Note: this article contains discussion of themes including sexual assault that some readers may find upsetting.
In the finale of Outlander's fifth season, Claire Fraser (Caitríona Balfe) was abducted from her North Carolina home by a gang of men, led by Lionel Brown (Ned Dennehy), before being beaten and raped.
The harrowing storyline, which was drawn from Diana Gabaldon's sixth Outlander novel, A Breath of Snow and Ashes, proved divisive, with a number of viewers arguing that its inclusion was unjustified, and yet more evidence of Outlander's unhealthy relationship with sexual assault.
But while other TV shows such as Game of Thrones have rightly come under fire for using rape gratuitously, focusing on a man's response to a woman's rape or creating blurred lines around consent, Outlander is generally much more thoughtful about how it tackles assault.
Had the plot line wrapped up with the season 5 finale, in which Jamie Fraser (Sam Heughan) and his men rescued Claire and killed most of her abductors, he would have been placed front and centre. But that narrative rumbles on in the latest chapter, in turn illustrating that just because Claire's bruises have healed, recovery is a non-linear process.
Although it initially seems like life has returned to normal on Fraser's Ridge in the opening episode of season 6 – which features several new developments, such as the introduction of the Christies – Claire remains haunted by her assault.
Towards the end of the episode, following an unsettling visit from Lionel Brown's brother Richard (Chris Larkin) and his men, she wakes from a nightmare in which Lionel's taunts during her kidnapping are interspersed with other traumatic moments from her past. She goes to make a cup of tea, but finds herself tempted by something else entirely.
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Claire, who remains an enterprising 18th-century doctor, has been experimenting with ether – essentially a form of general anaesthetic – which will enable her to operate on her patients without them suffering. But she's tempted by its properties herself, which offer her an escape from her own emotional wounds.
Alone in her surgery, she places the ether mask over her mouth and nose, breathes deeply and collapses onto the bed.
It's a heartbreaking scene – and a major departure from what happens in the books. While Gabaldon does depict her struggling to cope in her writing, with Claire startled by sudden arrivals and reacting with instinctive terror when someone reaches out to touch her, she doesn't self-medicate as she does in the drama.
Sadly, that is a reality for many survivors who have PTSD, as Balfe explained to us.
It also feels apt for the self-sufficient Claire to try to handle this on her own. As a doctor, war veteran and an independent woman, she is used to dealing with whatever life throws at her and often resists asking for help. From nursing soldiers at the Front during the Second World War through to the failed Rising in the Highlands to nearly dying following a miscarriage, she has previously managed to deal with whatever distress or grief she has encountered. But now, as Balfe movingly depicts, she can't find a way past it.
It's also unusual for Claire to keep secrets from Jamie – he knows nothing of her self-medication – which should test their bond in interesting ways in season 6 and explore how mental health disorders not only impact those suffering from them, but their loved ones also. Given that Jamie was subjected to a similarly horrifying experience when he was beaten and raped by Black Jack Randall (Tobias Menzies) in season 1, he is able to empathise with Claire more than most.
But that shared ground doesn't promise a less difficult path to recovery for Claire. What Outlander is vividly demonstrating here is that every trauma manifests differently, and every survivor reacts differently. Claire using ether clearly isn't a wise choice, but we're not invited to judge her. Instead, it's about extending compassion, even when her methods of survival are visibly risky, and understanding that an outwardly strong person might be suffering in silence.
The gang's attack also had a major impact on Jamie and Claire's adopted son Fergus (César Domboy) and his wife Marsali (Lauren Lyle).
As well as being devastated by what had happened to Claire, a pregnant Marsali was also personally injured by Lionel and his men, which prompted her to poison him when he was brought back to Fraser's Ridge for interrogation. In the original source material, it's housekeeper Mrs Bug who carries out the deed, but the decision to have Marsali murder Lionel allows the series to further tap into the corrosiveness of trauma – and that continues for both her and her husband in season 6.
As we see in the first episode, Fergus is now drinking heavily, ashamed and angry that he wasn't able to protect his family. Rather than have the attack bring the pair together, their marriage is currently in a precarious place as they continue to lash out at one another.
There is also growing hostility between the Fraser clan and the Browns. Although Richard begrudgingly accepted his brother Lionel's death, he still thirsts for revenge, and his presence will continue to stoke the flames of trauma for everyone.
It's exactly the type of plot line that Outlander does best: nail-biting conflict combined with deep character studies set in a rich, historical setting.
"It's the payoff that I've been waiting for," Heughan said of season 6 when speaking to RadioTimes.com. Judging from the initial episodes, his promise rings true.
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