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PTSD & Relationships: Supporting a Partner With PTSD

Published: September 23, 2021 Updated: May 17, 2022
Published: 09/23/2021 Updated: 05/17/2022
Headshot of Meagan Turner, MA, APC, NCC
Written by:

Meagan Turner

MA, APC, NCC
Headshot of Rajy Abulhosn, MD
Reviewed by:

Rajy Abulhosn

MD
  • PTSD & RelationshipsPTSD & Relationships
  • How Does PTSD Affect Romantic Relationships?Impacts
  • How to Improve Your Relationship When Your Partner Has PTSDImprove the Relationship
  • Helping Your Partner Find Treatment for PTSDTreatment
  • Couples Therapy OptionsCouples Therapy
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Infographics for Supporting a Partner with PTSDInfographics
Headshot of Meagan Turner, MA, APC, NCC
Written by:

Meagan Turner

MA, APC, NCC
Headshot of Rajy Abulhosn, MD
Reviewed by:

Rajy Abulhosn

MD

Having a partner who suffers from posttraumatic stress disorder (PTSD) can be challenging. Your partner has been exposed to a traumatic event that felt overwhelming, and now they react in a way that impacts your relationship.1 Helping your partner get treatment can improve their life as well as the quality of your relationship.

Working on a relationship when a partner has PTSD can be difficult, but you don’t have to figure everything out on your own. BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you.

Choosing Therapy partners with leading mental health companies and is compensated for referrals by BetterHelp

Visit BetterHelp

PTSD & Relationships

Having a partner with PTSD can be difficult. Your partner may feel unpredictable to you, and maybe even to themselves, due to their constant feeling of being alert or on edge as a result of their trauma. It’s important for you and your partner to discuss PTSD and the symptoms that come along with it so that both of you are on the same page.

Being able to recognize your partner’s symptoms of PTSD can be healing for both of you and improve your relationship. Important considerations for you to discuss with your partner include any changes you’ve noticed in your partner, the triggers that impact them, and what helps them feel calm and safe. If your partner’s changes go unaddressed, your relationship might become confusing, hurtful, and difficult to navigate together.

Royce Lee, MD Associate Professor of Psychiatry and Behavioral Neuroscience, University of Chicago“Because PTSD affects all kinds of emotions, even positive emotions like warm, attachment-related emotions, people with PTSD can seem like they have changed,” says Dr. Royce Lee, MD, Associate Professor of Psychiatry and Behavioral Neuroscience at the University of Chicago. “But we know that when PTSD gets better with evidence-based psychotherapy, the whole range of human emotions improves. So, yes, be prepared for new challenges in the relationship. Be realistic about expectations that things stay the same. The good news is that treatment works.”

Why Is Understanding PTSD Important for Partners?

It’s vital to recognize changes in one person in a relationship as it can cause changes to the partnership. Therefore, managing the effects of PTSD reaches beyond just the person with the diagnosis.2 Even if your partner does not have an official PTSD diagnosis, they can still exhibit many symptoms of PTSD.1 This can be even more difficult to navigate depending on the type of trauma they’ve experienced – for example, if they had PTSD from a past relationship, they may be having trouble trusting you. Women experience additional risk factors for developing PTSD, which is also important for a partner to understand.

How Does PTSD Affect Romantic Relationships?

PTSD impacts relationships in several areas due to its wide range of symptoms. PTSD can affect your partner’s physical health, mental health, emotions, and behavior.3 Couples can fall into negative patterns, have difficulty expressing emotions, or create a downward spiral where PTSD symptoms and anxieties negatively affect relationship quality. This spiral, in turn, intensifies your partner’s symptoms.4

Here are eight ways that PTSD may affect your relationship:

1. Change, Loss, & Disappointment

It’s common for the partner of a trauma survivor to feel disappointed, particularly if the trauma occurs during the course of your relationship and your partner changes. You may feel disappointed that your partner no longer seems to be fully themselves or that your relationship isn’t turning out the way you’d hoped.

Prolonged disappointment can often lead to resentment as well, doubling down on the difficult aftereffects of trauma in your relationship.5 The immense changes that occur in your partner as a result of trauma often feels like a loss to you – loss of the person you loved and aspects of their personality that you loved about them.5

2. Difficulty Communicating

When your partner’s trauma first occurred, their brain did a lot all at once. One of the first actions it took was to shut down the Broca’s area,6 which is the part of the brain that puts thoughts and feelings into words. Your traumatized partner may literally be unable to communicate with you, either about the traumatic event or at times when they become triggered and feel unsafe.

