PTSD Symptoms: Feelings of Loss and sense of self

Q: Dear Frank, A cause of dissatisfaction I’ve heard and read from survivors is about their feeling of loss — the loss of one self after their traumatic event. People say that they are not the same person. Who I am now is not who I was. How do you feel about this expression of pain and grief?

A: Dear reader, The famous anthropologist, analyst and author, Erik Erikson, described an elderly gentleman who complained to his physician, “Oh, doctor, my head hurts, my bowels don’t move, my joints are sore, and doctor, I myself don’t feel so good.”

I can picture this scene so clearly!

It makes one think about the meaning of “I, myself.”

Surely we are more than our body parts, than our feelings and thoughts, than the way we appear to others. So it doesn’t surprise me to hear that many of our gift from within survivors express a sense of being somehow different after profound trauma. I assume the change is in some aspect of that difficult-to-describe thing we commonly call “I, myself.”

What is the self? Let’s go back to Dr. Erikson. He described identity and the identity crisis. Identity crisis is something we face in adolescence and it is a confusing, turbulent transition from childhood to maturity. As adults, we achieve “self-sameness through time.” We are no longer children. We have times of stress and change, but we are essentially molded and we have a feeling of knowing who we are. We have, according to Erikson, identity.

After certain traumas, our identity is shaken. We have more than PTSD symptoms. We have an altered sense of self. At best, this is a loss of innocence. At worst, it is a loss of capacity for trust. I want to be very careful here because individuals are different, “capacity for trust” is a complicated concept, and readers who suffer impaired capacity for trust need encouragement, not gloomy forecasts. Post-traumatic therapy is an individualized search for optimum outcome – not for return to a former sense of self. Once major symptoms are overcome, survivors re-examine their goals and values and the meaning of their lives. They are NOT the same as they were before. Often, they are sadder and wiser. When they are relatively confident in their new circumstances and, in a manner of thinking, in their new skins, they can trust and relate and recover human connection. Later, perhaps much later, there is a sense of integrity (Erikson’s word, again). He doesn’t mean honesty, he means that the whole journey of one’s life adds up, makes sense, and feels coherent. In looking back, one recalls losses and gains, tragedies and magical moments. One knows who one is and where one has been. The sense of self is clear. One no longer feels lost or damaged or diminished.

To admit to “loss of self” is a candid and thoughtful insight. It is common among victims of major trauma. As a rule, it does not last a life-time. But the “self” that is found may feel different for a long while. It can feel as different as the difference between childhood and adulthood. But it is the same self – and eventually, if all works out as it should, that sameness of self is felt and understood.