Johns was one of those British men of a certain era with a biography that sounds that it can’t possibly be true, featuring more heroics, odd incidents, narrow escapes, and prolific writing than one would expect from any twelve reasonably adventurous people. He was a fighter pilot in WWI, where he had a number of exciting incidents, including accidentally shooting off his own propeller, culminating in being shot down and taken prisoner. He then became an RAF recruiting officer, and rejected T. E. Lawrence for giving a false name. Mostly after this, he wrote 160 books, including 100 about ace pilot Biggles. (I cribbed this from his Wiki article, which is well worth reading.)

These books were hugely popular in the UK for while, and are probably still easier to find there. They were also reasonably popular in India when I was there. I virtually never see them in the US, and had I known this I would have obtained some before leaving India. They weren’t huge favorites of mine, but I did enjoy them and they are excellent for researching early aviation and fighting tactics, such as they were; Johns notes that WWI pilots were not formally taught to fight, but had to learn on the job. Casualty rates were high.

Biggles Learns to Fly is a solid, if episodic, adventure story; the interest is in the very realistic details. It takes new pilots time to learn to spot enemy aircraft while flying, even when a more experienced gunner is screaming that they’re on top of him, because they’re not used to scanning in three dimensions. It fascinated me to read the details of such early, primitive aircraft and aerial warfare. Pilots communicated with hand-signals, and Biggles was sent on his first combat mission after something like ten hours of solo flying.

Here’s an excerpt from the very last page, after yet another heroic action. Major Mullen shot a glance at Biggles, noting his white face and trembling hands. He had seen the signs. He had seen them too often not to recognize them. The pitcher can go too often to the well, and, as he knew from grim experience, the best of nerves cannot indefinitely stand the strain of air combat. The Major sends him off for a week’s rest.

This is what we would now call combat stress (acute stress in civilians), which may or may not be a precursor to PTSD. (It becomes PTSD if it doesn't go away.) I found it interesting because of how matter-of-fact and sympathetic Johns is, depicting it as something that happens to everyone and doesn’t reflect badly on Biggles. Some other writing from WWI sees it as a sign of cowardice or mental/moral deficiency. Possibly he would not have been so sympathetic if Biggles wasn’t back in reasonably good shape after his rest. Or possibly the RAF had a different attitude. Then again, the book was written in 1935. Benefit of hindsight?

That's also a good example of the tone in general; emotions are noted but not dwelled upon. We only get enough of anyone's interior life to make their actions make sense.
Anderson is an extremely well-known and acclaimed writer of YA problem novels (also historicals and one charming comedy, Prom). I’ve reviewed several of her books under her author tag. Speak is excellent, but Wintergirls, with its mythic resonances, is my personal favorite.

The pattern of her problem novels is a teenager with an “issue”-type problem (rape, anorexia, etc), their struggles and ambivalent relationship with the problem and their family, a dramatic (sometimes melodramatic) climax which forces them into a final confrontation with the problem and their need to get help, followed by a quick conclusion in which they’re getting help/therapy and are clearly on the road to recovery.

They sound very formulaic, laid out like that, but her characters are vivid and often pleasingly snarky, her prose is excellent, and in the better books, the characters are much more than the sum of their issues. I particularly liked Wintergirls, in which the heroine is haunted by her dead best friend, for its refusal to provide simple answers to the question of whether the ghost was an actual ghost, a memory, a fantasy, a delusion, a metaphor, or several of those.

The Impossible Knife of Memory, unfortunately, did feel formulaic, and did have characters who were exactly the sum of their issues. It also had a climax that stepped over the melodrama line and plunged into laughable.

Teenage Hailey is being raised by her veteran father, who returned from Iraq with a bad case of PTSD and has been a depressed alcoholic ever since. Her mother and grandmother are dead and his army buddies are rarely around, so the main relationship in the book is (or should be) between Hailey and her father. Their actual relationship consists of him being a disaster and her alternately mopping up after him and avoiding the fallout.

It’s not that this is implausible. It’s that there’s not enough actual emotion between them. There should be a bond, however strained, or the angry ghost of a broken bond. But I didn’t get a sense of that. Hailey thinks about her father’s actions and their effect on her a lot. But she doesn’t spend much time thinking about him as a person, or about her feelings about him. There’s surprisingly little actual interaction between them, and what there is isn’t very revealing of anything but “Severe, untreated PTSD wrecks your life and makes you a bad parent.”

I read some criticism of the book on Goodreads that the PTSD is whitewashed. I didn’t get that feeling, given that the Dad’s an alcoholic who can’t keep a job, can’t have a relationship, can’t parent his daughter, trashes the house, does drugs, and attempts suicide. That seems sufficiently serious to me. As far as PTSD goes, he’s on the low-functioning side of the spectrum. My criticism is that we never see him in a scene that isn’t about his PTSD. There’s little sense of what he was like before, or what he’s like beneath the array of harrowing symptoms.

