The Other Side of Change: Who We Become When Life Makes Other Plans

Olivia's initial physical-therapy sessions involved a relatively basic task: sitting upright. Her therapists would prop her up against a sturdy set of pillows in her hospital bed and challenge her to sit in this position for only a minute or two. But the sessions were excruciating, the pain in her limbs so fierce and unrelenting that she would sometimes vomit. 

"I-D-O-N-T-W-A-N-T-T-O-B-E-H-E-R-E," she blinked repeatedly to her parents. Why had this happened to her, of all people? She rarely drank, never did drugs, ate well, and exercised regularly. Every time a nurse came around with scissors or a needle, Olivia imagined lunging for the instrument and stabbing herself in the neck. She wondered if she might be able to persuade a friend to bring her pills so that she could overdose. The thought of having such agency was intoxicating. 

Olivia's family knew that she was in desperate need of inspiration. Her grandfather, a former rehabilitation counselor, discovered the memoir Running Free, written by a woman named Kate Allatt, who had become locked in after suffering a stroke at the age of thirty-nine. Kate had made a miraculous recovery, regaining her ability to speak and walk in less than six months. She had even gone on to run in a race. As Olivia's grandfather read the memoir aloud, Olivia clung to the details of Kate's story. She decided that she, too, would have a miraculous recovery. If she didn't, she told herself, she would have no choice but to move someplace far away and live underground, maybe in a cave. She would cut off contact with everyone. 

In the weeks that followed, Olivia became obsessed with Kate's recovery, memorizing every element of her rehabilitation plan. She asked her friends and family to email Kate on her behalf, requesting more detailed information about how and when exactly she had met certain milestones. Kate even became a bit of a hero among Olivia's friends. When they came to visit Olivia in the hospital, they'd scroll through Kate's Instagram account and show Olivia videos and photos to encourage her. 

One afternoon, at Olivia's request, her grandfather opened YouTube and found a TEDx talk that Kate had given. He stationed his iPad in front of Olivia so that she could watch it with headphones, and then he returned to his chair to read a book. Because his YouTube account was set to autoplay, though, a new video with similar content immediately started after Kate's finished. This one was about a woman who'd become locked in at the age of twenty and had only minimally recovered over the years. Olivia watched in horror as images of this woman's daily life played out on-screen, but she could not yell out to her grandfather to stop the video. As it played on, she grew increasingly panicked. Finally, the video ended, but the possibility of encountering another story like this one became her greatest source of anxiety. She asked her grandfather to watch the iPad carefully whenever he played things for her in the future so that she could shield herself from any stories that did not resemble Kate's. What she needed from her family was constant reassurance, often two or three times a day, that Kate's story would be her story. 

But by December, two months after her stroke, it was clear that Olivia's recovery was not at all resembling Kate's. Other than regaining the ability to breathe on her own, Olivia felt she'd barely made any progress: she could only tilt her neck a tiny bit upward, raise her left arm by an inch or so, and sometimes lift her left index finger by a centimeter. When she'd first moved her finger, her family had cheered out loud. It was a remarkable achievement, and not one to be taken for granted, given the fates of so many other locked-in patients. But Olivia felt patronized. She was going to be the next Kate. Why couldn't her family understand this? Being able to walk would be a milestone worth celebrating. 

Her grandfather tried to give Olivia more realistic expectations, telling her that she might experience a range of outcomes and that that was okay. They should rejoice in any improvement, however modest. But Olivia rejected this advice. The prospect of being a diminished version of herself was simply intolerable. How would anyone—her boyfriend, her friends, her community—accept her? How would she even accept herself? In order to go on, she denied the possibility of anything less than a full and speedy recovery.

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Before her stroke, Olivia could not have imagined, even with her health-related anxieties, just how suddenly she'd be thrust into uncharted territory. The same can be true for any of us; in a moment, a change can disrupt all that was familiar. And though the changes we face may be nowhere near as severe as what Olivia experienced, they can still send shock waves through our lives. When a romantic relationship ends, we must conceive of a life without the other person. When we get laid off, we might be unable to pay our bills. When we receive a diagnosis of depression, we may struggle with the stigma that surrounds it. 

As we muddle through these transitions, it can be tempting to deny our new situation as a way of protecting ourselves from negative emotions like grief, shame, fear, or helplessness. Although denial commonly occurs in the immediate aftermath of a change, it can also emerge later on, in different ways and at varying degrees of intensity. "People are constantly seeking a way to comprehend what is happening to them," writes the psychologist Richard Lazarus. "This ongoing process of construing reality is a constantly changing one, depending on many variables within and outside of the person." Lazarus says that, when it comes to denial, "we are dealing with flux, and we must always be aware of the slippery nature of the event we are trying to understand."