Frustrated by their own inability to describe anything accurately, your partner may look for someone to blame or become angry that you can’t just “get it.”5 In turn, it can be easy for you to feel irritated by your partner’s blame-shifting or think that your partner doesn’t trust you with intimate information. This downward spiral can lead to conflict that, without healthy communication skills, can sour a relationship quickly.

3. Withdrawal Leading to Detachment

The trauma survivor in your relationship may withdraw from you and from themselves. Often, their brain may feel disconnected from their body because the trauma feels like too much to handle.7 As a result, the person with PTSD may feel shame, embarrassed that they’re unable to cope with their feelings, or feel out of control over their own behaviors.5

4. Intimacy & Sex

When you feel intense emotions, whether fear or intimacy, the same regions of your brain light up and are activated. Your brain isn’t able to differentiate between whether it’s experiencing positive or negative emotional intensity.8

For the trauma survivor, sexual arousal becomes difficult to achieve because that response is so closely paired with the fear and horror associated with the traumatic event that led to their PTSD.8 Thus, as a protective measure, their brain begins to shut down, abruptly ending an otherwise romantic moment.7

5. Trust

Intimacy requires trust. During a traumatic event, the trauma survivor’s sense of self often becomes shattered as the intensity of the fear of abandonment rises.9 The trauma survivor craves trust and safety from others but has a hard time believing that they can be safe, so they often go back and forth between engaging in intimacy and withdrawing completely.9

Given that relationships, and especially sexual intimacy, are built on a foundation of trust and emotional vulnerability, those suffering from PTSD symptoms result in less satisfaction in their relationships.10

6. Numbing

Overwhelming feelings that result from PTSD can cause someone to do anything at all to escape from the present moment, and they may resort to numbing tactics. Numbing can look different for different people. Numbing tactics can span an entire spectrum, from obviously harmful like an eating disorder or substance misuse, or it can manifest as a hyperfocus on things that seem benign, like developing a compulsive need to exercise – anything that can keep the painful feelings away.

However, because they cannot stay fully in the present, it remains impossible to feel “fully alive.”7 This cycle can keep your partner living in their head or in the past. Numbing in the present moment can make both happy occasions, like a wedding or graduation, and devastating occasions, like attending a funeral, all part of the same dull hum of emotions.

In turn, the constant numbness your partner may be feeling can further lead to shame about having felt nothing at important events and gatherings.

7. PTSD and Anger in Relationships

It’s been hypothesized that anger in trauma survivors is a result of ruminating over the traumatic event, how it could have been prevented, or how it has changed life for them.11 Anger can be directed internally, towards the self in the form of shame, or externally in the form of yelling or physical aggression.12 Your partner may experience one or both of these forms of anger, perhaps even at the same time.

8. Hypervigilance

Trauma survivors, having had their foundation of basic safety in the world shattered, are usually in a state of high-alert afterwards, often called hypervigilance. For the trauma survivor, it is as if the traumatic event were “continually recurring in the present.”9

Thus, they may be easily startled, always on edge, and have difficulty sleeping. The body is on high-alert during both sleep and wakefulness, so your partner may have become a light sleeper or have intense dreams as their brain attempts to process the trauma.9

Working on a relationship when a partner has PTSD can be difficult, but you don’t have to figure everything out on your own. BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you.

Choosing Therapy partners with leading mental health companies and is compensated for referrals by BetterHelp

Visit BetterHelp

How to Improve Your Relationship When Your Partner Has PTSD

While dating someone with PTSD can be difficult, there are ways your relationship can be improved. Sometimes just understanding how your relationship is affected by PTSD symptoms can provide enough explanation and empathy to reconcile many areas of conflict between you and your partner.

Dr. Lee encourages, “If a partner is sharing something about their trauma or symptoms, the most important thing is to provide some positive comments about their sharing with you. Sometimes it may seem like a burden to solve a problem than can be chronic. You don’t have to solve it yourself, because PTSD is complicated and even trained professionals have to work pretty hard with their clients. By providing some positive feedback about the act of sharing, such as thanking the person for their trust, that helps assuage feelings of guilt that come up with PTSD.”

