What is STSD?
Those who have been associated with trauma survivors may experience their own difficulties. Secondary Traumatic Stress Disorder, also known as Compassion Fatigue or Secondary Stress, is a real problem for many of our families and many of our health care givers.
Anyone associated with a veteran diagnosed with PTSD may find themselves suffering from STSD.
The following information was taken in part from Nancy Brossart of Company G. (http://www.angelfire.com/va3/companyg/index.html).
When any family member experiences psychological trauma and suffers PTSD, the entire family is profoundly affected. Though the trauma was directly experienced by only one family member, the other family members may experience shock, fear, anger and pain in their own unique ways simply because they care about, and are connected to, the survivor. Living with an individual who has PTSD does not automatically cause PTSD, but it can produce “secondary” traumatization. Whether family members live together or apart, and whether or not they feel emotionally close to one another, PTSD affects each member of the family in several ways.
- The survivor may lose interest in family or intimate activities and may become emotionally isolated or detached. Family members may feel hurt, alienated, frustrated and discouraged.
- The survivor may exhibit behaviors that indicate he is irritable, tense, anxious, worried, distractible, startled, enraged, controlling, overprotective, and demanding. Family members may feel like they live in a war zone, often reacting in anger, or purposely distancing themselves from the trauma survivor.
- Even if the trauma occurred decades ago, the survivor may act feel as if the trauma is still happening. Family members may also feel as if their secondary trauma is still happening. As time passes, the family may begin to avoid activities with others, and become isolated from friends outside the family. They may feel that no one outside the family could possibly understand their situation.
- The trauma survivor often feels there is no future for which to look forward. Family members may find it very difficult to have a cooperative discussion with the survivor about important plans and decisions for the future.
- The survivor may have difficulty listening and concentrating. He may become easily distracted, tense, or anxious. He may become hyper vigilant, displaying angry and overly suspicious behavior toward family members. As well, the family may find it difficult to discuss personal or family problems because the survivor may become controlling, demanding, overprotective, and anxious. The trauma survivor may become fearful about problems becoming terrible catastrophes.
- Family members may become over involved with the lives of healthy family members due to need for positive emotional feedback, or they may ignore the healthy members of the family giving all of their attention to the trauma survivor.
- Family members may find their sleep disrupted by the survivor’s sleep problems (reluctance to sleep at night, restlessness, severe nightmares or episodes of violent sleepwalking). Family members also often find themselves having terrifying nightmares, leading to a fear of going to sleep, or difficulty getting a restful night’s sleep.
- Ordinary activities, such as shopping, driving or attending a movie may trigger traumatic memories and flashbacks throwing one into “survival mode” suddenly and without explanation. The survivor may shut down emotionally, or leave abruptly leaving family members feeling stranded, helpless, and worried.
- Trauma survivors with PTSD often struggle with intense anger or rage and often have difficulty coping with the impulse to lash out verbally or physically. Family members can easily feel frightened and betrayed by the survivor, despite feeling love and concern for their loved one.
- Family members are also frequently exposed to emotional, financial, and domestic problems. Survivors experiencing PTSD may seek relief and escape with alcohol or other drugs. Addictive behaviors such as gambling and eating disorders are common. Addictions offer false hope to the survivor by seeming to help for a short time. Soon these addictions increase the fear, anxiety, tension, anger and emotional numbness which go hand in hand with PTSD.
- When suicide is a danger, family members face the unavoidable strains of worry, guilt, grief, fear, and anger.
What can families of trauma survivors with PTSD do to care for themselves and the survivor?
- Continue to learn more about PTSD by attending classes, viewing films or reading books on the subject.
- Encourage, but don’t pressure, the survivor to seek counseling from a PTSD specialist.
- Seek personal or family counseling if troubled by “secondary” trauma reactions such as anxiety, fear, anger, addiction, or if you are having problems in school, at work or with intimacy.
- Children often have low self-esteem and blame themselves for the survivor’s unhappiness. There is a good chance that the child will feel unwanted, unloved and inadequate. Seek counseling for the child and keep an open line of communication.
Secondary Stress – STSD in Wives
We are aware that many women serve in our Armed Forces and that these women may suffer from PTSD. The information available is mainly written from the perspective that men suffer from PTSD and their wives suffer from STSD. If you are a male and you suffer from STSD because your wive suffers from PTSD, we welcome your feedback and will gladly include helpful information from that perspective on our website.
Like other working women, spouses of veterans with PTSD play many roles. A spouse also needs to worry about the husband’s psychological condition while continuing to function at work. For financial reasons, she can not afford to lose her job. Often she has to play the role of both mother and father. Eventually, she realizes that she doesn’t have time to take care of herself, and blames herself for all shortcomings.
The wife may experience constant tension and anxiety because she “never knows what he’ll do next”. She may develop a critical attitude because of “what he puts me through”.
The wife may have few friends or be unable to relate to friends as she would like because her husband has alienated them with his attitude and actions. Her friends may not understand and encourage her to walk away from the relationship.
The wife may become emotionally numb. She may no longer be able to experience true intimacy with her husband. She may feel that God has let her down. She may escape into a fantasy world of television or books. She may resort to compulsive shopping or eating or even turn to an extramarital affair. She may rely too heavily on her children, her parents, or her friends to fill the void.
The wife may become “tired of trying” and a sense of helplessness and hopelessness may set in. Low self-esteem may be evidenced by poor appearance and a dirty home.
Over the years, resentment and bitterness will likely develop toward the husband as well as others. This will lead to frequent arguments between family members.
In an attempt to keep the family stable, the wife may become an enabler. She may take over duties and responsibilities for fear they will not be taken care of by the trauma survivor. The husband may learn that he does not have to take responsibility for these tasks. This will lead to further feelings of anger and resentment.
The wife may feel guilt for negative feelings toward the trauma survivor. She may feel guilt for taking things out on the children or friends and extended family. She may even feel guilty because she does not suffer from PTSD.
The wife may also deny that she or the children have problems themselves. It may be easier for her to blame everything on her spouse. She may feel that no one can possibly help her and deny herself the opportunity for help.