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	<title>Anna DeStefano&#039;s Blog</title>
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	<link>http://annawrites.com/blog</link>
	<description>Nationally Best-Selling Author and Speaker</description>
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		<title>I Hear the Craziest Things: Anyone Got a Tissue?</title>
		<link>http://annawrites.com/blog/2012/02/02/i-hear-the-craziest-things-anyone-got-a-tissue/</link>
		<comments>http://annawrites.com/blog/2012/02/02/i-hear-the-craziest-things-anyone-got-a-tissue/#comments</comments>
		<pubDate>Thu, 02 Feb 2012 14:00:54 +0000</pubDate>
		<dc:creator>Anna DeStefano</dc:creator>
				<category><![CDATA[I Hear The Craziest Things]]></category>
		<category><![CDATA[Anna DeStefano]]></category>
		<category><![CDATA[anna's world]]></category>
		<category><![CDATA[creativity & inspiration]]></category>

		<guid isPermaLink="false">http://annawrites.com/blog/?p=5535</guid>
		<description><![CDATA[Every time I pull a tissue from a tissue box in my house (once or twice a week), it&#8217;s always the LAST one in the box&#8211;even the box beneath my beside table reserved solely for my personal consumption. What does this say about our family dynamic?
 



Do others&#8217; allergies outpace mine so dramatically?
Am I unknowingly using [...]]]></description>
			<content:encoded><![CDATA[<div><span><strong>Every time I pull a tissue from a tissue box in my house (once or twice a week), it&#8217;s always the LAST one in the box&#8211;even the box beneath my beside table reserved solely for my personal consumption.</strong> What does this say about our family dynamic?</span></div>
<p><span> </p>
<p></span></p>
<p><a href="http://annawrites.com/blog/wp-content/uploads/2012/02/dude-wtf.jpg"><img class="aligncenter size-medium wp-image-5536" title="dude-wtf" src="http://annawrites.com/blog/wp-content/uploads/2012/02/dude-wtf-300x237.jpg" alt="dude-wtf" width="300" height="237" /></a></p>
<ul>
<li>Do others&#8217; allergies outpace mine so dramatically?</li>
<li>Am I unknowingly using tissue in some fugue state, after which I suffer PTSD symptoms due to the tr<span>auma of blowing my nose and promptly forget I&#8217;ve indulged?</span></li>
<li><span>Are my men scurrying about, from one box to the next, looking for ways to score their next tissue hit while avoiding the horror of reaching into the linen closet for a new box?</span></li>
<li><span>Do they have a covert scanning method I&#8217;m not privy to, where infrared sensors alert to the immanent arrival of the final tissue, so they can be certain not to remove it from the box???</span></li>
</ul>
<p><span><strong>My entire morning will be consumed, pondering said mysteries&#8230;</strong></span></p>
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		<title>How We Write: The Soul of the Matter&#8230;</title>
		<link>http://annawrites.com/blog/2012/02/01/how-we-write-the-soul-of-the-matter/</link>
		<comments>http://annawrites.com/blog/2012/02/01/how-we-write-the-soul-of-the-matter/#comments</comments>
		<pubDate>Wed, 01 Feb 2012 14:02:38 +0000</pubDate>
		<dc:creator>Anna DeStefano</dc:creator>
				<category><![CDATA[Anna's "Soul of the Matter"]]></category>
		<category><![CDATA[How We Write]]></category>
		<category><![CDATA[Anna DeStefano]]></category>
		<category><![CDATA[anna's world]]></category>
		<category><![CDATA[creativity & inspiration]]></category>
		<category><![CDATA[Entangled Publishing]]></category>
		<category><![CDATA[fiction]]></category>
		<category><![CDATA[indie publishing]]></category>
		<category><![CDATA[novel]]></category>
		<category><![CDATA[publishing]]></category>
		<category><![CDATA[Soul]]></category>
		<category><![CDATA[writer]]></category>
		<category><![CDATA[writer resource]]></category>
		<category><![CDATA[writing]]></category>
		<category><![CDATA[writing articles]]></category>
		<category><![CDATA[writing coach]]></category>
		<category><![CDATA[writing craft]]></category>
		<category><![CDATA[writing resources]]></category>
		<category><![CDATA[writing workshops]]></category>

		<guid isPermaLink="false">http://annawrites.com/blog/?p=5518</guid>
