Understanding and Treating Post-Traumatic Stress Disorder Symptoms in Female Partners of Veterans with PTSD
Nelson, Briana S., Wright, David W., Journal of Marital and Family Therapy
Studies of post-traumatic stress disorder have focused primarily on veterans, generally ignoring their female partners (wives or girlfriends). Recently, clinicians have begun to identify PTSD-like symptoms in these female partners, but the literature describing this phenomenon has been limited. This paper addresses the fact that women in long-term relationships with veterans suffering from PTSD commonly experience PTSD-like psychiatric symptoms themselves. These women's symptoms and issues they face in their relationships with their veteran partners are described. Conceptual explanations of and causal factors for these women's symptoms are presented, followed by discussion of treatment approaches and issues.
Despite growing awareness of PTSD and the personal and relationship problems associated with it, many veterans experiencing PTSD symptoms have been waiting since Vietnam, Korea, and even World War II to receive help. Before receiving help, many survived with isolation, anger, guilt, flashbacks, dreams, and depression -- never knowing there was a name for their problems. Eventually, treatment programs have become more readily available for these veterans, but their partners often are overlooked by professionals, even though they too exhibit symptoms (Maloney, 1988; Williams, 1980). For example, Matsakis (1988) has described the complex multiple roles wives of Vietnam veterans try to fill and the strain associated with their attempts to do so. In a sense, these women take on the role of overworked managers of chaotic stressful families. In so doing they experience a great deal of pain, fear, anger, depression, sexual dysfunction, lack of emotional intimacy, substance abuse, and domestic violence.
As clinicians become more aware of the symptoms and etiology of PTSD, some are beginning to consider the possibility that problems such as those described by Matsakis (1988) actually constitute a type of PTSD (Coughlan & Parkin, 1987; Maloney, 1988; McCann & Pearlman,1990; Solomon et al., 1992; Williams, 1980). It is the goal of this paper to clarify the picture of PTSD symptoms in partners of veterans. Characteristics of PTSD partners, problems they face, factors instrumental in producing their PTSD symptoms, and explanatory conceptual frameworks will be discussed first. This will be followed by a discussion of therapeutic implications for female partners and for the relationship between these women and their veteran partners.
Although both male and female veterans experience PTSD, the focus here will be on female partners of male veterans. The term female partner is used to include any woman who is currently involved in a long-term ongoing adult relationship with a veteran. It is not our desire to exclude male partners of female veterans or to exclude survivors of other traumatic events and their family members. However, because of the novelty of many ideas presented in this paper, we have chosen to limit the scope for the purpose of clarity. Continued theoretical and clinical evidence will be necessary to expand on the concepts presented in this paper.
CHARACTERISTICS AND EXPERIENCES OF PTSD PARTNERS
Although each female partner of a veteran with PI SD has different symptoms and circumstances unique to her own situation, there are commonalities, just as there is similar symptomatology among veterans experiencing PTSD. Many of these women have endured severe stressors during most of their relationship with the veteran (Coughlan & Parkin, 1987), and many have had problematic lives prior to their relationship with the veteran (Maloney, 1988). Four primary characteristics or experiences are considered here: (a) caretaking, (b) gender roles, (c) survivor skills, and (d) psychological symptoms.
Much of the identity for many female partners of PTSD veterans is derived from their caretaking. Often they take the major responsibility for household tasks and the maintenance of relationships (Maloney, 1988; Verbosky & Ryan, 1988; Williams, 1980). …