Sarah Fine's Blog

Today, my 5th novel is out. Chaos is the third and final book in the Guards of the Shadowlands series.


This is bittersweet for me. It was hard to say goodbye to these characters, but I'm proud of their journeys and I hope this final book resonates with readers in the same way the first two did. Here's the blurb, which is somewhat spoilery about the end of Fractured:

With Juri in control and everything in absolute chaos, Lela plunges into the depths of hell to free Malachi from creatures that have waited decades to exact their revenge. But the Judge has her own way of doing things, and Lela must work with Ana, the new Captain, who has a very personal mission of her own. Together, they infiltrate the most horrifying realm either has yet encountered in the Shadowlands—the bitter landscape ruled by the Mazikin. 

The stakes could not be higher, and Lela must accept the help—and love—of people she barely knows or trusts. As alliances and loyalties shift and she realizes the soul she came to save isn’t the only one in need of rescue, can Lela summon the strength to see the fight through to the very end?

You can, of course, get Chaos at Amazon, but you can also order the hardcover or paperback at Barnes & Noble or your local indie.
If you're a fan of the series and aren't yet ready to say goodbye, you don't have to! You can get Vigilante, a short story from Ana's perspective that represents a bridge between Fractured and Chaos:

And you can also pick up Stories from the Shadowlands, which is 250-pages of bonus material, giving readers an in-depth look at the life of a Guard through Malachi's journals, bonus scenes, and a novella from Jim's perspective that takes place in the Blinding City. 

So there it is. Series done. And now all I'm feeling is gratitude. I never expected this series to find such enthusiastic fans, and I'm grateful to each and every person who has read, reviewed, told someone else about the books, or reached out to me to let me know how much the characters touched their heart. I worked really, really hard on this series, but knowing that the books have meant something to people has made every minute worthwhile. 

Welcome to YA Scavenger Hunt!

If you're new to the game, go here for instructions on how to hunt--and WIN. And, after you've gotten your info and read the fabulous exclusive content I've got below, please stay and enter to win a KINDLE PAPERWHITE loaded up with all the books and novellas in the Guards of the Shadowlands series!


 THE HUNTThis bi-annual event was first organized by author Colleen Houck as a way to give readers a chance to gain access to exclusive bonus material from their favorite authors...and a chance to win some awesome prizes! At this hunt, you not only get access to exclusive content from each author, you also get a clue for the hunt. Add up the clues, and you can enter for our prize--one lucky winner will receive one signed book from each author on the hunt in my team! But play fast: this contest (and all the exclusive bonus material) will only be online for 72 hours!
Go to the YA Scavenger Hunt page to find out all about the hunt. There are SIX contests going on simultaneously, and you can enter one or all! I am a part of the GOLD TEAM--but there is also a red team, a blue team, an orange team, a green team, and an indie team for a chance to win a whole different set of signed books!

If you'd like to find out more about the hunt, see links to all the authors participating, and see the full list of prizes up for grabs, go to the YA Scavenger Hunt page.
SCAVENGER HUNT PUZZLE
Directions: Below, you'll notice that I've listed my favorite number. Collect the favorite numbers of all the authors on the gold team, and then add them up (don't worry, you can use a calculator!). 
Entry Form: Once you've added up all the numbers, make sure you fill out the form here to officially qualify for the grand prize. Only entries that have the correct number will qualify.

Rules: Open internationally, anyone below the age of 18 should have a parent or guardian's permission to enter. To be eligible for the grand prize, you must submit the completed entry form by OCTOBER 5TH, at noon Pacific Time. Entries sent without the correct number or without contact information will not be considered.
SCAVENGER HUNT POST
I am so excited today to be hosting Rachel Carter, author of FIND ME WHERE THE WATER ENDS, book three in the So Close to You series. You can get your own copy of Find Me Where the Water Ends right here! Rachel grew up surrounded by trees and snow and mountains. She is a graduate of the University of Vermont and Columbia University, where she received her MFA in nonfiction writing. She is the author of the So Close to You series with Harperteen. These days you can find her working on her next novel in the woods of Vermont. 
VERMONT, you guys. I'm pretty sure they get at least 26 feet of snow a year up there. 


EXCLUSIVE CONTENT
Lydia has been trained into a person she might have once feared: focused, fierce, deadly. Although she never wanted the life of a Montauk Project recruit, the Project has captured someone she loves-someone she'll do anything to save.