The actual relationship in the book is between Hailey and her quirky new boyfriend. I believed them as a couple— he’s aggressively quirky, she’s quirkily aggressive— but the book felt like it should be more about the father-daughter relationship. The generic teen romance didn’t interact much with the Dad-has-PTSD story, resulting in a book that felt like two different books awkwardly integrated.

And then there was the accidentally hilarious climax, complete with physics-defying injuries. Read more... )

Even in much better books of the kind, include Anderson’s own better books, I find it frustrating that after an entire book full of lovingly depicted trauma, the healing is almost always summarized briefly rather than shown in depth, or at all. Or, to phrase it fannishly, you get 386 pages of hurt and 7 sentences of comfort.

Part of the issue may be structural. If you follow the forms we’re taught in school, a story is supposed to have a beginning, a long period of rising action, a short climax, and a very short conclusion. If the decision to seek help is the climax, you can’t see the healing, because that’s the conclusion. The only way you can show the process of healing, if you stick with this model, is if the start of healing begins right after the beginning, and the healing is the rising action. I’ve read books like that— The Secret Garden comes to mind— but they’re rare.

If I may make a modest proposal: there is no law of nature stating that all American books and movies must slavishly adhere to a single model of dramatic structure. There are perfectly valid alternate types of structure.

I wish more writers would try some other model out when they’re writing trauma stories, so they could show more of the recovery. It can be very interesting and dramatic, seriously. And it’s way better than the OMGWTF you broke your ribs how climax of this one.

As for this book, as far as books featuring a daughter living with her veteran father with PTSD go, I liked Flora Segunda better.

The Impossible Knife of Memory
Reading for one of my trauma classes. I’m not summarizing the whole thing, just bits I found especially interesting.

Chapter One: Clinical Features of PTSD. Nothing new here.

Chapter Two: Cognitive and Behavioral Features of PTSD.

Amnesia. People rarely have global amnesia for traumatic events (not even knowing it happened or having no memories of any of it), unless they also had a head injury or other physical damage (ETA: or are children, or there were a whole series of similar events, of which only some are remembered. What doesn't happen often: a sober adult has something horrible happen to them, and later does not even recall that it ever happened.) But partial amnesia is extremely common. A typical example is “weapon focus,” in which a person might recall every detail of the gun but nothing about the attacker’s face.

Taylor suggests that this is caused by “attentional narrowing,” which is a common result of extreme arousal. The apparent amnesia is caused by hyperfocus on certain details and total ignoring of others, so the ignored details were never encoded into memory at all. (As opposed to being forgotten or being present but inaccessible.)

My note: be upfront with people about this – they may never be able to recall everything, and that’s okay. Total recall is not necessary to healing.

Guilt. Trauma survivors tend to have a number of incorrect beliefs about the trauma which cause them a lot of pain and suffering. Helping them identify and argue with these beliefs can be very helpful. Great breakdown of common false beliefs on p. 34-35. I’ll just list a few.

- Hindsight bias. “I should have (magically) known the drink was roofied.”

- Justification distortion. “What I did/did not do during the trauma was unjustified.”

- Responsibility distortion. “It was entirely my fault.”

- Wrongdoing distortion. “What I did during the trauma went against my morals and ethics.”

These come about for the following reasons (I only excerpt a few); unraveling them and making them explicit may be very helpful.

- Judging your actions not based on the reality of the situation, but against an ideal or fantasy that didn’t actually exist. “I should have disarmed and kicked the asses of the men who were holding me at gunpoint.”

- Blaming yourself for not acting on ideas you didn’t get until after the fact. “I should have memorized the license plate.”

- Overlooking actual benefits of actual actions. (ie, you got out alive, possibly because of what you actually did.)

- Focusing only on imaginary good outcomes of actions you didn’t take. “If I’d tried to disarm him, I definitely would have succeeded.”

- Not taking into account that when all options are bad, selecting the least bad is a highly moral choice.

- Not taking time and emotional factors into consideration – what you’d do if you had an hour to contemplate it in the peace of your own living room is different from what you do when you have seconds and a gun to your head.

Beliefs about Symptoms

- People with PTSD often think their symptoms mean they’re “going crazy.”

- They tend to interpret emotions or physiological responses as objective truth. “My heart is pounding and I’m frightened, therefore the situation is dangerous.”

- Physical/emotional arousal has become so entwined with negative feelings that they may avoid all arousal, including that caused by exercise or positive feelings. (Anxiety sensitivity.) Interoceptive exposure (inducing arousal in a safe, controlled manner) is good for this.

