Reclaiming Your Identity After Trauma
David Van Nuys interviews Michele Rosenthal
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The following is an excerpt from a David Van Nuys interview with Michele Rosenthal, a trauma survivor who struggled with posttraumatic stress disorder (PTSD) for over 25 years before launching a successful “healing rampage,” and is now free of PTSD symptoms. She is an award-winning PTSD blogger, founder of HealMyPTSD.com, popular keynote speaker, post-trauma coach, host of Changing Direction radio, and award-nominated author of Before the World Intruded: Conquering the Past and Creating the Future and Your Life After Trauma: Powerful Practices to Reclaim Your Identity. Michele is a former faculty member of the Clinical Development Institute for Timberline Knolls Residential Treatment Center.
Dr. Dave: Perhaps you can tell us about the trauma that befell you at a very young age?
Michele Rosenthal: Absolutely, and you know, David, it’s because I speak and write about it so much that I never mind being asked, because I think the power of telling our stories lies in being able to own the past and transcend it. So, I’m absolutely happy to share.
In 1981, I was a thirteen-year-old kid being raised in the most wonderful family: two parents who absolutely adored me and adored each other, and a little brother who was my best friend, who still is to this day my best friend. And life was just fantastic. We went on this long family vacation that summer, in a 26-foot Winnebago, driving all around out west, so we were in, like, the bubble of what a happy family vacation can be. And when we came home I had a history, a new, a very new history, within a year, of bladder infections. And so when we came home – I’d spent a lot of time in the water, we went white water rafting in California, and so a lot of times sitting in a wet bathing suit – I got home; I’ve got a bladder infection. We went to the paediatrician, and my paediatrician was on vacation (this was the middle of August) and the covering doctor – you know, they run their test, “Yes, you’ve got a bladder infection.” Without reading my chart, he prescribed the regular, run-of-the-mill antibiotic that everybody takes for bladder infections. And what I had happen to me was anything other than the regular run-of-the-mill response. My body had an allergy that we did not realize to this medication. And what they speculate is that the body can’t metabolize the medication and so it sends it out through the skin. Now, people always ask me, “What did you take?”I took a sulfa-based drug, a regular antibiotic.
But this can happen with Ibuprofen, and all kinds of over-the-counter drugs, because this is just basically the body’s little secret that it carries and, in extreme cases—what happened to me—you start with these little blisters and a rash, and then the next thing you know, I was in one of the top hospitals in New York City being treated as a full-body burn victim, because the allergic reaction just completely takes over your body if you’re on the extreme end. I lost 100% of my skin, as blisters just covered me head to toe by the time I came out of the hospital – I should say it’s easier these days.
I know that there was a big case in the media just last December. A woman who the media was saying she was burning from the inside-out (I don’t know if you saw that coverage; she was in California) – and these days, a lot of times they just induce people into a coma until it’s all over. Which I think would be, you know, much easier. But as a thirteen-year-old kid—think about yourself David—What kind of coping skills would you have for being a full-body burn victim at thirteen?
Dr. Dave: Yes, not much. (laughs)
Michele Rosenthal: No. How do you even conceptualize what that means as a kid? And when I came out of the hospital, I knew, okay, I was scarred, but not anything that anybody outside of my family would see. And even to this day, I deal with some of the residual physical effects of that, but nothing that would stop a life from going on, so I knew I was going to make a full recovery. But my brain just could not wrap around what had just happened to me. I’d had a near-death experience, and that haunted me, something horrible. And the anxiety that all of the fear of recurrence…when I left the hospital, they had told me, “If this ever happens again, you won’t survive.”
Michele Rosenthal: “So you’d better be careful.”
Dr. Dave: Yes. Wow. Now the title of your book is Life After Trauma: Powerful Practices to Reclaim Your Identity, and identity is a really key concept there, because of all the books that I’ve read recently on trauma I think yours is really distinctive in its emphasis on identity. So, how would you describe your pre-trauma personality and sense of identity?
