Do You Avoid or Tackle Mental Health Issues in Fiction?

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I bring up mental health a lot here.  Usually, it’s in regards to the topic itself and not connecting it to writing.  Well, I’m going to switch that up here.  Wednesday and Friday are going to be some 7 Tip lists for depression and anxiety in fiction while today is going to be more of an open forum.  The question:

Do you think mental health issues should be avoided or tackled in fiction, especially genres like fantasy?

Personally, I think it depends on the author.  You can’t force someone to include a subject or trait that they aren’t comfortable with.  They might know enough about the mental issue to use it, which means research is needed.  It could also be that they are afraid of offending a sufferer with an incorrect depiction or to trigger something.  Since we are talking about a sensitive situation, it’s totally understandable that one would feel this way.  Honestly, I don’t think it’s fair to attack an author who tries and fails to depict a mental health issue even if they were being a jerk about it.  Respond with a rational criticism and try to educate if possible.

That also brings me to the other side of the spectrum that I’ve seen.  Some authors will take the more sensational version of a mental health issue for dramatic effect.  Anxiety-riddled heroes who can barely get out of the house.  Depressives who cry every time they speak and are covered in self-inflicted scars.  OCD is a term that is flung around so casually that it loses all meaning to some people.  Don’t even get me started on dissociative identity disorder, which used to be split personality disorder . . . Mostly because I’m still not 100% sure on how to work this one.  Anyway, these extremes can exist in reality, but they aren’t always the case.  To make it look like this is the only way it can go can be upsetting to those who suffer in a different way.  Especially when your depiction causes readers to expect those extremes in sufferers, so they doubt the words of anyone suffering in any other way.

This really is a delicate topic to add into your stories.  With fantasy, I think there are magical ways to cushion the blow or explain why it isn’t widespread.  Kind of a big cop out there, but it’s something.  At least with the more severe mental illnesses because you have psychics, casters, and healers out there.  One thing that is a dangerous tactic here is to use mental health issues as ‘curses’.  It’s pretty easy to do and comes off like a good idea when it’s in an outline stage.  The brave hero is sudden afflicted by anxiety or depression or a phobia or OCD or any number of things.  Yet, this can backfire and come off as insulting because it makes the conditions appear evil.  They’re not.

As I continue writing, I’m considering adding some mental health issues into my stories, but I’m still twitchy on trying.  There is going to be an addiction subplot in one book series, which stems from severe grief and depression.  I don’t know if this counts since it’s a deep sadness with a source and not a depression with no clear catalyst.  Anxiety is one that I might consider more because I have a better idea of that one.  I guess another reason for me personally is that I really want to maintain the escapism and heavy topics like this can shatter that illusion if you’re not careful.  They won’t be the main focus of a story, so they’ll be there as subplots or character traits.  This kind of prevents me from tackling the really heavy ones because those need a lot of attention and focus.

Anyway, what do you think about this topic?  Also, if anyone ever wants to write up a guest post on a specific mental health issue then feel free to ask for a spot.  Awkward request, but I feel like I’m limited in experience and knowledge here.

About Charles Yallowitz

Charles E. Yallowitz was born, raised, and educated in New York. Then he spent a few years in Florida, realized his fear of alligators, and moved back to the Empire State. When he isn't working hard on his epic fantasy stories, Charles can be found cooking or going on whatever adventure his son has planned for the day. 'Legends of Windemere' is his first series, but it certainly won't be his last.
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81 Responses to Do You Avoid or Tackle Mental Health Issues in Fiction?

  1. Marcia says:

    Good post, Charles. I believe that life is filled with folks who suffer from various levels of mental health issues. Sometimes they are mild, sometimes severe. Sometimes, they are lifelong issues, and sometimes they are temporary things. In my own books, I’ve dealt with PTSD, the damage inflicted in by dysfunctional family situations, a former spousal abuse victim trying to learn to trust again, and insecurities of various types. Mostly in my stories, they are not permanent conditions, though they don’t go away with the wave of a wand, either. And since I believe in the redemptive and healing power of love and support, they are often either resolved fairly well by the end of the book, or well on the way. I don’t think I make them demeaning issues, and since I’m not writing medical themed fiction, I don’t go overboard with technical detail. But I do try to make them believable reactions to life based on the character involved.

