Embodiment and the narrative self in PTSD

Freddy Purcell explores the complexity of narrative selfhood through the lens of trauma, revealing an entangled and deeply connected relationship with embodiment.

(image via sapienlabs.org)

Author’s note: This essay was adapted from coursework with help of Darcy Skinner. It includes short descriptions of some distressing episodes from people’s lives, so reader discretion is advised.

In this essay, I use several case studies of how trauma affects individuals’ lives to support an account of the narrative self that is fundamentally embodied, entangled, but also susceptible to disruption. I argue that how trauma changes the body, appearing to prevent creation of new narratives, supports the integration of embodiment into the narrative self. Although I argue trauma shows the limits of narrative only approaches, I also discuss how narratives have an important role to play in bodily regulation and self-conception. This sets up an entangled self where embodiment influences the creation of narratives while narratives influence embodiment. I will argue that trauma shows that this interplay can be disrupted, where reconnection between embodied and narrative self is a necessarily complex process. 

PTSD (post-traumatic stress disorder) is a disorder developed in response to a violent or threatening experience or experiences, characterised by numerous symptoms including vivid flashbacks, avoidance, hypervigilance, diminished self-worth, and difficulty sustaining relationships (WHO, 2025). While all these symptoms deeply affect an individual’s life, I will focus on a few that illuminate specific aspects of embodiment and the narrative self. All examples I draw on come from PTSD, but I believe the arguments from this essay apply to individuals who have experienced trauma but fall short of the diagnostic criteria contained within manuals. I therefore use the language of PTSD and trauma loosely. 

The narrative self and embodiment

A minimal definition of a narrative is a depiction of at least two events that are meaningfully connected and told in some way, with a necessary temporal dimension (Lamarque, 2004, p.394). Taking the idea of narrative, Dennett (1991, p.430) argues that the self is an organisation of narratives centred around the body of the individual but not including it. As a result, Dennett conceives of the self as coming into being when we gain awareness of narratives told about us, and begin to tell them about ourselves. The concept of the narrative self therefore neatly explains how we view ourselves as continuous beings with stable personalities by integrating disparate events into the coherent meaningful whole of the self. However, this account of the self as wholly constituted by narratives appears to miss the crucial role of the body. As Mackenzie (2009, p.114) convincingly argues, our bodies provide the perspective from which we see the world and act within it, constraining the narratives that we can build about ourselves. Individuals often are not aware of this bodily perspective until their bodies change during injury, illness, or aging, in turn changing how they interact with the world and so understand themselves (ibid., p.114). For example, if a person loses bodily mobility with age, they may start to conceive of themselves as frail and lose confidence in physical tasks they were once comfortable with. This leads Mackenzie (ibid., p.122) to argue that the narrative self is an integrated whole with embodiment. While I find Mackenzie’s argument convincing, I think these cases make the body’s framing of perspective appear abstract in relation to the narrative self, creating a range of possible narratives but not so directly impacting them. I will therefore draw on a case study of PTSD to argue that narrative and embodied self are more closely connected. 

Disconnection (van der Kolk, 2014, pp.7-21): 

Alongside many Vietnam war veterans, Tom had both witnessed and committed terrible violence. Upon returning home to his long-term lover, he married, had kids, and begun a successful career as a lawyer. However, Tom felt deeply disconnected from his family, often erupting into rages that meant he had to remove himself from the family home. He also felt unenthused by his career, only caring about it during stressful highly focussed periods. Tom would struggle to open up to anyone due to intense shame, something common amongst traumatised individuals, and the upset that reliving his trauma caused. Many other veterans experienced similar disconnection in all aspects of their lives and were highly reluctant to discuss issues affecting them, except when gathered for group therapy they would suddenly come alive while sharing stories of the war. In these groups, veterans could only connect over trauma, even considering their therapist a “Captain” of their newfound regiment, making him one of their own to feel able to discuss their trauma. 

