During the months leading up to DC's 2018 comic event Heroes in Crisis, various DC characters have been placed into the care of a mental health center called Sanctuary. According to Heroes in Crisis writer Tom King, Sanctuary was set up by Batman, Superman and Wonder Woman as a place where superheroes (or even villains) can get treatment for mental problems that stem from trauma.
Sanctuary was modeled on veterans’ crisis centers, King has stated; although being in a fictional, sci-fi universe like the DCU means there are additional resources for treatment. For example, King has stated that Batman’s funding allowed a state-of-the-art facility to be constructed, and the treatment uses Kryptonian technology and Amazonian-type mysticism.
King is pretty knowledgeable about the subject of violence and how people process trauma, having served as a CIA counter-terrorism agent for seven years (including service in war-torn areas like Iraq, Pakistan, and Afghanistan). The writer has also shared that, some time after his service, he suffered from a psychological breakdown, needing help from professionals who understand the mental effects of trauma - and needing love from his family and friends.
In the first and second parts of our series on “Trauma and Heroes in Crisis,” Newsarama had information on the symptoms and extent of PTSD and other trauma-related mental illnesses, then examined how trauma is already dealt with — and might be more realistically handled in the future — in superhero comic books.
In this third installment, Newsarama examined the treatment process for trauma-related symptoms and how it appears to be utilized in DC’s Sanctuary during Heroes in Crisis.
As Newsarama traced previously, the diagnosis and treatment of trauma-related disorders have advanced greatly in recent years.
“The initial progress was made in how do you go about evaluating people for the presence or absence of PTSD? There’s been tremendous progress in that arena alone,” said Terry Keane, director at the National Center for PTSD at the U.S. Department of Veterans Affairs. “The treatments actually took awhile.”
What emerged from decades of study by researchers at the Veterans Affairs and elsewhere is a variety of treatments, including therapy, medications and support networks.
Keane said one of the most common treatments is exposure therapy. (In fact, Keane and colleagues published research in the 1980s about its effectiveness for Vietnam War veterans.)
“[Exposure] means, basically, helping people to recall the things that are most frightening to them that happened, in a very sensitive, systematic way in the therapy room,” Keane said. “We published that study 30 years ago, and it’s been replicated now literally dozens and dozens of times across languages, cultures, borders, [and] different kinds of traumatic experiences.”
Another approach to treating PTSD, Keane said, is cognitive processing therapy.
“Cognitive therapies are trying to identify what the distortions are that people have about the experiences,” he said, stating that sometimes patients feel responsible for what happened or take ownership of the experience.
“So [cognitive therapy is] trying to work on people’s beliefs about things, you know?” Keane said. “That they’re ashamed for what they did or didn’t do, that they are convinced that they’re a bad person or that the world is completely unsafe, all of which can be the targets of cognitive therapy, depending upon what somebody is bothered by. Each person is different and they respond differently.”
There are also various internet treatments available which help people who are struggling with symptoms. “There’s a treatment approach that we have developed called VetChange.org,” Keane said. “And you can actually go in there and explore the treatments that we put together for alcohol and PTSD. Alcohol and/or drugs and PTSD occur commonly together.”
Ken Duckworth, medical director of the National Alliance on Mental Illness, said there are medicines that sometimes help with symptoms. “There’s a biological component to it, so medication can be part of an overall treatment plan,” he said.
Duckworth said exposure is also utilized in EDMR, or “eye movement desensitization and reprocessing,” to treat symptoms from trauma. The process requires patients to concentrate on their traumatic experience while the therapist utilizes a flashing light, sound or movement to help them reprocess the event.
“Exposure is thought to be the leading model,” Duckworth said. “But I would describe the primary treatment as a healthy support network, usually with a group of people, so you’re reminded that this didn’t only happen to you.”
Translating to Superheroes
So how do these types of real-world treatment translate to superheroes and the process described for DC’s Sanctuary?
The staff at Sanctuary are actually three robots, or artificial intelligence “caretakers,” as King has described them. Inspired by Wonder Woman’s compassion, these caretakers are loosely modeled after Ma and Pa Kent and Lana Lang, but they are not human.
Although therapists are an important component of real-world treatment, Keane’s mention of internet-based treatments lends itself to the possibility that a technologically advanced society like the DCU would be able to forego the human element by utilizing similar technology-based methods.
And will those high-tech methods include real-world treatment like exposure or cognitive therapy?
That’s likely. King has stated that Sanctuary patients have access to hologram suites that help them create environments and holographic people that help them work through issues. Presumably, this technology could be utilized for several types of therapeutic processes utilized by psychologists in the real world.
For example, the hologram suite can create a scenario that will help a superhero confront their beliefs, working through their shame or anxiety. The suite could help with exposure, either allowing someone to work through a traumatic event or helping create a new similar event that allows them to produce new, positive experiences.
As King described in a recent interview, Batman could “spend time with his Robins as the young boys they once were,” meaning the possibilities for therapeutic holograms are almost endless.
So far, however, there’s no mention from DC about superheroes receiving any help from medication, but Vasilis Pozios, co-founder of the mental health and media consultancy Broadcast Thought, hopes that element will emerge in future issues.
“An essential part of psychiatric treatment for PTSD often includes treatment with medications,” he said, “so hopefully this aspect will not be ignored in Heroes in Crisis.”
As for the “healthy support network” prescribed for recovery in the real-world, Heroes in Crisis is including this idea with pins that will be worn by superheroes who have completed the Sanctuary program.
Graduates of the Sanctuary treatment receive pins that have a Superman-type “S” logo (for “Sanctuary”). The pin also features three hands that symbolize the Trinity and the friendship of the superhero community, and the pins will also show up in other books, on various characters.
Or as one of the psychologists we interviewed put it, “the Justice League and the Avengers are in de facto support groups.”
“All members have been on the front lines, and know what it’s like to be knocked unconscious, suffer bodily damage, and be unable to prevent havoc happening to innocent victims,” said Robin S. Rosenberg, a clinical psychologist who has written several books on the psychology of superheroes. “They have each other to lean on.”
At the end of the treatment at Sanctuary, patients remove their masks and go through a confession process that’s meant to help them use their pain as a strength. And during the next few months of the Heroes in Crisis event, several DC books will actually feature one-page confessions of well-known heroes to emphasize that even the strongest people sometimes have mental health struggles.
The strength that comes from treatment in the real-world is similar, Duckworth said.
“It’s not a superpower per se, but it is strength that grows from vulnerability,” he said. “And I think there’s a nice narrative that could be woven into some of these comics.”
Check back for future installments of Newsarama’s Heroes in Crisis tie-in series exploring superhero comic books and the mental effects of trauma, including an examination of whether superhero comic books have moved forward with their depiction of mental illness.
For more information about mental illness or to get help, there are several resources and phone numbers available on The National Alliance on Mental Illness website. The V.A. also has information and resources specific to PTSD awareness at ptsd.va.gov.