    One of my characters inspired the tagline “Those who march to a different drummer sometimes lose their way.” All his life he was that guy who didn’t quite fit in, and he also had a dysfunctional family dynamic he tried desperately to cope with, until a terrible tragedy occurred, which sent him over the edge. It was a very long and difficult struggle for him, but I hope I handled it with respect and sensitivity. He’s winning his battle by the end of the book, but his issues were not the kind that were going to go away overnight. And I think that’s okay, too. He’s reached the point in his life where, with the love and support of his wife, he has learned that it’s okay to be different, and is growing more comfortable with his place in the world every day.

    Personally, I don’t think it would matter if the genre was fantasy. People are people, and suffer from every sort of human frailty, including all sorts of mental health issues, whether diagnosed as such or not. It might be tricky to develop those issues for a dragon, perhaps, but then again, maybe not. Aren’t they often said to be a bit compulsive about amassing piles of gold and shiny baubles? 😉 And certainly, they could have fiery tempers. 😀 Okay, that might not be what you mean, but if you are wanting to include some mental health issues in your work, I say give it a go. Why not? It could make for some interesting story lines, and add a whole new slant to your character development. Just my thoughts, for what they’re worth. 🙂 Good luck, whatever you decide.

    Liked by 1 person

    • I only mention fantasy because it’s my preferred genre. The blog is geared more towards that. Also, fantasy tends to gloss over mental illness more than other genres. Actions are made more good and evil with the latter having no underlining circumstances. You rarely see even the more common illnesses like depression and anxiety appear in fantasy. I think another reason is because people expect the heroes to be pure noble (and then they complain about no flaws) and villains to be monsters.

      Liked by 2 people

      • Marcia says:

        I still think that if you want to include some mental issues in your fantasy, there’s no reason not to. Even with heroes. It would make them more human to have something they struggle to overcome, as long as it’s well thought out and handled right. Bottom line, for me personally, I don’t believe they should be avoided if they fit the plot line and character, and I don’t think it should matter about the genre. Again, just my opinion as a dedicated reader for many, many decades.

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      • You totally can and should. It is a little difficult though. Magic and psychics create a type of cure. It’s a similar issue with physical diseases. Personally, I’ve tried depression and ptsd in my books. I’m working a storyline where a vampire has a drug addiction too. Part of the challenge is to do this in a way that maintains the magical tone of the world and doesn’t make the disease something one could erase with a spell.

        Liked by 1 person

  2. I think I’d prefer a “show not tell” approach, personally, since I’ve observed the downsides you mentioned. A friend and fellow blogger, Stephen Black, made OCD a main characteristic of his protagonist in his debut novel, Skelly’s Square. Black is open about his own OCD, and says he wants to help people learn about the condition.

    Liked by 1 person

    • I remember your talking about this earlier, and still agree that authors need to avoid using mental illness as an inaccurate excuse for a villain’s behavior.

      Liked by 2 people

      • Marcia says:

        I’d agree with that, pretty much completely, Chelsea. Though by definition, it’s obvious many villains have mental issues. Serial killers come to mind. But I’d avoid something like that, too. I’ve tried to handle my character’s issues with understanding and love, and not make the character in question a stereotypical or cardboard figure. I’ve gotten some pretty good feedback, so I hope I’m on the right track, though I seldom include an actual diagnosis, unless therapy is involved, and then I’ve gotten input from therapists.

        Liked by 1 person

      • ❤ That sounds perfect. I’ve not encountered many fumbled attempts, but I haven’t read much indie fiction. I was working from Charles’ and others’ complaints and examples.

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      • That’s a tough one. There does have to be some illness for a villain to act on evil impulses. To say otherwise makes them less human while their actions are the darker side of the species.

