15 Tips for Helping Someone with PTSD cPTSD or Trauma | Relationship Skills

Hey there everybody, and welcome to this video on being in a relationship with somebody with PTSD or CPTSD. I'm your host, Dr. Donnellice Snipes. Before we get started, please make sure to click that subscribe button and the bell right next to it to be notified every time we put out a new video. In this video, we're going to explore the symptoms of PTSD and cptsd. We'll identify strategies to support the person in coping with their symptoms, as well as explore how their symptoms impact you and strategies for self care. The mnemonic I came up with this or for this is Watches, Sand Pits. It's just designed to help you recognize some of the many different symptoms that somebody with PTSD or CPTSD may have. Some of these symptoms are in the DSM 5TR. Others of them are very common symptoms in people with PTSD or CPTSD but didn't make it into the dsm. Doesn't mean they're any less valid symptoms. So let's start out by just going through what the mnemonic stands for, and then we'll go back and talk about how to support a person that has these symptoms. W stands for withdrawal or isolation A avoidance of reminders, T Thinking that's inflexible, C Concentration difficult H hypervigilance E exhaustion S Sleep difficulties S Startles easily S A Attitude is negative, N Emotional numbing D dysregulation P physical symptoms I impulsivity T thoughts that are intrusive or flashbacks and S A sense of helplessness. So in order to support a person with some or all of these symptoms, it's important communicate with them, talk with them about their vulnerabilities, their triggers and their solutions. Now remember, vulnerabilities are things that make them more likely to be triggered. For example, if they are have experienced a trauma and it happened to be in a public place, then when they're in public places, they may already be more primed, more stressed, more vulnerable to being triggered or to having these symptoms triggered in them. Likewise, if the problem occurred at home, then when they're at home by themselves, they may be more vulnerable to some of these symptoms being triggered. And it's important to ask them what solutions work for you. The solutions that work for you, the supporter, may not be the same solutions that work for them. So it's important to ask them what support, what solutions work for you. To address this symptom, make a list of them. And I do have a video on the YouTube channel on creating a distress tolerance toolbox. And that'll help you start getting part of the way, but that's not going to get you the whole way. It's important for each symptom to identify anything that makes them more vulnerable to having that symptom triggered. So withdrawal and isolation. If people have experienced trauma, especially at the hands of others, they've been victimized in some way, then they may withdraw or isolate because being around other people is too, it reminds them of the trauma or they don't trust other people, so it may be hard for them to feel safe in environments around other people. Other times they may withdraw or isolate just because they're overwhelmed and over stimulated so much of the time because they don't feel safe. And it's not in particular because of another person, it's just they can't take any more input. So inquiring with your loved one, what function is withdrawing serving for you? You know, is it helping you because you just, you can't take anymore, you feel overwhel and no more input? Or is it that being around people, you just, you don't trust people, so that makes you anxious talking with them about that. And then when you have to go into situations that they would prefer to withdraw from, talking about ways to mitigate that, for example, riding on the subway or on the bus, or going shopping or being at home at night by themselves or whatever it is that tends to make them feel overwhelmed. Avoidance of reminders can also be, it kind of goes along with withdrawal. Sometimes when you have experienced trauma, then going into a store or going different places may remind you, or watching different television shows may remind you of that trauma. And for the person with trauma, avoiding those reminders helps them feel safe. For the person in a relationship with them, it may make that person feel sort of hemmed in because we can't do this, we can't do this, we can't watch this. There's this whole list of can'ts in order to help the person feel safe. And I'm not saying ignore that. No. But recognize if they don't want to watch particular things or if they don't want to go to particular places, it's not because they're trying to be difficult. It's because those places are too triggering and too, they trigger too much anxiety. Again, if you have to go there talking with them about what can I do? Or what needs to happen to help you feel safer or more empowered. If they've experienced a traumatic event in a hospital, for example, and they have to go to the hospital for Some reason, talking with them about, okay, how is it that I can support you in this particular event, at this con, in this context, at this time? You know, I know in the past you had a really bad experience. How is it that I can help you get through this situation? Inflexible thinking is also really common when people are experienced, have experienced trauma. And when those memories are triggered, they go into fight or flight. When people are in fight or flight, they are not thinking, they are acting, they are reacting. So thinking becomes inflexible. They are thinking, I need to get the heck out of here. That may come out as being argumentative or stubborn and again stepping back and saying, okay, is this person