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Trauma

American Sniper

The portrayal of PTSD in this academy-award winning film

Chris/Bradley – the real life expert sniper played by Oscar-nominated (for this role) Bradley Cooper – is portrayed in “American Sniper” as a resilient guy, who teeters on the brink of getting PTSD (quite understandably), probably has it for a brief while, and ultimately overcomes/treats the post-trauma symptoms of distress (due to some treatment, but largely his resilience).

His life is much more than this side story of PTSD, of course, but I am going to hone in on the “trauma from battle” piece since I am writing a “psychology” blog.

The first part of PTSD is the traumatic event. You need to have experienced a “trauma” to then get post-trauma symptoms (PTSD).

Chris/Bradley goes on four tours of battle in Iraq. He works as a sniper and goes “door to door” on the battle field. He sees the worst that war (perhaps the worst experience imaginable) has to offer. He kills lots of people, including women and children (the movie portrays all of these choices as fairly clear cut, i.e. he shoots a child that was clearly about to kill American soldiers), and he watches his close friends die in front of him.

A trauma event is anything in which there is exposure to or direct experience with serious injury/harm, intense violence, and death. The presence of fear and helplessness used to be included in this definition but has been removed – probably because a person’s self-report of the degree to which an event elicited feelings of fear and helplessness is so subjective, and inconsistent to the event itself.

Judging by that definition it is safe to say Chris/Bradley experienced “trauma” – repeatedly and intensely.

When trauma is experienced most victims show at least some residual psychic pain and difficulties adjusting/returning to “normal,” with a smaller (large minority) displaying more intense, long-lasting symptoms (in which case a diagnosis of PTSD is warranted).

The emergence of post-trauma stress consists of a specific, wide-ranging and nasty constellation of symptoms. The trauma experience, which is now a memory in the mind, repeatedly, uncontrollable and violently intrudes on day-to-day consciousness and functioning in the form of related cognitions and affects (reminders of the trauma event), nightmares and flashbacks (a more vivid re-experiencing of the event).

Then there’s the avoidance symptoms – efforts to avoid talking about the trauma, avoid feeling feelings (either trauma-related or just in general, i.e. reports of chronic “numbness”), and withdrawal (general social isolation and/or avoidance of activities that feel related to the trauma experience.

There’s a general shift in mindset and mood as well – after a trauma you might get much more stuck on how dangerous the world is, and the degree to which you have failed yourself or others. You might start to ruminate on the trauma itself – endlessly re-evaluate all that went wrong, what you could have done differently, and unhealthy lifestyle changes you need to make to “be ready” for the next trauma. Such ideas, of course, spark and intermingle with “hot affect” – frequent, sometimes inexplicable, always distressing emotion states – horror, guilt, fear, shame, anger and irritability, etc. The misery coalesces into an exaggerated startle response (i.e. a car backfire “feels” like a gunshot), hypervigilance (“I better get ready for the threat around the corner!”) and self-destructiveness (excessive drinking, drugging and reckless thrill-seeking behaviors…it goes without saying that concentration, sleeping and general mood are all disrupted, if not shot to shit.

Chris/Bradley starts to show many of these symptoms, mostly in-between his second and fourth tours. He remains adaptively sharp and competent on the battlefield but during his brief re-integrations into normal society and home life there are some telltale signs: we see him uncomfortable in his own skin, anxious about being away from the battlefield, lost in thought (awful war-related recollections) and, less frequently, sucked back into some re-experiences. He is also adamantly opposed to his wife’s efforts to discuss his experiences and, in general, seems unable to relax into his old life and affable persona. His default mode at home is irritable and guarded; he is visibly edgy when lawnmowers sound off, and inappropriately panicked when his infant cries.

These difficulties are relatively mild and brief compared to the classic PTSD presentation – a few highlights are notable:

His symptoms are exacerbated by his repeated returns to the battlefield (after each tour, his symptoms are more intense, and in his last tour he shows some compromised judgment when he endangers a large group of American soldiers in an effort to capture an enemy with whom he’d become a bit obsessed).

Takeaway - It is probably good policy to limit the human mind’s exposure to such trauma.

Chris/Bradley’s mind never breaks, but it bends and buckles under the psychological weight of the scary, dangerous, violent, disturbing and ugly experiences.

His symptoms are reduced with the specific treatment measure of engaging in a mentorship role with injured veterans – keeping busy, being supportive to others, re-connecting with his military identity and seeing suffering worse than his own are just a few of the underlying curative mechanism at play with this “intervention.”

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