Monday, October 1, 2012
Help! My Partner Has PTSD: Seven Strategies for Coping as a Couple
If you are partnered with someone who is struggling with PTSD or you both have PTSD, you know your life together is challenged in some very profound ways. Fights can be explosive, resulting in fireworks or endless stony silences. Misunderstandings can abound. The non-PTSD partner may start to develop secondary or vicarious trauma just being exposed to the intense PTSD in their loved one. Life can start to feel very unpredictable, like threading one’s way through a minefield. It can be easy to start walking on eggshells or conversely getting fed up and moving away from each other. Love and connection are harder to feel. PTSD challenges couples like nothing else. Waiting it out doesn’t work and neither do threats or force. What to do?
1) Educate yourself. PTSD is a whole body process that affects every aspect of the human being. It has predictable stages (see my book, The Trauma Tool Kit) and effects on the person and the partnership. You would educate yourself if your partner had a major medical illness, right? This is no different. Forewarned is forearmed, as the saying goes.
2) Set some clear boundaries around behavior in the relationship. Just because someone is suffering does not give them the right to be abusive. The anger/fear response is hardwired and amped up in full-blown PTSD. Often people with PTSD dissociate when they are angry and don’t even realize what they are doing. Sit down with your partner, ahead of time, and set rules for what is tolerable and allowed in the relationship and what is not. These can change over time depending on where each of you and your life circumstance. For instance, shouting might be OK if it is just the two of you, but if you have a child in the next room, shouting can become off-limits behavior. Violence or abusive behavior is never to be tolerated under any circumstances.
3) Learn to take time-outs, or, as we call them around here, amygdala resets. Your amygdala is the part of your brain that is the crisis response center. When it goes on red alert it highjacks the brain to deal with threats, whether real or perceived. With the amygdala in the red zone, people are very close to being out of control or they are out of control. Taking 20 minutes, the average reset time, to reboot the brain for both parties, will lend itself to a more peaceful and safe outcome. Either partner should be able to call time-out at any time. Be sure to make it a time out not an end to the discussion. Always come back together to resolve the issue at hand. If it is just too explosive get into couple’s therapy. Which reminds me…
4) Get into couple’s therapy! More research is showing that couple’s treatment can be very helpful in coping with PTSD. Individual therapy is great, but couple’s issues are complex and require their own special interventions. Not all therapists like to do or can do couples’ work well. Look for someone with previous education and training or with a degree in family work, who also is knowledgeable about trauma. Even a few sessions can make a tremendous difference. If you are worried about money (and who isn’t these days) know that there are many organizations that provide these services for low and no cost. If you are a veteran or married to one, you may be even more eligible. If money is still on your mind, remind yourself of how expensive divorces are, as long as you both shall live.
5) Study triggers together. Big rages and emotional swings are almost always brought on by triggers to PTSD. A trigger can be anything at all. I worked with a couple whose partner was an Iraq war veteran. He became severely triggered one afternoon by three events happening in close succession: he saw someone in the parking lot of the restaurant with camouflage clothing; he got a freeze headache, and he got closed in when more people joined his table. The clothing and feeling of being trapped are obvious triggers, the freeze headaches not so much. But it turned out he’d had a number of them in the desert, and it had become a trigger. The more triggers you figure out together, in the calm times, the easier it becomes to avoid setting the PTSD partner off, or resolving it more quickly if you do. This is an empowering step that often brings couples closer together. In this case, the couple avoided, what would have been in the past an angry meltdown on his part. His partner then could respond with concern and compassion.
6) Make healing PTSD a joint task in your relationship. Strategize together. Discuss medical options. Open up lines of trust and communication. Often a spouse or partner is the only person to tell one’s story to with complete safety and trust. Don’t avoid the issues just because your partner wants to. Avoidance is part of the disease of PTSD. Don’t collude with it.
7) Join together in mental and physical fitness. Develop couple’s routines around calming down the mind and body on a daily basis. This could be through prayer, meditation, tai chi, yoga, or long walks. The evidence is pouring in daily about the beneficial effects of calming techniques on PTSD. You will both be better for it!