		<description><![CDATA[If you want to write, write. If you want to publish, prepare to work your ass off getting very, very good at your writing. This business is all about soul. And I&#8217;m not just talking about your unique, creative voice&#8211;though that&#8217;s incredibly important, too. Today, I&#8217;m talking about grit. Stick it out, find your own way, stop waiting [...]]]></description>
			<content:encoded><![CDATA[<p><strong>If you want to write, write. If you want to publish, prepare to work your ass off getting very, very good at your writing.</strong> <strong>This business is all about soul.</strong> And I&#8217;m not just talking about your unique, creative voice&#8211;though that&#8217;s incredibly important, too. Today, I&#8217;m talking about grit. <em>Stick it out, find your own way, stop waiting for everyone else to make this crazy business sensible and welcoming and easy</em>, G-R-I-T.</p>
<p><a href="http://annawrites.com/blog/wp-content/uploads/2012/02/grit.jpg"><img class="aligncenter size-medium wp-image-5520" title="grit" src="http://annawrites.com/blog/wp-content/uploads/2012/02/grit-300x166.jpg" alt="grit" width="300" height="166" /></a></p>
<p>I write my books; I edit for other authors. I&#8217;m close to offering my first two book contracts for <a href="http://www.google.com/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;frm=1&amp;source=web&amp;cd=1&amp;sqi=2&amp;ved=0CDgQFjAA&amp;url=http%3A%2F%2Fwww.entangledpublishing.com%2F&amp;ei=L0YpT4HAFdTqtgez-PiFBQ&amp;usg=AFQjCNHEAcTTsPNVvyz2DHDyRHJPooFajw">Entangled Publishing</a>. <strong>After publishing 16 novels of my own and reading countless propsals others have written over the years, all I know for sure is, <a href="http://annawrites.com/blog/category/annas-soul-of-the-matter/">this is all about soul</a>.</strong></p>
<ul>
<li><strong>Have you been rejected (like me)?</strong> Figure out if you have what it takes to get up the next morning and start over from nothing&#8211;because every published author must do that each and every time they meet a deadline.</li>
<li><strong>Do you have a day job (like me)?</strong> Buckle down and accept that your personal life off the clock belongs first to the book you need to finish, not your hobbies and social (media) life&#8211;because the majority of published authors don&#8217;t make enough off their writing to support their families, so we&#8217;re all hoofing it to make ends meet while trying to stay creative in the dark hours of early morning.</li>
<li><strong>Do you have a busy family (like me)?</strong> Love them and care for them, the tell them your entire life doesn&#8217;t revolve around them and they&#8217;re going to have to take care of themselves the 1,2,3 hours a day that you devote to your writing. Otherwise, they&#8217;ll consume you (and maybe that&#8217;s what you want, if family is the excuse you&#8217;re making daily for not creating new words).</li>
<li><strong>Have you been dealing with an illness (like me)?</strong> Deal with it, by all means, your health is everything. But for Dog&#8217;s sake, knock off saying your illness is responsible for you not moving forward in your writing. I don&#8217;t mean to be insensitive or unkind, but whatever your condition is, I assure you I can find others who&#8217;ve managed to succeed battling far worse circumstances&#8211;because they refused to quit.</li>
</ul>
<p><strong>Soul is the thing that lives and breathes inside us, regardless of the piles of s**t raining down on our worst days.</strong><span id="more-5518"></span> And on our best days, it&#8217;s the piece of us that sings the loudest, reminding everyone of who and what we are at our essential core. <strong>So, what are you? How strongly do you want that dream you say you want? How hard and for how long and through what difficulties are you willing to grit out this journey?</strong></p>
<p><a href="http://annawrites.com/blog/wp-content/uploads/2012/02/soul.jpg"><img class="aligncenter size-medium wp-image-5522" title="soul" src="http://annawrites.com/blog/wp-content/uploads/2012/02/soul-300x203.jpg" alt="soul" width="300" height="203" /></a></p>
