I absolutely love writing trauma in fiction. It’s been an intense interest of mine since I majored in psychology in college, taking several classes on the effects of trauma in various stages of life. Traumatized characters are often some of the most complex, and trauma narratives can be incredibly rich stories and evoke deep emotion in the reader. When writing a story of trauma, especially if you haven’t dealt with traumatic experiences yourself, it’s crucial to do research and make sure your portrayal of trauma is realistic (and not contrived or gratuitous). If you’re close to somebody with trauma in their past and they’re comfortable discussing their experiences, it can be really helpful to discuss the effects of trauma with those who have lived experience. PTSD and general trauma response are very complex sets of behavior, feelings, and reactions to the world. Here’s some advice on navigating those complexities—
There are several types of trauma, and the effects of trauma really vary.
Trauma can take many forms and cause a variety of symptoms, which also vary widely in severity. Generally trauma is caused by being in a situation in which you experience or witness potential or actual death / severe injury. While trauma responses are as diverse as the people affected by trauma, there are two broad categories of traumatic experience––complex post-traumatic stress, and what is often referred to as “uncomplicated PTSD” (even though it’s totally complicated from an emotional standpoint). To simplify it, complex PTSD results from repeated trauma, such as abuse continuing throughout childhood. Uncomplicated PTSD is typically the result of a singular event, such as an accident or one-time assault. As far as symptoms, the difference between the two types is mostly a matter of severity. Complex PTSD includes the symptoms of uncomplicated PTSD, but they’re frequently more severe and take longer to treat. Both types have many possible symptoms which may or may not impact those struggling to overcome past trauma.
PTSD symptoms are usually grouped into four categories––changes in emotion and physical reactions, changes in cognition, avoidant behavior, and intrusive memories. These categories often overlap. Because human beings are immensely complex (fun fact: many scientists believe that the brain is the most complex object in the known universe), individual reactions to trauma may be entirely unique…but most symptoms do still fall under one of these four categories.
Avoidant symptoms stem from an inability to face trauma. Many people suffering from PTSD will avoid reminders of the trauma, but avoidance can go beyond this. Trying to stay extremely busy, or substance use can also be symptoms.
Intrusive thoughts of the trauma may be a problem to the point where they heavily impede the individual in their day to day life, from career to relationships. Re-experiencing the trauma can happen in the form of dreams, and emotional and physical reactions to triggers, which may include full flashbacks to the event.
On a related note, people with PTSD often struggle with hypervigilance. They may have an exaggerated startle response, paranoia, and be ultra sensitive to sensory information as a means of protection, because the threat of trauma can still feel very real. Hypervigilance and related symptoms are just a few of many, many emotional and physical reactions to trauma. Other symptoms may include trouble sleeping, lack of focus, decreased appetite, extreme negative emotions (guilt and anger are very common), and emotional numbness, in extreme cases total dissociation as a means of self-protection. Cognitive symptoms are difficult to separate from emotional and behavioral effects of PTSD, but they tend to relate to the individual’s worldview, interests, and low self-esteem. PTSD may also cause serious relationship problems, although this is more common with complex PTSD.
PTSD and trauma responses are not necessarily one and the same.
PTSD is a very specific mental illness resulting from trauma, with particular symptoms that not everybody who goes through something traumatic will experience. Trauma response refers to a much wider range of behaviors and emotions. Many cases of trauma, particularly more minor, uncomplicated trauma like a car accident in which only minor injuries are sustained, may resolve in the months following the event. Acute stress after trauma is one thing, and PTSD is another. PTSD occurs when extreme negative experiences overwhelm the brain’s ability to cope (trauma can actually change brain chemistry). When writing a character who has experienced trauma, consider whether their trauma is a significant problem they must overcome or something less central and severe. If your character does have PTSD, know that it’s the kind of thing that very heavily impacts a person’s life. And if you are writing a character who has experienced extreme complex trauma, realistically it’s likely they would struggle with some degree of PTSD.
People will frequently have trouble talking about their trauma, especially to people they don’t know well.
After a traumatic event, many people will become withdrawn and struggle to speak freely about their most painful experiences. This is not always the case––sometimes people find talking about their experiences incredibly therapeutic. I know people who will talk lightly, even joking about their trauma, although the more severe the trauma the less likely this is. People deal with terrible things in all different ways. But in my experience, many who have experienced a traumatic event are hesitant to talk about it and will only do so in a particular environment, to people they fully trust (and building trust takes a long time). If your character is struggling to cope in the aftermath of trauma, they may find themselves literally unable to talk about their experience, either freezing up completely or becoming very emotional when they attempt to discuss the event(s). Others only feel comfortable expressing their feelings in writing or other art forms. Trauma victims may feel nobody can understand them, and some may even have trouble remembering details of the trauma. These are the kind of things that can add realism to your story and provide character development.
Triggers. Most people who have been through something traumatic have them.
