• BCS Mental Health Service

Fictional story – Real world issues ; Game of Thrones

Examining the cause and effect of PTSD and Disassociation

This comparison is an effective way to talk about topics using fictional examples based on theoretical characters, I am in no way making light of these serious conditions. Some assumptions were made in order to complete the case study.

Patient: Theon Greyjoy

Age: Early 20’s

Background: Only living son of Balon Greyjoy and heir to the throne of the Iron Isles. Conquered Winterfell and further asserted his authority by killing two young boys; heirs to Winterfell. Greyjoy was then taken hostage by enemy Ramsey Bolton, a sadistic manipulator who seized Winterfell and kept Greyjoy for his tortured play thing and captor. Case: Prior to his capture Greyjoy was a confident conqueror, things were definitely looking good for him and his ego. He was the only rightful heir to his kingdom, he had just taken over a huge and significant land and was planning his next move to power. Everything about him is brimming with confidence, he was almost untouchable and this is the key to understanding his demise into “Reek” (his damaged alter-ego). Bolton; a man with no limits to his sadistic nature (whose psychological torment would require a whole new case!), holds Greyjoy in a dark candle lit room. Tied to a large wooden cross and stripped of his clothes, dignity and power! Greyjoy is whipped, sliced and beaten, whilst also suffering psychological abuse at the hands of Bolton who openly displays his enjoyment at watching his emotional vulnerability (it could be suggested that Bolton also receives sexual gratification from watching his pain). Greyjoy’s finger and then penis is chopped off by Bolton who taunts and mocks him for his shortcomings. What could Bolton possibly achieve from this heinous act? I could argue that it wasn’t so much about the pain and the torture but the end psychological affect. This act of castration stripped Greyjoy further back by taking his manhood and his ability to father an heir to his family’s name. Psychologically Bolton now holds Greyjoy’s masculinity, identity, sexuality and life in his hands! Literally!

Analysis: So we now have a man who has endured unimaginable pain, his physical and emotional make up has started to decompose. This is where we see the real capabilities of the human brain; all of this trauma and torture has triggered one of the brain’s most amazing yet problematic defence mechanisms; disassociation. We essentially wipe out and revert to nothing, a former shadow of one’s self or sometimes even to a child. The events happening are too much and too painful to deal with, the beginnings of a condition called PTSD (Post traumatic stress disorder). This coupled with the complete breakdown of Greyjoy’s ability to withstand any more physical trauma “Reek” is born. This is a condition people face after many different types of trauma, it is commonly associated with the Armed forces, and other blue light services, but the truth of the matter is anyone can suffer with it after a traumatic event. During disassociation we can become easily influenced. Imagine rain water erasing the ink of a book, leaving blank pages to be written on by a new author, the end result would still be a book but could have a completely different story. In other situations when someone suffers disassociation or a PTSD episode they may be 100% convinced they are in another environment or are in a previous time in their lives, how someone reacts to these conditions is a very independent experience and varies from person to person. In the case of Bolton he is able to flex his sadistic muscles and convince Greyjoy of his “new personality”, a sad defenceless Dog like creature called Reek who is a loyal servant to Bolton. He baths him, fetches his wine and dinner and caters to his every need. Greyjoy now truly believes he is Reek, he no longer associates with his previous name Theon Greyjoy. Eventually Reek (Greyjoy) is able to escape the torture and free himself from Bolton. A face from the past manages to revert his brain back to Greyjoy, however when faced with a situation that reminds him of the control he encountered and fear he had he quickly reverts back to Reek. This is a very common occurrence for PTSD sufferers. When faced with another event of a similar magnitude to that which caused the initial decline, the brain uses disassociation as a coping mechanism.

Treatment: In today’s world there are many different treatments for PTSD and disassociation, including EMDR, which is Eye Movement Desensitization and Reprocessing. EMDR seems to have a direct effect on the way that the brain processes information. Normal information processing is resumed. Therefore following a successful EMDR session a person no longer relives the images, sounds and feelings when the event is brought to mind. You still remember what happened, but it is less upsetting and becomes less of a trigger for disassociation. Another treatment being CBT, Cognitive behavioural therapy. Although these are not the only forms of treatment they are well researched and proven techniques, if you would like to know more about how they work please see the links below. If you or someone you know is suffering with any of the conditions mentioned in the above please contact your GP.

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