PTSD – how writing worked for me by Matt Johnson

It has quite surprised me how many people are now trying out writing as a contributory means to help treat PTSD, post traumatic stress disorder. Questions levelled at me, as to how writing helped me, have prompted me to repeat this post, which I originally published last year.

PTSD – the chemistry

In examining PTSD, one of the known factors is that an instance of overwhelming terror can alter the chemistry of the brain, making people more sensitive to adrenaline surges even decades later.

This sensitivity to adrenaline surges is a major factor in post-traumatic stress disorder, in which people can experience normal events as repetitions of the original trauma.  PTSD affects combat veterans, crime victims and millions of others. Its cause has biological basis in its affect on the brain.

New studies in animals and humans suggest that specific sites in the brain undergo these changes. Scientists say the findings may allow development of medications to blunt the biological changes present in post-traumatic stress disorder.

For the brain changes to occur, scientists now say that people usually have to experience the stress as catastrophic, an overwhelming threat to life or safety and one over which they have no control. Less severe stresses, such as the death of a loved one or relentless financial problems, do not seem to trigger the biological changes.

When I started  receiving counselling, it was explained to me like this.

When you are working in a high stress environment such as a war zone or any work where you are subject to regular, frequent and high adrenalin surges the brain is slowly, cumulatively, affected by this regular level of adrenalin in the body. Whilst adrenalin is an incredible aid in the preparation for and enactment of the flight and fight response, it has a side effect in that it ‘eats up’ a chemical called serotonin.

Serotonin is a naturally produced chemical that works in the body as a neuro-transmitter. It is widely thought to be a contributor to feelings of well being and happiness. What is does is smoothly transmit thought processes so that the brain operates in an organised and structured way.  Serotonin also has some cognitive functions, including memory and learning. It’s presence in the body is essential to the regulation of mood, appetite and sleep.

So, when exposure to a work environment or a series of events causes the body to regularly produce adrenalin, the effect is that serotonin levels drop.

As a result, the brain starts to operate less efficiently. Thought processes become less clear, sleep is interrupted, memory confused etc.

Then a major catastrophic event causes a massive adrenalin surge.

PTSD symptoms

I wonder how many people reading this will have heard of PTSD and wondered exactly how victims are affected? How many will have seen veterans talking on TV about experiences and see that brave people become emotional and unable to talk any further, the surge in feelings overcoming their ability to talk.

In fact, symptoms are far more wide ranging than most people realise and can vary widely between individuals. They may develop during the first month after a person witnesses a traumatic event. However, in many  of cases there may be a delay of months or even years before symptoms start to appear.

This is a summary, it is not exclusive, as I am not an expert.

A person with PTSD will often relive the traumatic event through nightmares and flashbacks, and have feelings of isolation, irritability and guilt.

Problems sleeping and find concentrating difficult. The symptoms are often severe and persistent enough to have a significant impact on the person’s day-to-day life.

Some people with PTSD experience long periods when their symptoms are less noticeable. This is known as symptom remission. These periods are often followed by an increase in symptoms. Other people with PTSD have severe symptoms that are constant.

Re-experiencing is the most typical and widely publicised symptom of PTSD.

A victim may involuntarily and vividly relive the traumatic event in the form of flashbacks, nightmares or repetitive and distressing images or sensations. Being reminded of the traumatic event (the trigger) can evoke distressing memories and cause considerable anguish.

Trying to avoid being reminded of the traumatic event is another key symptom of PTSD.

Reminders (triggers) can take the form of people, situations or circumstances that resemble or are associated with the event.

Many victims of PTSD will try to push memories of the event out of their mind. They do not like thinking or talking about the event or events in detail. Think of those WWII veterans who well up when being interviewed for documentaries, a display of emotion repeated by Iraq and Afghan veterans who appear to talk about their experiences in more recent programmes.

Some victims repeatedly ask themselves questions that prevent them from coming to terms with the event. For example, they may wonder why the event happened to them and whether it could have been prevented. Often, they may blame themselves and many feel guilt that they survived when others didn’t.

Someone with PTSD may be very anxious and find it difficult to relax. They may be constantly aware of threats and easily startled. This state of mind is known as hyperarousal. Irritability and anger may be a clear indication of this arousal state.

Some victims try to dampen down their feelings by trying not to feel anything at all. If you know an ex-cop or a veteran who you might describe as a ‘cold fish’ then what they may be showing is emotional numbing, a way of coping.

Someone with PTSD can often seem deep in thought and withdrawn. They may also give up pursuing the activities that they used to enjoy.

