In the first weeks and months following the traumatic event, survivors of disasters, terrible accidents or illnesses, or community violence often feel an unexpected sense of anger, detachment, or anxiety in intimate, family, and friendship relationships. Most are able to resume their prior level of intimacy and involvement in relationships, but the 5 percent to 10 percent who develop PTSD often experience lasting problems with relatedness and intimacy.

Yet many trauma survivors do not experience PTSD, and many couples, families, or friendships with an individual who has PTSD do not experience severe relational problems. Successful intimate relationships require:

  • Creating a personal support network to cope with PTSD while maintaining or rebuilding family and friend relationships with dedication, perserverance, hard work, and commitment

  • Sharing feelings honestly and openly with an attitude of respect and compassion
  • Continual practice to strengthen cooperative problem-solving and communication
  • Infusions of playfulness, spontaneity, relaxation, and mutual enjoyment

For many trauma survivors, intimate, family, and friend relationships are extremely beneficial, providing companionship and belongingness as an antidote to isolation, self-esteem as an antidote to depression and guilt, opportunities to make a positive contribution to reduce feelings of failure or alienation, and practical and emotional support when coping with life stressors.

As with all psychological disturbances, especially those that impair social, psychological or emotional functioning, it is best to seek treatment from a professional who has expertise in both treating couples or family issues and PTSD. Many therapists with this expertise are members of the International Society for Traumatic Stress Studies, whose membership directory contains a geographical listing indicating those who treat couples or family issues and PTSD. Types of professional help that survivors find helpful for relationships include:

  • individual and group psychotherapy for their own PTSD

  • anger and stress management, and assertiveness training
  • couples communication classes and individual and group therapies
  • family education classes and family therapy