Clinician's Guide to PTSD: A Cognitive-Behavioral Approach
Courtney Milan was recommended to me at Sirens last year by Sarah Rees Brennan, and more recently by Oyce. Great rec! This book was basically written for me: a sweet, sexy romance, with some action and lots of psychologically-based angst. Bonus points for including a bunch of stuff which I happen to like, including scenes at a theatre, food descriptions, characters with families and responsibilities, period-accurate birth control (it bugs me when I keep thinking that the heroine is going to get pregnant at any moment), and a "mistress for a month" agreement.

I managed to read the last in the series first, but it didn't seem to matter. It's a series of historical romances about three brothers who were raised by a psychotic, abusive mother, and what happens to them afterward. In an afterword, Milan said that she was interested at looking at how different people react differently to similar events: a theme right up my alley.

This book focuses on the middle brother, Smite (short for a long Bible verse) Turner, who grew up to be a justice-obsessed magistrate with PTSD. I would love to claim the credit for the increased frequency, realism, and individuality of portrayals of PTSD in romance novels, but I think it must be some sort of zeitgeist phenomena. Anyway, it's very believable, and, of great interest to me, the way he thinks about and deals with it is also very believable.

There was a point early on where he tells the heroine that he isn't broken and doesn't need fixing, and I thought, "Oh, God, here comes the anachronistic lesson on the social construction of disability!" Thankfully, later events proved that he had something much more specific and personal in mind. (Nothing against the social construction model! But while I don't look to romance novels for historical accuracy, I do look to them for plausible characterization. And while people with PTSD often have very complicated mixed feelings about getting better, there is a lot of inherent suffering going on completely apart from social stigma and lack of accommodations.)

I also liked the dialogue, the subplot involving the heroine's entanglement with a mob boss, and the way that the characters consistently told each other what was going on, thus averting a great many opportunities for stupid misunderstandings. They were adults with problems, who acted like adults. Also, I count five sympathetic gay men in the cast. Good going.

Milan was a Harlequin author who decided that she could do better self-publishing. This book is selling for under four dollars on Kindle: Unraveled
My paper for one of my trauma classes is copied below, on the question of including CPTSD (complex PTSD) in the DSM-V . It's 4 pages long, and as per the assignment, summarizes the arguments in a set of papers I read, then describes my own proposal. Quote marks used here as LJ doesn't support block quotes. Also, apologies for the alphabet soup.

Read more... )
rachelmanija: (Oh noes!)
( Jun. 24th, 2012 03:06 pm)
The great epic Mahabharata describes vivid combat stress reactions exhibited by the ancient worriers. (Check this out: PTSD in the Book of Job. Not a bad case, but they are clearly reaching in some parts. The "feelings of detachment or estrangement from others" is more about the person's own feelings than, as in the verse they site, others literally ditching the person.)

Some nice sources here to look into, but one thing I'm noticing is that a lot of people are citing the same 20 or so primary sources, often without quotes. I'm sure there's much more out there that could be turned up with original research.
I'm writing a paper on PTSD and combat-related berserk states as depicted in pre-1650 sources and comparing it to the current understanding of both. Ideally, I will be able to reference substance/alcohol use and abuse in relation to this.

Can you recommend me some sources to check out? I am definitely going to be using Shakespeare's Henry V, Part I. I have already thought of Macbeth (possible PTSD), and The Iliad and The Mahabharata (berserk states). Nonfiction is also fine.

NOTE: No Civil War memoirs! I'm trying to find sources from before PTSD was really conceptualized as such, and it had been conceptualized as "soldier's heart" by then.
rachelmanija: (Gundam Wing: Sane against the odds)
( Feb. 14th, 2012 11:27 am)
This is about triggers in the technical sense, of the "cues" mentioned by the DSM-IV in its criteria for PTSD: "intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event."

I have a much more detailed explanation of triggers here. (Warning: uh, triggery in that it contains descriptions of PTSD and abuse.)

In LJ/DW culture, people often use "trigger" in a much more colloquial sense, to mean "a thing which is upsetting/disturbing/unpleasant." But in the technical, trauma-related sense, this is what a trigger is:

Triggers are not merely upsetting in general. They are things which bring back memories or feelings associated with trauma.

Triggers are highly, highly idiosyncratic. (There are exceptions to this, which I'll get into in a moment.) They don't have to directly relate to the general nature of the trauma. In fact, they are at least as likely to relate to some random thing associated with the trauma, not with the nature of the trauma itself.

For instance, a person who was raped in a car would be at least as likely to be triggered by hearing the song which happened to be playing on the radio during the rape, or by the feel of a vinyl car seat, as she would be by fictional depictions of rape, discussions of rape, or the word "rape." (Some people, of course, do end up triggered by all fictional depictions of rape, etc. I'm just saying, not all people, not always.)

