accomplishes nothing and you end up running in circles. Every attempt to get the upper hand results in the shadow deploying a new tactic, as it knows you inside and out. What’s more, it’s fueled by your own fear, your own uncertainty. It fights as long as you do, because that’s just what you’re doing.

What happens when you allow your fear to just be so? And not just fear, but any feeling that you wish you did not have, feelings of weakness, shame, and doubt? To be imperfect, scared, hurt, uncertain, confused, undecided, and not judge yourself is incredibly difficult. But it is the only way to end the conflict.

Holding Someone Else's Pain

When a friend tells you that their mom just died, it is shocking. Maybe you saw it coming - your friend was crying, or was giving one-word responses to everything you said - no matter what, it feels like a lightning bolt. You feel a sudden urge to do something, anything; give them a hug, tell them you’re sorry. You aren’t sure how to help, but you want to.

You go home, and think on and off about your friend. Do you call and check in on them, or leave them be until the weekend when you had plans to hang out? The uncertainty stays with you, keeps you up at night, follows you at work the next day. You think about friends and family you’ve lost, or others who have died. When you see your friend again, it’s still unclear as to how to help. Some things you say seem to help, other things don’t. You stick around awhile and eventually say goodbye for the night.

Pain isn’t always your pain, it is often the pain someone else feels, and that you end up holding for them. Empathy is quite ordinary. It can be very painful. Truly horrible pain is a reality of life; we run into it ourselves, and also when we meet someone else who has their own pain. The natural thing to do in such circumstances is to pull away and distance yourself. This may feel shameful; it is a survival trait. Our instinct for taking on other people’s pain is very powerful, and without grounding our capacity will be overloaded.

Compassion is empathy that has found its voice. The pain you feel on the behalf of another person demands to be expressed somehow, whether in words or actions or both. Finding the right way to express the sadness and anger you feel for someone is a challenge. The uncertainty surrounding it is very intimidating: How will they react? Will they take what I say the wrong way? Will I screw it up completely? Am I just not good enough to help them?

Allowing yourself to be in pain at the same time your friend is is very important. It is right and just, and by being so also helps your friend more so than doing otherwise, but most important is that it is right and just for yourself. Your own compassion will come automatically. Becoming aware of your own pain, your own empathy, enables your compassion to arise; the most powerful compassion you can have for someone else is that which you have practiced on yourself.

The Campfire

For tens of thousands of years fire was our sole means of extinguishing darkness. Night imposed its own authority, forcing us to huddle together for safety. The day was too valuable to waste; a good night’s sleep was necessary to make the most of it.

Nightfall excites the imagination. Storytelling around a campfire is an ancient tradition that brought a structure and prelude to the night. Everyone gathered together to listen and savor the warmth, and when the tales were finished it was time for sleep (or sex).

Now we have incredible technology for shaping the hours after the sun. Electricity grants the power to flood rooms, buildings, and cities with light. Cybernetics has made us a nocturnal species, and work and social life have exploited this, demanding and expecting late hours from all.

Bringing an end to the day is a fine art made invisible by the campfire masters. Doing this for yourself is a skill that is never taught. I try to practice it each day, and it is hard.  But when I put a value on my own rhythm, not just time, I find the night to be more inviting, relaxing, and peaceful.

Memory and Learning

Memory is incredibly important, yet easily taken for granted.  The movie Memento depicts this elegantly, showing a man who becomes completely transformed because he can’t remember anything that happened more than five minutes ago, despite knowing who he is.  Poor sleep can fizzle memory in a similar way - you know where you grew up and who the president is, but people’s names evaporate and simple tasks have frequent hiccups.  But there’s a much deeper and subtler way sleep deficiency affects memory.

When you learn something, your brain processes it and makes connections.  You expect and anticipate what likely comes next.  While listening to someone speak you can understand what they’re saying even if they mispronounce some words or mumble.  You can follow the plot of a TV series while answering emails and browsing the web; the familiar story beats and character archetypes make this possible.

