How to Help a Partner With PTSD

Conflict Resolution with your PTSD Partner/Spouse

For someone who is suffering with PTSD, life is always on high gear. Unfortunately due to the trauma(s) experienced, no matter how long prior, their brain is simply overactive and on high alert, prone to anxiety, anger, depression and in a nutshell defensiveness. It is one thing for them to learn behavioral techniques to deal with their anxiety and defensiveness symptoms and it is another thing for their brain to not be triggered. In other words, as opposed to most individuals where they feel emotions first, make interpretations of them and then have reactions, those suffering from PTSD, have a more automatic response chain. In fact due to their trauma, their thinking tells them that no reaction is quick enough. Therefore, the way they come across to others is over-reactive and confrontational more often than not.

How does it feel to be the partner or spouse to a PTSD Sufferer

Being a partner, spouse, coworker, neighbor, child etc. of someone with PTSD feels like being on the battle ground in a war zone at times. You are going about your day, you feel as though you are being a helpful, loving and supportive partner, but then without warning or precedence, all of a sudden, your partner transforms to The Hulk in front of your eyes. They go from docile and even keel to, hostile and an amped up turbulent ocean of waves that feels like it will swallow you whole. Their pitch, their eyes, their body language, their tone of voice and volume and even choice of words become accusing, mean, full of anger and disgust. It is very difficult to see them unravel in front of your very eyes, but it’s even more difficult to come to terms with the fact at that moment in time, when you are hurting, that you didn’t cause their reaction; but this is imperative. Similar to an alcoholic’s disease, PTSD is a real disorder and makes the individual suffering from it susceptible to environmental triggers. You can do the best you can, to get to know your partner, and create an environment in your home that is less stress prone, but of course there is no guarantees and sometimes a simple phone call can transform to a snowball effect of emotional turmoil.

The best thing that you can do however, is to neutralize your environment, including your loved ones reactions for your self. This does not mean at all to avoid, or to numb yourself, it mean learn to navigate the terrain though developing your own Emotional Intelligence.

How to respond to your partner’s triggered response

The reason PTSD is so unique in the psychiatric community is because, it is the only mental disorder with real flashbacks. Although Obsessive Compulsive Disorder has its roots on flashbacks as well, it is really a trauma that has given life to the Obsessions and the Compulsions of OCD. Therefore, it is commonly found that those with PTSD also may commonly also suffer from OCD.

It is also a very difficult mental disorder to cope with because unlike schizophrenia, the people, places and things that are troubling to the individual are not false or imagined. An individual suffering from PTSD is not having imagined hallucinations, or delusions, they are also not having anxiety over general situations. They are reliving real trauma(s) that have occurred and have left them scarred. What this means to a partner is that although from your point of view, what is happening seems like a very exaggerated in comparison to the situation at hand, your partner’s perception of what is actually happening is real to them. They don’ just have a fear, they have a fear that’s been supported in the past. Therefore, having been a victim to it before, their reaction is in support of the fact that they never want to be a victim of anything similar to it again. The reason I say this is because it is very common for a loved one, no matter how caring and supportive they are, to naturally want to “reason” with their partner. There is no logic; there is no true anti-venom that you can inject into the situation in the form of a rebuttal. It is only going to make the person feel angrier, more triggered and more different from you. Here are some steps I would recommend:

1. Acknowledge and validate their feelings (ex. “I am so sorry you are feeling this weight on you right now”, I love you and we are in this together”)
2. Depending on your partner’s level of anxiety at the time, and how triggered they are, and of course, how much experience you have together in the relationship, you may need to take a step back and detach with love by saying something like “I am going to give you some time to breathe, and relax, I have to go the bathroom for a couple minutes”. This step is there to make sure you are not alienating the person, or adding another layer of fear to theirs by signaling any sign of abandonment or rejection. But also, importantly you are protecting yourself. Whether they are yelling, or coming at you with rage, or saying hurtful things, you are the victim to it at that moment in time, and you need protection. You are setting boundaries and you need to.

Often times, there is a period prior to the attack that those suffering from PTSD experience, which I call “Surged Flashbacks”. I call it surged because a dormant flashback is always there buried in the mind of those suffering from PTSD, similar to a virus, which can be dormant without an actual outbreak or symptoms. A surged flashback means unlike other regular times, the flashback has somehow become flared and is no longer laying there like the sleeping Giant but rather, the giant has awakened and unless coerced otherwise, will start hunting.

