Handout W

PTSD and its Impact on the Family

  1. The diagnosis of PTSD is only made when very specific criteria are met. The specific traumatic experience and the impact on the patient and his/her loved ones are unique to each family. The diagnosis can only be made by a trained mental health professional.

  2. First, the patient experienced or witnessed an event that involved actual or threatened death or serious injury, and the patient felt very afraid or helpless.

  3. Patients may RE-EXPERIENCE the event in a variety of ways (e.g., distressing dreams).

  4. Patients may AVOID certain reminders of the event.

  5. Patients may report feeling NUMB.

  6. Patients may experience INCREASED AROUSAL (e.g., anger, sleep problems).
Treatment Options for PTSD
  1. Overall goals of therapy

    1. Examine and learn how to deal with strong feelings (such as anger, shame, depression, fear or guilt).

    2. Learn how to cope with memories, reminders, reactions, and feelings without becoming overwhelmed or emotionally numb. .

      Trauma memories usually do not go away entirely as a result of therapy, but become less frequent and less intense..

    3. Discover ways to relax (possibly including exercise).

    4. Increase in pleasant activities.

    5. Re-invest energy in positive relationships with family and/or friends.

    6. Enhance sense of personal power and control in his/her environment.

  2. Components of treatment

    1. Psychiatric medications.

    2. Education for client and family about PTSD.

    3. Group therapy.

    4. Cognitive/behavioral therapy.

    5. Writing exercises.

Tips for family members and friends on relationships with someone who has PTSD
  1. Learn as much as you can about PTSD.

    Good Books on PTSD:.

    Catherall, D. (1992). Back from the brink: A family guide to overcoming traumatic stress.
    Mason, P. (1990). Recovering after the war.
    Mason, P. (1990). Why is Daddy like he is? A book for kids about PTSD.
    Matsakis, A. (1996) Vietnam wives.
    Matsakis, A. (1998). Trust after trauma: A guide for relationships for survivors and those who love them.
    Parkinson, F. (2000). Post-trauma stress.
    Sherman, M.D., & Sherman, D.M. (2005). Finding my way: A teen’s guide to living with a parent who has experienced trauma. Edina, MN: Beaver’s Pond Press. Available at www.seedsofhopebooks.com

    Interesting Movies about PTSD and its Effects on the Family:
    The Great Santini Ordinary People Saving Private Ryan
    Born on the 4th of July In Country Fearless
    Prince of Tides Copy Cat We Were Soldiers
    Coming Home The Accused  

    Relevant Web Sites:
    www.patiencepress.com [site with examples of the “Post-Traumatic Gazette”]
    www.adaa.org [Anxiety Disorders Association of America]
    www.ncptsd.org [National Center for PTSD]
    www.sidran.org [Sidran Traumatic Stress Foundation]
    www.trauma-pages.com [David Baldwin’s Trauma Information Pages]

  2. Do not push or force your loved one to talk about the details of his/her upsetting memories. Try to avoid feeling jealous if your loved one shares more with other survivors of similar traumas or to his/her therapist than to you. Rather, work to be pleased for them that they have a confidant with whom they feel comfortable.

  3. Do not pressure your loved one to talk about what he/she is working on in therapy. Also, avoid trying to be his/her therapist.

  4. Attempt to identify (with your loved one) and anticipate some of his/her triggers (e.g., helicopters, war movies, thunderstorms, violence). Learn and anticipate some of their anniversary dates.

  5. Recognize that their social and/or emotional withdrawal may be due to their own issues, and be unrelated to you or your relationship.

  6. Do not tolerate abuse of any kind – financial, emotional, physical, or sexual. Individuals with PTSD sometimes try to justify their behavior (e.g. angry outbursts, destroying property, lying) and “blame” their wrongdoing on having this psychiatric disorder. Patients may try to rationalize their behavior by stating that they were “not themselves” or “not in control” or “in another world.” However, patients should always be held responsible for their behavior.

  7. Pay attention to your own needs.

  8. Take any comments that your loved one makes about suicide very seriously and seek professional help immediately.

  9. Do not tell your loved one to just “forget about the past” or just “get over it.”

  10. Explore the available treatment options in your community, and encourage your loved one to seek professional help. However, respect that they know if/when they are ready to take this courageous step, and do not pressure them excessively.
Local Treatment Options for Veterans with Symptoms of PTSD
  1. PTS Recovery Program
  2. Men/Women of Courage sexual trauma groups
  3. Time-limited inpatient programs for veterans with PTSD (only at some sites)
Parts adapted from Trust after trauma: A guide for relationships for survivors and those who love them by A. Matsakis (1998).

What We’d Like our Family Members and Friends To Know about Living with PTSD
Suggestions from Veterans who were Involved in Combat in the Vietnam War Oklahoma City VA Medical Center Spring, 2000 (Printed and shared with permission of the patients in these groups)

  1. GIVE ME SPACE when I need to be alone – don’t overwhelm me with questions. I’ll come and talk to you when I’m ready.

  2. Get away from me if I am out of control, threatening or violent.

  3. Be patient with me, especially when I’m irritable.

  4. Don’t personalize my behavior when I explode or get quiet.

  5. Learn and rehearse a time out process.

  6. Don’t patronize me or tell me what to do. Treat me with respect and include me in conversations and decision making.

  7. Don’t pity me.

  8. Don’t say “I understand” when there are some things that you cannot understand.

  9. Realize that I have unpredictable highs and lows – good and bad days.

  10. Anticipate my anniversary dates – recognize that these could be tough times.

  11. I’d like to share my traumatic experiences with you, but I fear overwhelming you and losing you.

  12. I want to be close to you and share my feelings, but I’m afraid to … and sometimes I don’t know how to express my emotions.

  13. I also fear your judgment.

  14. Know that I still love and care about you, even if I act like a jerk sometimes.

  15. Don’t ask me to go to crowded or noisy places because I’m uncomfortable in those settings.

Support And Family Education:
Mental Health Facts for Families
Michelle D. Sherman, Ph.D.