Then Lydia glimpses a world in which the Montauk Project never existed. The Project has taken so much from Lydia already, but she knows that she will sacrifice everything to make her vision of a world without the Project a reality.

Publishers Weekly said that "readers will be hooked" by Rachel Carter's plot-twisting So Close to You series. The conspiracy theories, romance, and compelling "what if?" questions build to a satisfying series end, making Find Me Where the Water Ends the perfect fit for the teen fans of light science fiction like The Time Traveler's Wife.



In a very, very early draft of Find Me Where the Water Ends, Lydia and Wes trained together before they went on their mission to 2049. This is a deleted scene from that alternative storyline, where Lydia and Wes spar for the first time.
“Seventeen, you’ll fight Eleven.”            I feel my body jerk. “Excuse me?”            “You two haven’t fought yet; since he’s physically stronger than you and better trained we’ve been waiting until we thought you were ready. But we don’t have the luxury of waiting anymore.” Twenty-two states this in the clinical, matter-of-fact way she has of speaking, but I don’t miss her use of the word we. As if they are one unit. As if they are facing down an enemy together.            “Fine.” I narrow my eyes at Wes. “I’m ready.”            “You’re not, but we don’t have time left to wait,” Twenty-two says calmly. “Let’s get this over with.” I glare at her, searching for patience.            But then Wes is there, right in front of me. He keeps his eyes on mine as he starts to circle. I spin with him. He moves his body with complete control, complete ease. His arms are loose against his side and as much as I fight it, I can’t help but remember how they felt curled around me that night we slept wrapped together on an old, run-down couch in Tag’s East Village squat. The couch smelled like mildew, and springs were poking into my side through the holes in the worn fabric. But it was the night we decided to run away to the 1920s together, a time where the Montauk Project couldn’t find us, and it was the best night of sleep I’ve ever had.            Now the person I thought I would spend the rest of my life with is getting ready to throw me to the ground. Wes is staring at my face, but I keep my eyes glued to his body, to the way he shifts his weight back and forth. From watching him fight Twenty-two and Tim, I know that he relies on his speed and agility over strength. If I have any hope of beating him, I need to anticipate what he’s going to do before he does it.            Unfortunately, I’ve never been good at predicting Wes’ next moves. He feints to the right, and I shift with him, ready to block, but then he quickly comes at me from the left, his arms closing around mine. I twist out of his hold, and use the momentum to aim a side snap kick at his face. But he easily blocks it, and again closes his arms around me. He is trying to restrain, not attack, I realize. This was not the way he fought Tim or Twenty-two.                       Fine. If he’s not going to take me as a threat, then I’m busting out the Krav Maga. I grab the hand that’s wrapped around my stomach and use it as leverage to swing my body to the left, hard enough to break Wes’ hold and twist myself around and onto his back. I lock my legs around his waist, and put him into a chokehold. Our heads are close together, and for the first time in nine months I can smell him. Pine needles, the forest, a heavy rain. It is achingly familiar. I have no idea how he smells like that when we’re all using the same soap, but I suck in my breath anyway. Wes hears it and freezes. We stay locked like that, me hanging on him, his head tilting back against mine. Our mouths are inches apart. If he turned his head…but then his hands come up and grab my calves. I tense, gripping his neck harder. He suddenly drops to his knees, and uses the force of the movement to flip me over his head. I close my eyes at the sensation of flying through the air, but then feel his hand hard against my back. Instead of slamming into the mat, I’m eased down onto it.             “He’s holding back,” I hear Tim say. And he’s right, Wes is holding back, though I can’t imagine why. If he didn’t want to hurt me, then he wouldn’t have betrayed me in the first place.             I spare a glance to the side of the mat. Tim is watching us closely, Twenty-two is frowning at Wes, her eyebrows raised, like she’s surprised, or maybe realizing something for the first time.             Wes twists around, so quickly that I do not have time to get up, and then he’s there, on top of me. His legs are straddling mine, his hands pinning my arms down onto the mat. I stare up at him, breathing hard. We lock eyes. His are dark, so dark they look black in this harsh gym light. His lashes are long, almost girlishly so, but the bump in the bridge of his nose prevents him from looking too pretty. He is staring at me just as intensely, scanning my face, my green eyes, my too-full lips. I can’t read his expression, though it reminds me of how he used to look at me, open, searching, as if I’m some kind of mystery he’s trying to solve. He is breathing heavily, I realize, and our panting chests are moving in unison, almost touching over and over.             “Aren’t you going to fight?” I hear whispered. “Are you just going to let him win like that?” It is Tim’s voice, though it could have been coming from inside of me. No. I’m not going to let him win. I’m not going to be vulnerable like this again. I heave my body to the side, trying to shove Wes off of me. But he clings, his grip on my hands getting tighter. I manage to turn to my front, but now he is just sitting on my back, my arms twisted above my head. I can barely move, though still I fight against him, trying to gain leverage, to push him off of me. He leans down. “You’re done,” he says into my ear. “It’s over.”“No.” I grunt the word, and struggle harder. Sweat beads at my temples, dripping down onto the mat below me. There is a ringing in my ears that’s getting louder, but I refuse to give up.Wes moves my arms up farther, and bends down. He is practically lying on top of me. “Be still,” he whispers.His voice just makes me want to fight more. I pull at the hands holding me down. “Be still,” he repeats, his voice a growl. “Lydia.” He breathes the word into my hair. “Be. Still.”It is my name that does it. I have not heard it in so long, and suddenly my body is like water, the tension flowing out of me in a stream. I am motionless under Wes. He feels me surrender, I know he does, but he still doesn’t move, his body pressing mine into the mat. “Lydia,” I hear him whisper again, or maybe I just imagine it; the word is so soft I can’t even feel his breath against my neck. “Seventeen, are you okay?” I cannot lift my head, but I see Tim’s bare feet move into my eye-line. His voice grows colder. “Get off of her, it’s over.”Wes hesitates, then slowly gets up. I breathe easier as soon as his weight is off me, though the air in the gym suddenly feels colder. I roll into a sitting position and wipe the sweat from my eyes. Wes has his back to me and I see the sharp rise and fall of his shoulders as he takes a deep breath.


WHEW. Intense, right?? Thank you, Rachel! Don't forget to enter the contest for a chance to win a ton of signed books by me, Rachel Carter, and more! To enter, remember that my favorite number is 26. Add up all the favorite numbers of the authors on the gold team and you'll have all the secret code to enter for the grand prize!
CONTINUE THE HUNT
To keep going on your quest for the hunt, you need to check out the next author--TERI HARMAN! But here's a treat for you before you go--enter to win a Kindle Paperwhite:

a Rafflecopter giveaway

"This love story for the ages, set in a reimagined industrial Asia, is a little dark, a bit breathless, and completely compelling.
Sixteen-year-old Wen assists her father in his medical clinic, housed in a slaughterhouse staffed by the Noor, men hired as cheap factory labor. Wen often hears the whisper of a ghost in the slaughterhouse, a ghost who grants wishes to those who need them most. And after one of the Noor humiliates Wen, the ghost grants an impulsive wish of hers—brutally.

Guilt-ridden, Wen befriends the Noor, including the outspoken leader, a young man named Melik. At the same time, she is lured by the mystery of the ghost. As deadly accidents fuel tensions within the factory, Wen is torn between her growing feelings for Melik, who is enraged at the sadistic factory bosses and the prejudice faced by his people at the hand of Wen’s, and her need to appease the ghost, who is determined to protect her against any threat—real or imagined. Will she determine whom to trust before the factory explodes, taking her down with it?"
This is my fourth YA novel, and it's really special to me. 
Here's more about the inspirations for the book. 
And here's where you can find it:IndieboundBarnes & NobleAmazon

From Publishers Weekly:

By the end of this year, I'll have five YA novels out, with two more coming out next year. And I have every intention of continuing to write YA fiction (I'm writing one NOW, as a matter of fact). But with the encouragement of my agent, I've also decided to branch out a bit and try my hand at adult romance. 

Marked is about Cacy Ferry, a paramedic in post-eco-disaster Boston who moonlights in the family business of transporting souls to the afterlife. When her CEO father dies under mysterious circumstances, she has to solve his murder and prevent the company from falling into the hands of the mischievous, evil Kere--living personifications of violent death--before her handsome new partner, Eli, becomes one of the casualties.

Writing this book was SO. MUCH. FUN. For those of you who are fans of Sanctum, I know Marked might sound similar, what with mentions of the afterlife, but I promise you, this book will take you on a very different kind of ride. Boston is a chaotic canal city teeming with monsters seen and unseen, ruled by a family at war with itself.  There's a lot of gritty violence (okay ... I guess that's not that different from my other books) and some major sexytimes (which is quite different from my other books). I am super-excited to be working with David Pomerico and the rest of the team at 47North so we can share Marked with you!

Oh, blogging has gotten away from me, and that's the simple truth. The last few months have been so incredibly busy, and there's no sign of things letting up. In fact, I'm booked through 2015.

I'm not joking. Which is both awesome and daunting.

So! I've come to a point where I need to be brutally honest and realistic about what I can do, and the truth is that blogging has fallen to the bottom of a very long priority list.

Instead of making promises I can't keep, I'll tell you where to find me. I might post here from time to time with big news, but it's not the main way to get day-to-day updates about my books and projects and random thoughts ... not that I expect you to be interested in those.

I am often lurking and sometimes babbling on Twitter. If you want to interact, find me there!

If you're interested in news about the Guards of the Shadowlands series (Sanctum, Fractured, and BOOK 3), look for it here. That tumblr account is also the place to read Malachi's journal entries--check the archives, because I believe there are well over a hundred entries at this point!

For general news--including updates and info on SCAN (May 2014) and OF METAL AND WISHES (August 2014)--interviews, giveaways and contests, etc., please check my Facebook page.

And now, before I sink into my cave once more:



FRACTURED is out and available! Because it is published by Skyscape/Amazon Children's Publishing, you're highly unlikely to find it in a bricks-and-mortar bookstore, but perhaps they will order it for you if you ask nicely :)

Hardcover:
Indiebound
Barnes & Noble
Amazon

Paperback:
Amazon

Ebook:
Amazon (it's Kindle exclusive)

I believe you can get the audiobook at any of those sites as well.

And that's it for now.

I know--I'm ridiculous, popping up to do a long blog series and then disappearing again. Still, I suspect half of you are on vacation anyway!

Nevertheless, I have to share this, because I am just so excited. OF METAL AND WISHES, formerly "Factory Ghost," was a book I never meant to write. It hit me sideways while I was on sub with SCAN, and I wrote it in a few weeks. It came tearing out of me, the voice, the world, the characters. It is so different from Sanctum, more lyrical, I guess--but in its own way, no less brutal. It's an odd duck of a book that landed me with an editor and an imprint I hugely admire.

And today I get to share the jacket copy!

There are whispers of a ghost in the slaughterhouse where sixteen-year-old Wen assists her father in his medical clinic—a ghost who grants wishes to those who need them most. When one of the Noor, men hired as cheap factory labor, humiliates Wen, she makes an impulsive wish of her own, and the Ghost grants it. Brutally. 

Guilt-ridden, Wen befriends the Noor, including their outspoken leader, a young man named Melik. At the same time, she is lured by the mystery of the Ghost and learns he has been watching her… for a very long time. 

As deadly accidents fuel tensions within the factory, Wen must confront her growing feelings for Melik, who is enraged at the sadistic factory bosses and the prejudice faced by his people at the hand of Wen’s, and her need to appease the Ghost, who is determined to protect her against any threat—real or imagined. She must decide whom she can trust, because as her heart is torn, the factory is exploding around her … and she might go down with it.

That's the long version. The short version: this is Phantom of the Opera set in a meat factory. But I added a few twists of my own. And if you want a hint, I offer you this gif (lovingly provided by an early reader, also the intern who plucked Sanctum from the slush). This image also sums up how I feel about this book.


You can add Of Metal and Wishes to your to-be-read pile here ...

This is getting comical. But never fear! I think this is pretty much it. Next Tuesday, I'll be posting at YA Highway, a kind of summary about things to consider when writing traumatic events and characters exhibiting PTSD symptoms.

Up to now:
Part 1: General factsPart 2: Types of tramaPart 3: Aspects of trauma that make it more or less likely to have lingering psychological effectsPart 4: Individual factors that make it more or less likely a person will develop PTSD after a trauma
Part 5 A and B: Developmental trauma (some thoughts on Nobody But Us by Kristin Halbrook) and an interview with Kristin herselfPart 6: Intrusive Recollection
Part 7: Understanding Triggers
Part 8: Avoidance and Numbing
Part 9: Hyper-arousal

Okay ... so you have a traumatized character, and you want to depict him/her going to treatment. This post is for you.

It is widely accepted that treatment for trauma really can't begin until the person is safe--you can't recover from trauma if you're still IN that trauma. Of course, there's a lot of debate about what "safety" means, and whether we're just talking about physical safety (e.g., not still living in the home with an abuser) or both physical and psychological safety (e.g., is living with a temporary foster family a psychologically safe place to deal with traumatic memories?). We have to use our best judgment and keep doing research on that one.

I'm going to describe prolonged exposure therapy in VERY general terms (that often apply to other research-supported treatment approaches as well, such as EMDR). PE is one of the most well-researched and effective treatments for PTSD in existence. There are other treatments like it, such as trauma-focused cognitive behavioral therapy, which is often used with traumatized children and their parents. These are not the only treatments--but there is SOLID evidence to show they work. And I don't like to waste time talking about stuff that I don't believe has a reasonable chance of working. If you're going to apply another model of therapy, it might be cool to see if there's any research support to show it's effective in treating PTSD.

A two-minute video on prolonged exposure therapy:



Once the person is in a reasonably safe place (i.e., not being re-traumatized), treatment can begin, and it generally includes three phases. If you're writing someone receiving treatment for PTSD, please do not have the person walk right in and start dealing in-depth with what happened to him. Because of those avoidance/numbing symptoms, it's unlikely a person with PTSD would even be willing or able to do that. Also, there's work to be done before you can get to that, because of those hyper-arousal symptoms. You can't dive into the deepest, most dangerous waters before you've given the person a nice lifeboat and a life preserver and a tether to LAND.

What you do first is establish some coping skills. Sure, initially you don't expect a person who's been traumatized to be able to use those coping skills when hyper-aroused, but think of it as planting bulbs in the fall--you don't expect them to sprout until the spring. You work with the person on safety and what's referred to as "grounding" skills. Grounding is all about staying in the present. Examples of grounding techniques include counting (like, bricks in the wall, books on the shelf, tiles on the floor) or focusing on a sensory sensation, like the feel of your butt in the chair and your feet on the floor. Some people use objects to hold them in the here and now, like a paperweight or one of those squeeze balls. There are a variety of means to cope (e.g., breathing exercises), but the goal is to develop a way to "come back" or "stay present" when hyper-aroused, so that you can bring your body and mind back into that comfortable cool zone where logic is possible.

Once those skills are well-established, the person can begin to process and grieve the traumatic memories. Usually, it's good to focus on one event, even if the person is dealing with multiple events. In this phase of treatment, the person is asked to describe, in great, painstaking detail, what happened. The therapist asks questions, but also checks in every few minutes and asks the client to identify her distress level on a kind of scale (subjective units of distress, or SUDS). The client uses grounding techniques to keep herself in the moment, but she continues to discuss the memory and think about it with the guidance of the therapist. She does this over repeated sessions and exposures until she is no longer unduly distressed or impaired by the memory. It usually happens relatively rapidly when done right--this therapy only takes 8-12 sessions in a lot of cases!

Describing the trauma repeatedly (and listening to tapes of that description) is only one part of it--if the trauma has led to avoidance of specific places or situations (e.g., driving at night after a carjacking), the therapist will help the client create a "hierarchy" of feared situations that she will gradually expose herself to, starting with the easiest situation and moving to the hardest.

Symptoms can re-emerge during the processing phase, but the therapist is ready for that and helps the client through it. The final phase is about consolidating those coping skills, increasing positive emotion and social connections, and re-engaging with the world.

Aaaand that's pretty much it. Speaking as a psychologist, I guess what I would beg each and every one of you is to do your research if you're writing treatment for PTSD. There are remarkable resources out there, free and available for use and dissemination.

On Monday, I'll do a little wrap-up and answering questions that have come up. If you do have questions that I haven't answered, today would be the day to post them in the comments section!

