Annotated Works Cited (In Progress)

 Annotated Works Cited

A., Van der Kolk Bessel. The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma. Penguin Books, 2015.  

For the purposes of my independent study in how PTSD is portrayed by Digital Media, 

The Body Keeps the Score will act as a baseline in what PTSD is, how it manifests through the use

 of empirical data, anecdotal evidence as well as the over 40 years experience in mental health

 from author, Bessel Van Der Kolk, M.D. The book is divided into 5 parts. Part 1, 

The Rediscovery of Trauma, works through the origins of PTSD & the research that went into

 its classification. Thanks to connections found by Dr. Van Der Kolk  (and others) PTSD became 

its own categorization for a collection of symptoms related to experienced trauma.


Assion, HJ., Brune, N., Schmidt, N. et al. Trauma exposure and post-traumatic stress disorder in bipolar disorder. Soc Psychiat Epidemiol 44, 1041–1049 (2009).


This study focuses on PTSD as a comorbid condition for those with Bipolar disorder. The findings from this 

study focus on a relatively slim subset of individuals of European descent, and act in counter to findings from a 

Similar American study on the same topic. While it is found that patients with bipolar disorder do suffer from 

PTSD as a relevant comorbidity, the study somewhat glossed over what the individual affects of what the 

comorbidity produced.  


Benioff, David & D.B. Weiss. Game of Thrones.  HBO. (2011 - 2018).

 The hit action/fantasy show has been criticized, particularly in its later years for its inclusion of traumatic rape and violence against women. The narrative, which tends towards the violent and gratuitous, has come under fire in particular over the season 5 arch where Sansa Stark, who started the show as a child actor, is raped on her wedding night. The outrage over this scene overshadowed many other examples of sexual violence throughout the show, and incurred a massive backlash from the fan-base world wide. Accused of being a piece of traumatizing media, this scene is looked at in counter to other scenes of sexual violence, in particular the sexual mutilation of Theon Greyjoy by the same man who rapes Sansa. Looking at the differences in backlash over these scenes, and comparing them with literature surrounding how they were handled sheds light on what greater society values when it comes to who is deserving of outrage vs who is not. It becomes less a matter of media that inspires trauma, and more about observing who's trauma is cared about..


Bowins, Brad. “Repetitive Maladaptive Behavior: Beyond Repetition Compulsion.” The American Journal of Psychoanalysis, 70, 282-298, 2010,

This article seeks to revisit Freud's concept of Repetition Compulsion, identify two differing types of repeated patterns of repetition compulsion (traumatic and non-traumatic) and to rename these as repetitive maladaptive behaviors instead. It posits that RMBs relating to trauma stem from dissociation and avoidance behavior, while RMBs not related to trauma stem from evolutionary processes that define behavior patterns from an early age. Those without trauma are able to adjust these behavior patterns through a process similar to grief, while those with trauma often refuse to change because they avoid acknowledging the pattern to begin with. Very well written article that explains elements of Freud's theories in a new way that holds with modern psychological thought.



 Brady, Kathleen T., et al. “Substance Abuse and Posttraumatic Stress Disorder.” Current                 Directions in Psychological Science, vol. 13, no. 5, [Association for Psychological Science, Sage        Publications, Inc.], 2004, pp. 206–09,


This article takes a look at the likelihood of patients suffering from PTSD to also suffer from substance use disorders. This article is more focused on explanations of how substance abuse can manifest than in specific empirical data. It looks at three primary hypotheses of the time to determine the reasons why patients with PTSD are more likely to become substance abusers. 



Flying Mollusk. Nevermind. Flying Mollusk. (2015).


 This game focuses directly on Trauma and how trauma is visualized as fragments of distorted memory. The player plays as a mindprober who goes through connecting the dots that lead characters to revelations about what caused their trauma in the first place. While the game does simplify the resulting treatment for trauma, the game does show interest in diverse mechanics that use real-time neurofeedbacks from the player to intensify the distortions in the mind. This elision between the real world and the game are intensely interesting and provide a glimpse at how feedback can be used in games about mental health.



Irrational Games. Bioshock Infinite. 2K Games. (2013).


 The power of Bioshock Infinite comes from its dramatic storytelling and narrative, paired with it's fun and action packed mechanics and world building. From the perspective of trauma, Bioshock Infinite works it into the narrative subtly, never truly calling it by its name but placing it as the impetus for how both of the main characters, Booker and Elizabeth respond to the world. Of particular note is how Elizabeth is affected by trauma, particularly in the DLC Burial at Sea Part II. After the events of the main game and having finally killed the last version of Booker left in the universe, Elizabeth begins seeing hallucinations of Booker as a means of survival. This piece of her causes Elizabeth to grapple with her conflicted feelings over Booker, her own shame and the isolation of feeling truly alone with the consequences of her actions.

