Supporting the people we love isn’t always easy and can be distressing, confusing, and overwhelming at times. Despite the challenges, supporting someone you care for as they work to overcome a traumatic experience can be empowering. Maintaining boundaries, listening to their needs, and researching the causes and effects of trauma are all important steps toward maintaining a healthy and supportive relationship. While trying to make sense of PTSD literature may feel daunting, the best way to support your loved one is to build your understanding of how trauma is likely to affect them.
What is Trauma?
Trauma is a response to a deeply distressing event or series of events that causes a disruption in the brain’s normal functioning. It is thought that around 70% of the US population will live through a traumatic experience in their lifetime , although less than 2% will develop Post Traumatic Stress Disorder (PTSD). A traumatic experience can be subjective because the same event may be traumatic for one person and not for another. This is thought to result from a number of factors, including life experience and resilience. Common examples of traumatic experiences are:
- Serious road accidents
- Natural disasters
- Sexual assault
- Serious or life threatening health problems
- Difficult childbirth experiences
- Mugging or robbery
- Combat exposure or war displacement
- Childhood abuse
Any experience that causes intense fear, stress, or threat to life can be traumatic. Moreover, close proximity to and care for a traumatized person or community can cause secondary trauma . Secondary, or vicarious, trauma refers to indirect trauma that occurs from regular exposure to disturbing stories and images. Indirect trauma is common among paramedics, child abuse investigators, humanitarian aid workers, and the loved ones of people working in close proximity to traumatized populations.
It is important to be aware of vicarious trauma when supporting a loved one in therapy and to give yourself time to process and maintain a healthy degree of emotional distance from the experiences of others.
What is Post Traumatic Stress Disorder (PTSD)?
If your loved one is in therapy, you may have heard them mention PTSD. Post Traumatic Stress Disorder is a mental health condition that is triggered by experiencing a distressing traumatic event or, in cases of complex PTSD, several distressing events.
Symptoms and Effects of PTSD
The symptoms of PTSD can have a profound impact on a person’s daily life, often becoming noticeable during the first month after a traumatic event. In some cases, however, there can be a delay of months or even years before symptoms appear.
One of the most common and well-known effects of PTSD is re-experiencing the trauma. These intense spells are often called flashbacks, and while they typically last only a few moments, the emotional after-effects can linger for hours or even days. Flashbacks are generally triggered by a sound, feeling, smell, or other sensation that reminds someone of a traumatic experience. More than just a memory of a trauma, a flashback makes one feel as if they were vividly re-living the experience.
Other common symptoms of PTSD include:
Avoidance – changing patterns of behavior in order to avoid situations that may remind you of the traumatic event is a key symptom of PTSD.
Guilt – self-blame and shame are often associated with PTSD. Your loved one may begin to distrust themselves, lose confidence, and blame themselves for the trauma.
Hyperarousal – People with PTSD can become incredibly anxious and “on-edge,” finding it difficult to relax and concentrate. They may become constantly aware of potential threats, feel angry or agitated, and startle easily. It may affect your loved one’s ability to function at school or work and cause relationship difficulties.
Physical symptoms – headaches, dizziness, and stomach problems including IBS are all associated with PTSD. Adapted levels of cortisol in the blood as a result of PTSD can increase allergies, cause weight gain, and cause digestive issues.
Complex PTSD is often caused by maltreatment in childhood and can cause a range of profoundly challenging effects throughout a person’s life. The effects of complex PTSD can be similar to but more intense and enduring than those of PTSD. Symptoms of complex PTSD include dissociation, difficulty maintaining relationships, and intense hopelessness and worthlessness, among a range of others . Reassuring, comforting, and maintaining stability for loved ones with PTSD is incredibly important. They may attempt to push you away as a defense mechanism, but it’s important to know that this is a behavior they have adapted to keep them safe and that it is not personal against you. Trust that you are doing your best, and maintain a connection without overwhelming or smothering your loved one.
Steps to Support Your Loved One
With a basic knowledge of how trauma and PTSD can affect your loved one physically and mentally, you are building the foundation of a supportive relationship. Whether your loved one has been in therapy for years or only a few weeks, healthy, supportive relationships, along with healthy, therapeutic space, are an essential part of healing.
Support by Listening
As you watch your loved one struggle with the effects of trauma, you may feel the urge to try to offer solutions or help them feel less isolated by relating their experiences to your own. However, actively listening without trying to fix or solve problems validates the feelings of your loved one and helps them feel understood and loved unconditionally. Often, just listening and reflecting on what they have said shows that you are a safe person to confide in and talk to. Offering solutions to problems and sharing stories of similar experiences may be done with good intentions, but it can feel as though you are dismissing your loved one’s feelings.
Support Their Space
Avoidance and hyperarousal can make it difficult for people who have experienced trauma to relax and feel safe in a space. Your loved one might feel anxious around you, even if they have been close to you for years. Be mindful not to take this personally and respect their personal space. Be sure to regularly assess how they feel about touching, including hugs and a hand on their shoulder.
Emotional space is also important when supporting someone you care for. Don’t press them for information or intimate details. While talking about feelings and recognizing and naming emotions are important, it needs to be on their terms in a space and at a pace in which they feel safe. Let your loved one know that you are available and open to talking whenever they feel ready.
Remember that Healing is not Linear
Overcoming trauma takes time, and many people experience set-backs, intensified side effects, triggers, and flashbacks. This may feel frustrating to both you and your loved one and seem like the progress they had made has been undone. However, healing is not linear. As we go through life and experience new challenges, changes, and joys, we adopt coping mechanisms and new behavioral patterns. Try to maintain a sense of stability and hope during changes to your loved one’s life, and remember that healing from trauma is not the same as healing from a physical wound.
It is important to set and maintain healthy boundaries with your loved one. Keep in mind that vicarious trauma can affect those in a supporting role, and you cannot support them if you are burned out. It is not your role to heal or fix your loved one, and any notion that you can will exhaust you. Instead, focus on maintaining the relationship you have and on building trust, stability, and a sense of normality.
Maintaining boundaries can also include setting certain parameters for when you need space. This may look like having your phone off at night, ensuring them that they have the details of emergency support lines, or setting time aside to engage in self care without being in a directly supporting role.
Remember, taking care of yourself and ensuring that your needs are met make it easier and more productive to show up fully for your loved one.
Traumatic Stress Disorder Fact Sheet – Sidran Institute. Retrieved October 10, 2022, from https://www.sidran.org/wp-content/uploads/2018/11/Post-Traumatic-Stress-Disorder-Fact-Sheet-.pdf
 Rienks, Shauna L. “An Exploration Of Child Welfare Caseworkers’ Experience of Secondary Trauma and Strategies for Coping”. Child Abuse & Neglect, vol 110, 2020, p. 104355. Elsevier BV, https://doi.org/10.1016/j.chiabu.2020.104355. Accessed 10 Oct 2022.
 Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health Services. Substance Abuse and Mental Health Services Administration (US), 2014.
 Cloitre, Marylene. “Complex PTSD: Assessment and Treatment”. European Journal of Psychotraumatology, vol 12, no. sup1, 2021. Informa UK Limited, https://doi.org/10.1080/20008198.2020.1866423. Accessed 10 Oct 2022.