        Liked by 1 person

      • I relate better to villains with a decent motivation.

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      • But not all of them do. A villain who is killing children to save their souls from corruption could be said to have decent motivation. Dark, but clear. It’s also am obvious mental issue.

        Liked by 2 people

      • Yes, but the former is more important than the latter for me.

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    • I think that does help, but there is a danger there. Most people can’t recognize mental illness and chalk up such actions in negative ways. A depressed character is a downer and wet blanket. An anxious character is a worrywart. Someone with OCD is annoying and picky. Sadly, many need it spelled out for them to get the point across.

      Liked by 1 person

      • True, but I think naming their habits is detrimental. I don’t know about others, but I’m a whole fruit basket of anxiety-driven habits and depressive tendencies. I think saying “Alex has OCD” is going to cause the reader to associate all of Alex’s behaviors with OCD.

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      • Most people are a combo. Yet, I think it helps in fiction to highlight one illness. It helps uninformed readers get a sense of that problem instead of trying to differentiate between many. You can phase more in later I guess. My personal preference here is to assume most of the audience knows nothing about mental illness. That means they have to be eased into it or they’ll come out misunderstanding a lot.

        Liked by 1 person

      • That makes sense.

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  3. L. Marie says:

    One of my classmates just published a book with a main character with OCD. Hope to interview her at some point. In the meantime, Though I have mentioned the state of depression, I haven’t called it as such because today’s labels don’t fit my fantasy land. However, I agree that the subject is critical especially in contemporary fiction.

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    • OCD is fairly popular in fiction. I wonder if it’s simply a hot topic. Maybe it is seen as fairly mild, but clearly observed. There are clearer external signs of ocd than for depression and anxiety. I keep thinking back to how Monk was defined by his physical habits.

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  4. Reblogged this on Chris The Story Reading Ape's Blog and commented:
    Let Charles know your thoughts in the comments under his original blog post

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  5. My characters have not had any mental issues of significance. John Cannon is slightly OCD but it only shows on the rarest of conditions.

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  6. TermiteWriter says:

    I write SF, but one of the things I’m most interested in is what goes on between people’s ears. I don’t set out to deal with a particular psychological topic – it just grows out of the character. For example, In The Termite Queen, I wanted Griffen Gwidian to be a man with a dark secret, something like Rocester in Jane Eyre, only not with a mad wife in the attic. In Griffen’s case, something that happened in his childhood warped his relationship with women. The latter part of the book is spent exploring the nature of that event. In The Man Who Found Birds among the Stars, my hero Robbin Nikalishin suffers a whomping case of PTSD because of the disaster at the end of Part One. Even my fantasies are dependent on the mindset of the characters, particularly the one I’m working up now, The Blessing of Krozem, where an old man has to cope with the terrors of suddenly being made immortal. It doesn’t have to be focused on a particular type of mental disturbance, like bipolar disorder or schizophrenia – everybody has some kind of mental hang-up that can be a feature of the plot.

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    • True. I think it sometimes helps to use a textbook or defined mental illness because it can be more relatable. Having it be an anonymous issue can lead to people not even realizing it’s a mental issue. They think it’s nothing more than personality. How did you work the PTSD into the story? I tried that with a character who spent an entire book being tortured by the main villain. After that, he didn’t have the same amount of courage or humor that he did before. Hate to use the term ‘broken’, but that’s the best I’ve got.

      Like

      • TermiteWriter says:

        At risk of spoilers, I’ll say that in the 28th century Robbin Nikalishin was the captain of a space ship that was ordered to undertake a risky mission that went disastrously wrong and he was forced to leave his Enginerr, who was also his closest friend, behind to die while he went to save the rest of his crew. The ship was interdimensionally embedded in an asteroid. Afterward, Robbie developed flashbacks. As an example, the sight of a baked potato triggered a vision of an asteroid (you know how they resemble potatoes), and he thought an asteroid had struck the ship he was on at that moment and went berserk. With lots of help (a psychotherapist plays an important role in the story) he overcomes his troubles and goes on to become the first spaceship Captain to make contact with extraterrestrials, but he never quite gets rid of the flashbacks. The best way to know how I handled this is to read the first two volumes of the series The Man Who Found Birds among the Stars. Part one is on sale at Amazon right now. Hope you don’t mind a link. http://amzn.to/2iTNuUd

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      • Interesting. Never thought about the potato and asteroid thing, but it does make sense.

