Caring for someone with PTSD can sometimes lead to secondary trauma.
And researchers at the University of Utah wondered just how bad that secondary trauma could be.
While completing her graduate studies, Catherine Caska Wallace, PhD and her research team studied two groups of male veterans, along with their female partners. In 32 couples, the veterans suffered from PTSD, and in the control group of 33 couples, PTSD wasn’t a factor.
The veterans in both groups had been deployed to Iraq or Afghanistan at least once in the past decade.
After the researchers interviewed the couples to measure PTSD, depression, marital satisfaction, and areas of disagreement, they asked the couples to undergo a brief experiment.
Researchers asked each couple to have a conversation about a current issue on which they strongly disagreed.
Before and after the conversation, researchers took physiological measurements from both partners, including blood pressure and heart rate.
Some of their findings probably weren’t surprising. Both veterans and partners in the PTSD group reported significantly higher emotional stress, measured through disaffection and disharmony. They also reported problems with frequent and intense emotional conflict.
But when they looked at the physiological measurements, researchers found something particularly interesting.
While the couples in the PTSD group showed elevated blood pressure during the conversation relative to controls, the partners of the veterans in particular showed the highest blood pressure – even compared to the veterans themselves.
It’s important to note that this study didn’t use random assignment when selecting its sample, so there’s a limit to how much we can generalize its results.
Although preliminary, this research suggests that PTSD can have far reaching and significant physiological impact even among people who don’t suffer from it.
Of course, the blood pressure finding stood alone in this study. I’d like to see more research that examines other physiological and mental factors with the partners of post-traumatic stress sufferers. If PTSD really carries significant health risks for the partners of veterans, more attention should be paid to them in future research.
If you’re interested in reading the full study, it was published in Health Psychology, Volume 33, Issue 11, pp. 1273 – 1280.
For more on working with trauma’s impact on clients, and their relationships, be sure to check out the Treating Trauma Master Series.
You’ll get insights from: Dan Siegel, MD; Pat Ogden, PhD; Allan Schore, PhD; and Ruth Lanius, MD, PhD.
Now we’d like to hear from you. What’s your experience in working with veterans, or their partners, who suffer from PTSD? Please leave a comment below.
As a spouse of a veteran with PTSD, it’s constant, sometimes surprising, sometimes it’s just the undertones of a conversation.
The gist is simply unknown. I will never do anything correctly in his eyes.
I didn’t work for over a decade as a stay at home mom. So, I will always owe him for all the bills I didn’t pay.
Regardless of his time away in action or rehabilitation, I’m wrong.
I didn’t amount to his standards. I didn’t do x, y, z…
I also didn’t abuse my children the way he did… pulling hair out from the roots, in instantaneous response to a feeling of rebellion. Our oldest son remembers both instances of abuse.
That will never change. Our youngest son only remembers mind games. Both are inappropriate and cannot be undone. Apologies will never undo the abuse; there will never be an apology.
As a full time student now, I’m reprimanded for ignoring his needs for attention. I’m too busy studying and making sure I’m not behind in my requirements for each class. This sometimes takes all my energy and time even on the weekends.
Date night gets postponed because of a quiz. He reacts with a typical blowout of emotions. Leaves for happy hour on his own. Pouts. Distance.
What’s the point, really. I’m not paying bills because I’m in school to get a better job than eventually will.
I supported his career until he was medically discharged. Then I supported his rehabilitation. Then I supported his schooling to get a better job afterwards.
Now that I am trying to better myself, he’s hostile.
This is PTSD. Abusive, constant judgments, and irrational what if’s as fact in his mind. It’s not fun.
I don’t want a divorce, just freedom. The stuff he fought for, he doesn’t allow in his own home.
Speak on this fact!
Maybe retaining veterans until they are safe to reside with is the next step in the future. For now, home is hell on earth.
Our sons will flee as soon as they are able.
Maybe I will too.
No one looks after us but us.
Not even the VA, I’m not a veteran, just the victim of one.