Tom and the other military veterans illustrate a deep feeling of disconnection that is typical of PTSD. Van der Kolk (2014, p.99) attributes this disconnection to how PTSD prevents the body’s stress response from ending after the traumatic event, stopping a person from feeling able to show the vulnerability necessary to connect with other people or enjoy new experiences. Tom was unable to connect to his growing family and understand himself as a father or husband, while also struggling to enjoy his career and therefore integrate being a lawyer into his identity. If the body’s changed stress response is to blame for this disconnection, then it appears that the body can prevent new narratives from being created, not merely framing the perspective from which they are formed as Mackenzie suggests above. This direct causal impact on the narrative self suggests a deeper connection with embodiment. I therefore think that the example of trauma lends useful weight to the argument that the self ought to be understood as an integrated system with embodiment and narrative. 

It is also worth noting that effective trauma therapy appears to work from the assumption of an integrated system. Van der Kolk (2014, p.3) argues for both talking approaches and bodily approaches, like yoga or meditation. Development of narrative understanding appears essential, as, in cases like Tom’s, the traumatised person seems to derive value from talking through their past to better understand feelings of shame and articulate what they feel is lacking in their lives. Although, it is evident that talking about trauma is often difficult as individuals can have vivid flashbacks that only compound the issue or can freeze, becoming distant and unable to communicate with a grounded, emotional connection to their trauma (van der Kolk, 2014). This is why therapists working with trauma often include strategies to manage stress and attend to affective states in the body or develop ways of forming narratives that aren’t conversational (Crawford, 2010, p.709). For example, Crawford (ibid., p.711) has found using body maps, where the traumatised person draws their body and indicates what they feel in different parts with words or symbols, a less confrontational way of drawing out people’s narrative self-understanding, with the benefit of encouraging bodily connection. For both practical and philosophical reasons, I therefore argue that there is compelling reason to think of the self as an integrated narrative and embodied entity. 

Entanglement in embodiment and the narrative self

Trauma can also help to elucidate the relationship between embodiment and narrative. Brandon (2014, p.68) helpfully distinguishes between a unidirectional account, where embodied experiences simply feed the narrative self, and interactive accounts, where the narrative self feeds back into embodiment as well. In an example of a unidirectional account, Menary (2008, p.75) argues for a minimal embodied self that is present from birth in our experiences and actions. He then argues that as a child’s linguistic ability develops, they can use narratives to make sense of their embodied experiences in the formation of a narrative self (ibid.). Menary (ibid., p.66) therefore believes that the bodily and narrative self are integrated but denies that narratives shape embodiment, claiming “we shouldn’t expect to find narratives in our more basic embodied engagements”. Against this idea, Dings (2019, p.194) constructs a useful account of how narratives can affect embodiment through self-programming, where one sets a narrative goal to predispose oneself to certain embodied actions. For example, if I were nervous about going to a party because I might see someone I passionately dislike, I could think through how I might behave or what I might say in that situation, reducing the shock I’d feel upon seeing that person. Additionally, Brandon (2014, p.77) points out how narrative self-conceptions can impact our ordinary embodiment. For example, seeing oneself as a confident person can encourage an open posture, making eye contact, and speaking clearly. I think the narrative self’s impact on embodiment is exhibited in both ways mentioned above in examples of trauma. I now turn to two further case studies to illustrate this point.  

Self-regulation through narratives (van der Kolk, 2014, p.235-239): 

Nancy suffered from ‘anaesthesia awareness’ that meant she was partially conscious during a surgery to cauterise her fallopian tubes. Owing to the way trauma represses memory, she could not remember what had happened afterwards, only feeling disconnected and anxious with a strong fear of objects emitting heat. After a few days, Nancy started to remember her experience in intense flashbacks, increasing her anxiety and causing her to lash out at those around her. She quickly learned to avoid things that would induce flashbacks, including lifts and certain areas of the hospital she worked in, as well as manage the intense anger she felt towards people around her. This self-knowledge helped her manage anxiety successfully when she eventually had to have surgery again. After two years, a combination of a good therapist to help her understand her life and a Pilates class to develop physical strength and new social relationships eventually helped Nancy to create a sense of safety and relegate her trauma to the past. 

