When a soldier comes home from war, the return to civilian life can be extremely challenging. It can feel easier to share openly and deeply with fellow soldiers who know the same battlefield experience than with a spouse.
Now during the COVID-19 pandemic, hospitals in hard-hit areas have been compared to warzones. And for some frontliners, it can be hard to go home and connect meaningfully with family after such intense shifts at work.
In the video below, Ruth Lanius, MD, PhD will explain how she would help a client reconnect with their partner, even when they aren’t able to talk about distressing experiences from their job.
Have a listen.
Dr. Lanius: I think we often see certain individuals like soldiers or, I think this is very relevant for the COVID-19 pandemic as well, that they feel almost closer to their buddies who are frontline healthcare workers or soldiers than to their own partner. I think that’s very understandable because as a frontline healthcare worker or as a fellow soldier, these individuals really know what the other person has experienced and so it’s so much easier for them to exchange deep feelings and difficulties with their comrades from work. So often that leads to a lot of tension in their intimate relationships because they can’t share those same deep feelings and experiences because their partner, who hasn’t been part of this work, doesn’t fully understand and they haven’t been there. Often, the partners then complain that the individual has a much closer support network with their fellow soldiers or their fellow frontline healthcare workers and often that can lead to the deterioration of this relationship. I think, as therapists, we have to normalize that for the couple and say, “You know that’s completely normal that you share different experiences with the individual than the individual does with their co-workers, but that doesn’t make the relationship any less meaningful,” to really help them understand how their relationship is still incredibly important and that it’s okay to have two close relationships. In one, you share those deep feelings and deep connections around the work and in the other relationship, you share other deep feelings.
Dr. Buczynski: I would think there’s a way in which that would really be hurtful if it continues to the intimate relationship – not the idea of having two relationships that you’re close to – but the idea that, “I can only share or only feel connected when I’m with the people who went through what I went through. How do you help build back that intimacy with civilians?”
Dr. Lanius: So how do you overcome the difficulty that individuals often face in their intimate relationship if they can’t share those distressing and deep feelings they’ve had at work? I think, again, that’s a process, but I think it’s very doable in many cases. I think it’s working with both partners and really finding out what’s preventing the partner who’s been to the front lines of COVID or the front lines of war, what’s making them anxious to share some of their really distressing feelings with their partner? The person who was at the front line of COVID may say, “Oh it’s so disturbing, I’m afraid that this would really push you over the edge if I talked about this.” And the partner may say, “Well actually no, it wouldn’t push me over the edge. I’d rather hear from you about distressing things than you shut down, detach from me, and leave me out of that part of your life.” Then we can work with the couple and say, “Okay how can you communicate these distressing feelings and both feel safe with that and what pace do we need to go at for you guys to feel safe with that?” Maybe also feeling different forms of connection, and I worked with a couple the other day that were really detached from each other, and they couldn’t communicate in words and so I said to them, “What would it be like if both of you were just to hold your hands?” They were startled at first and it was amazing to see actually once they started to hold each other’s hands, after about five minutes of saying nothing, all of a sudden through that physical connection, words came online and they were able to start communicating with each other and telling each other what had been bothering them and what they needed and how meaningful the relationship actually was to them. So that really taught me, yes, we start with words but also using physical touch between the two partners can be incredibly important to bring words online.
What are your takeaways from this video? Please take a moment now to share in the comments below.
If you found this helpful, here are a few more resources you might be interested in:
COVID-19 Frontliners and Moral Injury
What Can Help COVID-19 Frontliners Who Are Exhausted and Overwhelmed?
When the COVID-19 Pandemic Leaves Us Feeling Helpless
OK….
I shall try to be as soft as possible while expressing my feelings of
being like insulted on any level, as a person, as a student of your course and as a psychotherapist working on my MA in psychotherapy.
If I understood correctly, Ruth Lanius was ask to explain why military personnel after coming back from war zone and Covid 19 front line workers, have one thing in common, which is difficulty opening up to their families, partners about the painful experiences they had, emotions left lingering inside…?
I did not hear single useful thing including holding hands!!!!
Why we have this phenomenon? What do they have in common? How do you approach first a person suffering from PTSD and then as a couple?
Sorry but not a happy student
Katarina Kildare
Thank you, But what about someone who lives alone and is going through this , I’m one of them I work with traumatizes children and with everything being shut down , now I’m not okay and don’t know where to start, no one understands
Hi,
I think this is a great topic for supervision.
Rather than what the clients think and feel or couples think and feel. What about what we feel?
I think it is important for the clinician to express what they have thought and felt during this difficult time as well.