trying to be oppositional, stubborn, argumentative, or are they stuck? They may be stuck in that fight orf flight mode and they can't think of anything else right now. And one of one thing that can be helpful is to talk with them about what is it that I can do right now to help you feel safe and secure, to help you get into your wise mind. And once they're in their wise mind, then they can engage that higher order thinking and it often becomes much more flexible or they can at least become more open to listening to ideas. They may not have other suggestions or other options or other tools to use. So they may be approaching every problem like it's a nail because the only tool they have is a hammer. But if you can help them feel safe and empowered to at least learn about other options, then they may be willing to take those steps. Emdr, for example, is an intervention that can be very, very helpful. For a lot of people with trauma, concentration is difficult when you're HPA axis. When you're in fight or flight, your stress response system is kicked off. Your brain is not in thinking mode, it's in fight or flight mode. So you're not going to remember things, you're not going to be able to concentrate as easily. And this can come out as it can seem like inattentiveness. For example, if the person doesn't feel safe and you're in a restaurant, they may be looking around at everybody else and it's not because they're scoping out other people or they're disinterested in you. It may be because they don't feel safe and they are watching and waiting for any indication that things are going to go bad. Recognizing that identifying situations that are more difficult for them to concentrate and situations where it's easier easier for them to concentrate, where do they feel safer if they have to be in a restaurant, for example, do they feel safer if they're sitting in a position where they can see the entrance and the exit and they have their back to a wall? A lot of people do. That's okay. Accommodating. That can be very helpful for somebody with ptsd. Hypervigilance is very common in people who've been traumatized and I'm just going to say traumatized from now on. And, and that encompasses people with PTSD or cptsd. But being hyper vigilant means they're not going to be caught unaware. Being hyper vigilant is kind of like the bunny rabbit or the squirrel, the prey animal in a world full of predators that is causing has difficulty relaxing because they don't ever feel a hundred percent totally safe. When people are hyper vigilant, when they don't ever feel a hundred percent totally safe, it creates a whole cascade of problems. And one of the best things that you can do for a person whose experience who has traumatic injury and, and has developed either PTSD or CPTSD is to work with them, listen to them, identify with them, things that you can do in order to help them feel safe and empowered and be able to relax, at least in certain circumstances. For example, if they get really stressed out driving, then maybe you can drive and they can ride. Or, you know, in my husband's case, he gets really stressed out if he's not driving. So I ride and he drives. When you go to restaurants, what would help them feel safer? And maybe that means not going to really busy restaurants or go. Going to restaurants during an off time when there's not near as many people and near as much hustle and bustle. So there are all kinds of compromises. It doesn't mean that you have to stay home all the time. It means planning appropriately so the person is less bombarded with potential traumatic stimuli. Going shopping during off hours, for example, is another intervention that can be helpful for some people at home. What is it that you can do to feel safer for in. In our house, we close the blinds. We live out in the middle of the country, but it still makes stresses me out to have the windows open at night if I can't see out but people or creatures can see in, doesn't work for me. So pull it. Closing the blinds at night helps me feel safer in my environment, reduces my stress level. Exhaustion is a consequence of hypervigilance and constantly feeling unsafe because the person often isn't able to get good quality sleep. Additionally, there's a really high Correlation between having traumatic injury and developing sleep apnea. If you're not sleeping well, it's important to get that assessed. You are not going to be able to heal your stress response system or the person is not going to be able to heal their response stress response system until they're able to get adequate quality sleep. Recognizing that their sleep difficulties. If you're sleeping together or if you're a caregiver and they're waking up with night terrors, their sleep difficulties are impairing your sleep as well. What can you do so you can get a good night's sleep so you can get the rest that you need in order to stay healthy and functioning and, and recharge? People with a history of trauma often have an exaggerated startle response. It is what it is. Recognizing that can be very helpful. Announcing to them before something happens, if you can. I mean, if you live in an apartment complex and slamming doors is a trigger for them, you may not be able to address all of that. But whenever you can warn them before something that might startle them, it helps. Being startled is an extreme stress response. It doesn't last very long, but it's still dumping a bunch of energy. So get the special closures on your cabinet doors so they close softly. Instead of slamming same thing on all the other doors in your house, try to get them so they have the special little closure things that make them close more slowly. Before you make loud noises, like turning