Healing Shame and Trauma Through Writing and Reading

Miskin’s memoir, Hell Gate Bridge: A Memoir of Motherhood, Madness, and Hope, reveals the emotional toll of living with depersonalization-derealization disorder (DPDR), highlighting the isolation caused by misdiagnosis, societal pressures on motherhood, and the critical need for equitable mental health care during pregnancy.

While Miskin was in the early stages of treatment, telling her story wasn’t therapeutic—it led to feelings of self-erasure and shame. In the psychiatric ER, repeatedly sharing her story “continued to subtly erase [her] sense of self” (35). Later, when she was in the hospital being induced for Nora’s birth, she felt she "had to shame [herself] by recounting [her] story," this time to even more people during rounds than in the ER, when asked why she was being induced (89).

However, Miskin reveals how writing her memoir, Hell Gate Bridge, was a quick yet consuming and therapeutic process. Rather than promoting shame and erasure of self, writing this memoir offered a release from the trauma she experienced. Though emotionally taxing, revisiting difficult memories was crucial to telling her story honestly. Her ultimate hope is to open conversations about perinatal mental health and DPDR, providing a beacon of hope for others facing similar struggles.

Source: Used with permission of Barrie Miskin

Melissa Rampelli: When you were able to engage with literature again, what specific texts or authors resonated with you or helped you in the process of healing and/or writing Hell Gate Bridge?

Barrie Miskin: Catherine Cho’s Inferno and Susannah Cahalan’s Brain on Fire were the two books I went back to again and again. Also, Suleika Jaouad’s Between Two Kingdoms about her recovery from cancer and my mentor Sarah Perry’s book After the Eclipse in which she contends with the devastation of her mother’s murder when she was a child.

When I was recovering, I found myself drawn more to books about medical mysteries rather than mental health memoirs because my illness felt unsolvable for so long. There are a lot of beautiful and poignant mental health memoirs out there, but they often gave me a completely irrational sense of envy—they all had diagnoses, and I didn’t, which made me feel even more alone.

MR: Writing about deeply personal and traumatic experiences can be emotionally taxing. How did you protect your mental and emotional well-being while writing Hell Gate Bridge?

BM: It’s interesting because I wrote the book in the thick of the pandemic, during the winter and spring of 2021, so it was a very isolating time and my main coping mechanism is to connect with friends and family and loved ones. Everything was over Zoom or FaceTime, including sessions with my psychiatrist, so that was a challenge for me, staying centered and steady. It was a trying time for my husband and I as a couple as well. We had to relive different parts of that very traumatic time. It brought up feelings of sadness, of course, but also a lot of anger, which, in retrospect, was probably healthy for both of us to work through.

MR: Did you find the process of writing the memoir therapeutic in itself? Can you talk about any specific moments or breakthroughs during the writing process that felt particularly transformative for your mental health?

BM: I wrote the book very quickly—about three months to the day, from start to finish. It was like I had no control over it, I was obsessed. Once I started, the story had to come out. Those three months were challenging in a myriad of ways. I was so consumed with writing that I not only traveled back through a dark place but also was not fully present for my family. But writing quickly was also a blessing in disguise. Once the book was finished, my husband and I felt this sense of being released. Like our story was now separate from us, compartmentalized and placed in a little box.

MR: How did you manage the process of revisiting traumatic memories during the editing phase of your memoir? Did you find it challenging to read and revise those sections?

BM: Absolutely. There were two sections in particular—one in which I make an attempt to leave everything behind and another where I’m self-medicating by drinking heavily. Those parts brought me so much shame, but I knew they were crucial pieces of the story that I needed to share with the reader. Even so, I do struggle with what will happen if and when our daughter reads the book. I’m working with my psychiatrist—still the same psychiatrist that I started seeing in the book—to come up with a gentle way to introduce her to the book when she’s ready, which we don’t think will be for several years. Our daughter is 7 now and a huge reader, but she is completely and utterly uninterested in anything I write.

MR: Were there any particular challenges you faced when translating your internal experiences into a narrative that others could understand and relate to? How did you overcome these challenges?

BM: In writing about mental illness, I quickly learned you have to use quite a bit of figurative language and turns of phrase. Especially with dissociative disorders, there isn’t a wealth of concrete language one can use to convey the experience. For me, DPDR had to be described in almost these dreamy conjunctions as I struggled to link a creepy fantasy realm to a neurotypical reality. There was a lot of I feel as if…, I feel as though…

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Throughout the process, I was constantly reading pieces of the manuscript aloud and asking people, “Does this make sense?” I was also lucky enough to work with a wonderful mentor where she read about 20 pages of the book per week and was able to help me both flesh out scenes and tighten phrases so there would be a deeper sense of clarity for the reader.

MR: How do you hope your memoir will contribute to the conversation around perinatal mental health and/or DPDR?

BM: I’ve always loved to read and have always looked to books to help me make sense of myself and of the world. When I was going through those painful years, I searched for books that could reflect my experience, but I didn’t have much luck. The book that most closely mirrored my own was Susannah Cahalan’s Brain on Fire, especially in how she was treated as a patient suffering a mental health crisis. I must have read that book over 30 times.

That being said, I wanted to write Hell Gate Bridge as a kind of beacon of hope as well as a source of information on maternal mental health disorders and DPDR. My hope for the book, more than anything, is that it reaches anyone who needs it. It’s a tiny book! Definitely far from best-seller status, so it doesn’t have quite as far of a reach as Brain on Fire, but I have heard from some mothers in my community who have read the book and felt grateful to find someone who provided an entry point into a conversation about maternal mental health issues that they previously might have been too ashamed to discuss.

MR: As someone who has gone through the process of writing a memoir about mental health, what do you believe is the most important thing for aspiring writers to keep in mind when tackling similar topics?

BM: I think the most important thing with writing a memoir is giving yourself the gift of time to heal and reflect on the period of your life you are exploring. For me, I felt like I was in this sweet spot where I was about three years away from my crisis point, yet still close enough that I could remember specific details and conversations.