How PTSD Is Depicted In Literature

At the first mention of Post-Traumatic-Stress Disorder (PTSD), it is common to jump to the association with war veterans, or thinking of the phrase “shell shock”. This is not incorrect, as PTSD was first recognized with relation to war veterans, and this is how the literature most frequently describes it. However, the disorder is applicable to much more than only war veterans, although this is often not as widely recognized, but still equally as valid.

PTSD in Healthcare Workers

The COVID-19 pandemic is a known cause of PTSD, especially in health workers. An article entitled Post-Traumatic Stress Symptoms in Healthcare Workers Dealing with the COVID-19 Pandemic: A Systematic Review explores this, the following passage is taken from this report:

“During the current COVID-19 pandemic, HCWs face unprecedented scenarios often outside their ordinary levels of experience and training, as they are at the forefront of the fight against the virus worldwide. This critical    situation increases HCWs’ risk of suffering from symptoms ranging from    psychological distress to psychiatric disorders, as a result of the effort to    continuously fight with several COVID-related unfavorable conditions”

As a very much relevant situation to many over the course of the pandemic, the onset of PTSD in healthcare workers during this pandemic is a perfect example of how PTSD is not only limited to war veterans, although it is undeniable that healthcare workers have been the heroes throughout this pandemic. The research into PTSD in healthcare workers can act as reassurance towards other sufferers of PTSD or in the recovery of their own trauma, that war veterans are not the only sufferers. 

Symptoms of PTSD

One of the most common symptoms of PTSD is re-experiencing. This could be through - flashbacks, nightmares, repetitive and distressing images or sensations, as well as physical sensations such as pain, sweating, feeling sick, and trembling. 

These symptoms can be exceptionally frightening to experience, distressing and traumatic. Sometimes, these symptoms are coupled with negative thoughts about the traumatic event.

One example of this could be questioning the validity of the memory, wondering if it was a “real” trauma, and asking oneself if they could have done anything to make the situation better or less traumatic, sometimes even blaming themselves entirely for their experience.

Of course, though, it was a real trauma, because they suffer deemed it so. If they see it as a trauma, then it is classed as a trauma, because it was their own experience and was unique to only them, even if others were present at the time. 

PTSD in Literature: War Poetry

Within the literature, PTSD is often referenced again with regards to war veterans, perhaps understandably so, because this is where the disorder was first referenced. One example of this is the poem entitled Dulce et Decorum Est, by Wilfred Owen: a soldier fighting in WW1 and a known sufferer of PTSD, labeled “shell-shock” when he was hospitalized in 1917 (2) due to the condition:

Dulce et Decorum Est 

Bent double, like old beggars under sacks,

Knock-kneed, coughing like hags, we cursed through sludge,

Till on the haunting flares, we turned our backs,

And towards our distant rest began to trudge.

Men marched asleep. Many had lost their boots,

But limped on, blood-shod. All went lame; all blind;

Drunk with fatigue; deaf even to the hoots

Of gas-shells dropping softly behind.

Gas! GAS! Quick, boys!—An ecstasy of fumbling

Fitting the clumsy helmets just in time,

But someone still was yelling out and stumbling

And flound’ring like a man in fire or lime.—

Dim through the misty panes and thick green light,

As under a green sea, I saw him drowning.

In all my dreams before my helpless sight,

He plunges at me, guttering, choking, drowning.

If in some smothering dreams, you too could pace

Behind the wagon that we flung him in,

And watch the white eyes writhing in his face,

His hanging face, like a devil’s sick of sin;

If you could hear, at every jolt, the blood

Come gargling from the froth-corrupted lungs,

Obscene as cancer, bitter as the cud

Of vile, incurable sores on innocent tongues,—

My friend, you would not tell with such high zest

To children ardent for some desperate glory,

The old Lie: Dulce et decorum est

Pro patria mori (3)

This poem is full of references to PTSD, some perhaps more obvious than others. This in itself could be a reference to the condition, because some do not make it known to others that they are suffering, or they give off exceptionally subtle hints rather than explicitly stating it. 

The vivid description of the events in the poem indicates the speaker is re-experiencing the events that occurred. For instance, the phrase “Gas! GAS! Quick, boys!” taken as a direct quote from orders he received shows the vividity of the memory, and the second “GAS!” being in capital letters suggests that this was spoken louder than the first.

These minute details do not disappear from the memory of PTSD sufferers, and this poem is representative of how strong and overpowering these traumatic experiences can be, especially once the condition develops. 

Another poem, also by Owen, entitled Exposure similarly depicts PTSD symptoms. The poem reads as follows:

Exposure

Our brains ache, in the merciless iced east winds that knive us . . . 

Wearied we keep awake because the night is silent . . .

Low drooping flares confuse our memory of the salient . . .

Worried by silence, sentries whisper, curious, nervous,

But nothing happens. 

Watching, we hear the mad gusts tugging on the wire,

Like twitching agonies of men among its brambles.

Northward, incessantly, the flickering gunnery rumbles,

Far off, like a dull rumour of some other war.

       What are we doing here?

The poignant misery of dawn begins to grow . . .

We only know war lasts, rain soaks, and clouds sag stormy.

Dawn massing in the east her melancholy army

Attacks once more in ranks on shivering ranks of grey,

       But nothing happens.

Sudden successive flights of bullets streak the silence.

