Moonlight and dew-drenched blossom, and the scent
Of summer gardens; these can bring you all
Those dreams that in the starlit silence fall:
Sweet songs are full of odours.
– Siegfried Sassoon, “The Dream”
I have Post-Traumatic Stress Disorder. Which is difficult to admit, because fiction—the medium through which people most often learn about the experiences of others—tends to imply that those who suffer from PTSD are non-existent at best, broken as par of course, and dangerous lunatics at worst. And sometimes the only depiction available in a story or series is the “worst” scenario.
It’s a little upsetting, not least because people fall back on the stereotypes presented in fiction when they know you have PTSD.
But, like anything else, occasionally fiction gets it right.
In this post I’ll discuss the caricature of PTSD in fiction; in a second post, I’ll talk more in depth about some specific examples that mostly get it right (and, in one case, pretty much all of it right).
Before I cover either, however, I ought to describe how PTSD is actually experienced. This goes rather beyond the Merriam-Webster definition or, to be frank, the times when fiction would like to show off PTSD.
Parasites of the Mind
PTSD is the intrusion of traumatic memories in life. It’s important to note that these memories intrude upon life, like an unwanted relative intrudes upon the peace and order of your household; they aren’t simply a remembrance. This effect is due to the way these particular kinds of memories are stored.
They say that memory is not digital, by which they mean that the storing of memories is an imperfect process compared to, say, videos or pictures. Information is lost as memories are integrated into long-term storage, often removing much of their vividness and immediacy, putting them at a distance.
Traumatic memories in PTSD aren’t integrated this way. Your brain says DO NOT WANT, and as a result, they remain unprocessed—vivid and, unfortunately, so immediately accessible that they slip into consciousness at the drop of even tiny triggers.
But because you need to deal with everyday life, you need to put these memories somewhere other than your immediate attention, and so a compromise is reached: you toss the equivalent of a tarp over them.
And then, for the most part, you’re functional. Just like unwanted aunts or uncles, the traumatic memories aren’t around most of your life.
But just like tarps, sometimes the winds of real life blow across your memories. Maybe it’s a gentle but persistent zephyr that blows up a corner or side of the tarp, letting loose merely a potent aspect of terror or fear or hopelessness. Maybe a stronger storm wind blows off full corners, and you get something more immersive, shall we say.
And sometimes a hurricane whips up out of nowhere and tears off the whole thing. You can guess what happens then.
I called these episodes “waking nightmares” before I knew what they were.
The tarp comparison means that, in other words, a trigger can result in anything from
a slight change in behaviour, which can be so subtle that neither you nor those around you are aware of it until you completely lose composure, i.e. sudden expressions of anger or fear. The most common occurrence of PTSD intrusion.
partial reliving of one or more senses that occurred during the original trauma. Examples include abject fear, physically shivering, senses of gut-churning disgust, strangling sensations. This doesn’t occur anywhere near as often as the first type.
the stereotypical full flashback, where you entirely relive the full memory. You disassociate entirely with the present, and you probably will have an extremely vague recollection later, or even none at all. This is actually pretty rare, and many afflicted with PTSD may never experience it.
When I said the tarp was a compromise, I didn’t say it was a good compromise. And obviously the way towards healing is actually integrating these memories properly.
But do you really want to permanently integrate memories of rape camps, war, or child abuse?
I didn’t think so. The cost of waking nightmares seems surprisingly cheap next to full integration, although it isn’t, really.
Some people are more vulnerable to PTSD than others, some situations are more prone to produce PTSD than others, and severity can vary. The people who aren’t vulnerable are the ones you want to turn into Navy SEALs. Fictional characters, on the other hand, tend to be rather binary about this….
There Are No Therapists
“One must wonder why Jack Bauer isn’t Ax Crazy by now.”
