We have discussed in earlier blogs the impact of trauma on relationships, reconsidering the anger in your relationship, communication for anger management, the impact of trauma on sexual intimacy and attempts to reclaim it.

Where Does Forgiveness Fit In?

With Couples, forgiveness implies the recognition that one has been hurt by the other, and the willingness to release the negative thoughts and feelings toward the other partner. Forgiveness is not about denial, condoning abusive behavior or remaining in a dangerous situation – it is about finding a way to go on. It is about dealing constructively with anger in a way that leaves room for a couple to keep trusting, moving and hoping.

Self-Forgiveness

Forgiving yourself is crucial to your own emotional well being and that of your partner. Forgiving yourself is central to forgiving others. One of the most difficult reactions that people have in the aftermath of natural and manmade disasters, war and even serious illness is shame and self-blame. Blame is associated with guilt for action or failure to act. “Why did I take the car out in the snow?” “Who lives in a place that has hurricanes?” “Who turns their back on a baby for even a moment?”

Shame is a perception of self as unworthy, damaged, unacceptable in the eyes of self or others. “How can I be an acceptable spouse if I have been raped?” “How can I be a tender lover if I spent a year as a warrior?” “What smart cop gets himself shot?” Often it is a partner’s inability to forgive self, that leaves no empathy for them self or for anyone else.

Self Forgiveness on the other hand involves an acceptance of humanness and lack of control in the face of the uncontrollable. It accepts that most people do the best they can in the unexpected moments in life. It recognizes that forgiveness of self facilitates recovery because it takes back energy from the “Could have” and “Should Have” to moving on.

Are There Some Things You Just Can’t Forgive?

Behavior that does not change and remains purposely hurtful or dangerous is behavior that …

It takes more than just showing up to reclaim or renew a good sexual relationship. Would you just show up on the dance floor to dance the tango together? Apart from the fact that you may have no interest in the tango – probably not. To really dance, you need a plan. When two people make a plan and share a goal to connect – it usually happens. Yes, at first your timing will be off, the pace may seem wrong and you will step on each others feet, but if you want to dance together you will hang in until it becomes smooth – until you know and trust each others’ moves as only partners can.

In our book, Healing Together, A Couple’s Guide to Coping with Trauma and Post-traumtic Stress, the title of the chapter on reclaiming sexual intimacy is “Dancing in the Dark” because we wanted to invite couples to reclaim, renew and even reinvent their intimacy as partners. The chronic stresses of daily life as well as the assault of unexpected trauma and loss can create enough stress and distrust to make partners feel like strangers. The touch, the trust, the physical connection and intimate knowing that couples can share is an invaluable emotional and physical source of transforming, healing, and renewing.

How Do You Find A Way Back?

Too often couples feel that so much has happened, so much has been said or unsaid, so much time has passed that they give up on reclaiming intimacy. Some partners get stuck in the face of sudden changes and want to wait until it is the “way it was.” Many believe they have to “feel” the urge to be with the other to even consider a plan.

It Is Only Too Late To Start If You Don’t Start. Often I ask people to consider that any intimate reconnection even just holding hands changes their feeling state and the state of the person they touch. It is the nonverbal validation of a connection. If they physically connect they will feel differently about who they are and the bond they share.

Embrace What Is New. …

Because trauma affects you physically and emotionally, it inevitably impacts your conscious and unconscious desire for closeness and connection. Traumatic events of both a sexual and nonsexual nature can have a devastating impact on a couple’s sexual intimacy. After rape, female victims often distrust and avoid intimate relationships and may struggle with difficulties in arousal or psychical response. (Mills and Turnbull, 2004). Avoidance of sexual activity, finding sex boring or burdensome, reduced desire and performance difficulties have been associated with war exposure and combat trauma ( Matsakis,1996). The grief from losing a child as well as traumatic life events like cancer, miscarriage, auto accidents and natural disasters impact intimate relating and sexual connection (De Silva, 2001).

Most partners don’t realize that it is common for one or both partners to experience a lack of desire, sexual performance problems or avoidance of intimacy after trauma. Feeling shame and blame, they often fear that the lack of responsiveness in themselves or their partner is an indication of lack of love or permanent dysfunction. They assume that they alone are struggling sexually so they avoid speaking about it – even to each other!

