Category: creative writing

Writing Narcolepsy

Best known as the condition that causes Grandpa Simpson to fall asleep at a moment’s notice, narcolepsy is an uncommon disorder linked to sleep patterns. This article looks at how to write believable characters with narcolepsy.

Narcolepsy is a decreased ability to regulate sleep-wake cycles. The overwhelming problem with narcolepsy, and its most characteristic feature, is that people with it can feel extremely tired during the day. The most notable symptom is recurring bouts of extreme daytime sleepiness, which can result in falling asleep in unexpected and inappropriate places.

Because being properly awake during the day is virtually a necessity for normal life function, narcolepsy can be a crippling condition for those afflicted. If it’s bad enough, driving a car will be impossible because of the risk of crashing (similar to epileptics). Taking public transport might not be possible either, which means that the life of the a narcoleptic character in your story might have to be a restricted one.

The author should pay close heed to what’s known as the “tetrad of narcolepsy”: cataplexy, sleep paralysis, hypnagogic hallucinations and being extremely tired during the day.

Cataplexy is a strange condition that involves the sudden weakening of large muscle groups. A bout of cataplexy can involve a weakening at the knees, or in the neck and head (similar to nodding off to sleep). This is one symptom that can truly wreck the life of a narcoleptic. It isn’t just that the physical debilitation is a problem, it’s that the narcolepsy sufferer learns to fear the social occasions that pose a risk of provoking one.

Sleep paralysis is the experience, often terrifying, of not being able to move one’s body when awakening or falling asleep. The experience of a character undergoing sleep paralysis might be similar to one undergoing night terrors. They may feel as if they have died.

Hypnagogic hallucinations are felt by narcoleptics when falling asleep. These are intense, vivid and dreamlike experiences that usually manifest as sights and sounds. These experiences can feel much like salvia divinorum experiences in that they are surreal and cause one to feel like one is present in another world. These hypnagogic experiences are sometimes disturbing enough to cause a person to get out of bed again.

The excessive daytime sleepiness is probably the most striking and obvious symptom. This manifests as powerful “sleepiness attacks” that overcome the narcoleptic, no matter how much sleep they have had the previous night. These attacks may be irresistible, so much so that the narcoleptic can literally fall on the ground asleep.

Narcolepsy might be more useful as a plot device than as something to afflict a character with. It could be that someone’s narcolepsy in the past led to a car accident, which then had far-reaching consequences for the protagonist of your story. Or it could be that, as a small minority of narcoleptics are “supertasters” with heightened olfactory awareness, your protagonist has a special use in forensic science or perfumery.

It might even be that a character’s narcolepsy has led to them waking up and rearranging their environment during the night. This could be combined with more interesting sleep disorders, like somnambulism.

Another curious point about narcolepsy is that it’s easy to confuse with an addiction to heroin or some other drugs. After all, it need not be immediately obvious to a close observer if a given person nodding off is doing so because of narcolepsy or heroin, drunkenness or something else. A character with narcolepsy might then feel that they are hard done by on account of being treated like something they’re not.

Unlike most of the other psychiatric conditions in this book, narcolepsy is not caused by early childhood abuse or neglect. So a character with it is unlikely to demonstrate signs of being damaged. Possibly they are an entirely normal person by most apparent measures apart from the narcolepsy.

Many stories about mental illnesses are tragedies because of the exposure to violence, neglect or abuse that caused the trauma underlying the illness. In this sense, a story about narcolepsy is probably different. The trauma might be ongoing, on account of that the coming of narcolepsy can ruin the life of an otherwise entirely normal person who had previously given no indication that they might be mentally unusual.

Alternatively, the narcoleptic could be a good choice of character to place at the centre of a comedy. A problem with suddenly falling asleep all the time could make it very hard to get things done. If a band of characters had to achieve some set goal, and one of their number was a narcoleptic, that character might constantly be letting the others down by falling asleep at inopportune times.

