Trauma & Intimacy Series: Part 1 of 2

By Caralee Frederic, LCSW

You may not know it, but even the small traumas may be impacting your relationship. Here’s what you need to know about trauma – both the small and big traumas – and how it affects intimacy and friendship.

Trauma’s Effects On The Family

Early in my career, I thought I would be working primarily with children and adolescents who had been traumatized by abuse. I worked with foster teens, children and teens who struggled with depression, anxiety, ADHD and family conflict. My first job out of graduate school was working at the Giaretto Institute, which specialized in treating the entire family where there was sexual abuse. We treated the victim, siblings, non-offending parent and, yes, the offenders, too. Trauma was everywhere.

As a Licensed Clinical Social Worker, my primary theoretical perspective is the BioPsychoSocial perspective. What this means is that when a client presents themselves to me for help, I am thinking about them, their distress and possible solutions through this comprehensive lens of assessing for, and ruling out:

• Biological causes: a medical problem, thyroid, hormones, chronic pain, inflammation, a brain injury or brain chemistry out of balance, or other physical issues.
• Psychological causes: distorted thought patterns, a response to trauma – recent or past – or inadequate coping skills.
• Environmental/Social causes: their history with safety, attachment, family, friends, community or other factors. I see a person within their environment, holistically.

So, for example, when a couple comes to me for help with “communication” – easily the #1 reason couples seek marriage counseling – I see them through this BioPsychoSocial lens. While trauma has been acknowledged for a long time as a factor in many individual’s struggles, acknowledging the deeply impactful role of trauma in a couples’ interactions is a relatively newer territory in the field.

Trauma from any angle can be life-altering and destabilizing in ways that few, if any of us, are prepared to handle. Understandably, trauma can be threatening to the existence of a couple unit.

Entry Points For Trauma

There are several primary entry points for trauma in a couple’s relationship.

First, betrayal trauma is the result of a partner’s actions that have caused an attachment wound in the relationship, such as:

• an affair,
• not being available or responsive at a time of great need or
• domestic violence or abuse.

Second, the result of latent trauma from childhood that has not been addressed, but is now casting a shadow into the relationship.

Third, trauma from traumatic events that have occurred as an adult, and changes the individuals and the relationship. These could be:

• combat or first responder trauma,
• car accidents,
• violations such as robbery or rape or
• unexpected or violent losses.

We tend to think of trauma primarily in terms of these larger events: life-threatening, horrific “T” trauma. However, it is important to also recognize the deep and equally devastating impact of “t” trauma, which comes primarily from:

• attachment wounds,
• needs not being met,
• emotional abuse or neglect,
• unfulfilled promises,
• hostility and contempt or
• a mismatch in temperament between parent and child.

Trauma from any of these angles can be life-altering and destabilizing in ways that few, if any of us, are prepared to handle. Understandably, trauma can be threatening to the existence of a couple unit.

Symptoms Of Trauma

So, what is trauma exactly and how does it impact marriages and couples?

My favorite definition of trauma is short and to the point: “A separation from one’s true self.”

Something has happened that is so overwhelming to the person, that their response to it feels out of “the norm” and foreign to how they are used to being in the world. “Trauma, by definition, is unbearable and intolerable” (Van Der Kolk, The Body Keeps the Score, p 1), overwhelming one’s ability to cope with what is happening at that moment.

Of course, the clinical definition is much longer, as found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), which describes the necessary conditions and clusters of symptoms to make an official diagnosis. In a nutshell, the person experiencing trauma must have been exposed to an event that threatens life, serious injury, or threatened sexual violation.

What and who was safe, no longer feels safe. Intrusive symptoms related to the event are experienced, such as:

• nightmares,
• flashbacks or reliving the trauma,
• unwanted memories,
• dissociation,
• reactivity to cues that are reminders of the event.

Everyday activities are more difficult, if not impossible. Sometimes, it’s even difficult to distinguish what is real in the moment. Avoidance of thoughts, feelings, sensations, people, places, or objects that are reminders of the event, and negative changes in thoughts and mood towards self and others follow the event.

One’s world becomes more constricted. The negativity can be all-encompassing. Almost inevitably, there is an underlying feeling of undeserved shame, that there’s something fundamentally flawed or wrong with oneself, which seems to prove the idea that one is unlovable.

In addition, some symptoms of increased arousal are present such as:

• difficulty concentrating,
• feeling “on guard,”
• increased startle response,
• irritability,
• aggression or
• trouble sleeping.

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Shock Trauma And Developmental Trauma

Spouses and children are the ones most likely to experience the repercussions of such changes. These symptoms must last more than a month and cause distress in multiple areas of life to qualify for a diagnosis of PTSD. Many people describe themselves and their relationships as very different before vs. after the traumatic event.

