This page provides suggestions and help on how to help rebuild the trust and safety between you both, along with information on how to help deal with flashbacks or panic attacks and anger that may result from PTSD.
TIPS FOR REBUILDING TRUST AND SAFETY
Trauma alters the way a person sees the world, making it seem like a perpetually dangerous and frightening place. It also damages people’s ability to trust others and themselves.
Anything you can do to rebuild your loved one’s sense of security will contribute to recovery. This means cultivating a safe environment, acting in a dependable and reassuring way, and stepping in to help when needed. But it also means finding ways to empower the person. Smothering someone with PTSD or doing things for them that they’re capable of doing for themselves is counterproductive. Better to build their confidence and self-trust by giving them more choices and control.
THINGS YOU CAN DO TO INCREASE YOUR LOVED ONE’S SENSE OF SAFETY
- Express your commitment to the relationship. Let the person know you’re here for the long haul.
- Create routines. Structure and predictable schedules will enhance the person’s feelings of security. You can also help create a safe place.
- Be aware of things that can make a person with PTSD feel unsafe, such as new places, crowds, confusion, or being physically constrained or ordered around.
- Try to minimize stress at home and make sure your loved one has time alone for rest and relaxation.
- Speak of the future and make plans. This can help counteract the common feeling among people with PTSD that their future is limited.
- Keep your promises. Help rebuild trust by being trustworthy. Be consistent and follow through on the things you say you’re going to do.
- Tell them you believe they are capable of recovery. Emphasize their strengths. Help them (and others) see their positive qualities and successes.
ENCOURAGING AND SUPPORTING TREATMENT
Despite the importance of your love and support, it isn’t always enough. Many people who have been traumatized need professional PTSD treatment. But bringing it up can be touchy. Think about how you’d feel if someone suggested that you needed therapy.
- Wait for the right time to raise your concerns. Don’t bring it up when you’re arguing or in the middle of a crisis. Also be careful with your language. Avoid anything that implies that he or she is “crazy.” Frame it in a positive, practical light: treatment is a way to learn new skills that can be used to handle a wide variety of PTSD-related challenges.
- Emphasize the benefits. For example, therapy can help them become more independent and in control. Or it can help reduce the anxiety and avoidance that is keeping them from doing the things they want to do.
- Focus on specific problems. If your partner shuts down when you talk about PTSD or counseling, focus instead on how treatment can help with specific issues like anger management, anxiety, or concentration and memory problems.
- Acknowledge the hassles and limitations of therapy. For example, you could say, “I know that therapy isn’t a quick or magical cure, and it may take awhile to find the right therapist. But even if it helps a little, it will be worth it.”
- Enlist help from people your loved one respects and trusts. He or she may be more open to counseling if the idea comes from someone else. Suggest the person see a doctor or talk with his/her pastor, rabbi, or spiritual leader.
- Encourage the person to join a support group. Getting involved with others who have gone through similar traumatic experiences can help your loved one feel less damaged and alone.
- Help your loved one understand their triggers. Take time to discuss and understand triggers – more information and advice is on our Anticipating and Managing Triggers page.
- Remember that your meta-language (body language) conveys 90% of your message. Your words convey only 10% of your message. Convey positive messages, not degrading ones.
HOW TO HELP IN THE MIDDLE OF A FLASHBACK OR PANIC ATTACK
- During a flashback, people often feel a sense of disassociation, as if they’re detached from their own body. Anything you can do to “ground” them will help.
- Tell them they’re having a flashback and that even though it feels real, it’s not actually happening again
- Help remind them of their surroundings (for example, ask them to look around the room and describe out loud what they see)
- Encourage them to take deep, slow breaths (hyperventilating will increase feelings of panic)
- Avoid sudden movements or anything that might startle them
- Ask before you touch them. Touching or putting your arms around the person might make him or her feel trapped, which can lead to greater agitation and even violence
DEALING WITH VOLATILITY AND ANGER
PTSD can lead to difficulties managing emotions and impulses. In your loved one, this may manifest as extreme irritability, moodiness, or explosions of rage. In fact, anger is so common in people with PTSD that it is considered one of the prime symptoms of hyperarousal.
