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Monday, February 25, 2013

Secondary PTSD - Mary's Story

I want to tell you the story of Mary.  I've changed her name to protect her identity and that of her former spouse, who is a military veteran.  Their story is one that gets played out thousands upon thousands of times all over the country in the homes of veterans and their spouses and children.  These innocent individuals are among the casualties of war that no one knows about, except for maybe the few who are close to them.  The war is brought into the relationship, and causes what is called secondary Post Traumatic Stress Disorder, where the spouse and children begin to "mirror" the PTSD living inside the person inflicted with PTSD.  Secondary PTSD occurs when a person has an indirect exposure to risk or trauma, which results in many of the same symptoms as primary PTSD.  The most common occurrence of secondary PTSD is in the homes of returning veterans from the wars.  It seeps in almost unknowingly, creeps in like a thief in the night, and with it, disrupts, dis-harmonizes, and brings an unending list of troubles.  If PTSD, primary or secondary, is not treated, recognized, and healed, it will destroy the integrity and love in the relationships of all concerned, leaving deep scars and trauma wounds that can impact an individual for the rest of their lives.

Mary's story begins when she first met Steven while they were in high school.  They attended different schools, and met at a summer church festival.  Steven was one of the most handsome looking young men his age, strapping, young, full of youth and vigor, and the desire of all the girls around him.  Mary was this beautiful, spunky, immigrant girl from Southern Europe who matched looks with Gina Lollobrigida  and was every young man's dream.  They fell in love with each other that first night, and Steven told her the first time he met her he was going to marry her.  They seemed like the perfect match.  Mary found him to be very kind and sensitive.  They talked about their lives together, growing old, family, children, respect; Steven wanted the same things Mary wanted.  Although Mary buckled when Steven told her he was going to marry her, as she wasn't sure what she wanted to do yet with her life, they kept in touch while he was away fighting the war, writing letters to each other, professing their undying love.

When Steven came back from the war after going through a few tours overseas, he had changed.  The war had changed him.  Mary found him to be very distant, stand-offish, and not very friendly.  Mary noticed this drastic change in his personality, but because she remembered how he used to be, she would cater to him for his love and affection, believing in her heart, that if she showed him how much she cared for him, he would get better.  She knew the kind of person he was - kind, sensitive, outgoing, loving - and so, in order to bring this side out of him, she became very submissive.  She also didn't want to lose him, she loved him so much, so she did what she had to do to keep him from leaving.

One night, right before they got married, Mary and Steven went to a bar where a man whom Mary knew came up to her and said 'hi'.  Steven was so upset about this, he stood up, and walked out of the bar, leaving his fiance there to find a way back home by herself.  Mary was so distraught by Steven's overreaction, she cried and cried all night long.  Her mother, seeing her daughter shaken up and brought to tears by Steven, warned her daughter, "this man is going to make you cry the rest of your life."  But Mary didn't want to hear what her mother had to say, she loved Steven so much, and believed her love could save him from whatever pain he was going through.  Little did she know the problems she would soon face.

Steven and Mary got married very soon after he returned from the war.  But the problems didn't stop.  Steven would drink a lot, a very common coping mechanism for returning veterans in how they attempt to drown out the pain they feel inside.  He would be out drinking many times until 2 or 3 in the morning, coming home very drunk.  He drank at home, and during the week he would go out until very late.  Steven was hurting so bad inside, but he didn't know how to handle it.  How else was a 24 year old man supposed to handle that much pain having seen, witnessed, and participated in so much horror?  At that time, PTSD was not given the attention it deserved and those returning from the war did not have the resources to get healthy again.  The military breaks you down, teaches you how to kill, then you go do it, you come back, they give you a medal, and say have a nice life.  But those men are left with the mental, emotional, and psychological scars that impact the rest of their lives and the lives of their loved ones.  Just ask Mary.

The first year of their marriage, Mary told me, was very difficult.  One night, Steven came home drunk and said he was leaving her.  Mary knew he'd been drinking and told him to go to sleep and we'll talk about this in the morning.  Steven wouldn't listen.  Mary stood by the door blocking him from leaving, and in a fit of rage, Steven picked her up and threw her on the couch, and walked out of the house.  Mary, not one to give up on someone, got pissed off, ran after him and jumped on him from behind, knocked him down, and hit his face.  Steven was completely caught off guard by this.  Mary told him to get his ass in there.  He did.  The next morning, when Steven sobered up, in one of his few moments of vulnerability, said, 'You love me so much, no body fights for me.'  They reconciled, and for a while things were better, but things were about to get much worse.