Michele Rosenthal: You know, that’s a really good question, and I would say I didn’t have one yet. You know, according to—you would know this even more than me—the theory, psychologically speaking, of identity formulation happens between thirteen and eighteen. So this happened to me when I was thirteen. I hadn’t even gone through the process of forming my own identity, of choosing my values, my purpose, my focus, and what I wanted to be, in terms of how I wanted to show up in the world. During adolescence, you’re just starting to wake up to the idea that you define who you are and you do it through a series of choices and actions. So, at thirteen, I hadn’t yet done that. When I think back to how I was before then, I don’t really have a sense of identity before this defining event. And so that was one of the really big problems for me—afterward I kept trying to go back to the “girl I used to be”. But I didn’t really have any guide posts for who that was. I speak to survivors now who have trauma, and, you know, maybe they’re forty, and this trauma has just happened. Well, they’ve had several years to live an identity that they understood and could, sort of, figure out how to recreate. But I didn’t. I just was Eileen and Gary’s daughter, Bret’s sister, you know. (laughs)
Dr. Dave: Yes.
Michele Rosenthal: I didn’t have a self-perception yet.
Dr. Dave: Okay, so, I got the impression from the book that you kind of had to actively work to create that identity that…which for most of us comes more or less naturally, without having to think it through—It’s just something that happens. What was that process like for you, and how long did it take?
Michele Rosenthal: Honestly David it took probably from the time I was thirteen until the time I was...forty?(laughs) A really long time, because of course, at first, you don’t realize that anything’s missing; you don’t realize that anything’s wrong; you don’t realize that things could be different. For a long time, I didn’t realize what was wrong with me. I knew I was acting out for, you know, for my teenage years, when my parents tried to get me into counselling because I was very depressed, and I was argumentative, and I was unable to discuss what had happened to me. I literally came home from the hospital and put a gag order over my family, and said, “Don’t ever bring up what we just went through.” And so it didn’t occur to me that there was anything wrong with me. I just started, then I got into an eating disorder, and then, you know, life just started mushrooming and all of this anxiety and this anxiety-driven behavior, and I thought…honestly? I thought that’s who I was. Until several years went by—it took 24 years for me to have a diagnosis of Post-Traumatic Disorder, so by then, I thought, “Well, this is my identity. This crazy person. And some people are crazy, and that’s who I’m supposed to be.” And yet the whole time, David, I have all of these notebooks from my PTSD years, where I was constantly journaling. Everyday. And year after year, you can see scrawled over these pages, “Who am I? Who am I? Who am I?” I was obsessed with answering that question, even though I didn’t have an answer.
Dr. Dave: Yes. Well was it a professional who gave you that diagnosis of PTSD?
Michele Rosenthal: (laughs) Not in the beginning. In the beginning, I finally, because I had so many medical complications that were these mysterious illnesses—bone, liver, stomach, intestinal—all kinds of problems that the medical community could not diagnose. But meanwhile, I was rapidly falling apart. And I finally went into therapy to figure out how to live as a chronic patient.
And so I started – of course we talked about my trauma, but looking back, I don’t think my therapist knew what to do with it. He knew how to help me with the anxiety I was feeling, and the help that he gave me was enormous. But he didn’t know it actually had a name. And so, as I got worse and worse and worse over a series of years, and I finally had to just flat-out quit my job—I couldn’t work—they thought I had liver cancer, because things were so bad with my body, and I thought, “I need to take responsibility for what’s happening here.” And I started researching what my symptoms were, and I came across PTSD. You know, there are all kinds of PTSD self tests. Even on the website I have now, the Heal My PTSD website, we have a self test based on the diagnostic criteria from the DSM.
And I took this test and it has 22 questions, and I answered positively to 20 of them. And I thought, “Well, this is interesting.” And so I took it to my therapist, and I said, “What do you think of this? Do you think I have PTSD?” And literally, he said to me, “What is PTSD?”
Dr. Dave: Oh my goodness. Yes. That must have been before there was so much attention on it.
