PTSD (post-traumatic stress disorder) is a medical condition some people develop after experiencing or witnessing an emotionally disturbing or life-threatening event. The likelihood of PTSD affecting a person’s life is high with 60% of men and 50% of women exposed to at least one trauma in their lives and about 7-8% of the population developing PTSD as a result. The most common event experienced by women is sexual assault and child sexual abuse, while men are more likely to experience accidents, physical assault, combat, disaster, or to witness death. (National Institute of Mental Health, 2016)

After experiencing trauma it takes time to adjust, but sometimes a person feels stuck and maintains a constant sense of vulnerability as hurtful memories from the incident fail to subside weeks and months after the incident. Symptoms vary depending on the individual but generally include:

• Reliving the event through flashbacks
• Avoiding situations that trigger memories
• Negative beliefs and feelings associated with depression
• Hyperarousal characterized by irritability, anger, and trouble sleeping or concentrating

(Source: U.S. Department of Veteran Affairs, 2016)

The distressing combination of symptoms is often overwhelming for family members as well and can wreak havoc on intimate relationships making trust, closeness, and communication a constant struggle. Feeling helpless is the last thing you want in such a situation. If your partner or a loved one has PTSD, here’s how you can be supportive and help them cope with the condition.

1.) Understand how PTSD can affect your relationship

When someone you know has PTSD, it can become difficult to understand their behavior. You might question their lack of affection, volatile behavior, paranoia, or excessive irritability and end up feeling like you are with a total stranger. Living with someone who has PTSD can lead the survivor’s family to experience some of the same feelings of trauma. Frustration doesn’t end here; untreated PTSD symptoms can result in job loss, substance abuse and increased aggression and violent behavior.

Understanding the symptoms of PTSD and remembering that the person may have limited awareness of their behavior are the first steps in creating a supportive environment for your loved one.

2.) Practice Active Listening

People suffering from PTSD may have a hard time opening up about their feelings and should not be pushed to talk. Since trauma is a sensitive topic, talking about it in the wrong context can make coping all the more difficult. Let your loved one know that you are willing to listen but that you also understand if they don’t feel like talking. Have patience and give your partner space to gradually open up about the incident. When they do share, give them your undivided attention, let them guide the interaction, listen without expectations or judgment and refrain from giving advice.

3.) Help Socialize

People suffering from a current or past diagnosis of PTSD may experience symptoms of Social Anxiety Disorder (SAD) as well (according to a recent study, 28 percent people suffering from a current or past diagnosis of PTSD were found to have Social Anxiety Disorder).

Since avoidance and withdrawal are two major symptoms of PTSD, this can lead to detachment from others and a general emotional numbness. The person may lose interest in their favorite activities and avoid social interactions. Remember that this change in behavior and emotional detachment is not due to lack of caring; it’s indicative of the pain they are going through.

Respect your partner’s boundaries and continue to offer love and support while encouraging them to pursue hobbies or other activities that bring them pleasure. Socializing with a few close friends in a safe space and attending fitness or dance classes is a good place to start.

4.) Encourage Relaxation Techniques and/or Therapy

Flashbacks and nightmares from the traumatic event are a common symptom of PTSD. This may cause intense distress manifesting in rapid breathing, nausea, pounding of the heart, muscle tension, and sweating. Regular practice of relaxation techniques can help them cope with the distress and anxiety.

Deep-breathing exercises are effective stress-management tools to evoke a relaxation response by lowering blood pressure and encouraging full oxygen exchange (Harvard Health Publications, 2016).

Yoga offers another method of self-regulation through the use of breath, meditation, and physical strengthening. Research by Dr. Bessel van der Kolk on the use of yoga in treating traumatized people suggests that routine practice “offers a way to reprogram automatic physical response…The process of being in a safe space and staying with whatever sensations emerge and seeing how they come to an end is a positive imprinting process,” (Integral Yoga Magazine, 2009). PTSD can create a disconnect between mind and body; yoga promotes a reintegration through a study of the present.

Professional counseling and therapy may also be warranted.  While each person will respond to different therapeutic approaches, empirical studies highlight EMDR, CBT and Somatic-oriented therapies as being particularly effective with treating PTSD. For example, three studies by the EMDR Institute indicate that practicing EMDR leads to the elimination of PTSD diagnosis in 70-90% of civilian participants after 3-7 sessions. In treating survivors of sexual assault and childhood sexual abuse, studies show that CBT decreases self-reported PTSD severity and associated anxiety, that participants do not meet criteria for a PTSD diagnosis at follow-up assessments, showing sustained improvement. (Nilamadhab Kar, 2011)

5.) Give Them a Sense of Security and Rebuild Trust

Trauma takes away a person’s ability to trust others or even themselves. They may view their world as a perpetually dangerous and frightening place which makes them feel unsafe nearly all the time. Therefore, it’s important to support a sense of security and stability in your relationship with a loved one suffering from PTSD.  

Expressing your commitment to the relationship, keeping promises, and making plans for the future are some small steps you can take towards cultivating further trust. Creating a daily routine can also help your loved one reclaim a sense of security in their life, as predictable schedules can restore stability and contribute to recovery.

6.) Manage Triggers and Impulses

Sights, sounds, places, things or situations can trigger PTSD symptoms such as flashbacks and cause distress. In severe cases the response could induce panic attacks. Talk to your partner about possible triggers and how you can reduce their anxiety in such situations. Have a plan in advance about how to respond to the situation.

People living with PTSD, in particular combat-related trauma, tend to be irritable and can be prone to sudden outbursts of anger. (Chemtob, 1997) This is stressful for you as well as your partner. Don’t engage them while they’re in this state. Have a plan in advance to deal with the impulses and develop healthy coping skills to stay calm.

FINAL WORD: Remember that PTSD comes with a potential risk of secondary traumatization for the caregiver. Managing your own stress is just as important as caring for your partner. Professional therapy can help both you and your partner to cope and heal from PTSD.

References/Additional Reading

Chemtob, C.M., Novaco, R.W., Hamada, R.S., Gross, D.M., & Smith, G. (1997). Anger regulation deficits in combat-related posttraumatic stress disorder. Journal of Traumatic Stress, 10(1), 17-35.

Harvard Health Publications. (2016, March 18). Relaxation techniques: Breath control helps quell errant stress response. Retrieved from http://www.health.harvard.edu/mind-and-mood/relaxation-techniques-breath-control-helps-quell-errant-stress-response

National Institute of Mental Health, (2016, February). Post-Traumatic Stress Disorder. Retrieved from https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

Nilamadhab Kar. (2011). Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: a review. Neuropsychiatric Disease and Treatment, 7, 167-181. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3083990/

U.S. Department of Veteran Affairs, (2016, October 4) What Is PTSD?. Retrieved from http://www.ptsd.va.gov/public/PTSD-overview/basics/what-is-ptsd.asp

Yoga and Post-Traumatic Stress Disorder: An Interview with Bessel van der Kolk, M.D. – Integral Yoga Magazine (2009), pp.12-13 Retrieved from: http://www.traumacenter.org/clients/MagInside.Su09.p12-13.pdf

About this Contributor: Jennifer Hill is a Licensed Family & Marriage Therapist (LMFT) and certified EMDR Specialist. She has dual Masters Degrees in Special Education and Mental Health Counseling, and specializes in working with adolescents. She currently serves as the Clinical Counseling Supervisor for the Pregnancy Resource Center in Vista, CA and her private practice. View more at www.JenniferHillCounseling.com.