Tattoos have become more acceptable over the years but are often only seen as having decorative value. My guest #DonnaTorrisi has written a book about the connection between tattoos and trauma. While a tattoo sits only on the skin, the meaning of tattoos may be much deeper for some individuals, telling a story of a difficult time in their lives, a loss or a story of abuse. In this way, tattoos are a form of self-expression that can tell you something about the person and their life’s journey. We heal from trauma in many ways…tattoos are one of those ways.

In this episode, you will learn:

1. How tattoos can create a bond between people who have experienced difficult life circumstances.
2. How body markings can play a part in healing from trauma.
3. Whether Dr. Carolyn has a tattoo and if yes, why?


GUEST – Donna L. Torrisi, MSN

BIO: Donna Torrisi is a nurse practitioner and founder of a Community Health Ctr in Philadelphia which grew to 5 sites. Her first book is about her experience of working with low income patients who were courageous and resilient. She is the recipient of numerous leadership awards for her work in this field. Donna is a 2005 graduate of the Robert Wood Johnson Executive Nurse Fellowship Program. She served on the Governor’s commission for chronic care management and the Governor’s Advisory Committee on Health Care Reform. She is a Fellow in the American Academy of Nursing. Her second book, Tattoo Monologues, Indelible Marks on the Body and Soul will be available in October 2021.

Website of Donna L. Torrisi:


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Hi everyone Dr. Carolyn here, and I’m bringing you episode number 94, and we’re going to be talking about an unusual topic, but I think you’ll see if you stay tuned, how it links to many of the other topics I’ve talked about before. So I have a special guest today who is going to be talking about what she’s learned about the link between tattoos and trauma. Stay tuned.

Hi, Dr. Carolyn here with my special guest and we’re going to be having a really interesting conversation with Donna Torrisi. Donna is a nurse practitioner and founder of a community health center in Philadelphia, which grew to five sites. Her first book is about her experience of working with low-income patients who she found courageous and resilient. She is the recipient of numerous leadership awards for her work in this field. And she’s also a 2005 graduate of the Robert Wood Johnson executive nurse fellowship program. She served on the Governor’s Commission for Chronic Care Management and the Governor’s Advisory Committee on Healthcare Reform and she is a fellow in the American Academy of Nursing. Now here’s where the kicker comes in, all of our experience in medicine practitioner and so on has led to the publication of upcoming publication of her second book called Tattoo Monologues, Indelible Marks on the Body and Soul, and that’s what we’re going to be talking about today.

Dr. Carolyn: Welcome to the show, Donna.

Donna: Thank you so much. I’m happy to be here.

Dr. Carolyn: So it is kind of curious that, you know, you, it looks like you had pretty much a standard nurse practitioner arc for your career and then out of the blue comes this tattoo book. What led to the publication or what, what led to your interest?

Donna: Though I was leading a fairly large network of community health centers. Um, I always had a small clinical practice and that was part of our culture is that all leaders had a small clinical practice, even if they were, you know, the dental director or whatever. So I think it actually might, my, my interest got perked in tattoos when my son was 17 years old and he was sleeping on the couch and his shoulder was showing and I saw a tattoo and I nearly freaked out and I had, and he was very intrigued with tattoos and I had to either lose him or join him. And I decided I would join him. So I became intrigued with tattoos. So I started noticing them on my patient and I started asking them about their tattoos. And I was so intrigued. I said to myself, someday I’m going to write a book about women and tattoos. I’m going to do that when I retire. And sometimes…

Dr. Carolyn: I have to ask you, do you have a tattoo yourself?

Donna: I figured you were going to ask me that question. I actually do and it hurt like hell and I can’t believe that people do this over and over, but I do have a tattoo on my right ankle.

Dr. Carolyn: I have a tattoo on my left ankle.

Donna: Oh, is that right? We can share what our tattoos are all about.

Dr. Carolyn: Yeah. So it sounds like though it was more than just asking people about, like, how did you get a tattoo or why, but that you made some kind of connection between the patient’s trauma or pain in their life or certain life events and why they got the tattoos that true?

