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I started writing this after coming across a referral from a therapist looking for another practitioner to work with one of their clients.
The client had grown up with a narcissistic parent, was struggling with depression, and had already worked with a number of professionals. They understood a lot about what had happened to them. And yet, their traumatic past continued to shape how they saw themselves and the world around them.
I read it and thought: I know this person.
Not literally. But I know this pattern. I meet versions of it constantly in my work: people who understand perfectly well what happened to them and why they are the way they are, and yet that understanding hasn’t really changed how they feel or the repeating patterns they find themselves living inside.
We live in a time drowning in psychological insight. I don’t know if you’ve noticed, but it’s everywhere. There’s now an explanation, diagnosis, framework, and therapy-speak for almost everything we feel and do. We know our attachment styles. Our trauma responses. Our nervous systems. Our neurodivergence. Our parents’ neurodivergence or personality disorders. We know our inner children. Our boundaries. Our triggers.
And still, somehow, we find ourselves doing the exact same shit over and over again.
If reading about trauma could fix a nervous system, every well-read overthinker on the internet—myself included—would be completely healed by now. Which makes writing another essay containing several thousand words of psychological information slightly ironic.
But there is another consequence of all this understanding that I don’t think we talk about enough. We went looking for language to explain our suffering. Why do I feel like this? Why do I keep doing this? Why does this keep happening to me? What happened to me? How do I heal?
But somewhere in that search, things took a turn.
The language that helped us explain what we were experiencing, and the diagnostic labels we gave those experiences, started becoming the language we use to explain who we are.
I experience anxiety became I’m anxiously attached.
I’ve been diagnosed with ADHD became I’m neurodivergent.
And the recurring pattern underneath it all is this:
I have this. I experience this. I was diagnosed with this.
Slowly became:
This is what I am. This is who I am.
And that’s where I want to begin this piece today.
How did we get here?
To understand how a description turns into an identity, we have to go back long before anyone handed us a clinical term—long before words like trauma response, attachment style, CPTSD, or neurodivergence were in our vocabulary. We were just kids figuring out how to survive the rooms we were in.
When you grow up in rooms where things feel unsafe, unpredictable, volatile, or overwhelming, you do what you have to do to navigate it. You do what you have to do to survive.
If a parent is volatile, you learn to read the room before opening your mouth. If love feels conditional, you learn which version of yourself gets approval. If conflict feels dangerous, you become invisible or learn to keep the peace.
That’s what words like adaptation, coping mechanism, trauma response or survival strategy are actually describing: the ways we learned to deal with what was happening around us.
You don’t sit down at seven years old and map out a strategy. You just do what works to stay connected and safe. And because it works, you keep doing it. You don’t suddenly stop when you get older, because what you learn in childhood becomes your baseline for how relationships work. It follows you right into adulthood—into your friendships, your career, and your romantic relationships.
Of course, we don’t all adapt in the same way. One person might become accommodating, another controlling or volatile. Some learn to disappear, while others become indispensable.
For me, the survival response I know most intimately is what I like to call the chameleon.
When you grow up around a critical, unpredictable, or controlling parent, adapting becomes second nature. You learn to anticipate rejection. You stop trusting your own perception. You manage other people’s moods without even realising you’re doing it. You scan for changes in tone, replay conversations in your head, apologise too quickly, and carry responsibility that was never yours to hold.
In adulthood, this can look like doing the thing no one else wants to do, that no one asked you to do, that you volunteered to do—and then feeling like shit when no one notices.
I played the role of the reliable workhorse for years. Always on, always available, always meeting the deadline, always going above and beyond—at work, with friends, everywhere. And yet it constantly felt like people who gave half the effort got twice the reward. I wasn’t paid more. I wasn’t recognised. I just kept doing more for breadcrumbs.
One of the more confronting things I eventually had to recognise was that, much of the time, nobody had actually asked me to go above and beyond. I had volunteered.
