The Effects of Post-Traumatic Stress Disorder on the Family - Literature review Example

The Effects of Post-Traumatic Stress Disorder on the Family: Effect on Intimacy, Parenting and Caregiver Outcomes Kinga Skowron Northeastern University [Course] [Professor] [Date of Submission] Effects of PTSD on the Family According to the description given by the National Institute of Mental Health (NIMH), post-traumatic stress disorder (PTSD) refers to the disorder characterized by anxiety, commonly found among persons who have experienced a psychologically taxing or dangerous event (NIMH, 2012). This description also enumerates the biochemical origin of the bodily reactions leading to the psychological state of uncontrollable stress. NIMH states that danger occasions a feeling of fear in an individual and that the flight-or-flight responses triggered bring the body to a stable and protective state. However, PTSD disrupts the effects of the responses and the frightened state continues long after the danger is withdrawn or overcome, leading to unnecessary responses to inexistent danger as illustrated in this study. Common effects of PTSD to the family manifest in faulty family relations, faulty parenting roles and caregiver burden. There is a wide spectrum of persons who can experience stressful encounters, which extends across ages, gender, work and mental health. Some people experience PTSD when someone close to them experiences danger, which underscores the extent to which causes are diversified. Similar observations are held by Dekel, Goldblatt, Keidar, Solomon, and Polliack (2005), who reckon that the extent of impacts of PTSD extends from the clinically affected to persons with significance in their lives. However, persons with a high danger exposure risk are more likely to experience PTSD. Within the context of the family, different members can expose the family institution into a number of challenges since the disorder disrupts social relations and the family is a relations intensive union. It therefore implies that the PTSD symptoms extend to more than an individual, posing threats to the integrity of the family as discussed below. According to studies conducted by Ray and Vanstone (2009), PTSD affects family members and the extra trauma sustained by members of the family may take time to heal. The researchers found that the PTSD symptoms such as emotional numbing and violent episodes lower relationships within the family resulting in emotional struggle. When members of the family experience high levels of emotional burden from the suffering of one of significant others, relationship injuries sustained require quick attention to avoid progression of trauma. According to Kramer (1993), control of stress involved in PTSD must target elimination of transfer of the stress damage persons with a close relationship, to risky levels that are difficult to deal handle. Familial relationships for persons with a higher exposure risks to PTSD must be protected, against the impacts of the condition, according to the studies by Panuzio, Proctor, Schumm and Teft (2008). The authors reckon for instance, that the manner in which members of the military are dispatched for duty and the reunion with their families faces readjustment challenges. In view of the challenges thereon, it is important that the appropriate assistance around psychological issues involved must facilitate reunion of members of the military with their families to avoid further traumatic experiences. According to NIHM (2012), PTSD occasions disrupted emotions, which always lead to injuries on intimate relations, among persons with long-term relationships such as couples. Apparently, persons with symptoms of PTSD cannot sustain consistency in expression of their feelings, since clinical manifestation of the disorder disrupt such expressions (Kramer, 1993). According to Dekel et al (2005), wives of war veterans experience difficult relationships within their marriage as a result of consequences of the disorder in their intimacy expression. Among the commonly occurring emotional disruptions include feelings of tension since the wives cannot predict the volatile tendencies of their affected spouses (Fairbank et al., 1992). In view of the symptoms of the persons with the disorder, rigidity in dispute resolution, violent episodes, low cohesive skills as well as restricted intimacy affect how intimate relations proceed. Alternatively, development of mental conditions from the interaction with an individual with a severe psychological condition such as PTSD always affects spouses, especially women than other members of the family (Fairbank et al., 1992). Empirical study conducted by Dekel et al. (2005) investigated how wives of war veterans in Israel responded to relationship difficulties witnessed in dealing with their spouses. It emerges in the study, that it is difficult to initiate separation proceedings in such cases since the negotiations environment is not conducive, since the PTSD victims have their decision-making abilities impaired. For instance, it would be difficult to engage a violent person in negotiations requiring compromise of hardline positions such as denying divorce. Alternatively, emotionally stronger partners devote relatively more input in sustaining the relationship, which is unfair in terms of intimacy contribution (Maloney, 1988). The author reckons that secondary traumatization always leads to multiplier transfer of the negative emotions from the victim to their spouses. Cases of recovery however indicate that the supportive intimate relations that victims obtain from their spouses contribute to development of desirable recovery environment. This implies that a supporting environment for the victims to recover is needed, including ensuring a warm social environment even if it is not always available. This underscores the psychological aspect of the healing process, which targets to resolve the psychological disruption to dealing with flight-and-flight. In studies conducted by Fairbank et al. (1992), couples in a relationship