And triggers can literally be ANYTHING. I know someone who for many years was triggered by green beans, after being forced to eat them during treatment for an eating disorder. Writing a traumatized character’s triggers into the story can be great for character development, and increase the emotional impact of the story. They can be a good way to introduce elements of the character’s past, or as a kind of foreshadowing before the character’s full backstory is revealed. Many, many effects of trauma are not directly related to the event, but to formerly nontraumatic things that the individual now associates with the trauma.
PTSD can really affect relationships.
PTSD, especially complex PTSD, can and often does negatively impact relationships. In some cases it may not, and may even bring people closer, particularly if they’ve experienced trauma together. But it’s certainly not rare that PTSD or even a relatively healthy trauma response would cause problems with family and friends, and especially with romantic partners and professional relationships. It’s kind of a given––PTSD can cause someone to withdraw from others, and be incredibly moody (angry outbursts are very common). As much as the individual’s loved ones may want to be supportive, it can become difficult. If trauma plays a significant role in your story, it would be very realistic for the lingering effects of the experience to cause issues related to how your character interacts with the people in their life.
PTSD is frustrating in addition to being extremely painful.
More often than not, people who suffer from PTSD have some degree of self-awareness and are grounded in reality, so they usually know the threat is gone and that their behavior is unhealthy. But, as is the case with most mental health problems, that doesn’t make it any easier to overcome. Moving beyond trauma is a complex process that can take years, even a lifetime. I’ve heard testimony from Holocaust survivors who are still intensely affected every single day but their experiences, almost eighty years later. In the most severe cases of trauma, usually healing is a matter of making PTSD manageable rather than “curing it”. In short, depending on your character’s individual experience and temperament, it may be unrealistic to have them completely overcome what they’ve been through by the end of the story, and realistically this will be very frustrating to them. PTSD involves many conflicting emotions, and maladaptive knee-jerk reactions that can be nearly impossible to stop. Good fictional example––Doctor Owen Hunt from Grey’s Anatomy (favorite ginger of all time). After incredibly traumatic wartime experiences, he struggles to maintain relationships and at times completely dissociates. He improves over time but never fully recovers. And at many points, he’s angry at himself for his behavior. This is far more accurate than a character with severe trauma completely healing once they find their true love, so just be careful of how easily your character overcomes what they’ve been through.
People who have been through something traumatic often feel a need for control, because control was taken from them.
Again, not something everyone with PTSD experiences, but after experiencing something traumatic that was completely out of their control, it would make sense for your character to become bossy, particular, or generally focused on managing situations and people. Particularly when trauma was inflicted by an individual, the helplessness and anger a trauma victim might feel can result in a strong desire to take charge of all things that may affect their life. How does this look in fiction? You might have your character become very upset when things do not go according to plan, or get angry at those who do not follow their directions. Sometimes this need for control is limited to self-control, which can lead to significant anxiety and problems like eating disorders.
Trauma can lead to many negative outcomes later in life, but there are also protective factors that lessen the impact of trauma.
Protective factors are extremely significant in short and long-term outcomes of PTSD. Your character will fare much better in the wake of trauma if they have a strong support network, a stable identity, spirituality, and can find some kind of positive meaning in the trauma (ie. it made them stronger). High socioeconomic status and intelligence also improve outcomes. When writing fictional trauma narratives, keep in mind these protective factors when deciding how your character(s) will cope with their experiences.
Dissociation is common, especially with severe / complex trauma.
Dissociation is particularly associated with complex PTSD, and can vary in presentation and severity. For those who don’t know, dissociation is defined (by the Mayo Clinic) as “disconnection and lack of continuity between thoughts, memories, surroundings, actions, and identity.” Minor dissociation may be as simple as a feeling of disconnection and apathy with regards to life and personal identity. In severe cases, there may be psychosis (a clinically defined break with reality), to the point where the individual may completely lose their sense of self and be unable to function in the world. Very rarely, trauma victims may develop multiple personalities. Even short of this level of psychosis, it would be very realistic for a traumatized character to have symptoms such as unhealthy absorption in a fantasy world as a means of coping, lessened sensitivity to physical and emotional pain, memory loss, or distorted sense of time.
Think of things a character may do to feel better when they’re struggling to cope.
As far as coping, trauma survivors may deal with and treat their PTSD / trauma symptoms in a variety of ways. Some are healthy, some are not. Things like yoga, grounding techniques (Google it…there are so many), hobbies, therapy, exercise, and expression of feelings through creative work can be helpful. Those are all healthy means of coping. Depending on what your character’s personal story arc is, they may have unhealthy means of coping, like substance abuse, excessive spending, binge eating, or self-harm. When writing fictional trauma, it’s important to determine how the aftermath of trauma is going to look for your character. This is as central to the story as depiction of PTSD symptoms––coping mechanisms are how your character will either move forward or fail to overcome their trauma. Specific coping mechanisms can also provide great character development as far as personal traits and interests.
Final note (advice I give in almost every post on writing topics you aren’t an expert on)—look to primary sources for help and inspiration when depicting trauma in fiction. Read / watch real-life trauma narratives in order to better understand the various behaviors, feelings, and thought patterns that result from traumatic experiences. You should be developing your character’s reaction to trauma based on who they are, rather than creating a character solely based on reactions to trauma.