Bringing Up Brandel Part 5: A Little Delicate

Deeks: Ow.
Kensi: Workout wasn’t that hard. What’s going on? Did you tweak something?
Deeks: My lymph nodes are swollen, like really swollen. Feel this… You feel that?
Kensi: No.
Deeks: What are you talking about? It’s like the size of a frickin’ golf ball.
Kensi: Have you ever golfed in your life? Have you seen how big golf balls are?
Deeks: Alright it’s the size of a marble then. That’s still really big.
Kensi: OK, big deal, then maybe you have a cold or a sinus infection.
Deeks: But I have all these other symptoms too. I’ve got like, fatigue, and night sweats, like maybe it’s something worse.
Kensi: Well the night sweats are because our house is 90 degrees, and the AC is broken, something you were supposed to get fixed this morning. Did you?
Deeks: Do I have bubonic plague?
Kensi: OK, no, stop, stop! Nothing good’s gonna come from googling.

— Densi in “Where There’s Smoke…”

In previous posts on the roles and rules of dysfunctional families, we’ve touched on how survivors of these tough environments can suffer health problems. A childhood playing the role of Mascot can lead to mental illness, substance abuse, even suicide. Learning the lessons of Don’t Talk and Don’t Feel can lead to anxiety or depression. Today we’ll take a closer look at the physical and mental health effects of a childhood like the one Marty Brandel experienced.

Before we get started This is not an article infused with happiness (although – spoiler alert – it eventually ends pretty well for the hero of the story). I feel it necessary to issue a warning to anyone who might be triggered by discussions of child or domestic partner abuse, alcoholism, or their aftermath. But before you stop reading, let me add that there are an astounding number of organizations, in the U.S. and other countries, which can help those needing to escape a currently abusive situation or trying to recover from a past one. The National Coalition Against Domestic Violence has a wonderfully thorough list of places where victims and survivors of domestic violence can get help, including resources for children, teens, men, women of color, the disabled, and the LGBTQ community. In addition, mentalillnessmouse on Tumblr has compiled an equally thorough lists of mental health hotline numbers and on-line resources. If you need help, take a look.

Just a few other disclaimers: Keep in mind that just because children growing up in dysfunctional homes are more likely than others to experience certain outcomes, it doesn’t mean they all will. Every child is unique, with unique experiences that affect them uniquely. Most survivors of dysfunctional families grow up to be happy, well-adjusted adults. Also: Quite a bit of science, and lots of speculation, ahead.

A Chaotic Environment

We’ve talked about how stressful it can be to grow up in a chaotic household where abuse or alcoholism exists. What’s worse, some of the other challenges posed by being in a dysfunctional family make it even harder for its members to deal with that chaos and stress. For example, in a world where you’re not supposed to express your feelings, stress is especially difficult to handle.

You might remember in the initial installment of this series, we looked at a research study known as the ACE Study, which followed a group of Southern Californians from the same Kaiser Permanente health plan. It assessed the degree of childhood trauma each person had suffered, and then looked at their health problems as adults. It turned out that the more “adverse childhood experiences” a person suffered, the more likely they were to have heart disease, cancer, stroke, diabetes, skeletal fractures, and liver disease, among other problems. Other studies have shown a similar link between higher rates of various medical problems and having experienced child abuse, witnessed intimate partner violence, or both.

There are likely several causes of all these problems, including the impact early life stress has on the immune system and other body systems. Stress has been linked to many problems including elevated cholesterol, cardiovascular disease, and other metabolic problems. Then there’s the greater propensity for adult survivors to engage in unhealthy high risk behaviors like smoking, substance abuse, or risky sexual behavior. Even workaholic behavior, in which survivors often engage, can contribute to the same chronic conditions.

