Me as a trauma response

One of the things I’ve been going over and over again, tracing like an old path both in my professional work and in my personal life, is this idea of the created self. How do we become who we become? What makes us who we are, and differentiates us from one another? What are the conditions required for the self to flourish, and under what conditions do we become less of ourselves?

I feel like my life started when I was 23. Which is to say that prior to my liver transplant, my entire focus was survival.

I said to someone recently - someone also in the medical world but with a very different story than my own, who lived a relatively healthy life and had distinct memories of before and after - that one of the things I feel like transplant gave me was a personality. I say it as a joke, but also with a degree of seriousness. And each time I vocalize this sentiment, I notice how uncomfortable it makes people. They are quick to assure me I always had a personality, that transplant uncovered my truest self and that who I am now is who I was always meant to be.

I appreciate the sentiment, though I feel it is more for the person telling me this than it is for me. I don’t necessarily believe it. I believe it makes other people more comfortable with my reality, that by wrapping the truth in this butterfly-esque metaphor it can alleviate some of the uncomfortability that cloaks itself around the fact that my childhood was traumatic. Growing up sick was trauma, and its ripples extend throughout my life.

I remember the first time in college I said my childhood was traumatic, back when I sat in the back row of a psychology class and we were discussing types of family units, and I was told I was wrong. And it’s true that my childhood wasn’t marked with abuse, with violence and abandonment. But if that is the only thing we view as constituting trauma we have missed a broader picture.

As a child, I remember so many of the things people would note as my personality. (Also paying attention to I remembered what other people said my personality was. I do not have a single recollection of me being aware of my own personality traits, and especially not in any sort of positive, identity building ways). I was information oriented, quiet, analytical, observant. Looking back now, I don’t think I ever was any of those things as a personality trait. They were all survival patterns I put on because I learned I was deeply unsafe. I was told, from my earliest memories, that I needed to be in control, that my life had to become rigid and strict and small. I believed I was responsible for everything, that anything bad that happened was my fault, and therefore to stay safe I needed to always know what was happening. It wasn’t because that was my personality, or I simply preferred it that way or that was my default wiring but because I was traumatized and it was a learned behaviour. But saying that out loud is harder for people to accept. It means looking straight at how trauma shapes who we are as people.

In the study of human development, we learn that positive personality traits develop when there is safety. They emerge when a child is safe to explore, play, be curious… Going back to the model of Maslow’s hierarchy of needs, if basic needs are not met, things like development of personality or a self identity cannot take place. My body, through no fault of anyone’s, was in a constant state of survival due to hypoglycemia. If I never felt safe in my own body, of course what I would display as personality traits would be an arrangement of survival responses. This critical threat during the most formative years of development in a human meant the development of all of those core pieces of self would have been altered.

I remember in vivid detail the identity crisis that emerged post transplant. I hear often now working with patients the sentiment of the split, the before and after. The thing is I never had a before self to build on. I didn’t feel I had traits or hobbies to return to. And as I reached for things, I found their threads of trauma didn’t actually match my new self or the person I wanted to be. Some could say it was just the personality shift of finally having the embodied safety able to explore and form an identity, which is probably true in some degree, but I think it was also the revelation that trauma and survival had been dictating my life for so long I had no idea who I was without it. Thus began my construction of self in my twenties.

I was a full grown toddler. In more ways than one. I was learning to navigate the world like it was the first time, and in a way it was.

I was sold a myth by well meaning people that this was who I was, and that the core of me was in there somewhere, but it’s more comforting to think the opposite. I never had a chance to become who I was because there was never that stability the sense of self needed to develop. It’s been years since my transplant, and obviously I have a very strong sense of self now, but I do think a lot of that work was done post transplant as opposed to in childhood like the majority of my peers.

This was not a return to self but a building of self.

I didn’t find myself after trauma, I created myself.