Dr. Bessel Van Der Kolk says, “trauma is not just an event that took place sometime in the past; it is also the imprint left by that experience on mind, brain and body. This imprint has ongoing consequences for how the human organism manages to survive in the present” (The Body Keeps the Score, p. 21).

In other words, trauma “teaches” us what to do and not do through the lens of that experience.

Peter Levine, another expert in the field of trauma, distinguishes between what he calls “shock” traumas and developmental traumas.

A shock trauma would typically be a one-time event – unexpected, shocking, dangerous.

Developmental trauma is more about the attachment wounds we receive when our needs are not met along the way of growing up for safety, care, comfort and connection.

Trauma from any angle can be life-altering and destabilizing in ways that few, if any of us, are prepared to handle.

Understandably, trauma can be threatening to the existence of a couple unit.

Impact On Intimacy

With both types of trauma, the impact can be life-altering.

When we consider that all systems in the mind and body are affected by a traumatic event, and more so by repeated traumas, it is easy to see how having a history of trauma could impact a person’s intimate relationships. Intimacy requires trust and vulnerability. When a person has experienced overwhelming pain or fear from trauma, trust and vulnerability feel threatening rather than connecting.

For example: “Tom was upset by how difficult it was to feel any real affection for his wife. …he felt dead inside…He felt emotionally numb and distant from everybody, as though his heart were frozen and he were living behind a glass wall. That numbness extended to himself as well.” (Van Der Kolk, p. 14).

Imagine living with someone who:

• Felt she was floating in space, lacked any sense of purpose or direction; had explosive rages; uncontrollable temper;
• Was unable to find any real pleasure in life;
• Had a sense of futility;
• Was withdrawn and detached;
• Had chronic vigilance and sensitivity to threat in the environment;
• Complained about a vague sense of emptiness and boredom when not angry, under duress or involved in some dangerous activity. (Van Der Kolk, p. 31).

With any trauma, whether experienced between the couple or from outside of the relationship, reactions to neutral incidents can seem “extreme.” These extreme behaviors are difficult to understand and make sense of, and can easily be taken personally. Very often the person carrying the trauma is unaware or unable to express fully what is happening for them. Hence, miscommunication is even more likely and more painful it would be otherwise.

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Wired To Be Connected

We know that relationships are crucial to our survival. We are wired to be connected and we don’t do well when we’re not connected. When a relationship is supportive and loving, the partner can be crucial in healing from trauma. Having a loving partner who can listen to and witness a person’s trauma demonstrates that the traumatized partner is no longer alone. When a traumatized person sees or hears the compassionate response of their partner to their experience, this can negate shame, self-blame and self-loathing.

However, it is just as likely that a partner will have their own difficult reactions to the trauma or PTSD of their loved one. It may seem like the person with the trauma is a different person now, leaving the partner feeling anxious or confused. A partner may be confused by unpredictable changes in mood. A partner often feels the desire and need to “fix” their loved one, so they can go back to the way things were, or “back to normal.”

He or she may have anger at the traumatized spouse for not managing emotions better, especially anger. A partner may feel:

• hurt from emotional withdrawals or the lack of sharing positive feelings,
• frustrated from avoidance of activities or places,
• bewildered at flashbacks or amnesia,
• grief that their spouse can no longer dream about the future,
• resentment at the changes in their partner and life, and
• fear that their loved one may suicide or harm themselves.

If the traumatized spouse is using substances to manage their PTSD symptoms, a partner may try to control behaviors in an unhealthy, co-dependent way.

Study on the impact of trauma on couples tends to focus on betrayal trauma when one partner has betrayed the other through infidelity or other betrayals of trust. When I talk with a couple where this is the case, we talk about the devastation of betrayal trauma in such as a way to understand that the “home” of their relationship is fundamentally destroyed by the betrayal and the trauma it caused. We are not patching up holes or replacing broken windows, but rebuilding “marriage #2” on a new foundation. This may not be the case as much when the trauma has originated from outside the marriage. However, the partner of the traumatized person may still be impacted profoundly.

Dr. Bessel Van Der Kolk has said, “Trauma, whether it is the result of something done to you or something you yourself have done, almost always makes it difficult to engage in intimate relationships” (The Body Keeps the Score, Van Der Kolk,

13).

When we consider that all systems in the mind and body are affected by a traumatic event, and more so by repeated traumas, it is easy to see how having a history of trauma could impact a person’s intimate relationships.

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Trauma & Intimacy Series: Part 2 of 2

Elements Of A Healthy Relationship

To understand how trauma affects the way we relate to our loved ones, we must first understand the components of a sound relationship.

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