This is Your Brain on Stress

Or it could be the brain. There have also been some fascinating (well, to me anyway) studies that have demonstrated an actual physical effect of trauma on the brains of those experiencing it. [Feel free to skip ahead if you don’t want to talk a little science.] In one such study, Harvard researchers scanned the brains of close to 200 adults. They also interviewed them about their childhood experiences using the ACE scale along with other measures of childhood trauma, plus they collected information about their current health. Just like in the ACE Study, people who scored higher on the ACE survey, meaning they suffered more kinds of trauma, were more likely to have suffered depression or post traumatic stress disorder.

The innovative part of the Harvard study was in the brain scan findings. Key parts of a section of the brain called the hippocampus were significantly smaller in those subjects with high ACE scores. Even those who hadn’t (yet) experienced mental illness showed the same pattern in their scans. Past studies have suggested that high levels of stress hormones could cause such damage.

What’s significant about a damaged hippocampus? Well, the very parts of the brain that seem to be affected by trauma are the parts that help the brain deal with stress. They signal the “fight or flight” reaction in a stressful situation. But if they’re over-stimulated by too much stress, they can actually produce such high levels of neurotransmitters that they kill off brain cells, particularly those in the hippocampus. This negative feedback cycle sets the brain on permanent high alert, which affects its ability to cope with stress later in life.

One possible related characteristic of many adult children of alcoholics is that of hypervigilance. These survivors are always on the look-out, both in their environment and in their relationships, for signs of potential danger or trouble. They constantly try to read the faces of those around them to try to stay safe from all the perceived danger.

Have you ever thought about or attempted suicide?
Have you learned to disconnect yourself from your feelings by refusing to pay attention to them?
Are you inclined to feel a certain feeling more often than others, particularly depression?

— Journal questions in Survivor to Thriver, The Morris Center for Healing from Child Abuse’s manual for adult survivors

A reduced ability to cope with stress can make childhood trauma survivors more prone not just to a laundry list of physical health problems, but also to psychological problems like depression or anxiety, eating disorders or even PTSD. Depression is one of the most commonly occurring consequences of past abuse or neglect: survivors are 2.5 times more likely to experience it, and even more likely if they also experienced parental divorce. Severe depression and even suicide attempts show similar patterns. Survivors who experienced higher numbers of abuse types or had longer lasting abuse have further increased odds of developing a mental health problem. For example, adults who scored a 4 or higher on the ACE study (Deeks scored a 6) were 12 times more likely to have attempted suicide than those with no adverse childhood experiences.

Changes in the brain could also play a role in addiction. One affected section of the hippocampus regulates part of the dopamine network, which might prompt survivors to self-medicate their anxiety through alcohol or drugs. Again using the ACE scores, adults with a score of 4 or higher were seven times more likely to consider themselves an alcoholic, five times more likely to have used illicit drugs, and ten times more likely to have injected drugs compared to adults with no adverse childhood experiences.

Delicate and Sensitive

Deeks: Uh, SPF 70 sunblock, ChapStick and a sea-foam green Slanket? Really? What’re-what’re…What are you trying to say here?
Kensi: Come on. Everyone knows you’re a little… delicate.
Deeks: Not delicate. I’m sensitive. And my lips get chapped because we live in a desert.
Kensi: Yeah, right.

— Densi in “The Job”

Another way the body manifests stress-related strain is via a number of relatively minor physical problems such as headaches, stomach or digestive problems, hives or other skin disorders, muscle tension or pain, back problems, asthma or other breathing problems, and heightened susceptibility to illness and infection. Adult survivors of childhood trauma are more likely to experience these problems than the general population.

Do you have constant worries about your health?
Do you have any psychosomatic ailments such as skin disorders, asthma or lower back pain that are not due to physical or systemic causes?
Do you have any loss of bodily functioning that cannot be accounted for by medical reasons?
Do you have a susceptibility to infectious illnesses?
Do you have frequent fatigue and body aches?

