Trauma survivors with PTSD often experience problems in their
intimate and family relationships or close friendships. PTSD involves
symptoms that interfere with trust, emotional closeness, communication,
responsible assertiveness, and effective problem solving:
- Loss of interest in social or sexual activities, and feeling distant
from others, as well as feeling emotionally numb. Partners, friends,
or family members may feel hurt, alienated, or discouraged, and
then become angry or distant toward the survivor.
- Feeling irritable, on-guard, easily startled, worried, or anxious
may lead survivors to be unable to relax, socialize, or be intimate
without being tense or demanding. Significant others may feel
pressured, tense, and controlled as a result.
- Difficulty falling or staying asleep and severe nightmares prevent
both the survivor and partner from sleeping restfully, and may
make sleeping together difficult.
- Trauma memories, trauma reminders or flashbacks, and the attempt
to avoid such memories or reminders, can make living with a survivor
feel like living in a war zone or living in constant threat of
vague but terrible danger. Living with an individual who has PTSD
does not automatically cause PTSD; but it can produce "vicarious"
or "secondary" traumatization, which is almost like having PTSD.
- Reliving trauma memories, avoiding trauma reminders, and struggling
with fear and anger greatly interferes with survivors' abilities
to concentrate, listen carefully, and make cooperative decisions
-- so problems often go unresolved for a long time. Significant
others may come to feel that dialogue and teamwork are impossible.
Survivors of childhood sexual and physical abuse, rape, domestic
violence, combat, or terrorism, genocide, torture, kidnapping
or being a prisoner of war, often report feeling a lasting sense
of terror, horror, vulnerability and betrayal that interferes
with relationships:
- Feeling close, trusting, and emotionally or sexually intimate
may seem a dangerous "letting down of my guard" because of past
traumas -- although the survivor often actually feels a strong
bond of love or friendship in current healthy relationships.
- Having been victimized and exposed to rage and violence, survivors
often struggle with intense anger and impulses that usually are
suppressed by avoiding closeness or by adopting an attitude of
criticism or dissatisfaction with loved ones and friends. Intimate
relationships may have episodes of verbal or physical violence.
- Survivors may be overly dependent upon or overprotective of partners,
family members, friends, or support persons (such as healthcare
providers or therapists).
- Alcohol abuse and substance addiction -- as an attempt to cope
with PTSD -- can destroy intimacy or friendships
In the first weeks and months following the traumatic event, survivors
of disasters, terrible accidents or illnesses, or community violence
often feel an unexpected sense of anger, detachment, or anxiety
in intimate, family, and friendship relationships. Most are able
to resume their prior level of intimacy and involvement in relationships,
but the 5-10% who develop PTSD often experience lasting problems
with relatedness and intimacy.
Yet many trauma survivors do not experience PTSD, and many couples,
families, or friendships with an individual who has PTSD do not
experience severe relational problems. Successful intimate relationships
require:
- Creating a personal support network to cope with PTSD while maintaining
or rebuilding family and friend relationships with dedication,
perseverance, hard work, and commitment
- Sharing feelings honestly and openly with an attitude of respect
and compassion
- Continual practice to strengthen cooperative problem-solving and
communication
- Infusions of playfulness, spontaneity, relaxation, and mutual
enjoyment
For many trauma survivors, intimate, family, and friend relationships
are extremely beneficial, providing companionship and belongingness
as an antidote to isolation, self-esteem as an antidote to depression
and guilt, opportunities to make a positive contribution to reduce
feelings of failure or alienation, and practical and emotional
support when coping with life stressors.
As with all psychological disturbances, especially those that
impair social, psychological or emotional functioning, it is best
to seek treatment from a professional who has expertise in both
treating couples or family issues and PTSD. Many therapists with
this expertise are members of the International Society for Traumatic
Stress Studies, whose membership directory contains a geographical
listing indicating those who treat couples or family issues and
PTSD. Types of professional help that survivors find helpful for
relationships include:
- Individual and group psychotherapy for their own PTSD
- Anger and Stress Management, and Assertiveness Training
- Couples Communication Classes and Individual and Group Therapies
- Family Education Classes and Family Therapy
SUGGESTED READINGS
- John N. Briere and Diana M. Elliott, "Immediate and Long-Term
Impacts of Child Sexual Abuse," Future of Children 4:2 54-69 (1994).
- Rebecca Coffey, Unspeakable Truths and Happy Endings: Human Cruelty and the New
Trauma Therapy (Sidran Press, 1998, ISBN 1-886968-04-7 or 1-886968-05-5)
- Patience Mason, Recovering from the War: A Woman's Guide to Helping Your Vietnam Vet, Your Family, and Yourself (Viking, 1990, ISBN 0-670-81587- X; Penguin, 1990, ISBN 0-14-009912-3)
Aphrodite Matsakis, Vietnam Wives: Facing the Challenges of Life with Veterans Suffering Post Traumatic Stress (Sidran Press, 1996, ISBN 1-886968- 00-4)
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