Marriage is a beautiful journey, but like any adventure, it comes with its own set of detours and roadblocks. For many, a trauma (past or current) in a partner’s life can significantly impact the relationship. Most of the US population is exposed to a traumatic event during their lifetime1 and about 10-20% of those individuals meet the criteria for PTSD².
For those dealing with PTSD or who have a spouse who is, understanding the impacts of PTSD on a marriage can help you prepare and minimize the damage. It is possible not only to weather the storm but to build an even stronger and supportive partnership in the process.
Caveat: This article will generally be focused on PTSD as a result of events outside of the specific marriage or relationship. It does not focus on PTSD resulting from any form of abuse incurred by a current partner and how to address that. If you or anyone you know is currently experiencing domestic violence, please access the National Domestic Violence Hotline at https://www.thehotline.org/, 1-800-799-7233 OR TTY 1-800-787-3324.
What is PTSD?
Post-traumatic Stress Disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event. These events can range from accidents and natural disasters to sexual assault, combat, or other forms of violence.
After the event, the person may experience or demonstrate:
- Flashbacks, recurrent dreams/nightmares
- Intrusive recollections
- Increased avoidance of triggers
- Flashbacks where they feel as if the event is recurring
- Reckless or self-destructive behavior
- Hypervigilance
- Exaggerated startle response
- Marked physiological reactions to triggers (e.g., increased heart rate, sweating profusely, eye pupil dilation)
- Irritable behavior or angry outbursts
- Reckless or self-destructive behavior
- Negative beliefs about self and/or others
- Persistent negative emotional state (e.g., fear, anger, shame)
- Detachment from others
- Detachment from others
- Problems with concentration
- Sleep disturbance
For many people, these symptoms resolve over the course of a few weeks. Those whose symptoms do not resolve and instead remain for more than one month and cause significant impairment may meet the criteria for PTSD.
For the partner experiencing PTSD, the symptoms can lead to difficulties in daily functioning, work performance, and interpersonal relationships. Specifically, in a marriage, the partner struggling with PTSD may have pulled back from the relationship, need more support, and struggle with communication and/or intimacy. Meanwhile, the other partner may struggle with feelings of helplessness, frustration, or even resentment as they navigate how to best support their partner.
Navigating PTSD Together
If PTSD is impacting your marriage, know that you’re not alone, and there is hope! Here are some strategies to help navigate PTSD as a couple:
Knowledge is Power
Empower yourselves by learning and understanding PTSD. More importantly, understanding your specific symptoms and triggers will be crucial in overcoming PTSD. Together, that understanding creates space to decrease blame and judgment and increases the probability of empathy and curiosity.
Seek Professional Support
Don’t do this alone! Therapy, both individual and couples counseling, can provide valuable support and guidance. A qualified therapist can help you identify symptoms and triggers, understand various treatment modalities, and develop coping strategies. They can also work with you as a couple – to build an understanding of the situation from each other’s perspective, improve communication, and identify ways to strengthen your bonds.
Open Communication
Communication is the foundation of any healthy relationship, especially when dealing with PTSD. Sharing vulnerably about the experience and how it shows up in your daily life is powerful – for both partners. Have open and honest conversations about how the disorder impacts you both; practice sharing and listening without judgment. Express your feelings, worries, and needs in a safe environment. Remember – communication doesn’t automatically dictate frequency; talking “all the time” isn’t always the most helpful.
Establish Boundaries
Reassess your boundaries. What boundaries may need to change, be added, or removed in your current situation? What are each of your needs and limitations? Temporary boundaries may be needed until the severity of PTSD symptoms decreases, so plan a future time to check in and make changes as needed. Having a frank discussion increases the chance that you both will respect and abide by each other’s boundaries.
Practice Self-Care
Living with PTSD is not easy. Identify activities, settings, and people who help you relax, recharge, and maintain a sense of balance. Focusing and prioritizing yourself isn’t selfish—it’s necessary for your overall health and well-being and to be a support for the other partner.
Stay Connected
Despite the challenges, make an effort to stay connected as a couple. Don’t be afraid to schedule in connection! With all that you’re holding, scheduling a specific day and time to be together just increases the chance that it will actually happen. It doesn’t have to be a big to-do… it just has to happen. Maybe it’s incorporated into an existing daily routine, like cooking dinner or cleaning together. Or it can be big – like a weekend trip. These positive moments and experiences will strengthen your emotional connection. In turn, this will act as a “reserve” to pull from in difficult moments as you navigate PTSD.
Supporting a Partner with PTSD
If your partner is living with PTSD, here are some ways you can support them:
Listen With Curiosity
Be a compassionate listener and allow your partner to express their thoughts and feelings. Remind yourself to listen with the intention of better understanding them rather than to problem-solve, judge, or disprove. Sometimes, just having someone to listen to can make a world of difference.
Small Acts, Big Impact
Help alleviate your partner’s stress by offering practical support with daily tasks or responsibilities. Simple gestures like cooking a meal, running errands, or taking care of chores can show your love and support.
