PTSD Archives - Lisa Hall-Wilson

How To Write About PTSD In Deep Point Of View

October 23, 2018 by Lisa Hall-Wilson 14 Comments

Post Traumatic Stress Disorder – PTSD – is a popular device for fiction authors. PTSD forces your characters to overcome insurmountable obstacles emotionally and mentally. Characters who are at war with themselves in addition to any external conflict just makes good fiction.

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.

**UPDATE** So, this is one of my more popular posts and it’s personal for me because even though I haven’t been officially diagnosed with PTSD, I’m very close to the line. One therapist called what I struggle with mild-PTSD (which, I know isn’t a clinical term, but sometimes having a label helps).

As this has been a personal struggle for me especially over the last few months, I wanted to go back and add some details and nuance that hopefully you’ll find helpful.**

What Do Writers Get Wrong 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 or melodramatic. 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.

Do more research than just symptoms. Flashbacks seem to be the most appealing aspect of writing a character with PTSD, but actual recurring flashbacks are a symptom of very severe PTSD which is absolutely debilitating in every way. Try talking to someone who struggles with this. Read blogs written by those who live with or struggle with this, or have a loved one who struggle with this. Know that the symptoms don’t encompass the whole struggle but are simply the tip of the iceberg.

What Else Is There To PTSD Other Than Flashbacks?

Yes, flashbacks can happen with PTSD, but here’s the truth about flashbacks – not everyone has them frequently or even at all. Most writers love the idea of using flashbacks, I’ll admit they’re fun to play with, but where writers often miss the mark with PTSD are all the OTHER symptoms that are debilitating and soul-crushing. Far more common are triggers which require more subtlety and art to really convey how devastating they can be.

PTSD is a filing problem – basically. Where most brains are able to process and appropriate file away a traumatic memory, for whatever reason – a particular memory or file gets left out and never gets filed away (processed). It’s kept front and center for easy access essentially rewiring the brain.

When triggered, (a smell, a place, a feeling, a person, etc.), the inner-most part of the brain (the amygdala – stay with me) sounds off like a fire alarm. When that fire alarm goes off, the rest of your brain diverts all power/energy to that alarm centre. So, once the fire alarm goes off, you’re incapable of “thinking” your way out of a situation. Instead, you’ll instinctually react in the way that’s most likely to “save you” whether it’s fight, flight, or freeze.

When PTSD rewires the brain, that fire alarm (which is useful, which is necessary) is now super super sensitive. It’s like placing a fire alarm over your toaster. You’re going to get a lot of false alarms. So, in real life we might take the battery out of the alarm, move the alarm or move the toaster. But with PTSD, because the brain can’t figure out where to file that memory, you’re kind of stuck with these constant false alarms. So most or at least a lot of energy goes into avoiding setting off that fire alarm.

This creates a near-constant hyper-vigilance that is exhausting. Utter, soul-draining, bone-weary exhaustion. To the point where you can’t think clearly – you struggle to order your thoughts or prioritize things correctly (Learn more about the mental fog here.) It’s debilitating and can very thoroughly undermine your self-confidence. Every small task or outing gets weighed against the emotional and physical and mental toll it could exact. And let me tell you, this foggy thinking makes life seem pretty f—ing hopeless pretty fast.

And while only the most severe cases have persistant flashbacks, that hyper-vigilance and exhaustion is pretty common. The mental fog caused by the hyper-vigilance or a trigger is common. The frustration and internalized shame of not being able to sort your thoughts, or trust your own thinking is intense.

Give Your PTSD Character A Coping Mechanism

Most people learn coping mechanisms to manage the symptoms of PTSD simply to function, but those mechanisms wear out, their effectiveness wanes over time, our tolerance of them grows thin. If a trigger is the fire alarm, the coping mechanims are essentially the broom being used the fan the fire alarm to prevent it from going off.

If that “broom” is the only way you can manage life at all, you’ll go to some pretty extreme lengths to prevent having it ripped from your hands. Now, that “broom” can be expressed in a wide variety or combination of ways: anger or violence, self-medicating with drugs or alcohol, workaholism, eating disorders, becoming a hermit, suicidal, etc.

At the same time, someone with PTSD is going to cover up their pain at all costs. People stare. They avoid you. They whisper. And all of that gets internalized over time. They’ll be fine in a social situation until they aren’t and they react in (what might appear to be) an irrational or erratic way, but internally they’ll have clamped down and “soldiered up” as long as possible.

Show the consequences of how ineffective that bloody broom strategy is! Show what happens when the broom is taken away (alcohol, a person, a schedule, etc.).

