Updated: Aug 30, 2022
By Megan E. O'Laughlin
For most adults, the skin weighs about eight pounds, the weight of an average cat. The skin can stretch to cover an area of twenty-two square feet, roughly the size of a small storage closet or a huge dining table. Besides keeping us protected and hydrated, the skin offers a map of our genetics and past injuries. Similarly, our metaphorical skin—our emotional skin—can also hold such histories.
The Latin prefix epi means over or on, and the epidermis is the top layer, protection for the body’s deeper layers. Epidermis cells flake off and regenerate every twenty-seven days. Look around a room and see the dust on the tabletop or floating in a sunbeam: this is your epidermis released to the air. The settled dust, which you may wipe away with a wet rag while listening to a podcast, is last month’s epidermis. It is last month’s you.
Deep in the epidermis, the melanocyte cells bring pigmentation to the skin. My skin is light, barely melanated except for the freckles and moles, of which I have many. Some moles have been removed and a few of those biopsied. An inflamed scar runs across my left shoulder from an old surgery to remove one such mole. Once someone asked me if it was a gunshot wound. I laughed, for my skin hasn’t experienced such jolting trauma.
But perhaps it has.
Unlike the epidermis, the dermis layer does not regenerate. Any damage will last for as long as the skin exists. Depending on what happens to the body after death, this may be a long time.
A tattoo marks the dermis layer of the skin, perhaps as decoration, a symbol, or even identification. The etymology of tattoo is from the Samoan word tatau, meaning ‘to strike’, the act of striking a needle to place ink into the skin. Tattoos come to life in the skin in many ways: a tattoo gun, a needle, a safety pin and ballpoint ink, or with an ink saturated thread woven through the skin.
Coal miners often suffer from traumatic tattoos—accidental tattoos—when coal dust enters open wounds. Whether invited or not, the external object becomes stuck. Traumatic tattoos don’t look like colorful dragons or sultry pinup girls. Pictures online show shapeless shadows like dusty ghosts within the skin.
Trauma can also refer to a physical injury- a blow to the head, a broken bone, a cut to the skin. Through my years of providing psychotherapy, I've learned trauma means something is stuck. Psychologically, the damage may not be so apparent, although it leaves a shadow, more dusty ghosts beneath the skin.
The Latin prefix hypo means beneath or below. The deepest layer of the skin is protected, and it also protects. The hypodermis connects the skin to the bones and muscles, and covers deeper layers of the body, such as blood vessels and organs.
The hypodermis also stores fat, which I learned from a young age is a terrible enemy. I often heard the women in my family lament what they ate as they judged their bodies. They scowled in the mirror and pulled at their clothing. I imagined a body in rapid transformation after a meal, like Popeye’s bulging biceps after a can of spinach, except it was a woman’s distended stomach after a piece of cake. Popeye smiled and puffed his chest up, so strong. But the woman slumped over and covered her torso with her arms, embarrassed of what she ate, so ashamed she had a body at all.
The Latin prefix extra means outside or beyond. Extradermal refers to the space beyond the layers of the skin. My vision here is dreamy and not scientific. There is no diagram for such a thing, but I know this to exist because it’s a part of me. Imagine an invisible net above and outside the skin, where the consciousness floats, and little is felt save for an occasional buzz of light sensation. I found this feeling intentionally by drinking and sometimes unintentionally when my nervous system shorted out and I hovered helplessly over my body.
Despite my barely melanated skin, my epidermis appears colorful in other ways, injected with various ink colors. If the skin can cover a large table, at least a few place settings are covered in various tattoos: a spider web with a garden orb weaver, bright hydrangeas, a meditating cat, an anatomical heart, several lotus flowers, a tree of life, two bluebirds, one large crow, a woman's head, various clouds, and shading of all sorts.
The epidermis heals quickly after a tattoo. It scabs, scales, and itches quite intensely, but within those twenty seven days, it is renewed. There is an illusion here: the skin's surface looks utterly changed, yet the alteration is at a deeper level. The marks may fade, but they will stay for as long as the skin exists.
I was a teen when I got my first tattoo in a bar in Naantali, Finland. At age sixteen, I left my high school in small town Idaho to study in Finland as an exchange student. I squandered that fantastic opportunity by keeping my blood alcohol level as high as I could for the entire year.
I buzzed with excitement, ready for my tattoo. I was drunk, as was my friend Laura, who was also ready for a tattoo. My Finnish friend Kea already had a tattoo from the skinny man behind the bar, both the bartender and the tattooer. He poured shots as he prepared the tattoo gun.