We have to remember, that when a man enters the military he does so by choice. He does not open his heart to the military though. A spouse has opened their heart to the military partner and thereby sustains damage from the person with PTSD on a level which does not occur for the soldier in the military. While the soldier may well be exposed to greater psychological trauma than the spouse in war, the spouse is exposed to greater damage to the heart and soul than the soldier/military personal.
It is very stressful on the non Vet partner since they wish to please their vet partner yet they do not know EXACTLY what they experienced first hand.so the unknown is always there and then they walk on egg shells–uncertainty births high wired relationship patterning.
Thank you this information is very useful in PTSD.
I want to tell the world that PTSD is a serious problem for family relationships. My father in law saw active duty in Korea with a comand position and he brought all of the trauma home with him and shared it liberally with his wife and kids. The Army was his career when he had a total nervous break down they sent him to their hospital in Colorado for treatment. Schock treatment to be exact. He still drank too much and was a total bully to his wife and kids but always had a job and went to church. I was just 19 when I got married I had no idea what was going on I thought drunks always lived on skid row. My husband became a professor and well known researcher in his field a very good provider but a poor excuse for a husband and father. As a husband he was selfish and demanding as a father he was not kind or encouraging he was very critical and demeaning to all of us and yelled and bullied just like his own dad. This home life was so totally different from the one I grew up in that I didn’t know what to do I thought for years that I was at fault. My husband had a nervous breakdown also and spent a month in a psychiatric hospital and the whole family had to go for counseling. I was in counseling for a couple of years and found it very helpful. He died of suicide in 2011 and after that I had 3 more years of counseling. I lived with the residual affect of my fathers in law PTSD for all of my married life! My life now is so much more enjoyable,peaceful, and quiet. I feel safe to come home and I don’t always want to leave! I do still have some guilt to resolve but I’m trying to deal with it. The past is over and I can’t change it.
Peace is priceless! I hope this isn’t the end to my story. I want my spouse to get better. Can’t make him though.
I have not worked with veterans, but have many couples with PTSD, not only in their partners but all relationships. I have one case where a male from India who comes from childhood unintentional and intentional trauma. A rare case due to cultural values, and approval seeking addiction. I wonder about PTSD, as there are signs of mass manipulation and narcissistic behaviour. The sad part is that this man ‘played God’ to gain the control he lost as a young child. He is a physician, married, two teens, and fear driven and soon to lose everything he has worked years. He left his wife in order to threaten her with power and privilege; she finally stood up and stopped enabling him, one of his children the son decided he can no longer play the alpha or parent to his father who was never there for him all his life. The is 21, and refuses to talk to his father and this along with court dates set to give the wife equal access to assets has driven this 50 year old to seek help as authority has brought his attention to facing reality. Last I saw him, his blaming others changed to humble words such as “I am numb, I am lost, and I want to move forward as he sought approval to his sponsor form Alanon. I struggle to find this man towards a soften heart and is driving himself to the ground. His wife has sought therapy and workshops and is waiting that one day he will accept his belief and return. He used divorce as the last threat to hope his wife would cave, but she did not and the divorce was granted before settlement. The day the divorce was granted he fell apart and was unable to work full time as a physician, and recently had to take two full weeks off while his business is under investigation for tax fraud, and other matters.
I suffer very greatly from PTSD, although it is not from combat. I am still suffering every day now, as the trauma is still actively occurring . My PTSD was caused by abuse, neglect, and assault. Secondary, my PTSD was made worse over the course of 3 years, where an inflammation response in my body gave me a level of pain that could kill a person at any moment from heart attack, shock, or stroke, and i was in fear of dying at every moment of every day. Sadly, i have a genetic condition that makes most pain relievers and anesthetics ineffective, so it made things worse.
