The Forgotten Victims: significant others trying to cope with a partner’s PTSD

Almost forty years later, many veterans are still dealing with the aftermath of the Vietnam War in the form of PTSD, or post-traumatic stress disorder.  In fact, over a quarter of a million Vietnam Veterans have in one form or another (Handwerk, 2015). For their significant others, the caregiver burden is at times overwhelming.  It is the atrocity of war that simply won’t go away.  These caregivers are the forgotten victims.ptsd1

When living with a traumatized veteran, it is often the spouse or significant other that must pick up the yoke in managing the household.  Coping with the emotional outbursts, nightmares, negativity and lack of intimacy of their PTSD afflicted partner takes its toll.  A number of studies revealed that veteran’s PTSD symptoms negatively impact family relationships (Calhoun et al, 2002).  So much so that these negative relationships actually inversely impact and sometimes exacerbate the PTSD.

As therapists explain, therapy, in order for a PTSD affected person to improve, is two-pronged;  establishment of close relationships and the ability to spend time with those also involved in the same type of combat, for example at VFWs or squadron reunions.  When one of these two processes is broken, many times the PTSD only worsens producing compromised relationships, family violence, divorce, sexual problems, aggression, depression, and increased caregiver burden (Mikulincer et al, (1995).

Impaired relationship functioning produces a high rate of separation and divorce in these veterans. In fact, about 38% of Vietnam veteran marriages failed within six months of the veteran’s return from Southeast Asia. Rates of divorce for veterans with PTSD were two times greater than for those veterans without the disorder.  Those with PTSD were three times as likely to divorce two or three times. (Kulka et al, 1990).ptsd2

Many of the impaired relationship aspects involve communication and intimacy. The PTSD veteran simply can’t relate to everyday living. A sense of anxiety exists around intimacy which can lead to sexual dysfunction and decreased couple satisfaction and adjustment.  They simply feel they don’t know each other anymore.

The severity of the veteran’s PTSD symptoms correlated with the severity of physical and verbal aggression family outbursts. One study reported that 92% of veterans with PTSD had committed at least one act of verbal aggression against their partner.  In the same study 42% admitted to at least one act of physical violence.

Because of this data, Veterans Affairs PTSD programs and Vet Centers are now offering groups, couples, and individual programs for families of veterans with PTSD.  This is a huge relief for caregivers and partners who were shell shocked themselves at the behaviors coming from loved ones that just don’t make sense.ptsdvets-with-ptsd

Joy Lathrop, the wife of a USMC pilot who served in Vietnam described guilt and frustration in her inability to manage the outbursts.  Ten years into their marriage, which was a second for both of them, the nightmares began in her spouse.  Then followed his tears and inability to control his emotions.  Friends and family at gatherings complained about the repetitive stories of Vietnam.  Her teenage daughter was embarrassed and began to spend time away from home with friends.  Neighbors complained about his erratic behavior. There were times when she herself thought she was going crazy dealing with it all.

But Joy was determined to not become another divorce statistic. She scoured the library for books and research.  She educated herself about the disorder and how best to overcome its manifestations, which is key to caregiver survival (Johnson, 2002). She sought out couples therapy and support groups. But mostly she tried to remind herself every day that the man she married was still in there.  In her heart, she knew he was still her husband.  It was the PTSD that was to blame.  The verbal assaults and then his own guilt over it was what made him seem so distant and aloof.

Joy, like the others in the studies did what she could to maintain a sense of normalcy with household up-keep, family relationships, and general day to day life.  She found tasks for him to be involved in that capitalized on his strengths, like small projects and planning historical travel.  She was patient with his hours at the typewriter, excising his demons through verse.  She attempted these strategies with little or no expectation for their outcome.  Thus, when something worked, it felt like a success.  She also took time to care for herself to renew her own spirit and will to continue.

Her husband’s book of poems, THE DARK SIDE HEAVEN, recently published by AgeView Press, was the source for him expressing the conflicting emotions of carrying out the missions required during Vietnam.  He found writing so therapeutic that he also penned a memoir, ETERNALLY AT WAR which is due to be published in 2016. In addition, he completed an oral interview with Texas Tech University Vietnam Center and Archive which allowed him to relate his journey.TDSH ecover

Theirs was a success story.  But as the research shows, many others are not. The most important message for families living with a traumatized victim is that they are not alone.  These emotional struggles, although difficult and painful are normal (Price and Stevens, 2010).  Social media now abounds with free support groups.  Just like in the veterans, talking about it helps.  Seeking out support, education, and therapy will help improve family relationships and overall mental health.

“We owe it to the Vietnam generation, it’s an amazing sacrifice that they made,” says Dr. Charles Marmar, Director of The Steven & Alexandra Cohen Veterans Center at the NYU Langone Medical Center. “But it’s also the path ahead for the Iraq and Afghanistan generation, and we have to do better than we did for Vietnam.”

There are several excellent resources:

VA Caregiver Support:  (1-855-260-3274) provides caregiver support those caring for a loved one with PTSD.

National Center for PTSD

Coaching Into Care: A VA program that works with families who become aware that their loved one has traumatic issues post-deployment and finds resources for help. (1-888-823-7458)  CoachingIntoCare@va.gov

Twitter:   @ptsdPLUS  @VA-PTSD_Info  @Help4VetsPTSD

Facebook:  https://www.facebook.com/#!/PTSD-Support-And-Recovery-275580472648386/?fref=ts

Back from the front:  combat trauma, love, and the family.  Matsakis, A. (2007). Sidran Press, ISBN 188698187.

After the war zone: a practical guide for returning troops and their families. Slone, L. and Friedman, M. (2008). Da Capo Press, ISBN 1600940544.

References:

Calhoun, P., Beckham, J. & Bosworth, H. (2002). Caregiver burden and       psychological distress in partners of Veterans with chronic post-traumatic stress disorder. Journal of Traumatic Stress, 15 (205-212).

Handwerk, B. (2015). Over a Quarter-Million Vietnam War Veterans Still Have PTSD. http://www.smithsonianmag.com/science-nature/over-quarter-million-vietnam-war-veterans-still-have-ptsd-180955997/?no-ist

Kulka, R., Schlenger, W., Fairbank, J. Hough, R., Jordan, B., Marmar, C. et al. (1990). Trauma and the Vietnam War generation:  report of findings from the National Vietnam Veterans Readjustment Study.  New York: Brunner/Mazel.

Mikulincer, M., Florian, V., & Solomon, Z. (1995). Marital intimacy, family support, and secondary traumatization: a study of wives of veterans with combat stress reaction. Anxiety, Stress, and Coping, 8 (203-213).

Price, J., and Stevens, S. Partners of veterans with PTSD:  research findings. http://www.ptsd.va.gov/public/family/partners-of-vets.asp