<p>Grit is what I call that indiscernible thing I&#8217;m looking for in my own work and the manuscript submissions I read. It&#8217;s my name for what drives us as artists to create, then to refine and revise and rework and create some more, until we&#8217;ve done absolutely everything we can do for a project. <strong>Grit is the magic we all hope to write and read one day. It&#8217;s the soul of every thing and every person who&#8217;s touched us in that indescribable way we&#8217;ll never forget.</strong></p>
<p><strong>I went for nearly 2 years before my thyroid issues stopped zapping every ounce of creativity away, not to mention the energy it requires to sit before a computer and write thousands of words a day on deadline.</strong> So, instead, I read research for 4 different projects (3 of which are being considered by publishers now). I upped my freelance editing business, because it took less concentration and allowed me to work in shorter spurts of time (and now I&#8217;m doing that as a second career). I got excited about my life again, despite the rest (and that excitement, I&#8217;m told by others, is shining through my new novels and every new endeavor I&#8217;m undertaking). It wasn&#8217;t easy. I nearly quit&#8211;every day. It took grit to keep going, but try as I did, I didn&#8217;t know how to quit. And here I am(hopefully), on the other side of it, wondering how I could have ever thought about stopping.</p>
<p><strong>As I read for authors fighting I have no idea what obstacles themselves, and as I write my new books and look forward to seeing them published and hearing from their readers, it&#8217;s grit that I long to see.</strong> Mine and others. I want to feel that faith and determination and the beautiful inspiration and inventiveness that flourishes when we persevere until our dream becomes reality. I want to see that in every beautiful word. <strong>If I don&#8217;t, I instantly know something&#8217;s missing. That either you or I have only given a portion of ourselves. And it&#8217;s not enough. Time is too precious. We can&#8217;t afford to waste it on sort-of, maybe, kind-of creating or experiencing anything.</strong></p>
<p><a href="http://annawrites.com/blog/wp-content/uploads/2012/02/time-slipping.jpg"><img class="aligncenter size-medium wp-image-5521" title="time slipping" src="http://annawrites.com/blog/wp-content/uploads/2012/02/time-slipping-233x300.jpg" alt="time slipping" width="233" height="300" /></a></p>
<p>Books/stories are our dreams playing out for the world to see. The courage it takes to touch another&#8217;s heart with our own, with nothing more than words strung together on a page, stuns me. Every time I see it in others or realize that core of pure steel that&#8217;s driving my own writing journey, I&#8217;m humbled that this is what we get to do with our lives on this earth. You inspire me, and I long to inspire you. Don&#8217;t short change that. Not a single word of it. Give your writing your all, your grit, every single day.</p>
<p><strong>Put your soul in every word, my writer friends. Grit out whatever obstacle stands in your way. Slay every excuse that tempts you not to revise or resubmit or start over or learn whatever lesson is holding you back. Make yourself proud, be proud of your work, be prepared to do whatever it takes.</strong></p>
<p><strong>And in the middle of that insane journey, know I&#8217;ll be writing, too, trying to make this craziness work. It&#8217;s all about soul. Leave yours on the page. I&#8217;ll meet you there!</strong></p>
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		<title>Shoes Are My Heroin: Seasonal Insanity&#8230;</title>
		<link>http://annawrites.com/blog/2012/01/30/shoes-are-my-heroin-seasonal-insanty/</link>
		<comments>http://annawrites.com/blog/2012/01/30/shoes-are-my-heroin-seasonal-insanty/#comments</comments>
		<pubDate>Mon, 30 Jan 2012 11:30:00 +0000</pubDate>
		<dc:creator>Anna DeStefano</dc:creator>
				<category><![CDATA[Shoes are My Heroin]]></category>
		<category><![CDATA[Anna DeStefano]]></category>
		<category><![CDATA[anna's world]]></category>
		<category><![CDATA[Cole Haan]]></category>
		<category><![CDATA[creativity & inspiration]]></category>

		<guid isPermaLink="false">http://annawrites.com/blog/?p=5499</guid>
