Post-Traumatic Stress Disorder

The pain of the world will sear and break our hearts because we can no longer keep them closed. We've seen too much now. To some degree or other, we have surrendered into service and are willing to pay the price of compassion.

But with it comes the joy of a single, caring act. With it comes the honor of participating in a generous process in which one rises each day and does what one can. With it comes the simple, singular grace of being an instrument of Love, in whatever form, to whatever end.
--Ram Dass

Post-traumatic Stress Disorder (PTSD) is a response to a situation in which an individual experiences personal trauma (serious or even life-threatening injury) or witnesses such an event occurring to someone else. PTSD is diagnosed when the symptoms of emotional chaos last for more than a month. In soldiers, PTSD has been called "shell-shock" or "battle fatigue," but combat is not the only situation in which people experience traumatic situations, hence the broader term. In PTSD, the individual feels intensely fearful, hopeless and powerless to change the course of traumatic events. Events that might trigger PTSD include natural disasters (e.g., earthquake, hurricane, flood), man-made disasters (e.g., war, bombing, vehicle crashes), or deplorable acts by an individual (e.g., torture, hijacking, bullying). PTSD may happen after a single disastrous event or in response to an intolerable, ongoing situation (e.g. war, torture, child abuse). Some individuals experience few or no symptoms, some may begin experiencing symptoms several years later. Most people, however, develop symptoms within three months of the traumatic experience.

Symptoms vary widely among individuals, as people handle difficult situations differently. Frequently, the individual re-experiences the traumatic event through nightmares, flashbacks and hallucinations. Symptoms may also include hypervigilance (always alert), insomnia or other sleep problems, restlessness, irritability and aggressiveness. It is as if the individual is constantly on the alert to prevent the trauma from recurring, or even to change the previous occurrence if it were possible. At other times or in other cases, a pattern of "learned helplessness" may be evident: the individual is powerless to change the traumatic experience and responds by withdrawing emotionally. The person is unable to enjoy activities he used to like and may become indecisive (whether because of not caring or feeling powerless to effect an outcome of his decisions). Depression, sometimes with suicidal tendencies, is a frequent companion. Secondary symptoms, such as alcohol or drug abuse, whether as self-medication or as a form of self-abuse are also common. Deep guilt and even shame for not having been somehow able to prevent the experience or deal with the consequences may occur.

There is hope, though. PTSD can be effectively treated and individuals can live a normal life. A strong support structure of family, friends, and community who can help the individual come to terms with the event(s) in a psychologically safe environment and also to realize that he or she is not to blame for the traumatic event is important for successful recovery.

These films are all emotionally charged, as should be expected since the disorder results from a shock to the emotional and psychological centers of an individual. The person's feelings of hopelessness and uncertainty may be represented in the movie by darkness, shadows or haziness. Individuals may feel confined by circumstances, as represented by tunnels (horse in The Horse Whisperer, Max's drawings in Fearless) or even constricted breathing (Carla, Max in Fearless). After such darkness, it is natural to look for the light, whether at the end of the tunnel (drawings in Fearless) or with the coming of the dawn (Megs' talk of the sunrises in 'Nam, also pre-dawn fishing trip in Jacknife). At other times, the way out of the tunnel lies in surrounding one's self in natural or wide open spaces (Montana countryside in The Horse Whisperer, trout fishing spot in Jacknife). See what other examples of darkness and light, or what other metaphors for emotional pain and relief you can find in these films.

Questions to consider while viewing:

• What traumatic event triggered the character's PTSD? Did the character experience the event personally or was he a witness to an event happening to someone else? Was the situation acute (single disastrous event) or chronic (ongoing traumatic experience)? Was the individual directly responsible for the event?
• In what ways did the character re-experience the traumatic event -- e.g., nightmares, flashbacks? What other symptoms did the character exhibit? Were there secondary symptoms such as drug or alcohol abuse? If more than one character in the film experienced the same event, did they respond in the same way?
• Did the character(s) have a support system -- family, friends, community -- to help him or her deal with the experience? If so, who or what was it? In what ways did these help?
• Did the character recover or have hope of future recovery by the end of the film?
• If you or someone you knew had a traumatic experience, what support structure and resources would you draw upon? How would you re-establish a regular routine? How would you re-establish control of your life?
• If you watched two or more of these films, compare and contrast the PTSD characters' traumatic experiences, how they each responded to it and how they approached recovery.

• David Baldwin's Trauma Information Pages
• PTSD.com - Post Traumatic Stress Disorder Resources