I May Destroy You – an insight into living with post-traumatic stress disorder and recovery

This is a review of a multi-BAFTA award-winning television drama series called I May Destroy You (BBC, 2020) rather than a book review. It explores the pervasive effects of sexual violence. Following being raped, Arabella, the central character, experiences significant symptoms of post-traumatic stress disorder (PTSD). She frequently experiences distressing intrusive memories and flashbacks of the rape. She avoids the bar where she met the man who later raped her. Arabella also experiences significant hyperarousal: she finds sleeping difficult and finds it hard to concentrate. She becomes increasingly irritable. These three core symptoms of PTSD lead to significant functional impairment with her unable to write, losing her writing contract and arguing with friends. Although Arabella is offered some therapy, she does not really engage with this, and her symptoms and impairment worsen.

In common with many people with PTSD, Arabella does not just avoid places that remind her of the rape, she also avoids feelings and memories of it. This is powerfully demonstrated metaphorically when she throws her clothes (used in forensics as evidence) under her bed after retrieving them from the police. The narrative style helps us to appreciate Arabella's experiences of disorientation more, with strong visual imagery, the story jumping chronologically and replaying multiple versions of the same event. This is typified by one episode ending with Arabella trying to drown herself after feeling emotionally drowned followed two major rejections; then the next episode starts as if nothing happened. Has Arabella simply put memories of her suicide attempt ‘under the bed’?

Following a difficult evening with friends, Arabella feels overwhelmed and reaches out to her therapist where they reach a breakthrough. The therapist listens to Arabella and draws an image on the paper between them. She discusses the separation Arabella seems to have between good and bad, Arabella and the night of her rape. She draws a line between A (for Arabella) and X (everything bad). Despite Arabella's efforts to keep the bad things ‘under the bed’, the therapist recognises that they still hurt her. Arabella takes the pen and combines the A, X and the line in between them into one image. Such a breakthrough represents a shift from the Kleinian schizoid to depressive position. She goes home and faces what is under her bed. This leads to significant healing for Arabella. Later, upon finishing her book, the cover shows the image she had created in therapy, reinstating the importance of that revelation.

This series portrays PTSD in a way that is powerfully informative to viewers. Viewers that may be trying to cope with trauma may recognise themselves in Arabella. They too may be trying to cope without help and unsuccessfully stuffing difficult feelings ‘under their beds’. This series demonstrates how incredibly helpful therapy can be for PTSD, if we are prepared to open up and discuss what is so difficult for us. We hope that it has led to other ‘Arabellas’ seeking help and recovering.