		<description><![CDATA[Lots of Facebook chatter lately about shoes you need and those you lust for. I&#8217;ve scored both in the last few weeks. Neither are completely practical. But what&#8217;s the fun in practical? They fit like a dream and will feel great on my feet for hours. And there were bought at killer sale prices. PERFECT! [...]]]></description>
			<content:encoded><![CDATA[<p><strong><a href="http://annawrites.com/blog/wp-content/uploads/2012/01/shoe-bootie.jpg"></a>Lots of Facebook chatter lately about shoes you need and those you lust for. I&#8217;ve scored both in the last few weeks. </strong>Neither are completely practical. But what&#8217;s the fun in practical? They fit like a dream and will feel great on my feet for hours. And there were bought at killer sale prices. PERFECT! Whatcha think?</p>
<p><strong>These are my early-spring, neutral, sensible business pumps.</strong></p>
<p><a href="http://annawrites.com/blog/wp-content/uploads/2012/01/shoe-pump-wedge1.jpg"><img class="aligncenter size-medium wp-image-5501" title="shoe pump wedge" src="http://annawrites.com/blog/wp-content/uploads/2012/01/shoe-pump-wedge1-300x198.jpg" alt="shoe pump wedge" width="300" height="198" /></a></p>
<p>Okay, they&#8217;re wedges, too, and will look great with summer pants and cotton skirts and even shorts. But also the trousers and spring dresses/suits I&#8217;ll wear when I teach. No, really, that&#8217;s why I bought them. That, and they have rounded toes (thank Dog, the pointy ones are out again)&#8230;</p>
<p><strong>And since this time of year&#8217;s all about transition, I also needed something not-so-black to mix with the lighter things we wear under our coats in the south the next few months</strong>,<span id="more-5499"></span> when its cool but not frigid, and warmer but still chilly.</p>
<p><img class="aligncenter size-medium wp-image-5503" title="shoe bootie" src="http://annawrites.com/blog/wp-content/uploads/2012/01/shoe-bootie1-300x182.jpg" alt="shoe bootie" width="300" height="182" /></p>
<p>Now, before you start pointing at the heels and snickering, these have Nike Air Soles that cushion the pressure points on your feet like track shoes. Add in my high arches, and there&#8217;s nothing better. Plus, they&#8217;re prettyyyyyy ;o)</p>
<p><strong>Insanity, you say? I&#8217;ll be wearing both during upcoming travel and meetings. </strong>Catch me with them on, win a prize!</p>
<p><strong>I&#8217;ve missed hearing your shoe dreams. Check back each week,</strong> and we&#8217;ll find something even more outlandish to talk about in each <a href="http://annawrites.com/blog/category/annas-shoe-project/">Shoes are my Heroin post</a>, than my neuroses that my  heels must be high enough to keep me taller still than my now 6 foot+ 15-year-old.</p>
<p>There&#8217;s a world of dream shoes out there. Tell us about your faves!</p>
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		<title>How We Write: Living the Book&#8230;</title>
		<link>http://annawrites.com/blog/2012/01/26/how-we-write-living-the-book/</link>
		<comments>http://annawrites.com/blog/2012/01/26/how-we-write-living-the-book/#comments</comments>
		<pubDate>Thu, 26 Jan 2012 14:39:20 +0000</pubDate>
		<dc:creator>Anna DeStefano</dc:creator>
				<category><![CDATA[How We Write]]></category>
		<category><![CDATA[Anna DeStefano]]></category>
		<category><![CDATA[publishing]]></category>
		<category><![CDATA[writer]]></category>
		<category><![CDATA[writer resource]]></category>
		<category><![CDATA[writing]]></category>
		<category><![CDATA[writing articles]]></category>
		<category><![CDATA[writing coach]]></category>
		<category><![CDATA[writing craft]]></category>
		<category><![CDATA[writing workshops]]></category>

		<guid isPermaLink="false">http://annawrites.com/blog/?p=5481</guid>
		<description><![CDATA[What challenges us emotionally in life, challenges our novel writing. What we&#8217;re best at in life, becomes what we look forward to most in our writing process. I teach this dynamic all the time&#8211;and I live it. If you&#8217;re a seat-of-the-pants writer, it wouldn&#8217;t be a coincidence if you&#8217;re not a list maker or a planner in the &#8220;real&#8221; [...]]]></description>