Dimartino, Michael Dante & Bryan Konietzko. The Legend of Korra. Nickelodeon, (2014).


 The Legend of Korra is a dark young adult fantasy series that uses a mix of martial arts & magic to tell stories of endurance, friendship and balance. The protagonist, throughout the course of 4 seasons, must learn to deal with PTSD following a series of traumatic events which leave her paralyzed. Of greatest interest in this series is its treatment of traumatic response as a superpower with a great cost attached to it. While becoming stronger and protective, the user of the avatar state can end the cycle of reincarnation if killed in this state. The other point of interest, in terms of trauma, is how the series deals with Korra's ability to heal from past events. The majority of season 4, following a near death experience opens with Korra unable to walk. She slowly must regain her sense of self using grounding techniques, bottom up therapy, and eventually confronting her trauma and reintegration of her traumatic memories into her history. The show makes efforts to show slow progress in her ability to deal with her PTSD, and it makes sure to include incidents of re-traumatization and avoidance as a part of her journey. This process is visualized in a nuanced way, and while it does show manifestations of her PTSD literally, there is nothing heavy handed in its interpretation of the subject matter. 


Esrick, Michelle, director. Cracked Up: The Darrell Hammond Story. Netflix, 2018, 

 Cracked up is a personal narrative about SNL actor Darrell Hammond, who suffers from PTSD from longtime child abuse from his mother. The film, which includes interviews with Dr. Bessel van der Kolk, author of The Body Keeps the Score, is structured as a look into Darrells life and successes, broken up by fragments of Post Traumatic Stress. In a documentary where form meets function, the audience comes to understand not only the symptoms and knowable aspects of PTSD but also garners insight into methods of treatment and how the brain functions on Post Traumatic Stress


Flanagan, Mike. The Haunting of Bly Manor. Intrepid Pictures. Netflix (2020). 

The Haunting of Bly manor uses ghosts as trauma. Through the subtle movements of human set pieces, the air in bly is off, though the audience may not always know why. Ghosts appear in the background of many of the shots creating a sense of forboding, and leading the viewer to a state of hyper vigellance. The narrative and characters grapple with trauma - sometimes directly, as in Dani's dead fiance appearing in mirrors or indirectly through repeated actions and memory loss. The show is very sucessful in its approach to giving the audience the heightened vigelence that someone with trauma would face daily, and shows, mostly in subtle ways, how individuals can have their life disrupted. While not ending in a positive manner, the show is very successful in expressing these experiences and treating its characters with the dignity they deserve.

Folman, Ari, director. Waltz with Bashir. Amazon Prime, 13, May. 2008,

Waltz with Bashir (2008) is an adult animated film that uses highly stylized animation and color palets in order to explain how trauma related memory loss can manifest year later. This documentary looks at Ari Feldman's experiences during the Lebonese/Israel war in 1982 and attempts to piece together where he was and what he saw during the Sabra and Shatila massacre. Possibly the most interesting thing about the film is that it forgoes both a traditional resolution (we never find out what has caused Ari to remember an event that probably never happened) and it does not try to discuss methods of healing from trauma. In spite of both of these things, the film still feels complete, as it demonstrates the first person experience of looking at a traumatizing event logically until the topic renders the audience into a complete shutdown, following a series of graphic archival footage from the event. This film is proof that you can make a well done art piece about PTSD and trauma without needing to preach healing techniques to the viewers. 

Freud, Sigmund. “Beyond the Pleasure Principle.” Beyond the Pleasure Principle (1920) by Sigmund Freud, 1920,

Beyond the Pleasure Principal focuses on Freud's work on the concept of Repitition Compulsion, a term he has coined to encompass any number of repeating pheonomena related to trauma and what will eventually be known as PTSD. In it he discusses the concept of Death Instinct, where many traumatized individuals seak out repeated instances of trauma rather than changing their ways.


Gelbart, Larry. M*A*S*H*.  20th Century Fox. Ep: "Mad Dogs & Servicemen" S3:13, "War of Nerves" S6:5, "Goodbye, Farewell & Amen" S11:16. (1972 - 1983). 

