The Canyon's Edge

Nora and her father have post-traumatic stress disorder (PTSD), triggered by their shared experience of a mass shooting that killed her mother. PTSD influences Nora’s outlook on life and her feelings about herself. Learning more about this psychiatric disorder can provide a deeper understanding of Nora’s character and greater empathy in general for those who have PTSD.

PTSD can result from any traumatic event—experiencing a natural disaster; being in a car accident; being a victim of violence, abuse, bullying, or sexual assault; seeing someone hurt or killed; or losing a friend or family member to violence. People who witness or experience such an event initially have trouble coping with their feelings but usually get better over time. If their symptoms worsen, last for a long time, or interfere with their daily lives, they likely have PTSD.

Though once considered primarily a disorder affecting military or combat veterans, PTSD can affect anyone of any age who has had a traumatic experience. According to the American Psychiatric Association (APA), PTSD affects 3.5% of adults in the US, and the APA estimates that one in 11 people will be diagnosed with PTSD in their lifetime (“What Is Posttraumatic Stress Disorder (PTSD)?” American Psychiatric Association, Nov. 2022).

PTSD symptoms fall into four groups, the first of which is intrusive memories. Flashbacks, involuntary recurring memories, nightmares, and negative emotional or physical reactions to anything that reminds one of the traumatic event are all evidence of intrusion. Nora experiences most of these symptoms: She avoids sleeping to avoid having her nightmare about the Beast, and the “booms” of thunder from the storms make her remember the “booms” of the shooter’s gun.

Avoidance is another category of PTSD symptoms. People with avoidance symptoms are reluctant to talk about the traumatic event or how they feel about it. They avoid thinking about it and avoid anything—including people or places—that may remind them of the event. Nora notes the “many barriers” that she and Dad have “built between [them] and others” (14). Nora won’t initially share her poetry with Dad, which suggests that she doesn’t want to discuss her emotions with him. Mary notes that Nora and Dad haven’t completely analyzed the traumatic event and their reactions to it.

Negative changes to one’s mood and thoughts are another criterion of PTSD. Symptoms in this category include having negative feelings about oneself or the world and blaming oneself or others for the traumatic event. Experiencing ongoing feelings of anger, guilt, fear, and shame and other negative emotions is another symptom, as is the inability to feel positive emotions or maintain close relationships. Nora feels guilty for hiding and surviving while others died to protect her. She cuts off her friendship with Danielle, angrily resenting her for living while Mom is dead. In the poem “Rebuild,” Nora puts her negative emotions—including guilt, anger, fear, and shame—into her emotional wall to keep others out. She doesn’t want to feel.

Another group of PTSD symptoms involves changes in arousal and reactivity or changes in one’s physical and emotional reactions. Moving quickly to anger, having trouble sleeping, self-harming, being easily startled or frightened, and being overly alert for possible danger are all symptoms in this category. Nora’s father displays “hypervigilance.” He’s constantly on the lookout for potential threats, is unwarrantedly suspicious of all people, and obsessively avoids public places where he thinks danger may lurk. Nora also shows symptoms from this group. She admits that she goes from “fine to anxious to depressed to angry to numb in split-second bursts” (27). When Nora’s anger gets out of control, she becomes self-destructive, pulling out her hair in bloody clumps. Additionally, PTSD causes physical symptoms for Nora: shaking, rapid heart rate, and hyperventilation.

PTSD can be successfully treated and turned around with therapy, and various treatments are effective. Mary’s counseling exemplifies the cognitive behavioral therapy (CBT) approach, which focuses on “identifying, understanding, and changing thinking and behavior patterns” (“PTSD Treatment and Facts.” Anxiety & Depression Association of America, June 2021). Two important components of CBT are exposure therapy and cognitive restructuring.

Mary gives Nora skills to address her symptoms, including grounding techniques that use her five senses to bring her into the present, thereby distracting her from overwhelming emotions during a panic attack or flashback. Through cognitive restructuring, Mary urges Nora to change her negative thinking about herself, helping Nora see that her guilt isn’t realistic. In addition, Mary uses mild exposure therapy, trying to get Nora to face and control her fears—and empower herself—by rewriting her nightmare and reframing the trauma. Thanks to Nora’s mental courage and the advice she internalizes from Mary, Nora faces her fears and finds herself, defining herself not by PTSD but by her “post-traumatic growth” (267).