I suspect that the reason for this is that "rape" is a very general thing. But a specific trauma is specific. A fictional rape may bear very little resemblance to one's real rape, and so not touch off any specific memories. But the song, the vinyl seats, the smell of the man's cologne, and so forth, are real things which get burned into the very cells of one's brain, and the fibers of one's nervous system. They may bring up reactions which happen before you even know why you're reacting.

ETA: Forgot about the exceptions to the "idiosyncratic" thing. There's two big categories of those:

1. Most people whose traumatic reactions reach the level of diagnosable PTSD will be physically triggered by sudden loud noises and unexpected touch. It has to do with how our nervous systems are wired. Those things are inherently startling, and if your startle reflex is cranked up past a certain point, inherently startling things will provoke the same level of physiological/emotional reaction people normally have when, say, someone suddenly leaps out of a dark alley and sticks a gun in their face.

2. When similar sorts of traumatic things happened at the same time, in the same space, to large groups of people, you can take a pretty good guess at what triggers will affect many or most of them simply by looking at notable features of the trauma or the area in which it took place. For instance, some insensitive landscape designer stuck a bamboo grove on the grounds of the Veteran's Administration. Unsurprisingly, you can tell who the Vietnam vets are by which ones are taking a very wide path around the bamboo. In the unlikely event that burning papers start fluttering down from the sky, the people who have very strong reactions are probably the ones who were present in New York during 9/11.

End ETA.

People often warn me about fictional depictions of child abuse. I am not triggered by that, or by fictional anything. I was tied up and abused. I'm not bothered by rope bondage in fiction. (Feel free to rec me rope bondage in fiction!) But I did have something trigger me yesterday, and I'm writing it up because it was such a great example of how triggers actually work - and can be dealt with.

Cut for length; also, kind of navel-gazey. )
Two years ago I wrote a set of posts called “A User’s Guide to PTSD.” They attracted a lot of attention, and several people friended this LJ in the hope that I would write more in the same vein. I pointed out that I write about mental illness approximately once every two years, so it could be a long wait. If any of them are still reading, I hope they enjoy this follow-up. If you missed the first set, I've linked them below.

Part I: What I Did In The War. (Introduction; background; what happens during trauma; what happened to me.)

Part II: What Does A Flashback Feel Like? (My history with PTSD, what it felt like to me, and dealing with other people who have it.)

Part III: I Don't Have To Do That Any More. (On recovery; lingering effects; book, film, and TV recommendations.)

I recently underwent training to join a team which counsels people in crisis situations. A crisis situation could be finding the body of a loved one who died of natural causes. It could be witnessing a car crash. It could be surviving a brutal mass murder. (All calls are absolutely confidential, so while I discuss the training a bit below, you will never hear any counseling anecdotes on this blog.) Since the team is run by psychiatrists, they’re very concerned with the psychological effects on the volunteers. During the training, I and the other prospective team members were repeatedly asked to consider what triggers we might have and what situations we might find especially disturbing, so we’d either be able to prepare ourselves or bow out of situations involving those triggers.

Since I was abused as a child, had a family member murdered in a domestic violence situation, had other family members die slowly and painfully of natural causes, was in a serious car accident, and have done several suicide interventions not to mention attempting suicide myself, I was confounded by the idea of avoiding crisis situations with possible triggers. What crisis situation wouldn’t have one?

“I think I’d be upset by dead children,” I hazarded. “That’s one I haven’t encountered yet.”

Statistically speaking, a prior history of PTSD puts you at risk of recurrence should you again be exposed to trauma. We are not strong at the broken places. The broken places remain fragile. We build up our strength around them to compensate. If we’re lucky, that’s sufficient.

I do not expect to have any kind of catastrophic meltdown. If I did, I wouldn’t have volunteered. I do expect that, if I come across a particularly disturbing situation, it will exact some sort of price – some sleepless nights, some nightmares, some hyper-vigilance – the sort of thing I’m subject to anyway if there’s a lot of stress in my life. Basically, the same sort of thing the counselors are subject to regardless of personal history, should they encounter something sufficiently unsettling.

One can’t avoid all stress, but it’s easy to avoid work which puts you into direct contact with other people’s traumas. But avoiding it also exacts a price. I sometimes get a feeling as if a fire alarm went off in my head, a sudden sense of urgency and the conviction that something terrible is happening somewhere and I ought to be doing something about it. This sense can keep going at a low level for weeks on end, periodically startling me with an especially intrusive feeling that I should go! Go now! Run!

I used to identify this as a peculiarly specific anxiety attack, though what it really feels like is the world's most useless psychic power. I cope mostly by consciously acknowledging it for what it is - a habitual firing of neurons that were overused for too many years, and never got used to peace. It's not meaningful. It's annoying background noise. It doesn't mean I have to actually do anything, though if it gets especially "loud" stocking up on earthquake supplies or activities of that nature sometimes helps.

