The RAND Corporation estimated that, as of October 2007, 300,000 service members returning from foreign battlefields were suffering from post traumatic stress disorder, or PTSD. Current estimates indicate that somewhere around one in five combat vets will experience the disorder. Add in the survivors of various other kinds of severe trauma–modern life certainly produces no shortage of those–and the timeliness of a book about relating to people with PTSD becomes more than obvious.
The Post Traumatic Stress Disorder Relationship: How To Support Your Partner and Keep Your Relationship Healthy is a concise, clearly written overview of the disorder, issues involved in coming to terms with it, available therapies, and coping strategies for minimizing the negative effects that symptoms like disrupted sleep, flashbacks, and irritability can have on a relationship.
Dr. Dianne England has set herself a tough task, walking a fine line between optimism and the recognition that PTSD, especially untreated, can be difficult and even dangerous to live with. Her simple and compassionate explanation of how the disorder arises and what it does to human brain chemistry and emotional life helps the reader move from anger, fear, and shame toward compassion and enlightened empathy.
From that kinder and wiser place, she leads a walk through the treatment possibilities. The result is a kind of consumer’s guide to mental health offerings that helps demystify many issues the reader may never have considered: how serotonin functions, what beta blockers do, what goes on during exposure therapy, image rehearsal therapy, and cognitive restructuring. Throughout, there are reminders that treatment is not a one-size-fits-all proposition; this section of the book should and could be useful to the PTSD sufferer as well as to the significant other.
This assuming, of course, that nobody is in denial. While the book serves as an excellent road map to treatment for couples who accept its necessity, a would-be helpmate whose significant other is actively pushing them away might despair of ever reaching that place where they can shop for a therapist hand in hand. England acknowledges the fact that denial has to be overcome; it would have been nice to be offered a few more strategies for helping that vital first step to come about.
The first step, of course, is only the beginning of the journey. There are excellent suggestions offered here for how to keep walking, such as imagining one’s self within a protective bubble. There’s a concise explanation of the victim-rescuer-persecutor triangle and where to find its off-ramp. A few suggestions may strike readers as obvious: don’t drown your sorrows in substances or food and get enough sleep, for instance. The author also reccomends you don’t journal about your anger in the same diary you keep to document symptoms, which may be useful to your partner and their therapist, or, in a worst-case scenario, to your divorce lawyer.
The book has a clear subtext: it’s not about you, and it’s really not about your partner either. The relationship, through no fault of anyone’s, has become a triad, with the constant streaming of the fight-or-flight reflex an unwelcome third leg, and the only way out is through the difficult terrain of pain and change. The upside is, anyone who digests and makes use of the suggestions she offers for changing one’s own destructive thought processes, maintaining calm, and resolving relationship conflicts will emerge better off. This is the case whether or not the relationship that led them to this book survives; just as the PTSD sufferer who finds the courage to peel back the defensive layers of rage and/or addictive behavior may ultimately emerge stronger and wiser from the other end of their personal hell.
This is an enormously practical handbook, with a great deal of invaluable information packed into its dense pages. England is well aware that people in this situation are confronted by multiple challenges on social, emotional, and economic fronts. If there’s a flaw, it lies in a slightly clinical tone that occasionally veers toward condescension: “When you must buy something of significant cost, make sure you comparison shop…” It’s true, however, that people in crisis can forget the most basic things at times. A book written for those who have little to no prior experience of mental health issues and not much more of coping with any sort of major crisis most certainly has a place.
As the wife of a survivor of multiple and complex traumas, I might have wished for a little more depth in spots and a more poetic grasp of the havoc and the positive possibilities alike, but this book does not try to be that book. The goal, well achieved, is to expand the tool kit and perspective of those who’ve come to understand that PTSD is different from the types of ingrained personality issues its symptoms may suggest. The book, full of practical, honest ideas for the path forward, is certain to be a lifeline for many who have no idea what to do with this understanding, other than the knowledge that they’re not ready to give up on a loved one.
Adams Media, 2009, $14.95.