Part 1

Ways to Manage Trauma and Stress Related Disorders in a Poly Relationship

Okay, I said this about anxiety and the same goes here:

If anxiety manifests in ways that look like jealousy or controlling behavior, do not follow standard poly advice for dealing with jealousy. Learn to tell the difference between anxiety-induced and jealousy-induced behavior. Treat jealousy like jealousy and anxiety like anxiety. Your partner has tools for managing anxiety for a reason. Use them! Treating anxiety like jealousy just compounds the problem.

Similarly, treating PTSD like abuse just compounds the problem.

When someone’s trauma causes them to act other unhealthy manners—including abusive manners—treating them like an abuser doesn’t help. That doesn’t mean their harmful behavior should be allowed to pass. But telling someone in the middle of a triggered response to past trauma that they are guilt tripping you and you won’t stand for it doesn’t help anyone.

Similarly, calling someone out for gaslighting and telling them that you aren’t going to put up with this shit, does no good when they honestly believe what they are saying.

This is also a good place to link to an old rant of mine. At some point in the healing process, people with trauma and stress related start to recognize that their thoughts and feelings are distorted. “I know what I’m feeling isn’t real, but I can’t stop feeling this way,” or any similar statement is not an invitation to tell your partner all the reasons why they are wrong to feel that way.

Managing trauma and stress related disorders starts with everyone involved learning to recognize what is the real person and what is the disorder. This can be as simple as not taking it personally if a partner needs to cancel a date because they can’t drive that night. It can also be as complicated as learning to recognize the unintentional gaslighting of a partner who honestly remembers things wrongly.

You can’t deal with the disorder until you can recognize when the disorder is fucking with things.

Next, focus on small steps. If the very idea of polyamory is triggering flashbacks of past betrayal, scheduling your first date next week will not work. In fact, this is one of the rare situations where I would actually encourage a couple to date together. Either both date the same partner or double dates with both their partners. Yes, this is completely against The Big Book of Poly. Explain the situation to potential partners, be VERY aware of the difference between a triangle and a T, and it can work.

Another option, if you are living with a partner and that partner going out on dates is triggering is for your partner to try having “date nights in.” I hope it goes without saying, but this absolutely needs to be your partner’s decision. Date nights in is something I’ve done a fair bit of in the last few years. Not because of mental health issues, but because my most entwined partner is disabled and we have a young child. Leaving my partner who sometimes couldn’t stand up w/o help alone with a young child (or worse, infant) he might or might not have been able to take care of was not something either of us were comfortable with. So poly partners and potential poly partners would come to our home, usually after the kid was asleep for the night. My live-in partner would put on his headphones and lose himself in a computer game or video. My visiting partner and I would have a “date night” on the living room couch, bed, or front porch.

Now, moving slowly doesn’t mean refusing to make changes. You can start out dating together or having date nights in to reduce the amount of triggering someone in your polycule is dealing with. Eventually you will want and need to move towards dating separately/having date nights out. Exposure is a big part of treatment for trauma and stress disorders for a reason—the only way to heal is to slowly push the boundaries of the disorder. Note, NOT your boundaries, but the boundaries imposed on you by the disorder. And ONLY at a pace you agree to. Note also, I didn’t say “a pace you are comfortable with.” When it comes to trauma there ain’t no such thing. Like doing physical therapy for damaged muscles, if you stick to what is comfortable you will not heal. But it needs to be your pace, and no one else’s. Poly partners can support, encourage, suggest, or set their own boundaries on what they are and are not willing to deal with. They can’t set the pace for you.

Once the effects of the disorder are recognized, everyone involved needs to be involved in setting ways to work around, with, and through these things. For something like not being able to drive, or needing to avoid dogs, this can be as simple as making alternate transportation available.

For problems directly triggered by polyamory it can be more difficult. I suggest having two levels of response for most trauma related problems. “This is triggering me but I can deal with it (maybe with a bit of support.” and “OMFG help!!!”

If a poly partner recognizes signs that someone’s reaction or action is due to a disorder, point it out. “Hey love, it sounds like this is triggering you. I get you are angry and scared. How do we deal with this?”

If there are things that can make it easier to deal with your partner leaving, ask for them. If there is nothing that will help, but now that you recognize being triggered you can deal with it, this is a good time to try to push through. There may be backlash later but you can probably manage until your partner gets back from their date—tell them that. They’ll go out, and you’ll deal as best you can until they come back, and when they come back you can ask for whatever aftercare you might need.