But in fact, terrible things really are happening somewhere at any given time, and I really ought to be doing something about them. I don’t expect that being a volunteer crisis counselor will make the alarm turn itself off permanently. But at least I will be doing something.

(I could elaborate, but I had to write three separate essays over the course of ten weeks on “Why I Want to Join the Crisis Response Team (please detail your strengths and weaknesses,)” and I’m a bit sick of the subject. No, I didn’t say anything about fire alarms in my head. I figure that sort of thing can wait till they know I’m not a raving axe maniac me a bit better. Though I think that if most and maybe all people were to disclose absolutely everything that goes on in their heads, they'd all sound at least as strange as I do.)

A year ago I was involved in several (unrelated) extremely stressful situations. I would lie awake at night thinking, “What if right now [something terrible] is happening?” I should note that this wasn’t my internal fire alarm. There really was a reasonable chance that [terrible thing] might, in fact, be happening at any given moment. That being said, my insomniac obsessing was helping neither the situation nor me. I wanted to see a therapist, but my insurance only covers therapy in cases of “major mental illness” as defined by the insurance company.

I went to a psychiatrist and asked for a diagnosis, only to be informed that in her opinion, I was under a lot of stress and would benefit from therapy, but did not have a mental illness, major or otherwise. “Actually, especially given your history with mental illness and what’s going on in your life right now, I think you’re pretty emotionally healthy.”

You can probably imagine my mixed feelings about that statement. (When I explained the situation with my insurance, she kindly wrote down for their behalf that I met the DSM-IV criteria for an adjustment disorder. “Technically speaking,” she added to me. An adjustment disorder is psychiatrist-speak for “temporarily unhinged by the sort of stressors that occur under normal life circumstances (death of a loved one, job loss, divorce, etc), as opposed to the extraordinary stressors that can cause PTSD (rape, combat, natural disaster, etc).” And yes, the therapy was very helpful. I'm now much better at walking away, letting go, and otherwise not pouring all of myself into a futile attempt to fix someone else's life.)

It wasn’t only that, after so many years of trying to fix my mental illness, the fact that I had largely succeeded was now preventing me from getting needed mental health care. It was also that PTSD, even before I knew what it was, had shaped so much of my identity that I felt strange without it, or even contemplating the idea of being without it. And yet she was only telling me what I already knew. It was as if, after many years of debating with myself over whether I was willing to lay down my armor and weapons in order to get out of the war zone, I found that I had already dropped them. And that I’d known I had, but rather than either pick them up or kick some more mud over them, I’d taken mental note of where they lay, just in case, and tried not to think too much about the lack of weight at my belt and back.

I thought of finding a different metaphor, because PTSD is not actually helpful protective armor but rather a set of massively counterproductive and painful reflexes that can feel like they’re all that stands between you and your own destruction. I also realize that my choice of imagery does not exactly shout out “emotional health.” But the metaphor I used is the one which feels true.

I can sleep through the night. I can eat without having to consciously make myself swallow each bite. I can let people touch me. I can walk down a busy street without flinching. I can sit with my back to a window or door. I can sleep while people walk into my room, if I know in advance that they might. I can let people walk up behind me and not turn around. I do notice when people walk up behind me. I guess I kept a pocket knife.

This is not PTSD as defined by psychiatrists and as recorded by history. I no longer meet a single one of the criteria. By that standard, I don’t have that illness any more. What I have now, technically speaking, is a sub-clinical set of reflexes, attitudes, and sensitive areas that were shaped by the experience of having PTSD.

(By the way, it’s still totally fine to say, “Rachel has PTSD.” I’m not particularly attached to the DSM-IV criteria, nor to the concept of having it now vs. having had it in the past.)

To return to the crisis counseling, I’ve considered the possibility that I’m attracted to it because it offers me the chance or excuse to pick my weapons back up, so to speak. But I don’t want to automatically assume that my subconscious is trying to kill me. Sometimes it’s best to operate under the assumption that your instincts are sound. That nothing bad is happening right now. That you’re not in denial. That, however unlikely it may seem, you really are all right.

Any sort of crisis-related field draws people who have been shaped by trauma. Those fields also draw people who haven’t, but are there for other reasons. I know why I’m there – and that it’s fine that that’s why, but it doesn’t make me a better counselor, let alone a better or cooler or stronger or more compassionate person, than those other guys. It’s just the road I happened to drive in on.

Like my first set of posts, this one is intended solely to reflect my own experience, not anyone else’s. That being said, having gone through all of this, I’ve learned some things:

That trauma is influential, but doesn’t define us or our lives or our choices.

That trauma isn’t what makes us special or interesting or ourselves, though how we choose to deal with it may be one of the things that does.

That we all live with our own private battles and own private pain, even those of us who don't have horrific stories to tell.

That ongoing pain and struggle doesn't mean we're not leading quite happy lives anyway.

