PTSD and Couple Stress: How to Overcome PTSD Together By Benjamin Burke By now, you’ve probably heard about the negative toll that posttraumatic stress disorder (PTSD) can have on a person. People with PTSD may feel emotionally numb in their relationships, or experience intense anxiety when re-imagining the traumatic event. What you may not know is that PTSD affects not only individuals, but also the relationships around them. Recent research has looked at how PTSD symptoms affect marriages. In short, one partner’s PTSD symptoms can spillover into the other partner’s life and negatively affect their views of the relationship. This negative spillover effect may be attributed to people with PTSD feeling emotionally numb and, as a result, may have more difficulty bonding with his/her spouse. These difficulties follow a logical pattern. Someone who feels emotionally numb is likely struggling to manage their emotions-they may get angry more easily, or may want to avoid the discomfort that comes with feeling and expressing complex emotions. They may even be trying to keep from lashing out at their loved ones! Though behaviors like avoiding difficult emotions usually stem from good intentions, like protecting themselves or their partner, difficulty arises when a person or a couple are stuck in a cycle of emotional challenges and have difficulty connecting or supporting one another. The negative effects of PTSD are not isolated to significant others. PTSD that goes untreated for a long time can result in lower amounts of social support. This means that it gets harder for friends and family to support their loved ones dealing with PTSD. This is not anyone’s fault. PTSD symptoms are hard to overcome, so partners and friends may find it difficult to continue offering support. Luckily, research has provided some good pieces of advice that can help manage PTSD. Advice for managing PTSD 1) Regardless of whether you or your partner (or both) have PTSD, be sure to practice good self-care. It is difficult to offer support or cope with challenges when you are not taking care of yourself. It is okay to do things for yourself. Take a walk. Go see a movie. Spend time with friends. Go to therapy. Spend time praying if spirituality is helpful for you. Self-care allows us to relax and recharge our batteries so that we can deal with the challenges of life and support others. 2) If your partner is dealing with PTSD and is reluctant to receive treatment, there may be some things you can do to encourage him or her to seek treatment: • Showing patience during the process • Respecting their choice in the matter and trying not to compromise their independence • Refraining from “nagging” • Trying to understand their perspective • Discussing treatment as a normal, healthy way to promote strength 3) Finally, if your partner agrees to seek help, it could be a good idea to accompany them. Remember, PTSD in one partner affects the couple as a whole. Therefore, partners and friends can be useful companions in treatment. Going to therapy or classes together may help both the individual and relational challenges that come with PTSD. If you are dealing with PTSD, or have a loved one struggling with this challenge, you’re not alone. Be sure to take care of yourself, encourage seeking help, and work through the process together. Bohnert, K. M., Sripada, R. K., Ganoczy, D., Walters, H., & Valenstein, M. (2018). Longitudinal patterns of PTSD symptom classes among US National Guard service members during reintegration. Social Psychiatry and Psychiatric Epidemiology, 53(9), 911-920. https://doi.org/10.1007/s00127-018-1542-x Beck, A., Ruhlmann, L. M., & Goff, B. S. N. (2018). Pilot data on the nature of trauma exposure in military couples. Journal of Veterans Studies, 3(1), 67–84. Allen, E., Knopp, K., Rhoades, G., Stanley, S., & Markman, H. (2018). Between- and within-subject associations of PTSD symptom clusters and martial functioning in military couples. Journal of Family Psychology, 32, 134-144. http://dx.doi.org/10.1037/fam0000363

