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The Walking Traumatized
JANINA SCARLET
Shane: “Jim, nobody is gonna hurt you, okay?”
Jim: “That’s a lie. That’s the biggest lie there is. I told that to my wife and my two boys. I said it 100 times. It didn’t matter. They came out of nowhere. There were dozens of them. Just pulled ’em out of my hands. You know, the only reason I got away was ’cause the dead were too busy eating my family.”1
The Walking Dead provides a window into emotional trauma. The protagonist, Rick Grimes, seems especially traumatized by the events that follow the apocalypse. After Rick has to kill his best friend, Shane, his personality changes drastically. Once calm, friendly, and level-headed, Rick becomes controlling, suspicious, and angry. He grows distant from his wife, Lori. After she dies in childbirth, Rick has hallucinations, hearing the voices of people who have died since the outbreak and then seeing his deceased wife haunt the prison.
What’s Wrong with Rick?
What does this mean for Rick? Does he have posttraumatic stress disorder? Does he have schizophrenia? Is his reaction normal? How does he get better?
Does Rick have PTSD?
Posttraumatic stress disorder (PTSD) is a mental health disorder that can occur among a substantial minority of those who experience life-threatening trauma.2 The symptoms people with PTSD experience fall into these categories:
• Intrusions: flashbacks, nightmares, or constant thoughts about the traumatic event. Rick’s flashbacks dealing with Shane’s death are an example of intrusions.
• Hyperarousal and change in mood: being easily startled, overly vigilant, having trouble sleeping or relaxing, feeling angry and irritable, acting aggressively. When Rick first learns of Lori’s death, he reacts by lashing out at the prison’s walkers and anyone in his way, including Glenn.
• Avoidance: This is perhaps the biggest manifestation of PTSD.3 Symptoms typically include avoiding anything related to the traumatic event, including thoughts and feelings about the trauma and reminders such as people, places, and conversations. After Lori dies, Rick stays away from his children and friends. Not until after he hallucinates a phone conversation with Lori, who reminds him of his duty to protect their children, does he hold his daughter for the first time.
To be diagnosed with PTSD, a person must experience symptoms from these categories for at least a month. Although Rick’s symptoms become most severe immediately after Lori’s death, he already experienced most of them after killing Shane. He continues to show most of the PTSD features long after he stops hallucinating. When one considers all these symptoms together, it does seem likely that Rick has PTSD.
Although hallucinations are not part of the PTSD diagnosis, research suggests that as many as 20 percent of people with PTSD are likely to develop some kind of psychosis,4 especially if they experience hyperarousal, as Rick does. Psychosis refers to a loss of reality in which a person may create false beliefs (delusions) or see, hear, or smell things that are not there (hallucinations). Rick experiences visual and auditory hallucinations when he sees Lori and speaks to her on the telephone. On the television show, his auditory hallucinations stop after he realizes he is hallucinating and says farewell to Lori. In the comic books, the phone conversations continue for a longer time but eventually stop when his PTSD symptoms start to subside. This suggests that his hallucinations most likely were triggered by the traumatic loss rather than by another condition, such as schizophrenia.
Along with PTSD, a likely diagnosis for Rick might be brief psychotic disorder, which is characterized by the presence of one or more of the symptoms listed for schizophrenia but lasts less than one month. This disorder often results from a major stressor or trauma, and this fits with what we know about Rick.
Research5 suggests that PTSD affects a number of different beliefs, especially those related to safety, trust, control, esteem, and intimacy.6
• Safety beliefs relate to our ability to protect others or ourselves. Rick confides to the CDC scientist Jenner that he feels he may not be able to protect his family.
• Trust beliefs have to do with people’s ability to trust themselves and others. When Tyreese and his friends ask to live in the prison, Rick refuses, shouting at them to leave.
• Control beliefs have to do with needing to be in control. Rick, Shane, and the Governor push themselves to control situations and don’t usually trust others to lead.