I have so many feelings of inadequacy in my marriage because of it. I rarely feel that i am enough for him, even though he loves me so. My husband is absolutely amazing. He has such a kind and careful hand with me. He even knows the slight sounds i make when having a night terror. (I will be screaming in the dream, but barely make noises in real life) He has been totally fine when i have woken up mid dream and punched him straight in the face (one night, he actually grabbed my fist and said, “baby, is your hand ok? That was a big one”.) I feel that i make him sad, though, feeling bad for me. I hate that my condition hurts him. He often doesn’t understand my current state of mind. For example, he has friends that are very condescending to me bc we have a 13 years age difference (we dont visit them often) that he grew up with. When we do visit them, he often reports later that i seem “drunk”, without alcohol. I wonder of why being in such a stressful situation can make me seem intoxicated. I understand how panic could happen, or over emotion in a negative way, but i wonder how the situation can make me “drunk” without substance influence, sometimes belligerent, louder than i should be, giving everyone a major hard time. I also tend to have memory black outs of these times. The only time i have ever had memory black outs in the past was when i was put on antidepressants for anxiety, (which always made things worse). I feel that the part of my brain that has blocked out some of the traumatic events in my life (I know there are things i cannot access in my memory, bc i have unexplained irrational fears), activates when i am around people who hurt me, so i also don’t have access to the new memories. The worst part of the problems between my husband and i, is that we have issues with being able to have sex. When we do have sex, it is AMAZING. Like we are truly made for one another. It is soul quenching. Both of us seem to be so afraid of initiating it, tho. I wish i could find a way to bring back the intimacy, fearless.
i find it interesting that the people living with someone with ptsd are as affected. could be that part of military training is a survival coping strategy that is ingrained and works well to survive combat, but once home…thing is…the symptoms if seen as the body and mind attempting to heal…integrate…and we stopped seeing and judging so much…we normalized the rawness of the symptoms as healing work…maybe they would have a different social reaction. but combat is not a civilian experience. not saying trauma experienced in childhood or what have you is not bad…but how does military culture make it worse? and different deployments have some differences in experience…for some. i would love to see that the process is…explained better. and frankly…people close to someone who is healing…need their own supports. kids need outlets to be kids. caregivers need space to attend to their needs. what worked to get through deployment is actually not helpful…its knowing that the symptoms are normal…as it takes the brain and the hormones time to adjust….like the jumping out of your skin over little things…well…the sensitivity reaction thing…needs time to reset. and more peer to peer with training support. it’s hard to watch people not cope well and feel alone. i just see it as needing time…and patience….and some cases…maybe different work for a while…
I will say that when i have been my worst, my children were so sensitive to it. I felt like a failure of a mother, yet my 5 year old will pick up on it, & he will stop what he is doing and just come and hug me and tell me he loves me. My 12 year old wrote his “My Hero” final exam last year on ME. I still weep about that one.
I know that i was not in combat, but i saw so many people killed and had nightmares of it, while a small child in north GA, when the KKK decided to “cleanse” our area. I just want to say that as survivors, it doesn’t make us strong. It doesnt make us able to handle things better. It, at worst, makes us afraid, stone-locked, unable. At best, we are alienated from the rest of the world. It is so difficult to be able to relate to a single person on any situation. Feeling a million miles away and alone when there are a hundred people around. But we do have some strengths that no one else has. We can snap into action any time there is an emergency, like it is a reflex. We can separate ourselves from the emergency enough to get everything needed done, and sometimes even enough to instruct others. We can counsel those that still have their own trauma raw, bc we can have a balance of true, full empathy, yet be able to separate ourselves from the situation, in order to prevent it from damaging us further. This is an imperative and unique trait that will not only allow us to heal others, but gives us the ONLY way that we can heal ourselves- works of service.
Thank you for bringing the importance of how PTSD can affect not only the one affected but their loved ones. This information can really help me to understand and know how to help my clients who are stuck in this circumstance unknowingly and affected by it.
The most important thing for them to remember, is that between the 2 of them, there is no fault.
Thanks for sharing this.
I experienced some secondary PTSD during a marriage to someone who had a heavily traumatized childhood, within a family environment of mental illness, and then seemed to have a nose for injustice, so that through his line of work, he landed in a position of receiving client considerable conflict around his work. His previous marriage had dissolved under the conflict. His nuclear family, mother especially ( as his siblings had done lots of work on themselves) was still highly dysfunctional. It took me years to recover from my guilt and grief at leaving him and his daughters, and to process with my therapists the situation surrounding it. Happy to say, now as adults, I am in touch with his kids. It also highlighted for me that I had not completed the work I needed to do from my own childhood experience, both a smaller amount of family violence and an incident of sexual abuse. I think I was drawn
Into that marriage partly because of my own pain. Still I hope he has since then found some kind of healing. He wasn’t about to trust any therapists then.