IFS (van der Kolk, 2014, p.351–354):

Internal family systems (IFS) therapy is a strategy where therapists ask clients to identify aspects of the self that represent certain ages or play certain roles, with the idea that this uncovers conflicting parts of the self that often emerge in trauma, to gain greater self-knowledge (ibid., p.337). Peter turned to therapy after his wife threatened to divorce him if he didn’t change. He described himself as blunt and maintaining high standards, while his wife complained that he was distant, highly critical, and prone to bouts of anger. As part of the IFS process, he was asked what he would be afraid of happening if he stopped his heavy criticism. It emerged that Peter’s critical voice was that of his father, who had pushed Peter to hide any perceived weakness and criticise others before they could criticise him. Having identified the role of his father, Peter then looked to his childhood self and imagined taking care of that boy, instead of being disgusted by his weakness. After this therapy, Peter would still get angry when something reminded him of his trauma, but he managed to repair his relationship with his wife and even stopped suffering from tension headaches. 

Traumatic experiences naturally resist being understood in narrative form. In addition to the shame often accompanying trauma, during the experience itself, the part of the brain that deals with sensory experience becomes extremely active while the part dealing with speech diminishes (van der Kolk, 2014, p.53). This causes memories of trauma to be experienced in terms of vivid sensory reminders, like strong images of medical staff in scrubs or the feeling of heat in Nancy’s case, that cannot easily be put into a coherent narrative. Some traumatised individuals lack intense flashbacks but instead experience an overall decrease in brain activity when confronted by their trauma, causing them to freeze up and making articulation equally difficult (ibid., p.82). While this challenges accounts of the narrative self by showing how some experiences cannot be easily integrated into self-understanding, Nancy’s case also shows how individuals instinctively reach to narratives to make sense of what they do understand about their lives and can be used for self-regulation. For example, Nancy learned to avoid certain locations and could anticipate what would remind her of her trauma to manage it better, much as Dings argued above. However, Nancy’s case shows that when suffering from PTSD, these simple narrative strategies aren’t necessarily enough, as she only began to full recover after incorporating bodily strategies into her therapy. 

IFS therapy is a more complex narrative strategy that involves isolating parts of the self and imagining them in the third person. This replicates the power of a second-person conception of oneself that Hibsham (2022, p.619) discusses, where the individual gains valuable self-understanding by imagining how another might view them. In Peter’s case, this involved imagining his childhood self from the perspective of a loving adult, allowing him to see that he was not weak, but only needed taking care of. This realisation appears to have soothed a trauma in Peter, removing bodily stress that caused headaches and decreasing his disposition to get angry. While there may be limits to the use of narrative in shaping embodiment in trauma, I think these cases show that narrative strategies for self-regulation (as Dings articulates) and soothing trauma to change one’s self-conception (as Brandon articulates) can have powerful bodily impacts. The benefit of using trauma as a case study is that compared to the examples like posture that Brandon gives, PTSD stems from deeprooted physical issues that prove difficult to shift. These examples therefore prove the power of narrative to shape embodiment, while also supporting an entangled interpretation of the embodied and narrative self where both aspects shape each other. However, as the case of trauma proves, this dynamic can be disrupted. 

Disintegration and the problem of re-integration

Losing the body (van der Kolk, 2014, pp.102-104): 

Sherry had a compulsive issue where she picked her skin until she bled. Her compulsion stemmed from neglection and abuse by her mother, with additional trauma from being kidnapped. After talking therapy failed to establish a close enough relationship to be useful, Sherry was encouraged to see a massage therapist. In her first massage session, Sherry panicked while she was lying down because she didn’t know where her therapist was, unaware that the therapist had been holding her feet the whole time. This complete disconnection from bodily sensation is found across traumatised people and is attributed to diminished activity in the self-sensing area of the brain because of trauma (ibid., p.106). An interesting aspect of Sherry’s case is that she understood that she picked at her skin to feel relief from numbness, and knew what traumatic events precipitated this behaviour, but couldn’t stop herself. 