Here are 12 ways to improve your relationship with your partner with PTSD:5

  1. Don’t minimize their trauma
  2. Validate their feelings and experiences
  3. Rebuild your emotional connection
  4. Keep things in perspective
  5. Encourage them to seek treatment
  6. Accept that your relationship has changed and the trauma can’t be undone
  7. Become familiar with your spouse’s triggers (and how they affect you)
  8. Avoid shaming or minimizing your partner
  9. Express empathy and work to build their trust
  10. Be honest about and own your feelings
  11. Do self-care to make sure your own needs are also being met
  12. Communicate your needs to your partner

Helping Your Partner Find Treatment for PTSD

Getting your partner treatment for PTSD can be helpful for them, but therapy could also benefit you as you learn to cope with the changes to your relationship. For your partner who suffers from PTSD, there are several evidence-based, trauma-focused therapies that work well. If you or your partner aren’t sure how to find a therapist, an online directory can be a great place to start.

The three types of therapy that are considered the most highly recommended by the National Center for PTSD are:13

  1. Eye Movement Desensitization & Reprocessing Therapy (EMDR): EMDR is an excellent treatment for PTSD. It helps you process through trauma and can ease intense reactions to triggers. These sessions typically happen once or twice a week for about 6-12 sessions, each lasting for 60-90 minutes.14 It can be performed in-person or online.
  2. Cognitive Processing Therapy (CPT): CPT helps you to identify and change negative thoughts that often accompany the onset of PTSD. During CPT sessions, you will work with your therapist to identify the negative thoughts brought on by the traumatic experience and then to challenge those thoughts with healthier, more positive ones.13
  3. Prolonged Exposure (PE): PE deals primarily with the avoidance aspect of trauma. The reminders of traumatic experiences that you seek to avoid are faced head-on by repeatedly talking about (and thereby exposing yourself to) the traumatic memories in a safe environment. The purpose is to gain control over your thoughts and feelings so that you can regain your quality of life.13

Couples Therapy Options

If you and your partner are looking to do therapy together, the most heavily researched and well-known treatment for couples where one has PTSD is cognitive-behavioral conjoint therapy (CBCT). It was uniquely designed to decrease PTSD symptoms and improve relationship adjustment based on a cognitive-behavioral interpersonal theory of PTSD.

This theory suggests that cognitive, behavioral, and affective processes all work together to affect the individual and their partner such that their interactions serve to maintain PTSD symptoms and relational difficulties.2,15 CBCT looks at themes in your relationship and prioritizes sharing thoughts and feelings. It consists of fifteen 75-minute sessions and aims to make meaning of the traumatic experience.15

Final Thoughts

Going through a traumatic experience can be life-altering, but talking to someone who is familiar with PTSD and trained to help you and your partner, can help you regain a sense of normalcy and control in your life.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for referrals by the companies mentioned below.

BetterHelp Online Therapy – BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you. Get Started

Talkspace Online Therapy – Online therapy is convenient with Talkspace. Get therapy for as little as $69 per week, or potentially much less if you have insurance from Cigna, Optum, or UHR. Try Talkspace

Choosing Therapy’s Directory – Find an experienced therapist who is committed to your wellbeing. You can search for a therapist by specialty, availability, insurance, and affordability. Therapist profiles and introductory videos provide insight into the therapist’s personality so you find the right fit. Find a therapist today.

Online Psychiatry & Medication – Answer a few questions and Talkspace will match you with an online prescriber and get schedule a video psychiatry session. Your online psychiatry prescriber will personalize your treatment, which may include psychiatric medication and follow-ups. Get started for $249 or see if your insurance is one of many Talkspace accepts. Learn More

Mindfulness & Meditation App – Headspace is an easy way to incorporate mindfulness and meditation into your routine. See for yourself how a few minutes each day can impact your stress levels, mood, and sleep. A monthly subscription for Headspace is only $12.99 per month and comes with a 7-day free trial. Try Headspace

Choosing Therapy partners with leading mental health companies and is compensated for referrals by BetterHelp, Talkspace, and Headspace

For Further Reading

  • Helpful Books for PTSD and Trauma
  • EMDR International Association
  • PTSD Statistics & Resources
  • The National Center for PTSD
  • The National Center for Victims of Crime (if you or your partner is a victim of crime or domestic violence)
  • Mental Health America
  • National Alliance on Mental Health
  • MentalHealth.gov

Infographics for Supporting a Partner with PTSD

PTSD & Relationships Supporting a Partner With PTSD Helping a Partner with PTSD Why Understanding PTSD is Important for Partners

Effects of PTSD in Relationships Ways to Improve Your Relationship When Your Partner Has PTSD Getting Help for PTSD

Finding a Therapist for PTSD

15 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.)