where one suffers from PTSD experience general relationship challenges such as violence and verbal aggression, which affects discharge of parenting roles. Despite the fact that the family faces such a problem, the partner taking more responsibility of the victim also assumes more responsibility for the family (Nelson and Wright, 1996). These authors also recommend that assuming more responsibility over children and family often affects the balance and quality of an individual’s life in the relationship. In light of the impact of the PTSD on one member of the family, it is difficult for the rest of the members of the family, particularly among the couples due to their responsibility over family and children. Desirable outcomes of treatment and management of the disorder among partners, involvement of the other partner and perhaps the entire family in the sessions illustrate the extent of the damage that the disorder can have on the entire family (Maloney, 1988). The damage that the family relationships sustain can be identified, depending on the prevalent symptom in an individual’s PTSD manifestation. Emotional numbing for instance may not affect the family in a similar manner as anger and bad dreams. According to studies conducted by Boxer et al (1999), therapy conducted with inclusion of the members of the members of the family delivers desirable results on the management of the victim’s condition. When a family member suffers from PTSD, various levels of emotional and psychological burden emerge, perhaps depending on the attachment trajectories among familial relationships (Maloney, 1988). In light of the attachment variables that different members of the family have with each other, caregiver responsibility may develop to characterize the different values of burden sustained by every member of the family (Nelson and Wright, 1996). As Maloney (1998) reckons, it is possible to observe that caregiver’s burden borne by a spouse is not similar to that taken by children and is equally different from that felt by members of the extended family. This implies that the closer to the victim members of the family and friends are, closest in the nuclear, closer extended family and further away from friends, the more they are to experience emotional burden. The caregiver burden construction dependent on the relative attachment trajectories that different family members have towards each other may be conceptualized from the apparent relationship held among members of the family (Nelson and Wright, 1996). This means that the different types of emotional attachment that persons close to the victim establish in their lives define the effect on emotional burden. From such construction, the impact of alteration of the ordinary life of an individual as a result of the sustained burden can also be generated (Beckham Fieldman and Lytle, 1996). This means that the life of the persons bearing the most emotional burden as they interact with victims of PTSD is bound to change in a significant way, even if they do not completely acquire PTSD. Such constructions may include the level of emotional drain as well as financial strain that different persons in the family may assume in caring for the victim. In conclusion, PTSD affects intimacy, parenting and caregivers with different impacts being felt by different persons depending on emotional attachment variables. It would therefore be expected that spouses and children would experience the highest emotional and financial burden than a house help or members of the extended family (Boxer et al, 1996). Caregivers would also experience some pressure from the burden attained in discharge of care duties. Studies by Beckham, Feldman and Lytle (1996) found out that individuals with a higher caregiver burden experience psychological distress when compared to persons with little burden or none. It implies that the family experiences high levels of impact originating from PTSD on one of them when compared with rest of the community in which an individual lives (Fairbank et al., 1992). References Beckham, J. C., Feldman, M. E., & Lytle, B. L., (1996). Caregiver burden in partners of Vietnam War veterans with posttraumatic stress disorder,” Journal of Consulting and Clinical Psychology, 64;1068-1072. Boxer, L., Crothers, J., Eth, S., Firman, G., Foy, D. W., Glynn, S., & Urbaitis, M., (1999). A test of behavioral family therapy to augment exposure for combat-related posttraumatic stress disorder, Journal of Consulting and Clinical Psychology, 67(2);243-251. DOI: 10.1037/0022-006X.67.2.243 Dekel, R., Goldblatt, H., Keidar, M., Solomon, Z., & Polliack M. (2005). Being a wife of a veteran with posttraumatic stress disorder. Family Relations, 54;24-36. Fairbank, J. A., Hough, R. L., Jordan, B. K., Kulka, R. A., Marmar, C. B., Schlenger, W. E., & Weiss, D. S.(1992). Problems in families of male Vietnam veterans with posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 60(6);916-926. DOI: 10.1037/0022-006X.60.6.916 Kramer, B. J. (1993). Marital history and prior relationships as predictors of positive and negative outcomes among wife caregivers. Family Relations, 42;367–375. Maloney, L. J. (1988). Posttraumatic stresses of women partners of Vietnam veterans. Smith College Studies in Social Work, 58;122–143. Nelson, B. S., & Wright, D. W. (1996). Understanding and treating post-traumatic stress disorder symptoms in female partners of veterans with PTSD. Journal of Marital and Family Therapy, 22;455-467. NIMH, (2012). What is post-traumatic stress disorder, or PTSD? Retrieved from http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/what-is-post-traumatic-stress-disorder-or-ptsd.shtml Panuzio, J., Proctor, S. P., Schumm, J., Taft, C. T., (2008). An examination of family adjustment among operation desert storm veterans. Journal of Consulting and Clinical Psychology, 76(4);648-656. Ray, S. L., & Vanstone, M. (2009). The impact of PTSD on veterans’ family relationships: An interpretative phenomenological inquiry. International Journal of Nursing Studies, 46(6);838-847. Read More