Burke, Benjamin

By now, you’ve probably heard about the negative toll that posttraumatic stress disorder (PTSD) can have on a person. People with PTSD may feel emotionally numb in their relationships, or experience intense anxiety when re-imagining the traumatic event. What you may not know is that PTSD affects not only individuals, but also the relationships around them. Recent research has looked at how PTSD symptoms affect marriages. In short, one partner’s PTSD symptoms can _spillover_ into the other partner’s life and negatively affect their views of the relationship. This negative spillover effect may be attributed to people with PTSD feeling emotionally numb and, as a result, may have more difficulty bonding with his/her spouse. These difficulties follow a logical pattern. Someone who feels emotionally numb is likely struggling to manage their emotions-they may get angry more easily, or may want to avoid the discomfort that comes with feeling and expressing complex emotions. They may even be trying to keep from lashing out at their loved ones! Though behaviors like avoiding difficult emotions usually stem from good intentions, like protecting themselves or their partner, difficulty arises when a person or a couple are stuck in a cycle of emotional challenges and have difficulty connecting or supporting one another. The negative effects of PTSD are not isolated to significant others. PTSD that goes untreated for a long time can result in lower amounts of social support. This means that it gets harder for friends and family to support their loved ones dealing with PTSD. This is not anyone’s fault. PTSD symptoms are hard to overcome, so partners and friends may find it difficult to continue offering support. Luckily, research has provided some good pieces of advice that can help manage PTSD. #### Advice for managing PTSD 1) Regardless of whether you or your partner (or both) have PTSD, be sure to **practice good self-care**. It is difficult to offer support or cope with challenges when you are not taking care of yourself. It is okay to do things for yourself. Take a walk. Go see a movie. Spend time with friends. Go to therapy. Spend time praying if spirituality is helpful for you. Self-care allows us to relax and recharge our batteries so that we can deal with the challenges of life and support others. 2) If your partner is dealing with PTSD and is reluctant to receive treatment, there may be some things you can do to **encourage him or her to seek treatment**: * Showing patience during the process * Respecting their choice in the matter and trying not to compromise their independence * Refraining from “nagging” * Trying to understand their perspective * Discussing treatment as a normal, healthy way to promote strength 3) Finally, if your partner agrees to seek help, it could be a good idea to accompany them. Remember, PTSD in one partner affects the couple as a whole. Therefore, partners and friends can be useful companions in treatment. Going to therapy or classes together may help both the individual and relational challenges that come with PTSD. If you are dealing with PTSD, or have a loved one struggling with this challenge, you’re not alone. Be sure to take care of yourself, encourage seeking help, and work through the process together. ##### References [Bohnert, K. M., Sripada, R. K., Ganoczy, D., Walters, H., & Valenstein, M. (2018). Longitudinal patterns of PTSD symptom classes among US National Guard service members during reintegration. Social Psychiatry and Psychiatric Epidemiology, 53(9), 911-920](https://militaryreach.auburn.edu//DetailResult?resourceid=9b384ab5-a90a-40ef-b621-f6ade1932a35&resType=resSum) [Link to Source](https://doi.org/10.1007/s00127-018-1542-x) [Beck, A., Ruhlmann, L. M., & Goff, B. S. N. (2018). Pilot data on the nature of trauma exposure in military couples. Journal of Veterans Studies, 3(1), 67–84.](https://militaryreach.auburn.edu//DetailResult?resourceid=f7b60493-64a4-47b4-9375-873ac35952fa&resType=resSum) [Allen, E., Knopp, K., Rhoades, G., Stanley, S., & Markman, H. (2018). Between- and within-subject associations of PTSD symptom clusters and martial functioning in military couples. Journal of Family Psychology, 32, 134-144.](https://militaryreach.auburn.edu//DetailResult?resourceid=e8b4f385-4e7f-4a44-9a4c-0a91f1336efb&resType=resSum) [Link to Source](http://dx.doi.org/10.1037/fam0000363)

Family Story

https://militaryreach.auburn.edu/ptsd-couple-stress.jsp

https://aub.ie/MilitaryREACH-AllenTRIP

Allen, E., Knopp, K., Rhoades, G., Stanley, S., & Markman, H. (2018). Between- and within-subject associations of PTSD symptom clusters and martial functioning in military couples. Journal of Family Psychology, 32(1), 134-144. http://dx.doi.org/10.1037/fam0000363

PTSD symptom clusters (numbing, hyperarousal, effortful avoidance, and reexperiencing) as a whole are related to marital functioning (e.g., satisfaction), but there is less information regarding how specific symptoms relate to specific aspects of marital functioning. Theoretically, numbing symptoms have been linked to deficits in positive relationship characteristics (e.g., positive bonding), and hyperarousal symptoms have been linked to greater conflict. Additionally, there is little known about how PTSD and marital functioning are related over time, such as whether changes in PTSD symptoms lead to changes in marital functioning. Data from 570 couples with male Army service members and civilian wives were used to examine these associations. Findings suggest a continued link between PTSD symptoms and marital functioning over time, with more evidence for the influence of numbing symptoms than other symptoms.

http://doi.org/10.1037/fam0000363

Couples
Mental health

Army

Active Duty

Active duty service member
Spouse of service member or veteran

Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)

Longitudinal study

Allen, Elizabeth, Knopp, Kayla, Rhoades, Galena, Stanley, Scott, Markman, Howard

Using data from 570 male service members and their wives, the current study investigated over-time associations between male service members’ self-report of posttraumatic stress disorder (PTSD) symptoms and marital functioning (marital satisfaction, positive bonding, conflict behavior) as perceived by both spouses. Analyses spanned 5 time points over a 2-year period and fully disentangled between- and within-subject effects. Higher levels of all four PTSD symptom clusters (numbing, hyperarousal, effortful avoidance, and reexperiencing) showed significant between-subject associations with lower levels of marital satisfaction and positive bonding, and higher levels of conflict for both men and women, whereas there were markedly fewer significant within-subject associations. When running models with all four PTSD symptom clusters entered at once, the primary between-subject finding was that men with higher numbing symptoms overall reported poorer marital functioning in all domains; there were no significant between-subject links between numbing and marital functioning for women. In contrast, within-subject effects for numbing were found for both men and women, linking increased numbing with decreased positive bonding and increased conflict behavior over time; women also had lower marital satisfaction when their husbands reported relatively higher numbing. Between-subject analyses also revealed that for men with higher average levels of effortful avoidance, wives reported lower levels of satisfaction and positive bonding, whereas men themselves reported less frequent conflict behavior. Finally, within-subject effects showed that at times when men reported increased hyperarousal, they also perceived increased marital conflict, whereas women surprisingly reported increased marital satisfaction. Implications of divergent between- and within-subject results are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)

American Psychological Association

Article
REACH Publication

University of Colorado-Denver, EA
University of Denver, KK
University of Denver, GR
University of Denver, SS
University of Denver, HM