Mary told me she was always in fear for her life when he drank.  Steven became very mean, everything was a problem, he wanted to hurt something, he had so much rage inside of him.  Whenever he drank, it relaxed him, and so this rage that he was bottling up, would come out.  As time passed and the problems continued, she felt that if she were not submissive to him, and instead was a woman who attacked him or stood up to him, she would have gotten hurt.  She slipped into a role, without even noticing it, which would define her role in the entirety of their relationship, of constantly watching out for people or circumstances that might "set him off."  Mary didn't want to aggravate or upset Steven in any way.  She catered to his needs, and when they had children, she took on handling all the childcare on her own.  She received very little help in the beginning in raising their son and daughter.  She wanted to keep everything "perfect" for Steven, but despite her best efforts, the problems continued.  Mary didn't know it, but she was showing the signs and symptoms  of secondary PTSD.

41/2 years into their marriage, Steven left Mary and their two young children, a boy who was 2 1/2 and an infant girl, who was 6 months of age, one night after coming home from drinking at 3 am.  Steven said he didn't love her anymore, and without any explanation, started packing up.  Three weeks before at a New Years Eve party, Steven had told Mary how much he loved and cared for her.  Mary begged him not to go.  "Please don't go, please don't go!" she screamed and hollered.  Steven was determined to do what he set out to do.  She cried and collapsed to the ground.  The emotional trauma was so extreme for Mary that within 24 hours her milk went dry for her still nursing infant daughter.

The next six months, all she did was cry and cry, and do her best to take care of the children.  Her son became her rock, and she clung to her children as a way to get through each day.  One day, while they were still separated, Mary got extremely angry with Steven because she'd found a receipt on the dash board of his car for flowers for some girl.  The two of them had taken their infant daughter to the doctor and Steven was driving them back home.  Mary attacked him and scratched her fingers on his face when they pulled up to the house.  Mary was so angry at him because she needed money for food for the kids and he was giving the money to buy flowers for a girl.  Steven blew up at what she did to him.  After dropping off their daughter inside with Mary's mom, they began arguing, and in a fit of rage, Steven picked up Mary and threw her in the snow.  Watching from the window, the violence, anger, hate, and pain, was their son.

Steven and Mary did get back together, for their children's sake and because they truly did love each other.  Mary though, grew even more submissive to him when he returned.  If the sky was purple, she would agree with him.  She did not want to upset him.  She wouldn't push him on issues, she would just agree, and would keep everything inside of her.  Mary did this because she didn't want to start any trouble.  She was afraid of losing him, and so she got through each day the best she could.  Mary did say though, not everyday was bad, there was a lot of good days, but she had to keep constant vigilance for that sign in him that said danger.

Steven eventually had to come to terms with his drinking.  The last night he drank during this period of their lives they were at a house warming party.  Steven was drinking pretty heavily, playing softball, being obnoxious and loud, kissing the girls around him, and getting drunk.  Mary was up by the house and couldn't find their son. She walked down to the fields where they were playing softball to find their son standing there watching his father doing all these things.  It got much worse as the night wore on.  By the time they left the party, Steven was beyond drunk, and insisted on driving.  Mary held her kids close to her side as Steven drove them home.  Steven nearly got them all killed in an accident.  Mary screamed at him, and was praying to God just to get them all home in one piece.  Steven, in his drunken stupor, slapped Mary, grabbed her hair, and became very violent.  Their son wrapped his arms around Mary's leg and buried his head into her.  Mary prayed and prayed all the way home.  When, by the grace of God, they did get home, Mary jumped out of the truck, and rushed her children inside.  Steven had fallen out of the truck, and was laying on the ground, but Mary didn't care at this point.  She'd made a pact with God that this was the final straw.  No longer was she going to put herself or her children's lives in jeopardy with someone who seemed so far from the man she remembered.  She knew there was a good man in there, but since the war, the man who returned was so full of rage and pain that he became a threat to the safety of them all.  Mary told me, in that moment, she became very calm, and knew what had to be done.

Steven made it inside the house and passed out on the couch.  Mary placed a bucket next to him so he had a place to vomit.  The next morning, Mary made coffee, and threw out the bottle of whiskey Steven used to add to his coffee when he drank it.  Steven was sobered up and completely oblivious to what had happened the previous night.  He had blacked out, and didn't understand why Mary was so cold to him.  Mary explained to Steven what happened, and told him, "That will never happen again.  You almost killed us.  They would have forgiven you because you were drunk.  But I was sober.  I'm never doing that again.  God gave me my children and you don't have the right to take them away."  Just then, their son came down the stairs and sat at the table for breakfast.  Steven tried to talk to him, and the boy, frightened and scared, said, "Papa, you scared me."  Steven really broke down.  This was his moment where the reality of the way he had been behaving became very clear, and the love he had for his child and his wife, made him make the choice to call and get help for his alcoholism.  Steven got the help he so desperately needed, for alcohol, not for PTSD, the true cause of his, and his family's problem.  Steven did stop drinking and didn't drink for many years, which diminished most of the tension and violence in the home.  But even when Steven was going in to get help, his parents told Mary, "the alcohol is just a symptom, its not the problem."