Likewise, a narcoleptic guard, surgeon or helicopter pilot might be considered inherently funny, on account of that their condition makes them exceptionally unsuited for that particular job, in a fish out of water sense. The author will have to take care to find the right balance between comic and ridiculous here.

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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 Conduct Disorder

Unlike most of the conditions in this book, Conduct Disorder (CD) is only diagnosed in children and adolescents. As the name implies, people who get diagnosed with it conduct themselves in ways that the clinician considers disorderly, in particular when it comes to respecting the rights of other people. This article looks at how to write believable and interesting characters with the condition.

The most important thing is to distinguish CD from Antisocial Personality Disorder. CD is the developmental precursor to Antisocial Personality Disorder – it can only be diagnosed in those too young to have a diagnosis of Antisocial Personality Disorder (i.e. 18 years of age). It is therefore a developmental condition.

One of the key symptoms of CD is a lower level of fear. This will express itself in a wide variety of ways.

The most notable way that a lower level of fear expresses itself in young people is when it comes to transgressions. A young person has not yet had time to internalise knowledge about the effects that their actions have on other people. They therefore have to learn to be afraid of punishment. This corresponds to Level 1 of Kohlberg’s Scale of Moral Reasoning.

A young person with CD will have a hard time internalising rules about those transgressions, in part because they don’t feel much fear, and so don’t have as much inhibition when primitive impulses towards violence and destruction start playing up on them. Because of this, they regularly violate boundaries relating to other people’s personal space and property.

Another way low levels of fear find expression is in transgressions against one’s own health. Young people already play fast and loose with their health when it comes to having a good time; young people with Conduct Disorder are nihilistically reckless. If the protagonist of your story has Conduct Disorder, chances are that they will be into the booze, weed and pills from their early teenage years.

A character with CD will likely be something of a daredevil. If they are male, they might find themselves drawn to racing motor vehicles or street fighting; if female, to shoplifting and starting trouble between men.

A story with a protagonist who has Conduct Disorder might read like J. D. Salinger’s Catcher in the Rye. Care must be taken here, therefore, not to sound cliched. Anti-hero stories mostly appeal to the same young audience, because they will most readily identify with the spirit of rebellion expressed by such a character. People with Conduct Disorder push the boundaries, for good or ill.

Punk stories, in particular cyberpunk, often feature protagonists who would appear (at least from the authorities’ perspective) to have Conduct Disorder. Young men like John Case of Neuromancer or Jonty Gillespie of The Verity Key are unrepentant criminals, usually because they have to be in order to make a living in the cracks of the edifice of respectable society.

After all, one man’s Conduct Disorder is another man’s righteous rebellion against a tyrannical oppressor. So a character with the condition might be the perfect choice of protagonist if your story involves going up against a large, faceless, totalitarian entity. After all, most of us have a point which, if pushed beyond, we will no longer behave in a co-operative manner.

If a character with CD is pitted against a malicious, evil entity (corporation or government), much of the difficulty in writing your story will come from making that entity unsympathetic enough that the reader readily comes to identify with that character. The more credibly this can be done, the less that character will look like a CD sufferer and more like a righteous hardarse.

Unsurprisingly, Conduct Disorder is highly correlated with all forms of early childhood abuse. A character with the condition might have learned by way of mimicry of their parents that violence and cruelty are perfectly acceptable ways to advance one’s interests, and that fear is for the weak and an invitation to be destroyed.

So if you are writing a character with CD they might not necessarily be a cool, daring and adventurous antihero. Realistically they are more likely to be somewhat brutal. If your protagonist encounters such a character, they might find them intimidating – the class bully, or local street thug.

If your protagonist encounters a character with CD, they could respond in a wide variety of ways, depending on how they themselves are (and their decision will be very revealing to the reader). They might consider that character a cool rebel to be befriended, they might consider them a danger to be avoided, or they might consider them a little brat to be corrected.

Conduct Disorder often occurs at the same time as Attention Deficit Disorder. It’s likely, therefore, that any character with it will have extreme difficulty at school, at work, or with either friends of family. Their life will probably be very chaotic, and will considerable Police or social worker involvement.

