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  • Natasha J. Thomas, MD

The Impact of PTSD on Marriage and Family: Trauma and the Drama It Can Cause

In a marriage, PTSD usually shows up as frequent arguments, threats to separate or divorce, or emotional withdrawal. Check out this post to see how you and your partner may be living out the drama of unresolved trauma in your relationship.


Marriage is a special kind of challenge, isn’t it? With its joys, obligations, occasional curve balls and daily demands for you to show up as your best self, it is many things – but easy isn’t one of them. When the spousal relationship is layered with mental health challenges in one or both partners, it can make marital success feel downright impossible.

I would argue that our trauma history (and its manifestations) should be part of the initial talks during committed relationship/marriage planning. It’s an area even the best counseled couples miss. We plan wedding day dresses and receptions, we plan where and how we’ll live, we figure out the type of family planning we’ll do, and nothing would be complete without a discussion on what we’ll eat. But discussing our partner’s health, especially mental health, often doesn’t happen. When people struggle with depression, anxiety, bipolar disorder or other mental health issues, they may feel obligated to share their diagnosis with their partner. But for most people, sharing how trauma impacts them just never comes up. Maybe that’s because we don’t realize it’s there.

As we discussed in my article on PTSD, 70% of American adults have encountered a traumatic experience and 20% of those people go on to develop Posttraumatic Stress Disorder (PTSD). In my estimation, that’s around 52 million people! It’s clear to see, then, that you’ll probably marry (or have married) someone with at least some trauma exposure.

PTSD results after an experience rips away the feeling of safety and integrity of the self. It takes the brain back to its basic instincts and makes us react with a fight, flight or freeze. It seems to get stuck in the mind, showing up as nightmares, flashbacks, aggression, depression, isolation, anger, fear, inability to relax or think, sleep issues and the list goes on. Give me your best guess on how you think all that would show up in a marriage. And when trauma or PTSD is doing double-duty, impacting both partners, there’s every chance that a full-on triggering free-for-all is taking place in the home – without us even realizing what’s behind it all.

People with PTSD do not feel safe in their bodies. They may not realize it, but they are on guard to protect themselves – at all times. Yep, that’s self-preservation. But being self-preserving in a relationship, or as a parent, doesn’t really lend itself to the development of emotional intimacy. Instead, the relationship with a person with unresolved trauma can feel like a cold, tense, and/or chaotic prison.

Let’s look at some examples:

I know of a couple. They have been together for 12 years. They are both professors and have advanced degrees. They have 3 children. She was sexually abused in childhood. He would say he had never been traumatized. In reality, he was jumped by a group of men when he was around 20 years old. He still never really goes into detail with what that was all about. The couple love each other deeply. He thinks she’s “slightly crazy” which he finds both endearing and frustrating. She often says “no” to every new opportunity or adventure. She often tells him he will NOT disrespect her. She often “freaks out” if she feels an area is too loud or crowded. And he’ll never forget how she panicked one day when he was teasing her and kept locking the door when she was trying to get out of his truck. She slapped him. He was stunned and cursed her out. They eventually bounced back from that. Now, he has decided to quit his job and create a new business. She has been supporting the family financially. She has never had to support the family before. She expected him to provide for her. No, she is not a gold digger. But money is what makes her feel secure in this world. Her father always made sure she felt secure – and he had money. Now the hubby doesn’t know it but she is planning her escape. She loves him and always will, but she feels she needs a man that can provide for her (regardless of the fact that she earns a great income herself). She looks at him sleeping and she resents him. He tries to be affectionate with her and she resents him. They get into an argument over directions to an event, or groceries, and it turns into a full-fledged brawl. What’s going on?

In this couple, the wife does struggle with much more residual psychological trauma than her husband, causing her to be controlling, aggressive in the way she speaks, and afraid of feeling physically or emotionally stuck in situations. This makes sense. When she was being molested or raped, she was immobilized. She cannot tolerate being stuck in any way. She is beginning to project her self-loathing onto her spouse and resents him for the things she sees in herself – lack of power and security. Because it’s too much to bear, she fantasizes about leaving him. The husband is healthier in many ways, but because of his history of being assaulted, he is not letting anyone get away with putting their hands on him. This is how they do their trauma dance.