Sleep loss damages these memory connections.  You might remember something but the meaning is lost.  It is like being familiar with all of the words in a language but being unable to say a sentence.  It can sometimes feel like having deja-vu.  When it overcomes you, it’s hard not to be stopped in your tracks.  The familiarity is there, but the understanding just refuses to show up.

What’s most frustrating about this failure of memory to coalesce into learning is the lack of empathy from others.  People often take forgetfulness and missed recognition personally, especially when it happens over and over, as it is wont to do for the sleep deprived.  

Microsleep

"Nodding off" isn't just a figure of speech - there is a real phenomenon of briefly falling asleep against your will. Sleep medicine has a term for this: microsleep.  

When you have a microsleep, you go to sleep for a half second or longer, up to thirty seconds. You don't notice it because it’s just like falling asleep at night - unconsciousness hits you before you see it coming. If you're watching TV the story will seem disjointed and hard to follow. If you're driving you may find yourself veering down the side of the road all of a sudden.

Microsleeps can impact everyday life in subtle ways. Even the briefest microsleep of a split second will disrupt your ability to follow a conversation, stay focused on a task, or learn something new. These small moments, added up over time, become very discouraging. You lose confidence in yourself and a wall seems to form between you and others. Being sleepy isn’t just going about things more slowly; your brain is rebooting itself every few moments. Sleep deprivation makes you less present in a very real way.

Take a look at these articles on microsleep:

http://www.sleepdex.org/microsleep.htm
http://www.sciencedaily.com/releases/2011/04/110427131814.htm

The Body's Expectations

When we get cold, our body shivers and spends energy to raise our temperature.  When we get hot, our body sweats and spends energy to lower our temperature. The human body prefers a particular temperature and tries to maintain it against however hot or cold it's surroundings may be. It prefers other things, too, such as a certain PH balance. This preference and regulation is called homeostasis.

When the body finds itself doing the same thing over and over, it takes note: "It is always cold." It then adjusts: "Since it is always cold, I am going to be ready for cold." The body expects cold surroundings and doesn't waste letting its temperature fall too far. The change in the body's expectations - its standard for homeostasis - is called allostasis.  

Sleep deprivation can cause an allostatic shift for your body. If you are regularly getting less than 8 hours of sleep each night, your body adjusts to this and makes the best out of the 6 hours you may be getting. This doesn't mean 6 hours of sleep is now healthy for you. If you were undernourished, your body would slow metabolism to stay alive. Allostasis is about being as effective an organism as possible given the circumstances. It doesn’t take into account how it feels to be that organism.

Our brains try to compensate: “This is the new normal, so I’m going to get used to it.” Getting used to things is just how we’re wired, since it has helped us survive incredibly harsh, changing environments. Problems crop up when there’s pressure to have a different allostasis: life expects you to operate as though you’re getting a solid 8 hours of energizing rest. “How much can you give” is expected in all venues of living - at work, in family, at school, and volunteering. A war of expectations emerges between your self - your body’s energy - and your environment.

Protecting yourself takes courage. It is not easy to erect a boundary between the outside pressures of life and one’s needs; bizarrely, taking care of yourself in the most basic way is considered selfish. Building this boundary is an investment that takes time, and rewards in time.

Not Just One Thing

One of the most frustrating parts of having a human body is that more than one thing can go wrong at a time.  Acquiring a headache doesn’t undo the fact that you threw your back out the other day.  We try not to talk too much about pile-ups of aches, pains, and illness since no one enjoys hearing about them, and complainers are judged and shunned.  But the reality of multiple problems is still there.

There’s a medical term for this phenomenon: co-occurring.  Diagnosing medical and mental health disorders gets tricky since they can come in twos and threes.  This is terribly frustrating when you are trying to get a clear and consistent answer from health professionals as to what will be a helpful treatment, since the answer is not straightforward.  

