Fracturing of Identity After Diagnosis

“One ever feels his two-ness… two souls, two thoughts, two unreconciled strivings; two warring ideals in one dark body, whose dogged strength alone keeps it from being torn asunder.” W.E.B. Du Bois (1868–1963).  The Souls of Black Folk.  1903 

There is a fracturing upon initial diagnosis with a mental illness. It is a schism that grows and begins to not only separate a person from the present moment, but also from his or her past. 

Memories of illness are questioned and probed for what was “sickness” and what was not. In the process, you can begin to lose faith in your own ability to know your own lived experience. 

You are torn from the norms of your life, and a new diagnostically defined identity is branded on your entire being. 

My life became BD and AD: Before Diagnosis and After Diagnosis. Unlike recovering alcoholics who celebrate the day they arrested their addiction and started to self-define as addict or alcoholic, I loathed the day of the death of my known self. The day my life became something I didn't want nor understand. 

Things completely foreign to me before that day became the focus of my entire life: day programs, SSI, psychiatric medication, side-effects, involuntary/voluntary commitment, group homes, seclusion and restraint, supported employment, etc. 

I felt an otherness to myself. An otherness to the world. 

Who was I? Who experienced these symptoms? Who did I turn into when I was experiencing mania and pushed out from my body? When would that persona return? Where could I possibly go from here? 

The recovery from a serious mental illness can be very solitary compared with recovery from addiction. I did not find others to relate to my bipolar disorder outside of a few books from the bipolar canon. With my co-occurring addiction, posttraumatic stress disorder (PTSD), and child abuse issues, I felt I simply didn't belong in this world. 

The adventurous, robust Navy veteran ready to take on the world had no relation or reference point for what he had become. My disconnection to self was absolute, and I was only prevented from “being torn asunder” by the skin that encased these “warring ideals” of who I was and therefore could become. 

I have found recovery from numerous behavioral health issues to be a trajectory and not a static destination. 

Early recovery is focused on symptom dampening and abatement. The goals are clear at the beginning: quiet the cognitive and somatic cacophony inside one’s self and begin to piece your life back together. 

As the recovery trajectory continues, larger questions arise and are discussed: What is a life? What kind of life can I have with this/these disorders? Will I find love? Should I reproduce? What marks the difference between the delusional thoughts and the being having those thoughts? 

As I progressed in my recovery, the journey became more existential. I moved from piecing together the Eric before and after diagnoses to trying to connect with the “deeper self” that the writer Franz Kafka spoke to in his work. The “deeper self” that stood behind these two constructed ideas of myself. 

In my recovery trajectory, I have been back to every hospital I was a patient in; gone to the house I lived in as a baby in Cincinnati; keynoted the annual American Psychiatric Nurse’s Association convention in Louisville, Kentucky; trained and lectured on the Naval Base in Illinois that made me a petty officer 20 years ago; and stood numerous times on the spot where my father tried to run me over as a child. 

But, as I move through my second decade without a symptom, one recent act has marked a true grounding in my late stage recovery. 

I often drive to the home in New Jersey that we lived in when my father first showed symptoms. It was a home built for us after we moved from Ohio. It was to be the crowning glory for my father as he returned to work in NYC to claim his throne. 

This house marked extreme pain and shame for my family and myself. It is where everything in our lives changed and where mental illness first started to tear us apart. 

I have visited the house hundreds of times. The first couple of times I would get nauseous, dizzy. My vision would blur and my pulse would race. I couldn’t see the house as much as sense it. I would dry heave while driving away. 

Over time, my reaction to the house began to normalize. I would ride my road bike there and stand across the street and begin to remember all the good that happened on the front lawn, where I learned to ride a bicycle and throw a baseball. Slowly, I was able to begin to rewrite the hyperbole of my youthful experiences. Edit my nightmares with stories of joy and connection. 

After I keynoted the annual Psych Congress event in Las Vegas, I drove back to the house. In that particular talk I used a photo of my biological father for the first time. It was healing and real. It was a real move to unite my life. 

For the first time ever, I got out of the car and walked the length of the sidewalk in front of the home. Slowly, I watched the house become more and more real to me. I could see the faded paint. The water stains near the drains from the roof. The cracks in the driveway. 

The home was no longer an ideal. It simply was a home. A thing. As I stood face to face with my past, my inner experience was still, silent, free. 

Quietly, I bent over and picked up a few blades of late October grass and a wet, brown leaf and placed them in a plastic bag and got back in my car. 

I feel no need to return. 

I don’t live there anymore. 

How do you move your clients through the different stages of recovery?

Eric Arauz, MLER, is an international behavior health consumer advocate, trainer, and inspirational keynote speaker. He is a faculty member at the Rutgers-Robert Wood Johnson Medical School Department of Psychiatry, the Vice-Chairman of the current New Jersey Task Force on Opiate Addiction in citizens 18 to 25 years old, and a person with the lived experience of bipolar I disorder, PTSD, addiction, and suicidality. He is the SAMHSA 2012 "Voice Award" Fellow and the author of An American's Resurrection: My Pilgrimage from Child Abuse and Mental Illness to Salvation. 

The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors.