Category: creative writing

Writing Phobias

Most people are familiar with the idea of phobias – the term refers to intense and persistent fears of things, to the point that a person with a phobia will take extraordinary measures to avoid triggering it. Although most people have mild, subclinical phobias of some things and manage okay, for others a phobia can cause immense disruption to everyday life. This article looks at how to believably write characters who suffer from phobias.

The degree of fear caused by a phobia is enough to cause chaos in a person’s life. Instead of merely feeling alarm, a person presented with the object of their fear (or even the threat of it), will often break out in sweats, heart palpitations, dizziness and shaking. They will go to great lengths to avoid being exposed to the triggering stimulus, even if doing so has a heavy impact on their day-to-day social functioning.

Generally speaking, there are three major kinds of phobia.

The first kind of phobia is called a specific phobia – it’s a phobia of something specific, such as spiders, heights or dogs. This sort of phobia is usually a reaction to situations that occurred frequently in the biological past. For this reason, there’s nothing really unnatural about them – it’s just that the fear has been exaggerated to a point where it causes more harm through disrupting a person’s life than it helps avoid harm from danger.

Many phobias begin with an incident in which the object of the phobia caused intense fear in a person. For instance, a person walking through a field and being stopped in their path by an angry dog might develop a phobia of dogs. A phobia of spiders might develop from a childhood in an unclean house that was full of spiderwebs.

Readers who have never experienced living with a phobia could well be interested in reading about the sort of thoughts that go through the head of a character with one, or how they behave (or feel themselves forced to behave) on account of having the phobia. Few who have never had a phobia can imagine how intrusive the fear can be, and how greatly it can impact the ability of a person to live a normal life.

Social phobia is different to a specific phobia in the sense that the phobia reflects a general fear that follows the person with it. Social phobia relates to an intense fear of being judged. In particular, it tends to revolve around a fear of being humiliated in public by means of some judgment being levelled. People with it tend to feel very uncomfortable around authority figures, and would never raise their hand in class to answer a question from the professor.

Most people have a degree of self-consciousness that modifies their actions, but for a person with social phobia this will be exaggerated well beyond mere shyness. For instance, someone with social phobia may be unable to get a driver’s licence on account of being unwilling to sit with the traffic control officer and risk being judged as unfit to drive a motor vehicle.

A character with social phobia might be more interesting if their phobia was ultimately grounded in narcissism. It might be that they were only afraid of being judged on account of having an enormous ego that could not handle even the faintest criticism. This might lead them to becoming vicious in defence of that ego, or to adopting an exaggerated ‘cool’ affectation intended to mask their extreme fragility in the face of judgment.

The third major kind of phobia is agoraphobia. This relates particularly to a fear of finding oneself in an environment that offers no easy means for escape. These environments are common ones such as trains, elevators or open spaces, which naturally leads to a significant impact on ordinary life function. Being caught in such a space with no easy avenue of escape can easily cause a panic attack in an agoraphobic.

Much like social phobia, a character that has agoraphobia might live a particularly lonely and unhappy life. Having agoraphobia makes it much harder for a person to get out of their house, because their house becomes a kind of safe zone from the horrors of society. Stressful and traumatic events can trigger agoraphobia, and central to it is the fear of loss of control. Going outside comes to feel like stepping into the maelstrom.

Generally speaking, it’s easy to include a character with a phobia in your story because almost all of your readers will understand fear, and so they will be able to relate to that character. Having a character with a phobia might be an easy way to create a strong sense of fear and dread in your reader, especially if the phobia is a common one.

Phobias are not generally believed to arise as a result of a moral failing or of any personal weakness. It will therefore be easy to write a character with a phobia who comes across sympathetically to the reader. Portraying a character who struggles valiantly to live a normal life despite a crippling phobia might read as heroic, but if emphasis is put in the wrong places the character might come across as a milksop.

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This article is an excerpt from Writing With The DSM (Writing With Psychology Book 5), edited by Vince McLeod and due for release by VJM Publishing in the summer of 2018/19.

Writing Anorexia Nervosa

A person with anorexia nervosa can see themselves as hideously fat even while dangerously underweight

Anorexia nervosa (usually just called anorexia) is an eating disorder characterised by an overpowering fear of being fat or of gaining weight. This fear is so all-consuming that it can lead to illness from self-starvation. This article looks at how to write engaging and believable characters with the condition.

The basis of the psychopathology of anorexia is believed to be valuing of thinness. People with anorexia feel that being thin is extremely important, to the extent of it being an obsession. For this reason, anorexia is much more common among women compared to men, and more common among women exposed to fashion media or who have an interest in sport and fitness compared to other women.

More specifically, thinness is considered important because it’s where a person’s sense of self-worth derives from. Thinness is seen as a virtue by anorexics, which is why the condition is so hard to understand for people who don’t have it.

Some might be surprised to hear that anorexia is one of the most deadly of all psychiatric conditions, up there with schizophrenia and major depressive disorder. An unusually low body weight is linked to a wide range of physical ailments, as many elementary bodily functions cannot operate past a certain level of starvation. Even without intending to, it’s common for anorexics to become sick and die as a consequence of lengthy periods of starvation.

If you are writing about a protagonist that suffers from anorexia, their internal dialogue might have a lot of anxiety based around a need to be in control of their body weight. Sometimes such a person will have a ruthless, almost sadistic approach towards their own body. This explains why there is a high degree of comorbidity with Obsessive-Compulsive Disorder. A person with anorexia often becomes extremely particular and fussy about their food and their calorie intake.

Then again, the approach might be more feminine. Instead of a desire to control, having a meal might conjure feelings of fear, almost panic. The sight or smell of food might trigger a reaction similar to that of a person with a phobia encountering their object of fear. It might be enough to also trigger powerful feelings of self-loathing.

Much like psychosis, anorexia tends to come and go in ’bouts’. An episode of anorexia is often triggered by a traumatic life event. It may be that sudden high levels of stress and anxiety result in a desire to compensate for a perceived loss of control.

Anorexia is not a psychotic disorder. A person with it will generally know that they have something amiss about them – but therein lies the difficulty. This reasonable part of the mind struggles incessantly against the part of the mind that commands that one must be thinner no matter what. It might be that the part of the mind that desires thinness above everything is somehow stronger, or more able to assert itself.

The effect that this might have on a protagonist of your story is therefore similar, in many ways, to that of one with depression. Constant feelings of having undermined oneself lead to guilt, personal recrimination, and a loss of confidence in one’s own intelligence, one’s competence or even one’s will to live. As is true of most of the conditions in this book, anorexics tend to have damaged self-esteem.

Like many of the other conditions in this book, it’s believed that anorexia nervosa frequently has an origin in childhood abuse. It might be that this is the reason for why it goes in bouts: dysregulated stress responsivity arising from the trauma leads to extremes of anxiety, and when one of those extremes is reached, a sudden desire for extreme control appears.

The experience of other characters who have a friend or family member suffering from anorexia is usually a difficult one. In many ways, watching someone waste away through anorexia is similar to watching them waste away through a heroin addiction.

This often brings with it a range of feelings that might profoundly affect that character, in particular frustration at not being able to get through to the anorexic about how dangerous their condition is, and guilt about not being able to “do more” for them. Although it’s true that it’s hard to reason with people who have mental illnesses – by definition – it’s still very common for friends and family of people with them to feel guilt about not being able to do more to get them to live a healthy, normal life.

A more distant character who encountered someone with anorexia might get the feeling that the anorexic is uptight and rigid. Anorexia is often associated with a sensitivity to insults and disrespect, as as perfectionism, and a character that demonstrated any of these traits could plausibly develop anorexia or have a past history of it.

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This article is an excerpt from Writing With The DSM (Writing With Psychology Book 5), edited by Vince McLeod and due for release by VJM Publishing in the summer of 2018/19.

Writing Obsessive-Compulsive Disorder

Frequent handwashing can be a sign of a person who is struggling with OCD

Obsessive-Compulsive Disorder (OCD) is characterised by the compulsive and repetitive performing of ritualistic behaviours intended to reduce anxiety. It’s a relatively common condition, and may not be as distressing as some of the others in this book, but a character with it will still be a striking one. This article looks at how to write believable and engaging characters with this condition.

An obsession is a pattern of thoughts that persists despite a conscious effort to get rid of it. These obsessions frequently cause anxiety, especially when they relate to lurid sexual or violent content, as they often do. Some other obsessions can border on the schizophrenic. God and the Devil are frequent subjects for obsessions, especially as pertains to future punishment for some misdeed.

These sort of thoughts can become highly intrusive and maddening in their persistence and the degree they distract from a normal life. If your protagonist has OCD, they might have a distressing interior monologue where anxiety and thoughts of decay and contamination are commonplace. Intrusive thoughts can be just as unpleasant as physical intrusions, especially when they come into the head when you’re trying to sleep or relax.

Compulsions are similar, only they relate to behaviours instead of thoughts. The classic example is compulsive hand washing. Others are compulsively checking that a door is locked, or that a stove is turned off. The person with OCD tends to worry about whether or not something is in correct order and this anxiety increases until that thing can be checked.

A person with OCD will usually be aware that they have a problem. This makes them different to psychotics, narcissists and psychopaths. A character with OCD might not necessarily be an outcast (or at least, not a true outcast), in contrast to the vast majority of characters inspired by this book.

Psychologists talk about a four-factor theory for understanding people with OCD. Essentially this is based on four groups of behaviours. There is a “symmetry” factor, a “forbidden thoughts” factor, a “cleaning” factor and a “hoarding” factor. If the protagonist of your story is or encounters a character with OCD, they will quickly notice one of these groups of behaviours.

The symmetry factor relates to an anxiety-driven compulsion to make everything balance in terms of symmetry. For instance, they might make sure that they take exactly the same number of steps to cross each segment of a repeating pattern of cobblestones. They might also be very fussy about books on a shelf or paintings on the wall lining up perfectly. Every left needs a right and vice-versa.

The forbidden thoughts factor relates to compulsively thinking about things only because one knows one isn’t supposed to. A character with OCD might start having frequently, intrusive, obsessive thoughts about a particular sexual fetish or situation, despite not finding it arousing (more the contrary). Thoughts of incest, pedophilia and homosexuality are all very common here.

Cleaning is probably the best-known of the common symptoms of OCD. The cleaning factor refers to how people with OCD are prone to quickly decide that something is contaminated and needs to be cleaned. For instance, just touching the ground might cause immense anxiety until the OCD sufferer washes their hands. Because there are thousands of potential contamination vectors, people with OCD often end up washing their hands dozens of times a day.

Hoarding is common but not often understood to be a symptom of OCD. Underlying this is often an anxiety about information being lost, and so the hoarder might hoard, for instance, a daily newspaper. The really clinical OCD comes into play when that person doesn’t want to get rid of what they’ve hoarded, even when it becomes a hygiene or fire risk.

It will be easy, if desired, to write sympathetically about a character with OCD. Usually people with the condition are regarded as eccentric rather than malicious. People with OCD don’t tend to take their suffering out on other people, although they can do if those other people prevent them from acting out their compulsions. Hoarding can, of course, lead to malicious behaviour, especially if the space in which the hoarding occurs is contested.

OCD can certainly feel malicious to a person with it, however, especially if the impulsive thoughts don’t give the person any peace. It’s common for impulsive thoughts to come at times that feel especially intrusive, like when trying to sleep or when making love. When this happens for long enough it’s possible to consider that a malevolent demon or entity might be causing them, although this is uncommon.

In contrast to most of the conditions in this book, OCD is not believed to be caused by trauma. The most generally accepted belief is that people with OCD have likely inherited an unusually high genetic propensity towards certain behaviours that were associated with survival in the past, such as checking for dangers and being meticulous about hygiene. A person with OCD is, by this reckoning, usually just hyper-vigilant.

For this reason, a character with OCD is likely to be doing considerably better than the a character with most other conditions described in the book. They might even be in a form of gainful employment where an extremely unusual level of meticulousness and cleanliness were advantages, such as surgeon. Certainly it is more likely that they will have a circle of compassionate friends than people with most other psychiatric conditions.

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This article is an excerpt from Writing With The DSM (Writing With Psychology Book 5), edited by Vince McLeod and due for release by VJM Publishing in the summer of 2018/19.

Writing Depersonalisation Disorder

Depersonalisation Disorder is a brutally surreal experience. Also known as Derealisation Disorder, this condition is characterised by feeling like an outside observer of one’s own body despite being in it, and feeling like one isn’t actually in control of that body’s actions. Also common are feelings about reality being vague, dream-like, or less real than usual. This article gives some hints for how writers can handle characters with Depersonalisation Disorder.

This condition is almost always the result of stress, but a distinction needs to be made between a person who is temporarily dissociating in the moment because of an intensely traumatic event that has just happened, a person who has an established pattern of dissociating when exposed to certain stimuli that should not themselves be distressing, and a person who has a tendency to dissociate under small amounts of stress owing to psychological damage from past trauma.

It has to be made clear that Depersonalisation Disorder is not the same thing as psychosis. A person in a dissociated state will be aware that their perceptions are altered (or, at the very least, that something is wrong). In other words, they will not have lost touch with reality, which is a necessary quality of a psychotic experience. They will just have dissociation.

Dissociation is when one starts to feel emotions and sensations that aren’t usually associated with the environment that one is in. For example, one might be in an extremely stressful situation but not actually feel any stress: one simply watches everything from the perspective of consciousness, as if floating outside the body. Things feel unreal, surreal, so that sometimes one feels as if one is watching a film with one’s life on it instead of actually living it.

This lack of connection with the body is the strangest and most difficult thing about the condition. A person with depersonalisation can look at their own hand and not feel like they’re looking at their own body, which is a highly disconcerting experience. It’s also disconcerting to look at yourself in the mirror and not really understand who it is or that it’s you, or to recall a past memory and feel as if it really happened to someone else.

If written from a first person perspective, and written well, the experience of a character with Depersonalisation Disorder might be terrifying to the reader. Dissociation is often terrifying to experience personally, especially for the first time, and may be difficult to distinguish from a panic attack. However, often it is more weird than frightening, especially when the alternative is genuine suffering.

If the dissociation is occurring in a character being observed by the protagonist, that character might seem distant, vacant and “spaced-out”. The protagonist might get emotionless, zombie-like responses from the character undergoing dissociation, which might be a problem if there is something that has to be done quickly. It’s very possible that the protagonist mistakes the person dissociating for being under the influence of a psychoactive substance.

Most readers don’t do a lot of drugs. If they do, they might find the experience amusing to read about. After all, dissociation is a common effect of many recreational drugs. For such an audience, a character’s bout of dissociation might come across as highly comical, and doubly so when paired with another character who is perfectly straight in all regards.

Like most psychiatric conditions, Depersonalisation Disorder is believed to have an origin in psychological trauma. It’s very possible that a character with the condition will have experienced repeated trauma in childhood (usually emotional) that was so relentless it caused the mind to dissociate with reality in order to protect itself. This could be abuse, or a witnessed tragedy, or even simply a realisation about the true nature of things.

The case of Depersonalisation Disorder might then be an ego protection response to extreme trauma so that the person suffering the trauma doesn’t become cruel as a consequence of the suffering. Essentially one goes mad, when under inhumane stresses, in preference to becoming evil. This might be a way of showing the inherent goodness of a character, or their inherent naivety, depending on one’s approach.

Writing about a character who has dissociation might not be very interesting if the story revolves around the dissociation itself. The story might be more interesting if your character is an otherwise mentally healthy person who becomes dissociated as a result of extreme circumstances. This might be a one-time event or it could be part of a pattern.

If it’s a one-time event, it might be a reaction to a grisly sight like a car accident or something seen on a battlefield. This need not, then, be the central role in the story, but might rather be something that befalls the protagonist at a particular juncture, possibly transforming them or causing them to grow.

If part of a pattern, it might play a more central role in the story. It may be that the sight of a certain thing triggers an episode of dissociation on account of being associated with what caused the initial trauma, or it could be that relatively small amounts of stress or uncertainty are enough to tip a character over the edge.

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This article is an excerpt from Writing With The DSM (Writing With Psychology Book 5), edited by Vince McLeod and due for release by VJM Publishing in the summer of 2018/19.