‘I don’t know who I am any more’: working through trauma is about reconnecting | Gill Straker and Jacqui Winship

PTSD can untether a person from a stable sense of self. Treatment is all about gaining acceptance of the fragility and unpredictability of life

• The modern mind is a column where experts discuss mental health issues they are seeing in their work

Gavin is a good-looking man in his early 30s who strode confidently into the consulting room. At first glance, it was hard to guess that his self-assured manner was masking a profound uncertainty and considerable psychological difficulties.

But as the incongruity between his persona and his subjective sense of self was slowly revealed, it became clear that he was suffering from a profound sense of disconnection at multiple levels following a highly traumatic event. This sense of disconnection is a key characteristic of post-traumatic stress disorder (PTSD).