My friend is a young physician working in the same hospital as me. We have known each other since childhood. She lived next door to me until we both started high school when she moved to another locality in the same city, but we remained in touch. We started our med school together later on, and this relationship became stronger over the period of years till the completion of our residency.

I know her childhood was difficult. She was the eldest among her siblings, and all of them were quite young. Her family had financial problems from the start. I know her parents never really got along well. All day we would hear their loud voices while arguing with each other on petty issues. This continued for years. She was an introvert and never shared her personal issues and the difficulties she faced at home with anyone. She loved her siblings a lot and really cared for them; they considered her as a mother and really looked up to her. She was intelligent and studious and kept on getting extremely good grades throughout her academic career.

The only problem was that over the period of time, when she realized that she had no power or authority to resolve the conflicts of her parents, she retreated and never tried again to make peace among them. She sought refuge in books, and we saw her reading different books all the time, most of which were borrowed from neighbors and friends. She was never interested in playing like other children. It doesn’t mean that she did not like socializing, but she preferred reading books while sitting on a couch on the rooftop. Years passed like this, and she kept on reading, maybe just to keep herself busy, or maybe this was just an escape. But she had no experience of the real world. She trusted people easily and was very forgiving. She could not judge people, and over time, she developed a very non-judgmental approach towards people, so much so that she even lost the rational or innate instinct to differentiate people around her as good or bad. Maybe she was not too cunning like us or too silly for her age.

I have noticed over the years that she never spoke her heart out, never shared her issues with anyone, and never cried in front of us. Some days I would notice her eyelids swollen in the morning as if she had cried a lot. But whenever I would ask her, she just brushed off my questions. She just kept on listening to others all her life. She always avoided conflict at all costs. She just wanted to make everyone happy around her. I have never seen her excited about things that we found really exciting. She was a really simple and accommodating person who was just interested in her own life. She was a great listener, but maybe she never listened to herself. Maybe she forgot the fact that she deserved to be happy as well. In fact, whenever any bad thing happened to her, and we asked her about the details, she couldn’t recall the exact details of the events or the conversations that hurt her. She continued to focus on all of her responsibilities, her siblings, and her career choices while forgetting everything that made her uncomfortable. I never knew that she had a tendency to forget her hurtful and unkind memories of the stressful events in her life. I wish I had noticed her extreme sadness over the years. Maybe she was the kind of person who could hide her sadness too well, and the tasks of her mundane life kept on distracting her from addressing her real issues.

After a few more traumatic experiences, extremely stressful events, and a lot of criticism, one day, she noticed that she had forgotten a significant period of her life. She was working with us, but she was like she had recently been inducted into the training. She kept on telling us that she did not remember how these things were done when she was highly skilled at doing these tasks in the past. We didn’t take her seriously because we thought that it was not possible at all that she would forget a lot of things suddenly without having a medical condition or any traumatic brain injury. Apparently, she was healthy and perfectly fine, but maybe her mind was not. And this memory loss was significantly affecting her performance at her workplace. Sometimes forgetting is the only thing that gets you through this life. Forgetting is, I think, a form of protection. I got to know about this fact a lot later.

Many times, I felt as if she was a kid. Her simplicity and silliness and her shyness made her a kid at times. Sometimes I saw a teenager in her when she was a lot happier and excited about silly things. I have also witnessed a part of her personality that was an old soul. As an adult, she had a killer sense of humor and a skill to laugh all of her woes away. Sometimes humor can also serve as an adaptive ego defense by helping people see the humorous absurdity of extremely difficult circumstances. In this sense, humor functions as a coping strategy as well as a defensive mechanism. Although all of us have different facets of our personalities, girls who have faced the fear of abandonment in their childhood usually turn out to have unstable personalities. They are codependent and see themselves through the eyes of other people. They avoid conflict and are extremely sensitive to rejection and criticism. They can have poor self-esteem and are always doubtful of their own strengths. When they have been deprived of healthy love all their lives, they can’t differentiate between honest and fake emotions. They try to find a father in their spouses, a brother in their male friends, and love and relationships in people who can’t give them the same warmth. In turn, they struggle a lot to maintain stable emotions and relationships.

