Lee Bougie, MS, DAIS
My former husband served in Afghanistan, where he developed PTSD. I have lived with that struggle for ten years, and ultimately our marriage did not survive it. Two years later, I am still on a journey of trying to sort everything out; I hope I can learn from the experience. It has taught me so much and brought so many special people into my life. I think we all need a supportive community of people in our lives, and that is particularly true for those of us who have a family member with PTSD.
Earlier this year, I had the opportunity to present Stress Mastery information at a self-care retreat for spouses of Service Members diagnosed with PTSD, and then to be included in a Global Stress Summit. A huge lesson for me is that I have had to recognize how much anxiety I carried myself. I also came to realize how much ten years of living with my ex-husband’s PTSD affected me. I believe part of my healing and growth is coming from starting to get out and talk about it, and to interact more with people about this. I am grateful that I am still friends with my former husband, and that he supports me in talking about it.
Classically we have looked at stress as a response in our body and minds to a perceived threat. Perhaps a better definition being talked about these days is that stress occurs when demand placed on the body and mind exceed their capacities. This is often defined more formally as “a condition or feeling experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilize.” (quoted from What is Stress? https://www.stress.org/what-is-stress) When one is living with a loved one with PTSD, there can be some pretty huge demands.
The first step in any therapeutic plan is assessing our stressors and I think this really hit home for me in thinking about my nutrition training and the forms we use around that. I’m trained as a holistic nutritionist, but we look at more than just nutrition, and we like to ask people on a scale of 1 to 10 where they would rate their stress. I noticed that where people rate themselves for stress levels is often inaccurate when you start working with them more and looking at how much stress they probably have in their life. The American Institute of Stress offers a low cost, comprehensive and scientifically validated stress assessment called the Stress Mastery Questionnaire (available here: https://www.stress.org/self-assessment).
When we asses our stress levels, people tend to be surprised by what their overall stress load actually comes from. People often tell me that they thought it was their job or relationship, but lifestyle showed up as number one for me. When we look at that total demand of stress there are a lot of things we can’t change. When we’re living with someone who suffers from PTSD, much of our life can seem out of our control. If you stop to examine individual stressors, such as are you getting enough sleep, it seems that those things should be able to be controlled. It is important to recognize how high the demands are, and then appreciate that you actually have control over some of them. I think that’s a very important step in assessing where we are at in our relationship with stress. Because when we are caregivers, it is so easy to put all the focus on the other person, and not do enough to take care of ourselves.
In addition to what our overall stress load is, our relationship with stress is also affected by our stress lens. We all have something called a negativity bias. We are set up for our survival to notice what around us is a danger to us or others. So if your child steps in front of a car you’re automatically going to react with that “fight or flight” reaction and pull them out of harm’s way. You don’t need to think about what to do there. That stress response is necessarily reactive, and it’s all about our primitive programming for safety.
Some people have a stronger negativity bias than others. Threat sensitivity is another name for it. I really want to highlight that because I think when we are living with someone with PTSD we are very likely to score higher on the threat sensitivity scale. We often hear that people with PTSD develop hypervigilance. But I don’t think it’s well recognized that many spouses and families develop a form of hypervigilance as well. At one point I had the opportunity to have an electroencephalogram, and the report came back showing that I had a very high level of hypervigilance. I had never thought about having developed that myself. When I brought that up at the retreat everyone in the room nodded their heads.
I found I hit a point where every loud noise made me jump out of my skin and sent me into the sympathetic dominant fight or flight reaction. Just like negativity bias, our sensitivity to things like noises and light vary between people. So pay attention to noises and other potential triggers, and recognize how that might be adding to your stress load. For example, going to a concert can be wonderful, and music is one of my favorite things. But if my stress load is high, the noise level can be challenging and so it may be best to avoid loud music on those days.
Another part of our stress lens is our mindset. Are you seeing what’s happening around you as a threat or are you seeing it as a challenge? I bring this up because this has actually been one of the life-shifting things for me that came out of the Stress Mastery Program. A quote that Dr. Heidi Hanna brought up in the program was, “Is your life difficult or is it big.” That just struck me like a bolt of lightning because at the time I heard it I was going through an incredibly tough period of time. I heard that quote and I thought, wow you know my life is huge. The things I am worried about are all coming from this amazing life I have and how much I care about everything. And that’s not bad. That’s not a threat. It is a challenge when the things you care about are adding a lot of demand. But I am this person with a huge open heart, and I do not want to lose that. So if I am going to have those demands placed on me, what do I have to do to increase my capacity to actually enjoy that big life I have.
That mindset shift was huge for me. I think that if we are living with someone who has PTSD we are living a huge purposeful life and we are important caregivers, but we also need to take care of ourselves and build our capacity by looking at our mindset so we are not reacting to everything as a threat.
It would take more than this one article to go through strategies for building your capacity to stress, but one thing I want to highlight is that there are two different things we need to look at for rebuilding our energy. There’s the regular, build it in our schedule kind of things we can improve to take better care of ourselves. Are we eating healthy and sleeping? Are we including exercise and regular movement into our day? Are we taking breaks? Are we practicing gratitude? All these things support us and help build that capacity. But people that are dealing with PTSD likely have a lot of anxiety themselves. It is worth finding the tools that we need and practicing them, so we are ready when we have that anxiety and massive worry popping up. Because at that moment we’re in the reactive brain stem, not the thinking part of our brain. So, we need strategies for ways to feel safe. Try several things and see what works for you. Maybe yoga or T’ai Ch’I, biofeedback, breathing exercises, aromatherapy, or you might have a mantra or music you enjoy. One thing that works for me is Rescue Remedy candies from Bach. I also have an herbal tincture that helps.
All too often spouses and families don’t get counseling and other support they might need. Some people have a hard time accessing resources. The American Institute of Stress website, www.stress.org, is a great place to find resources to manage stress. Many people suffer from caregiver fatigue, secondary PTSD, and vicarious trauma that is not recognized. Constantly trying to support the person with PTSD, and stopping them from getting triggered, while feeling responsible for how they are doing has effects on us. Adding to this is the trauma you end up going through yourself. It is common to have had way too many interactions with ambulances and hospital and police. One of the things that happened to me that I buried for a long time was that I was on a Skype call with my husband when they were bombed. And I heard glass shatter and it went dark and I didn’t hear from him for a while. He was fine, so I just put it behind me, and never talked to anyone about it. The things he went through were so much bigger. AT least I thought I buried it but it came out years later. It just popped out of my mouth in a group. Everyone in the room was so surprised and concerned, and at the time I didn’t even recognize how traumatic that was. I suspect many spouses of someone with PTSD have had similar experiences.
I think calling it secondary or something different makes it feel less important, but we need to recognize how important our experiences are. Acknowledge the trauma of being with someone living with their demons, and how that impacts your relationship. And it can be a different relationship in many ways. I’ve heard many people talk about how the spouse they knew did die in a way. Because the person who came back is not them. And so often we don’t look at the grief that we go through because of that since they are alive. We are supposed to be happy about that. However, grief is very real and very important to recognize our healing.
Lee Bougie: Contributing Editor and Author for The American Institute of Stress,
Lee is the resident scientist at Nested Naturals. She has a Master of Science degree in Experimental Pathology, is a Registered Holistic Nutritionist, and teaches science courses at a nutrition school. She is passionate about good food, family, being in the outdoors, and building a 1938 Ford hot rod with her dad!