on the blender, announce loud noise, you. There are things that you can do that are just kind and compassionate. If you are in a household with somebody you know startles to loud noises, you can also be sensitive and kind of going along with the startle. If there are certain triggers for them in the environment that trigger their stress response, maybe they grew up in a, in a house where there was domestic violence. So when people start yelling or when they're. Your voice starts to raise, they start getting really stressed out. Okay. Recognizing that and helping them evaluate the situation. Obviously trying not to yell around them is helpful. But if something happens and you yell, you know, you drop something on your foot and it hurts really bad and you yell all kinds of expletives that may trigger them. Okay. Recognizing that, addressing them, you know, sorry, didn't mean to, didn't mean to scream, everything's okay. You know, addressing it immediately can help them re regulate a little bit. And encouraging them to evaluate the current context. In this context at this time, what did it mean when I screamed? It's not the same as 20 years ago. When you were at home and your caregiver started to scream, okay, I understand. It sounds the same, and your initial reaction may feel the same. But upon closer inspection in this context, at this time, you're safe. People with traumatic injury often have a more negative attitude. This is because after a trauma, because they're hypervigilant, because they're scanning for any signs of threat in the environment, guess what? You look long enough for it, you're going to find it. So people who are hypervigilant often notice the negative, don't notice the positive, and when you're always noticing the negative, guess what, you're going to start to develop a more negative attitude. Acknowledging what people see, acknowledging their perceptions is important. It's not helpful to invalidate people's perceptions and responses. You can present your own or you can present additional information if that is okay with the person. So if they're in this place where they're seeing everything is negative, acknowledging, yeah, that stuff sucks. You know, I, I hear what you're saying there and did you know, you know, this happy thing happened and, and that can even be sharing your stuff, not telling them, hey, you should be happy about this. Don't tell them what they should and shouldn'. They can acknowledge the stuff that they're stressed out about and you can point out things that you're happy about. They can choose to be happy about it or not. Numbing is when people are not really feeling. They're not happy, they're not sad, they're not angry, they're just blah. And many times people with traumatic injury numb up because the feelings they're feeling are just too overwhelming, too powerful. So they just don't feel anything at all. Unfortunately, sometimes that means it's hard for them to even open up to feeling anything in the future. They don't feel anything related to the trauma, but they have a hard time feeling anything about anything. And that can be devastating for them. But it can also be terrifying to them to even think about starting to feel because they're afraid if they do start to feel, they're going to get overwhelmed. It's important not to should people with trauma. Shoulding is taking away their power. Telling them, you should feel this way or you shouldn't feel this way, that's taking away their power. Validating how they feel, acknowledge, which means acknowledging it. You're not saying I agree. You're saying, I, I see that you're stressed out, or I see that you feel completely overwhelmed, or I see that you don't feel much about anything right now. Okay? And talking with them about what is it that you can do to be as supportive as possible at this time. Now, the opposite of numbing is dysregulation. And that's when people go from kind of a flat state or maybe even numb state to being enraged or frantic. And we've talked about this in just about every other video because dysregulation is common to most mental health issues. When people go from flat to furious or flat to flat frantic, it can feel completely overwhelming. It can feel like they were, you know, standing on the beach and all of a sudden a tidal wave just completely engulfed them. And it takes them a minute or longer to re regulate understanding that even though in their mind they may even realize that this whatever event happened only warrants a reaction of a 3 or a 4, but they're react reacting with a 10. They may recognize that intellectually, but their brain, their stress response ain't hearing it. They're not being overly dramatic intentionally. They're not being, they're not exaggerating. They are actually experiencing a much stronger neurochemical reaction than somebody that doesn't have traumatic injury, somebody that doesn't dysregulate. Recognizing that is going to be important. Embracing that and saying, okay, it's going to take you a little bit to recover from this. Because unlike the person whose house floods, you know, a little bit because a pipe burst, this is more like a person whose house flooded six feet deep because the dam burst in the town and the damage is a lot more extensive and it takes a lot longer to dry out. Physical symptoms are also common in PTSD and cptsd. It can include muscle tension, teeth groan, grinding, upset stomach, systemic inflammation, and even autoimmune conditions are highly correlated with traumatic injury. The person who's experienced trauma may have more physical symptoms and those physical symptoms may become a lot worse in proportion to their perceived level of stress or threatening. It's important for us to be sensitive