How Do Trauma Symptoms Make Sense?
You wake at 5 a.m., unable to fall back to sleep. You notice that your partner has no patience for anything, including you. You find yourself dreading phone calls even from your closest friends. And you wonder: How can these reactions be normal?
Combat stress, a cancer diagnosis, a car accident or a sudden job loss are events that can jolt us physically, neurochemically and emotionally. It is common for people to respond to such distressing events with three clusters of symptoms : Intrusion or re-experiencing; hyperarousal; and constriction, numbing and avoidance.
These symptoms often appear within the first days after a trauma. They usually are very intense at first but eventually subside. Sometimes, however, these reactions are delayed. Couples who pull together in the crisis, manage the deployment, or work side by side after the storm are baffled when things become tense and symptoms erupt four months after Iraq, when the hospital stay is over, when life is supposed to go on.
You may recognize some of these reactions in yourself or your partner. You may be worried about post-traumatic stress disorder (PTSD), a persistent pattern of these symptoms lasting more than a month for which you may seek professional help. Even in such cases, understanding these symptoms as normal responses to an abnormal situation will help you manage their impact on your relationship. Let’s consider them.
Re-experiencing symptoms are like being caught in the indelible imprint of the traumatic moment. It is as if the hospital scene, the oncoming truck, or the explosion are playing over and over again, in the form of a nightmare, a flashback, a frightening thought or a traumatic memory. Although bewildering and disturbing, such repeated intrusions are actually the mind and body’s way of assimilating or fitting an incomprehensible experience into your existing life schema.
Recognizing re-experiencing as a common response may change your reaction. When you realize that your wife is watching reruns in bed to avoid closing her eyes and seeing the accident scene, you may be less likely to feel rejected, get mad or blame her for sleep problems. Perhaps you will watch some of the reruns together, remind her that you are next to her, validate the memory as common after the car accident. You might even ask if she wants to talk about the traumatic memory. According to traumatologist Judith Herman, “the action of telling the story in the safety of a protected relationship can actually produce a change in the abnormal processing of the traumatic memory.”
Hyperarousal symptoms reflect the persistent expectation of danger. It is as if your body and mind have not computed that you are no longer in danger. The inability to relax, constant worry, irritability, sleep difficulties, hypersensitivity to noise, smells, and taste actually are reflections of your body’s fight-or-flight response to danger.
It often comes as a revelation to partners that the irritability they feel and often direct toward each other over lost keys, noisy kids, and traffic jams has very little to do with them and much more to do with the hyperarousal they are feeling from the traumatic experience one or both has suffered. Putting behavior in context can prevent you from overreacting or retaliating.
Numbing and constriction involve physical and psychological “shutdown” in order to protect oneself from being overwhelmed by feelings. Often people blame themselves for being unable to cry, or one partner misinterprets numbness in the other as a lack of care or concern. It is hard to realize that we may constrict or unconsciously hold back feelings because we are not emotionally safe enough to deal with them. This is somewhat like the kid who gets hurt in school but holds it together without tears until she sees Mom at the bus stop. Avoidance urges often reflect an attempt to avoid those things that trigger feelings and distress symptoms.
It really helped one couple understand that his negativity and refusal to ” go anywhere or do anything” was really his avoidance of hearing people ask “How are you doing?” – the question that immediately triggered the pain of losing their son in Iraq and the angry urge to answer “How do you expect us to be doing?” Once she realized and could appreciate the triggers and feelings he was trying to avoid, she could stop feeling so isolated and annoyed. Together they agreed to try going somewhere with the plan of signaling “time to escape” when needed.
Essentially, understanding common trauma reactions reduces the fear that you, your partner and the relationship is forever changed or damaged. Often it gives a couple the language to talk about and deal with what they observe in themselves or their partner without shame or blame. If you are human, you will react to trauma. When you are standing next to someone who understands this, it feels a lot safer.
For Further Reading : Herman,J. 1997. Trauma and Recovery. New York: Basic Books.
Phillips, S. (2009). How Do Trauma Symptoms Make Sense?. Psych Central. Retrieved on May 29, 2015, from http://blogs.psychcentral.com/healing-together/2009/09/how-do-trauma-symptoms-make-sense/