— Journal questions in Survivor to Thriver

For survivors, these problems are by definition psychosomatic, meaning “a physical illness… caused or aggravated by a mental factor such as internal conflict or stress.” They may not have a medical explanation for the exact cause of the pain or problem other than the stress or other emotions involved. I liked one description I found that these ailments are the conversion of anxiety into physical symptoms. Survivors may also develop phobias, which are not technically physical symptoms, but may be directly related to the circumstances of the abuse (e.g. a child locked in a closet for hours develops claustrophobia).

Deeks: Okay, you know how I don’t do well over 100 degrees. I get xerosis.
Callen: Deeks, that sounds like an STD.
Deeks: No, no, not an STD. It’s dry and scaly skin.
Kensi: Like a lizard.
Sam: Lizards love the desert.
Deeks: You don’t have any, uh sunscreen, do you? Preferably something with, like, a moisturizer, hypo-allergenic?

— Deeks and the team in “Greed”

These illnesses may be a strict conversion of stress into physical problems, but they can have different meanings to their sufferers. For some, being sick might have been one of the few times they ever received good care from a parent. Or it may be the only time they stop and take care of themselves as adults.

From Xerosis to Bubonic Plague

So where does our Mr. Deeks appear amidst all these gloomy prognostications? Happily, we see no indication that he has suffered or is likely to suffer from any chronic conditions such as heart disease or diabetes. He takes great care of himself, working out regularly. He doesn’t suffer from eating disorders or seem to have had issues with substance abuse.

Do you often feel agitated and ill at ease?
Do you ever put yourself in dangerous situations?

— Journal questions in Survivor to Thriver

I did find the descriptions of hypervigilance interesting. The need to be on the lookout for danger, and the ability to read other people’s faces for signs of trouble, are skills an undercover detective desperately needs in order to survive. Deeks has likely benefited from his ability to read the bad guys; it probably helped him work his way into their good graces and sense when his cover was likely to be blown.

Deeks: Is it getting cold in here? Because I feel like it just got, like, rapidly cold in here. Like I need, like earmuffs because my fingers are tingling.
Hetty: Could be, um, early signs of Raynaud’s.
Deeks: What’s that?
Hetty: Look it up. Better yet, get it checked out.
Deeks: I will.

— Deeks in “Unwritten Rule” (Per the Mayo Clinic, emotional stress can cause an episode of Raynauld’s Disease)

Of all my research for this series, I think coming across many discussions of psychosomatic illness might have been the biggest surprise. I had always assumed Deeks had been written this way simply as a source of ongoing comic relief. That may indeed be the case, but regardless of the inspiration, it seems a perfect fit with his traumatic past. Now each time they show him suffering some new ailment, I can’t help but think of it not with humor, but with sadness. I even see his phobia about needles in a new light. I’d like to think that Kensi has done some of her own research into the aftereffects of childhood trauma, and now understands this part of Deeks’ character. In their conversation at the top of this piece about Deeks’ swollen glands, Kensi shows a lot of patience with him. She does gently mock him about Mercury being in retrograde, but in general she’s quite reassuring. This is exactly what Deeks needs.

After the Trauma… Traumatic Stress

Deeks: What I need… is sleep.
Nate: Why do you think you can’t sleep?
Deeks: Because every time I close my eyes, my mind just keeps runnin’.
Nate: With what?
Deeks: All sorts of stuff, man.
Nate: The abduction?
Deeks: Yes, the abduction.
Nate: Torture?
Deeks: The abduction…torture, when I was shot… falling off my bike when I was eight years old, stepping on a bee, nursery rhymes, grocery lists, infomercials. It’s like someone took all my memories and just put ’em into a blender.
Nate: You went through a traumatic experience.
Deeks: Yeah, but this is not my first traumatic experience.