That’s a difficult thing to admit when you’ve spent years feeling exploited by other people. Sometimes people really are exploitative. But sometimes nobody has to deliberately exploit you. If you are constantly making yourself available, anticipating everyone’s needs, carrying things nobody asked you to carry, and quietly expecting recognition in return, you have also made yourself remarkably easy to take advantage of.
Looking back, I can see how much of my own over-functioning contained an unspoken contract that nobody else knew they had signed:
I’ll be useful. I’ll need very little. I’ll anticipate what you need. I’ll do more than you asked. And eventually, you’ll see how valuable I am.
Except nobody had agreed to the contract.
So when the recognition didn’t come, I felt resentful. At times, I felt manipulated or exploited. But that resentment also kept my attention on what other people were doing to me, rather than on what I had been trying so desperately to get from them in the first place.
Underneath Why doesn’t anyone appreciate everything I do? was a much older need:
I need you to see me.
It almost didn’t matter who you were. The strategy was the same: if I could be useful enough, capable enough, indispensable enough, eventually you would recognise my value.
When you grow up without enough love, attention, or genuine acknowledgement, being useful becomes a remarkably convincing substitute for being seen. Useful becomes safe. Competence becomes protection. And anticipating other people’s needs becomes so automatic that eventually it doesn’t feel like a strategy at all.
It just feels like you.
And this is where the conversation around mental health gets messy.
We now have an enormous psychological vocabulary available to describe these adaptations: people-pleaser, anxiously attached, masking, hypervigilant, codependent, perfectionist, ADHD, OCD, traumatised, highly sensitive, dysregulated.
Getting that language can be profoundly relieving. Suddenly, something that has confused you for years has a name. You can read about it, find other people who experience it, and maybe, for the first time, feel seen.
But then what?
Because naming a pattern doesn’t automatically dismantle it. It just gives us something to point at.
I can know I’m hypervigilant—and believe me, I do—and still automatically scan every room I walk into. You can understand your attachment style and still completely unravel when someone pulls away. You can know exactly why you people-please and still find saying no almost physically unbearable.
Self-awareness gives us language for the pattern. It doesn’t necessarily give us the tools to change it.
And this is where we run into a much bigger problem.
We have become exceptionally sophisticated at identifying, categorising, and diagnosing human suffering. But once we have a name for an experience, our immediate instinct is almost always to fix it: How do we reduce this symptom? How do we suppress it, correct it, sedate it, manage it, or eliminate the problem behaviour?
We are so desperate to make an unwanted or uncomfortable feeling, symptom, or habit disappear that we almost never stop to ask what it is actually doing.
When people first start working with me, they understandably want their distress to vanish. So when I suggest we slow down and actually make space for what they are feeling, the reaction is usually utter disbelief:
What? You want me to give my anxiety more room? You want me to give the pain more space? The anger- you want me to let it out in front of you?
The answer is yes.
And this is the part people often aren’t prepared for: there’s no agenda behind giving it space.
We’re not giving the anxiety more room so that it will finally go away. We’re not listening to the pain in the hope that it will get smaller. It doesn’t need to change or give us anything in return.
We give it space and see what it does with the space.
That’s it.
Because before we decide that something inside us needs to disappear, I want to know what it is doing there. Think about what a survival response actually is. This thing was there for us when things were unpredictable or unsafe. It protected us when we had no other options. And years later, we turn around and tell it that it is the problem—that it is pathological, defective, inconvenient, and needs to be eradicated.
And the thing is, it doesn’t simply go away.
When you try to starve out or lock up a protective part of yourself, it doesn’t just surrender. Like a wild animal trapped in a cage, it can get frantic. It can get louder. It can find other ways to force its way to the surface. When we treat our own survival responses purely as unwanted defects to be managed or eliminated, we end up fighting our own defences.