Zoom Out
Understand that your partner’s symptoms may fluctuate, and there may be good days and bad days. Be patient and understanding, and avoid taking their behavior personally. While the day-to-day may still feel like a rollercoaster, zooming out can help you both see the progress your partner has made overall.
Celebrate the Wins
Celebrate your partner’s success and your part in it! Identifying, verbalizing, and celebrating the progress (big and small) is crucial. It helps to motivate your partner when they may feel like they can’t go on. Making this a habit will have a huge impact on validating the hard work your partner is doing.
Avoid Minimizing
PTSD symptoms can present in different ways for different people. There may be times when your partner’s PTSD presents in ways that may not make sense to you. Avoid minimizing their experience – instead, use the opportunity to be curious about what’s happening for your partner. This will increase your understanding, and your partner will feel heard and validated.
Encourage Treatment
It can be a scary thing to share with a complete stranger (no matter how trained they are). There are evidence-based treatments for PTSD, and they have been proven to be effective. Encouraging your partner to explore professional support (e.g., therapy, psychopharmacological options) may be the nudge they need. Be open to joining in the treatment as needed, accompany them to sessions, explore partner support groups, and look into couples therapy.
Prioritize Your Partner
Not forever, but for a certain period of time, your partner’s needs may need to take priority. For example, If your partner’s trauma resulted from a terrible car accident, you may have to take over all the driving until they’ve developed enough coping strategies to drive again. It’s not fair, but it may be what your partner really needs right now. Talk through these and be open and ready to step in.
Take Care of Yourself
Just as they say on airplanes, you have to put your oxygen mask on first before helping anyone else. Identify and put into place your own support system – friends, family, support groups, or an individual therapist. Carve out time for yourself, and build in ways to regulate your own emotions throughout the day. To best care for your partner, you have to be at your best as well.
The Bottom Line
PTSD presents unique and significant challenges in a marriage. But with education, honest discussion, and support, couples can overcome this challenge together. Some days, it may feel like you’ve taken one step forward and three steps back, but remember, it’s a marathon, not a sprint. Make use of evidence-based treatment, support (online+IRL), and trained professionals to address PTSD symptoms. There is a light at the end of the tunnel, and with love, compassion, and grit, you can weather the (PTSD) storm.
Frequently Asked Questions about Navigating PTSD in Marriage
Here are some commonly asked questions when Navigating PTSD in Marriage
Q: Doesn’t PTSD only happen to vets?
A: No. PTSD can develop after any traumatic event in which the person truly believed their life was in danger. Learn more about PTSD from the National Center for PTSD.
Q: Is my partner just being dramatic? One day, something triggers them, and the next, it doesn’t.
A: Unfortunately, PTSD isn’t that straightforward. Triggers can be complex; they may be sounds, smells, events, specific phrases, or a combination. In the course of treatment, an individual may also be able to handle a trigger one day but (for various reasons) be less equipped to handle it another day. Be patient with your partner and curious, but most importantly, try not to judge. They may not even know why something is triggering them, and invalidation can set back the progress they are making.
Q: I’m not sure if my partner/spouse has PTSD… how can I tell?
A: If your partner experienced a traumatic event and is displaying any of the symptoms above, meet with a professional to be screened. Just as you would go to your primary care doctor and be screened for various health concerns, psychological providers do the same for PTSD. Screening often includes questionnaires and interviews to get a sense of current thoughts, feelings, and behaviors. You can also take an online screening test through Mental Health America. *Note: Use this as an informal tool. No matter the results, if you or your partner are concerned about PTSD, please seek professional services to be assessed.
Women with PTSD may present slightly differently than men. The U.S. Health Department of Health and Human Services found that women with PTSD were more likely to be easily startled, have more trouble feeling emotions or feeling numb, avoid things that remind them of the trauma, and/or feel depressed or anxious.
Q: What are some treatment options to consider for PTSD?
A: A number of psychological treatments for PTSD exist; they can be trauma-focused or not. A few examples of common treatments are Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), stress inoculation training (SIT), and interpersonal therapy. These therapies may treat memories of the trauma (including other thoughts & feelings related) or address the PTSD symptoms without directly focusing treatment on the thoughts, feelings, or memories tied to the traumatic event.
Reach out to a professional and ask more about what treatments they would recommend and why. Remember, finding a fit with a provider is important – as they explain how they would treat your symptoms, assess if that feels like a match for you.
References
- Sledjeski E. M., Speisman B., Dierker L. C. (2008). Does number of lifetime traumas explain the relationship between PTSD and chronic medical conditions? Answers from the National Comorbidity Survey-Replication (NCS-R). J. Behav. Med. 31, 341–349. 10.1007/s10865-008-9158-3
- Watkins, L.E., Sprang, K.R., and Rothbaum, B.O. (2018). Treating PTSD: A REview of Evidence-Based Psychotherapy Interventions.
Dr. Vivian Oberling is the Founding Psychologist at Pace Groups. She is also a licensed clinical psychologist who has dedicated her career to improving the lives of clients across the lifespan. Background-wise, she’s been trained and worked in academic centers and hospitals (Stanford, Harvard, UCLA, Kaiser and Rady Children’s), and utilizes evidence-based treatments and research to enhance non-clinical, supportive services.
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