The human mind is a complex thing. It uses forgetting some of our memories as a way to protect us from pain. According to psychology, humans have three types of memory. Remembering things as one would recall a movie is known as episodic memory. Semantic memory is the recall of words, dates, and facts, as well as knowledge about the outside world. The capacity to recall motor actions, like combing one’s hair, is known as procedural memory. Traumatic brain injury, cerebral vascular accident, space-occupying lesion, or toxin exposure may result in organic damage to the neocortex, and this can result in memory loss of any of these three types. But there is another kind of memory loss known as dissociative amnesia. The inability to recall specific events or the details of some part of the traumatic experience. It is diagnosed after ruling out other organic causes of memory loss. There are a lot of types of dissociative amnesia, but the most common are localized and selective amnesia. A person with localized amnesia has a memory gap because they are unable to recall a particular event or sequence of events. Stress or trauma are frequently linked to these memory lapses. Many people who suffer from localized amnesia experience memory loss in multiple episodes. A person with selective amnesia only loses part of their memory from a specific time period. This could, for example, entail partially forgetting a traumatic event but not completely. Sometimes a stressful event can even result in the retrieval of repressed past memories and emotions from the subconscious mind as well, which is a lot painful for the individual and difficult to manage as well.

When she went to a psychologist to discuss her memory loss, after completing the assessment, she was recommended exposure therapy. It is a kind of cognitive behavioral therapy that unlocks one’s traumatic memories in a safe way. With the support of this behavioral therapy, a person can safely confront memories and

situations that made them uncomfortable in the past, and their repressed memories associated with a traumatic or stressful experience are brought back in a safe way under a skilled psychotherapist. They can only learn to cope with them when they feel those feelings again. When she unlocked all those memory gaps, the difficult times, which she had tucked so safely in her subconscious mind just as a defense mechanism, there were months of crying and grieving. Grief is a cruel thing. There is no timeline for grief.

What people do not talk about as much is that to heal trauma, you have to grieve a lot. You need to grieve the life you didn’t have, the love you didn’t get, the years lost, and the way you treated yourself. We don’t like to feel this way, so that’s why most people avoid it. They suppress it. They dissociate, they will stay frozen in their grief for years, and they won’t even know it. But it will show up in their lives as depression, stagnancy, and disconnection from their emotions and relationships. It’s some of the most difficult emotional work that a person can ever do. But it’s the only way through. Because without that grieving, without that letting go, the trauma stays with you. It poisons your body, your mind, and your spirit and makes you keep re-living and recreating the past as it’s still present. The only way out of this is by going into the emotions that weren’t safe for you to feel when the trauma happened. If you can feel those emotions, it’s a sign that you are already healing. You can’t heal what you don’t feel has a profound truth in it. When we feel, we remember our souls again. We regain our connection to life, and all that is. When we grieve, we heal our hearts. Underneath all the feelings you don’t want to feel are your aliveness, your vitality, your laughter, your love for life, and your soul. Grieving is a soul retrieval, where you dive into the darkness to recover the truth of who you are.

– Laura Matsue on X

Sometimes, when we see people around us who struggle to focus on positive things, we immediately label them as pessimists or feel as if they can’t progress in life. It’s true that you have to have a positive outlook towards life, but we never know the inner struggles or the past history of a person, the conditions under which they have been brought up and spent all their lives. The kinds of beliefs that have been inculcated in their minds as young children and the behaviors they learned on their own from their surroundings are not that easy to modify. We just have to be a little bit compassionate and kind to everyone because we can never have the slightest idea of what they had gone through in the past and what demons they are fighting in the present in their minds.

I know that sometimes even the finest of physicians who help a lot of people on an everyday basis are themselves facing periods of darkness and nobody knows about it. My friend has a lot of talent and skill, but the only thing she lacked in life was grit and resilience. She still has a long way to go, to learn not only to cope with her grief but also to develop grit and resilience. Successful people have grit and unwavering faith in themselves. Grit and resilience can be developed by possessing a growth mindset. The ability to learn is not fixed; it can always be changed with effort. Sadness and happiness are two faces of the same coin. She has to learn to accept failures and accept uncertainty in life. Uncertainty is the only certainty in life. She has to learn to have positive emotions and be flexible. There is no need to rush the process because things take time.

Damane Zehra is a radiation oncology resident in Pakistan.