I know of a family. The parents have been together about 25 years. She is an elementary school teacher, he is a certified engineer but is out on disability. They have two teenage kids. He was in the Army – received an honorable discharge after returning from Operation Desert Storm, three times. He is trying to get his medical care covered by the VA hospital. They say they can’t be sure he sustained his medical and psychological injuries in military service.

In the morning, he takes his kids to school. He shouts at them to hurry up, that they don’t know the value of time. He tells his wife she has to stop “being stupid” when she forgets to sign forms the school needs. He comes home and does not eat. He spends all day in his bedroom. He’s not quite sure what he does to pass the time. His kids come home from school and he comes out of his room to tell them to get their work done. He goes back in. On Mondays, Tuesdays and Thursdays, his younger son has to go to baseball practice, dad takes him. Dad has to watch practice from the car. He’s been banned from attending practices or games for the rest of the season. It’s because he called the coach a “punk a#@ piece of s@%#” in front of the kids. That was prompted by the coach simply saying to the son “C’mon, don’t be lazy out there.”

After practice, they go back home. When dinner has been prepared, he sits at the table with the family, his plate and a beer. If the kids get excited while telling a story, he tells them to be quiet. If the wife gets excited telling a story, he tells her to be quiet, too. He drinks another beer. He complains that the TV is too loud, the house is a mess, they are all lazy, they don’t know how to be efficient in life. He goes back to his room with two more beers. He drinks through the night, he does not sleep. He cannot sleep. He tosses, turns and has nightmares. His wife sleeps on the couch, tries not to disturb him while she gets ready for work in the morning. She prays for him often.

In this family, the father clearly has PTSD and it is from his military service. When it’s not treated, it wreaks havoc in homes. Because he feels no one understands things he went through in combat but other soldiers, he does not discuss it with his wife. And because he holds resentment toward the VA for what he sees as them dragging their feet on getting him service connection, he refuses to go there for the PTSD support group. This leaves him completely isolated in his experience. He self-isolates because he is constantly on edge. Loud noises, frustrations with other people, and any situation where he feels people are trying to make his life difficult or take advantage of him triggers his PTSD. He is aggressive, angry, fearful, and overreacts constantly. And like many veterans, he has a horrible time sleeping. He uses beer to subdue all the emotion that is constantly threatening to bubble up. His wife is afraid of him. Even though she is humiliated about how he talks to her, she is afraid it will get worse if she stands up to him. She resents him for how he talks to their children. And being overwhelmed by all of it, she uses prayer as her coping technique.

Let’s do an Exercise:

Take an inventory of your life. Have you had any sort of traumatic experience? Witnessed a serious threat to someone’s life? Or learned of something really bad happening to a close family member? If you answered yes, then in the past month, have you had unwanted memories of the traumatic experience? Nightmares? Flashbacks? Have you felt really upset if something reminded you of the experience? Do you avoid thinking of it, or situations that remind you of it? Have you felt sad, distant, guilty or undeserving of good things in life? Are you jumpy, easy to startle, irritable? Can you sleep ok? And here’s the big one: do any of the symptoms listed here have a negative impact on your ability to function day-to-day or to interact with others? If you answered yes to any of the first 3 questions, you may want to talk with a counselor. If none of this applies to you but applies to your spouse or someone in your family, share this article with them.

The home is so beautiful when it can be an escape from the world. When I was in med school, I loved the song “Refuge” by John Legend. In it, there’s a line that says, “Peace is so hard to find, we’re terrorized and victimized, but that’s when I close my eyes and think of you to ease my mind.” Hear the song here.

Get yourself healthy so your home can be a safe haven for you – and everyone who lives there. Trauma has no place in your palace!

Let us hear from you. Have you and your spouse evicted trauma from your home – your marriage? Tell us how you did it. Inspire someone!

*The couples described in this blog post are not patients of mine. Any resemblance is completely coincidental.

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