Despite interests that included writing, ecology, and neurobiology, in my early twenties I decided to enter a helping profession. Given my history of adverse childhood experience (ACE), this choice was predictable. Those from traumatic backgrounds often favor helping careers. For instance, nursing students report greater ACE history than those in unrelated fields. For many, including myself, clinical work engages caretaking habits developed during chaotic childhoods.
Eventually, I acquired skill as a subspecialty surgeon. With that craft came recognition and reward. Raised with little love and support, it seems likely I sought validation by succeeding in a competitive field while serving others. Regardless of motivation, the work was of value, and assisting patients helped me feel better about myself.
Unfortunately, my surgical career ended early due to neck problems. I had learned to push myself beyond my limits, performing surgery for increasing hours despite harsh discomfort. Commuting home each night, my body rigid with pain and tension, I would notice myself clenching the wheel while holding my breath. I was working to heal my patients but neglecting my own wellbeing.
When searing pain began to undermine the quality of my procedures, and after doctors failed to offer a viable treatment, I saw no option but to abandon my career. The decision was reached impulsively and later regretted, but it probably was the right choice. Nowadays I know how to care for my body and psyche, but back then I lacked the tools.
Since my self-esteem rested on the pedestal of my profession, early retirement devastated my spirits. After some rounds of suicidal depression alternating with manic inflation, which culminated in two psychiatric hospitalizations, I began a long struggle with despair, panic, and self-loathing. The battle lasted nearly a decade, but I eventually recovered from the shock of career loss. More importantly, I gained release from the devastation wrought by my upbringing.
In my opinion, recovery from formative trauma requires recognition of both our wounds and the strengths that grow out of them. Of course, believing that early horrors can germinate into positive qualities seems to risk excusing mistreatment of children. We should avoid suggesting that all ordeals build character, but we are each free to conclude so for our individual traumas. Understanding how early hardship motivated me to serve helped me view my past in a more nuanced and healing way. Similarly, writing now about overcoming trauma lends meaning to my losses.
We all know examples of those who respond to misfortune with positive acts. Whether famous or obscure, wounded heroes excel as artists, family members, healers, activists, and reformers. Harnessing the energies of trauma enables many to benefit humanity. However, although sublimating pain helps lessen it, those burdened by significant adversity need to direct some of their concern internally. If committed passion flows outward but never in, there is a danger of depletion and burnout.
The world deserves saving, but so do those who strive to save it. Mistreated children learn to appease and protect guardians, often at the expense of stable identity and self-esteem. We begin to heal when we understand the desire to offer gifts as positive but recognize how it can undermine wellbeing if personal needs remain ignored.
Treating oneself well sounds easy, but those from troubled pasts know it to be challenging. Childhood misfortune makes it difficult to distinguish self-care from selfishness. Erratic swings between refusing comfort and indulging cravings are common. But insights from psychology, meditative traditions, and neuroscience offer hope. We can learn to soothe ourselves without yielding to addiction, and we can begin to help others without sacrificing our own mental and physical health.
© 2013, Will Meecham, MD, MA
Note: The foregoing essay was initially written as part of a fourteen article series for the Center for Post Trauma Wellness (CPTW) website, where most of the pieces are already online. The CPTW site is new and has yet to build up much traffic. In the interest of both finding a larger audience for this project and also giving CPTW some exposure, I am gradually posting portions of the series here.