Post Traumatic Stress Disorder (PTSD) is a well researched disorder that has been talked about in many contexts. With Military veterans I have found that there are an abundance of programs to support the treatment of PTSD whether through Veterans Affairs, Nonprofits, or other veteran service organizations. However, I found a vital flaw at times in where programs focus on the individual affected rather than also looking, in addition, at who this disorder is affecting around them. This can lead to making many positive changes through therapy that potentially can be erased in a matter of minutes because in some cases the person they were motivated by to make some of these changes for has decided to leave the relationship. 

In the military there are conversations about who you should be talking too. Oddly enough it is not who the civilian population would think! A person is not encouraged to go home to tell their spouse or their family about their day, struggles, or concerns. Instead they are encouraged to tell their brother- or sister-in-arms - their “battle buddy”- or even another veteran of a different branch, way before they are encouraged to tell a person they share a home with or sleep next to. Often times this is based in a belief that “I don’t want to traumatize them”, or “they just won’t get it”. Based on my experience these types of beliefs can hinder a person in their healing process.

Treatment plans should be discussed with a client in order for all involved to know “what am I doing here with my time?”. Whether its to lower my responses to “triggers” or to increase my self awareness, there just has to be steps towards “getting better”. An important question to consider is “who are my supports?” Often times this will include a romantic partner, but surprisingly in individual therapy the partner is often not made aware they are included unless the client tells them. Unfortunately, therapists are unable to reach out to make sure this person is aware they are considered a part of treatment without written consent from the client to do so. Thus it can easily be overlooked. This is where couples therapy can be supportive in addition or after to individual treatment. 

Couples therapy allows for a person diagnosed for PTSD to add some new tools to their toolbox. It is not there to push you to talk about the trauma you experienced. It is there to strengthen the relationship so it can feel safe to discuss how the trauma has effected behaviors observed today, allowing for the partner to step in because now they get the context. 

For example: 

My partner is putting together a birthday party. I see a stack of laundry folded on the couch, bags of party favors laying around, and a pack of birthday candles. My mind immediately is triggered and I have no idea how to explain this so I just get mad. I yell at how stupid this party is, a waste of time, and I walk out of the house. My partner is now left very confused, ticked off that I am the asshole, and is wondering what to do next. Now, lets rewind to break this down to my internal context. When I walked into the room the folded clothes set me off with the combination of the plastic bags which reminded me of a road I went down in Iraq. Plastic just flowed freely, and honestly an IED could have been under a stack of anything. Fires were a common thing to just be burning in places, and I told my partner I really would have preferred those number candles rather than the small bonfire on top of the cake that they seemed to be creating. The combination of those things sent me back to where my head is on a swivel, I am alert, and now my “danger Will Robinson” is going off in my head. I left like a bat out of hell, my partner is texting me WTF, and I am now ashamed of my behavior. But I may dig in because fuck it at this point they should just know better. None of this scenario is going to support my ultimate goal in which I am working on understanding my triggers in therapy, but my partner is not in therapy with me, so how are they supposed to know they can help that goal? 

Couples therapy allows for both sides to start being heard in the conversation. In the example above I am sure my partner had zero intention of combining those three things to set me off. In fact, since I most likely never told them the story of that road, they are blind to all factors and only know their own pain right now. Their own hurt that once again I blew up, yelled, and left them feeling they can do nothing right. With the use of therapy the partner can express what they feel. The internal “I” statements that occur and how helpless they feel in not knowing all they do not know. The partner with PTSD now has the opportunity to share triggers, and ask for a support to be in place. 

For Example:

Client and partner are in the session and the partner expresses how they always feel they can do nothing up to the clients standards. The client identified the standard is not what is important but actually they just really need routine. Together in session with the therapist they discover compromise, the client verbalizes the safety a routine creates, and the partner now understands the significance of that need is one that is more than just its outside appearance. It is greater than a routine; it is a means of safety for a person they love.

Couples counseling builds safety in vulnerability as a vital part of the treatment process; tearing down the negative emotions experienced within PTSD by growth through the positive emotions of being accepted. Couples therapy teaches communication skills and builds trust that we can be vulnerable and authentic because we see that our partner just wants to be able to support rather than sit on the sidelines. This ultimately improves the individual therapy because now we have an additional cheerleader in the path of trauma recovery. Learn more here on how bringing your support in closer can be the progress change you want to see in your PTSD treatment.