What Should Partners Know? It is important for partners to realize that what they are experiencing is a common sequel to a life threatening experience. The trauma symptoms of hyperarousal, intrusion, avoidance and numbing disrupt the psychological and physical safety and trust people need to be intimate.

It is difficult, for example, to feel sexual if you or your partner is frightened or hypervigilant to sound and touch. Partners suffering from nightmares and traumatic memories can be too exhausted to be sexual or too preoccupied to relax and connect. The numbing and constriction which keeps a person from feeling in the aftermath of a trauma can also keep them avoiding intimacy because it stirs up feelings – and all feelings have become unsafe.

How Does Knowing Help?Accepting all of these responses as understandable does not mean you must surrender to them. It means that you must put them in perspective and address them if you plan together to reclaim your intimacy.

First Steps in Reclaiming Intimacy

“More than Friends”
One …

Couples can use the language between them to make love or to make war. Sadly, verbal aggression can be a dangerous trigger to destructive exchanges or even physical violence. Effective communication techniques, on the other hand, help couples manage difficulties and anger in a way that is constructive and adds to relationship satisfaction.

When working with couples to develop more effective communication skills we always ask:
Do you speak in a way that makes your partner listen? Do you listen in a way that makes your partner speak?

If when he walks in she says, “You really don’t get it — I do everything in this house and you do nothing!” There is a very good chance that he will walk right past her into another room, flick on the remote and respond with a comparable put-down.

Essentially this couple would have enacted what is labeled by Christensen and Heavey (1990) as the demand/withdrawal sequence in which a complaint or demand made by a partner in a negative way predictably triggers the other partner’s withdrawal and defensiveness. His refusal to listen and in most cases his actual withdrawal is likely to escalate her negative feelings and “keep her speaking” but not in a positive way. Soon he will be telling her “She never lets up.” The pattern leaves them both feeling victimized and angry. The chances of mutual understanding or positive resolutions are very low.

Effective Couple Communication Techniques

Drawing upon couple communication ideas offered in two of my previous blogs, (Couples Psychological First Aid and Reconsidering the Anger in Your Relationship) we might suggest to her that she communicate her needs at a more appropriate time ( A partner’s first steps into the house are never a good time) and with an “I message” – “I’m not sure I can manage all the chores.” “I think I need some help.”

There is now an increased chance of his listening and even starting a conversation by asking what she means because he has not been put down. In fact, if he is able to use the “Active Listening” technique by putting himself in her …

On Oct 15, 2009, the front page story in the New York Times by Rod Nordland described Operation Proper Exit, a program which invited American servicemen wounded in the Iraq War back to Iraq to visit those very places where they suffered severe injury and loss as a way to help achieve psychological closure.

When we consider healing and recovery from trauma, revisiting ( literally,in this case) fosters the remembering and mourning necessary for integration of traumatic memories and unspeakable loss. Welcomed back by American Officers and the Iraqi Army Brigade Commander, these servicemen, one blinded and five amputees, had the benefit of others ‘bearing witness” to their sacrifice. The opportunity to feel respected for their service, to see changes in Iraq, to hear that the last unit replaced at that base had suffered no casualties gave meaning to their loss and trauma. The report of reduced fears and guilt “left behind” in Iraq as a result of such revisiting underscores the importance of this unique program.

For couples this program highlights the importance and value of partners understanding the importance “bearing witness” as a way to afford healing. In the case of the military partner, firefighter, police, the ill spouse, the other partner who has not faced the trauma often feels dismissed, minimized or not necessary to this process.

It is valuable to consider that when people have shared an unspeakable experience of horror and loss, there is what Lindy (1986) calls a trauma membrane that unites them. For military, firefighters, police, the band of brothers that gives them cohesion and courage is an essential component to their resiliency as well as their healing. It is seen in the “welcomed return” of the servicemen in Operation Proper Exit, the fact that after 9/11 firefighters stayed searching “the pile” at ground zero for months and the reason cops will drive across state lines to pay homage to a fallen officer.

Understanding your partner’s need to connect with others who can provide a certain type of support is a crucial aspect of healing together. It does not have to detract from the unique …

Many couples are both perplexed and stressed by the anger that erupts between them in the aftermath of trauma. Working with small groups of men and women after they had experienced a trauma, we often heard comments like: “Is anyone else angry?” “We never fought this much before.” “He’s nice to outsiders but angry with me and the kids.”

