We’re always looking to create dynamic characters who are faced with insurmountable (and often life-threatening) obstacles. Characters who are at war with themselves in addition to any external conflict just makes good fiction, and one popular or common internal conflict writers use is post traumatic stress disorder (PTSD).
The problem is writers research symptoms and run with it. There’s so much more to PTSD than flashbacks that can add emotional layers, depth, and connection for readers.
Why Write About PTSD?
Post Traumatic Stress Disorder (PTSD) has been called shell shock and historically was lumped in with ‘hysteria’ for women. You can research this mental illness, the causes, and the symptoms, (here’s a great link), but I’m more interested in helping you write it with accuracy.
Giving characters a traumatic past and an ongoing condition that hinders their ability to move on is great for character arc if you can pull it off. Otherwise it can come off sounding trite. The character struggling with PTSD is facing overwhelming odds, and any character who stands up to a bully of any kind (even when it’s a mental illness) is someone readers will cheer for.
Recalling Traumatic Events
It’s true that flashbacks can happen with PTSD. What’s really happening with PTSD is that your mind is stuck and forces your body to relive a traumatic event as though it’s happening in real time. So whether the PTSD was caused in a combat situation, a hospital room, or a dark bedroom – your mind convinces your body that you’re right back there again.
Only the most severe cases have flashbacks though. What might be fun to play with is the person discovering their PTSD. They don’t know what’s going on with their bodies, and unless they learn to be very self-reflective won’t be able to figure out what’s wrong.
Who consciously relives traumatic events on purpose? Nobody. But I see this all the time in fiction — as though that’s the only way PTSD manifests. More likely, those memories are shoved to the very back of the mind and actively avoided, and numbed when avoidance isn’t possible. Instead, show the coping mechanisms used to control the symptoms or turn their mind off (escapism, fantasy, porn, drugs, alcohol). Show symptoms of anxiety (sweating, twitchy/jumpy, checking exits, feeling of being trapped – needing to get out/escape) and then send them for another lap around the block even though they’ve already done five more than usual.
The emotions and physical symptoms left by the trauma are so uncomfortable your character will proactively seek a way to get control, but they will avoid thinking about the why. Try showing the emotions and discomfort and leave the memories to be discovered like a bread crumb trail in the woods.
Show The War Going On Inside Your Character
When PTSD is triggered, an adrenaline rush hits with something close to the force the traumatic event caused. The unconscious mind is triggered and it alerts the body to imminent danger — except your conscious mind is aware there’s no danger at all — so you’re at war with yourself quite literally. It will seem to come out of nowhere or can build up slowly to a crashing crescendo.
While part of your mind is hitting the red alert button, the other part of your mind is consciously grappling with your body’s response to the perceived threat and regain control of the physical response. How would this look to an observer? The response will trigger the survival instinct of: fight, flight, or freeze. Will they come out angry, shouting, defensive? Will they try to escape, come up with crazy nonsensical excuses to leave or simply not come after they’ve promised to? Will they stay where they are because running or fighting isn’t going to help them survive – subterfuge, avoidance and compliance will? Will they stay at the party even though they look like they’re being tortured every second of it?
What Does PTSD Look Like?
The physical symptoms are easy to show; just write what’s happening to their bodies. Let internal dialogue focus on their awareness of being irrational, that there’s no threat, yet they’re unable to feel safe. They’ll struggle to control, to conceal, to minimize what others can see. Get it? I’m a BIG fan of Deep POV so I focus on showing the primary emotions through physiology and internal dialogue and showing secondary emotions through outward actions and spoken dialogue.
The Netflix series Jessica Jones is about a woman who struggles with PTSD but won’t admit it. She chooses to numb her emotions with alcohol, anger, and by pushing everyone away. She’s hard to like. But we can cheer for her because every episode she manages to put that aside long enough to help someone who can’t help themselves — she puts herself in danger even though she doesn’t want to because she knows she’s the only one who can help. But the PTSD and addiction is like an anchor everywhere she goes.
PTSD Is About Minimizing Triggers
Those managing PTSD will have a proactive (but not necessarily healthy) strategy to manage symptoms. Some methods might be subtle while others are extreme. Know what your character’s primal goal is when they’re triggered. Is it safety? Is it survival? Is it escaping? Have them seek that out at all costs.
They could have a mantra they recite to control their thoughts. They might have a safe person, someone they trust to watch their backs in new or upsetting situations. Grounding techniques involve consciously cataloguing why the what-ifs won’t happen (There are two exits, It’s a public space, etc.). The slow removal of their dependence on these management techniques is a great way to show growth.
Those who know what their triggers are will actively avoid situations that might set them off. This is a potential for conflict – force them into a situation where they’re uncomfortable, where they feel threatened or unsafe. Put them in new situations. I wasn’t aware that exercise fatigue mimicked my PTSD symptoms, so I was triggered by a jerk at the gym and couldn’t feel it coming on because I was in the middle of a workout. The times when you’re triggered without warning are the worst. Being blindsided by it sets you back days, weeks, even months.
Give Them A Tell
Self-awareness is critical, it’s a hyperawareness often because if you can see it coming or starting you can get off the crazy train before it really gets going. Your unconscious mind will get the ball rolling after a trigger: I’m not safe. I’m not safe. You have to be aware of that mental shift and think your way out of it but more often what tips you off is physical symptoms.
I have a couple of tells that always tip me off: blushing and sweating—profuse sweating disproportionate to the environment. Does your character have a physical symptom they’ve trained themselves to watch for? Are they suddenly jumpy or have an intense urge to leave no matter what?
They’ll want to hide what’s going on because it makes others uncomfortable (people stare, they avoid the character, or treat them differently). Show the character’s awareness of the stigma, and let them fail from time to time.
Blindside Your Character
You can be blindsided by a trigger at any point. A situation that’s been fine a thousand other times can trigger you that one day. This is a great device to save for a pivotal conflict.
It’s like a two-by-four to the head. Show their emotional wounds bleeding all over the floor and have them keep going anyway. Show them growing stronger, trusting people again against their instincts, forgiving themselves because they couldn’t get a hold of themselves again, etc. Let the whole process be messy, two steps forward and one step back. The stories that end in a pretty bow and leave everyone “cured” simply aren’t authentic.
Have a question you’d like to ask about writing PTSD in fiction with realism? What’s the most compelling portrayal of PTSD in fiction you’ve seen so far?