All survivors of torture suffer from physical and/or psychological effects, and many never fully recover from the experience. Life is often described in terms of â€˜beforeâ€™ and â€˜after I was torturedâ€™; as the survivorâ€™s personal history suffered an incision at that point. Although everyone who had to undergo torture in whatever form is affected by it, not every person develops a mental condition within diagnostic clinical vocabulary. Not everyone shows symptoms of posttraumatic stress.
Now, what about Dean?
Dean survived not only the physical trauma during the time he was tortured, but also the psychological trauma which accompanied the physical pain and proved to be more severe (in particular becoming a torturer himself, a massive inconsistency with the protective and caring nature of his).
Typical posttraumatic sequelae and symptoms of experienced trauma and coping problems are e.g. recurrent re-experiencing of the traumatic events which will occur in nightmares, hallucinations, flashbacks (even during the day sometimes memories will befall the survivor and he will go through a traumatic moment as if it was happening that very instant which often results in panic, erratic behaviour, sometimes even thoughts of suicide).
Dean was often confronted with acoustic (mostly screams) and visual hallucinations (blood red colours, perhaps he even saw something he did or was subjected to, but we, as viewers, were not explicitly informed about it). The moment he experienced those, he got confused and distracted, if only for a couple of minutes (for instance in â€˜Itâ€™s The Great Pumpkin, Sam Winchesterâ€™, the masks hanging from the teacherâ€™s ceiling made him remember something from hell and he stopped in his tracks, a reaction Sam misinterpreted as Dean being reminded of his teenage angst). Those masks, though, served as so-called triggers to open memories of horrific events.
Other symptoms include the persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness. Survivors will try to avoid any contact with thoughts, activities, places, people that might arouse recollections of the trauma. A variation of avoidance will often be the increased misuse of drugs, alcohol or medication (sedatives and analgesics in particular).
They will also often be incapable of recalling important aspects of the experience, show diminished interest or participation in activities formerly important to them, and they will feel detached or estranged from others. Also their range of showing emotion will mostly be restricted.Furthermore, survivors of trauma will frequently feel to have a foreshortened future, not expecting to succeed in their jobs, relationships or even having a â€˜normalâ€™ life span.
Additionally, survivors will complain of difficulties falling or staying asleep, nightmares, generally increased arousal, thereby often suffering from outbursts of anger or irritability.
The avoidance observable with Dean was expressed by his refusal to talk about his time in hell. In fact, he lied to Sam from the moment he came back, denying to remember anything, which he, unfortunately did. No merciful oblivion here. Memory flashes jumped at him in the coffin, in front of the mirror in the fill-up joint, inspecting the mark of Castielâ€™s hand on his shoulder, etc.
Dean also showed less interest in hunting, and his reactions changed. For instance in â€˜On the Head of a Pinâ€™ the brothers, returning from Pamelaâ€™s funeral, talked in the car â€“ Dean was tired, emotionally drained. Before his stint in hell Dean would have been enraged, not unlike Sam. But here we saw only a shadow of his former self. Even the anger he mustered up in defiance of the angels was not full-hearted. In fact, the quiet moment with Castiel, shortly before Dean started to torture Alistair shows in a nutshell the psychophysical state Dean was in at that time (I recommend the extended scene on the dvd).
When I work with patients who survived torture of whatever kind (or trauma in general), we donâ€™t talk about the events right away. One of the most important part of therapy lies in the building of a relationship between the patient and myself which will allow him to feel completely safe, respected and understood and â€“ very importantly â€“ which will allow him to assume that I am capable of bearing what he has to tell (when he (or she) will be ready to talk about it). To my experience, that is crucial. Often survivors donâ€™t speak about what they underwent because they feel that they might overtax others, primarily their loved ones, trying to protect them. Furthermore, they need to learn how to stabilize themselves when being overwhelmed by flashbacks.
Considering Deanâ€™s relationship with Sam it is most likely that he did not talk about hell for three reasons: a) he was hardly able to handle his memories and afraid of looking back, b) he wanted to protect Sam from the unbearable knowledge of what his brother had to endure (and perhaps protect him from the increase of bad conscience, because Sam had not been able to save Dean from that fate) and c) he was afraid of having to tell the whole truth â€“ that he had become some kind of monster himself.
Instead he tried to quiet those inner voices and the nightmares with alcohol. Weâ€™ve seen him drink a lot more that he used to, and he got a drink first thing in the morning after waking up. It took him ten episodes into the fourth season to finally open up, at least a little, about his four decades of hell time.
I need to sing Jensenâ€™s praises here once again â€“ the manner in which he played that scene could have been taken directly from my work. Iâ€™ve seen this on a daily basis so often, and itâ€™s heartbreaking how authentically Jensen delivered those lines. I am in awe whenever I watch him play that moment. However he did itâ€¦ this is very much how a person in such a situation might react.
At first Dean tried to establish some stability with an initial chat, having a beer, slowly beginning to get into the story. All the while not looking at Sam. To be able to speak about it at all, he wasnâ€™t able to see Samâ€™s face, his feared reaction. Dean started to recount the events in a matter-of-fact way, desperately trying to split away any emotion that might overwhelm him. And Dean managed to do that quite well until he came to the part where he had to admit (once again to himself) what he had done. .â€™ God help me, I got right off and I started ripping them apart. I lost count of how many souls. The things that I did to themâ€¦ â€¦ how I feel? Thisâ€¦. inside meâ€¦ I wish I couldnâ€™t feel anything, Sammy. I wish I couldnâ€™t feel a damn thing.â€™
Of course he was wishing to be numb, to not feel anything, as what he carried on his shoulders was more than he felt capable of bearing.
But he did.
Although there are symptoms of posttraumatic stress to be found, Dean is still functioning on a high level. Those survivors who develop a mental condition clinical psychiatrists/psychologists/therapists call posttraumatic stress disorder usually donâ€™t. They might be able to go about their lives in some way, but very often â€“ from my experience â€“ they are not fit for work (or need a long time to get there), sometimes their relationships fall apart.
Dean has undoubtedly been in danger of that. But there are many factors on his side that protected him from getting sucked in by that disorder. He found himself still efficient, capable of doing what he had done from his youth on (fighting the paranormal world), even though the scars, physical and mental, will need more time to heal (if they ever do entirely). I will elaborate that in another article.
You might have noticed that, after referring to tortured people as victims, I called them survivors in the second part. I did that deliberately, because I found it essential when dealing with people who have experienced the kind of hell torture provides to help them see that they are above all â€“ survivors. Some inner strength helped them to stay alive, albeit wounded beyond description. And, hopefully, they will find that again. But the path is stony.
It holds true for Dean. He managed to survive, but he will have to learn to live again, having become more than he was before he entered hell. He will learn to defeat the â€˜hidden enemyâ€™ of the wounds his soul still carries, fed by guilt, his possible future as Michaelâ€™s vessel or the danger of having to kill Sam eventually, should he succumb to the devil, as we have been warned about.