Show Don’t Tell A Trigger With PTSD

You want to show and not tell, right. The person struggling with these kinds of anxiety or PTSD is going to go to great lengths NOT to think about the original traumatic event. Who consciously relives traumatic events? Nobody.

More likely, the traumatic memories are shoved to the very back of the mind and actively avoided, and numbed when avoidance isn’t possible. They’ll be ruled by emotions, and unless they dig down into the WHY of their strong emotion, the PTSD may go untreated for a very long time.

Instead, show the coping mechanisms (the broom) used to control the symptoms or turn their mind off (escapism, fantasy, porn, drugs, alcohol). For me there’s a predictable progression that happens that tips me off to that fire alarm detecting smoke. I feel it in my gut first, a clamping down, a tension, a tightness, and a feeling like I don’t want to be in that place. Then I start to blush, my face feels like it’s on fire. Then I start to tremble. I’ll look down and notice my hands trembling, but at times it won’t feel like I’m looking at my own hands at all. Then my last warning is profuse sweating – regardless of the environmental conditions.

Now keep in mind, that through all of these symptoms, I’ll be waving my damn broom at the fire alarm with the ferocity of a kid trying to put out a fire with their breath. I’ll be using all the grounding techniques I can think of because I’ve decided I can’t or won’t let myself leave the situation.

When PTSD is triggered 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. A moment ago you were rationally able to recognize there wasn’t any danger, but then the switch is flipped and your body is absolutely convinced you’re in mortal danger.

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. The slow removal of their dependence on their grounding techniques or coping mechanisms 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. Spring it on them. 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 sets you back days, weeks, even months.

A Blindsided Character Could Be An All-Is-Lost Moment

Being blindsided by a trigger at any point. A situation that’s been fine a thousand other times can trigger you that one day because someone new is there, because you can’t get your usual seat by the door, because someone’s wearing the cologne that your attacker wore. 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 leaves 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?

I’m opening up the 5 Day Deep Point Of View Challenge on Facebook again from May 20-24! Join the free group and get 5 days of free video lessons and get feedback on your homework! Make sure you answer the questions to get into the group!
https://www.facebook.com/groups/5daydeeppovchallenge/

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5 Tips On Writing A Trauma Backstory

September 29, 2017 by Lisa Hall-Wilson 10 Comments

Life is hard and as writers, we aren’t doing our jobs unless our characters struggle. Am I right? Good fiction isn’t borne out in the comfortable and easy living we might dream about, but in the tension and conflict between characters and/or their own desires.

Giving a character a backstory that includes trauma (part of their backstory at any rate, because no one wants to be defined by that one awful thing that happened or they witnessed) is a great device to create inner tension, and often leads to conflict.

When writing in Deep POV (point of view), the intent is to be as authentic and real as possible. It’s a personal observation that trauma backstory either irreparably cripples a character (think Lisbeth Salander from The Girl Who Kicked The Hornet’s Nest) or doesn’t seem to affect them at all (think any of the principle characters from Criminal Minds – I mean, how much trauma can you witness and still not have it affect outside relationships?). And sure, there are outliers who struggle with severe PTSD and some who seem able to brush anything off, but for the majority of us the reality of a past (or backstory) with trauma is somewhere in the middle. The power of Deep POV is the ability to layer emotion and create realistic reactions.

Just a word from the King 😀

Posted by Confident Writers on Friday, September 29, 2017

5 Truths About A Traumatic Past Writers Need To Remember

Trauma Requires Writing Secondary Emotions

Traumatic events, current or historical, are the equivalent of an emotional tsunami. Primary emotions are the raw, knee-jerk emotional reactions to stimuli we all experience and are the most common emotions given to characters. Some primary emotions that could be triggered by trauma would be: fear, frustration, guilt, self-doubt, hopelessness, loss (physical or psychological), powerlessness, loathing, denial, sad, etc.

When someone is hit by a tidal wave of primary emotions like that, secondary emotions are triggered. Secondary emotions are emotions are caused by one or more powerful primary emotion and include things like: anger, anxiety, and shame. Some of the secondary emotions that could be triggered because of trauma might be: anger, shame, anxiety, bitterness, resentment, numbness, and grief.

Don’t be lazy. As a writer, you need to dive deep into these secondary emotions and layer the primary emotions so the reader can experience the loss, anxiety and trauma with your character. Writers Helping Writers has a great entry on overcoming abuse here that walks through trauma and character motivation.

Historical Trauma Needs Authenticity In the Present

For someone who’s experienced past trauma, (emotional, physical, sexual, verbal) each time the anxiety is triggered doesn’t mean that the actual events are recalled with any amount of detail except in severe cases (like with combat veterans). For someone with PTSD, unless it’s severe, their body reacts to the past trauma as though it’s happening all over again but they don’t actively recall the event. They’re more likely to avoid thinking of it at all unless they’ve gone to counseling or there’s some other explanation for that level of self-awareness. Writers need to treat this carefully when using trauma as backstory.

