First of all, thank you for your incredible work. I am in awe of this blog and the time you must put into it. I have a question about the aftermath of torture. I am writing a story about a character who was tortured by the secret police and then sent to a labour camp for several years. During that time, he has been tortured on a number of occasions, mainly as a form of punishment. Even day to day, it is a very unhealthy place 1/3
(restrictive food rations, washing facilities treated as a luxury rather than a necessity, poor access to health-care etc.) In the story, my character has just been released, and he is both physically and mentally unwell. My question is about the onset of posttraumatic symptoms. My understanding is that some posttraumatic symptoms are initially adaptive. 2/3For instance, being on edge and thinking people might be about to kill you is an understandable, even helpful thing to feel on a battlefield. However when you are not in that environment and that still sticks, it becomes maladaptive. How would the way you deal with trauma of past torture differ if you are somewhere unsafe like a labour camp as opposed of somewhere safe (e.g. with family)? Might new symptoms start appearing after release? ¾ (previously 3 - messed up my count) Might new symptoms start appearing after release? Might they change how they present? My MC’s trauma is going to be new to his family who have not seen him since before his arrest, but to what extent might them be new to *him* too? Thank you! 4/4
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That’s an interesting question. Keep in mind that I’m not a mental health professional so my answer is based on a combination of survivor accounts, personal experience with mental health issues and what mental health professionals say about survivors.
I don’t tend to think of symptoms as being adaptive while I’m writing but that’s very much bound up in how I tend to approach writing symptoms. If thinking about symptoms as adaptive and becoming maladaptive helps you then by all means use that approach. I think you can make that argument for most of the common torture symptoms.
I’m not sure if it’s accurate to say that new symptoms appear after release, I think it might be more accurate to say new symptoms are discovered after release.
What I mean by that is that symptoms don’t suddenly pop up out of nowhere, but they might suddenly become more apparent or consciously recognised as conditions.
For instance- a lot of forced labour camps use dogs as guard animals and occasionally weapons. Within the camp it just makes sense to avoid the dogs. But back out in the world the character might suddenly become aware that dogs make him feel anxious, that barking causing panic attacks. And that would be a lot more difficult to deal with in a culture where dogs are companion animals that can be encountered virtually anywhere at virtually any time.
He might also discover aspects of his symptoms that he just didn’t have a chance to notice existed before.
For example depression often causes problems around food. It’s very common for people with depression to feel nausea and have difficulty eating. It’s also very common for people to over eat and make themselves feel sick.
In a highly regimented environment where food is strictly controlled your character may not have experienced that particular aspect of depression. Which means any depression-related issues around food could take him completely by surprise.
It’s also very possible for presentation of symptoms to change with time and with environment.
If I keep using depression as an example; let’s say the character and his family recognise that his problems are probably depression and he goes for treatment quite quickly. Let’s say he gets a prescription and he’s one of the lucky people who finds an effective medication first time. As the depressive symptoms ease he might expect life to get easier- only to find that now he’s not in deep depression most of the time other symptoms become more apparent and seem more severe.
I say ‘seem more severe’ because I’m not actually sure if symptoms really become worse in these scenarios or if they just seem worse because the survivor doesn’t have as many coping strategies for these other symptoms.
I guess what I’m driving at here is that yes I think a lot of these symptoms and behaviours could be (or at least feel) new to the character. But they don’t necessarily have to be new to the readers.
Establishing some of these behaviours and thought patterns beforehand or just hinting at them is perfectly realistic and can be a good narrative choice.
I get the impression that any huge change, especially if it’s unexpected, can have a negative impact on mental health. I’m saying this because I think it’s worth stressing that going from one safe environment to another safe environment would have a negative effect on most mentally ill people.
Suddenly being in control of his routine, the type and amount of food he can eat, access to hygiene facilities; all of that is a positive change but it would also be a stressful one. A lot of survivors from this kind of forced labour scenario seem to struggle with that sudden shift from having no real control of their lives to being in control of everything again.
The impression I get is that at first it’s good, it’s a relief. But after a while it can become a source of stress, especially if the character’s symptoms involve memory problems.
For instance perhaps he finds he likes spending a long time in the shower now. A lot of people find hot water soothing and it would be perfectly normal for him to indulge in something that was denied him.
But if it becomes something that he turns to often then it could easily go past the point of soothing or indulgence and start having a negative impact on his life.
‘Why were you later for this appointment?’ ‘Well I was having a shower’ That lasted two hours. Why’s the water bill so high? Why’s his skin red and flaky?
And then the behaviour starts becoming stressful, perhaps even a guilty cycle.
Learning to establish a routine of his own again could be quite difficult. Especially if his family have little experience with mental health problems.
Because it’s hard to tell when it’s ‘right’ to let someone have a lie in (he’s been through so much, let him rest) and when it’s an extension of depressive behaviour driving him to withdraw.
The presentation of symptoms can change a lot with such a sudden and extreme environmental change. The reasons behind the changes can be hard to pin down and there is quite a bit of variety.
I think the only thing I’d caution against is having a main established symptom vanish completely and replacing it with completely new, unestablished symptoms.
Partly because I’ve never seen that described by a survivor, but also partly because I think it wouldn’t work in a story. Readers need to be able to see at least a little of where these symptoms come from and how they change. Otherwise it can seem like it’s come out of nowhere.
Wrapping this up the ask reminded me a lot of Levi’s The Periodic Table. It’s a series of short stories covering incidents before, during and after his incarceration during the Holocaust. It’s been a long time since I read it and I’m not sure if it would be helpful to you. It might be though.
Generally, it sounds like you’ve thought about this scenario and the character a lot. I’m confident that you’ll be able to establish the symptoms you pick and the ways those symptoms change.
Writing this sort of long term recovery is a challenge, in part because there often isn’t a pre-defined end point. But it sounds like you are putting in the work and care a lot about how this story comes out.
And that’s more then half the battle. :)
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