That we can get much, much better.

That it isn’t our fault if we haven’t yet.

That change is possible, always, at any time, regardless of what we’ve done or haven’t done or for how long.

That it isn’t hopeless unless we’re already dead.

And that, courtesy of one of our more entertaining training sessions, you’re not dead till the coroner says you’re dead.
rachelmanija: (Default)
( Feb. 16th, 2010 10:38 am)
Have gotten sucked in. Spent entire weekend watching first 4 discs of season 1. Am a little bit in love with entire male cast, except for Jason Gideon whom I enjoy watching but who sort of scares me with his resemblance to various men in mentoring positions I've known who got off a little too much on their own wisdom, compassion, and influence over others. Possibly that's just me projecting my own issues. Send help before I mainline the entire series and get no work done in the meantime!

This is the show about the FBI profiling team that catches serial killers via psychology, and the inspiration for "Shadow Unit." I can't help watching it with the Malcolm Gladwell article that says that profiling doesn't actually work in mind (and I am pretty sure that they see more serial killers in a month than the world really gets in a year), but as fiction, it's quite compelling. Note that it is about serial killers and so is extremely violent, disturbing, and gross. (But has no onscreen puking, so I find it much more watchable than Farscape.)

I saw an episode or two a while back and wasn't impressed. No one seemed to have any personality, and I have pretty much zero interest in serial killers. Then I idly started watching a marathon that was running on TV while doing way-overdue housecleaning, and noticed that actually, the detectives do have personality, it's just extremely underplayed. Underplayed in the way that makes you hang upon every brief insight into their psyches. One episode had an exchange which seemed to sum up the show's theme:

Hotch, the icy, controlled, literally and metaphorically buttoned-down team leader whom of course I adore, and look forward to him breaking down spectacularly, which I am sure will happen eventually (quote from memory): "Some abused kids grow up to be monsters. Some of us grow up to catch monsters."

So this a show about how people are shaped by trauma, respond to trauma, and are further chewed up and spit out by their job. The portrayal of PTSD and related issues is very good, for the most part, though I'd like to have some of the hypervigilance and other stuff be shown rather than told. (We hear that Gideon won't sit with his back to a door and avoids windows, but so far we haven't seen this in action.)

In other issues, the victims are given an unusual amount of autonomy (I mean by the writers) and character development, which I like. Considering that it's about serial killers, it's less trashily exploitative and sexist than one would expect, which isn't to say that it's not at all. And, while it can be a little PSA-like, the portrayal of mental illness is reasonably sensitive, again considering that this is a show about serial killers, some of whom are mentally ill.

Negatives: Only one major character of color (Morgan, one of the agents, unless Garcia's name is meant to signal that she's Latina.) Except for Garcia, I don't find the female characters as interesting as the men - JJ has so far had little of interest to do, and I'm failing to be intrigued by Elle, though that may be my problem. Gay people mostly don't exist. And the device by which episodes are bracketed by quotes utterly fails to work for me.

Something else which I don't think is a negative per se - it's part of the tone of the show - but which I think is a little unrealistic is the total lack of gallows humor. I guess it would come across as too insensitive, but seriously, in real life those guys would be breaking up on the plane now and then.

To return to the agents and their traumatic pasts, Reid has mentioned being a victim of bullying, and the way he spoke to the schizophrenic train guy did suggest some level of personal experience. The way Reid speaks reminds me of the way some people with Asperger's do, and his body language is a little odd. I think he has some kind of autism spectrum disorder.(I don't actually buy that he could ever get into the FBI in real life, but whatever.)

Because of the TV marathon, I already saw the episode about Morgan and the youth center. (On a side note, how heartbreaking was Reid's "He talks about me?") I think Elle has some kind of sexual trauma on her past. Gideon we already know has been traumatized on the job. I also wonder if his wife was murdered. Hotch I am very curious about. I had been thinking childhood abuse by his father, but he and his brother didn't speak of their father in a way that implied that. Abuse by someone else? Family habits of total denial?

Please don't spoil further developments, but if there's any spectacularly terrible episodes you think I should avoid, feel free to tell me so I can skip them.
We got word that General Westmoreland wanted us to "maximize" destruction of the enemy.

"What the fuck does that mean?" Peewee asked. "We get a Cong, we supposed to kill his ass twice?"

This is one of the best Vietnam War novels I've ever read, and I've read quite a few of them.

It follows the usual structure of a novel from the point of view of an American soldier: the arrival of a naive kid who has no idea what he's in for, his brutal baptism of fire, his bonding with his fellow soldiers, his realization of the absurdity of military rules in a situation where logic doesn't seem to apply; disillusionment, misery, PTSD, questioning of what the war is about and whether killing other scared kids is right; black humor, grief, violence, terror; concluding in either death or a homecoming that, whether it's actually depicted in the novel or not, the reader knows is just the beginning of yet another long and harrowing journey.