In my youth, I did not excel at sports, but I was quite good at drinking. My tastes were specific--no cheap beer, no gin, yes to vodka. Years of drinking taught me that I might be the most dangerous type of drunk. While some slur their words as they clumsily stumble about, I sat upright, engaged in conversation, and walked for hours. Sometimes I woke up with scratches on my skin and didn't know how they got there.
I read that when a person has alcohol blackouts but can eat, walk, and talk, it is not because they are cool, as I once believed, but because the brain is alcohol tolerant.
My brain was alcohol-tolerant at age sixteen.
I wanted an eagle tattoo on my left bicep simply because they were cool. In the mid-90s, bald eagles were endangered in the US, wiped out by the chemical agent DDT, which weakened their eggshells. As a kid, we traveled to the Northwoods of Wisconsin for fishing trips with my dad’s family. For hours we sat in green boats and pulled in bass, pike, and trout. The fish too small to keep were cut open by my dad’s knife, a long slice through the belly. He flung the fish on the water where it floated on the surface.
We waited for the bald eagle, and this vivid memory lives in my body: the fishy smell, the bright sun, the sound of the eagle’s wings, a whoosh as it deftly grabbed its food—dead flesh in giant talons. Then, the eagle flew off to take its spoils to its post in the trees.
From the bartender’s book of clipped magazine pictures, I selected an eagle with outstretched wings. I pulled the picture out of the book, slid it across the bar, and poked it with my finger. “This one,” I said. My friend translated a bit to the bartender. What exactly she said, I didn’t know.
The summer before I moved to Finland, I became taller, grew breasts, and my hips expanded. None of my clothes fit. My pale skin stretched with the growth, marked with purplish-pink lines. Embarrassed, I refused to wear the short gym shorts in class. My parents yelled, exasperated that my grade was docked to a D because of my refusal to wear my gym uniform. Even on the hottest summer days, I covered my shame with fabric, denying myself comfort.
I felt adolescence's usual sensory roller coaster—icy chills in the skin, vivid fantasies, and an animalistic draw towards certain people. I was interested in sex and felt attracted to both guys and girls, which was confusing. But I knew sex involved the removal of clothes, so I resolved to never do that. I could not do that.
Stretch marks are aptly named. The stretching skin ruptures the connective tissue, leaving marks like a frayed piece of fabric. They can show up during puberty, pregnancy, and any other time of rapid weight change. Like tattoos or other scars, they occur in the dermis layer, where the cells do not regenerate. They stay on the skin as a small, banded mark. The bright streak indicates that a change happened quickly, and the skin had to adjust. They may fade, but they never heal completely.
I knew from a young age that the culprit of fat was food, and the better the food, the more likely it would cause fat. I despised food yet loved it. In my frenzied obsession, I hid treats under my bed and hoarded money to buy sweets. I insisted on rifling through my friend’s cupboards to find the sweet snacks in plastic bags we rarely kept in our house, which was always stocked with wheat crackers and diet soda.
In the evenings, I sat in the bathtub and listened to the radio. When Salt n Pepa said their song was for sexy people, I knew I was excluded, for I was too fat to be a sexy person. Eight years old, and I already detested my own body. In the scalding bath, my awareness detached from the skin.
My friend Laura screamed as the skinny guy inked the outline of a treble clef on her ankle, but my first tattoo barely bothered me. The needle pokes infiltrated my body's near-constant numbness. Endorphins rushed through my brain and mixed with the alcohol. I giggled.
The tattoo guy wiped my arm, bright red spots on the washcloth. Then, he called it in his thick Finnish accent: “too much blood.” Now I know that alcohol and tattoos don't mix because alcohol thins the blood and causes excess bleeding. Any decent tattoo shop won't allow an intoxicated person to get tattooed. Still, it was done. My first tattoo.
Enough ink remained to make out a fist-sized bird with sloppy wings and the head of a chicken, hackle feathers pointing downwards. Instead of a majestic eagle, I had a sad little fowl. Embarrassed, I called it The Fucking Rooster. Once, in a fit of self-disgust, I tried to rub it off with an eraser, but I could not rub enough to remove the ink. Perhaps I could cover it up, but it would never go away.
My arm bore The Fucking Rooster when I had sex for the first time, a drunken incident which started and ended in a small hotel room. First, a group of us convened with bottles and loud laughter. But it ended with only me, on a quiet tiptoe to the bathroom, where I found a bright spot of blood on my underwear. This was the inverse of the wedding night sheet stained with blood, for this stain didn’t reveal good news about virginity. It told only some of my secrets: I'd never had sex, sex scared me, and I had no language with which to speak about sex or my body.