Some admitted fear of and avoidance of anger- of walking on eggshells. “I don’t want to rock the boat.” “It’s better that I just keep my mouth closed.” Most worried that anger could destroy their relationship.

Can Anger Destroy A Relationship?
The basic answer is NO. Anger is a human feeling and in itself is not damaging. According to attachment theory one characteristic of a secure attachment, be it between a mother and child or a couple, is the “safety to protest” without the repercussion of extreme anger or destruction of the relationship. Essentially if it is not safe for a couple to fight – it is not safe. Compliance, self-silencing, hidden resentments to keep the peace are not solutions. Research that studied the argument styles of 4,000 men and women in Framingham, Mass., revealed that self-silencing for women and battles of control for men created as serious a heart risk factor as smoking or high cholesterol. Being angry is not damaging – it is what you do with it, how you communicate it and what it does to you and your partner that can be destructive.

How Do We Keep Anger From Becoming Destructive?

Reconsider the Meaning of Anger
An invaluable step for any partner is to reconsider the meaning of their own anger and that of their partner – at a calm, non-stressful time. Understanding the causes of anger when you are in a state to think about it actually fosters perspective and alters response in the heated moments.

It is important to recognize, for example, that anger is a common and complex reaction to trauma which can be tripped by many sources and can reflect different things. Anger can be experienced as a physical state - a component of the fight/flight reaction to danger …

An article written by Shelley Gable, Gian Gonzaga and Amy Strachman in 2006 in the Journal of Personality and Social Psychology asks the question “Will You Be There for Me When Things Go Right?” This is actually a very good question for couples to consider no matter what is happening in their lives.

Most couples recognize the need to step up and respond with interest and concern for their partner in the face of negative or traumatic events. Too many couples, however, overlook the power of the positives in enhancing and restoring relationship resiliency and health.

In my work with couples, I always explore a couple’s use of the positives. At some point I ask:   “Do you compliment each other?” “Do you let each other know about the positive things that happen in your daily lives?”

The answers I get suggest that couples may not even realize the true value of sharing the positives and affirming each other:

“You mean you’re still supposed to do that when you are married as long as we are?”

“She knows I’m proud of her.”

“He knows I appreciate him.”

“We probably think about it, but don’t actually say it.”

“If we are going to a wedding or something, he’ll tell me I look nice.”

“She tells me when she doesn’t like what I’m wearing.”

“I just don’t think he notices.”

“I didn’t grow up with people doing that in my family.”

“We both always praise the children.”

The sharing of positive events with a partner who receives it in a positive way is termed by Christopher Langston (1994) capitalization. He suggests that the sharing actually capitalizes on the event and results in a positive experience independent of the actual event. For example, when she tells him that she has been selected to run the golf league, his excitement for her becomes another positive event that they share.

As  Gable, Gonzaga and Strachman  (2006) report, research has shown that when close relationship (romantic) partners regularly respond to the disclosure of positive events  in an active, supportive manner,  both partners experience positive emotions.  The relationship resources of commitment, satisfaction, intimacy and love are enhanced.

Because couples share an emotional and physical bond, they are important reference points and …

Nationally and internationally, the most endorsed response in the first hours and weeks after a traumatic event is Psychological First Aid.
Just as Medical First Aid is given immediately to a person to minimize injury and reduce future medical complications and disability, Psychological First Aid involves providing connection, safety, basic needs, information, and recognizing if professional care is needed as a way to reduce the possibility of longterm emotional impact.

Couples Psychological First Aid unfolds from an understanding of the power of attachment by researchers like Alan Shore (2003) . It causes us to recognize that in the immediate aftermath of crisis, disaster, and unanticipated loss, the presence of the partner, even their voice on a phone, has a more soothing physical and emotional impact than that of anyone else. Actually, couples often have a great deal to offer each other but they are often uncertain how to proceed or whether their presence even makes a difference.