Myers' novel fits that structure to a T. What makes it special is that it's just so well done: the black humor is actually funny, the characters are vivid, the atmosphere makes you feel like you're there, the philosophical and moral dilemmas are real and complex. Myers particularly excels at making combat suspenseful without making it seem glamorous. He captures the boredom of the troops without boring the readers by depicting them doing all sorts of ridiculous things, like watching a movie with the reels mixed up, in a desperate effort to kill time.

The dialogue is especially great. I kept marking pages with bits I wanted to quote, then moving the marker to the next page, and the next. Highly recommended.

The book's dedication: To my brother, Thomas Wayne "Sonny" Myers, whose dream of adding beauty to this world through his humanity and his art ended in Vietnam on May 7, 1968.

Click here to buy the paperback from Amazon: Fallen Angels
This is Part III of a three-part essay on Post-Traumatic Stress Disorder: understanding it, having it, writing it.

Part I: What I Did In The War. (Introduction; background; what happens during trauma; what happened to me.)

Part II: What Does A Flashback Feel Like? (My history with PTSD, what it felt like to me, and dealing with other people who have it.)

Part III: I Don't Have To Do That Any More. (On recovery; lingering effects; book, film, and TV recommendations.)

ETA: Several years later, I added Part IV: Postscript.

After all that, I have never been either formally diagnosed with or treated for PTSD.

Unusual Circumstances May Cause Unusual Problems )

Recovery: Traditional Methods )

Recovery: Non-traditional Methods )

Don't fall in love with your own beautiful suffering. )

Recommended Media: Nonfiction )

Recommended Media: Fiction, TV, and Movies )

I hope this was helpful, useful, or enlightening. It was hard to write, and not just because of its extreme length. Some of it was stuff I've never told anybody before. There was even a point when I considered not posting it at all.

I was tremendously pleased and flattered when so many of you, when nominating the anime character I most resemble, thought that sanity and stability were among my most notable traits. I briefly had the woeful thought that after writing a three-part essay detailing my suicide attempts and blackouts and flashbacks and sleeping with a weapon in my hand and so forth, if I ever asked that question again, you would all say, "You are crazy suicidal teenage terrorist Heero Yuy from Gundam Wing!"

On the other hand, most of that craziness is in the past. Regarding what remains, I believe that while I may have more total crazy than the average person, I am also much better than average at dealing with and controlling it. Not to mention the advantage I gain from not pretending that I have no crazy. In equation form:

More crazy + more anti-crazy skills - denial = less insanity.

Less crazy + fewer anti-crazy skills + denial = more insanity.

Or so I hope. Actually, so I believe, considering that the total amount of time I spent considering not posting this was approximately thirty seconds. Surely Heero would have deleted the entire series without posting, in the unlikely event that he had the self-awareness to compose it in the first place.

As always, please feel free to link, ask questions, comment, share your own experiences, correct my science and statistics, or recommend media on the subject. And anyone is always free to friend this LJ. (Though I mostly write about manga, anime, and books, not mental health issues.)

ETA: I do still read and am grateful to receive comments on these posts, even many years later. I can't guarantee to respond to every one because it can be a bit overwhelming, but I do read them.
This is Part II of a three-part essay on Post-Traumatic Stress Disorder: understanding it, having it, writing it.

Part I: What I Did In The War. (Introduction; background; what happens during trauma; what happened to me.)

Part II: What Does A Flashback Feel Like? (My history with PTSD, what it felt like to me, and dealing with other people who have it.)

I Don't Have To Do This Any More. (On recovery; lingering effects; book, film, TV, and music recommendations.)

ETA: Several years later, I added Part IV: Postscript.

It is generally a bad sign when you lose six months of your life. )

You don't have to eat the eggplant. )

If you have PTSD, odds are good that it is not your only problem. )

Attempting suicide via sleep-deprivation will make you even crazier than you were when you got the crazy idea to try it. )

What does a flashback feel like? )

Don't go to sleep with a gun in your hand. )

NEVER EVER hug a stranger from behind. )

Or shake a sleeping soldier. )

At this point, you may be wondering how in the world I was managing to lead anything remotely resembling a normal life. Writing this essay, I wonder the same thing. And yet I did get an undergraduate degree, then a graduate degree, have friends, and hold various jobs, all of which I managed to perform with at least some degree of competency.

But, remember that I didn't have all the symptoms all at once. They come and go. I wasn't diving under desks 24-7, just if my level of overall stress, my level of symptomaticness (is that a word?), and outside triggers combined to produce a visible reaction. And even then, a lot of what was going on was not visible to others, because I was highly invested in and skilled at putting up a front of normalcy.