Here we go--we're getting to our final few posts in this series. To catch you up to this point:
Part 1: General factsPart 2: Types of tramaPart 3: Aspects of trauma that make it more or less likely to have lingering psychological effectsPart 4: Individual factors that make it more or less likely a person will develop PTSD after a trauma
Part 5 A and B: Developmental trauma (some thoughts on Nobody But Us by Kristin Halbrook) and an interview with Kristin herselfPart 6: Intrusive Recollection
Part 7: Understanding Triggers
Part 8: Avoidance and Numbing

Today we talk about the third and final symptom cluster in PTSD (according to the DSM classification system). The symptoms, according to that manual, are as follows:

Persistent symptoms of increasing arousal (not present before the trauma), indicated by at least two of the following:Difficulty falling or staying asleepIrritability or outbursts of angerDifficulty concentratingHyper-vigilanceExaggerated startle responseRemember what I said in the last post about how our reactions to trauma are about survival? Basically, when we're exposed to a traumatic event, our minds process it in a way that helps us stay alive, and sometimes, that survival mechanism gets a little glitchy. Trauma memories are processed in a different part of the brain than most other memories, and can trigger an instant ALARM. Our bodies respond to that alarm in several ways:
Acceleration of heart and lung actionInhibition of stomach/intestinal actionConstriction of non-vital blood vesselsFreeing of nutrients for muscular actionDilation of blood vessels for muscles
See how those things might help you stay alive? If you're faced with a charging hippopotamus or have to escape a burning building, you might be able to because we're evolved to respond--your body reroutes resources to the essential places while limiting blood flow to other places. And if you're *really* in trouble, your brain might release endorphins that allow you to keep going despite serious injury or intense pain. It's a truly amazing process ... until it gets applied in the wrong situation. Like that veteran I mentioned who was triggered in a public park on a sunny day, simply by a trickle of sweat on his face, and he had a panic attack. Basically, his body switched into survival mode without consulting him, all because of memories processed deep in his brain. 
People who are hyper-aroused are different than when they are not in this state. It's of crucial importance for you to remember that if you're writing this type of character and scene. Here's a diagram adapted from the work of Bruce Perry, MD, PhD, an expert in child trauma (THIS ARTICLE is a helpful must-read!):

You see how someone in a calm, resting state has a clear sense of time and can process abstract thoughts, but as the body kicks into survival mode, she starts to lose that long-term focus. Everything constricts, her sense of time, her ability to reason. Her mind is entirely focused on fighting or running--or freezing. 
Trauma experts talk about how it's not just "fight or flight"--it's "fight or flight or fright." When someone is in an extreme hyperarousal episode, he'll do one of those three things. Most people have a tendency toward one kind of response, though a person who tends toward flight will OFTEN fight if cornered. Women are more likely to engage in flight responses, while men are equally likely to engage in fight or flight. The "fright" response, which you could liken to a possum playing dead, is most often exhibited by young children, youth abused by an adult, youth in an inescapable situation (especially if it involves pain), and girls (twice as likely as boys). 
Now ... for some examples!
A "flight" response:

“One of Coin’s men lays a hand on my arm. It’s not an aggressive move, really, but after the arena, I react defensively to any unfamiliar touch. I jerk my arm free and take off running down the halls. Behind me, there’s the sound of a scuffle, but I don’t stop.” ~ Katniss, from Mockingjay by Suzanne Collins

 A "fight" response (specifically "irritability or outbursts of anger" from the symptom list):

“I felt the violence rising in me with every encounter with the world outside my home. Even inside it I frequently, and with little cause, no cause, boxed Benny’s ears. If I made him squeal and cringe and look at me with eyes gone grave with love and incomprehension, I fancied I felt relief.” ~Tashi, Possessing the Secret of Joy by Alice Walker

A "fright/freeze" response:
Erm. Just read Living Dead Girl by Elizabeth Scott. But be ready when you do--it's intense.

“I hate knowing he’s waiting for me, that he will rub his hands and himself all over me and whisper things. His hands used to make me cry, but now I’m used to them. The thing is, you can get used to anything. You think you can’t, you want to die, but you don’t. You won’t. You just are.” ~ “Alice”, who is being held captive by a predator, Living Dead Girl by Elizabeth Scott

And finally, description of a rage/fight response followed by endorphin release (there's some speculation that those endorphin releases can become addictive, and that traumatized kids sometimes push things in an instinctive need to reach that point):

"Like, whatever I do, there it is, this …rage or …something…that owns my blood and it burns…burns my blood ‘cause it thinks it’s funny or something. I just…" I grit my teeth, shake my head ‘cause this shit ain’t right. "And I get angrier and angrier and then …I gotta do something about it." 

"You can’t hit everything and think that’s going to make it all better." 