			<content:encoded><![CDATA[<p><strong>What challenges us emotionally in life, challenges our novel writing. What we&#8217;re best at in life, becomes what we look forward to most in our writing process.</strong> I teach this dynamic all the time&#8211;and I live it. If you&#8217;re a seat-of-the-pants writer, it wouldn&#8217;t be a coincidence if you&#8217;re not a list maker or a planner in the &#8220;real&#8221; world.&#8221; <strong>If you LOVE to revise (like me), it&#8217;s likely that analyzing things and breaking them into their orderly parts is you everyday zen (at least it&#8217;s something that doesnt&#8217; drive you nuts the way it seems to for everybody else).</strong></p>
<p><a href="http://annawrites.com/blog/wp-content/uploads/2012/01/CatCrazyWriter.jpg"><img class="aligncenter size-medium wp-image-5485" title="CatCrazyWriter" src="http://annawrites.com/blog/wp-content/uploads/2012/01/CatCrazyWriter-300x232.jpg" alt="CatCrazyWriter" width="300" height="232" /></a></p>
<p><strong>Flip that around.</strong> If the unknown scares you, and you tend to plan for likely outcomes before you embark on a journey, drafting a new novel won&#8217;t make you warm and fuzzy (I tend to call the feeling a blank Page 1  invokes in me <em>abject terror</em>, but that might be a bit extreme for the rest of you.)</p>
<p> <strong>But if you&#8217;re the wanderer, dreaming of a backpacking trip through Europe where you merely have a start point and a destination and you&#8217;ll figure out pesky details like lodging and food and transpo along the way, well&#8230;you&#8217;re nuts! Eh-hem</strong>. What I meant to say is that I suspect writing blind into a new story is a mighty lovely place for you. Until you hit The End, and have to go back and break things down into their parts, rework your rough draft pieces into a better whole, then knit everything back together (which anal retentive, geeky analytical girls like me tend to think of as Nirvana ;o).</p>
<p><strong>My point to my students is never that either one or the other of these approahces is bad, in either life or writing.</strong> But that it&#8217;s best to know your strengths and weaknesses and to play one up, while compensating for the other. If it takes you forever to write a draft (to the point that you revise and revise and revise your first 100 pages while never writing the rest of the novel), take a look at why. If you can&#8217;t &#8220;make&#8221; yourself go back and revise a first draft because all the fun&#8217;s gone out of the story for you now that you know how it ends, and the idea of working with it anymore makes you nauseous, take a look at why.</p>
<p><a href="http://annawrites.com/blog/wp-content/uploads/2012/01/rock-bottom.jpg"><img class="aligncenter size-medium wp-image-5486" title="rock bottom" src="http://annawrites.com/blog/wp-content/uploads/2012/01/rock-bottom-300x220.jpg" alt="rock bottom" width="300" height="220" /></a><span id="more-5481"></span></p>
<p><strong>We make excuses for the broken parts of our writing processes. </strong>Excuses that in everyday life would impact our ability to do our jobs or run or families or keep our friends. In the &#8220;real&#8221; world, we learn to correct the personality traits (and control the emotions) that get in our way, so we can live better. Why, then, aren&#8217;t most of us doing the same thing in our writing lives?</p>
<p>How to draft can be taught to any writer with a true gift for telling story through the written world. How to revise and deconstruct story and analyze its parts can be taught to any writer with the desire to actually publish the beautiful creation that is their rough draft.</p>
<p><strong>The only real unknown is, how hard do you want to work on the internal life of your writing process? </strong>How honestly can you look at your strengths and weaknesses as a person, and the emotions that always come with challenging those weaknesses, no matter what you&#8217;re doing? How determined are you to make your writing work and sellable, not just fun.</p>
<p>The fun will always be there&#8211;the part of this writing journey that you love best. <strong>So will the challenges. But once you decide to combine the two into whole&#8211;a well-rounded writer who&#8217;s the entire package that a publisher, agent and reader are looking for&#8211;nothing can hold you back.</strong></p>