— Deeks and Nate in “Impact“

Some survivors of childhood trauma experience a health problem called Post Traumatic Stress Disorder (PTSD). This serious but treatable condition is caused by overwhelming stress that cannot be controlled by normal coping mechanisms. The sufferer’s capacity to function is disrupted by feelings of extreme fear and a sense of powerlessness. It occurs after they experience or witness a traumatic or terrifying event in which serious physical harm occurred or was threatened. Sometimes it doesn’t show up until many years after the trauma has ended.

We suspect that [the reductions in hippocampus size are] a consequence of maltreatment and a risk factor for developing PTSD following exposure to further traumas.

— Harvard researchers in a study called “Childhood maltreatment is associated with reduced volume in the hippocampal subfields CA3, dentate gyrus, and subiculum”

PTSD has long been associated with war, natural disasters, rape, accidents, kidnapping, torture, and other extraordinary events. Newer research has shown that first responders and health care providers who witness traumatic events can develop PTSD from vicarious trauma. Childhood exposure to domestic violence is related to higher rates of PTSD than “non-personal” traumatic events or acts of violence like accidents or natural disasters. Adults who’ve experienced child abuse are six times more likely to have PTSD compared to adults who haven’t, and the odds are even worse if the parents also got divorced. Other factors include the victim’s age and the length of the trauma. The younger the victim, the more likely PTSD is to develop. And the more a trauma is repeated, as opposed to a single incident, the longer lasting and more severe the PTSD may be. Repetition has a cumulative effect, layering unresolved trauma upon unresolved trauma. 

Symptoms of PTSD are often grouped into four main categories: 1) reliving the ordeal through intrusive memories; 2) avoiding reminders of the trauma; 3) increased arousal, a group of diverse problems related to changes in emotional reactions; and 4) negative changes in thinking and moods.

Do you have trouble sleeping or experience terrifying nightmares or sleepwalking?
Do you have sudden flashbacks of images or thoughts that are connected to the abuse?

— Journal questions in Survivor to Thriver

Reliving. People with PTSD can repeatedly re-experience their ordeal through unwanted thoughts and distressing memories of their trauma. These memories may come in the form of flashbacks (reliving the event as if it were happening again), hallucinations, nightmares, or night terrors (a more extreme type of nightmare occurring during non-dreaming sleep cycles). Even sleepwalking can be associated with PTSD, and could be indicative of unresolved trauma.

Often these events are caused by a trigger, which could be anything that might remind the survivor of their trauma- something someone says, being left alone, smells, tastes, the sound of ice clinking in a glass, the sensation of losing control… anything associated with the original trauma. It transports the person back to the original event with the emotional intensity that would have been an appropriate reaction then, but not now. Sometimes the actual memory of abuse is so repressed that an incident in the present may trigger the strong feelings associated with it, but without the victim identifying the link. They may simply become enraged by what merely annoys others, devastated when others are momentarily sad, or panicked when others are just worried. They tap into deep feelings without quite grasping their true source.

Do you need to withdraw periodically from the world in order to regain control of yourself?
Do strong feelings leave you feeling disconnected, numb or afraid that you are going crazy?
Do you sometimes feel like you are somebody else?

— Journal questions in Survivor to Thriver

Avoidance. People with PTSD may avoid people, places, thoughts, or situations that could remind them of their traumatic experiences. They in essence begin to organize their lives around avoiding the pain caused by their trauma. They may avoid any intimate connections. This can lead to feelings of detachment and isolation from family and friends, or a lack of interest in activities they once enjoyed. Though they may actually have highly developed social skills and even appear extremely extroverted, they may have great difficulty expressing their feelings.

Or they may be unable to even feel a range of emotions, particularly the anger, fear or sadness associated with their trauma. Instead, they may feel emotionally numb. In extreme cases, survivors may experience something called dissociation, where the mind splits from the body in an effort to protect itself from pain. There is even evidence that survivors of extreme and prolonged child abuse might be susceptible to developing multiple personalities as a means of self-protection.

