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Researching the psychology in Girl Against the Universe
by Paula Stokes

The draft of the book that I sent my editor back in December of 2014 was very different from the book you received in your Uppercase box. For one, the book was called Bad Luck Charm. Also, the mental illness component was much less and the story was lighter—more similar in tone to The Art of Lainey. Main character Maguire did have the same tragic history and the same survivor’s guilt, but instead of being on the path to recovery like she is in GATU, she was on the path to realizing she needed help. Part of that draft’s ending was Maguire’s decision to enter therapy.

The finished book starts with Maguire in therapy, so obviously a lot changed. The creation of Dr. Daniel Leed and all of the therapy chapters happened during a fairly quick revision process. This meant I had to do the necessary psych research to get Maguire’s revised mental state and subsequent treatment accurate in a limited amount of time. Luckily, I have an undergraduate degree in psychology and wrote a thesis about anxiety in nursing students for my graduate degree in nursing. I also struggle with social anxiety myself. The combination of my education and personal history gave me a solid foundation to build upon. Here’s a look at some of the additional mental health research that I did for Girl Against the Universe:

Online research:
The internet was helpful for general information and also to read anecdotes from real people who have experienced issues and feelings similar to Maguire’s. One thing I always do with any information I get online is to verify it with at least two or three other sources. For this book, I looked at websites targeted to people with anxiety, PTSD, and survivor’s guilt. I also looked at major mental health websites like nami.org and read pages about dealing with the loss of loved ones and reviewed the stages of grief (though it’s important to note that not everyone goes through those stages in the same order or at the same speed.)

Personal interviews:
This is without a doubt the best way to get accurate, real-world info. Unfortunately, it’s also the most time-consuming and difficult to arrange. I limited my interviews for this story to personal acquaintances who I knew had undergone therapy for anxiety and/or PTSD. They gave me feedback on things like how Dr. Leed’s office was set up, how he might respond when Maguire doesn’t want to talk, and whether her progression through her list of tasks felt realistic. pg 1-11 + throughout the story

Consulting experts:
I directed a few targeted questions to a PhD psychologist friend who does cognitive behavioral therapy and had the entire manuscript reviewed by one of my critique partners who is also a pediatrician. It was the pediatrician who pointed out that Maguire’s coping behaviors felt like they might qualify her for a diagnosis of obsessive compulsive disorder (along with PTSD and anxiety). p 30

Book research:
The major book research I did involved the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. The DSM-V breaks out the criteria for every recognized mental disorder and I wanted to be sure that I was portraying Maguire accurately. It turned out that whether she qualified for an official diagnosis of OCD was kind of unclear and would depend on how she and her therapist viewed the intrusion of her compulsive behaviors upon her daily life. Therefore, I have purposely left this open in the book but made a point of mentioning the possibility. pp 29-31

Beta-reading:
I knew of one person who had struggled with similar issues to Maguire who was willing to do a quick read of the revised manuscript and give me feedback. Then I saw a blogger on Twitter comment that she had anxiety and was looking forward to the book. I reached out to her and asked if she’d be willing to do an early read and let me know if anything felt inauthentic to her. Both of these “mental health” readers gave the revised book two thumbs up, and their feedback went a long way in making me feel comfortable and confident with the portrayal of mental illness in Girl Against the Universe.

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