"I know that! But it feels good to just…stop fighting it and let it control me. Like …I don’t gotta think none or decide or hold back or nothing.”~Will, who suffered chronic developmental trauma, talking to his girlfriend, Zoe. (Nobody But Us, by Kristin Halbrook)

Ah, there we go. On Friday I'll talk about treatment!

This series is getting comically long, but I promise--only a few more posts! If you need a recap, here you go:

Part 1: General factsPart 2: Types of tramaPart 3: Aspects of trauma that make it more or less likely to have lingering psychological effectsPart 4: Individual factors that make it more or less likely a person will develop PTSD after a trauma
Part 5 A and B: Developmental trauma (some thoughts on Nobody But Us by Kristin Halbrook) and an interview with Kristin herselfPart 6: Intrusive Recollection
Part 7: Understanding Triggers
And congratulations to Marcy, who won the copy of Nobody But Us by Kristin Halbrook!

Now ... back to our discussion of symptoms of PTSD. We've discussed the most well-known symptom cluster--intrusive recollection, which includes things like flashbacks, nightmares, and other sorts of re-experiencing of the trauma. That's the one you'll see portrayed in the movies and in books most often.

Today, we discuss a symptom cluster that is equally prominent in PTSD, but much less understood by lay-people, in my experience: Avoidance and general numbing of responsiveness.

Here are the symptoms from the DSM-IV-TR:

Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:
Efforts to avoid thoughts, feelings, or conversations associated with the traumaEfforts to avoid activities, places, or people that arouse recollections of the traumaInability to recall an important aspect of the traumaMarkedly diminished interest or participation in significant activitiesFeeling of detachment or estrangement from othersRestricted range of affect (e.g., unable to have loving feelings)Sense of foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

Some examples from fiction (these next two aren't YA, but are so appropriate that I couldn't not offer them):

It was in the nature of their love that Kathy did not insist that he see a psychiatrist, and that John did not feel the need to seek help.  By and large he was able to avoid the sickness down below.  He moved with determination across the surface of his life, attending to a marriage and a career.  He performed the necessary tricks, dreamed the necessary dreams.  On occasion, though, he'd yell in his sleep -- loud, desperate, obscene things -- and Kathy would reach out and ask what was wrong.  Her eyes would betray visible fear.  "It wasn't even your voice," she'd say.  "It wasn't even you." ~In the Lake of the Woods by Tim O’Brien (emphasis my own)

He is here. And I can see as he looks at me that he does not know whether to laugh or cry. I feel the same. My eyes see him but they do not register his being. Nothing runs out of my eyes to greet him. It is as if my self is hiding behind an iron door.” ~ Possessing the Secret of Joy by Alice Walker (emphasis my own)

If you were experiencing intrusive memories of the worst moments of your life, you probably wouldn't embrace that experience, right? Instead, you'd want to control and suppress those memories as much as you could, just so you could go on with your life. So as you think about humans' reactions to life-threatening, heinous events, remember this: Our responses to trauma are about survival . Most symptoms of PTSD are the brain's attempts to keep the organism alive and safe and functional ... gone a bit haywire. But the impulse for health and survival is there. Avoidance and numbing is no different--the brain is trying to protect the person by keeping him buffered from incapacitating and threatening stimuli.

People who have PTSD do not say, "Hey, let me tell you about what happened to me." In fact, the most effective treatments for PTSD involve repeated (and carefully controlled) exposure to that trauma narrative and those memories, and it's extremely daunting for people with PTSD to do. It works, but it requires a lot of courage and determination. If you're writing a character with PTSD, remember that. They duck reminders of the trauma, conversations about the trauma, and emotionally withdraw, but it's a matter of emotional survival and self-protection.

Dissociation is not exactly a codified symptom of PTSD, but it is widely acknowledged as something that goes along with it. Dissociation is exactly what it sounds like--it's what happens when a person detaches from reality. And ... it's completely normal. Daydreaming and fantasy are forms of dissociation, a typical response to being trapped in an inescapable situation. Like a boring class, for example. But like so many other things, it's a continuum, and some forms of dissociation impair functioning and are actual disorders (Dissociative Identity Disorder, for example). Dissociation can essentially be considered extreme avoidance. If you're writing a traumatized character, you might want to look into it and make sure you understand it.

