We've talked generally about trauma, specific types of trauma, and factors that make events more likely to result in PTSD symptoms. Today we'll focus on individual factors that make a person more vulnerable to PTSD. If you're writing a character who's going to develop PTSD (or not), you'll want to think about some of these things!
Vulnerable people are vulnerable. As you might have guessed, individuals with pre-existing depression or anxiety or more likely to develop PTSD after a trauma.
Age matters. We now know that the most vulnerable period for trauma is birth to three years of age. THIS IS NOT BECAUSE OF MEMORIES. I'm not going to get into a debate about childhood amnesia here because it's a huge topic, but memories of trauma don't appear to be the relevant thing when it comes to early trauma. Instead, it's about our developing brains, and whether they're geared for survival or learning. And because of the nature of trauma in this population (usually the result of abuse or neglect), it can affect our synaptic connections and how our DNA is expressed (called epigenetic effects).
Here's an interesting and tricky thing about trauma in childhood/adolescence--often, the person sort of freezes in that place in terms of their emotional development, as the brain switches from a focus on learning/growth into survival mode. The person might be quite intellectually capable and typical, but in terms of understanding the self in relation to others, and with respect to processing emotional experience and regulating strong emotions, it's a completely different story. This is a crucial consideration in treatment, and it should be on the mind of anyone writing a character who experienced trauma in childhood.
Trauma is cumulative. If a person has experienced a trauma in the past (and particularly if they've experienced lingering symptoms as a result), they are more vulnerable to developing PTSD if they endure another traumatic event. For example, soldiers are more likely to develop PTSD after deployment if they've experienced a childhood trauma when compared to fellow soldiers with no trauma history.
Social support is CRUCIAL. There's actually a window of about 72 hours after trauma where providing social support to someone can reduce the likelihood that s/he will develop PTSD. A few interventions have been developed that do exactly that. But it's not just immediately post-trauma--imagine a girl disclosing to her parents that she's been raped. How her parents respond to that disclosure REALLY matters. There's some research that suggests that if social supports respond with anger--even toward the perpetrator--it might actually make things worse, because it confirms how damaging the event was, and the girl then has to process her parents' intense and dysregulated emotions on top of her own. So--how many people know about the trauma, and how they react, is really going to have an impact on how a character deals with what happened.
Disruption makes it worse. This is actually a good way to think about the effects of lots of trauma--how disruptive is it to the person's life? Think about it--does the character get to go home and recover, or is home even there anymore? Can the character turn to a loved one, or is that person injured or dead or ... the perpetrator of the trauma? Does the character get to walk away on two legs, or is one of them gone? Does she get to go back to her school and her friends, or has she been placed with a foster family in a different school district? The more disrupted a person's life, the harder it is to recover from trauma.
Thoughts can be sneaky little buggers. It's not unusual for a trauma survivor to have some thoughts and feelings of guilt and shame. She might feel guilty for some small decision that put her or a loved one in the wrong place at the wrong time. He might blame himself for being in the situation in the first place. He might blame himself for not being stronger. She might feel ashamed and fear how people will think of her. Unfortunately, these enemies reside in our minds, where they fester like wounds if not challenged or treated.
If you'd like, tell us about your character, and why this person is going to be resilient in the face of trauma--or terribly vulnerable. Or, how about you analyze an example? Think of Katniss from The Hunger Games. Which of these factors was relevant to how she responded to what she goes through in that series?
I'll be back on Wednesday of next week, where the focus will be on developmental trauma. I'll do that by discussing Nobody But Us, a riveting and powerful book by Kristin Halbrook featuring a character who exemplifies someone who's experienced this type of trauma. Next Friday, Kristin herself will discuss how she researched the characters so she could write an accurate portrayal, and I hope you'll stop by and check it out, because I am telling you--she did it right. I'll be giving away a copy of Nobody But Us next week as well!