Donna: Yes. I can tell you how it proceeded from there. Uh, if you want to hear that now, so I decided I’m not going to wait till I retire that’s ridiculous I’m going to start doing this now. So I found a photographer who was very interested in joining me for the project. His name is Kenny Kaufman, and what he would do is videotape the interviews and then take stills of the women and their tattoos. So after I interviewed a few women, we sat with a friend of ours who was actually a licensed clinical social worker therapist. And we’re talking about our experience and that the first two people, the first three or four, maybe had attached to this, having to do with some kind of a difficult life experience really helps steer me in the direction of really sticking with that issue not just women in tattoos, but tattoos that really told the story of some kind of a life difficulty or trauma.

Dr. Carolyn: So, can you give some examples of them?

Donna: Sure. I have women from all walks of life. I have a woman who was a severe alcoholic and had her children taken from her and had her four children tattooed on her body and have another woman who was working as a volunteer in animal shelter and when she went to feed a pit bull, it grabbed her arm and nearly took part of her arm off. And, she ended up with a tattoo with the preference of her, her, the dog that she had and told the story about how depressed she was and that she had PTSD. And that she had rescued this little Chihuahua that she had named Elf. And now it was rescuing her because she had to get out of bed to take him for walks.

Dr. Carolyn: Awesome.

Donna: He had his footprint and she had, she had a palm on her arm, that was really lovely.

Dr. Carolyn: Yeah. Wow. So, you know, everybody, almost everybody has a tattoo now, even as older women and they don’t seem to be as frowned upon although, you know, I can say even within my own family. One of my sons is very pro-tattoo to the younger one and then one is very against tattoos. And so it doesn’t seem like everybody is on board, but do you feel that the majority of tattoos have some meaning or because I’m thinking about my younger son who like you, I got interested in tattoos when he got his first tattoo, right around the same age as your son, but his tattoo definitely had a meaning and it had a connection to some trauma as does my tattoo. However, subsequently he’s had probably four or five other tattoos, which he says have no meaning and he doesn’t intend to. Get any other tattoos and have meanings. So what is your take on, you know, whether the tattoos are just decorative or mostly have meaning, and is it different for men?

Donna: I think the answer to your first question is it’s really mix. I had a patient in my office yesterday who, you know, was disrobed because I was doing an exam on her and she, I asked her about her tattoos. She said she had 15 them and some of them, she said were just pretty and some of them had a story. So I think it’s really mix. I don’t know so much about men. Probably the answer would be the same, but at least, and I haven’t done a book on men and so I haven’t really gotten into it deeply, but I certainly have seen men, especially in our community that is primarily African-American of rest in peace tattoos on their arms, having to do with a lost friend or family member.

Dr. Carolyn: Yeah. Okay, good. So what else have you learned though, about talking to your patients about tattoos?

Donna: Well, I’ve been very intrigued with what is it about a tattoo that would help a person come to grips with or heal from trauma. First of all, they have to be conscious of the trauma. As you probably know, there are some traumas that we don’t allow to surface into our consciousness because we just can’t manage it at that point in her life it we will be too flooded emotionally. So first it has to be in one’s consciousness and it can become in one’s consciousness. One, we’re ready to manage it or sometimes something triggers a memory. So, anyway, the question I’ve often asked myself and ask women is why a tattoo. Let’s say it’s in memory of someone who died, why not wear a piece of their jewelry or on some object that they own and I get different answers. Some people have told me that something material can be taken away from them, but the tattoo can never take them because no one can take my skin. I’ve had other people who have had sexual abuse. And the, the symbol of, of their other tattoo is almost a telling of their story. Hey, you know, here I am, look at me. This is what happened to me. And, you know, as you know, we heal from traumas often by talking about them in the presence of a healing or the presence of a compassionate individually.

Dr. Carolyn: So what is it though about a tattoo that gives it some kind of healing power?

Donna: I’m not sure. I totally have the answer to that. But I think it’s the combination of those things of it’s. It’s always with me. I can see it. I felt it, you know, when someone gets a tattoo, they put an incredible investment. And time and money and space on their body and in physical discomfort. So one has to be really serious about it to make that decision.

Dr. Carolyn:But it’s interesting because trauma experts like Bessel van der Kolk talk about the body, keeps the score that trauma stays in our body and even decades after it’s happened, could the tattoo almost be, uh, you know, kind of a metaphor for that or a visual representation of the trauma that lives in our bodies.