        Liked by 1 person

  7. Dissociative identity disorder. I’m actually taking that path in a couple of years. It’s a mis-diagnosis if that helps any. This is a slippery slope you’ve brought up today. I’m interested in what you bring to us later in the week. For me, I might have a few traits, but not offer a diagnosis on the page. The one story will have to offer the diagnosis so it can be shown as wrong, but I’m talking in general terms.

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    • It’s is a difficult topic. Never thought of it as a slippery slope exactly. Everyone seems to have their own opinion and perspective on this too. Makes the whole situation very murky.

      Liked by 1 person

      • The world seems fairly calm in light of all the real problems around us. When this is over, there are people who are going to call out anything they perceive as wrong, misrepresented, or not how they experienced it. I don’t think we can write in fear, but sometimes less detail is more.

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      • Maybe it’s because of where I live, but the world doesn’t seem very calm to me. It’s fairly stressful and chaotic. Still, you are right that there will always be a group that takes things the wrong way.

        Liked by 1 person

      • The news said today wasn’t worse than yesterday where you are. Might not sound like much, but it could signal a turning. I hope so, anyway.

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      • The thing is that while many are saying the deaths are leveling off, it doesn’t mean we’re in the clear. No idea how many asymptomatic people are out there or what will happen if we all go back to work at the start of May. Hong Kong flattened the curve at one point and then told everyone to go back, but then it started a second wave. I’m seeing a lot of people taking the lower death count as a sign to go outside in groups too.

        Liked by 1 person

      • I don’t think you’re even close to being clear. It could be the first signs of change, but it isn’t the end at all.

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      • Nope. I’m waiting for the other shoe to drop. I see a lot of people on Facebook pushing the recovery numbers too. They’re trying to be optimistic, but I’m also seeing some people respond to that as if the thing isn’t nearly as dangerous as they were led to believe. Bad combination of mentalities there.

        Liked by 1 person

      • Someone on FB just compared how we’re dealing with the virus to how the Ministry of Magic dealt with Voldemort’s return. There are a lot of parallels, sadly.

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      • I saw that one. Fairly accurate.

        Liked by 1 person

  8. I had to come back, so we might get two threads going. It might be fun to have a character who keeps the disorder at bay with a potion or something. Of course, somewhere in the book, he has to be denied that potion so everyone can see what happens. It’s almost like a reverse Mr. Hyde. He has to have his potion, or else.

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    • I’ve seen that happen with curses before. While that could work to show how that world deals with mental illness, it would be a touchy solution. Many argue that you can’t truly handle it with medication, but only keep it at bay as you said. It hides the symptoms, which they would say is wrong. I’m not sure where I stand on this one. You also have to be careful with how you work the potion to avoid it coming off like a drug addiction.

      Liked by 1 person

  9. I think these kinds of issues should be tackled in fiction. However, I also think people should either have personally experienced them, or be thorough in learning about them first. It’s like with disabilities in characters: if you do it properly, and handle the situation, it’s fine. If you either don’t have personal experience with the issues, or haven’t spent a lot of time talking to people who have, you better tread carefully though, or maybe even avoid it all together.

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  10. I think representation is very important, and if the author can handle it in a respectful way, they should include these traits. Readers who are struggling may see they are not alone and seek therapy if that’s what a character in a story does.

    You always have to ask why they want to include this, though. If they’re working through their own pain or empathizing with a friend or family members, that’s a good reason. If it’s just to be sensational or “grab eyeballs” then I would say to leave it alone.

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    • Shock value is definitely a sour path to take here. It may work as a reveal in some genres to gain sympathy for a previously misunderstood character, but that’s a high risk. I do wonder if these can be added solely on the ‘they exist in real life’ motivation.