Good morning , could not find your reference; If you’re interested in reading the full study, it was published in Health Psychology, Volume 33, Issue 11, pp. 1273 – 1280. any help would be appreciated
Everything I read about circumstances in the United States: you, the Guardian, Lionet Shriver, Naomi Klein, all of it, suggests that the whole nation is full of ex-army people in terrible states of mind; and here you poiunt out how that’s affecting other people with whom they are in contact. It seems as if everybody rushes round in high states of anxiety, shooting at each other with formidable weapons of war.
For a long time, since the break-up of Yugoslavia, I’ve thought that, because of PTSD, (there was a clip of film of a young boy attacking a tree as if to kill), each war generates the next one.
I am wondering what we as therapists can do to cut down on warfare at all. I regard thinking of a group of people as “the enemy” is a primitive sort of thinking , likely to lead to regarding the other as not really human and available for subjection to atrocities.
Very interesting study. I’d like to see studies of this kind of couples where one of them has a generalized anxiety disorder, OCD, or ADHD, or others with significant aggressive behavior. I’m saying this as it reaffirms my own experience with my ex partner. I can relate to the reactions of the wives in the study personally. Although my ex partner didn’t go to war, I believe his behavior was unpredictable, controlling and aggressive with me, and I can remember that it affected me physically or physiologically. It would be wonderful to see research on this.
I’d like to thank Dr. David Ward for standing up for nurses who are “there” for patients in both inpatient and outpatient settings. I am a retired nurse psychotherapist who has worked in many different settings. I believe strongly in the power of psychotherapy and the therapist/patient relationship. I also believe we need to use all the tools available, and at times, meds can be used as a tool to relieve suffering and facilitate the healing process.
So far, I have not heard anything about the coexistence of a major mental illness with the history of trauma or of the impact of substance abuse disorders and the need to address these coexisting conditions.
I wonder how a husband of a wife with PTSD would do in such a study. Although I am not a veteran, I lived for decades with PTSD. Some years ago I came across a therapist who is an expert in treating clients with severe trauma. Today I am doing much better. Recently an acquaintance talked to me about seeking treatment for her PTSD. Although I didn’t mentioned it to her, I wondered how her husband would be affected. As for the military, it should be interesting to study the reverse since more women are active in combat.
On Tuesdays, my Black Lab “Sam” and I visit the veterans at Perry Point Veterans Medical Center in Perry Point, MD. We visit one inpatient building of mostly Vietnam vets, and we visit another inpatient building of mostly vets who served in Middle Eastern deployments. We also visit vets who have been discharged from inpatient status and who now continue treatment as outpatients. Virtually to a person, whether inpatient or outpatient, the veterans are able to make a connection with “Sam.” Even on a bad day, most of them want to be with “Sam.” Just petting his big, kind head and talking to him visibly soothes them. Many of the veterans watch for us on Tuesdays. I have many examples of the wonderful work “Sam” does at Perry Point. In 2017, “Sam” and I were the humble recipients of Perry Point’s Volunteer of the Year Award and a Presidential Voluntary Service Award. It is our privilege to share out time with those who have given so much.
With regards to Dr. Lanius.
Dr. In you statement re med,s. you are giving nurses a slap here.
Stating the first thing the nurse does is run for med,s. this implies that there is a panicked professional, running for med,s.
I have had nurses work with me in a hospital setting, never have I seen a nurse rush to get med,s.
Disappointed.
Dr.David Ward.
Thank you, Dr. Ward, for standing up for nurses who are “there” for patients in so many ways in both inpatient and outpatient settings. I am a retired nurse psychotherapist with the emphasis on psychotherapy. However, I believe that meds can be part of a holistic approach to healing when used as a tool rather than the primary treatment. Unfortunately, there is no one guaranteed approach to treating trauma, and I believe we have to use all the tools we have available, keeping in mind that different people respond to different approaches.