Dr. Carolyn: Yes, Carolyn, it certainly can. I have had some women tell me that there’s something about the physical pain and getting a tattoo that in and of itself has some kind of healing properties. I curious about it. The only thing that I can think of that is cutting and, and we know that that is a phenomenon sometimes when people who’ve had trauma, but I, you know, I’m not sure I totally have the answer to that. I have another woman who had been the victim of sexual abuse. This is a really interesting story. And she had repressed the memory. She had been molested as a very young child in a basement of her home, by a neighbor. And she had repressed it until she was an adult and got an apartment in a basement and those emotions came flooding back to her. And the perpetrator’s last name was Wolf and she had a Pacific Northwest Wolf tattooed on her arm. And that was her way of taking back the name by having that symbol on her body. I’m not sure I understand totally about that, but we do understand that people want to take back things that have been hurtful to them. I hate to use this as an example, but it’s one of the things I think of is in the African-American culture the N word is something we don’t want to hear, but it’s used in African-American music.

Dr. Carolyn: Rap music and all of that. There’s a huge argument about that between Jay Z and Oprah about, you know, the taking back the N word versus perpetuating the stigma of the N word. And I, you know, I think there’s a lot of precedent on both sides to that argument, but it’s an interesting one. Yeah.

Donna: Right. Exactly.

Dr. Carolyn: So what is one of the most unusual tattoos and stories that you remember hearing from clients? Something else that’s, you know, really stuck in your mind.

Donna: I, I’m not sure this is the most, one of the most unusual, but certainly is one of the most profound, there was a woman working in, we had a large business office and the woman who was my assistant and her younger daughter who was a college student, also worked in our office and the young college student, uh, her name was Tukwila, was killed tragically in a car accident, which was incredibly traumatic for their family, but also all of our staff. Tattoos were not in her definition of herself. This is the mother. She absolutely, that was not who she was and had no intention until she had this tremendous loss. And she also had twin severely disabled sons who her daughter helped her care for. And she would say, my daughter always had my back. So on her back is the name of her daughter acquainted with angel ones.

Dr. Carolyn: How beautiful.

Donna: That was one of the touching stories. The other woman who was actually in the accident with her who survived. She had a tattoo. Uh, she had already had several tattoos in the story she told me is my mother never saw my tattoos, so I was in the hospital, but she had the tattoo on her back. That’s called footprints, which you might be familiar with. And I don’t remember the exact words, but, this is when I didn’t see it footprints when, when the lawyer was carrying me and she had that down was fine. Cause she believed that she learned to walk again and to recover because of her strong spiritual beliefs.

Dr. Carolyn: Such amazing stories related to tattoos. So tell us about the story related to your tattoo.

Donna: You know, I wish I had a very profound story, but I really don’t. It’s actually more about my childhood and I can actually, it does mean something to me, but it’s not about a trauma. I have Tinkerbell on my ankle and Tinkerbell to me was a first of all, I wanted to be Peter Pan when I was a child and a Tinkerbell was willing to give up her life to save her good buddy Peter Pan. And so for me, it’s a real symbol of love and compassion and friendship and loyalty.

Dr. Carolyn: That’s beautiful. But what made you decide to actually go through it and get the tattoo?

Donna: You know what, I really think it was around, you know, I have two children, one of them is a biological child and my son is adopted. And sometimes the ties between, uh, parents and adopted child are strange or attended. And I think I tried so hard to be, um, to want to be up to be a part of his life. And I really think it was a joining him and his intrigue and his love of tattoos that really led me to get one. And actually he came with me when I, when I got it.

Dr. Carolyn: Now you, you say this is your son who was adopted and is there a story also with tattoos regarding his birth mother?

Donna: Yes, actually, there is, you know, first in full disclosure, we absolutely supported him at age 19. When he asked us to help us find his birth parents. And we hired someone to help us find her. And we found them very quickly. And then we can begin their phone conversations. And I’m not going to say that I wasn’t a little bit jealous, I was. But their relationship grew over the years. We brought her out here from Kentucky to spend time with us. Um, when, when they first met for a few days, we put her up in a hotel and since then he’s become friends, uh, very close to his three half sisters anyway, to make a long story short he and his birth mother had a tattoo. And yes, that makes me jealous, but I’m not going to get another tattoo.

