Psychoanalyze Your Characters 4: PTSD

Onto our fourth installment of Psychoanalyze Your Characters, my attempt to share some psychological knowledge to help you flesh out your characters’ psyches. Today I’ll shift from Axis II to Axis I, focusing on the clinical syndrome of Post-Traumatic Stress Disorder (PTSD).

PTSD is a normal reaction to an abnormal event. It’s an anxiety disorder that some people develop after seeing or living through a threatening event. Most experience a “fight or flight” syndrome in response to a dangerous situation, but in PTSD this reaction is damaged and individuals feel threatened long after the danger subsides. Potential traumas include:

* Abuse (physical, sexual, emotional)
* Sudden, unexpected death
* Natural or human-caused disasters
* Personal assaults
* Military combat
* Accidents

I’ve seen PTSD develop after individuals have experienced sexual abuse, motor vehicle accidents, childhood bullying, domestic violence, and suicide of a loved one, to name a few. What’s interesting is that a group of people might all experience trauma but only selected few develop PTSD. Some factors that increase the likelihood of PTSD include a history of anxiety, past losses, and lack of coping resources. Abuse survivors are more likely to experience PTSD when that abuse occurred at a young age, was frequent and intense, and was perpetrated by someone close to them charged with their care.

There are three groupings of symptoms in PTSD: distress, numbness, and avoidance.

Individuals typically alternate between states of high distress (reliving the traumatic event through flashbacks and nightmares, feeling on edge or “hypervigilant”) and numbness (emotionally flat, exhausted). The distress taxes our systems so much that the body shuts down and goes into a dull state of fatigue at times.

The third symptom is avoidance of the trauma. For example, an individual who was sexually abused might avoid romantic relationships, because intimate situations remind her of the trauma. Or, a car accident survivor might not want to get into a car.

One of the best movies I’ve seen about PTSD is Fearless. The movie features Jeff Bridges and explores the aftermath of a horrific plane crash. If you watch it, keep the tissues handy.

Another good PTSD movie is The Prince of Tides (except for the part about the psychiatrist sleeping with her client’s brother–why does the media always have to portray therapists sleeping with their clients? *winks*). At its most severe, abuse can result in a splitting off of oneself in order to cope with the trauma, resulting in dissociative disorders like Dissociative Identity Disorder (formerly Multiple Personality Disorder). Primal Fear and Sybil showcase this disorder.

Why do individuals with PTSD behave like they’re in danger when they’re not? A colleague explained it using a screen door metaphor which I thought was brilliant. Picture a screen door in your brain. When a stressful event happens to you, chemicals like adrenaline flow through the screen door and prepare you to handle the stress. However, when a trauma occurs, sometimes the chemicals scream through so fast that they bust a hole in the screen door. Now individuals are left with a hole in their screen door. The next time they experience something resembling a trauma (a “trigger”), the adrenaline rushes through the hole and they feel like they are re-living the trauma. Their heart races, they can’t get air, they tremble, they freeze.

Treatment can be very effective for PTSD. Since the brain is living in the past, one strategy is to bring the brain to the present through using grounding skills. Individuals should use their five senses to anchor themselves in the present: “I see the painting on the wall. I hear the clock ticking. I feel the surface of the sofa beneath me.” Deep breathing is essential. When we are very anxious our breathing becomes shallow and fast, and deep breaths help quell the cascade of the stress response.

Treatment also involves correcting dysfunctional beliefs that might have developed. The most common seems to be the belief “It was my fault” for abuse survivors. Because children are egocentric, they believe they alone are the cause of good and bad things that happen to them. As adults they need to learn that they are not to blame for the actions perpetrated by others. Therapy, specifically a technique called EMDR, might help individuals adopt a more functional belief like “I did the best I could.”

We all experience stressful events and life is also full of trauma, so this disorder can provide a realistic and dramatic backdrop to your characters. Good luck!

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Readers, please hop from one blog to another. 🙂

17 thoughts on “Psychoanalyze Your Characters 4: PTSD”

  1. Oh Jenn, I loves the PTSD…well, I mean, I feel sorry for people who have it…BUT…my main character in my book that I'm writing right now is dealing with it and it's sooooooooo much fun for me to write. I love to write angst and I suppose at it's base, PTSD would be a very angsty point of view to write due to the tension and anxiety. Great post!! 🙂 Jess


  2. Hi Jess, PTSD does indeed provide some rich drama for your character's background. What kind of trauma did your character sustain? For some reason I often write about characters who were physically abused as children–it just breaks my heart. Thank you!


  3. PTSD, especially originating in war, fascinates me. I've written two Regency-era war vets now (one who remains in dust-covered file and one who will meet the public in February. Both have physical as well as mental scarring, to a greater or lesser degree.For me, it's one of the ways to show their grace and courage under fire. And the aftermath.Thanks for sharing your knowledge on this!


  4. A 1960's cocktail party for New Year's Eve – Awesome!!! I would suggest a long epire dress or stonewashed blue jeans and a tee shirt. Definitely wear a head band across the forehead.


  5. Taryn, the physical and emotional scars of PTSD fascinates me as well. I was spellbound during the movie Saving Private Ryan, and one of my favorite books \”Word of Honor\” by Nelson Demille focuses on the aftermath of the Vietnam War as well. Good luck when your war veteran meets the public!Liz, I didn't know a little black dress would work though I was thinking of a bouffant hairdo. Somebody said that psychadelic clothing might work, but is that the wrong era?


  6. \”At its most severe, abuse can result in a splitting off of oneself in order to cope with the trauma, resulting in dissociative disorders like Dissociative Identity Disorder (formerly Multiple Personality Disorder). Primal Fear and Sybil showcase this disorder.\”Now why bring THAT up???;)


  7. Hey Janine, yeah I was interested to learn that abuse by a parent is often much worse than abuse by a stranger. It's a huge betrayal. And if the other parent knew about it and let it happen, that's a betrayal too.So you got my little joke about psychologists sleeping with their clients? Hee hee.Thanks, Janine!


  8. Congratulations on the Goodreads nomination! Well deserved, I'm sure, and I cannot wait to read WGB in 2011.It's interesting that some people deal with trauma just fine while others don't – thanks for providing some factors that can explain these differences. How heartbreaking that children are automatically geared toward thinking everything is their fault. Do you know what I thought of while reading this – Good Will Hunting: \”It's not your fault…it's not your fault…it's not your fault…\”Have fun at your 60s New Year's cocktail party. 🙂


  9. Yeah–Robin Williams kind of bopped Matt Damon's character over the head with that phrase–kind of hard to forget! I loved that movie.Thanks for the congrats. I have some very supportive friends! Here's to a great 2011, Nicki.


  10. It's so amazing to be in such great company on Goodreads! Holy cow.I've never seen Fearless. I'll have to see if that's a watch it now on Netflix. I did see Prince of Tides, and felt so uncomfortable with the subject. Not very worldly of me, huh?Thanks for all this great information about PTSD. Happy new year!


  11. Hi Julie! That nomination was quite a nice surprise. 🙂 There's nothing comfortable about sexual abuse so I totally get your ick factor with Prince of Tides. Gah, Fearless is really good but really intense.Happy New Year to you!


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