9 Tips to Support You & Your Spouse with PTSD

Feeling lost on how to support yourself and your spouse with PTSD?

Are you not feeling heard?  Your partner is not able to hear or handle your emotions.  Being extra cautious? You don’t know what or when he or she will be triggered.  Need tips to help you and your spouse diagnosed with Post Traumatic Stress Disorder (PTSD)?

As a trauma therapist, I love seeing the influx of articles, resources, and therapy treatment information growing to help change the stigma of PTSD and mental health.  My heart is filled when I see how many veterans, first responders, and other adults with childhood trauma are seeking therapy to heal from their traumatic experiences and regain a sense of stability and control again. But,

What about you, as the spouse, of a partner with PTSD?

Who is helping you to understand, cope, and later adjust to the changes that are happening in therapy?  When do you get to be heard and understood?  How do you know what is a healthy reaction or a PTSD trigger?  And what do you do when he or she is triggered?

These are common questions that I hear from partners of my clients or my clients reports of what their hearing from their partners.

Let me give you the key.

It's important for you to support your partner during his or her time in treatment for PTSD, BUT, also important that you feel supported during his or her treatment too.  So, what does this look like?  Here are a few tips that can help.

• Have a conjoint session with your partner and the therapist sometime within the first 6 weeks of his or her treatment. 

Notice I say not the first or even second session, but sometime early in therapy.  It’s important that your partner begins to build a sense of safety and trust with the therapist.  This step sets an important foundation in the therapeutic relationship, which is one of the contributing factors to a person’s success in therapy.  It’s okay to let your partner make the decision as to when the conjoint session should take place, and it may be the first session.  But it’s important that he or she decide with their therapist.  This provides them with some control over their treatment, which helps to maintain an openness to therapy.

A conjoint session early in therapy should cover the following:

How long the therapist believes therapy will take for your partner.  Understand that this is often estimated and may change as therapy progresses.  It can range from a few months, to a year, to a few years.  Usually, the longer the history of trauma, the longer the therapy.

Attempt to identify what each of you need currently to build that support.  For example, maybe a client’s trigger is a raised voice.  For his partner, it's needing him to let her know where he is when he leaves after being triggered.  She may agree to watch her tone when upset and he agrees to send her a text that he is safe.  This is a perfect example of each one supporting the other during his or her treatment.

• Know his or her triggers.

As therapy progresses, your partner will be getting better insight into his or her triggers.  Some may know even before therapy.  Either way, have your partner share this information with you.  This will allow you both to be more conscious and at least attempt to minimize them.  Understand, you are both human.  You're not perfect and will forget.  That’s okay.  You can’t control everything.  Again, it’s about minimizing triggers.

• Ask your partner to show you the coping tools he or she is learning to manage triggers.

Coping tools are the first step in therapy.  Your partner and therapist are identifying, practicing, and learning what coping tools work best for him or her.  When you learn what works best for your partner and practice with him or her at home, it reinforces the practice and builds your partner’s ability to reach a relaxed state.  These coping tools most likely will benefit you as well.  In fact, have the kids join in at homework, dinner, or bedtime.  Deep breathing benefits us all!  Finally, when your partner gets triggered, as they begin to come down from the trigger, reminding them of these coping tools will help.  Again, this is as they are coming down.  It may not be possible initially.

• Pick and choose your battles and when to go into battle

You know your partner best.  The facial expressions, body gestures, mood.  If there is something you need to talk to your partner about, try to make sure he or she is in a good place.  If you’re not sure, ask.  Be willing to wait if he or she may say its not a good time, BUT, also let them know its important to you and if he or she can check in with you later or vice a versa.  You have a right to be heard too, but also know that it can be very difficult for your partner.  If it’s something you feel is not crucial and can let go, then try.  Not all issues can be let go and that’s okay.  It’s important that present issues are attempted to be resolved.