  • Blount, T., Fredman, S. J., Pukay-Martin, N. D., Macdonald, A., & Monson, C. M. (2015). Cognitive-behavioral conjoint therapy for PTSD: Application to an Operation Enduring Freedom veteran. Cognitive and Behavioral Practice, 22(4), 458–467. Retrieved from: https://psycnet.apa.org/record/2014-26340-001

  • Levers, L. L. (Ed.). (2012). Trauma counseling: theories and interventions. New York: Springer Publishing Company.

  • Renshaw, K. D., Campbell, S. B., Meis, L., & Erbes, C. (2014). Gender differences in the associations of PTSD symptom clusters with relationship distress in U.S. Vietnam veterans and their partners. Journal of Traumatic Stress, 27(3), 283–290. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/24823939/

  • Zayfert, C., & DeViva, J. (2011). When someone you love suffers from posttraumatic stress. New York: Guilford Press.

  • van der Kolk B. (2000). Posttraumatic stress disorder and the nature of trauma. Dialogues in clinical neuroscience, 2(1), 7–22. https://doi.org/10.31887/DCNS.2000.2.1/bvdkolk

  • Van der Kolk, B. (2015). The body keeps the score. New York: Penguin Books

  • Yehuda, R., Lehrner, A., & Rosenbaum, T. Y. (2015). PTSD and sexual dysfunction in men and women. Journal of Sexual Medicine, 12(5), 1107–1119. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/25847589/

  • Herman, J. (1997). Trauma and recovery. New York: Basic Books.

  • Blais, R. K., Geiser, C., & Cruz, R. A. (2018). Specific PTSD symptom clusters mediate the association of military sexual trauma severity and sexual function and satisfaction in female service members/veterans. Journal of Affective Disorders, 238, 680–688. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/30029163/

  • Orth, U., Cahill, S. P., Foa, E. B., & Maercker, A. (2008). Anger and posttraumatic stress disorder symptoms in crime victims: a longitudinal analysis. Journal of consulting and clinical psychology, 76(2), 208–218. Retrieved from: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.495.6041&rep=rep1&type=pdf

  • Germain, C. L., Kangas, M., Taylor, A., & Forbes, D. (2016). The role of trauma-related cognitive processes in the relationship between combat- PTSD symptom severity and anger expression and control. Australian Journal of Psychology, 68(2), 73–81. Retrieved from: https://psycnet.apa.org/record/2015-21179-001

  • Department of Veterans Affairs (n.d.).  PTSD: National center for PTSD. https://www.ptsd.va.gov/

  • American Psychiatric Association. (2017, July 31). Eye movement desensitization and reprocessing (EMDR) therapy. https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing

  • Pukay-Martin, N. D., Torbit, L., Landy, M. S. H., Macdonald, A., & Monson, C. M. (2017). Present and trauma-focused cognitive–behavioral conjoint therapy for posttraumatic stress disorder: A case study. Couple and Family Psychology: Research and Practice, 6(2), 61–78. Retrieved from: https://psycnet.apa.org/record/2017-14475-001

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Headshot of Meagan Turner, MA, APC, NCC
Written by:

Meagan Turner

MA, APC, NCC
Headshot of Rajy Abulhosn, MD
Reviewed by:

Rajy Abulhosn

MD
  • PTSD & RelationshipsPTSD & Relationships
  • How Does PTSD Affect Romantic Relationships?Impacts
  • How to Improve Your Relationship When Your Partner Has PTSDImprove the Relationship
  • Helping Your Partner Find Treatment for PTSDTreatment
  • Couples Therapy OptionsCouples Therapy
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Infographics for Supporting a Partner with PTSDInfographics
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