It is very common for insomnia to co-occur with depression and anxiety.  Each one can cause the other, creating a vicious cycle.  It is natural to feel shame when faced with a problem that you can't resolve; no one wants to be seen as a complainer, after all.   Shame is no help in easing sleep or recovering from mental stress, however (since, of course, it is mental stress).  Approaching the feelings around sleep loss, such as shame and frustration, opens a gate of escape from this cycle.  When the twin challenges of mental stress and sleep issues gain slack in their tether, there is more room to move, more energy to pursue action, and less strain on the self.

Dissociation

Seeing a two-year-old scream at the top of his or her lungs is an annoying but clear reminder that you can maintain yourself.  When I shuffle past a yelling kid and harried parent in a store, I think to myself that I’m hungry too, and also frustrated by it, but relieved that I can just check this feeling and take care of it according to what I want.  My bulwark keeps my inner feelings from bursting out of me and dictating my actions and reactions; everyone older than two has a bulwark.

Bulwarks work a little different for each person.  A five-year-old will have a little more self-control than a two-year-old, but a twenty-five-year-old will have more self-control than that five-year-old (hopefully).  And two different twenty-five-year-olds will have different strengths and weaknesses of what taxes their energies.  But no matter the person, the bulwark has a breaking point where it ceases to hold the feelings it contains.  You explode at someone; you start crying without knowing why.  It can be frightening to feel emotions rip out of you, and also a relaxing release.

Despite that, sometimes a bulwark holds too well.  In these cases, you don’t even realize that it’s there.  The same feelings are behind it - rage, grief, terror - but they don’t show up as they should, they just stay deep inside you, sealed so tight they barely change your facial expression.  

Emotions are strange in that they don’t go away even when you don’t feel them. Instead they show up in physical and mental ways: being tired, having trouble concentrating, out-of-nowhere sensations of nausea or pain, or lightheadedness.  They may give hints through indirect feelings: being anxious without any clear reason, feeling a little on edge, finding loneliness in a crowd, experiencing pessimism you don’t embrace, having sadness you can’t place.

Dissociation is not being able to feel your emotions.  It sounds like a paradox, but only because emotions are easy to take for granted - they come without us calling.  Thing is, they don’t come when called, either.  Our main way of dealing with pain is to do anything but feel it, which is sensible - true pain has the power to stop us cold, so muscling through it (sometimes literally - imagine a boxer at her fiercest the night her father dies) is necessary to survive and thrive, and we do so naturally.  But it puts us in debt.  If we stay in emotional debt too long, emotions don’t give us any more credit.  They don’t come when they should, they don’t let us feel.  Our emotional selves have a sense of whether it’s safe to come out or not, and after too much, they just don’t bother.

How does one overcome dissociation?  If emotions go away and they don’t come when called, how do you make them come back?  Fortunately, emotions are always hungry to find safe people.  The longer the emotions have been hidden, the longer it takes for safety to be built, but there is never an impenetrable door.  Debt can be repaid, and also forgiven.  Asking someone to hold your emotional debt for you as you rebuild self-trust reduces dissociation and brings back emotional connection, awareness, and expression.

Bringing Yourself

At one point in high school I and a giant group of fellow students were made to participate in an on-campus “retreat” that involved a series of games.  These games were meant to teach teamwork and probably other things I didn’t care about much at the time.  I’m not writing this to say that I learned anything from the experience, at least as was intended.  Like the rest of everyone there, I was jaded and bored.  

For one of the games, we took turns introducing ourselves (“Hi I’m Steve”) and an item we’d bring to an imaginary barbeque we’d all attend (“And I’m bringing soda.”)  The item had to start with the same letter as our name.  Naturally, this quickly became a slog (one student: “Dan.” [long pause] “Dog.”).  When my turn came up I said, “Hi I’m Mike and I’m bringing myself.”  This got a few nervous chuckles, and became weirder as play continued, since after introducing yourself you had to recount what each person would bring.  “That’s Mike and he’s bringing, um, him.”