There seems to also be a strong correlation with mental illness for children of Veterans or parents who have experienced PTSD. Even as adult children the effects linger with poor self esteem, inability to cope. Poor life skills, attachment disorders and social anxiety.
Certainly true Pepi. As the daughter of a WWII vet with PTSD I have first hand experience of second generational trauma, manifesting as a sense of separation/anxiety/depression, that probably could have been diagnosable from early childhood. I did all I could myself as a young adult mainly through Yoga, never found a counsellor who was of help. Yoga was wonderful and is still my foundation. But I have only really started to feel in control of life since using EFT Tapping in more recent years. I’m now a certified Clinical EFT practitioner– it’s amazingly effective and safe for many psychological problems, including PTSD in war vets.
I was the spouse and carer for 16 years to my ex husband and my children’s father. He is a Veteran with PTSD.
My children’s early life was like living in a battlefield. Fear of making a noise incase their father flew into a rage.
Being the receiver of daily abuse and threats has taken its toll on us all. After leaving the marriage, I completely broke down, the fear of retaliation for leaving the marriage was with me 24 hours a day. I was diagnosed with complex PTSD. I have successfully recovered through EMDR, it saved my life. I learned of EMDR through watching and reading Bessel van der Kolk.
My 20yo daughter suffers from OCD, is an over achiever and lives her life being fearful of doing the wrong thing and letting people down. She is still scared of her father. My 16yo son has debilitating anxiety, depression and suicidality. He cannot attend school and has to study via distant education. He is booked in to begin EMDR next month.
The effects of Military PTSD on the spouse and children I can say are severe. I don’t know if my children will ever recover from the trauma trapped in their bodies. Both of them have been in therapy for years now.
There is very little support for the broken family left to pick up the pieces.
I do hope there is more research into these types of studies. Whilst there is a war to be fought…that war will come home within the soldier to play out in a different battleground.
Hi Leanne
I’m saddened and sorry to hear of your experience, it sounds like it’s had a devasting impact on yourself and your children.
I have found on my journey in healing my own CPTSD that Somatic Experiencing by Peter Levine has been amazing for healing the trauma trapped in the body. So much so, that I have started the S.E. training to be able to use it with my clients.
I wish you and your children all the best in your recoveries.
The experience of veterans and their families hold important lessons across the wide range of human struggles. I am grateful to read all the comments and the insights across a full range of discussion. I am encouraged by the teachings presented in this course.
I think it is terribly important for the vets to understand that while they were away their partners were also living a life, waiting, without the partners imput to their lives so that each were in the process of changing and adjusting and growing in experiences and possibly don’t know each other very well when reconnecting. We can give them a place to learn about each other in a safe place with our questions and comments. It gives an opportunity to become a team with a common goal of rediscovering each other and looking at what future they both can work toward. It doesn’t do well to focus all energy on the PTSD partner…there is a lot of education that needs to happen on both sides, emotional and cognitive.
Again, when we speak of measuring the effects of trauma, it behooves us to track the pregnant Mom and her Baby as much, if not more than War Veterans. Perhaps there would be less war if we changed our focus.
Definitely a good idea to work with everyone in the family. Epigenetic effects of trauma can be transmitted to children through the genes of a parent with PTSD too.
If it were more acceptable for our troops to admit to this psychological consequence and not be treated as a mental disorder a different message would be sent and our former combat veterans treated with respect which they deserve. The suffering of their partners needs to be recognized so we don’t generate secondary fallout and give the accolades to all family members who take part in our ugly wars.
Yes Barbara Melamed.
This is layers on layers of victim blaming.
Is it the fault of the veteran suffering PTSD? Or should we place focus where it belongs – on recognising that war has devastating consequences on both military and civilians and their trauma needs supporting and healing?
Let’s not blame the people suffering. Let’s look at stopping humans from traumatizing each other in the first place.