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.
What Is PTSD?
PTSD is a mental health condition that results from experiencing a traumatic event or being in a situation with prolonged exposure to traumatic events. Events include experiencing abuse, experiencing natural disasters, or traumatic accidents which led to serious injuries.
Symptoms of PTSD
Symptoms of PTSD can include:
- Distress when around or hearing about a traumatic event
- Night terrors and insomnia
- Flashbacks
- Intrusive thoughts
- Changes in sleep and appetite
- Avoidance tendencies
- Easily startled by certain sensory stimulation
- Risky behaviors
- Expressing rage, guilt, and shame in extreme ways
- Feeling numb, withdrawn, and depressed
- Feelings of hopelessness and low self esteem
- Dissociating
- Suicidal thoughts
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 can help both of you heal from PTSD 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.
“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 your partner as it can cause changes to the relationship. 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 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, which is the part of the brain that puts thoughts and feelings into words.6 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, leading to a lack of communication in relationships.
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 and overthinking that, without healthy communication skills, can sour a relationship quickly.
3. Withdrawal Leading to Detachment & Avoidance
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. Difficulties With 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 Issues
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 often have less satisfaction in their relationships.10
6. Numbing Behaviors
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 hyper focus 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
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
Common PTSD Triggers in Relationships
PTSD triggers may vary from person to person, however there are some common triggers to be aware of while in a relationship with an individual who has PTSD, such as:
- Sensitivity to large crowds
- Fear and anxiety around the source of the traumatic event
- Becoming emotionally overstimulated
- Panic attacks during times of conflict
- Certain phrases and communication styles
- Situational triggers: how conflict is handled, tone of voice, volume of voice
- Non-verbal communication
- Intimacy at certain times or differences in intimacy expectations
- Lack of boundaries
- Concerns with safety
- Holidays, birthdays, and other memorable dates
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 and that you can support your partner. 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.
Here are 12 ways to improve your relationship with your partner with PTSD:5
- Don’t minimize their trauma
- Validate their feelings and experiences
- Rebuild your emotional connection
- Keep things in perspective
- Encourage them to seek treatment
- Accept that your relationship has changed and that the trauma can’t be undone
- Become familiar with your partner’s triggers (and how they affect you)
- Avoid shaming or minimizing your partner
- Express empathy and work to build their trust
- Be honest about and own your feelings
- Do self-care to make sure your own needs are also being met
- Communicate your needs to 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.”
What to Do When Someone With PTSD Pushes You Away
It can be hard to know how to support someone with PTSD when they are pushing you away. It can feel hurtful and confusing for you, but it’s important to understand that when they are triggered and having a PTSD episode, having a hard time regulating their nervous system, they are going to need space, help, and support to calm down and have their body and mind remember that they are safe.
It’s important that you support them through this and remind them of your love and your presence. Showing that you are reliable and available can be really helpful. It is also important that this is communicated in a sensitive way, as language is a big part of connection. Using language that helps them feel supported, validated, and recognized can go a long way as well. What you see on the outside is not necessarily what is happening internally, so being mindful that your perception may not be their reality is key.
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, asking for a referral from your primary care provider or using an online therapy directory can be great places to start.
Here are three types of therapy that are considered the most highly effective for treating PTSD:13
- 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.
- 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
- 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 type of couples counseling where one partner 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.
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