For me…
I have been working flat out during covid isolation with out- patient mental health groups which were still conducted live in a very big room with chairs spaced a long way apart.
I think with doing my normal and somewhat increased work load with the added stress of working with people in group who are in the outside world coming into a hospital, getting their temperature taken and me getting my temperature taken as well. There is always in the back of my mind “am I safe ” with these people and are they safe with me?
The other part of my practice with individuals and couples and training as the trainer has gone online and Ive had to learn new technology, work from home which has also been stressful and an adjustment. I really had no choice in that however now things are opening back up in Australia and I have a choice of how and when I go back that is stressful having to make those decisions and putting me first in those decisions is also quite stressful and there are no guidelines because we’ve never had to do this before.
I have also found it quite stressful being an essential worker and working during this period that I have some “isolation envy”. I have not had any down time or any isolation.
As both Ruths have said its hard to explain that to others what that has been like except to others that have been doing the same thing and are going through the same thing still.
Karen, I am with you on the isolation envy!!!
Kris from Sydney
Being on both sides, a psychologist who worked the front lines in inpatient mental health and now a psychologist who works with uniformed and non-uniformed first responders in a private clinic, I agree that it is often hard to explain all the politics and subtle nuances that contribute to sanctuary trauma in addition to ptsd to someone who hasnt worked within big organizations. But opening up bit by bit to a partner strengthens that intimate social support.
Thanks for this aspect . I also experienced and heard about the same difficulty with people who had spent time in concentration camps in the third reich. These people need somebody to listen to who knows about the depth of the excrudiatung pain they have gone through. They got in touch with existencial aspects of life that very few people can resonate with. Thank you for poinnting this phenomenon out, with warm regards Maria from Germany, war child and therapist
Just as an analogy was made to soldiers in war who have difficulty relating their experiences to frontline personnel in the hospital setting, anyone who has undergone a traumatic experience and is suffering the fallout may have difficulty communicating their experience to those who have not undergone the same. I think Dr. Lanius made a “freudian slip” when she said “meaningless” instead of “meaningful”…in that, the affected person can feel their experience will be meaningless to their partner if they have not actually undergone the same emotions.
I noticed that slip, too. As a person suffering from Complex Trauma, that is my experience, exactly. Even when I say the words about what happened to me and how it affected/affects me, the other person often cannot join me there. They simply cannot understand or related to my experience and reactions.
I’ve been a professional counselor for over 22 years, and I must say that helping people suffering from PTSD is extremely hard.
It doesn’t matter if the trauma was caused by going to war, a terrorist attack like September 11, the tragic loss of a teenage son or daughter by suicide, devastation by natural disasters such as hurricane, tornadoes,etc. The psychological trauma is severe. Now we are facing the aftereffects of a global pandemic due to the coronavirus COVID-19, and many health care providers it is the first time they are at the frontlines facing this invisible threat to human kind. They are afraid of the unknown, they are frustrated, in some cases hopeless. They are being asked to care for sick people without the right tools and equipment. Some of feel like they are going to war without weapons. They putting their own lives at risk of death.
I strongly suggest that clinics and hospitals provide respite care for the healthcare providers on site.
They could assign a room for them to meet and process their fears and feelings.
These groups should be lead by mental health providers with experience on dealing with Trauma and PTSD
Olga Harris, MA, MAMFC, LPC
I have been working primarily with people that have various forms of dementia and their families and also Covid frontline workers. I also work with clients that have lost a child to traffic violence. Thank you for this timely subject. For me, this brings to mind the trauma in the family system and couple after the death of a child. Men and women grieve differently and are reluctant to share feelings pain and guilt with each other. It is easier to speak with other friends in similar situations than with your own family that doesn’t understand.
Thank you. I’m working with many frontline medical people in my practice. I saw from the beginning the immediate effect on them and their families.
I agree it’s key to truly be present and listen, discuss at pace that fits, and look at all other factors that are influencing the individual and couple.
I wrote a brief piece about this early on when it hit NY. See below:
??True Listening for the Pandemic Time & Forever??
By Dr. Denise Morett
I’m a doctor of psychology, author and professor with a 30 year career. I’ve always been struck by how difficult it can be to truly listen and give attention to ourselves and others. I was recently asked how to deal with the pandemic and added challenges in relationships and communication, specifically for people working on the frontlines. Unusual and unimaginable challenges have created circumstances ripe for relearning and new learning.
We find astounding levels of benefit to our physical and emotional health from just paying attention. It’s simple yet seems so hard to do. Especially when stressed.
