Articles for the Month of October 2014

PTSD: How Couples and Families Benefit from Therapy Too

PTSD: Couple's Conjoint Therapy - San Antonio Therapist

PTSD: Couple’s Conjoint Therapy – San Antonio Therapist

Revised September 11, 2015.

Constantly witnessing the debilitating effects of PTSD on someone you love is tough. It’s tough to be the loved one of someone with PTSD. So tough, in fact, that without help, too many marriages crumble completely and too many of their affected children suffer, too. Depression, anxiety and violence can become the destructive legacy borne out of the trauma playing on repeat in the mind of a spouse or parent with PTSD.
Trauma, Emotional Fatigue and the Resulting Family Drama.
As much as he or she tries to get a handle on it, PTSD won’t go away on its own. Too often, PTSD sufferers still try to suppress or control the feelings of fear, anger, powerlessness or shame with disastrous results to their relationships. The PTSD symptoms make the sufferer unpredictable and disruptive to the family dynamic. Family members may begin to fear and resent the change in their loved one.  They also may become hyper-sympathetic, bending over backward to help, hoping to love their partner or parent back to normalcy. When family attempts to help only result in more disruption or withdrawal by their loved one, family interactions become even more complicated. Soon emotional disturbance starts to plague families in the following ways:

  • High conflict with the sufferer
  • Detachment from the sufferer
  • Depression and hopelessness
  • Guilt at their inability to help
  • Anger at the sufferer’s inability to improve
  • General negativity towards the sufferer
  • Anxiety regarding safety and unpredictability
  • Caregiver burden, especially among female partners
  • Unhealthy coping mechanisms and habits

With all of this happening in the home, it is no wonder why the PTSD sufferer becomes more discouraged and family members are at a loss about how to take care of themselves, much less their loved one.

How Conjoint Couples Therapy Complements Individual PTSD Therapy…And Finally Brings Relief.

Therapy for the individual PTSD sufferer is necessary and definitely the place to begin. The PTSD victim requires quality treatment as he or she learns more effective ways to cope, manage symptoms, and deal with the feelings of guilt, vulnerability, and responsibility that accompany family life.

However, the benefits of Cognitive-Behavioral Conjoint Therapy should be considered and employed for the benefit of the sufferer’s primary relationships.

Intentional time spent in therapy together would support efforts to help the couple cope with the high levels of stress and emotional problems created by the disorder. Individual treatments help the sufferer but don’t necessarily help an affected couple reconnect, often postponing relationship work too long.

So what does PTSD couples therapy look like?

Recent research indicates that a method called Cognitive-Behavioral Conjoint Therapy for Post-traumatic Stress Disorder (CBCT for PTSD) is extremely helpful in helping couples reestablish emotional intimacy.

CBCT for PTSD is basically 15 treatment sessions of 75 minutes each. Couples focus on their problems, and work toward the goal of improving the individual’s PTSD while simultaneously improving relationship functioning.

Results from this type of therapy have shown that partner social support does two key things:

  • CBCT utilizes the relationship to make the PTSD sufferer feel better and more inclined toward self-disclosure rather than feeling pressured, guilty or ashamed.
  • CBCT provides a safe, productive environment for fostering greater relationship satisfaction, which promotes feelings of security and greater contentment for the entire family.

The impact to PTSD sufferers is real and his or her family suffers, too.

But with the help of a qualified therapist, PTSD doesn’t have to destroy relationships and trauma doesn’t have to have the last word.  Call me to discuss CBCT for your and your partner.  You can also go online to make an appointment.

Why Social Media, Texting, and Marriage Just Don’t Mix

By Cathy Neville, LPC

social media

Does Social Media Impair Your Intimacy and Interaction?
Take a look around. It’s happening everywhere, all the time.  Couples barely speak or look at each other. They rarely hold hands, engage in lingering looks, or share a long laugh. Glowing screens and the persistent need to post and tweet are draining the electricity from a legion of marriages. And, often, couples are too distracted to notice.How can you spare your union the negative effects of a media overdose? Look away from the screen. Awareness is power! Consider how your social media and texting usage could be hurting your marriage:
  • Social media can quickly turn sexual. All it takes to create a perfect storm of social media misbehavior is a few suggestive “selfies,” a couple of posted inside jokes, and a few unresolved issues in your marriage. Social media is a breeding ground for problems stemming from 24-hour access and a lack of accountability. When social media becomes suggestive, a secret wedge can work its way between partners.
  • Social media makes keeping up with the Joneses a full-time job. Who has time to focus on real life if you’re always posting photos and inspirational quotes of the life you wish you had? Beyond the problems of being authentic, you may start to find your relationship lacking simply because is doesn’t measure up to the equally inauthentic posts of your “friends” or followers.
  • Social media idealizes long forgotten ideas. Something about social media creates relationship amnesia. We forget that some relationships need to be forgotten, left behind, or relegated to occasional visits. A lot of what happened in high school should stay in the past. Your mature marriage relationship and your high school love need not ever make contact. To build a healthy marriage, keep moving forward.
  • Social media makes you an ostrich. There is no need to cope with real life problems in your relationship when you have the encouragement and support of a “friend” who really understands you. Failure to focus on your marriage leads to a failed marriage. Chances are, your cyber relationship won’t be worth the strain to your union.