People suffering from PTSD live in a constant state of physical and emotional stress. To make matters worse, they usually have trouble sleeping. They are exhausted, on edge, and physically strung out—which increases the likelihood that they’ll overreact to situations and stressors in their day-to-day life.
For many people with PTSD, anger can also be a cover for other feelings or a defense against grief, helplessness, guilt, or shame. They’d rather be mad than sad. Anger makes them feel powerful, instead of weak and vulnerable. For others, their anger is so intense that they’re afraid of letting it out. Instead, they try to suppress it. But it simmers under the surface, like an active volcano, and can erupt when you least expect it.
- Watch for signs that your loved one is angry. Their face may get red, they may clench their jaw or fists, talk louder, start pacing or getting agitated. Take steps to defuse the situation as soon as you see the initial warning signs.
- Try to remain calm. During an emotional outburst, do your best to stay calm (or at least pretend to be). This will communicate to your loved one that you are “safe.” It will also help keep the situation from escalating.
- Give the person space. Don’t come closer unless asked and avoid crowding or grabbing the person. This can make a traumatized person feel threatened.
- Ask how you can help. For example: “Do you want me to help you calm down?” or “What can I do to help you right now?” You can also suggest a time out or change of scenery if you think that might help.
- Put safety first. If the person gets more upset despite your attempts to calm him or her down, stop what you’re doing and go for help. Leave the house or lock yourself in a room if necessary. Call 999 immediately if you fear that your loved one may hurt themselves or others.
LEARNING HOW TO CONTROL ANGER
Anger is a normal, healthy emotion, but when chronic, explosive anger spirals out of control, it can have serious consequences on a person’s relationships, health, and state of mind. But anger doesn’t have to hijack your (or your family’s) life. You can get anger under control by exploring the root issues and learning healthier ways to express your feelings.
TIPS FOR COPING WITH PTSD IN THE FAMILY
- Be patient. Getting better takes time, even when a person is committed to treatment for PTSD. Be patient with the pace of recovery. It’s a process that takes time and often involves setbacks. The important thing is to stay positive and keep at it.
- Educate yourself about PTSD. The more you know about the symptoms, effects, and treatment options, the better equipped you’ll be to help your loved one, understand what he or she is going through, and keep things in perspective.
- Don’t pressure your loved one into talking. It can be very difficult for people with PTSD to talk about their traumatic experiences. For some, it can even make things worse. Instead of trying to force it, just let them know you’re willing to listen when they’re ready.
- Take care of your emotional and physical health. As the saying goes, put on your own oxygen mask first. You won’t be any good to your loved one if you are burned out, sick, or exhausted.
- Accept (and expect) mixed feelings. As you go through the emotional wringer, be prepared for a complicated mix of feelings—some of which you’ll never want to admit. Just remember, having negative feelings toward your family member doesn’t mean you don’t love them.
- Be a good listener. While you shouldn’t push a person with PTSD to talk, you can let them know you’re available for them. If they do choose to share, try to listen without expectations or judgments. Make it clear that you’re interested and that you care, but don’t worry about giving advice. Leave that to the professionals. Instead, do your best to simply take in what they’re saying. Never underestimate how much the act of empathetic listening can help. A person with PTSD may need to talk about the traumatic event over and over again. This is part of the healing process, so avoid the temptation to tell your loved one to stop rehashing the past and move on. Instead, offer to talk as many times as needed. And remember, it’s okay to dislike what you hear. Some of the things your loved one tells you might be very hard to listen to. But it’s important to respect their feelings and reactions. If you come across as disapproving, horrified, or judgmental, they are unlikely to open up to you again.
THINGS NOT TO DO OR SAY
- Giving easy answers or blithely telling the person everything is going to be okay
- Stopping the person from talking about their feelings or fears
- Offering unsolicited advice or telling the person what he or she “should” do
- Blaming all of your relationship or family problems on the person’s PTSD
- Invalidating, minimizing, or denying the person’s experience
- Telling the person to “get over it” or “snap out of it”
- Giving ultimatums or making threats or demands
- Making the person feel weak because they aren’t coping as well as others
- Telling the person they were lucky it wasn’t worse
- Taking over with your own personal experiences or feelings