I confess that to this day I still feel clever in getting out of committing to any responsibility for a pretend party.  Yet despite this minor rebellion, my words had an oblique honesty about them - I brought way more of myself in that moment than I usually did at that age.  My inclination would have been to say something boring, like matches or mayo, and keep my sarcasm to myself.  Instead I showed my disdain.

Alright, so it’s corny to write a post about bringing myself by telling a story about when I “brought myself.”  I concede that I could not resist.  But I do think about that little moment in my life sometimes, especially when I crack a joke or share a thought that is more personal than I’m used to offering.  It’s easier to withhold yourself than it is to be completely there with other people, as the latter is risky.

Emotional Immune System

We have emotional immune systems that have a lot in common with our physical ones.  Kids get sad, angry, or happy easily, but they are also constantly taking in new experiences and learning what to watch out for.  Adults are more stalwart and set in their ways.  Adults have resistances to emotional threats, but they can’t adapt as well as kids can.  It’s good to get chicken pox when you’re young, and it’s good to face emotional threats (safe ones, of course) when you’re young, to build resistance early.

Therapy is about regaining the resiliency you had as a kid.  In order to do so, you have to set aside the resistance you’ve built up.  It’s risky to shut down your emotional immune system in public - I bet you’ve met people who have been so raw and open, and felt concern for them - so a private, confidential place is necessary.  In therapy you safely work out which parts of your resistance protect you and which are no longer needed.  You also find out what new kinds of resistance can protect you, which is very hard to do when your immune system is already in place.  

The tricky part is that it’s impossible to just completely set aside your emotional immune system as though it had an Off switch.  When you power it down, little by little, the system gets agitated - as it’s supposed to; it’s trying to protect you, and doesn’t always know whether something is a threat or not.  Therapy is about building a space in which you can power the system down at will without setting it off.  

Impostor Syndrome

Sometimes, while talking to a friend, I will hear him or her express doubt in his or her abilities and success.  I will tilt my head, wondering if my friend is putting me on; how could such a smart, successful person say such a thing?  On other occasions, the roles will be reversed: I express doubt in myself, and my friend cannot see how I would feel so.

Just recently I have learned that this phenomenon has a name: Impostor Syndrome.  People who are capable and successful often worry that they are an impostor of their own achievements.  They attribute their success to luck, downplay the significance of their success, and worry that their perceived incompetence will be found out.  The Caltech Counseling Center has an excellent description of the syndrome, as does Dr. Pauline Rose Clance, who, along with Dr. Suzanne Imes, first suggested the concept.

There is another side to this: feeling like an impostor actually shows how strong you are.  Self-doubt makes all tasks harder, and forging ahead despite it requires resilience and passion.  To even feel like an impostor in the first place, you must find yourself in a position you believe is worthy of recognition, which requires dedication to gain and hold.  Consider how you want to focus your courage, and redirect it towards what drives your passion. 

Thought and Action

I once saw a question on a personality quiz that read, “Which do you value more, thought or action?”  This struck me as a silly choice, and it bugged me that the premise implied that both thought and action are always good things.  The truth looks more like this:

Thought Without Action = Contemplation

Action Without Thought = Spontaneity

Thought and Action Together = Initiative

No Action, No Thought = Meditation

Contemplation is important for relaxing and reenergizing one’s mind.  Spontaneity fuels your creativity and sense of humor.  Initiative shapes who you are, realizes courage and fulfills ambition.  Meditation gets you in touch with your senses, feelings, and present self.  

We do all of these things throughout the day, without having to make a conscious decision - “I am going to be spontaneous now!”  There’s plenty of grey area between them, and one floats from one territory to another naturally.  Valuing each one is important, and being conscious of which zone you're in relative to another person can be useful for recognizing sources of conflict.