• Esteem beliefs relate to self-esteem as well as regard for other people. Rick blames himself for Lori’s death and confides to Daryl that he has “screwed up too many times.”7
• Intimacy-related beliefs have to do with our ability to get close to other people. Shane’s death causes a rift in Rick and Lori’s relationship and is undoubtedly traumatic for them in different ways. When Lori tries to talk to Rick, he pushes her away: “You want to talk? Talk to Hershel. I’m doing stuff, Lori. Things.”8
What Causes PTSD?
Many people (approximately 60 percent)9 are exposed to traumatic events during their lives. Nearly all who are exposed to trauma initially may have some symptoms similar to those seen in PTSD, but most people get better.10 Approximately 4 to 10 percent of those exposed to trauma develop PTSD. Some of the most common reasons for developing PTSD have to do with how we feel, think, and act.
After a traumatic event, a person may learn to associate certain cues in the environment with danger.11 For example, because Lori dies as an indirect result of the inmate Andrew’s actions, Rick regards all strangers as dangerous to his group. He drives Tyreese’s group away.12 Because he remembers Andrew, his automatic response becomes that of mistrust and defensiveness toward anyone outside the immediate crew. Occasionally he is right, of course, but there are also times when he isn’t.
Another cognitive (thinking-based) cause of PTSD has to do with the way a person interprets the trauma. Those who blame themselves for traumatic events are more likely to feel guilt and shame about them, and this makes PTSD more likely. For example, Morgan, the first person to tell Rick about walkers and the apocalypse,13 later blames himself for his son’s death.14 Even though Morgan is not directly responsible, he could not bring himself to kill his walker-turned wife, who later kills their son. The blame that he places on himself prevents him from mourning his son adequately. Mourning is a natural process after losing a loved one. If it is interrupted, a person can develop a mental illness.15 Morgan appears to be spiraling downward: He doesn’t recognize Rick when he sees him again, mutters to himself, and writes strange notes no one can interpret.
When forced to act against their moral code, people with strong moral values such as Morgan and Rick are very likely to feel guilty, possibly affecting their self-esteem and identity; this change is called moral injury.16
Rick, a county sheriff, often feels responsible for protecting others and is overall a moral and compassionate person. Even when he exterminates a walker, a woman crawling around in a park, he bends down to tell her, “I’m sorry this happened to you.” However, between his old life ending, his son Carl getting shot, and his wife getting pregnant, Rick’s goals shift from saving the world to protecting his family. As he tells Shane, “I’m not a good guy anymore. To protect Carl, I would do anything!”17
Not until Rick kills Shane does he seem to experience the effects of moral injury. Specifically, Rick stops trusting his group, stating, “This isn’t a democracy anymore.”18 Feeling defensive, guilty, and angry about killing Shane, he pushes away those closest to him, including Lori. All these symptoms are consistent with moral injury,19 which can make a person more likely to be suspicious, distant, and prone to sabotaging his or her relationships with others.
Moral injury, insufficient social support, and continuous exposure to violent trauma not only make it more likely that a person will develop PTSD, they make it less likely that that person will recover from it.20 Unlike the other characters, Rick awoke into the post-apocalyptic nightmare. Nearly dying from a gunshot wound can traumatize even the most resilient people. Subsequently waking from his coma alone in an abandoned hospital, starved and dehydrated, and then discovering dead people’s remains (both inanimate and reanimated) might push anyone over the edge, and the stresses keep piling up. Learning that the outbreak affects the entire world, nearly losing his son to a gunshot wound, killing his best friend, repeatedly losing members of his group, and losing his wife all form a perfect combination of continuous mind-boggling traumas that finally knock Rick off his feet, causing a mental breakdown. After Lori dies, Rick goes on a rampage, slaying walkers throughout the prison. In the process, he becomes covered in blood and guts, looking a bit like a walker himself.21
After all his painful losses, Rick is not the same optimistic person he once was. He sometimes loses hope that things will ever improve again, and he is not the only one. Beth Greene (after the extermination of the walkers in her family’s barn, including her mother) and Abraham (after losing his entire family) attempt suicide at different times. Others, including Jacqui and Jenner at the CDC, do take their own lives, believing that there is no hope left. Hopelessness is one of the biggest factors in why a person may commit suicide, especially when it relates to all three of the following aspects: negative view about oneself, having to do with the person’s own negative judgments (for example, Abraham might have thought, “I’m a failure as a husband and father”); negative view about the world through evaluations of other people (e.g., when Father Gabriel says, “Nowadays people are just as dangerous as the dead”); and negative view about the future (e.g., Jenner saying, “There is no hope. There never was”).