Less deadly than the air that shudders black with snow,

With sidelong flowing flakes that flock, pause, and renew,

We watch them wandering up and down the wind's nonchalance,

       But nothing happens.

Pale flakes with fingering stealth come feeling for our faces—

We cringe in holes, back on forgotten dreams, and stare, snow-dazed,

Deep into grassier ditches. So we drowse, sun-dozed,

Littered with blossoms trickling where the blackbird fusses.

       —Is it that we are dying?

Slowly our ghosts drag home: glimpsing the sunk fires, glozed

With crusted dark-red jewels; crickets jingle there;

For hours the innocent mice rejoice: the house is theirs;

Shutters and doors, all closed: on us the doors are closed,—

       We turn back to our dying.

Since we believe not otherwise can kind fires burn;

Now ever suns smile true on child, or field, or fruit.

For God's invincible spring our love is made afraid;

Therefore, not loath, we lie out here; therefore were born,

       For the love of God seems dying.

Tonight, this frost will fasten on this mud and us,

Shriveling many hands, and puckering foreheads crisp.

The burying-party, picks, and shovels in shaking grasp,

Pause over half-known faces. All their eyes are ice,

       But nothing happens. (4)

By being written in the present tense, the poem as a whole is clearly depicting a symptom of PTSD: reliving. As such, readers feel like they are experiencing the memory alongside the speaker, which is perhaps as close as one could get to being in the speaker's mind, having not lived these memories but read them as if they were experiencing them.

Similarly, the repetition of “but nothing happens” and other phrases throughout the poem reinforce the prominence of these memories in the speaker’s mind; perhaps this could be a reference to flashbacks and/or nightmares.

PTSD in Literature: Excluding War

It was considerably harder to find a poem about PTSD that was not about war, hence bringing attention to the fact that PTSD in relation to themes other than war are less spoken about, but do deserve recognition and awareness because PTSD in other scenarios are just as valid as war veterans, even though experiences are so different. 

Developing PTSD in relation to children, birth or parenthood is also fairly common. I first came across this when reading the article ‘I got PTSD after witnessing my daughter’s birth’ (5), again in this poem and with relation to infertility also. 

The struggle to conceive, fall pregnant or having to endure test after test to figure out why is unbelievably traumatic, yet this seems to go unnoticed and is not spoken about a lot in literature and is hard to find when searching for it. Infertility affects 1 in 7 couples, a high figure, and of those many will go on to struggle with mental health as a result. One famous writer who explores this is Sylvia Plath, in her poem entitled Childless Woman which reads:

The womb

Rattles its pod, the moon

Discharges itself from the tree with nowhere to go.

My landscape is a hand with no lines,

The roads bunched to a knot,

The knot myself,

Myself the rose you achieve—-

This body,

This ivory

Ungodly as a child's shriek.

Spiderlike, I spin mirrors,

Loyal to my image,

Uttering nothing but blood—-

Taste it, dark red!

And my forest

My funeral,

And this hill and this

Gleaming with the mouths of corpses. (6)

Whether Plath had developed PTSD as a result of her experience losing a baby as well as enduring an abusive relationship with her husband Ted Hughes and an ongoing battle with depression is unknown however, it is clear that the trauma she had faced contributed to her struggles with mental health which ultimately led to her suicide in 1963.

She was an accomplished writer, her novel The Bell Jar as well as poetry collections such as Ariel exhibits her success, and how she produced raw, emotive, and moving works perhaps as a result of all she went through, however, her illness (depression) was ultimately overpowering and won the war. 

The way that PTSD is explored in literature is most commonly related to war poetry. However, there should be a deeper exploration awarded to PTSD in other contexts. Plath has paved the way for an insight into mental health and severe mental health, however, the initiative did not seem to take off with relation to PTSD.

The misconceptions of PTSD surrounding just war poetry have likely evolved from the literature most commonly covering the disorder from this one angle, and as such more poetry, novels and literature should be produced, published and made mainstream. Just as both of Owen’s poems are on GCSE English Literature specifications, more should be taught around other causes of PTSD, to spread awareness. 

Even so, the inclusion of Owen’s poems in GCSE specifications are not to explore PTSD, they sit in the “Power and Conflict” cluster (Exposure- AQA specification) therefore drawing attention to the war aspect as opposed to the PTSD; this is only discussed should a teacher lead a discussion on it, as poetry is all down to interpretation, and every teacher, understandably so, teaches different perspectives on set texts.

As such, some may not even mention the PTSD aspect at all, as they choose to focus on other aspects, so the education surrounding PTSD is therefore not necessarily provided.

PTSD is a complex illness, and there are many different types, such as cPTSD or delayed-onset PTSD. However, it is important to remember that they are all valid, deserve recognition, and sufferers need to be heard, just the same as all traumas are traumas if the victim deems it so.

If you feel you or someone you know is exhibiting symptoms of PTSD, it is important to remember that there is help out there and available.

See the Mind.org.uk website for useful contacts that can provide support. 

References

• https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/symptoms/
• https://www.bbc.co.uk/bitesize/guides/zwbxp39/revision/6 
• https://www.poetryfoundation.org/poems/46560/dulce-et-decorum-est 
• https://www.poetryfoundation.org/poems/57261/exposure-56d23a961ef5a 
• https://www.bbc.co.uk/news/stories-57442294 
• https://allpoetry.com/Childless-Woman