to that and again, not accuse them of malingering in some way. It's important for that, for us to recognize what those physical symptoms are communicating and be as compassionate as possible. Yes, it can be exasperating and frustrating for you because maybe you wanted to go hiking or maybe you wanted to, yeah, go do something for the day and your significant other had a bad night, maybe they had night terrors all night and now they're exhausted today and they just don't have it in them to go do it. And that can be frustrating. It's important to respect the fact that they're exhausted. And again, talk about ways that you can make a workable compromise. Sometimes that may mean you go do it anyway, and because they want to stay home and rest and recuperate. Other times it may mean you change plans. You're still going to do something together, but it may not be quite as active or for quite as long. Being compassionate is important. Recognizing that trauma is, is exhausting. And it's not just quote, all in their heads. It's a physiological response as well as a psychological. People with traumatic injury may also be impulsive. They react, they feel stressed, they react in order to protect themselves. Noticing the environments and the situations that make your loved one, that cause your loved one to be more vulnerable to impulsivity is going to be important. And sometimes this impulsivity may come out, like drinking or random shopping or spending. It can come out in a lot of different ways, and it may be designed to distract them from the pain or distress they're feeling. Or it may be as a reaction to push away something that they are seeing as a threat. Intrusive thoughts and flashbacks are also problematic. And I wish I could say that at a certain point, they just completely go away and you never have them again. However, for most people, that's not the case. For most people, it those intrusive thoughts and flashbacks, as they feel safer and more empowered, once they've processed the trauma, they will be much fewer and further between and much less intense. However, it's possible that they can be triggered. So some people, for example, will have thought they process their trauma and be doing just fine. They, they had a, a trauma when they were a young child, and then they have a, a child of their own. And all of a sudden they start having those intrusive thoughts and flashbacks again. Okay, that's the brain going, oh, been here before, don't forget. This can be scary. They can be dealt with. But it's important to recognize, and I hate to say normalize, but normalize it. This is not an unexpected event. And help them feel supported and empowered to address it. Which takes us finally to our sense of helplessness. People who've experienced trauma have experienced, experienced helplessness. And if they've experienced ongoing trauma, especially, you know, years of trauma, then they may start to feel helpless to change anything. They may feel helpless to address anything. And it's important if you want to help, support them, to encourage them to, to identify what their rich and meaningful life looks like, what the things that are problematic, what the things that are bothering them. Are and what the steps are to address those things. And they're not going to change overnight. But helping them see baby steps, helping them see incremental progress can help them figure out, feel empowered and feel like they are safe in their current environment. Help us continue to make practical mental health tools available to everybody. You can join the channel@doc snipes.com YouTube donate@doc snipes.com donate and of course like subscribe, comment down below and share Every person's trauma issues look a little bit different. There is no one size fits all way of supporting people with PTSD or cptsd. Ultimately, we want to help them feel safe and feel empowered to keep themselves safe and move toward what they view as a rich and meaningful life. But what that looks like is going to be different for just about every person. It's important to understand their vulnerabilities, triggers and effective interventions to help them feel safe or empowered. So when they're triggered, you've got a toolbox you can share with them and they've got a toolbox that they can pull from. It may be helpful to encourage mindful awareness of vulnerabilities and triggers. For example, we're coming up on holiday season and for some people going home for the holidays is just full of all kinds of triggers and they feel a lot more vulnerable during this period because they're just constantly being reminded of those traumatic experiences. So encouraging them to check in with themselves at least in the morning and at night and say what do I need right now in order to feel as safe and empowered as possible for the person in a relationship with somebody who's experienced trauma, it's vital to take care of yourself. If you're not rested, you are and and you're not taking care of yourself if you don't have supports for yourself, you're going to get worn down and you're not going to be able to be as empathetic. You're not going to be able to be as supportive and nurturing as you could if you took time out for yourself to prevent those burnout things from happening. Other videos that might be useful understanding and addressing trauma. You can find that on the YouTube channel at doc snipes.com PTSD-list and two other videos that I've recommended in every other video in the series, Caring for Caregivers and Burnout Prevention. Both of those can be really eye openening as far as ways that your loved ones mental health issues may be impacting you and strategies you might not even be considering in order to take care of yourself.