Other possible symptoms of PTSD include depression, anxiety and phobias. Drug and alcohol misuse are common as a means to dealing with the symptoms expreienced.

PTSD often  leads to the breakdown of relationships and causes work-related problem.

Surprised at the range of symptoms? Imagine trying to cope with them and you will have a handle on the challenges facing victims.


Many victims, me included find that counselling helps them to understand what is going on within their own minds and bodies. It helps to appreciate how a simple chemical imbalance in the brain has been triggered and how the physical and psychological effects that follow are a result of that imbalance.

But counselling doesn’t fix the symptoms on it’s own. Anti depressants are a great help and they worked for me. The pills help the body restore chemical balance so that the brain can then start to regain control.

For me, writing started as a way of helping the counselling. Like many victims, I became emotional when prompted to talk about experiences and describe what had caused the PTSD in the first place. Like many, I was advised not to worry and to try and make notes to bring back to counselling session that I could use to refer to and which might help the counsellor to help me. I made the notes at times when I felt up to it, writing down what had happened, how I had felt, how it had affected me. I recorded dreams that I had, flashbacks and imaginary. Over the weeks and months I found that writing things down helped my brain to get things focussed, to get my thoughts back in order and to regain structure and control.

When asked how it helped, I describe it like this. Before the writing, my brain felt a bit like a fragmented hard disk. Lots of data, confused, hard to join up and recall. Thought processes were slow, decision making was poor. After writing, it was like a PC de-fragment, where the information/memory is more organised and easier to use. It works more quickly and efficiently, thereby reducing frustration and making life easier.

Also, consider the analogy of a PC screen with too many tabs open to really use any of them effectively. After writing/counselling I was able to close down many of the tabs and focus on the relevant. Memories and distractions were filed away enabling me to concentrate on the here and the now.

It helped immensely.

And had an unexpected benefit when my counsellor was moved to comment on how much she enjoyed my writing.

So, one day I followed her advice again and started to weave the notes jotted down into a novel. The more I wrote the better I felt. There were several dips, several times when I found myself reliving things in a way that I preferred to avoid, but, despite the low points, the overall direction was onwards and upwards.

PTSD affects people in many ways, so what works for one will not necessarily work for another, but the fact that so many people have had such enjoyment out of reading a book that came about in such an unexpected way has given me immense reward. People have contacted me, some have described me as inspiring. That may be. What I can say is that the feedback has inspired me to carry on writing and we’ll just see if it continues to help keep the demons at bay. Not just for me, but also for the many others that have and will experience the nightmare as well.

Matt Johnson on ‘Writing a sequel – Second Novel Syndrome’



Stephen Fry put forward an interesting theory about second book syndrome. “The problem with a second novel is that it takes almost no time to write compared with a first novel.

“If I write my first novel in a month at the age of 23, and my second novel takes me two years, which have I written more quickly? The second of course.

“The first took 23 years, and contains all the experience, pain, stored-up artistry, anger, love, hope, comic invention and despair of that lifetime. The second is an act of professional writing. That is why it is so much more difficult.”

As true as it is for ‘one hit wonders’ in the music industry, the challenges of writing a second novel are huge, particularly if the debut has received critical acclaim.

Have you ever read a series or trilogy and found that, despite how much you enjoyed the first book and, perhaps the third, the second one didn’t quite cut it?

The Harry Potter books, for example, are said to have dipped in The Chamber of SecretsCatching Fire was said by some to be a bit of a disappointment after the pull of The Hunger Games.

I’m 94K words into writing a sequel to Wicked Game. At the moment I have a target of about a 110K, which will, no doubt be reduced after editing. The sequel even has a working title, Deadly Game. The outline for the third book, End Game, is also drafted and sitting safely on my PC.

In the case of a trilogy, it’s only natural that the second book should be a bit of a plateau. The author follows a story structure, the one that holds all decent narratives together, the progression from Orientation to Conflict to Climax to Resolution. Of course, within these steps a whole bunch of ups and downs can happen, but basically the average story structure follows that progression.

The first book is the ‘getting to know what’s going on’ and the first conflict, the third is the build-up to the climax, the tying up of loose ends and the finale that you may, or may not expect. The second book falls in that middle bit and will feel, naturally enough, feel like the middle of a story, only over an entire book.

And then there is the additional question. Is the story going to be told in just three books, or is Finlay, the main character, destined to feature in a series? It would make sense, I like him, and it seems that readers do as well, so it would be great to have him prevail and live to fight another day.

