PTSD and Relationships
A National Center for PTSD Fact Sheet
How does trauma affect relationships?
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.
- Survivors may experience a
loss of interest in social or sexual activities, they may feel distant
from others, and they may be emotionally numb.
- Partners, friends, or family
members may feel hurt, alienated, or discouraged because the survivor has
not been able to overcome the effects of the trauma, and they may 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 may prevent both the survivor and partner
from sleeping restfully, which may make sleeping together difficult.
- Trauma memories, trauma
reminders or flashbacks, and the avoidance of such memories or reminders
can make living with a survivor feel like living in a war zone or like
living with the 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 similar to having PTSD.
- Reliving trauma memories,
avoiding trauma reminders, and struggling with fear and anger greatly
interfere with a survivor's ability to concentrate, listen carefully, and
make cooperative decisions. As a
result, 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 and survivors of rape,
domestic violence, combat, terrorism, genocide, torture, kidnapping, and being
a prisoner of war often report feeling a lasting sense of terror, horror,
vulnerability, and betrayal that interferes with relationships.
- Survivors who feel close to
someone else, who begin to trust, and who become emotionally or sexually
intimate may feel like they are letting down their guard. Although the
survivor often actually feels a strong bond of love or friendship in
current healthy relationships, this experience can be perceived as
dangerous.
- Having been victimized and
exposed to rage and violence, survivors often struggle with intense anger
and impulses. In order to suppress
their anger and impulsive actions, survivors mayaboidaaa avoid closeness
by expressing criticism toward 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, which can result from an attempt to cope with PTSD, can destroy
intimacy and friendships
In the first weeks and months following a traumatic event, survivors of
disasters, terrible accidents or illnesses, or community violence often feel an
unexpected sense of anger, detachment, or anxiety in their 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 people in
intimate relationships, families, and friendships with individuals who have
PTSD do not experience severe relational problems. People with PTSD can create
and maintain successful intimate relationships by:
- Establishing a personal
support network that will help the survivor cope with PTSD while he or she
maintains or rebuilds family and friend relationships with dedication,
perseverance, hard work, and commitment
- Sharing feelings honestly and
openly with an attitude of respect and compassion
- Continually strengthening
cooperative problem-solving and communication skills
- Including playfulness, spontaneity,
relaxation, and mutual enjoyment in the relationship
What can be done to help someone who has PTSD?
For many trauma survivors, intimate, family, and friend relationships are
extremely beneficial. These
relationships provide:
(1)
Companionship and a sense of belonging, which can act as an
antidote to isolation
(2)
Self-esteem, which can act as an antidote to depression and
guilt
(3)
Opportunities to make a positive contribution, which can
reduce feelings of failure or alienation
(4)
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 PTSD and in treating couples or families.
Many therapists with this expertise are members of the International Society
for Traumatic Stress Studies, whose membership directory contains a geographical
listing and an indication of those who treat couples or families and PTSD. Survivors
find a number of different professional treatments helpful for dealing with
relationship issues, including individual and group psychotherapy for their
own PTSD, anger and stress management, assertiveness training, couples communication
classes, family education classes, and family therapy.
Related Fact Sheets
Family coping with war
Coping when a family member has been called to war
Nightmares
Explains what nightmares are, how common they are, how they are related to
PTSD, and what effective treatments exist
Symptoms of PTSD
Learn about how traumatic experiences affect people, what survivors need to
know, and the common symptoms of PTSD
Treatment
Information on availble treatments for PTSD
Suggested Readings
John N. Briere and Diana M. Elliott. (1994).
Immediate and long-term impacts of child sexual abuse. Future of Children 4(2), 54-69.
Rebecca Coffey. (1998). Unspeakable truths and happy endings: Human cruelty
and the new trauma therapy. Sidran Press, ISBN 1-886968-04-7 or 1-886968-05-5.
Patience Mason. (1990). Recovering from the war: A woman's guide to helping
your Vietnam vet, your family, and yourself. Viking, ISBN 0-670-81587-X;
Penguin, ISBN 0-14-009912-3.
Aphrodite Matsakis. (1996). Vietnam wives: facing the challenges of life
with veterans suffering post traumatic stress. Sidran Press, ISBN
1-886968-00-4.
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