I’m getting close to the end of this section of Marc McCutcheon’s book  Building Believable Characters. Thanks for sticking with me. Today’s psychological problems include PICA, PRESSURED SPEECH, PSYCHOGENIC PAIN DISORDER, and PSYCHOPHYSIOLOGICAL DISORDER. Those are some fun words to type. Now let’s see what they mean and how they can be used to create a believable character for your novel.

PICA: “Abnormal craving for or eating of unusual foods, such as dirt or laundry detergent, seen in the emotionally disturbed and sometimes in pregnant women.” I’ll admit, the word “food” followed by “dirt or laundry detergent” brought a smile to my lips, but let’s move beyond that little slip-up. The TV show Grimm used this in a much different manner, but the symptoms were the same: the sergeant ate the stuffing from pillows, a penny, and a strange assortment of other non-edible stuff. The comedic value was astronomical when it first happened. Then it became serious. If you use this in your novel, research it well so you do it justice. 
PRESSURED SPEECH: “Rapid speech accelerating out of control, so that words are sometimes jumbled or unintelligible.” Again, I can see this being used for both comedy and drama, depending on how it’s handled. In a side-kick who has a mild form, it could be used for humor. In a protagonist, it could be quite tragic. Again, research is paramount. I don’t know enough about this to comment beyond the vaguest statements, but the idea could inspire someone out there.
PSYCHOGENIC PAIN DISORDER: “The manifestation of mental stress through physical aches and pains, which may be chronic or severe.” I had a friend who suffered from severe pain, and her doctor told her it was all in her head. Later she was correctly diagnosed with fibromyalgia. I had terrible wrist pain long before carpal tunnel and repetitive motion syndrome were labeled, and my doctor tried to convince me it was all in my head. Then there are those people who experience pain when there is no identifiable/known cause. Maybe this is it. 
PSYCHOPHYSIOLOGICAL DISORDER: “Any physical illness that can be traced to a psychological cause. Also known as psychosomatic disorder.” I know less than nothing about this, so I’m not qualified to comment. However, the mention of it may spark an idea for you. How could you use this in a protagonist? Or would it work better for an antagonist? Is he doing bad things because of the pain he’s in? 
Please share your ideas in the comments section. I love to hear from ya’ll.


  1. Pica is definitely a bizarre one (hair-pullers – trichotillomaniacs – sometimes will eat the strands of hair they’ve pulled out, making it a combination of trich with pica). It can be tempting to turn it into a circus sideshow (Look at how bizarre and freakish this character is! Marvel and gape as they eat things not designed for human consumption! Step right up!), but as you pointed out, this might seem amusing on the surface but is very, very dark and horrifying at its core.

    Pressured speech is often going to be seen not as a stand-alone issue but as a symptom secondary to the primary diagnosis. It often appears in manic swings for a bipolar sufferer, for instance. So yes – research! 🙂

    Chronic pain sufferers can tell you (at length) how difficult it is for them to be told ‘it’s all in your head.’ I’d love to see a novel that boldly delves into this phenomenon, especially if it is psychologically rooted. For some reason, it’s considered to be less of a disease or an issue if it is ‘all in their head’ – but why? Does that make it magically hurt any less if the pain is due to the brain misfiring rather than physical nerve damage at the site of the pain? There’s an underlying attitude that if it is based inside the brain, then all the person has to do is make a choice to bring it to a stop, and it’ll all be over – thus, if a person continues suffering, they are choosing to suffer and deserve no sympathy or help because it’s all their own fault. It’s amazing/shocking to me how people find it so hard to accept that the brain can have glitches (hey person with depression, why are you sad when you have so many good things going for you in your life?) when it’s so easy to accept that all the other internal parts of the body can have glitches (hey person with asthma, why are you wheezing and struggling to breathe when you’re surrounded by fresh air?). There is no blame or shame in asthma or heart murmurs or things like that, but when the brain goes haywire, suddenly it’s a sign of weakness of character.

    Okay, rant done. The point is, keep in mind that the brain is an incredibly powerful thing, and just because the root cause of an issue – whether it’s a mood issue or physical pain or physical illness – might lie in the brain does not make it any less of a painful, difficult ordeal for the sufferer than it would be if they suffered any other physical ailment, nor do they possess greater control of their symptoms than someone whose ailment has a physiological root rather than a psychological one.

    Good resource:

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