Like many debut authors, I was initially bewildered by the success of Wicked Game and so my hands were a bit shaky when it came to doing it all again. Will readers like the sequel as much as the first? Should I change and evolve the style or stick with the same formula that made its predecessor popular? These are all worries (and fair enough ones too) of the sequel-writer, and especially for someone like me, who is only creating their second novel ever.

I am not a trained writer. I have never studied the art of authorship, read about creative writing, or even learned about the English language beyond the standard of ‘O’ levels. I write from the heart, what I see, feel, perceive, and I use the words that I use in my every day conversation. I don’t write to impress, I write because I enjoy it and I gain pleasure from receiving feedback that tells me other people have enjoyed the fruits of my labours. And so, having ploughed the history of my life into my writing, I find myself wondering if it was a fluke, or is it a talent?


Looking at the experience of others, it occurs to me that it could be that the dip in quality or enjoyability of book two is due to the author getting their act together and still getting the hang of their craft.  Did they tread too carefully and follow the exact same pattern they did in their book one?

Is book two destined to suffer ‘Middle Child Syndrome’, leaving poor old ‘Book Two’ to feel caught in the centre? Book one demands all our attention with its intrigue and introduction to the new world, and book three blows us away with its shattering conclusion (well it might if I get that far). Book two is stuck between them,  sadly sighing at the metaphorical dinner table while the readers fuss over the other siblings of the family.

I’ve now discovered that the challenge I face has a name. It’s called ‘Second Book Syndrome’. I also learned – and you’d think I would have known this already – is that writing is hard.

My future plans have also been thrown into a state of flux. With retirement looming, I wasn’t planning on starting another career. The way that Wicked Game has been received has surprised me. To learn that people enjoyed it and for so many to write praising my ‘talent’ for writing, has been a humbling, yet enjoyable experience. The media interviews, radio appearances and the growing readership have been a surreal experience. I have likened it to being a novice surfer, riding the perfect wave and not knowing how to make the best of it or when it will end, crashing down in an explosion of froth.

And at the risk of sounding like a whinger, I have to admit that for a while, in the middle of writing Deadly Game, the realisation that writing is hard has hit home. There are times when I experience periods of serious doubt. Every time a new review appears on Amazon saying how great the debut is and how much the reviewer is looking forward to the sequel, I suffer. Don’t get me wrong, I relish the praise, but every positive review raises the bar. The second book must NOT disappoint.

Sometimes, I wonder if I will ever finish it. At first, I set myself a target of a few months, that soon went by… and then a year. Again, I didn’t make that deadline. The reason? Self doubt. I examined every paragraph, every sentence, every word and ask myself if it is good enough. This writing-stories-for-a-living idea is proving to be a bit of a dream! I’ve now reached a point where I am just writing, getting the story down, and have decided to look at the quality during the ‘proof-reading’ process.


One thing that I am really grateful for is that no reader or reviewer has suggested that I am letting them down by taking my time. Nobody has ever suggested that I am failing.

And I’ve learned something about me in the meantime.

‘I love writing,  but I especially love having written.’

Getting started on a book

I’ve recently had two ‘tweets’ asking about starting a book. 

As I am in the initial stages of my second novel, I can tell you how I got started. There is a lot written about the subject, there are courses, qualifications and degrees in creative writing, but to my mind, it comes down to one important thing, the ability to tell a story. If you can, then you may well be able to complete a book.

Some writers have the story mapped out before they even start page one. They write the skeleton, then add flesh to bones, chapter by chapter. That’s how I work but, rest assured, the skeleton will change as you write. New ideas will come to you and the tale will evolve. I enjoy this process and never quite know where the adventure will take me.

It is a good idea to read a lot. Don’t just read the story, look at the style, the layout, the plot and ask yourself why popular books work. 

Getting started. First rule for me, don’t be afraid. Chances are you will not use what you write, you will not be happy with your first scribblings. But you must start that first chapter, if you spend all your time thinking how to write the perfect introduction, you will never make that all important first step.

Dont worry too much about the ending. That will evolve as you write, but do think carefully about the characters and do write down their features, personality etc. They are real and their presence in the novel must be consistent. A simple example, if your main protaganist has short brown hair, don’t have her combing her long blond locks later on in the story. Readers pick up on such things and it can spoil their enjoyment of the story.

Don’t be too concerned with the title. Do start with one, but be prepared to change it as the story develops. Wicked Game had several titles before the final draft. 

Matt J.