PTSD Partners

Imagine going on a hike with your significant other. It's a challenging trail with some steep hills and rocky and even uncharted paths. Although some times the weather is warm and the path relatively flat, there are also long periods of time when it's dark and raining and you can't find your way. Some trials are rocky and even dangerous at times and you must carry a backpack with your food and sleeping bag and other supplies. Together you must travel this trail, not exactly sure of how long it will take. But you've been told that at the top is a wonderful mountain retreat; complete with plush beds and 5-star meals. Now imagine that in the midst of this journey, your companion must also carry a 50 pound boulder in addition to the supplies you each have.

You can't help them to carry this huge load, they must carry it alone. From time to time they are able to chip away at the rock, lightening the load, making it smaller but they still have to carry something extra. Because of this extra weight, they get tired more quickly than you do and are more prone to being injured. They are easily irritated and often need more supplies. Sometimes they even say they will give up or that you should just leave them alone. You feel compassion for them but there are times that you also resent their struggle. If you went on without them you could be at the top of the mountain already; enjoying the view, resting comfortably in the warm lodge waiting for you. Instead you try to walk with them, slowly, and give up more of your supplies to them so that they can continue on.

It would be hard to stick with someone on this trail wouldn't it? They are courageous just for getting up and trying to make it and yet it's hard to know how to help. You can't take the load or even share the weight of it. All you can do is commit to walking with them on this journey. That is what it is like to be in a relationship with a partner who has survived trauma. The trail is life and post-traumatic stress disorder (PTSD) is the boulder they must carry. PTSD is a psychological reaction to surviving a traumatic experience. It comes with a complex array of difficult symptoms that one must learn to face in new and healthy ways if they hope to reach the top of the mountain. As the spouse (or family member) of someone dealing with PTSD you are faced with your own complex set of issues. You love someone who at times will struggle to trust you and demonstrate their love for you. They will experience emotional pain that you cannot alleviate and behave in ways that may even seem counter-productive. How do you love someone and build a relationship and life together in the face of these challenges? It can be difficult but there are ways to make it easier- educate, empathize, and engage. I like to think of it as the three E's of loving a trauma survivor. Through these three concepts you can become better equipped to support your partner and yourself as you make this journey together.

Educate
PTSD is a complicated disorder. Many therapists agree that there are far more people dealing with post traumatic stress disorder than diagnosed with it. In part that is due to the complexities of the symptoms; often people are diagnosed with depression or anxiety, treated for sleep disorders, or written off as being a borderline or difficult personality. In fact PTSD can manifest for many people as a combination of these and other issues. One of the most important things that you can do as a partner of someone with PTSD is learn all you can about the symptoms and treatments available. The more you understand the many ways in which PTSD can be expressed and felt, the better you are able to support and empathize with your partner. There are several excellent books and even free resources from NIMH and other agencies to get you started. It is also crucial to recognize that every person's experience is unique and therefore their response and the most effective treatments and self-care options will also be unique. As you learn about PTSD in general be sure that you are also learning about your partner's experience in particular. While one person may struggle with depression and try to isolate themselves, someone else may cope by using drugs and alcohol and excessive partying. Both are responses to PTSD but look very different and require a different approach.

Empathize
One of the reasons that education is so important is that it helps you to empathize with your partner's struggles and challenges. The pain of trauma (whether its sexual abuse, physical assault, or surviving combat) and subsequent difficulties of PTSD are overwhelming and not easily understood by someone who has not experienced trauma. Many partners of people with PTSD find it hard to live with someone who is just beginning to deal with PTSD. I have found that when you are able to empathize with your partner it is much easier to forgive some of the hurtful or isolating behavior that they may exhibit. I remember working with a couple where the wife had been sexually assaulted in college. They came in because the husband was angry and hurt by her constant angry outbursts and sometimes cruel verbal jabs whenever he expressed his love or tried to talk about intimacy with her. Over time he was able to understand that for his wife emotional vulnerability with a man (even her husband) was an unsafe feeling and triggered a survival-like instinct to protect herself. His ability to empathize with the power of her emotions allowed him to be patient and supportive as she worked on retraining her perception of emotional vulnerability with him and developed more appropriate and effective responses. Empathy is more than understanding the other person's feelings, it goes on to actually try to feel their feelings. It can be hard to imagine what it feels like to live with the effects of trauma on a daily basis. Go back to our hiking analogy; close your eyes and try to feel the weight of that rock on your back, feel the rocky terrain beneath your feet, and feel the uncertainty of each step as you forge an uncharted path. That is life for someone with PTSD. It gets better but in order to travel this journey toward healing with them, you must work towards a deep emotional understanding of their experience.

Engage
One of the most difficult things about PTSD is the overwhelming emotions and unexpected flashbacks or triggers. In the midst of a great day, someone might say something or you might smell something and suddenly all the fear and helplessness of living through trauma comes rushing back. Regardless of each person's unique combination of symptoms the desire to escape and disengage is almost universal in PTSD. This can be one of the most difficult and important ways in which you as their partner can help. Remaining engaged, in your relationship, in activities, in therapy, in life, is essential to everyone's emotional health. Even when your loved one seems to be checking out, you need to have the emotional resources to stay fully engaged. Think of it as a pit stop on the trail to healing. Sometimes the person with PTSD needs to stop and rest. It's your job to let them know that while they can rest, you will be waiting for them to get up and start moving forward again. This can be excruciatingly difficult, particularly when "disengaging" involves destructive behaviors like aggression, drugs/alcohol abuse, or even sexually acting out. This is when its important to also remain engaged with treatment and support systems. If you and your partner were going to therapy together and they don't want to go, don't stop going. It's easy to say that they are the one with diagnosis, or they need the help but the truth is that in order to keep moving forward you both need help. You cannot resolve PTSD on your own and you can't support someone with PTSD on your own. I often tell my trauma clients that when you think therapy is too hard and want to quit, is almost always the time when you need therapy the most. I believe this is true for the significant others involved with PTSD as well. Although only one of you can carry the full weight of trauma, as a couple you both feel its impact. Don't underestimate the importance of getting support when you are the person giving support.