Carey was hysterical when she learned that her younger brother, just 30 years old, had been diagnosed with late-stage lung cancer. Jack, her husband, was also stunned and not sure how to help. The only thing he could do was listen and hug her…While trying to understand her brother’s illness, Carey began to repeat, “This can’t be true. Who is healthier than my brother? You know him—he never even smoked! What happened? Tell me what you think happened.” Feeling the intensity of her pain but knowing he had no answers, Jack held Carey and said “Carey, I don’t know. I hear you—it’s too much to believe. He’s your brother, I know how much you love him and it just doesn’t make sense. It’s just too much.” ( Excerpt from Healing Together p.31)

Feeling helpless and upset himself,  Jack did not realize that he was  actually using Couples Psychological First Aid. The Four Principles of Couples Psychological First Aid include:

1. Being a compassionate presence for each other
2. Establishing physical and psychological safety
3. Identifying and responding to needs
4. Offering practical assistance and supporting coping skills

You may find as these are explained that you are already using some of these, that others seem too simple to make a difference …

A New York Times article on Jan. 7, 2005 reported on grieving parents in Sri Lanka who lost children in the Southeast Tsunami. It describes a couple. The mother, pictured with a group of women, is crying and talking about her daughters. The father,  who feels there is no value in dwelling on loss, asserts that ”this is no time to give up” and focuses his energy on rebuilding the family home.

Their reactions speak to a gender stereotype that is perhaps crosscultural -  in the face of traumatic loss, women need to speak about what has happened, men need to do something about what happened.

Do men and women react differently to trauma? Yes. Does it mean one suffers more than the other? No. Do the differences confuse and often create more tension for couples? Too often.

In their 2006 review of 25 years of research on sex differences in trauma and post-traumatic stress disorder in the Psychological Bulletin, David Tolin and Edna Foa reported that although men have a higher risk for traumatic events, women suffer from higher rates of post-traumatic stress disorder. In their analysis they suggest that the different rates of PTSD may actually be a function of the fact that men and women manifest their emotional pain in different ways.

In the aftermath of a traumatic event, women are more likely to have feelings of anxiety and depression, while men are more likely to express distress and depression in terms of irritability, anger and increased alcohol consumption.

Adding to these gender differences are other factors that affect any person’s reaction to a traumatic event. They include the type of traumatic event (sexual assault, for example, is more likely to cause PTSD than many other events), the intensity, proximity and amount of time a person must endure an event (extended deployments, witnessing loss of buddies, extended time trapped in a disaster situation increase the reaction to trauma), childhood history, earlier traumas and the meaning of the trauma to a person.

When she suffered a miscarriage in the beginning of her third month, Lynn was devastated. Then in her late 30s, she was worried that this might be her only chance to have a child.  Often unable to concentrate or sleep, she would ruminate and blame herself for waiting until her career was set before starting a family.

Lynn was further …

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Over the past 30 years as a couples therapist, I usually have met partners when they are suffering. Whether they have just been faced with a traumatic event or have struggled for years with chronic trauma and stress, they come because they are unable to find a way to be together without pain.

Accordingly, they are often surprised when, after each describes their reason for coming, I ask where they met  and why they decided to be partners.  If they hesitate, I follow with questions like:

• So what was it about this guy that you liked?
• What was it about her that attracted you?
• What was she wearing the first time you saw her?
• How did he ask you out on that first date?

In most cases there is a sudden, visible shift, if only for a few minutes, in the look and body posture of the two as they remember and share that romantic memory. Given what has been unhappily going on in their lives, they are often pleasantly surprised and sometimes shocked by those few minutes of a positive description or memory of the other – “I can’t believe you remember that green dress!”

This is what we call state-dependent memory.  State-dependent memories are registered in a highly charged, very emotional state like that of physical attraction. Their recall brings back the positive body memory and emotional state associated with the event when we experienced it. We might think of these as the positive imprints of connection that get lost in the face of the indelible imprints of trauma and its fallout.

Traumatic events “trap” people in time.  They wall off the past and make the future seem impossible.  Trauma always involves loss and for couples trauma often steals the “we” they once were. Recovery from trauma requires establishing safety, remembering and mourning and reconnection. While all of these components are crucial, there really is no rigid sequence to these stages.  In fact, from that very first meeting, I am inviting couples to go back to empower themselves, so they can go forward. If a couple can find some strategies for feeling physically and psychologically safe together as they journey through recovery, it will fortify them.

An initial strategy for doing this is “Finding A Safe Couple Place,”  an exercise in the book, …