Return..

Having returned from the roundhouse...and this photo is through the door into the meadow - the meadow where the wild deer would graze each morning as the sun began to rise...

Having returned we feel a lot stronger and more able to avoid getting caught up in the whirlpools of Service User's 'I should haves'.

The hardest part of returning is this, there is no one who can tell us what to expect or what to do. The only theory we have, underpinning what happened to Service User is that prolonged 'anxiety' damages the hippocampus. And, in theory, the hippocampus can recover if anxiety diminishes.

Studies are described to show that chronic stress or prolonged exposure to glucocorticoids can compromise the hippocampus by producing dendritic retraction, a reversible form of plasticity that includes dendritic restructuring without irreversible cell death. Conditions that produce dendritic retraction are hypothesized to make the hippocampus vulnerable to neurotoxic or metabolic challenges. Of particular interest is the finding that the hippocampus can recover from dendritic retraction without any noticeable cell loss. When conditions surrounding dendritic retraction are present, the potential for harm is increased because dendritic retraction may persist for weeks, months or even years, thereby broadening the window of time during which the hippocampus is vulnerable to harm, called the Glucocorticoid Vulnerability Hypothesis... to continue...

Meanwhile, Service User probably suffers from Over General Memory Syndrome:

Many emotionally disturbed patients summarize categories of events rather than retrieving a single episode. The mechanisms underlying such overgeneral memory are examined, with a focus on M. A. Conway and C. W. Pleydell-Pearce's (2000) hierarchical search model of personal event retrieval. An elaboration of this model is proposed to account for over-general memory, focusing on how memory search can be affected by (a) capture and rumination processes, when mnemonic information used in retrieval activates ruminative thinking; (b) functional avoidance, when episodic material threatens to cause affective disturbance; and (c) impairment in executive capacity and control that limits an individual's ability to remain focused on retrieval in the face of distraction...to continue.

But one thing I am increasingly aware of is...the way out of this has to be a combination of Service User feeling safe, and learning how to challenge his 'addiction' to the hit of adrenaline, anxiety produces.

And it sounds and feels to me as if over general memory is an unconscious avoidance strategy...So I continue to see that if we feel as if we risk spinning with him in the whirlpool, he is already deep below the water-line.

How seriously do I take what I've just written?
If I take it seriously it requires me to come up with a set of Summer-land experiences, and trying to get him to think beyond the top layer of recriminations...for the rest of this month.

Summer-land is a fantasy world where there is infinite time and money and sunshine. It means trips out and lots of delicious food, the creation of good memories...I'm fighting against this because:

1. Money!
2. It feels unreal to me.
3. I have work to do!

But it is what the theories I'm reading about, suggest to me