Because hopelessness is such a painful emotion, the sufferers often look for ways not to experience it. Experiential avoidance is the unwillingness to experience the painful thoughts, feelings, or other sensations that may occur when an individual is going through a hard time and is looking for a way to avoid experiencing these painful sensations.22 Paradoxically, trying to avoid painful emotions actually can make people feel worse and may make them more likely to want to commit suicide. Bob’s drinking and Merle’s drug use are examples of experiential avoidance. In the short term, experiential avoidance can temporarily mask or reduce physical or emotional pain. In the long term, though, it can make the pain worse because avoidance supports the idea that the situation is hopeless. Avoiding problems instead of facing and working on them often can cause or worsen PTSD, depression, panic, obsessive-compulsive disorder, and other mental health disorders.23
What Does The Walking Dead Teach about Survival?
Rick, Abraham, and Beth, like other apocalypse survivors, have been through some of the most horrific traumas, and all attempt suicide at various points in their lives. Each finds a reason to live and changes drastically in order to stay alive. What do the three of them have in common? How do they manage to overcome their fears and hopelessness? What keeps them alive for as long as possible? They each find a purpose.
After walkers eat his family, Abraham is ready to commit suicide before Eugene runs toward him, asking for help. Abraham saves Eugene’s life, and then Eugene saves Abraham’s by offering him a “secret mission.” This gives Abraham a reason to live. He is a soldier. Being needed, being responsible for the lives of others, and having a specific goal are exactly what he needs to regain hope and fight to stay alive. For most service members, belief in the importance of their mission can reduce the likelihood of developing PTSD.24
Like Abraham, many people struggling with depression, overwhelming anxiety, or PTSD can recover faster if they stay true to their values.25 Values—different categories of areas that are important to a specific person—can include family, friends, compassion, altruism, health, spirituality, and many others. When people stay true to their values and act in ways consistent with them, they are more likely to recover from mental illness.
Beth loses hope after Shane and others execute all of her walker family and friends who were kept in a barn. She concludes, “It’s just so pointless!” Terrified that she will be gutted and unable to cope, she begs her older sister, Maggie, to die with her. Not until she actually attempts to kill herself does she realize that she wants to stay alive.26 What arguably changes Beth’s outlook on life the most occurs when Daryl later tells her that she will be responsible for taking care of Rick and Lori’s newborn child.27 She finds purpose and follows her value of taking care of others.
Another value that helps people recover from depression and trauma is compassion,28 recognizing that another person is suffering, being able to empathize with that person (to “put yourself in their shoes”), and being able to offer kindness. Daryl Dixon provides a great example of how someone can heal through compassion. Daryl survives severe childhood abuse and neglect, which left him angry and mistrusting. He and his brother, Merle, are even planning to rob the rest of the crew before Rick arrives at the campsite. Over time, Daryl begins to connect with others, starting with Carol when her daughter, Sophia, goes missing. Tirelessly looking for Sophia, Daryl performs the ultimate act of compassion when, recognizing that Carol is in great emotional pain, he brings her a Cherokee Rose, a Native American sign of strength and hope for the mothers of lost children.29
It is through compassion, social support, and staying true to his values that Daryl is able to heal the scars of his turbulent past and Rick, Beth, and Abraham are able to face their new experiences. Ultimately, opening up to painful experiences and being true to our core values and to ourselves seem to be the key ingredients in overcoming trauma.
References
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). Washington, DC: American Psychiatric Association.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York, NY: Guilford.
Boelen, P. A., & van den Bout, J. (2010). Anxious and depressive avoidance and symptoms of prolonged grief, depression, and posttraumatic stress disorder. Psychologica Belgica, 50, 49–67.
Cribb, G., Moulds, M. L., & Carter, S. (2006). Rumination and experiential avoidance in depression. Behaviour Change, 23(3), 165–176.