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  11. Hi Charles. I don’t think that mental health issues should be avoided in fiction — especially fantasy. However, there are caveats, of course. If the author is only using the mental health issue as a tool, a gimmick, or some kind of “dressing” then that’s most definitely a no-no. However, if the author is writing about the issues from a genuine interest of drawing attention to the issues and researches it then that’s a great start. There have been stories written and published (especially in YA Land) that focus on mental health issues. On a personal note, I’ve been writing one for the past year (when will it ever end!) and it’s been equally rewarding and challenging. That said, I’d be interested in writing a guest post.

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    • That’s a tough caveat at times. If the mental illness isn’t the main focus of the story then it comes off as a gimmick. I write adventure tales, so adding anxiety to a character is for personality more than bringing genuine interest to exact issue. One may argue that heroes having these issues and continuing on a quest can be a positive though. Would you say this falls under acceptable uses?

      Liked by 1 person

      • I hear what you’re saying and appreciate where you’re coming from. It’s just that there’s more to a story and its characters than them dealing with their mental issues. For example, one of main characters suffers from PTSD, but this is just a part of who she is. It’s not the main focus of the story. It’s something that’s always present alongside the main conflict in said story. I think we may be saying the same thing. And yes, I do agree with your statement regarding acceptable use in that case because the ability to persevere in spite of ________ (fill in the blank with whatever may please you) is a positive for anyone — with or without a mental health issue. Though perseverance is something that people with mental issues face every day, some may not feel comfortable with being praised for them simply existing. C’est la vie. C’est la guerre. I mean do we generally approach someone with diabetes and say, “Oh my gosh! You’re so amazing for getting out of bed, and pricking yourself to make sure that your sugar levels are stable!” Does this make sense (I’m sorry that this is probably not the best analogy) and I hope that I’m making sense! 😐

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      • Okay. It looks like we’re saying the same thing. I took your first comment to mean that a mental illness needs to be the focus of the story or not be included at all. To be fair, I have heard people talk to diabetics about how brave it is to do the finger poke. It’s awkward to witness. I think another challenge with including mental illness is that most still believe that they shouldn’t be made public. I remember being told many times that I had to hide my anxiety because it would *insert dire circumstances*. Yet, that creates a level of shame that enhances the issue. It makes you feel faulty and defective as a human being. So, I think seeing characters persevere or at least admit to these things could help to clear that stigma. Maybe I’m being naive on that one though.

        Liked by 1 person

  12. Reblogged this on adaratrosclair and commented:
    🙂

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  13. ospreyshire says:

    I can understand since it’s a very line line to cross. That’s one issue that you don’t want to misrepresent in any way. If I want to write a character with a certain mental condition, I would talk to someone who I know has it and ask them if the way the character is portrayed is okay. That and it’s also good to write a character who has a mental health issue than a mental health character. There’s a difference. This is something that I need to learn about and even I can tell when something is portrayed wrong like when I had the misfortune of watching and reviewing that Belgian movie Ben X which really trivializes Asperger’s Syndrome in that film.

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    • Autism in general is a challenge because it’s a spectrum. Honestly, I don’t really like calling it a mental illness either. That denotes there is a cure or that it’s a disease. Autistic people are simply wired differently. That’s just my nitpick. I am curious as the difference between a mental health character and a character who has a mental health issue. Do you mean the latter is defined solely by the issue and the former is not?

      Liked by 1 person

      • ospreyshire says:

        That’s true. Sorry if I implied that it was mental illness. They are wired differently and it’s not any kind of disease. I mean the opposite, actually. A mental health character would be someone who only is defined by their issue while a character who has a mental health issue may have that as a trait, they have other things going for them as a character.

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      • No problem. Many people think autism is mental illness because that’s how it used to be. I’ll admit I thought that when growing up because of how it had been portrayed in fiction and news. I remember how people would always use the nonverbal, easily upset extreme version. That colored the view of people.