 An allegory for the vietnam war, M*A*S*H follows the story of a mobile army medical unit during the Korean War. Because of the time at which the show was written, the way trauma is viewed and treated changes drastically over the course of the series, and the ending highlights the new research into PTSD as a diagnosis in a much more nuanced way than could normally be expected from TV at the time. While it starts using flawed logic and termonology in earlier seasons, its treatment of the subject in its final episode shows just how far media has come in its interpretation, and proves that even media that does poorly at first can turn around and create a surprisingly thoughtful look at a mental health issue now


Inderbitzin, Lawrence B., & Steven T. Levy. “Repetition Compulsion Revisited: Implications for Technique.” The Psychoanalytic Quarterly, 67:1, 32-53, 1998,

This article seeks to revisit Freud's concept of Repetition Compulsion and analyze these behavior patterns. The article ultimately feels it best to ignore this concept, as Freud was trying to push together a series of behaviors only linked by the concept of repetition, rather than something based in a more concrete vision. The most important note they make on the subject of repetition is that traumatized individuals do not repeat actions, events, flashbacks etc. for the purposes of mastery, as supposed by Freud. They mark that, instead, Traumatized individuals will get work with endless repetition of their trauma.


 Jones, Duncan, director. Source Code. Summit Entertainment, 2011, DVD.
 Source Code is a film in the same vein as Grounhogs day, where a young soldier, Colter Stephens relives the last, traumatizing, 8 minutes of a dead man's life over and over in order to find a terrorist threatening Chicago with a second attack. The film looks at looping and flashback, as well as iterations on behavior, suggesting that even flashbacks do not allow for a traumatized individual to relive trauma the same way twice. 

Marshall, Neil, director. The Descent. Pathe Distribution, 2006, 

 The Descent is a horror film set in the dark recesses of an unmapped cave in North Carolina. The film offers a glimpse into the many fears, triggers and horrors of a cave in, including sights, sounds, and accidents waiting to happen, that all hamper the ability of spelunkers from making their way out. The first half of the film focuses on the realistic issues with making it out alive, while the twist in the middle turns a nuanced film into the stereotypical monster flick of the era. Unfortunately, most of the nuance flies out the window at this point, as characters become more concerned with killing monsters than the genuine horror of a cave collapse. 


Mitchell, John T., et al. “Assessing the Role of Attention-Deficit/Hyperactivity Disorder Symptoms in Smokers With and Without Posttraumatic Stress Disorder.” Nicotine & Tobacco Research, vol. 14, no. 8, Oxford University Press, 2012, pp. 986–92,

 This artical looks at the relationship between PTSD and ADHD as comorbitities that affect the patients substance abuse in relation to smoking and nicotine specifically. It found that patients who suffered from one or both were exacerbated to smoke through negative reinforcement which dampened the affects of both PTSD and ADHD


Ninja Theory. Hellblade: Senua's Sacrifice. Ninja Studio. (2017).


 The game, set in the 8th century, tells the story of a young woman, Senua, who suffers from the comorbidities of PTSD & Psychosis. The game, which tells its story through non-linear flashbacks and a constant stream of disembodied voices, uses both puzzles and difficult fights to guide the player into Hellheim to attempt to save Senua's dead lover, Dillion. The game plays heavily with perception and uses a wide variety of visual and auditory stressors to keep tension high for the player, as they traverse a death filled landscape, literally fighting the denizens of Senua's mind. This game had a focus on mental illness and the strength of those who have it, is an excellent example of what to strive for when making a narrative game out of a specific condition. 


Pugh, Mary Jo V., et al. “Complex Comorbidity Clusters in OEF/OIF Veterans: The Polytrauma         Clinical Triad and Beyond.” Medical Care, vol. 52, no. 2, Lippincott Williams & Wilkins, 2014, pp. 172–81,         

 This study looks at how comorbidities create clusters of likely paths that a PTSD patient can take. It identifies several likely groupings that care professionals can look to as predictors for what sorts of comorbidities to look for in patients with certain backgrounds.


SadSquare Studio. Visage. SadSquare Studio. (2018).


 Visage is an exploratory horror game that deals with psychosis and trauma through iterative exploration from a home environment. The game is visually stunning and incorporates an impossible house design to give a feeling of uncertainty to the player as they travel around. The game includes randomized events to increase horror, and makes it possible for the player to die thanks to a sanity mechanic that decreases as the player stays in the dark. The game gives little information to the player and the player must wander through the house to uncover the secrets trapped within its walls. The game can leave too much work to the player however, and it can be hard to figure out where to go or what to do next, leading to a difficult playing experience.


Scheller-Gilkey G, Moynes K, Cooper I, Kant C, Miller AH. Early life stress and PTSD symptoms in patients with comorbid schizophrenia and substance abuse. Schizophr Res. 2004 Aug 1;69(2-3):167-74. doi: 10.1016/s0920-9964(03)00188-9. PMID: 15469190.

This article looked specifically at how PTSD and Schizophrenia work together as comorbidities to promote an environment where substance abuse can come into play. It looks at the affects that schizophrenia has on the brain and how drugs and alcohol affect those reactions, as well as the affect that substance abuse can act as self medication for each.  