Michele Rosenthal: Well, I mean, I think he was very good at what hedid, but he just wasn’t up to speed on the rest of what I needed. And it was at that point that I high-tailed it to a trauma therapist. And then, once I had my diagnosis and I was with somebody who really understood what this means, then I really took off in terms of “okay, how are we going to heal this?” And it was in healing that I resolved my identity crisis. (laughs)
And so that’s the sort of long answer to the question that you asked me, how did I get it done? I finally took responsibility for how was I going to heal, what was wrong with me, and what did I want my identity to be, since I didn’t have one to fall back on.
Dr. Dave: Yes. Yes. So it sounds like it was, really, a process of sort of mixed ingredients of some therapy, and then self-diagnosis, and more appropriate therapy, and then really, you kind of pioneering what was going to be good for you.
Michele Rosenthal: That’s absolutely true. That’s a great synopsis. And I think we don’t talk about it enough, how important it is for survivors to engage in that process. You know, so much of trauma recovery, to me, is making that shift from powerless to powerful. And the more you engage in creating your recovery process and saying, “This feels right to me. This is what I need. This is what I want to try.” Doing all those things reclaims a sense of self-connection. And self-connection can just blossom into such a self-perception that grows by leaps and bounds, because you reclaim control over who you are just in making choices and identifying options and actions.
Dr. Dave: So tell us what you know, what you found out about identity and the brain, and trauma, and why identity would be so pivotal in relation to trauma?
Michele Rosenthal: Well, I think that that question is a great segue from where we just were, because so much of the way that trauma affects the brain is to shift us into a state of constant reactive mode. I’ve interviewed so many experts, both for the book, Your Life After Trauma, and also on my radio show. So many scientists and neuroscientists and PTSD experts. And the thing that I’ve really come away with is how enormously trauma affects our brains in ways we don’t even realize. So, for example, your amygdala is your threat detection center, and after a trauma, if it doesn’t get the message to relax and to allow your body to naturally shift from reactive to responsive mode—which we all do all the time—if your body doesn’t get that message, you stay in that place where your amygdala’s constantly looking for the threat. And so your amygdala, which sensitizes to the dominant experiences in your life, is constantly looking for the next threat. Well, anyone who has post-traumatic stress knows exactly what I mean by that. You live in a state of hypervigilance, which is one of the hallmarks of Post-Traumatic Stress Disorder.
So, with the trauma, your body responds to trauma through your sympathetic nervous system becoming activated. Your stress hormones come up, your body systems that aren’t necessary for survival come down, and you respond to the threat. And let’s be serious: 80% of the people go through a trauma, and then they find a way for their bodies to re-acclimate, their minds to organize and integrate, and they move on. So when we talk about people getting stuck in the way that trauma affects the brain, it’s not everybody. I’d like to make sure that we always understand this, so that nobody walks away thinking, “Well, that’s going to happen to me. I’m going to get stuck.” Because it doesn’t always happen. So, you’re sympathetic nervous system fires up, your amygdala tunes to this dominant experience, and your hippocampus, which is where you process and consolidate all of your memories, integrates your memories to be placed out along the outer cortex of your brain. When you’re in that heightened survival mode, however, your hippocampus gets completely disregulated, so that in that moment, you’re not consolidating all of the memories that should be consolidated and placed around, and what’s happening is you’re getting stuck and hung up in this activated loop. And in that activated loop, you are going to constantly be feeling all of the effects of the trauma, and feeling like you’re stuck in this place, like I said earlier, where it’s going to happen again. And you’re looking constantly for “what’s wrong, when’s it going to affect me, and how is this going to bring harm to me?” The interesting things that we see sometimes, is the amygdala, over a period of years of this kind of heightened intensity, actually enlarges and the hippocampus shrinks. Now, the good news is we also see all of that reverse in recovery, many times: The amygdala will shrink back to its regular size, and the hippocampus will enlarge back to its regular size.
Dr. Dave: Oh, that’s fascinating.
Michele Rosenthal: It is, isn’t it? And it’s one of those things that makes me always feel so hopeful for recovery. The brain is designed to change. It changes in response to your experience of trauma, and it changes again in response to other experiences that are more positive.