Is Texting Hindering Your Communication?

  • You’re texting too much. If you constantly have your thumbs poised to shoot a text to your friends, boss, children, or whoever else crosses your mind, but you can’t remember the last time you actually looked at your partner’s face, it’s probably time to put the phone away and schedule some quality time before it’s too late.
  • You text to avoid talking. Talking is often messy between partners. Yet, attempts to maintain your relationship through texts is often messier. Misread tone and intention often exacerbate misunderstandings. Authentic connection is lost without the ability to visually read nonverbal communication. Respect may be compromised by the ease with which a text conversation can be terminated, used to say things you’d never say face-to-face, and employed as a crutch for poor communication skills.
  • Texting is easier. When life is hectic it’s tempting to think that a quick text is enough to make your partner feel loved. While texting can support a good connection, it can’t create connection. At the very least, try to make an actual call and enjoy the sound of each other’s voice.

If things have gotten out of hand, you can still make a change.

Put down the iPad.

You can do it.

Unplug the laptop.

Back away from the phone.

Seek out your spouse.

Don’t be afraid to call a counselor if you need help plugging back into each other.

Soon you’ll find that your marriage offers more fulfillment than Facebook ever could.

PTSD: Why Women Are More At Risk


By Cathy Neville, LPC

Just being female puts a woman at risk for developing post-traumatic stress disorder.
According to the National Center for PTSD, 5 out of 10 women often relive the circumstances of their individual traumas and struggle to move forward.
They attempt to manage the hyperarousal, nervousness, and shame; quell the sense that their trauma will always be with them; and do their best to cope amid the responsibilities of their daily lives.
Is it that women experience more trauma than men?
Actually, men face more distressing incidences. Men suffering from PTSD usually show some outward indicator of the disorder. They may become outwardly defensive, operating primarily out anger rather than sadness, and often turn to substance abuse to cope.
It seems that female PTSD is linked to the way women experience trauma.
A woman dealing with PTSD usually wrestles with depression, worry, and nervous energy more than anger. The after-effects of trauma are evident in the way she is easily startled, emotionally numbs herself, and is prone to avoid places, topics, and people that remind her of the most disturbing events she ever faced.
What happens in the life and mind of women to make them so vulnerable to PTSD?
Consider these three commonalities often shared by women with PTSD:
o A female’s first exposure to trauma is usually some sort of sexual assault.
Research indicates the effects of sexual trauma are similar to those faced by war veterans. Experiencing sexual violation wreaks a devastating toll, negatively impacting a woman’s worldview and sense of herself. The experience is all too common, transcending culture and location. It is always life altering and always traumatic, and especially damaging if a woman receives no therapy or treatment.
It may be that because this type of abuse is so pervasively tied to the sufferer’s own body, infringing on every intimate relationship, that it lays a foundation for a trauma response in some women’s lives. Sexual trauma seems to solicit a more emotional response than other types trauma, as well, setting the stage for more easily recognizable PTSD symptoms and an earlier diagnosis.
o Cumulative trauma may result from untreated emotional problems or a combination of traumatic incidents causing intense suffering.
PTSD is much more likely to affect a woman with other unresolved mental health issues or who is exposed to another traumatic experience following the original event. For example, a woman who hasn’t acknowledged or dealt with sexual trauma in her past may experience significant PTSD after a car accident or natural disaster. The symptoms may seem overblown, but are essentially an outgrowth of both traumas.
o The emotion–based way most women respond to trauma makes them more likely to receive a PTSD diagnosis.
Women generally express trauma in ways that coincide with the criteria used to make a PTSD diagnosis. Women are more prone to show their emotions, divulge their depression, or act out their anxiety. The mental and emotional expressions of PTSD among females are typically more readily available for examination and identification.
Conversely, men simply don’t tend to report their struggles with depression or anxiety, though they may experience them too. They will instead point out problems of self-control and anger, substance abuse and addiction. Therefore, a PTSD diagnosis may not be made until much later.
Fortunately, being female puts many women in a good place for treatment.
The same willingness to express feelings that make them susceptible to PTSD, makes recovery likely with the appropriate help.
If you think you may be suffering from PTSD, seek help and put your traumatic past behind you.