There was a long pause on the phone as Mary collected her thoughts.  She hadn't thought about these things for a very long time.  She said things got a lot better after that, but it didn't end completely.  She said she never knew when it would be World War III.  They built a successful life together, but that didn't stop the fear that he could explode if things weren't done in a certain way.  Little things became a monumental issue.  Everything was a war, or a problem, or a danger to Steven, according to Mary, and she remarked ironically, "Steven was always in the jungle, looking around."  Mary, to avoid confrontation as much as possible, kept the house clean (she also said she liked to keep the house clean too, so it wasn't really a problem or an issue), took care of the kids, did all the laundry, etc., everything in the family felt like it was left up to her.  And if she should fail or not do it perfectly, all hell would break loose.  So she did her very best not to give him any reason to complain.

I asked her about behaviors that stood out.  Mary told me that when they went to weddings, they would have to sit in the back of the room.  Steven didn't care much for crowds and wanted to see everyone who came into the room.  He stood on guard and watched most of the time, standing or sitting, and when he felt comfortable would go out and dance with her.  Steven was very judgmental and didn't trust anyone, especially women.  Back in the war, the enemy often used women and kids as boobie traps to kill soldiers in the field.  Mary sighed, held back a cry, and said, "Steven has such a good wonderful heart, but it was just damaged and in pieces."  Mary told me as the kids grew older, they used to make signs with their hands to indicate the temperament of Steven when he came home from work.  One finger meant Steven was happy, and five fingers meant everyone needed to be on their guard.  At times they felt like they were walking on eggshells.  Steven became a workaholic and Mary did everything else.  She told me he provided very well, and did the best he could, but didn't want to deal with the emotional side of life, or just wasn't capable of it at that time with his wife and children.

Mary went quiet for a moment, and then told me of a time when Steven had fallen off a roof and nearly died because of it.  Steven survived the fall miraculously, and while in the hospital, was the most kind and gentle person to her.  "He was so kind and gentle, he told my family how much he loved them, how he was going to change, how lucky he was to have her.  It was everything I ever wanted from him.  But then, three days later, it switched, and the old Steven was back."

I could sense the pain in her voice.  I asked Mary gently, was he ever there for you emotionally?  "Oh," she said, "I would cling to those windows of emotion, feelings and connection.  But it didn't last."  Mary said she tried to hide everything going on within the family to make things look perfect.  I asked her why and she said because he would get so upset.  He was like Dr. Jekyll and Mr. Hyde, his reaction to these everyday family emotional issues would be so over-the-top that you would feel like you and your children's lives were threatened.  But the BIG stuff, the big crises that would occur, Steven was great at handling.

Which makes perfect sense.  See, Steven, spent weeks, months, faced with constant fear, death, adrenaline, and danger.  This changes the way the brain looks and functions.  Steven could handle the big stuff extraordinarily well, it was the "normal" situations that he was ill-equipped to handle.  Hence, Steven would be very calm when the BIG stuff hit, while those around him marveled how he could handle these major life crises when they were on the edge of losing it.  But when the small stuff came in, what Mary considered "normal" family issues, Steven's reaction would be so over-the-top it would cause others, and her children to fear him.  So, she began to hide stuff from him to keep the peace.  Eventually, her behavior - hiding things from him about the children, her hyper-vigilance to keep a look out for cues and triggers that could bring about Steven's reactivity - most assuredly became a stressor and a problem for Steven.

In a healthy relationship, these "normal" family issues would not have become monumental events.  They would have been dealt with as soon as they occurred, and with the appropriate reaction and emotional response.  Here's the problem with PTSD (among many other things): you overreact to the small stuff, but are well equipped to handle the big stuff.  However, most of life is in the little details of everyday living.  Two, three, or four episodes of overreacting emotionally (excessive rage, threats, anger, etc.)  conditions the spouse or child to be in an hyper-vigilant state when the small things occur.  People start hiding things and covering up for fear of the reaction of the person with PTSD.  This creates major problems in the relationship and when the children grow older.  Issues that need to be addressed - potentially destructive behavioral patterns, truancy, emotional problems the child might be having - these things are kept hidden to keep the peace.  This constantly being on alert by the spouse, in this case Mary, and her children created the conditions for secondary PTSD to happen, and thus, the war got passed down to Mary and her children.

Throughout the interview, I couldn't help but think how beautiful and innocent Steven and Mary must have been when they first met, and how terrible war is and the casualties it inflicts, both on the battlefield and off.  

We ended the interview there.  Mary was kind enough to share with me her story of her experience with a vet.  I was very grateful she would open her life up to me.  She hopes her story will resonate with other spouses who might be experiencing similar circumstances to know that you are not alone, and to seek help, together with your spouse who suffers from primary PTSD if possible, in order to learn how to cope and heal the problem together.  The problem though with most vets with PTSD is they don't recognize they have a problem.  Until they recognize it, the best you can do is inform yourself about what PTSD and secondary PTSD is, and seek counseling for yourself and your children.