And when that fight becomes a lifelong project—another fix, another strategy, another effort to keep ourselves contained—we don’t get closer to who we are. We get further away. We end up relating to ourselves as a collection of problems to be managed rather than a human being to be understood.
If we never ask what the adaptation is doing, what it protects, why it exists, or what happens when we actually give it room, we can spend a lifetime managing expressions of ourselves without ever encountering what exists underneath them.
Which leaves a much more difficult, much more confronting question:
Who am I underneath the survival strategy?
That question gets complicated when the strategy doesn’t actually feel like a strategy. When it feels like a perfectly ordinary part of your personality—or even something you value about yourself.
Hypervigilance Doesn’t Feel Like Fear
Take hypervigilance. People often imagine someone who is visibly anxious or constantly on edge. But hypervigilance doesn’t always feel like fear. Sometimes it feels like responsibility. It feels like being the reliable one—thoughtful, considerate, prepared, and emotionally intelligent.
It can feel like a capability that makes for extraordinary therapists, wellness practitioners, coaches, bodyworkers, nurses, social workers, facilitators, and leaders. Because if you’ve spent years scanning your environment for signs that something might go wrong, paying that much attention doesn’t feel like a survival strategy. It just feels natural. Automatic. Second nature.
You barely realise you’re doing it.
I once worked with a client who couldn’t relate to the word hypervigilance at all. So we dropped the terminology and shifted our attention to the body instead.
This is a core part of psychosomatic practice: bringing the narrative from the mind and the sensations of the body back into conversation with one another, rather than assuming either one holds the whole story.
Anyway, we landed on their eyes. Their eyes were tired, tense, and sore. As we stayed there, we both became curious about just how much unconscious scanning was happening without them even realising it. The word didn’t particularly matter. Their body was already showing us the pattern.
Working this way has also made me interested in which words we’re willing to identify with—and which ones we resist.
My first therapist once said to me that people who have experienced abuse can have an incredibly difficult time acknowledging that they were abused at all. Even using the word can feel almost impossible. I certainly resisted it for a long time.
Abuse was not a word I wanted anywhere near my identity.
Resilient? Sure. Tough? Absolutely. Capable? Great.
Survivor of abuse? Yeah, no thanks.
Years later, sitting with a different therapist, I said very firmly in the middle of a session, “I’m not a victim.”
He looked at me, blinked, and said, “Yeah. You’re not a victim.”
There are words we can tolerate being associated with and words we absolutely cannot. Some labels make us feel capable, interesting, understood, even special. And then there are labels that make us feel powerless, defective, helpless, or ashamed.
Which makes the relationship between psychological language and identity much murkier than simply saying that labels are either good or bad. Even some of the qualities we value most in ourselves can have complicated origins. Empathy is one of them.
If understanding the person creating the instability was once part of how you stayed connected to them, becoming extraordinarily good at reading and understanding other people makes sense. Empathy is a wonderful human capacity. But it can also get tangled up with survival. You can become brilliant at explaining everybody else. Their childhood. Their stress. Their intentions. Their wounds. Why they did what they did. And all of those explanations might even be true.
But understanding someone doesn’t make what happened to you disappear.
Sometimes understanding everyone else becomes another very sophisticated way of abandoning yourself.
The High-Achiever’s Finish Line
Some survival strategies are difficult to recognise because we don’t identify with the language used to describe them. That was the case with the client I mentioned earlier: hypervigilance simply didn’t feel like them. But others are hiding in plain sight. We recognise the qualities perfectly well. We just don’t necessarily see them as survival strategies.
Sometimes we recognise them as gifts.
Empathy can be a gift. So can sensitivity, perceptiveness, independence, ambition, and the capacity to perform exceptionally well under pressure. Sometimes adaptation genuinely does become a skill.
