I will begin this post by saying an entire blog itself could be (and should be–anyone out there an expert??) dedicated to the topic of PTSD, and the havoc it wreaks on the lives it touches. This blog entry is mostly to acknowledge the partners and relationships that are struggling under the weight of PTSD from past trauma, and it will be a topic I return to from time to time.
When I think of PTSD and therapy clients, I think of experiences such as military service, rape, sexual abuse, and traumatic car accidents, and the subsequent paralyzing symptoms of nightmares, flashbacks, the inability to relax (hyperarousal), intense fear of something bad happening again, and panic attacks.
What I don’t often hear about is the role the non-traumatized partner has in the life of the partner with PTSD. Again, this blog entry will just touch the tip of the iceberg, but it will be a start and guide you towards other helpful resources. Also, in this entry, I will be speaking generally about PTSD, not to specific causes, such as military experience vs. sexual abuse history, which can look very different.
For clients with PTSD, many say that their partners just can’t understand their internal experience, and sometimes end up making things worse rather than better, even though the healthy partner has good intentions.
The “big three” symptoms people with PTSD experience are:
- Uncontrollable memories of the traumatic event(s), in the forms of nightmares, flashbacks, or vague recollections that disturb their sense of self
- Emotional numbness
- Severe anxiety that interferes with many aspects of daily life, ranging from the mundane to their ability to relate to you
The uncontrollable memories are the opposite of memory loss–they are intrusive, and often appear out-of-the-blue, or in response to a trigger, such as interacting with a person who abused them or a loud sound that resembles gunfire. Ways to help your partner who experiences frightening memories:
- Ask if you have been helpful in preventing or minimizing flashbacks in the past. If so, find out exactly what you can do to continue to offer support.
- Ask your partner if it is helpful to have you with them when they are experiencing a flashback. For some people, they need to be alone, and your presence may actually agitate them further. For others, a loving touch, such as putting your arm around them while they are in the midst of a flashback, may help.
- Some partners benefit from recounting their experience to others as a way of minimizing the threat of a flashback. If you are able, being a listening ear can help. However, be mindful of your feelings as you hear the story; you may become angry at the perpetrator of the abuse or other circumstances surrounding the trauma to your partner. This is called vicarious traumatization, and can happen to therapists as well. In this case, seeking out your own therapy to deal with your reactions is recommended.
- Identify any “anniversary triggers,” such as important dates related to the trauma, or interactions with people who were involved in the trauma. Discuss an escape plan with your partner in advance, in case unpleasant memories are triggered.
Emotional numbness seeps into all the areas of a PTSD victim’s life, and it can cause problems in your relationship as well. You may question whether your partner loves you anymore, because emotional affection is non-existent. Your sex life is probably impaired as well, and you may wonder if things will ever be “normal.” What you can do about emotional numbness in your partner:
- This symptom of PTSD takes time to resolve. There is no timetable for recovery. Patience, understanding, and relieving your partner of shame around not being interested in intimacy are all helpful.
- If your partner is in therapy, ask if you can attend a session to discuss your concerns and needs. You may want to have a couples counseling session, or speak to your partner’s therapist alone, which is called a collateral visit. The therapist can give you an assessment of where your partner is struggling the most, provide some suggestions of how to help, and perhaps offer perspective on where your partner is in the healing process.
Finally, severe anxiety can limit your partner’s ability to function in daily life. Physiologically, your partner has more adrenaline in their system than a person who does not have PTSD, and this causes a more sensitive fight-or-flight response. Your partner may seem jumpy, or can be hypervigilant, which often looks like paranoia, but is not. How to help reduce anxiety in your partner:
- Recognize that your partner may try to “self-medicate” as a way to reduce anxiety, through abusing alcohol, prescription drugs, or street drugs. Use your communication skills to express your concerns, and if your partner is not already in therapy, encourage them to go.
- Relieving the anxiety that comes with PTSD is very similar to relieving anxiety associated with any other mental illness, except that the anxiety with PTSD is generally far more extreme. Encourage healthy habits, such as exercise, good nutrition, and good sleep habits (recognizing that sleep is often impaired by nightmares in PTSD victims.)
- Encourage your partner to approach anxiety-provoking situations slowly and with preparation, including a safe way to leave the situation if it becomes overwhelming. Avoidance makes the anxiety worse.
Other resources for partners and family members of PTSD victims:
PsychCentral: PTSD and Relationships
About.com: Coping With PTSD in Family Members
National Center for PTSD: Effects of PTSD on Family
Book review: The Post-Traumatic Stress Relationship
Online forum: Combat PTSD