Physiological symptoms are one way to signal to a reader that the character (or at least their body) is reliving a traumatic event even if they won’t think about it. A woman who was abused as a child will not want to relive the abuse in her mind every time a man larger than her walks into a room. Who would want to live like that? Those who can’t not relive that event often turn to something to numb the memory whether it’s a substance or some other addiction. However, this woman might notice her heart rate accelerate, she might begin to sweat or blush for what feels like no reason. She may maneuver herself to make sure she can make a quick exit if needed or insist on sitting at the end of the row or table. These are all symptoms of anxiety. By providing this evidence of what this woman is experiencing, the reader can draw the conclusion that she’s struggling with something from her past.

With backstory, you want to answer one question and leave the reader with two more.

Past Trauma Has Three Main Lasting Reactions: Fight, Flight or Freeze

Most people have heard of the fight or flight survival instinct humans are typically born with. Victims of trauma (or perceived trauma) when the primary emotions from that trauma are triggered, experience the one of three (or an overlap of) survival instincts: fight, flight or freeze. If they choose flight they’ll look to escape the situation or the possibility of a similar situation (numbness, isolation, withdraw from society). Fight usually comes out as anger or rage either directed at themselves or other people. If they choose freeze, they’ll stay when they should run, refuse to acknowledge the effect of the trauma, catatonic, constantly overwhelmed, no energy, etc.

Emotional Triggers Caused By Past Trauma Have A Desire At Their Foundation

When anxiety is triggered, there’s an immediate flood of primary emotions and secondary emotions come to the front almost instantly. That’s why much of the time, we aren’t aware of the primary emotions causing the secondary emotion. However, at the base of the emotional trigger is a vow, a promise they’ve made to themselves, or some kind of motivation.

Examples of these desires or motivations might be:

never to be a victim again, never let someone hurt me again, not be made a fool of again, never let them see me cry, never let them see I’m hurting, never be hurt emotionally again, never trust a man again, etc.

These inner desires may be expressed through internal dialogue as a vow, but this kind of survival instinct could also be shown through other internal dialogue or choices. What these desires signal is that there’s a wound that’s still festering the character wants to keep covered up and hidden. What they need to do is expose that lie to the air and let it heal, work through the primary emotions causing it all. The Myers Briggs personality tests claims that a large majority of people are equipped with enough introspection to sort these things out, but some personalities do it better than others so it’s unrealistic to think that your character (barring some other obstacle such as psychopathy or narcissism) isn’t capable of this growth. Here’s a great article that talks more about those personalities and how they deal with introspection.

There’s a lot of room in these situations for character arc. Let these characters learn as they go through the story. If they begin the story having already overcome the trauma, make sure there’s real justification for giving them the trauma to begin with. Don’t end the story with them as broken and floundering as when readers first meet them, they must grow somehow. Something has to give, right? No one repeatedly signs up to be beaten and abused by their past, either they get over it, they get even, or they find some way to forget about it/numb the pain.

Causes of Historical Trauma

The thing about PTSD and anxiety is that the effects and consequences are very individual. It’s usually a result of feeling powerless (having no voice), and hopelessness at being unable to change the situation or outcome. Two people can experience the exact same trauma and one person can walk away with PTSD and the other not, they both might, neither of them could have PTSD. They could both have PTSD to differing degrees or have different triggers.

Those feelings of powerlessness and hopelessness can be caused by a wide variety of situations that to some people may not seem all that traumatic at all, so personality can play a large part in this. Having surgery or intrusive medical procedure at a young age can leave someone with anxiety. Neglect, abuse, or simply an unsafe living environment can cause trauma. Loss or separation from a parent at a young age can cause trauma. Basically anything that forces a child to feel insecure can cause trauma. The younger a child is when this trauma is experienced, the more devastating the adulthood anxiety can be.

As a writer, you don’t need your character to experience some kind of catastrophic attack (rape, kidnapping, torture) to experience anxiety. Being locked in a pitch-black room as a child just once can cause lifelong anxiety. The degree to which the adult allows this anxiety to define them, or shape their thinking (often trauma leads to shame), the more the consequences will become evident in day to day life.

Remember that whatever sort of trauma is given to a character, to layer the emotions the event caused. Make sure to realistically portray how the character thinks or remembers the traumatic event. However, don’t be afraid to make that character uncomfortable, to throw them head first into whatever their worst fear is and let them become stronger because of it. Those are the characters readers cheer for!

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What kind of historic trauma have you given your characters?

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