Let’s face it. It’s annoying for a writer to deal with characters and trauma that’s not actively forwarding a plot point or other. And let’s also remember that in many societies, one of the easiest ways to lose audience sympathy is for a character to be mentally ill. You’d have to work that much harder in characterizing your protagonist and that much harder in plot synthesis.
And yet, trauma is undoubtedly an interesting part of saying who your character is. And, well, forwarding plot points. Indeed, some of the most memorable parts of fiction occur when a character “loses it”.
That is why There Are No Therapists in much of fiction, even where they’re badly needed.
And because trauma seems… easy, like feeling sad, surely everyone knows about that!… this also leads to a certain amount of Did Not Do The Research with respect to more complex disorders like PTSD. Don’t even get me started on some of the Armchair Psychology that can also show up.
Thus results two main branches of PTSD portrayals in fiction:
A. What PTSD?
B. Set Piece PTSD
In What PTSD?, a character may witness horrible things, experience horrible things, be forced to do horrible things. During these events and perhaps a few days, even only hours later, the character is conveniently recovered enough to move to the next plot point or to the denouement. Butchered human carcasses, murder, torture—it doesn’t matter. Actual PTSD is never a possibility for the main character.
This is the purview of military science fiction. Actually, any military fiction. And actually, a lot of fiction across all genres and mainstream. I can count on the fingers of one hand fiction I’ve run into that doesn’t invoke this pattern, including works that I very much enjoy.
Despite the name, What PTSD? may feature PTSD in a marginalized way. For instance, something like PTSD may be referred to, but its actual treatment is short (which is odd, since the average minimum for recovery of “mild” PTSD is around three months 1) and offscreen. Or PTSD symptoms are used as a simple flag to mark other characters as weak, broken, and just not as good a person as the protagonist. Fiction that uses What PTSD? in this way will drop the matter into a dark hole after it has expired its usefulness to forwarding plot.
On the other end of the scale is Set Piece PTSD. It bears a surface similarity to the intrusiveness of PTSD, but without all the subtleties that would have allowed PTSD symptoms to be more than the instigator of plot points, a convenient plot barrier, or a crippling affliction of secondary characters.
In Set Piece PTSD, PTSD only occurs as flashbacks—full and frontal, leading to actual unconscious physical attacks, gunfire, and other extreme drama involving the endangerment of others and self. At all other times, the character often lives in What PTSD? Land. There is no in between.
Set Piece PTSD is wonderful to give to villains, either proving that they’ve passed beyond a moral event horizon or are imperfect in karmalicious ways. “Out, out, damned spot!”, wrote Shakespeare, making the use of this very old indeed.
It’s also wonderful to give a kind of neutered Set Piece PTSD to protaganists as well, because it helps block plot and gives them a just-debilitating-enough weakness while keeping them mentally pure and sympahetic. Any number of stoic characters who happen to be war veterans are like this.
Oh, and you can use it to get characters to see Thestrals.
Set Piece PTSD is often not mentioned outside of forwarding plot points or creating Very Special Episodes, but it’s kept in the toolbox for later use.
And this is all fine and well for writers, who don’t need to waste time researching trauma or fiddling with its depths, and for the readers who are blissfully unaware of what the actual follow-through of seeing Thestrals means.
It is not at all fine for those of us with PTSD, who wonder what the hell the rest of the world is on, because we want some. Also, the whole “you are pathetic and weak, because you allowed yourself to break like this. If you want to matter, you must be fixed instantly. Chop chop!” message is a bit, well, depressing. PTSD doesn’t just happen to “weak” people, it happens to most people when presented with the appropriate circumstances, including school shootings, bombing terrorism, and the aftermath of severe natural disasters.
There’s some work here to be done by writers.
Next time: Living With PTSD While Solving Mysteries, Battling Aliens, Questing—You Know, the Little Things in Life.
Originally posted on Tor.com.
- Source: The Post-Traumatic Stress Disorder Sourcebook, by Glenn Shiraldi. And yes, it is available for the Kindle. [back]