<p><a href="http://annawrites.com/blog/wp-content/uploads/2012/01/promise-land.jpg"><img class="aligncenter size-full wp-image-5487" title="promise land" src="http://annawrites.com/blog/wp-content/uploads/2012/01/promise-land.jpg" alt="promise land" width="185" height="272" /></a></p>
<p>We live our books. We live our writing process. Our minds are creative, yes, and the artist&#8217;s heart within us must be protected.<strong> But the writer&#8217;s mind is also a tool that can be trained to overcome any challenge it faces&#8211;including the parts of us we don&#8217;t like to look at any more closely in our writing than we do in our other lives.</strong></p>
<p><em>&#8220;Look,&#8221;</em> I tell my students. <em>&#8220;See what you are and what you&#8217;re doing. Keep what works, fix the rest.&#8221; </em></p>
<p><strong>Life&#8217;s just that simple.</strong></p>
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		<title>Dream Theories: Parasomnia, Brains Gone Wild!</title>
		<link>http://annawrites.com/blog/2012/01/24/dream-theories-parasomnia-brains-gone-wild/</link>
		<comments>http://annawrites.com/blog/2012/01/24/dream-theories-parasomnia-brains-gone-wild/#comments</comments>
		<pubDate>Tue, 24 Jan 2012 09:34:04 +0000</pubDate>
		<dc:creator>Anna DeStefano</dc:creator>
				<category><![CDATA[Dream Theories]]></category>
		<category><![CDATA[dream emotion]]></category>
		<category><![CDATA[dreams]]></category>
		<category><![CDATA[fantasy]]></category>
		<category><![CDATA[fantasy author]]></category>
		<category><![CDATA[Legacy Series]]></category>
		<category><![CDATA[parapsychology]]></category>
		<category><![CDATA[psychic]]></category>

		<guid isPermaLink="false">http://annawrites.com/blog/?p=5463</guid>
		<description><![CDATA[Welcome back guest blogger “Dr.  C” to Drem Theories. She&#8217;s sharing her in-house know how about the sleeping mind. Today, let&#8217;s spook our way through the confused and abnormal disruption (and potential trauma) parasomniacs endure.This is the kind of science I LOVE to play with in my contemporary psychic fantasies. Understanding more about how our brains [...]]]></description>
			<content:encoded><![CDATA[<p><strong>Welcome back guest blogger “</strong><a href="http://annawrites.com/blog/2011/12/06/dream-theories-sleep-dream-myths-debunked/"><strong>Dr.  C</strong></a><strong>” to </strong><a href="http://annawrites.com/blog/category/dream-theory/"><strong>Drem Theories</strong></a><strong>. She&#8217;s sharing her in-house know how about the sleeping mind. Today, let&#8217;s spook our way through the confused and abnormal disruption (and potential trauma) parasomniacs endure.</strong>This is the kind of science I LOVE to play with in my contemporary psychic fantasies. Understanding more about how our brains work in sleep and out, makes me a happy geeky girl ;o) And it opens worlds of plotting happiness for even bigger and more exciting stories about worlds that play out in our minds alone. Bwahahahaha!!!</p>
<p><strong>So read on, then come back to Dream Theories often to hear more of my meanderings about my personal dream research&#8211;and more from Dr. C., as she feeds my (and your) imagination about the physiology behind oursleeping brains&#8217; most intriguing, if disturbing, patterns.</strong> If you look closely enough, even in today&#8217;s post, you&#8217;ll see the bones of the &#8220;fringe&#8221; science on which I crafted the parapsychology of my first two Legacy books. No, NOT <em><strong>Exploding Head Syndrome</strong></em> (though I don&#8217;t know HOW I missed that one!).</p>
<p><a href="http://annawrites.com/blog/wp-content/uploads/2012/01/exploding_head.jpg"><img class="aligncenter size-medium wp-image-5469" title="exploding_head" src="http://annawrites.com/blog/wp-content/uploads/2012/01/exploding_head-300x293.jpg" alt="exploding_head" width="300" height="293" /></a></p>
<p><strong>Don&#8217;t forget to ask Dr. C. your strange dream/sleep questions in the comments&#8230; She&#8217;s SO much fun to talk to ;o)</strong></p>
<p style="text-align: center;">***</p>
<p style="text-align: center;"><em>Dreaming permits each and every one of us to be quietly and safely insane every night of our lives.</em>  ~William Dement</p>