I work with a lot of ambitious, high-performing people. Many of them are amazingly perceptive, strategic, self-aware, socially attuned, and emotionally intelligent. From the outside, these qualities can look pretty glamorous. They build impressive careers, businesses, relationships, and lifestyles. But one thing I notice constantly in my practice is how quickly one goal gets replaced by another. They achieve the thing they’ve been striving towards for months—sometimes years—and run straight past it.
“Yeah, so I did this thing and anyway, now onto the next.”
And I have to stop them: “Whoa. Wait a minute. Do you remember when you first came to me wanting this exact thing? Do you remember how impossible it felt? You did it. Can we stay here for ten seconds before you move the finish line again?”
If you grew up not feeling particularly seen, acknowledged, or accurately reflected by the people around you, achievement can become another place you go looking for that reflection.
Maybe when I reach this milestone, I’ll finally be seen.
Maybe when I’m successful enough, I’ll finally feel valuable.
Except the finish line never stops moving.
And this is where the question of choice becomes important.
Can I stop when I’ve done enough? Can I acknowledge myself without immediately needing another achievement? Can I rest without feeling worthless? Can I fail without it becoming a referendum on who I am?
Because sometimes the problem isn’t simply that we don’t know how to stop. It’s what happens when we do.
When you’ve built an identity around being productive, useful, successful, resilient, needed, or exceptional, putting down the strategy can leave an enormous gaping hole in its place.
Now what?
Who am I if I’m not doing this?
And this is where identity matters again. Because if the survival strategy has become indistinguishable from the person, stopping it can feel like losing yourself.
So we keep doing it.
This is where burnout can enter the picture. It can also be where exhaustion, anxiety, shutdown, pain, and other chronic symptoms begin to demand our attention. I don’t assume that every chronic symptom has a psychosomatic origin, but in my work I am interested in what the body may be communicating when someone has spent years overriding their own limits.
Sometimes the message is pretty simple:
I can’t keep doing this.
But stopping can feel intolerable too.
And that leaves us in a strange bind: continuing the strategy is becoming harder and harder to sustain, while imagining ourselves without it can feel like stepping into an enormous void.
If I’m not this person anymore, who am I?
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Meeting Yourself in the Dark
The perfectionist, the writer, and the practitioner in me desperately want to finish this essay by answering the question I’ve spent this whole piece asking:
Who am I underneath the survival strategies?
I’d love to have the answer for you. I’d love to say, “Here’s my method. Do this, and you’ll be healed.”
But I’m not going to do that, because it would be a lie. And more importantly, I’d be doing the exact thing this entire essay is questioning. “Here’s more language. Here’s more self-awareness. Here’s the missing piece of information that’s finally going to explain you.” Another piece of scaffolding to hold onto as you release the old one.
What I do know is that when you start loosening the protective strategies that have held your identity together for years, it doesn’t necessarily feel like a spiritual awakening.
It can be deeply uncomfortable and even destabilising. It can feel like grief. A lot of grief. Pain. Emptiness. Loneliness. It can feel existential and disorienting, like the structures you’ve used to understand yourself are falling away before you’ve figured out what will replace them.
It can feel like depersonalisation, derealisation, or stepping directly into a void.
And I’m sure we could find another dozen psychiatric terms for what can happen there.
Which leaves me wondering whether our instinct to name the experience can sometimes become another way of getting away from the experience itself.
Most of us will do almost anything to avoid standing at that threshold—that uncomfortable space between all the things we have used to define ourselves and whoever we might be without them.
We listen to another podcast. Read another Substack essay. Analyse another childhood memory. Find another therapist offering the next best modality. Get another diagnosis. Try another prescription. Learn another framework or another set of clinical terms.
Anything to keep from standing naked in front of ourselves without an explanation to hide behind.
I wonder sometimes whether we have become so invested in understanding ourselves that even healing, therapy, self-awareness, and spirituality can become ways of avoiding ourselves.
We want more. More insight. More self-awareness. More emotional intelligence. More vocabulary. More information. More understanding.
