Without belief in victims’ stories and self-reported symptoms—and an investment in their fate—the study [of trauma] can’t exist. Unfortunately, given the frequent demographics of oppressor and oppressed, one key to the study’s advancement has been one of the least credible and most dispensable populations of all: women.
Ugh, women. Plaguing society with their hysterics.Irritable Hearts, p. 47
** First, a content warning for those diving into Irritable Hearts. The first third of the book includes non-graphic but direct discussion of sexual assault, sexual harassment, and rape; natural disasters; consensual violent sex; alcohol abuse; and suicidal thoughts. It also contains intense descriptions of PTSD symptoms, including flashbacks, constriction/withdrawal, nightmares, panic attacks, and hypervigilance. **
One of the things that I find most compelling about Irritable Hearts is an absence. At the very beginning of the book, McClelland* describes an event that contributed to her eventual PTSD diagnosis. But she doesn’t tell us exactly what happened. Instead, she writes,
I saw something.
That’s all. I’m not going to say much about it. I witnessed something very suddenly. It has something to do with a rape. I was extremely startled by the scene and by the sudden screaming–not mine, but the closest I’d ever been to anyone’s complete and abject terror. So close and so shocking that I lost myself in it.
The whole situation was immeasurably worse for those more directly involved, and they later decided they didn’t want to talk about it. The exact details are as bad as you might imagine, or worse than you could imagine.Irritable Hearts, pp. 17-18
McClelland writes about the decision not to disclose details about the event that contributed to her PTSD, and has spoken about it elsewhere. Part of the reason she can’t share more is ethical — the desire not to retraumatize anyone — part of it is legal. In interviews and talks about the booik she seems at the very least ambivalent about the choice (you’ll understand why when you read Chapter 8). But I think it’s a daring stylistic move, for a very important reason: It’s nobody’s business how you got PTSD.
Irritable Hearts helped me think through troubling interactions I often had in the early stages of me and Jason’s PTSD journey. When I’d share that Jason had PTSD, people would ask, “Where did he serve?” Or they’d ask “Oh no, what happened?” with an emotionally vampiric look in their faces, a look that I knew didn’t come from an abiding concern about Jason’s wellness.
One colleague, on hearing Jason’s story, literally rolled her eyes and said, “Lots of people get mugged.”
McClelland talks about this as “earning the diagnosis.” It is a strange position in which to find yourself, feeling like you constantly have to prove that whatever happened to you was traumatic enough that you deserve to have PTSD.
Non-PTSD sufferers grill folks with PTSD all the time. The first thing out of their mouths is rarely, “Oh god. I’m so sorry about that.” Much more often, the first thing they ask is “What happened?”
It’s gross for two reasons: 1) At best, it reflects a prurient interest in the suffering of others. 2) It also implies a hierarchy of suffering. And even worse, the question “What happened?” suggests that someone with no experience of PTSD has the capacity (and the right) to judge if someone who has suffered a trauma is authorized to claim PTSD.
And it’s not just those without experience of PTSD doing it. Those of us who suffer from the disease do it to ourselves. When I started to acknowledge my own struggles with PTSD symptoms, I found it really difficult to claim the diagnosis for myself, even after I was given the CAPS-5 and clearly qualified. “How dare you have these symptoms,” I thought to myself, “when what happened to Jason was so much worse?”
People with PTSD also also do it to each other, to some extent. Much to my shame, I’ve done it, even after Jason’s PTSD diagnosis, when I should have known better.
There’s a weird but common misperception about how trauma works that was illustrated by the fight we were having—that trauma exists only in the realm of those who have it worse than anyone else in the world. I myself held this misperception, the way I’d argued with Meredith that it was impossible for me to be traumatized. First, I hadn’t suffered anything serious. Second, the circumstances of my life generally caused me little suffering. I was in the bottom of the right-to-suffer caste system; it makes a kind of sense culturally, if not biologically.Irritable Hearts, p. 100
What happened was this: I went to pick up an enormous stack of PTSD books, five or six at once. I exchanged some pleasantries with the person who was checking me out — I’ve masked their identity here — and as they went through the stack, I asked: “Can you guess what I’ve been thinking about?” They laughed and said, “I’ll tell you, I read through a bunch of them before you came to pick them up.” They paused for a moment and then told me, “My child has PTSD.”