Do you have frequent panic attacks?
Do you have overwhelming anxiety that seems connected to a particular situation or stage of your life?
Do you have trouble concentrating or remembering?
Do you have periods of overwhelming grief or terror?
Do you have strong feelings of anxiety, fear, and depression that threaten to overwhelm you?

— Journal questions in Survivor to Thriver

Increased arousal. This category of symptoms concerns changes in emotional reactions, which can include excessive emotions, problems falling or staying asleep, irritability, outbursts of anger, difficulty concentrating, hypervigilance, or being easily startled. People with PTSD may exhibit self-destructive behavior, such as drinking too much or driving too fast. They may also suffer associated physical symptoms, such as increased blood pressure and heart rate, hyperventilation, muscle tension, nausea, and diarrhea. Along with these signs, survivors often report feelings of extreme anxiety, panic, general fearfulness and disorientation.

Negative thoughts and moods. People suffering from PTSD may feel negative thoughts about themselves or others such as blame, guilt, shame or estrangement. They may have difficulty maintaining close relationships. They may feel unable to experience positive emotions and be hopeless about their future.

Post-Siderov Symptoms

I think I’m, uh… I think I’m done being a cop.

— Deeks to Sam in “Ascension“

Brenda points out that, “when you think of what they all… have faced, [the risk for PTSD] applies to all of the team, including Eric and Nell.” She even sees much of Callen’s behavior as signs of post-traumatic stress (emotional avoidance, attachment issues, hypervigilance). It would seem, though, that the only team member to have at least semi-officially suffered from PTSD in the last eight seasons has been Deeks. While Nate may have never officially diagnosed it, I think Kensi and the fandom in general believed that Deeks did have PTSD after being tortured by Siderov.

In “Impact” we saw a comparison between Sam and Deeks’ respective recuperations. Sam described using dissociation to survive the actual trauma, with Nate worrying to Hetty that the technique might not work for him in the future. Regardless, Sam seemed to recover far quicker than Deeks. Yes, he had more training on how to deal with such a situation. But when I think about Deeks – with his shrunken hippocampus – even trying to withstand the incredible trauma that was Siderov, it seems that he never had a chance. Even Sam, with his loving and supportive family (and his well-developed hippocampus), struggled. Given Deeks’ childhood traumas that likely impacted his ability to deal with trauma as an adult, there seems to have been no way for him to have avoided PTSD. I’d like to think that in therapy sessions we never witnessed, Nate actually explored some of Deeks’ childhood trauma and helped him address some long-unresolved issues.

On the other hand, I think Deeks’ apparent challenges in dealing with stress make it all the more impressive that he was able to withstand Siderov’s torture. It wasn’t just his relative lack of training, but his childhood experiences, that would have made it harder for him than for Sam. As Nate described to Hetty, “The trauma and damage [Sam] experienced… it’s cumulative, physically and psychologically… If it happens too many times, he could reach a breaking point where he can’t take it anymore.” That has to apply even more to Deeks’ situation. While they’ve both experienced traumatic situations as adults, at least Sam’s childhood seems to have been trauma-free.

Deeks: I just… I want to walk away from it.
Kensi: Yeah, so take some time off.
Deeks: I just need to get away from everything, you know? I just, like… I just…
Kensi: And everyone?

— Densi in “Ascension”

We know Deeks has had nightmares since Afghanistan. We don’t know if he experienced them post-Siderov. But one of the reasons for his insomnia might have been an effort to avoid nightmares by staying awake. He definitely had the avoidance thing down, not returning anyone’s calls. But now I see that he was avoiding the entire team because they would have been a reminder of his traumatic experience. He shared that experience with Sam. Callen and Hetty ordered it, and Kensi failed to pull him out of it when he begged her to. Deeks also seemed to have lost interest in surfing, content to merely watch others participate in an activity that had previously brought him so much joy.