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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 Avoidant Personality Disorder

Avoidant Personality Disorder (AVPD) is characterised by extreme action taken to avoid certain feared stimuli, usually social. Social anxiety, feelings of unworthiness, timidity and sensitivity lead to a pattern of avoiding situations that involve interacting or socialising with others. This article looks at how to write engaging and realistic characters with the condition.

AVPD is a Cluster C personality disorder, which means that it’s primarily an anxious condition. The essential characteristic of it is an inability to form social bonds brought about by an extreme desire to avoid particular feared stimuli. For example, people with AVPD tend to be very sensitive to social rejection or humiliation.

It is believed to be caused by abusive or neglectful parenting patterns. In particular, rejection by one or both parents is thought to correlate highly with the condition. It can be observed in other mammals that rejection by one or both parents sharply reduces the ensuing life expectancy for that creature. No doubt the trauma from such treatment makes an impact on the behaviour of human survivors.

If your protagonist has AVDP, it might be that they experience loss and social rejection so strongly that they are simply devastated by it. They might have an internal monologue that heavily plays on fears of social encounters going wrong. A story featuring them might read very strangely as it involved a number of events that ended up not happening or not being attended by the protagonist, who felt too anxious to participate.

This can easily lead to a darker, resentful pattern of behaviour, especially if a protagonist with AVDP comes to feel a malicious desire for revenge as a consequence of their rejection. Social rejection need not lead to learned helplessness and submission in every case – it can lead to violent reprisals, especially if the rejected person feels that they have been treated unjustly.

Someone with AVDP might make a convincing villain if the author can convincingly portray a character who has become nasty as a result of their pride. It might be that the villain received some mild slight or insult and their massive ego was punctured, leading to narcissistic rage. They could be the sort of person who never forgives an insult, leading to complicated revenge schemes.

To many outside observers, AVPD looks very similar to just having low self-esteem. People with the condition tend to believe that their social presence is unwanted, and that they are unworthy of the time and attention that they are given in their social relationships. In cases of parental rejection it’s obvious how such thinking might come about, but it can be caused by other things, such as a generalised perception of social rejection.

In the mind of a character with AVPD, the everyday experience might be one plagued by self-doubt and feelings of unworthiness, in much the same way that it can be for a depressed person. Indeed, one particular strain of AVPD has a number of depressive features, in particular the casting away of, and refusing to deal with, certain traumatic memories.

A protagonist with the condition is likely to consider themselves socially inept. There might be a lot of blame directed at the self in their internal monologue. It’s possible that there is a personal quality of their own that they fixate on as an explanation for their lack of social success. As mentioned above, this can easily become projected outwards onto society.

People with AVPD can be difficult socially because they can be very needy and very resentful. There is a particular strain of the condition that is hypersensitive in a way that is not dissimilar to those with Narcissistic Personality Disorder. This type can become easily wounded by jokes or banter, to the extent that others might call them “precious”.

Feedback loops are an unfortunate common effect of this condition. Anxiety about being socially rejected often leads to a range of behaviours that themselves increase the likelihood of social rejection. Anxious eye contact often appears shifty to other people, who then come to distrust the person with AVPD. Because these people trust the person with AVPD less, they speak to them in a less friendly manner, which validates the initial feelings of anxiety and strengthens the avoidant behaviours.

A protagonist with AVPD might find their everyday experience tormenting, because people with the condition have a normal need for social interaction and intimacy – they just fear it. Because of this fear, and sometimes because of resentments, a protagonist with the condition might find their everyday experience tormenting. It might be a relentless march of anxiety, blame, missed opportunities, guilt and rejection.

AVPD sounds, and is, similar to Schizoid Personality Disorder, but there are crucial differences. For one, a character with AVPD will like be more anxious than a schizoid. For another thing, schizoids don’t generally care about other people, whereas people with AVPD will still desire positive social contact.