You also know yourself best.  If you notice emotions are high for you, most likely you will also react with emotions. You’re human.  Take space for you too.  Use your own coping tools to deescalate.   A resolution will more likely happen when you're both in a calm state.  Both will feel heard and satisfied.

• Your partner’s action of walking away may be to protect you, not hurt you.

One of the coping tools clients learn is to walk away or take a time out if they’re noticing that anxiety, anger, or another trigger is beginning to take over. Many trauma clients fear their anger and will walk away to make sure they won’t hurt anyone.  This is especially true with someone they love.  You, as the partner, make take this as he or she is ignoring me, doesn’t care, or "I’m not important."  This is where feeling unheard or sense of unfairness comes up.  Wait until your partner returns or deescalates, then ask.  He or she may be doing this because of the exact opposite.  They love you so much, they don’t want to hurt you.

• Triggered Reaction or Appropriate Reaction?

If your partner has been suffering from PTSD for a long period of time, it can be difficult to distinguish if a reaction is a trigger or is it a normal reaction to what is happening in the moment.  A trigger is often excessive or out of proportion to the situation, impulsive, escalates very quickly, and lasts much longer than just a few minutes.  No matter what you say, it’s as if they don’t hear you or not in the room with you.  Many trauma survivors describe it as someone hijacking their mind.  They feel embarrassed, scared, or guilty for their reactions once they are able to deescalate from it.  It’s not until after that they are able to recognize the intensity that took place.

An appropriate reaction can be escalated, but makes sense to the situation.  It is a more gradual escalation, and usually, deescalates within a few minutes to an hour depending what is happening.  They can listen to what you’re saying and respond.  You sense that he or she is present in the room with you.  This leads to Tip #7.

• Come back to conjoint session towards the end of treatment if needed

One of the many things I hear from clients as they are overcoming symptoms of PTSD, (and have more appropriate reactions to situations), is they don’t feel they're being heard.  A sort of Role Reversal.  Mainly because when he or she becomes angry or frustrated, their partner contributes it to his or her PTSD rather than being angry because they're angry.  Many feel that they're being dismissed. It’s often by this time, without realizing it, you may have developed automatic reactions to your partner’s reactions.  For example, walking away yourself, not listening, and waiting for your partner’s reactions to pass.  Perhaps, difficulty trusting it. 

Built up anger or resentment for having to place your own needs aside for so long can make it difficult to continue to be patient and open.  A few conjoint sessions are not uncommon and can be helpful to readjust as your partner improves, and provide you space to express how difficult it has been for you.  He or she is now in a better place to handle it.

• Remember, therapy takes time and is not linear

Typically, in therapy, there is progression with the middle being most difficult.  But regression for brief periods of time is to be expected and does not necessarily mean progression is not being made.  There are many different reasons.  Life is still happening beyond therapy, bringing present stressors.  An unexpected, unrealized trigger.  While working through trauma, a new memory is recalled to the surface.  Waves of progression and regression should be expected.   Leading to Tip #9.

• Take care of you!

Make sure that you are taking care of you too.   Have your support system of family, friends, church community, or your own therapist in place.  Make sure you have a tool box of coping tools.  Exercise, Yoga, hobbies, getting out, meditation/prayer, things you enjoy.  Journaling or art is an effective tool to give you a place to express and release your emotions.  If you are a spouse of a veteran or first responder, is there a community of spouses you can connect with?

It's easy to feel at a loss of what to do and of being heard yourself as a partner of someone with PTSD.   It’s a diagnosis that impacts the entire family.  Open, timely, and patient communication to support both of you are key and can ultimately strengthen your relationship even more.  Taking care of yourself and having support another important key during your partner's treatment.

If you would like to know more about PTSD and possible treatment such as EMDR, you can click on my Services page.  You can also go to my Meditations page if you are looking for some more coping and relaxation tools.

Below are links to further information on PTSD symptoms and treatments:

www.ptsd.va.gov

https://psychcentral.com/disorders/ptsd/

www.emdria.org