He reacted with anger to protect himself and push her away. This can include situations in which police officers and first responders witness trauma to others. About 7 to 8 percent of people in the U. In a given year, 8 million adults have PTSD; 10 percent of those are women, 4 percent are men. For spouses and victims of PTSD , healing may feel like an endurance event. But there is hope. The belief that a person with PTSD cannot recover is no longer valid.
When you see an amputee, his or her wounds and losses are somewhat obvious. But when your spouse struggles with PTSD, neither of you may know it.
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He conceals his emotional wounds to avoid feeling vulnerable. Her anger pushes others away and protects her from exposing her emotional scars. His reactions only hinder him from getting the help he needs to heal. She shuffles through each day like the walking wounded.
Emotional wounds may take time to manifest for several reasons. First, the victim of trauma may not realize how hurt he or she is from the threat or assault. Second, we all have a natural tendency to cover up a wound. If our arm gets hurt, we instinctively put our other hand over it. If our head hurts, we place our hands on the ache. But when a wound is so deep we cannot put our hands on it, we find emotional ways to cover it up. Third, a victim of PTSD may live with shame about feeling hurt, vulnerable or powerless.
The survivor may want to deny the effects of trauma or pretend it did not happen. He or she wants to get on living a normal life. Regardless of the traumatic event that caused them, the pattern of PTSD symptoms tends to be consistent.
Identifying these symptoms helps survivors and spouses understand how the disorder affects their marriage. These behaviors affect marriages in a number of ways, but those with the most impact are emotional detachment, numbness, anger and irritability. Not only can PTSD drive a wedge between a husband and wife, it can devastate marriages.
Survivors suppress their thoughts and feelings from their partner, worry more about intimacy issues and have lower sexual interest and satisfaction. Research found Vietnam veterans with PTSD got divorced twice as much as those without PTSD, had shorter relationships and were three times more likely to have two or more divorces. Spouses of Vietnam veterans reported less happiness and life satisfaction, more discouragement, and felt emotionally overwhelmed.
Even husbands of female veterans with PTSD reported a lower sense of well-being and more social isolation. The research on spouses of noncombat PTSD survivors seems to be more limited, but the spouses of people who were raped, threatened at gunpoint or lived through a natural disaster are likely to struggle with similar effects. PTSD wounds the intimacy in marriage because it dismantles the emotional connection. Emotional intimacy is formed through a developmental process. The prerequisite conditions for intimacy include safety, trust, power,control and esteem.
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A key way that trauma injures these preconditions for intimacy is by changing or reinforcing beliefs. For example, as a child you may have believed I am safe or the world is OK to explore because your parents protected you, you lived in a safe neighborhood, and the people around you were kind and respectful.
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However, those trust beliefs may change to people are dangerous and I could get hurt after a traumatic event. Even without basis, survivors could apply and overgeneralize faulty beliefs toward their spouses. Self-esteem is another key precondition for intimacy; an important principle here is that identity precedes intimacy. Developmentally, we form our identity in our late teens and early 20s, deciding what career we will pursue, whether we will go to college, enter the military or learn a trade. But, when trauma attacks esteem, the survivor may feel devalued as a person — he may feel like a replaceable part.
She may feel she deserves punishment. If a trauma survivor thinks he is no longer loveable and he dislikes himself, he cannot perceive that others still love him and receive love from them. Hope found that being a spouse and caregiver to a trauma survivor challenged her own emotional stability. She wanted to help Phil bear his burden Galatians , but he kept pushing her away. As she carried greater responsibility for the tasks around the house and within the family, she felt her needs were unmet.
A friend invited her to a support group for wives of men with PTSD. Hope realized she needed to take care of her own mental, emotional, physical and spiritual needs as she and Phil walked through a long and winding valley of life together. Spouses of veterans with PTSD are more likely to develop mental health problems than are spouses of veterans without the disorder. The survivor may displace outrage onto his caregiver, mirroring the anger he received from the traumatic event.
This could even take the form of physical aggression and domestic violence. It is vitally important that PTSD caregivers take care of themselves. The good news is that a person who suffers trauma can recover. Mental health professionals do not use the word cure because it implies that all the symptoms will go away and never return.
But survivors can improve and lessen the effects of PTSD on themselves and their marriages.
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According to the National Center for PTSD , 53 percent of those who received trauma-focused psychotherapy and 42 percent who took medication improved to the level their symptoms no longer met PTSD diagnosis criteria. A spouse must encourage the trauma survivor to get treatment, because PTSD is unlikely to go away on its own. He realized he was not alone and that others had experienced situations similar to his.
The group helped him feel less socially isolated as he learned about interpersonal relationships. He learned how to regulate and manage his emotions better, becoming less angry and more engaged.
He used what he learned to strengthen his marriage. Experts have developed several types of evidence-based psychotherapies for PTSD. Treatment can reduce PTSD and related depression over the course of 12 to 16 sessions.
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One is cognitive processing therapy CPT , a type of cognitive behavioral therapy for individuals or groups. Trauma survivors can make substantial progress in the recovery process due to changing their thoughts and beliefs. Therapists teach survivors how to identify unhealthy thoughts, challenge those mindsets and install new thoughts.
PTSD and Your Marriage
A beneficial treatment for couples is Cognitive-Behavioral Conjoint Therapy. It is designed to reduce individual PTSD symptoms and improve relationships. Similar to CPT, the survivor and spouse work to identify the thoughts and behaviors of PTSD and how those symptoms affect their relationship. Many couples lose hope for the relationship. But hope abounds through therapy and through spiritual resources. As noted earlier however, some chaplains may be reluctant to utilize any moral injury screenings or PND.
A duty of care however, may warrant the need for chaplains to be educated about the benefits of using available screening instruments—not for the purposes of reporting, per se for this would be a breach of confidentiality , but rather to assist chaplains to more empirically assess the narratives of their clients and ultimately assist their client's needs. In order, however, for chaplains to progress their clients beyond screenings and assessment interventions, there is also a need for chaplains to develop and utilize a systematic method of providing spiritual counseling and education, plus incorporate ritual activities to address moral injury.
The proposed PND technique is one way that chaplains may be able to encourage and achieve the appropriate spiritual care interventions, that will ultimately provide personnel with the beneficent support which they need to address their moral injury. All authors listed have made a substantial, direct and intellectual contribution to the work, and approved it for publication.
The PND technique forms part of the Ph. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Neil Pembroke and Dr. Carey LB. The utility and commissioning of spiritual carers. Oxford: Oxford University Press Chapter — Google Scholar.