<p style="text-align: center;"><em>Lady Macbeth:</em> <em>Out, damn&#8217;d spot! out, I say!—One; two: why, then &#8217;tis time to do&#8217;t.—Hell is murky.—Fie, my lord, fie, a soldier, and afeard? What need we fear who knows it, when none can call our pow&#8217;r to accompt?—Yet who would have thought the old man to have had so much blood in him? </em>~William Shakespeare, Macbeth</p>
<p><strong>What do these two quotes have in common other than being by men named William who like to ponder the weird things people do in their sleep</strong>?  It is often assumed that parasomnias, or “…unpleasant or undesirable behavioral or experiential phenomena that occur predominantly or exclusively during the sleep period,” (Mahowald &amp; Bornemann, Principles &amp; Practices of Sleep Medicine, 4th ed.) have their roots in some sort of psychological distress, including guilty consciences.  However, the cause is more physiological than psychological.</p>
<p>If you&#8217;ve learned to drive a stick-shift car or been in a car with a failing transmission, you know how it stalls out or moves jerkily from one gear to another if something is off, either with the driver&#8217;s clutch timing or in the transmission itself.  Remember that hypnogram from <a href="http://annawrites.com/blog/2011/12/06/dream-theories-sleep-dream-myths-debunked/">last week</a> showing the different sleep stages?  <strong>Sometimes the brain doesn&#8217;t shift smoothly from one stage to another, or it gets interrupted, and that&#8217;s when parasomnias can occur.</strong></p>
<p><a href="http://annawrites.com/blog/wp-content/uploads/2012/01/brain.jpg"><img class="aligncenter size-medium wp-image-5470" title="brain" src="http://annawrites.com/blog/wp-content/uploads/2012/01/brain-300x299.jpg" alt="brain" width="300" height="299" /></a><span id="more-5463"></span></p>
<p>Stage N-3 (formerly stages three and four) is when the body gets its deep, physically restorative sleep, and the brain puts out big slow waves.  <strong>Disorders of arousal, which include sleepwalking, night terrors, confusional arousals, and even sleep-eating and sleep-sex, occur during slow-wave sleep or during transitions into or out of it.</strong>  As you can see from the hypnogram, we get more slow-wave sleep during the first part of the night, so that&#8217;s when these disorders occur.  Since people tend to get confused between them, let&#8217;s talk about what they are.</p>
<p><strong>During a sleepwalking episode, the person may get out of bed, walk around, and perform complex motor behaviors.  There is little to no awareness of what&#8217;s actually going on, and they won&#8217;t remember it the next morning.</strong>  Often, the only clues to sleepwalking if a person lives alone is that objects may be moved around or go missing.  I know of one case where a pet fish went missing for three weeks, and then reappeared, still alive but not in great shape, in its tank. </p>
<p>A person with night terrors will seem to wake terrified, scream, cry, or make other noises associated with extreme fear, and perhaps jump out of bed and try to escape from something.  Although their eyes are open, witnesses say they seem to &#8220;see right through&#8221; them.  They often resist comforting, and will eventually settle down and remember nothing the next morning.</p>
<p><strong>Confusional arousals fall somewhere between night terrors and sleepwalking.</strong>  It used to be thought that in all three of these disorders of arousal, the person wasn&#8217;t dreaming, but one study found that people who experienced them did have some sort of dream imagery occurring that corresponded with their behavior.  <strong>These disorders occur most often in children, which makes sense because kids&#8217; brains are going through frequent reorganizations, but they are present in four to five percent of adults as well.</strong></p>
<p><strong>When someone literally acts out their dreams, REM behavior disorder, or RBD, is the culprit.</strong>  Typically, when we&#8217;re in REM, our brains shut off our voluntary muscles so we don&#8217;t act out our dreams.  Sometimes the signals get mixed up, and the muscles don&#8217;t get shut off, so people will do everything from talk to thrash around to get up and run or fight.  Since this occurs during REM sleep, it&#8217;s more likely to occur later in the night.  One of the first cases I heard about was an older woman who loved to sing in her church choir.  She&#8217;d wake her family early in the morning with shouts of &#8220;Praise Jesus!&#8221; </p>