3. If you pay attention as their partner you may get lucky to catch the dormant flashback period. During a flashback, people often feel a sense of disassociation, as if they’re detached from their own body. This is where your role becomes very important. Anything you can do to “ground” the giant will help them not have a full on episode or flashback. For example: you can say “sweeties, you are having a flashback and even though it feels real, it is not actually happening again.
4. Work with them to take account of their surroundings (for example, you can point out the dog, and what he is doing, or ask them to look around the room and describe out loud what they see while encouraging them to take deep, slow breaths. This is a mindfulness technique and I use this for many different areas of mental health coaching and conflict resolution within and outside of us. It is proven scientifically that hyperventilating will increase feelings of panic, while slow breathing is a natural relaxer.
5. Avoid getting loud just because they are loud, or sudden movements including body language or anything that might bring more fear in for them.
6. Some say touching a triggered PTSD sufferer during a flashback or full on episode is startling and therefore should always be avoided or that you should ask before you touch them. I disagree. Based on my years of experience, I have noticed an almost immediate “snap” of chain of events with startling actions (pun intended). I call this “the wasabi method”. None of us like pain or in this case a quick cool burn, but many of us love sushi and eat it with wasabi given the choice. For example, you can have your partner snap out of their flashback if they are not fearful of you at the time.   In other words, touching in a way that illicit fear is worst, but not all touching is the same. It’s a bit humorous (yes, humor is a medicine in and of itself) but if they are in bed laying deep in thoughts and flashbacks, you can jump on their body quick and be their blanket. Or if they are standing you can jump in their arms quick and let them hold you there briefly. On the other hand, your arms around the person might make them feel trapped, which can lead to greater agitation and even violence. This is a very step that takes a lot of finesse and Emotional intelligence as well as strong knowledge of your partners Love Languages. Talking of which the next step is a precursor.
7. During a time where the flashbacks are dormant and there is peace between you, together with your loved one, work on developing a guide on how you should respond when they have a nightmare, flashback, or panic attack. Having this in place will empower both of you to feel equipped and understood. And you will have a much higher rate of success in creating calm.

PTSD can lead to difficulties managing emotions and impulses. In your loved one, this may manifest as extreme irritability, moodiness, or explosions of rage, increasing the likelihood that they’ll overreact to day-to-day stressors. For many people with PTSD, especially at later stages in life post 30’s, anger is the go to emotion. It is important to realize that anger can be a cover for various other emotions such as grief, helplessness, or guilt. Although unconsciously, they choose anger because it makes them feel powerful, instead of guilt and sadness, which may to them feel weak and vulnerable.   On the other hand, although anger is a normal, healthy emotion when expressed in the right setting, when chronic, displaced, explosive anger spirals out of control, it can have serious consequences on relationships, mental and physical health, and long-term life satisfaction. You can help your partner get anger under control by exploring root issues, discovering expression of other emotions and learning healthier ways to express their feelings.

8. It is important to look out for physical and verbal signs that your loved one is angry, such as clenching jaw or fists, talking louder, or getting combative, argumentative, and confrontational or annoyed.
9. It is easy to feel attacked, accused, or abused even when you are subject to this volatility of emotions in your partner. But it is very important that you stop and take inventory of your emotions and use affirmations such as “I am not the cause for this and I can’t cure it”. This will take only a second, but that brief second is so crucial in your emotional health as well as the health of your relationship. Once you have done the check-in with yourself, you are ready to take steps to defuse the situation as soon as you see the initial warning signs. Defusing takes the form of doing steps 1-6 and using the planned notes you have developed together.
10. Remain Calm. Two emotional outbursts are never going to amount to a positive outcome. I always suggest using imagery to help you stay the course or remaining calm. One such imagery is the image of your loved one as a little boy or little girl. If it helps as a reminder to have a real photo around your home or office, great! Otherwise, your imagination of your loved one as a helpless child that just doesn’t know how else to express themselves other than a having a full on tantrum when they have a tummy ache is a powerful one. Be a good parent to your partner just for a few minutes; they need one at that moment in time. Be a source of wisdom, calmness and support. This will communicate to your loved one that you are “safe” . On the other hand, similar to a good parent, set boundaries. Don’t engage in arguments, and while you validate, safeguard yourself and your own sanity by using “I statements” and giving verbal and physical space to the person. Yes, they need you like a child at that time, but they are an developmentally an adult and unlike a child, they are stronger physically and can hurt you even if they don’t mean to. Put safety first.If the person gets more upset despite your attempts to calm him or her down, leave the house or lock yourself in a room. Call 911 if you fear that your loved one may hurt himself or others.
11. When it’s a bit calmer, ask your loved one, how you can help. For example say: “What can I do to help you right now?”
12. Seek emotional support. Join a support group, and constantly nurture that support by making time for it consciously. Some people are judgmental, some are directive and some are unempathetic. But there are good people, who understand and want to help. Privacy is an important factor in relationships because it is an extension of trust. But it also is dependent on the situation at hand. Your trust of others can only be based on faith and experience. Use both of those mechanisms to confide in the right person, and rather than advice, let them know you just want to talk and feel their love. Advice can only be fruitful if it’s coming from the right person. Leave the advice to the professionals, experienced or special support groups and seek emotional support.
13. Have fun and be a pal to yourself. Find and develop a working list of relieving activities just for you. Being a caretaker is hard in and of itself and taking care of a loved one with PTSD is a full-time job. Finding activities that help you get in touch with your spiritual self such as meditation, yoga, walks in nature, reading poetry by Rumi, delving into tranquil music and writing journals of gratitude. What you are doing is huge! Don’t undermine your efforts, don’t second guess yourself because your partner may act suspicious of you; you are amazing and remember: You are not alone!