It’s absolutely possible to be completely disabled by PTSD, but it’s also possible to have fairly severe symptoms and still hold down a job and seem more-or-less normal to a cursory inspection. This will be affected by a lot of factors, such as how much money you have and so how much it will affect your life overall if you forget to pay a bill or miss a few days of work, whether you hold a job which requires a lot of concentration and skill to achieve even minimal competency (like brain surgery) or one with more room for error, how invested you are in keeping up appearances, whether and so forth. This is similar to depression, anorexia, or alcoholism: some people hit bottom fairly quickly, and some people never really do.

In literary terms, I’d be surprised if a person’s work life is entirely unaffected, but I’d buy that they could continue working with reasonable or even excellent competence. However, some area of their life is bound to be falling apart, because that’s the nature of the beast. Typically even if your work isn’t much affected, your social, love, or creative life is. Or any variant on that.

Feel free to link, ask questions, comment, share your own experiences, correct my science and statistics, or recommend media on the subject. Also, anyone is always welcome to friend this LJ.

ETA: I do still read and am grateful to receive comments on these posts, even many years later. I can't guarantee to respond to every one because it can be a bit overwhelming, but I do read them.
This is Part I of a three-part essay on post-traumatic stress disorder: understanding it, having it, writing it.

Part I: What I Did In The War. (Introduction; background; what happens during trauma; what happened to me.)

Part II: What Does A Flashback Feel Like? (My history with PTSD, and what it felt like to me.)

Part III: I Don't Have To Do This Any More. (On recovery; lingering effects; book, film, TV, and music recommendations.)

ETA: Several years later, I added Part IV: Postscript.

You probably all know what PTSD is, in general terms: a mental illness resulting from trauma, often occurring in combat veterans but not limited to them, best-known for causing flashbacks, nightmares, and acute anxiety states. But people who have it often don't realize what's going on or don't seek help, and much of the fiction which deals with it reads as if the authors referred to a checklist of symptoms rather than finding sources from the point of view of someone who actually has it.

That would be my point of view.

Have you ever wondered what it feels like to have a flashback? I can tell you. (It does not typically involve acting out the entire trauma in real time, complete with dialogue and screaming. Vomiting is also not essential, nor even, as far as I know, likely.)

Also, the method I used to recover, more or less, and one of the issues I'm dealing with now, are both things which I have literally never seen addressed anywhere. I shall be very curious to hear if anyone else has had similar experiences.

I'm not a psychologist, and so can only speak from my own idiosyncratic perspective, plus a bit of research and discussion. But if you’re writing a story about someone who has cancer or know someone who does, it’s fine to look up cancer on Wikipedia, but you’ll learn more by going on to talk to a person who’s doing chemotherapy right now. And if you've ever done any interviewing, you know that the shortest route to an interesting response is "What did it feel like?" So I will tell you how it feels: how it feels to me.

Keeping that in mind, I mean this as a public service announcement— if nothing else, I hope that it will improve the depiction of PTSD in fiction, fan- and otherwise, for my own reading enjoyment, and reduce the incidence of gratuitous vomiting— so feel free to link far and wide.

Here's the DSM-IV criteria for PTSD. The DSM-IV is the American manual on diagnosing mental illness. I don’t think it's the be-all and end-all of existence, but it’s more familiar to me than other countries’ criteria, so that's what I'm using.

You don't have to have been in a war. )

Two people, same trauma; why only one case of PTSD? )

How I got into this mess-- skip to the next cut if you've read my book, know me well, or have been on my friends list for a while. )

What I did at the time, and some theory on how that relates to what happened later. )

This is trauma: You are walking along the path you always take, when suddenly the ground cracks under your feet like rotten ice, and you fall. You're shocked and terrified and you think you're going to die. Then you slam into the bottom. Maybe you break some bones, maybe you're just shook up and bruised.

This is normal recovery: You climb out of the pit. You go to a hospital. Depending on the extent of your injuries, recovery may be long or short, but after some length of time, the casts come off and you get on with your life. Maybe you're a little more cautious about where you put your feet, but it doesn't interfere with your life.

This is PTSD: You break bones at the bottom of the pit. You move to get out, and the bottom of the pit crumbles just like the path did, and you're falling again, stuck in that same moment of terror and shock and pain. And you keep on falling, and you will fall forever unless you grab a rope.

Grab that rope.

Feel free to ask questions, comment, share your own experiences, correct my science and statistics, or recommend media on the subject.

I am a fan and I read and write fic, so I will not feel in the least that you are being voyeuristic or trivializing if you want to ask me a question about how to make your Spooks/MI-5 or Magneto/Professor X or 3x4 story more realistic. In fact, I would probably request that you send me the link when you're done.

ETA: I do still read and am grateful to receive comments on these posts, even many years later. I can't guarantee to respond to every one because it can be a bit overwhelming, but I do read them.


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