Selkow, Ben, director. Buried Above Ground. Tubi & ITunes, 2 Oct. 2015,

Ben Selkow's hamfisted documentary on Post Traumatic Stress Disorder, Buried Above Ground, is a masterclass on how not to approach the difficult topic of mental health. Rife with harrowing visuals including the body of a Hurrican Katrina victim & a phone call of a woman in need of desperate help, the film meanders its way around the subjects, without saying anything new or meaningful about them. While the film does use several viewpoints and places of trauma, it does not really do anything coherent with them, and it is clear that the film makers only approached trauma with a surface level understanding. Things that should not be shown objectively are; things that should not be shown period are. The director and editors have, ultimately, done a disservice to the voices they have been trying to preserve through this piece. 


 Sheridan, Jim, director. Brothers. Lionsgate, 2009,
Jim Sheridan's American remake of the Danish film Brothers is a well-made, if stereotypical look at how trauma on the front lines can affect veterans after they return home. No fault can be found with actors Jake Gyllenhaal, Tobey McGuire, Natalie Portman and Bailee Madison portrayals as a family rife with Trauma. While the actual time spent watching Toby McGuire sink into the bowls of depersonalization is a rather short section of the overall piece, the film does hint at other types of trauma and how they manifest through how Jake Gyllenhaal's character responds to his Vietnam veteren father. Overall, the most interesting approach this film took was in its sound design, which acts as one of the few identifiable triggers. While not perfect, this film acts as a solid baseline reading of what the general public understands about PTSD and its relationship to war. 

Snyder, Zack, director. Sucker Punch. Legendary Pictures, 2011, Blu Ray.

Sucker Punch is a film who's primary goal is to tell a story about how women deal with trauma, both from sexual assault and from generalized PTSD. The Protagonist, Babydoll, utilizes multiple layers of reality to take her away from incidents of trauma, in a visual depiction of depersonalization and dissociation. The film, while somewhat ambiguous and ultimately pessimistic in its viewpoint, encourages the abused and traumatized to fight back from their oppressors, even if it is all for naught. It looks at how one can make their own reality to help them fight back, even if you can never fully win against what is traumatizing you. 


Speilberg, Steven & Tom Hanks. Band of Brothers. HBO Enterprises. HBO (2001). 

Band of Brothers episode 7: Breaking Point talks about trauma en masse. While it focuses specifically on a few cases of trauma, the episode makes it very plain that no characters who faced the Battle of Foy and the aftermath of the Battle of the bulge are free from trauma. This trauma is expressed in various forms by each different character from different points of view. Lip is hyper vigellant to the needs of his comrads. Buck Shuts down and winds up in a catatonic state. Luz pretends to be himself by making jokes from time to time, but also is shown staring off into the void, seemingly dissassociating. Even the background characters have moments where there trauma is shown more directly: One soldier is seen trying to dig a trench into the frozen ground with just his hands, ripping apart his fingernails. This media uses this wide range of responses to show not just one side of PTSD but all of them at once.


Spicy Horse. Alice: Madness Returns. Electronic Arts. (2011).


 Alice Madness Returns is a 3rd Person puzzle RPG game from independant director American McGee. The game, which uses a twisted take on the tale Alice In Wonderland, has the player traverse the fractured landscape of Wonderland as Alice tries to recover the traumatic memories of the fire that destroyed her home and killed her family. Done in a cartoonish style, the game works extensively in visual metaphor to explain the truth behind Alice's trauma using the environment and changes in Alice herself. As the player goes through the story they are able to pick up bits and pieces of memory that give building insight into why Alice has so much trauma surrounding the events. The game treats trauma much differently and blows nuance out of the way, yet does it in an effective and visually interesting manner that still works in a compelling and researched way.


Steiner, John. “The repetition compulsion, envy and the death instinct.” Envy and Gratitude Revisited IPA-Psychoanalytic Ideas and Applications series, 2008, 

This article looks at furthering Freud's concept of Death Instinct by discussing how death instinct is essential a trauma response that leads individuals to see change as new and frightening, therefore retaining patterns of repetitive behavior, regardless how it can affect their health and safety. This article goes off a bit about the Freudian concept of penis envy as a way to explain how traumatized individuals do not have the will naturally to try and attain the agency theorized in this work.

Tender Claws. Pry. iPad. (2015).


 Pry is an exploratory, narrative driven game that focuses on what it is like to experience PTSD, using the simple swiping mechanics of the iPad. The game is non-linear and cannot be fully completed in a single sitting. The player is given the option of opening the characters eyes to the real world or closing them to see the inner reality instead. Match cuts and player controlled parallel edits give the game tension, and this cinematic novella is part game, part experiential film. It does a fantastic job of telling the story of trauma from the outside in, keeping the most notable parts hidden from the players eyes.



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