Dr. Carolyn: What is their tattoo? Can you share it?

Donna: It’s a Celtic symbol and it’s a Celtic symbol. I think of bonding and loyalty. And they spend a lot of time going back and forth about tattoos that were too masculine that too feminine and so they came up with this and, you know, he, I wasn’t a real part of that conversation or that happening, you know, I was really left out of that until, you know, it happened. And I asked about it.

Dr. Carolyn: That must’ve been a little hard though.

Donna: Yeah it was hard, he had a very big private life around his, you know, bonding with his birthday.

Dr. Carolyn: Was, did that story influence your thinking about body art in any way?

Donna: Um, I think really what it did was sort of deepen my understanding of the profound, if the word is right. Profoundness of tattoos for men and women. And there’s something about giving up a place on your skin that is there forever. And I think that foreverness, and this is a really a huge part of this and the being a part of one’s body that one cannot separate from, or take away that has very, very deep meaning.

Dr. Carolyn:  But it seems like the younger generation is becoming increasingly tattoo, you know, people are getting whole sleeves and you know, the side of their flank and all of that. And it doesn’t always seem to have a meaning, but is there a meaning in society like culturally, that we’re, that you have uncovered that that’s explains why so many young people are getting tattooed?

Donna: You know, that’s an interesting question. We’ve really seen our culture think about tattoos, make a real shift from thinking of tattoos with drunken sailors, uh, prison inmates, uh, gangs, even associated with the Holocaust and some cultures and religions are really very much against marking the body. In fact, I couldn’t quote what passage it is in the Bible, but there is a passage in the Bible about not marking ones body. And I certainly see, uh, have seen that change and, and for tattoos, if they’re particularly, if they’re done tastefully have been largely accepted by society, I think we still might see, uh, cringing and difficulty with tattoos on the face, the neck, the hands and, and the sleeves that’s, um, you know, taking it to another level. I have no judgment about that, but I suspect that there is a lot of judgment on that, in our society.

Dr. Carolyn: Have you had any patients who’ve had neck or facial tattoos or tattoos in places that could never be covered up.

Donna: Oh, absolutely.

Dr. Carolyn: Are their stories?

Donna: I have a very interesting story to tell you, this is about a very dear patient of mine. In fact, I just saw her yesterday who had. I’m sorry, this is about a coworker of mine who lost her sister at age 23 to a seafood allergy. She had an anaphylactic reaction and die, uh, my patient, uh, whose name is Kim went to her tattoo artists and, and actually that tattoo artist is interviewed in my book. She went to him and said, put a tear, drop on my face and he refused to do it.

Dr. Carolyn: Why?

Donna: He said, it’s going to get in the way of your future career. People are going to judge you for it and I really urge you to not make that decision now. So, uh, this guy has also told me stories about, um, young people coming in and asking for tattoos and very visible areas and him not, being unwilling to do that. Because of his decisions. And so he said, you know, making a buck is not as important as, you know, following like my ethics around this.

Dr. Carolyn: Yeah. Did he have any further insight about why people get tattoos and what are the meanings are.

Donna: I can tell you that in our interview he talked about, and again, he was referring to women, calling him and telling, telling him I have to come see you soon I need my therapy. Yeah. So I need my therapy. I mean, really? What is, what does that mean? What is it about getting a tattoo that is therapeutic? I mean some of the things we’ve talked about, but I don’t know that I’ll truly ever really understand the therapeutic value of a tattoo.

Dr. Carolyn: Well of getting the tattoo, because for me it was so painful. I can’t even imagine getting another tattoo, but, you know, I’ve had patients who had, you know, I have one in particular who had probably the most beautiful tattoos I’ve ever seen. It was just like a whole work of art that covered her entire back and then one sleeve of her arm and it was done in different stages. So I saw it, you know, from when it was relatively small to when it was almost complete and it was unbelievably beautiful. And for her, it was all about, you know, it was more of a spiritual connection that she had to Buddhism and how that had changed her life and so on and so forth. But it was a massive work of art and, you know, for her. I mean, I’ve heard people say just as you have that, the pain is therapeutic for me. It wasn’t, I’m barely made it through my first tattoo without bolting because of the pain. But, uh, I know for some people it is, and then I have a friend who’s a trauma therapist who says that she views the tattoos as almost like self harm. Like you said cutting, so that’s another viewpoint that that’s out there about it too. So has, has talking about this or learning about this changed you in any way?