I left that hotel room with an icy sense of the skin and nausea in my gut. I could barely recall what happened. I continued to drink but in a sad, messy way. My friend Ben noticed tears in my eyes one night as we drank beers around a table. Worried, he pulled me aside, and I cried for a long time, saying little. His shirt was soaked with my snot and tears, but he didn’t seem to mind. I was so grateful for that.
I was well indoctrinated into the rules of dieting. I skipped meals but eventually became too hungry or drunk to continue my fast. But that summer after the hotel room, I released all the rigid rules. I devoured meatballs defrosted quickly in the microwave. At the local Hesburger, I dipped hot fries in the tangy cups of punainen majoneesi, or red mayonnaise. I savored pineapple ice cream with sweet licorice swirls. None of my pants fit except for the baggy black pair with an elastic waist.
My extra layers of fat helped me so I wouldn’t find myself drunk on a bed, hovering above my own body. Later, I discovered the definition of consent and realized I did not ever give it, did not even know how to give it. A drunk girl, disconnected from her own skin, does not speak the language of consent, only the language of drinking up and checking out.
My memory is a house full of rooms, many of them empty, while others hold a few plain objects: bottles, t-shirts, and that stained underwear. I walk the halls of memory, confused. The days after the hotel room, I followed that young man around. He was tall, skinny, and spoke multiple languages. He was usually drunk, too, and I was a ghostly, drunken girl. Once I was fun, when I took shots and yelled, but when I emerged that morning with my blood-stained underwear, I became quite unstable. I feared that boy yet wanted his approval. I expected that sex meant that we bonded in some way I didn’t understand. I felt pathetic.
It’s tempting to blame someone, but I don’t blame him, for he could have been anyone. I had little regard for my own safety because I couldn’t even feel my body that would need to be saved. I navigated my surroundings with a broken compass, in a world that doesn’t treat drunken girls with much kindness. Drunk girls are assaulted all the time. Sometimes they end up with bad tattoos as well.
In her book Could this be Magic? Tattooing as Liberation Work, author Tamara Santibañez shares what many have experienced: the ritual of tattoos can offer empowerment, particularly for those who experienced body trauma. Within the deliberate selection of meaningful symbols and care from a supportive artist, one can experience body autonomy and even healing.
But, as everything has its shadow, tattooing can also be harmful. Santibañez notes that “we do not tattoo in a void,” but in a world affected by systems of oppression and dominance. In recent years, many tattoo artists, some quite famous, have been reported for harassment, and even assault, of their tattoo clients. Recognizing the realities of coercive abuse, Santibañez offers thoughtful instruction for tattoo artists on trauma awareness through frequent consent and collaboration. There is a movement to ensure tattoo artists are just as trauma aware as anyone else who interacts with a person’s painful history: therapists, doctors, yoga instructors, massage therapists, and so on. After all, if trauma lives in the body, a tattoo artist literally sticks a sharp needle into the ghosts of the person’s past.
Just a few months before leaving Finland, I went to an actual tattoo studio to cover the Fucking Rooster. I picked a design from the flash books, a large bird to cover the little bird. I understood that it was an “American Northwest design.” It reminded me of the childhood fishing trips and my Northwest home, where my family moved when I was eleven years old.
Later, I learned that the design was not an eagle but a Native Tlingit thunderbird, a fierce mythological creature that brings the lightning and thunder. I am not Native American; my people were Irish, British, and Scandinavian. We were farmers and later, we were settlers and colonizers. They called us homesteaders when my grandmother’s family bought Sioux land for pennies on the dollar. The Fucking Rooster was a better fit for me, after all.
Eventually, I covered the thunderbird with a tattoo of a large anatomical heart. Even now, pieces of the thunderbird are visible underneath. If I look hard enough under the heart on my sleeve, I can see the faint lines of the Fucking Rooster under the layers of ink—very faded, but still there.
I never got that badass eagle I wanted.
In my various jobs, I’ve been exposed to many bodily maladies. I’ve cleaned blood and vomit, called the paramedics, and seen many scars. Working as a therapist, I’ve helped with many issues: eating disorders, panic attacks, arachnophobia, bipolar, PTSD. For years, I specialized in helping people who cut themselves, some considered to have a diagnosis called borderline personality disorder, a painful and heavily stigmatized condition increasingly believed to be related to complex trauma.
I taught my clients to cope when they felt like cutting. They slowed their breathing, placed ice packs on their face, walked the neighborhood, and sometimes we talked on the phone as they did so. Although they told me the cuts made life more bearable, I encouraged them to feel both within and beyond the skin. To hurt oneself is violent, and we can’t live meaningful, loving lives when we treat ourselves with hatred.
