POST TRAUMATIC STRESS DISORDER (PTSD): A FAMILY PROBLEM
In
the last article on PTSD, we defined it, explained its characteristics and
discussed the impact that PTSD has on the veteran. As was noted in that article,
the veteran has a significant impact on those around them.
Since it is only in rare instances that we find that the veteran is
living in complete isolation, it is important that we look at the impact the
veteran with PTSD has on the family as a unit.
We will identify some of the symptoms the veterans displays and their
effects on the members of the family unit.
We will also identify some of the coping mechanisms the family unit
develops in order to survive. Lastly,
we will briefly discuss treatment issues.
As
noted in the previous article, traumatic physical harm occurs when the body is
overwhelmed by forces outside the normal range of human experiences.
PTSD is the injury that occurs when there is an overwhelming assault on
the mind and emotions. The veteran and the family must learn how to cope with both,
in some instances, the physical and emotional wounds left by military service to
their country. The family unit is a
system and as with any system, it runs best when all parts of the system are
functioning properly. The veteran
with PTSD causes the system to be out of balance.
This imbalance affects everyone in the family unit to include the pets.
The
military, by design, is very conservative.
The socialization process that the veteran goes through demands that all
conform to those core values. Thus,
most veteran family units, as a result of the veteran’s socialization process,
has as its base, a conservative or traditional value set.
These core values dictate the spousal roles of the primary adult male and female within the unit.
The veteran with full blown PTSD is usually incapable of
fulfilling that traditional role. Consequently,
a role conflict emerges on top of the disorder symptoms. Is it no wonder then that the family unit is rife with teen
pregnancies, juvenile delinquency,
and other problems. Let’s take a
look at some of these symptoms.
Three
common ones are uncontrollable outbursts of anger, fits of rage and
hyperalertness. These three seem to
work together in wreaking havoc within the family unit as well as creating major
problems for the veteran. When the
veteran displays unexplained outbursts of anger and fits of rage, it causes the
family to “walk on egg shells”. No
one knows what will “set them off” or how to please the veteran.
It is for this reason that most people do not want to be around the
veteran. When they are around the
veteran, they are usually cautious.
The veteran is considered to be “a walking time bomb”.
One of the more colorful expressions is “p----- off in a half cocked
position”. The spouse and
children do not have guests over for fear of having them witness those
unexplained outbursts of anger. Children
who are normally boisterous and spontaneous, learn to play quietly and out of
the way. They become very much aware of their surroundings and what is going on in
their environment. Most learn to
anticipate the veteran’s moves and moods in order to minimize any backlash.
They began to display the same hyperalertness as the veteran.
Their Creativity is stifled as they are always “on guard” when the
veteran is around. The veteran’s
mate becomes the go-between, the
peace maker, and the schemer. The
mate’s motto becomes “peace at any cost is better than no peace at all”. The family members band together against the veteran, in many
instances, in order to survive. Isolation
and psychological numbing are two other symptoms which also operate together.
When
the veteran isolates themselves it is usually to maintain some degree of
self-control. There is always a
fear of losing control of things. In
order to maintain this control, in most cases, the veteran withdraws, shuts down
and goes on what is known as “auto pilot”.
The isolation and psychological numbing may take place within the family
unit or the veteran may withdraw to the woods, a lake or some other place.
These periods may last for a few minutes, hours, days or weeks.
The end result is that the family and spouse are excluded from the
veteran’s world. When this
occurs, the effects on the family can be disastrous particularly when coupled
with the three symptoms above. The
spouse and the children may began to feel as though they are hated.
Yet, they have no indication of what has caused the hate. The children often ask what did they do to be so unwanted.
Affection is usually not openly displayed.
Nurturing is usually only given by the veteran’s mate.
Consequently, in many instances, there is very little giving or receiving
of affection within the family. Children
who grow up without being loved oftentimes have a misconception of what love is
and wind up in difficulties as a result of it.
There is an unsettling atmosphere within the family unit and this can
lead to the members seeking solace elsewhere.
As a rule, the interaction within the family is on a surface level.
This prevents things from getting out of hand.
The last two symptoms we are going to look at are the flashbacks and
nightmares.
Life
is unsettling having to live in a house with someone who has unexplained
outbursts of anger and fits of rage. Add
to that, this person routinely tunes you and the rest of the family out. They even disappear for periods of time without saying
anything to anyone. On top of that, we toss in the fact that this person also on
occasion relives the past traumatic events as though they were there, this would
cause most children and spouses to say “that’s more than we can handle”.
Yet, there are many families that endure this and more.
The children oftentimes wonder if the veteran is insane, possessed by
demons, or just plain sick. There
is a wide range of emotions such as shame, helplessness, and guilt, just to name
a few, all within the family unit. The
family usually isolates itself or the family members, particularly the children,
physically and/or mentally divorce themselves from the family unit. This condition alone creates several problems within the
family and makes the children susceptible to many negative outside influences.
Are things hopeless? Not by
a long shot. Help is available.
The
key to treatment is first recognizing that there is a problem and wanting to get
help for the problem. The veteran
oftentimes does not know what is going on with themselves.
The spouse is the key to letting the veteran know what their moods and
behaviors are. It is important to
determine whether or not there is a cycle to the behavior and moods.
The spouse should keep a journal and a calendar to chart the behavior and
moods. Both items are beneficial
when the veteran either goes to the Veteran’s Hospital and/or Vet Center for
treatment. The bottom line is the
veteran must seek professional help. It
is wise for the spouse to obtain counseling as well as the veteran. The spouse has what is known as “secondary trauma stress”
in other words the spouse has PTSD just like the veteran. Unfortunately, the
children are also affected. There
should be individual treatment plans for each member of the family and there
should be a family treatment plan. It
is difficult to find an agency to deal with the complete family.
However, if the veteran and the spouse will work at it, it can be done.
It may mean that the veteran goes to the VA for counseling and the spouse
and children go to a community counseling center.
Then, at a later date the family as a unit receives counseling at some
agency. At some point in time they
should come together in a “living together” workshop which teaches the
family how to deal with family issues collectively.
The
main purpose of the workshop is to deal with those role issues which have gotten
out of balance and develop family
problem solving skills. The spouse,
in most cases, has been the dominant partner while the veteran sort of took a
back seat. As the veteran becomes
more able to manage his disorder and the family’s finance’s become more
stable as a result of disability checks, those basic core values will began to
right themselves. This is going to
create a new set of problems for
the family. If the issues are not
dealt with as a family unit, the family unit will splinter. There is a lot of excess
baggage that the family has taken on while the veteran was not dealing with his
PTSD. This excess baggage needs to
be dealt with for the sake of all family members.
The most important point to remember about those who are affected by PTSD
is that there is no quick cure or miracle drug. Counseling enables the veteran to better manage the range of
emotions that are associated with the traumatic events that caused the PTSD.
The longer the veteran has been affected by the disorder, the more
difficult the treatment of the disorder. There
are always associated issues in the treatment of those with long-term symptoms.
These secondary issues may, in many cases, overshadow the PTSD symptoms.
As
veterans, we have overcome adversity, high odds and many other obstacles.
If we choose to, we can manage this disorder and survive.
We must put our minds to the
task and realize that the family unit is strong and resilient.
If we decide as a family unit to beat the PTSD issue, we can.
In the next issue we will discuss the spouse and the impact of PTSD on them.