I did not say what I should have –“Ugh! I’m so sorry.” Or, “I know how it is.” Or, “If I can ever help, please let me know.” I said the single dumbest thing possible. “Oh,” I said, and then I asked, “Is it CPTSD?” [CPTSD is more common in people who have suffered ongoing, and often childhood, trauma.]
They looked at me, levelly and deeply, were silent for a moment, and then said, “I divorced my spouse. You do the math.”
See? Even as someone dealing with PTSD at home, the first thing I did was ask this acquaintance to categorize their child. What kind of PTSD? What happened? It’s none of my damn business if their child got PTSD from a car wreck, or abuse, or a natural disaster, or anything. It’s none of my business. Period.
Why do we do this to people with PTSD? Why do we skip sympathy and go directly to interrogation?
I suspect it is because it conveniently individualizes trauma while invalidating the person who experienced it. It saves us, as the Herman quote above points out, from having to acknowledge how much of trauma is structural and socially sanctioned — economic violence, militarism, patriarchy, white supremacy. It also allows us to escape the obvious conclusion: the society we live in harms people, deeply, sometimes irreparably. It spares us the realization that we participate in producing and worsening trauma, at the very least by cultivating ignorance about it.
It seems so much easier to diagnose suffering people than analyze and intervene in the structure that causes the suffering. So much easier to brand sexually abused women “hysterical” than to address rape culture. So much easier to describe soldiers as “nostalgic” or traitorous or weak than to genuinely calculate the human cost of military intervention. So much easier to characterize people of color as angry or jumpy or violent or apathetic or oversensitive than to name and dismantle the trauma-producing juggernaut that is white supremacy.
Judith Lewis Herman discusses in her book why people are so resistant to sympathize with a traumatized person. Traumatized people are saying, if inadvertently, Share the burden of my pain when they admit what’s happened to them. Do something—acknowledge it, at the very least. Share the experience of knowing—while eating cereal in the morning and putting one foot ahead of the other out the door on the way to work—that it is an atrocious world where something heinous could happen to you at any moment. Traumatized people are victims, of time or place or circumstance or evil, and nobody likes victims. It sounds counterintuitive at first, but it’s easier to identify with a perpetrator. A rapist, a child molester. People who are in control, who are in power, who have power, who are on the winning side. … Victims ask you to uphold human rights and decency and help. Repression and denial allow you to so nothing, which in inarguably easier.Irritable Hearts, p. 101
So whether McClelland left the answer to the question “What happened to you?” out of her book for legal or moral or ethical reasons, it serves a narrative purpose. I think it is a crucial and brave choice. That lack of disclosure forces us as readers to face a deep question about our own motives in asking someone who has suffered to relive that pain and display it to us for our judgement.
* The author of Irritable Hearts now goes by the name Gabriel Mac (@GayyybrielMac, http://gabrielmac.com/) and uses he/him pronouns. When referring to the main character and author of Irritable Hearts, I’ll refer to Mac by the name and gender he was inhabiting at the time of the writing and publication of the book. I don’t want to dead-name him, but many of the points about PTSD and relationships made in the memoir are gender-specific and I want to stay true to those original observations.
5 thoughts on “Irritable Hearts, Pt 1: Earning the Diagnosis”
” “What happened to you?” out of her book for legal or moral or ethical reasons, it serves a narrative purpose. I think it is a crucial and brave choice. That lack of disclosure forces us as readers to face a deep question about our own motives in asking someone who has suffered to relive that pain and display it to us for our judgement.”
Excellent idea 💡
I learned something from you today. 💐