So far, I have used examples from trauma to argue that the narrative self is entangled with embodiment as they shape each other. Trauma is a useful case study in this sense because it entails a disconnection between these two aspects of the self and shows how lack of well-being in one impacts the other. The bodily impact of trauma can prevent the creation of new narratives, as in the case of the veterans discussed above. Then, as Sherry’s case shows, sometimes narrative understanding cannot support a person in overcoming physical symptoms or reflexive behaviour. These stories show how damaging disconnection between the narrative self and embodiment can be, but I argue they also show how complex their integration is. Køster (2017, p.471) reasonably argues that we have regular experiences that we struggle to integrate into the narrative self, an experience that he describes as “alien”, like when we surprise ourselves by making a harsh comment that we do not particularly mean. In examining borderline personality disorder, Køster (ibid., p.475) suggests that individuals who suddenly behave in a way they don’t understand can retrospectively narrativize their experience to make sense of it and be better prepared to self-regulate should that situation arise again. However, I argue that trauma shows that this narrative focussed approach may be limited, as while embodied experience can be alien to the narrative self, the narrative self can also be alien to the body when it fails to conform to self-understanding (Sherry’s case is an example of this). This shows how reconnecting the narrative self and the body is a complex process that requires giving attention to both. I therefore argue that trauma provides another useful contribution to understanding embodiment and the narrative self by showing the complexity of their integration and management of their disconnection. An understanding of this complexity may be helpful in examining other conditions that lead to disconnection.

Conclusion

In conclusion, I have argued that PTSD provides valuable support to a particular formulation of the narrative self as it shows a strongly connected, but complexly entangled relationship with embodiment. I believe this integrated conception of the narrative self has also proved useful in understanding the complexities of PTSD and trauma recovery. Trauma shows the profound way in which the body constrains the narratives we can build about ourselves, strongly supporting the integration of narrative self and embodiment. I also argued that the essential role narrative practices can play in regulating and soothing bodily symptoms of trauma provides strong evidence of an entangled relationship between the two aspects. Finally, I argued that trauma demonstrates the complex and fragile nature of this entanglement, deepening understanding of how connection between the two functions and demonstrating the complex task of reconnection. 


Bibliography:

Brandon, P. (2014) ‘Body and self: an entangled narrative’, Phenomenology and the Cognitive Sciences, Vol.15, pp.67-83. 

Crawford, A. (2010) ‘If ‘The Body Keeps the Score’: Mapping the Dissociated Body in Trauma Narrative, Intervention, and Theory’, University of Toronto Quarterly, Vol.79, No.2, pp.702-719.

Dennett, D. (1993) Consciousness Explained. Penguin books. 

Dings, R. (2019) ‘The dynamic and recursive interplay of embodiment and narrative identity’, Philosophical Psychology, Vol.32, No.2, pp.186-210.

Køster, A. (2017) ‘Narrative self-appropriation: embodiment, alienness, and personal responsibility in the context of borderline personality disorder’, Theoretical Medicine and Bioethics, Vol.38, Iss.6, pp.465-482.

Hibsham, G. (2022) ‘Narrative, Second-Person Experience, and Self-Perception: A Reason it is Good to Conceive of One’s Life Narratively’, The Philosophical Quarterly, Vol.72, No.3, pp.615-627.

Lamarque, P. (2004) ‘On Not Expecting Too Much From Narrative’, Mind & Language, Vol.19, Iss.4, pp.393-408.

Mackenzie, C. (2009) ‘Personal Identity, Narrative Integration, and Embodiment’, in S. Campbell, L. Meynell, and S. Sherwin (eds). Embodiment and Agency. Penn State University Press, pp.100-125.

Menary, R. (2008) ‘Embodied Narratives’, Journal of Consciousness Studies, Vol.15, No.6, pp.63-84.

Van der Kolk, B. (2014) The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma. Penguin books. 

World Health Organisation (2025) Post traumatic stress disorder. Available at: https://icd.who.int/browse/2025-01/mms/en#2070699808 (Accessed: 06/11/25).

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