“I wanted to be Superman… I failed.”

I hear these words in some capacity at least once a week in my work with active duty service members with post-traumatic stress syndrome (PTSD).

What is PTSD?

PTSD is a condition that occurs in response to a traumatic event and consists of 3 types of symptoms: re-experiencing the event (flashbacks, nightmares, intrusive images of the traumatic event), physiological arousal (constant hypervigilance, increased startle response, constantly looking for signs of danger), and avoidance (of people, places, or reminders of the traumatic event).    Why does PTSD occur? Even though many people might be exposed to a traumatic event, and many might initially show the very symptoms listed above, for most people these symptoms reduce over time. Because these reactions to a traumatic event immediately after it occurred are natural, the actual diagnosis of PTSD only happens if the trauma survivor continues to experience all of these symptom types one month after the traumatic event occurred.

So why is it that some people get PTSD and some do not? Research studies find that PTSD occurs because of how we think, feel, and what we do about it.

What we do:

The biggest reason why someone might develop PTSD is avoidance. This might be surprising to some of us, after all, isn’t avoiding thinking about bad things supposed to help you forget them? As it turns out, this is not the case. While most of the time when someone is going through a hard time or has experienced a trauma or a loss, we might say, “just don’t think about it,” or “move on,” our minds don’t work that way. Sure, we can busy ourselves enough to be too distracted to think about the trauma in the moment and when we least expect it, it will come right back. We can keep avoiding, with being too busy all the time, with working until we pass out, so we don’t have to think about it, with drinking or using other legal or illegal substances, and the trauma will still be there.

So what do we do, how do we fight it? It turns out that processing the traumatic event either with people you feel comfortable with or with a mental health professional, is the best cure. Therapies, such as Cognitive Processing Therapy, Prolonged Exposure Therapy, Acceptance and Commitment Therapy, and EMDR are some of the leading therapies for the treatment of PTSD and they specifically target reducing avoidance and processing the event.

How we think:

It turns out that our interpretations of the traumatic event have a lot to do with how we feel and whether or not we develop PTSD. The first line of this blog post is an example of an interpretation that a trauma survivor might say. Very often trauma survivors blame themselves for what occurred (for example, the loss of a friend, an IED explosion, failed mission, or even for developing PTSD). Time after time, I hear these amazing young men and women state that they believe themselves to be “weak” or “broken.” A lot of this comes from the thought that “I should be like Superman, I should be strong, I shouldn’t have PTSD.” It is at this time that I like to remind my patients that just like them, Superman had a point of vulnerability (Kryptonite) and that being susceptible to something over which he has no control over, does not make him any less of a Superhero. Quite the contrary, it makes him a survivor, it makes him a hero, it makes him a Superhero.

How we feel:

There are two types of emotions that can follow a traumatic event: natural and manufactured. Natural emotions are the direct and raw responses to the event itself, such as feeling sad about losing a friend. Manufactured emotions are based on our thoughts and interpretations about the event. For example, if someone you love died and you had a thought “if only I did … then they would still be alive, this is all my fault,” this will create the feelings of guilt and might prevent recovery. Natural emotions dissipate over time and allow for healing to take place, whereas manufactured emotions are some of the biggest causes of PTSD and they keep us stuck, that’s why they are some times referred to as “stuck points.”

How do comic books, movies, and TV shows tie into all this?

Traumatic events can be alienating, often causing the survivor to not want to socialize with others, frequently leaving his or her loved ones feeling helpless and frustrated. In connecting with certain people or fictional characters that have been through such an experience, trauma survivors can sometimes feel more understood. It might be possible for a trauma survivor to watch Iron Man 3, for example and tell his or her partner/spouse “that’s what I go through”, or “that’s how I feel,” which can be very informative for both the trauma survivor and their loved one.
Iron Man 3 does a great job of demonstrating what a combat-trauma survivor might experience: flashbacks, startle response, and avoidance. I am not necessarily saying that Iron Man has PTSD but rather that seeing what he is going through can potentially be helpful and informative for someone who has been through trauma or has a loved one who has had that experience.

In the most recent Marvel movie, the first Avenger, Captain America, stated that he was struggling with adjusting to the modern times and catching up on all the things he missed while he was frozen. Interestingly, Sam Wilson (The Falcon), also reported having a hard time adjusting and is seen leading a support group at the VA for other veterans going through the same experience. While neither Captain America nor The Falcon appear to have symptoms of PTSD, they demonstrate something we often do not realize: when service members deploy, the civilian world continues to grow, expand, and change, and very often when a service member returns, it is almost as if they were frozen and woke up in a different time period, as the things they remember might have changed and people might have grown or aged.

Certain TV shows, such as Agents of S.H.I.E.L.D. also demonstrate what someone, even a very powerful someone, might experience after a traumatic event or a death experience. Agent Coulson, as unaffected as he pretends to be to most of his crew, appears to be going through a hard time as well.

Why does it matter and how does this help? Since comic books, movies, and TV shows are an important part of our lives and our culture, they are readily accessible to trauma survivors, their loved ones, and mental health professionals. Very often, it can be difficult to understand or explain what we might be experiencing, seeing or reading about someone else whose experience might mirror yours in some degree, might make us feel more connected and understood, and can allow us to explain to others what we are going through. Most of us have felt alone or had a thought that “no one gets it.” By finding a person or a character we can related to, we might feel less alienated and might be more willing to connect, and connection (with ourselves and with the people and activities that are important to us) is an important step in healing.