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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 Histrionic Personality Disorder

People with Histrionic Personality Disorder (HPD) are colloquially known as “drama queens” or “shit-stirrers”. Fundamental to the disorder is a desire for attention that borders on the narcissistic, as well as strong, shallow, rapidly-changing emotions. This article looks at how to write realistic and believable characters with HPD.

As is the case with many of the conditions in this book (and especially the personality disorders), people with HPD are often high-functioning in several ways. As with most of the conditions in this book, people with HPD can often be entirely competent and effective in their niche. For instance, they excel at screen and theatre acting.

A simple (if crude) way of conceptualising HPD is that, for people with it, drama is like a drug. They get hooked on it, they seek it out compulsively, they try to get bigger and bigger doses of it. The more attention they can draw to themselves the better. A cynic might call them a “psychic vampire” because dealing with them frequently leaves a person tired.

For these reasons, HPD is a fitting and excellent choice for some of the characters in your fiction. A character with HPD will naturally liven things up – even if they end up causing chaos. Because they seek drama out, it is never far from them. Not only do they like drama, but they tend to have just enough narcissism to bring some truly dark emotions out of others.

From the perspective of other characters who might encounter a character with HPD, one of the most difficult things about them is their apparent need to be overly emotional and dramatic all the time. Because emotional reactions are contagious to some extent, a person with HPD will tend to trigger those around them – a great quality in a bartender perhaps, but if there is a need for calmness and order this is usually unhelpful.

Other characters might also find the constant self-aggrandisement extremely tiresome. People with HPD like to use elaborate and flowery speech when unnecessary or even unhelpful, and love to tell stories that feature themselves looking good or being heroic. Such typically unsubtle attempts to draw praise are sometimes described as “needy”. Indeed, it is common for people with HPD to display symptoms typical of Dependent Personality Disorder.

Several common characteristics of HPD overlap with common characteristics of Narcissistic Personality Disorder. One of these in particular is the usual reaction to criticism. For the histrionic, any and all criticism is a brutal personal attack, an act of the utmost cruelty. It is so bad that any retaliatory measures are justified (although a character with HPD will tend toward passive-aggressive revenge tactics).

Related to this is the constant seeking of reassurance or approval. A protagonist with HPD might have compulsive thoughts about not being a good enough person and so seeks out ways of being told that they’re worthwhile. If a character has HPD, there might also be very clear ways that this can be shown through their clothing choice: “Loud and proud” would sum up their dress style.

Other characters might find it very stressful to be around a character with HPD, partially because of the narcissism but mostly because they don’t leave other people in peace. Because of their need to be the centre of attention, a character with HPD might continually butt into other people’s conversations, or make it all about them. They’re also generally happy to spread rumours around, especially if they think that doing so will make someone angry.

A character with HPD might strike other characters as superficial or false. After all, their emotions might strongly rise, but they also strongly fall and quickly transform into other ones. A second character might come to feel that they can’t really trust the histrionic one. It’s hard to know whether they’re acting or genuine.

One area in which the lives of people with HPD tend to be in particular disarray is romantically. They commonly perceive sexual interest where none exists. This makes their own lives difficult, as they often end up misreading the signals and making a move on someone who then rejects them. It can also make other people’s lives difficult, as people with HPD tend to perceive sexual infidelity where it doesn’t exist. This jealousy can fuel untold dramas.

On a darker note, people with HPD are well-known for hitting on people who are already in established relationships. This is partly because of the aforementioned tendency to perceive sexual interest where none exists, but this can also be influenced by a narcissistic refusal to respect other people’s boundaries and an inability to delay gratification.

Having said that, people with HPD are often very engaging to make love to. Excessive sensitivity and dependence on other people’s approval can make for a powerful contribution to the bedroom magic.

Adding a character with HPD to your story, or adding aspects of it to a character in your story, has the potential to liven things up but there is a risk that it can also make things more trivial. Because histrionic characters can get upset over small things, they can be hard for the reader to relate to, and therefore are often better as a foil to another character or as comic relief.

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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.