I’ve long been intrigued by Deeks’ first day back on the job in “Omni,” specifically his difficulties at the shooting range and his unwillingness to take a shot in two later shoot-outs. It all seemed clearly related to his trauma, but I had a hard time understanding it beyond that. Now I see it under the umbrella of avoidance. The last time he had pointed a gun at someone was to kill his tormenter on the roof in “Ascension,” and the time before that, he had surrendered it in order to save Sam, thereby leading to his trauma. I think he was fighting against being reminded of these events, scared that such reminders would pull him right back down into his PTSD symptoms. All in all, that he even got through the day being present at two firefights was impressive.

Kensi: Look, deaths from motor vehicle collisions, specifically motorcycles, are more prominent than suicides and overdoses in returning veterans. Five times the national average.
Deeks: Okay, and I fully admit that it’s a tragic statistic, but it’s irrelevant to me because I am not a combat veteran.
Kensi: No, you’re not, but you… you went through a very traumatic experience.
Deeks: Is that what this is about?
Kensi: I know what I’m talking about, okay? Risky behavior is one of the most common symptoms of post-traumatic stress.

— Densi in “Unwritten Rule”

We also saw post-Siderov Deeks experience signs of increased arousal. His insomnia was one. This must have led directly to the increased irritability he showed with Nate. Plus there was the self-destructive behavior we saw with the motorcycle and his standing in front of the moving van in “Unwritten Rule.” It’s also safe to assume he experienced negative thoughts and moods. He’s nearly despondent when Hetty drops in on him, and he must have felt a sense of hopelessness about being able to recover enough to go back to work (not helped by Hetty issuing ultimatums). I’d guess he also felt ashamed of his inability to bounce back as quickly as Sam. He is so good at beating himself up after all. He likely would have seen his symptoms as a failure, a further demonstration that he was “the weak one.”

Monica: Why should I believe a word you say?
Deeks: ‘Cause I’m the one telling you, not Max.
Monica: Yeah. And your imaginary friend, Max Gentry, absolves you of all guilt. “It wasn’t me, it was Max.” So lucky to have a friend like Max.

— Deeks coming clean to Monica in “Parley”

I don’t necessarily see Deeks’ sleepwalking as related to PTSD given he first mentioned it in Season 4’s “Skin Deep,” but it could be an indication of unresolved issues from his childhood. And while I have to say it would be pretty darn entertaining to think of Max Gentry as Deeks’ split personality, I don’t really see him that way. Sadly for Deeks, he’s all too present inside Max. He may watch in horror at Max’s bad behavior, but Marty is the one who’s still in control.

Coming Up Next

Speaking of Max, next time we’re going to talk a bit more about Deeks’ dark side, and how the lessons he learned as a child about using violence to solve problems have stayed with him as an adult.

Tomorrow, come back for a special fan fic from Divergent338 AKA Hannah, who is exploring this topic in her own unique way.

Want to Read More?

For more about the brain, read this Time article on the Harvard study or the actual study published by the National Academy of Sciences.

Check out this great article from the Winnipeg (Canada) Free Press on the growing reporting of PTSD among front-line emergency personnel like police, firefighters, paramedics and prison guards. Many victims shared their experiences dealing with this condition.

You can also visit the Adult Survivors of Child Abuse website or download their self-help manual Survivor to Thriver.

• Or, go back to the previous post in this series, Shame & Blame.
• If you’d like to know how to help those who need it, check out The Pixel Project’s “16 Ways to Stop Domestic Violence in Your Community.”
• The HelpGuide has a great overview of child abuse and neglect.

A huge Thank You to my fellow wikiDeeks collaborator Brenda for her assistance with research and editing of this article. Brenda is a nurse practitioner with more than 25 years of experience in caring for individuals experiencing significant trauma, and a PhD student whose research focuses on communication, conflict and ethics in human interactions. I’m very grateful for her input and review of this series.

And thanks to Hannah for her own special contributions, with fan fics inspired by these analytical articles, designed to illustrate the topic in a very different way. I’m so happy to have her partnership on this series.