True attention to ourselves and others is one of the most loving actions we can do now and always. Listening offers the most powerful message of being seen, valued, understood and loved. We can truly hold someone and ourselves. Even in physical distance, we can feel energetically held. Our cells respond in similar ways to being physically held as they respond to being energetically held. Being present for one another and ourselves is often the only thing we can do that makes a difference. This is especially true at times of stress, trauma, tragedy, loss, and death.
Here’s a tool to help remind us of what works:
?? “L-I-S-T-E-N” ??
?L- LOVE is all that matters. True attention is the most loving and healing thing we can offer someone. We can also offer this to ourselves.
“I hold space for you because I love you. I see you. I understand. I value your experience. I’m present for your experience. The simple day to day experiences as well as the adversity faced during highly stressful experiences. I’m especially present for the huge moments of devastating experiences, trauma and tragedy.”
Be present especially when you or your loved one is in an acute crisis. Acute grief. And always. If you can’t listen and be present, say that you’ll be able to perhaps later, but that in this moment you’re having a hard time. See if someone else can step in.
?I- INTERNAL check up for the the speaker. They are in their own reflection and expression. What is happening for that person in that moment. Not you.
No solving, dismissing or explaining anything. Just hear it all. Receive it. Warmly. No judging.
?S- SILENCE. Refrain from speaking. Nod in acknowledging. Eye contact. “Uh huhs”. “I hear you” “I’m sorry” or other neutral brief comments that let the person know you’re totally present. Do not check your phone, look away or get distracted with something else. And if you briefly do get distracted, say that “hang on one moment I have to read this text” “sorry, my attention was off you for a moment”.
?T- TENDER ATTENTION. “I’m sorry it’s hard” “I’m here for you” “It’s challenging. I hear your struggle. I’m listening” “I care” “I love you”.
?E- EMPATHY. I hear you. Get it exactly right. Don’t interpret or try to solve the issues. Empathy is like holding up a mirror. I see this and hear that. Empathy is as if you were in the other person’s shoes. Reflect only.
“I see you’re upset”
“I hear you’re in pain”
?N- NON REACTIVITY and NON ATTACHMENT. Have zero attachment to what you’re hearing. Neutrality. If something upsets the listener, that’s ok, but keep it to yourself for the moment. Your loved one is in pain. Give them a wide berth. Maybe they’re short with you or even acting worse. It’s their pain. You can discuss your reaction another time. Not now.
This is also not your moment to offer solutions or talk about yourself or your reactions.
You want to simply communicate that you completely hear the other person. And not by relating your own story. Not yet. Wait. There will be a time for sharing.
Then when the person is ready, and you get permission, you can perhaps share some helpful ideas or your experiences. But not until the other person is ready.
“I hear how hard this is right now. I’m here and listening. Would you like any other suggestions right now? Would it help if I share my experiences too?”
?????Listening is loving. Offer that to others. Offer it to yourself. Seek others who can follow these guidelines. Truly a gift to be able to speak to ears that can hear. May we all be at peace and be well. ?????
So well said. As a survivor of Complex Trauma this is exactly what I need. And it is VERY rare. Even with therapists so often they are explaining and reacting, not listening. It is a rare therapist who does not make me feel “wrong” due to my trauma reactions.
Thank you!
I’m so glad it was helpful and appreciate you comment.
I’ve been working with similar issues, particularly with former soldiers and their families in the Balkans since 1995. It is very much what you say. Most people with whom we have worked do not even communicate with one another. The key, in my view, is to open up the communication. Also, the children should be involved. When we’ve had family meetings, the children have said something like “we don’t know who Papa is”.Frequently, there is a great deal of frustration and even family violence. These also are dialogues that need to be opened in virtually all families that have undergone traumatization.This includes migrants, who have experienced trauma in their home regions, underway, and in the regions of integration. It is a very important topic.
This is very powerful. I am one of those Frontline healthcare workers, and function in the role as a clinical chaplain. I’ve been providing staff support within MICU, which is the dedicated COVID-19 Unit. Thank you, Ruth, for sharing this priceless piece!
Thanks for sharing this insightful videos about the struggles war veterans and Covid frontline workers have to connect with their partners.
Brings to mind the idea of office wife/husband. People often find someone in the place where they spend a quarter of their lives to be close with. The front line element introduces trauma to this phenomenon that is likely to take some recovery therapy for the front-liner to adapt to “normal” life again.
This is again a wonderful video clip raising important pertinent current issues we might encounter following Covid 19 pandemic also relevant to many issues around intimacy, sharing experiences, sense of isolation which comes up in therapy for clients and Therapists. Such a clear reflection of that aspect. Thank you for your continuing offerings of personal and professional development.