Hey hey! So I heard a lot about PTSD symptoms getting worse once a victim gets out of an abusive situation - I was wondering what kind of symptoms would be repressed during the situation, if I can say that. For context - it's a kid, was being physically abusive by his father, he got arrested, now he's with his mom but she's emotionally abusive so it's not like he's quite safe. Thank you for the hard work!! Take care!
Let’s chat about what ‘symptoms getting worse’ can mean before we dive into character conversation.
Symptoms getting worse can mean
a) ‘a person goes from short term survival state, to shock to having symptoms’
Given the ‘short term’ there, I do mean for single (or ‘short term’) traumas versus say, someone in an abusive home. People can go through natural disasters/car accidents and seem fine for a period afterward only to have symptom issues later once what has happened has ‘sunk in’ so to speak.
b) ‘a person goes from a long term survival state in an unsafe place to being in a safe place with maladaptive coping’
This one isn’t so much about ‘getting worse’ though it can appear that way on the outside. When someone is in an abusive situation there’s things they do to try and control the damage, both consciously and unconsciously- or to try and reclaim ground- both consciously and unconsciously.
Sneaking around the house at night to get food is a coping skill for a kid who is being neglected. Their hypervigilance of whether or not other people can hear them or see them is needed for their safety.
Sneaking around the house at night to get food as an adult in a non abusive household- maladaptive. Freaking out at their partner who got up to check on them? Maladaptive. It’s the left over fear response from when someone hearing them eat was Dangerous.
c) ‘survival state to break down’
Way back when I was in college- I was a multi-trauma survivor who had just left an unhealthy situation who was the retraumatized. As someone who had a life time of trauma experience, it didn’t stop me immediately.
But the body can only exist in a survival state for so long. I went from ‘here is a small handful of symptoms that really, aren’t obvious that they’re symptoms’ to full body break down. I know from the inside and looking back at that time that to me it /felt/ like I went from 0-100 in 60 seconds but the truth is it had been a slow simmering issue that suddenly hit an exponential curve. ‘Having issues sleeping’ escalated into ‘skipping nights’ went to ‘being awake for 70 hours straight’ (and do not argue with me about that not being possible- I fully accept that micro sleeps happened- that’s half the story. I would blink and fall over on a bus, I would blink and be in a plate of food. But that’s not *really* sleeping in a healthy sense, now is it?)
I went from food being a little bit hard to people asking when was the last time I ate and me telling them ‘but I ate lunch with you?’ only to find out that had been the day prior.
And then I broke. Pink eye. Something that looked like mono. Double ear infection. And an infection that had made it’s way to my blood that almost was found too late. You can’t survive without sleeping and eating without wrecking your immune system.
Symptomology is complicated. And they don’t always stay the same. Nightmares come and go out of people’s lives. Flashbacks experience different phases of intensity- or change forms all together. Dissociation can range from ‘I feel a bit odd and spacey in my body’ to straight up ‘I attended the wrong class and didn’t notice, I only know a few days later because the notes are about a different subject entirely.’
If someone who is used to say- having a bit of a rough time falling asleep, being depressed and having trouble experiencing joy, and having nightmares-
ends up going through a shifting period where maybe they start getting 2-4 hours of sleep a night tops but no nightmares, and food issues they didn’t realize were a problem end up triggered, and they can feel joy but it’s super unstable and their emotions are on 10 all the time-
that can be seen as getting worse.
It isn’t that one set of symptoms is actually worse than the other- it’s that to the person experiencing them, the set they have more coping skills for is probably going to feel more stable. Or seem more stable to their friends and family. After all, a lot of symptoms and coping skills aren’t seen as symptomology- they’re seen as ‘just the way that person is.’
I can’t tell you what symptoms your character wouldn’t have in an abusive situaton.
Some survivors of childhood abuse don’t experience flashbacks to abuse until they’re out of the abusive situation, but others are actively dealing with flashbacks while still in the traumatic place.
Some survivors of childhood abuse have maladaptive experiences related to the kind of abuse they experienced. Someone who had food withheld might binge, someone who wasn’t allowed to sleep as much as they needed might start sleeping all day. Someone who wasn’t allowed to show emotions in the household may struggle with managing emotions outside of it- and seem to have ‘too many’ all the time.
And other simply follow the patterns that were already being bult- continuing to starve because eating feels wrong. Struggling to sleep or viewing sleep as for the weak, refusing to feel emotions.
It isn’t as simple as ‘here are the symptoms that can exist while trauma is still occuring and here are the ones that exist later.’
But I do think you’re right to have the change reflected in your writing. Your character is going to have to shift their coping mechanisms from one abusive situation to another. There are going to be ‘misfires’ and maladaptive moments (and possibly patterns.) There are going to be complicated emotional feelings about ‘why do I still feel like this- I’m not experiencing _______’ anymore and possibly guilt or feeling like they’re making a big deal out of nothing. Or maybe the opposite- where instead it’s ‘I’d rather get hit than this.’
Both happen in real life.
So it isn’t offensive to write one over the other. You just have to decide what you’re going to portray.