What is PTSD? Who is at risk for PTSD? Why and how does PTSD impact relationships?
In North America, about 75% of the population will, at some point in their lives, be exposed to a traumatic event – some examples would include a motor vehicle accident, witnessing violence, a natural disaster, assault or military combat. Just shy of about 10% of people who are exposed to a traumatic event will be diagnosed with PostTraumatic Stress disorder, and many more will have symptoms.
Folks who are often exposed to these types of events because of their jobs (consider people who work as first responders, police, firefighters, paramedics and military personnel, for example) are at a higher risk simply because of the number of exposures that they will have over time. It is normal to experience a range of emotions and reactions after experiencing a trauma, but most people move through those initial symptoms over time.
PTSD, the abbreviation for Post-Traumatic Stress Disorder, occurs when someone experiences or witnesses a traumatic event and then gets “stuck” in their ability to process that event. The DSM-5 identifies the symptoms of PTSD, and a person could be diagnosed if they had a specific set of those symptoms over time.
Symptoms of PTSD can be categorized into similar groups – re-experiencing, hyperarousal, avoidance and emotional numbing. Symptoms in these groups show up for us as individual symptoms, and then also show up as relationship based issues. We could think about nightmares – they show up as an individual symptom, and then show up again as a relationship symptom when you’re sleeping in separate rooms because of nightmares or sleep disturbances. An avoidance symptom might look like a person avoiding going to certain places, and then shows up in the relationship because the partner feels limited or misses out on things you did together previously. or shutting down and feeling disconnected from your partner. Of course, the list is long and varies from person to person.
The research also reminds us that many traumatic experiences that lead to PTSD involve others – that is, they are often human induced (for example physical aggression, motor vehicle accidents) or they are experienced alongside others (military combat, natural disasters). Since the events often occur in an interpersonal context, it is important to take into account how important post-trauma social support can be for recovery. Through CBCT for PTSD, we can rebuild meaningful connections and move forward through the trauma in a way that fits with how we want our relationships to look as we move to a future less impacted by PTSD.
How do I know if this therapy will fit for me and my partner? What makes CBCT for PTSD different from other couples or marriage therapies and from other PTSD treatments?
This therapy is specific to people in a relationship impacted by PTSD, so the existence of PTSD is the primary piece of the puzzle.
Sometimes, seeking individual therapy for PTSD can feel out of reach, so this therapy might be right for you if you’re looking for support to enter treatment for PTSD. You can use your partnership to help get through a PTSD treatment that might feel too difficult to tackle alone, and you also have an opportunity to address relationship issues that so often go along with a PTSD diagnosis. This therapy could be right for you and your partner if one or both of you have been diagnosed with PTSD and are committed to working through it together.
Both people should be committed to attending the therapy sessions with the intention of seeing whether the relationship can be improved. Couples come to therapy with a range of relationship satisfaction, but generally, there tends to be a sense that something in the relationship could “get better” if and when the PTSD is addressed. Sometimes a partner may feel at a loss when it comes to helping their partner, or they may (with the best of intentions) be helping prolong symptoms with caring behavior. Sometimes the partner with PTSD is trying to protect their partner by either keeping them at arm’s length, and shutting down – and sometimes being so concerned about safety that they avoid or control many facets of their lives.
There are some cases in which we would not recommend this therapy – couples with ongoing infidelity, a substance abuse diagnosis, active psychosis, imminent suicidality or homicidality or severe relationship aggression would not be appropriate cases for this therapy and we would suggest addressing those issues before coming to Cognitive Behavioral Conjoint Therapy. If you’re unsure, you can always contact our Intake via our website, and we can point you in a direction that would be helpful.
How do my partner and I get started with this therapy? How can I get help?
References
Liebman, R. E., Whitfield, K. M., Sijercic, I., Ennis, N., & Monson, C. M. (2020). Harnessing the healing power of relationships in trauma recovery: A systematic review of cognitive-behavioral conjoint therapy for PTSD. Current Treatment Options in Psychiatry, 7(3), 203-220.
Monson, Candice M., and Steffany J. Fredman. Cognitive-Behavioral Conjoint Therapy for PTSD: Harnessing the Healing Power of Relationships. Guilford Press, 2012.
Pukay-Martin, N. D., Fredman, S. J., Martin, C. E., Le, Y., Haney, A., Sullivan, C., Monson, C. M., & Chard, K. M. (2021). Effectiveness of cognitive-behavioral conjoint therapy for posttraumatic stress disorder (PTSD) in a U.S. Veterans Affairs PTSD clinic. Journal of Traumatic Stress, 35(2), 644-658.
About The Author
Jennifer MacDonald B.A., BED., M.Ed., CCC, RCT-C, is one of the registered counselling therapists of the East Coast Psychotherapy & Trauma Clinic. In her 10+ years of experience as a counsellor, she has supported individuals, couples, veterans, and families through all sorts of challenges.