Dr. Marsha Linehan, the creator of dialectical behavioral therapy (DBT), the therapy I once specialized in, wrote “borderline individuals are the psychological equivalent of third-degree burn patients. They simply have, so to speak, no emotional skin. Even the slightest touch or movement can create immense suffering.” A third-degree burn destroys not just the outer layer of the epidermis, but all the layers of the skin. These burns often require intense intervention like hospitalization and skin grafts. We already know that this kind of damage won’t ever go away, not as long as the skin exists. Without intervention, such burns can be deadly.
The middle layer of the skin—the dermis—holds the tattoo. The small tattoo needle enters the skin about one hundred times per second, depositing the ink.
I watch my tattoo artist, Krysten, carefully wipe down her workstation and place a tiny vial of black ink on the worktable. She works meticulously, with precision, just as you’d want when someone creates something you’ll live with forever. Krysten is kind, talented, and for years, she helped me cover up old tattoos with no judgments about how the ink came to be on my body.
“Ready?” she says, and I nod. The stencil is on my shin, but soon the design will exist permanently, black ink in the dermis. She starts at the top of the shape, needle in the leg. At first it burns, my heart races, and my stomach churns. But soon, the endorphins kick in and my ears adjust to the high-pitched squeal of the tattoo gun. A few hours later, we are done, and she wipes the skin clean.
I slept early that night, my leg carefully wrapped, sober like I always am, and have been for years. In the morning I run the shower water extra hot to wash off the excess ink. I see the face there- serene expression and hair, a tangle of snakes. I have a Medusa head on my shin.
For the next few days, I wash Medusa’s face with soap. I wear baggy pants so she has room to breathe. My skin becomes itchy and scabby, but I leave it alone, except for the careful application of ointment several times a day. This process of healing is one of my favorite parts of a new tattoo piece. As I care for myself, my skin heals and regenerates in only a few weeks. My skin is transformed.
I know what it is like to feel your body is not your own. I could have cut myself every day, but I chose the oblivion of substances and food instead. My protection was my absence. I drifted away from my body, unfeeling and unconscious, distant from both the unpleasant and the pleasant. Like my clients who cut themselves, I simply did not know how else to cope. And like my clients who learned to soothe themselves, I eventually learned to truly live in my skin.
My Skin/ Our Skin
My epidermis has regenerated over three hundred times since the morning of the blood-spotted underwear in the hotel room. In these years, I have sloughed off old skin, regenerated old cells, gained wrinkles and gray hair, and my skin has both expanded and contracted. I even grew an entire human, with her own cells, in my own body.
Women with tattoos have long been considered slutty and even unstable. My first tattoo experiences, with the Fucking Rooster and the Thunderbird, certainly reinforce the problems of careless impulsivity mixed with the permanent rite of tattooing. But perhaps we tattooed ones are also courageous, for we celebrate and honor our bodies after a lifetime of floating above the skin's surface.
You are probably familiar with the story of Medusa, the snake haired Gorgon whose piercing eyes turn men into stone. She was decapitated by Perseus, who famously carried her head and used it as a weapon. In one account of Medusa’s origin, a god raped Medusa in Athena's temple. In her fury for the desecration of her sacred space, the Goddess Athena cursed Medusa with snakes for hair. Although she became monstrous, she also became dangerous, so she could never be so violated again. In Ovid’s Metamorphoses, Medusa is described: “Now, to terrify her enemies, numbing them with fear, the goddess wears the snakes, that she created, as a breastplate.”
Today I see Medusa on my leg, viewed through the epidermis window. She is the newest addition to my dermal ink, a symbol of a breastplate: a symbol of protection. Underneath my skin, there are all the makings of a healthy body, for which I am now so thankful: muscle, bone, organs, and fat.
Medusa can offer protection, and maybe we can aspire to be like her: she protects us as we protect others. She is a reminder of harm, but also a remedy. She inspires me, as a therapist and mother, as I arm myself and others with fierce awareness and self-compassion. I also realize that we are all a bit like the warrior Perseus, running scared through life’s many dangers. To be a protector, and to be protected, we must be too present to ever float away. We hold the snake-covered head, even when the hands shake considerably. We feel our skin—scarred and colorful—as we bravely move through the world around us.
Megan E. O'Laughlin writes nonfiction and works as a psychotherapist specializing in trauma recovery. She is an MFA candidate at Ashland University. Her work has been published or is forthcoming in the Blackfork Review and The Bluebird Word. She lives in Washington state.