        Got it. Well, I figured out the definitions even though I flipped them. Can I get partial credit? (Geez. I’ve been doing this homeschooling thing for way too long now.)

        Liked by 1 person

      • ospreyshire says:

        I’m glad to have cleared that up. I do agree with how people assuming autism is just one or two things. The movies and shows don’t help and it’s not just limited to Rain Man.

        That’s okay and I figured that’s what you meant, so you do get partial credit there. Hahaha! The homeschooling aspect makes sense. Speaking of which, my education job is going to switch online starting in a few days.

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      • Been there for a few weeks as parent and TA. It has good days and bad. Students need to realize they get back what they give now.

        Liked by 1 person

      • ospreyshire says:

        Gotcha. I certainly agree with that when it comes to students. My current batch of students are thrilled to be back though.

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      • That’s great. Mind if I ask the grade?

        Liked by 1 person

      • ospreyshire says:

        Thanks. I have adult students.

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      • That must be fairly easy. I do high school special education. Not easy getting the kids into the new system.

        Liked by 1 person

      • ospreyshire says:

        Teaching adults can be easier which I do agree with. I used to work in the K-12 system, so I know about the differences in teaching adults vs. teaching children.

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  14. Hhoky says:

    This was an interesting post! Thought provoking and requiring a deeper conversation with my brain. As a writer and blunt simple personality type, I have my knee jerk opinion. Yet, because I am human I often have conflicting mental opinions at the same time. I will definitely spend some time pondering over your question.
    I had a similar type of conversation with my daughter the other day. Over a TV show. She was against it, feeling the subject matter had too much ‘sensitive matters’. She was very, animated about her point of view. I, on the other hand, having lived/experienced those ‘sensitive matters’ first hand, thought the story/writing and character development was fantastic.
    Definitely worth a discussion with myself. Thank you for this post!

    Liked by 2 people

    • Sensitive topics certainly effect people differently. There have been times when I’m not happy with a portrayal and others think it’s great. Maybe it does come down to personal experience.

      Liked by 2 people

      • Hhoky says:

        Experience influences perception. You are right. I suppose that’s why humans are such colorful and entertaining people.
        I do believe though when a story comes to a writer, it needs to be told. Even, or perhaps especially if character with potentially sensitive subject matter is involved. A writer must write. Let the reader, cuz they will anyway, interpret it as they will. I wish you all the best!

        Liked by 1 person

  15. Arisha Jana says:

    Worth a read for everyone!

    Liked by 1 person

  16. ShiraDest says:

    Thank you for tackling this thorny question, Charles. In my second practice novellette I tried to introduce my protagonist in a way that showed she had PTSD and was trying to hide it. That part came off successfully, but my beta readers said it overwhelmed my ActI.

    Like

    • Curious how they thought it overwhelmed your Act I. PTSD is something that seems to suck all the air out of a room, especially in fiction. Was it that they thought it was too much?

      Liked by 1 person

      • ShiraDest says:

        I person simply found it disagreeable, she said, too heavy, and the other said that my opening scene was overshadowed by the internal monologue. I know that my writing still needs alot of work, but the first B-reader was a bit over the top, and also seemed to think the entire protag. was unlikeable.

        Like

      • PTSD is a tough one for people to read about. I think many find it uncomfortable or simply don’t understand why the character can’t just ‘get over it’. That seems to be a common suggestion for mental health both in reality and fiction.

        Liked by 1 person

      • ShiraDest says:

        Yes, that was exactly one of the comments she (that B-reader) made. 😦 I suppose this is why we need to write about it more?

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      • True. It’s ugly and rough, but a lot of people suffer through it. I tried a few PTSD story arcs with varying success. Writing it can be very draining, so I imagine reading about it isn’t much better.

        Liked by 1 person

      • ShiraDest says:

        I know, it was draining writing it, but it was almost a compulsion. I understand that reading it is not easy, either.

        Like

  17. Pingback: Do You Avoid or Tackle Mental Health Issues in Fiction? – Cafe Legacy

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