And all of those things are useful, sure. Finding words for something you have lived through can bring relief, meaning, connection, community, and the profound experience of finally feeling understood.
But eventually, understanding reaches its limit.
I can understand why I do something and still do it. I can know exactly where a pattern came from and still find myself living inside it.
At some point, there may simply be no more useful words.
There is an experience. There is a body. There is grief. There is uncertainty.
But there can also be softness. Sensitivity. Space. Vulnerability. Innocence. Intimacy. Quiet.
And strangely, those things can be every bit as difficult to tolerate as the pain.
Because we aren’t only defended against suffering. Sometimes we are defended against being seen inside it.
I know that discomfort from both sides of the room.
I’ve sat across from a therapist feeling so exposed in my own humanity that I couldn’t look them in the eyes. Not because anything terrible was happening, but because somebody was looking right at me and wasn’t turning away.
And I’ve experienced versions of it from the other chair in my private practice, too.
Witnessing another human being without immediately trying to change them, reassure them, explain them, diagnose them, or make what is happening go away requires an extraordinary level of intimacy.
Just: “I see you. I’m here. I don’t need anything from you. I don’t need you to change. You don’t have to perform.”
That kind of relational presence can be deeply uncomfortable when you have spent a lifetime surviving through adaptation.
Which brings me back to that question from much earlier in this essay:
Why doesn’t anyone see me?
We can spend years trying to answer that question by becoming useful, successful, perceptive, or resilient. We can search for language that finally explains us. We can receive a diagnosis and experience the immense relief of discovering that we aren’t alone and that something we have struggled with for years finally has a name.
But being recognised by a category and being known as a person are not quite the same thing.
A label gives us something solid to hold onto. It can give shape to experiences that previously felt chaotic or incomprehensible. It can allow me to tell you something important about myself without necessarily having to stand completely exposed in front of you.
“I’m anxiously attached. I’m traumatised. I’m neurodivergent. I’m hypervigilant.”
There. Now you know something about me.
But do you know me?
And perhaps the more uncomfortable question is:
Do I?
I don’t know exactly what remains when we loosen our grip on everything we have used to explain ourselves. I don’t know where the survival strategy ends and the person begins. I’m not even sure that is the right distinction to make.
Is my story who I am?
Is what happened to me who I am?
Are the ways I learned to survive who I am?
Of course they are part of me.
But are they all of me?
I don’t think so.
I sometimes think of what happens next as a kind of soul reclamation. Not the discovery of some pristine, untouched version of ourselves that existed before life happened to us. I’m not sure that person even exists.
More like slowly coming into relationship with what became abandoned, suppressed, dismissed, diminished, or unwitnessed along the way. And maybe meeting what we find there without immediately turning it into another project.
Without immediately asking: “How do I fix this? How do I heal this? How do I make this part of myself different?”
Maybe there isn’t a clean answer to “Who am I?”
Maybe that’s why the question is so confronting.
Sometimes I wonder whether the void feels empty only because we’ve reached the edge of everything we already know how to call ourselves.
Maybe there is more there. Maybe there is more to us than the identities, the histories, the adaptations, even the individual “I” we have spent so much time trying to understand.
I don’t know.
And perhaps that’s the point.
Rather than reaching for another word to fill that space, maybe there is something worth discovering in learning how to stay at the threshold of the unknown for a little while.
Without an explanation.
Just to see who—or what—we meet.
About Tanya
Tanya is a psychosomatic consultant and developer of the Psychosomatic Restoration Method™. Her work supports people in exploring who they are underneath the survival strategies, patterns, and identities they developed to navigate their lives. She works relationally and psychosomatically, offering another perspective through which people can begin to see and meet themselves more clearly.
🎧 Listen to the Podcast: When Did We Start Treating Diagnoses as Identities? is also available on Spotify and Apple Podcasts.
A diagnosis can be helpful and clarifying.
But when it becomes an identity…
That is not for me.