A brief example of dissociation from Nobody But Us by Kristin Halbrook:

He’s little, dark eyes and sharp smell drifting under my nose. It’s him. He’s here, he’s found me. I do what I always do. There’s this room, four walls painted pale sunshine but no windows. That’s where I hide. I’m stiff as a canoe, a vessel gliding effortlessly over still water in a sunshine room. His face is talking to me again, but there is no Zoe here to hear his words. ~Zoe, who was beaten by her father, upon getting caught shoplifting by a store owner.

In all three examples, plus the example from Speak that I used last week, the authors smoothly convey the avoidance, numbness, and dissociation not just by telling us, but by showing us through the prose. Something as subtle as saying "his face is talking" instead of "he is talking" shows a level of detachment the reader instantly and instinctively absorbs. In good examples, this kind of dual communication is nearly always present--the author shows images and moves the story along, but word choice, sentence organization and length, and cadence boost the impact tremendously.

Do you guys have any other examples of good passages or books that convey this particular symptom cluster of PTSD?

On Wednesday, we'll be talking about the third and final symptom cluster--Hyper-arousal. Then, on Friday, we'll discuss writing accurate treatment. And ... that's it! We'll have covered everything except perhaps a few of your questions--feel free to ask for additional information in comments, and I may do a final post to answer them.

This post is part of a series, so if you haven't read the first six posts, here are the links!

Part 1: General factsPart 2: Types of tramaPart 3: Aspects of trauma that make it more or less likely to have lingering psychological effectsPart 4: Individual factors that make it more or less likely a person will develop PTSD after a trauma
Part 5 A and B: Developmental trauma (some thoughts on Nobody But Us by Kristin Halbrook) and an interview with Kristin herselfPart 6: Intrusive Recollection
As we think about this, let us put on our writerpants, because portraying this well in fiction is all in the details. 
If you've read all the posts, you know I have a lot of admiration for how Kristin Halbrook showed how her characters' traumatic pasts altered the way they saw and experienced the world. Here's yet another quote from Nobody But Us:

We got music on and sugar highs from drinking Coke when we enter Utah. The mountains are a nasty reminder of Colorado and pain that came quick and the smell of burning skin.

For so many people, the sight of the mountains inspires awe or admiration. Most of us enjoy that view. It's pleasant and peaceful. Not for Will from Nobody But Us. What I love about this very simple two sentences is how Will isn't trying to remember what happened to him. He actually doesn't ever try to think about it because ... why the hell would he want to do that?!? [see more about this in my very next post] But the sight of the mountains triggers this sensation (pain) and then a scent memory. It's not overdone--it has impact, in fact, because it's so matter of fact and therefore startling.

A trigger can be anything. ANYTHING. A sight. A sound. A physical sensation. A scent. Even another memory. You have so many choices. You can drill down as deep as you want. You can stretch into the periphery for distant associations or a string of connected cues. Your options are nearly endless, so I suggest you don't go for the obvious.

My mentor, a psychologist who's an expert in treating trauma and spent many years working at a VA hospital, once told me about one of his patients, a former soldier, who was walking through a park on a sunny day and had a full-blown panic attack. A park! A beautiful day! He didn't know why he'd had that reaction. But after some discussion, they realized what had triggered it: a drop of sweat trickling down the side of his face.

Sometimes it is that small, that simple, that devastating. When humans are in crisis mode, our focus narrows and our perceptions are altered. It's a little like walking through a field of burrs--some of them will stick, and others won't. Some will fall off, and some of those little devils will somehow get so deeply embedded that it really takes effort to pry them loose. If you took the time to consider a particular fictional trauma from my second post, review those notes now! What pieces of that experience will embed themselves in your character's memory only to ambush him/her later?

Below is one of the most effective passages I've come across in YA that shows a character being triggered. I could tell you exactly why I think it works so well, but think I'll just leave you to chew on it for a while. Feel free to comment on why it's effective (or why you disagree--it's okay if you do!):

Our frog lies on her back. Waiting for a prince to come and princessify her with a smooch? I stand over her with my knife. Ms. Keen’s voice fades to a mosquito whine. My throat closes off. It is hard to breathe. I put out my hand to steady myself against the table. David pins her froggy hands to the dissection tray. He spreads her froggy legs and pins her froggy feet. I have to slice open her belly. She doesn’t say a word. She is already dead. A scream starts in my gut—I can feel the cut, smell the dirt, leaves in my hair.~SPEAK by Laurie Halse Anderson