Donna: Yes, I would say how could it not? I spent hours interviewing 29 women who by the way, were very eager to tell their story. And also I had no problem finding women to tell their stories. In fact, I finally had to put an end to the book and then I kept meeting people. I wish I could have put in a book. Yeah. I mean, it educated me. I, you know, I, um, I certainly was aware of the issue of trauma in the population that we care for because it’s a very traumatized population of people, male and female, but I had no inkling at all about tattoos representing the traumas. So it it’s changed me a lot and made me much more intrigued with asking. And I think it’s really deepens my relationship with my patients to be asking the questions and hearing about what they’ve experienced in their lives.

Dr. Carolyn: Do you recommend that within your clinics, do you talk about this subject and recommend that other healthcare providers ask about, you know, it shouldn’t be part of the regular history and physical that we do with, with patients.

Donna: You know, I haven’t gotten to that point. Certainly my, my primary care colleagues know about the book and have heard me talk about it. I actually have stopped short of ever asking them to inquire that because there’s so many things they have ask something about what we do inquire about trauma. I mean, depression and trauma are our routine questions that are part of the intake process of all of our patients. I have another story to tell you, this is another woman in her 80s who also tattoos were not in her vocabulary at all. And in her, I guess it was her around her 80th birthday. She was diagnosed with breast cancer and subsequently had a double mastectomy. And on the Eve of her going into the hospital to have a reconstruction, she canceled her surgery and just felt at her age. She just didn’t want to go through that again. Now she is a very active social activists and the environment is one of her very heartfelt issues. And so instead of getting a reconstruction of her breasts across her chest, she has a design of flowers and birds and bees it tell the story of what the environment means to her and protecting means to her.

Dr. Carolyn: Is it like a little?

Donna: More than that? It really pretty much her entire chest.

Dr. Carolyn: Really. Oh my goodness. That’s pretty incredible.

Donna: Yeah. To make that decision in one’s eighties and to experience that kind of physical discomfort and give up that much geography on one skin is pretty incredible.

Dr. Carolyn: Pretty incredible to have the courage to say no to the doctors as well. Cause that’s not, you know, that’s a tough one when they say you should have this done or else. And she made her own decision. That’s hard.

Donna: Yeah. She ran a marathon and at the end of the marathon, she pulled open her shirt.

Dr. Carolyn: Oh, wow. Very, very cool. Well, it’s really been interesting talking with you, Donna and I hope the listeners have gained some information that might be useful to them, whether they’re parents of tattooed teens or they themselves want to get a tattoo. I think it’s, you know, the therapy value is, is something we haven’t really talked about before. And it’s very clear that that’s the case. So I appreciate you coming on the show and I look forward to seeing your book when it comes out.

Donna: Okay. I think you said you wanted me to say what are?

Dr. Carolyn: I was just going to ask you, how can people find your book or find out more about you

Donna: It’s on Amazon and it comes out in October can be pre-ordered and by website is

Dr. Carolyn: Okay. So the name of the book is Tattoo Monologues, Indelible Marks in the Body and Soul, and I will put a link to Donna’s website in the show notes. So you should be able to access that there.

So thanks again, Donna. It was a pleasure talking with you.

Donna: Thank you.

I hope you found that interesting. I know many of my patients have tattoos that have a special meaning for them as does mine. I have a tattoo of a hummingbird on my left ankle which, uh, is in memory of my son, my middle son, Noah, who died from suicide back in 2004. And, when, when he passed away, I was living in Tucson and I would go for long walks to try to ease my grief and I would see hummingbirds every day when I walk, no matter what time of day it was and no matter what my route was. So that came to mean for me, the connection that I had with my son that continues to exist even after his untimely and tragic death. So if you have a tattoo or maybe you have a friend or a family member who has a tattoo, and you’re not really sure what it all means it might be worth it to question if you’re a healthcare provider. I think it’s, uh, something that we should be talking about because many people don’t really reveal their trauma when we ask the questions that we ask in the history and physical, but maybe they would be more open to talking about the meanings of their tattoos.

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