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319–345.
Farnsworth, J. K., Drescher, K. D., Nieuwsma, J. A., et al. (2014). The role of moral emotions in military trauma: Implications for the study and treatment of moral injury. Review of General Psychology, 18, 249–262.
Ferraj ão, P. C., & Oliveira, R. A. (2014). Self-awareness of mental states, self-integration of personal schemas, perceived social support, posttraumatic and depression levels, and moral injury: A mixed method study among Portuguese war veterans. Traumatology, 20, 277–285.
Foa, E. B., Zinbarg, R., & Rothbaum, B. O. (1992). Uncontrollability and unpredictability in post-traumatic stress disorder: An animal model. Psychological Bulletin, 112(2), 218–238.
Hayes, S. C., Strosahl, K., Wilson, K. G., et al. (2004). Measuring experiential avoidance: A preliminary test of a working model. The Psychological Record, 54(4), 553–578.
Kaštelan, A., Franciskovi T., Moro L., et al. (2007). Psychotic symptoms in combat-related post-traumatic stress disorder. Military Medicine, 172, 273–277.
Kearney, D. J., Malte, C. A., McManus, C., et al. (2013). Loving-kindness meditation for posttraumatic stress disorder: A pilot study. Journal of Traumatic Stress, 26, 426–434.
Litz, B. T., Stein, N., Delaney, E., et al. (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29, 695–706.
Loew, B., Carter, S., Allen, E., et al. (2014). Military beliefs and PTSD in active-duty U.S. Army soldiers. Traumatology, 20(3), 150–153.
National Center for PTSD (2014, November 10). How common is PTSD? U. S. Department of Veteran Affairs: http://www.ptsd.va.gov/public/PTSD-overview/basics/how-common-is-ptsd.asp.
Orsillo, S. M., & Batten, S. V. (2005). Acceptance and commitment therapy in the treatment of posttraumatic stress disorder. Behavior Modification, 29(1), 95–129.
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Resick, P. A., Monson, C. M., & Chard, K. M. (2008) Cognitive processing therapy veteran/military version: Therapist’s manual. Washington, DC: Department of Veterans Affairs.
Resick, P. A., & Schnicke, M. K. (1992). Cognitive processing therapy for sexual assault victims. Journal of Consulting and Clinical Psychology, 60(5), 748–756.
Schnurr, P. P., Friedman, M. J., Engel, C. C., et al. (2012). Cognitive behavioral therapy for posttraumatic stress disorder in women. JAMA, 297(8), 820–830.
Notes
1. Episode 1–4, “Vatos” (November 21, 2010).
2. American Psychiatric Association (2013).
3. Plumb et al. (2004).
4. Kaštelan et al. (2007).
5. Resick & Schnicke (1992).
6. Resick et al. (2008); Schnurr et al. (2012).
7. Episode 4–2, “Infected” (October 20, 2013).
8. Episode 3–1, “Seed” (October 14, 2012).
9. National Center for PTSD (2014).
10. Ehlers & Clark (2000).
11. Foa et al. (1992).
12. Episode 3–9, “The Suicide King” (February 10, 2013).
13. Issue 1 (2003); episode 1–1, “Days Gone Bye” (October 31, 2010).
14. Issue (2009); episode 3–12, “Clear” (March 3, 2013).
15. Boelen & van den Bout (2010).
16. Litz et al. (2009).
17. Episode 2–10, “18 Miles Out” (February 26, 2012).
18. Episode 2–13, “Beside the Dying Fire” (March 18, 2012).
19. Farnsworth et al. (2014).
20. Ferrajao & Oliveira (2014).
21. Episode 3–5, “Say the Word” (November 11, 2012).
22. Hayes et al. (2004).
23. Cribb et al. (2006).
24. Loew et al. (2014).
25. Orsillo & Batten (2005).
26. Episode 2–10, “18 Miles Out” (February 26, 2012).
27. Episode 3–5, “Say the Word” (November 11, 2012).
28. Kearney et al. (2013).
29. Episode 2–4, “Cherokee Rose” (November 6, 2011).