<p><a href="http://annawrites.com/blog/wp-content/uploads/2012/01/nightmares.jpg"><img class="aligncenter size-medium wp-image-5471" title="nightmares" src="http://annawrites.com/blog/wp-content/uploads/2012/01/nightmares-300x225.jpg" alt="nightmares" width="300" height="225" /></a></p>
<p><strong>True nightmares, which differ from stress or anxiety dreams, also tend to occur later in the night during REM sleep.</strong>  These are dreams that contain disturbing imagery and have negative emotional and fatigue effects that last into the next day.  They often co-occur with Posttraumatic Stress Disorder.</p>
<p><strong>My favorite parasomnia is an extremely rare one called Exploding Head Syndrome, where the patient wakes hearing a loud noise and afraid their head has just exploded.</strong>  No, it doesn&#8217;t make sense – how would you have awareness your head was missing? – but very little does immediately upon awakening.  I&#8217;ve never seen a case of this, but one neurologist in a course I taught had.  Sadly, I didn&#8217;t get the chance to catch up with him after to ask him how he treated it.</p>
<p><strong>Parasomnias, especially in adults, can have a wide range of causes.</strong>  Remember, the group of disorders that includes sleepwalking are called disorders of arousal, so we often look for reasons why someone&#8217;s sleep may be getting disturbed, but only partially.  Sometimes another sleep disorder like obstructive sleep apnea, when the airspace closes during sleep, or periodic limb movement disorder, when the movement system kicks into gear and makes someone kick their feet, is to blame.  These disorders also tend to run in families, so there is a genetic component.</p>
<p><strong>A wide range of substances including alcohol and its withdrawal, caffeine, and some prescription medications have been associated with parasomnias.</strong>  I hear interesting Ambien stories from patients who have discontinued it due to eating, talking on the telephone, and other activities that they don&#8217;t remember later, including driving.  One tip:  don&#8217;t ever combine Ambien with alcohol.  Not only is it physically dangerous, but it could also have embarrassing results (and that&#8217;s all I&#8217;m going to say about that to protect confidentiality).</p>
<p><a href="http://annawrites.com/blog/wp-content/uploads/2012/01/parasomnia.jpg"><img class="aligncenter size-full wp-image-5479" title="parasomnia" src="http://annawrites.com/blog/wp-content/uploads/2012/01/parasomnia.jpg" alt="parasomnia" width="300" height="199" /></a></p>
<p><strong>There are a range of pharmacological and behavioral treatments for parasomnias for those who experience true distress or impairment as a result.</strong>  The behavioral ones focus on re-training the brain so it will be more likely to sleep through the night, or so the imagery it produces will be less disturbing.  I sometimes end up doing psychotherapy focusing on underlying anxiety or depression, although this isn&#8217;t always the case.  Unlike Lady Macbeth, most sleepwalkers aren&#8217;t doing so because they have some sort of psychological distress.</p>
<p><strong>I can&#8217;t diagnose or make treatment recommendations, but I look forward to hearing about the strange things you&#8217;ve done or heard of someone doing at night</strong>!</p>
<p style="TEXT-ALIGN: center">**********</p>
<p><em>By day, “Doctor C.” is a licensed clinical psychologist and behavioral sleep medicine specialist.  That’s a long title, so she answers to any variations, including “Sleep Psychologist.”  </em></p>
<p><em>By night, she writes fantasy and science fiction, <a href="http://random-oenophile.blogspot.com/">blogs</a> about wine and life, and interacts with other wine lovers and writers on twitter as @RandomOenophile.  She’s a featured first-place winner in this year’s Mystery Times Ten, a Young Adult mystery anthology, for her fantasy story “<a href="http://www.buddhapussink.com/Buddhapuss_Ink_Store.html">The Coral Temple</a>.”  </em></p>
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