If you absolutely can not deal, tell your partner. DON’T assume that they know how badly you are doing. Have an “OMFG help!” response you’ve discussed and agreed to try ahead of time. Maybe your partner doesn’t go out when you are doing this badly. Maybe they call their partner and switch to a date night in. Maybe your partner doesn’t leave you alone, but helps you contact another partner, friend, relative, etc, to come over and be with you while they are out.

Trauma and stress related disorders that are severe enough to regularly impact dating and relationships—especially if dating and relationships are triggers—definitely need to be discussed upfront. And that doesn’t mean just the person with the disorder discussing their needs with potential partners. It means their partners discussing it with their potential partners. Everyone who might be impacted by the disorder needs to know what to expect. Otherwise they do not have the opportunity to give fully informed consent.

Okay, But What If I’m Just Starting to Date Someone with a Trauma and Stress Related Disorder?

The above discussion is mostly directed at people with trauma and stress related disorders and their long term partners. If you are just starting to date someone with a trauma and stress related disorder—or if you are starting to date someone whose entwined partner has a trauma or stress related disorder—you are in a very different boat.

But it starts out the same. Learn as much as you can about their disorder, how it affects their behavior and how it affects you.

There is a line from the musical Rent that is very relevant here, “I’m looking for baggage that goes with mine.” As I’ve said before we all have baggage. Mild trauma and stress related disorders, especially when they are largely under control, can go with most people’s baggage, as long as you are willing and able to work with them a bit. Severe trauma are stress related disorders are a very difficult type of baggage to match. If your baggage doesn’t “go” with he baggage of someone who has a trauma or stress related disorder that’s okay. But if you find them attractive, interesting, and generally someone you’d like to be in a relationship with, and they tell you some of their baggage is labeled “PTSD” or “Acute Stress Disorder,” don’t give up on them just based on the label. Get to know them and their baggage enough to see if maybe their needs and challenges can actually fit with yours.

Be prepared for an adjustment period. Dealing with something like severe PTSD has a steep learning curve, and like I’ve said before flashbacks can be horrible to watch. In general, the longer its been since the trauma that caused the disorder the better a grasp your potential partner will have on it and the better they will be able to tell you what they need and how it affects things. But that is only “in general” because everyone, and every trauma, is different. My experience has been that trauma from a single incident (bad car accident) causes a smaller range of problems than trauma over a long period of time. That isn’t to say that trauma from a single incident is easier to deal with—but trauma related to a bad car accident will usually only have triggers related to cars. Trauma related to single incident of rape will have triggers associated with that single incident (where it took place, what was done, sex in general). Trauma from a long term abusive relationship can be triggered by a wider variety of things. The trauma isn’t just associated with being in the car—it’s associated with being in bed, and sitting down to dinner, and saying something foolish in public, and the smell of burnt bread, and the scent of the abusive partner’s shampoo, and broken dishes, and, and, and, and…

So depending on what caused the trauma (and how severe it is), a potential partner may not be able to tel you everything about how the trauma affects them. They may not realize that the smell of burning bread triggers them until you get distracted in a make out session one day and they forget dinner is cooking.

What they can and need to tell you is a general idea of how severe the problem is, what areas of life it affects, what they need from you if they are triggered while you are together (or triggered when you are supposed to get together), and as much as they can of their major and common triggers.

Once you now what you are dealing with, it’s a matter of patience, flexibility, and awareness.

When Disorders Become Abusive

I said before that treating a partner with PTSD like an abuser when the disorder causes them to say things that are gaslighting or otherwise abusive doesn’t work. But what does work? How do you respond in a healthy manner when negative thoughts start to sound like a guilt trip?

First off, you need to be able to recognize what is happening. If you can’t recognize 1) what my partner is saying right now sounds like gaslighting and 2) they are saying this not to manipulate me, but because they really believe it, you will not be able to deal with it. And dealing with this is, at least initially very much on the ill person’s partners. Why? Because you can’t even begin to fix something you don’t realize is happening. And from the perspective of a person with a trauma or stress related disorder, all they are doing is expressing ho they feel. Polyamory is supposed to be about communication, right? So why do people keep getting angry when they try to communicate how they are feeling or the way they perceive things?

Once you recognize what is happening, you need to NOT address it right away. Instead you need to address what is under it. Let’s say a partner with PTSD says that obviously they aren’t important, they don’t matter, they might as well just die for all anyone cares about them.

You recognize it as a potential guilt trip. But you also recognize that your partner is genuinely hurting and is really attacking themselves, not trying to get a reaction out of you. What do you do?

In my experience the best way is to address it head on. “I’m sorry you feel that way. I love you very much, and I love having you in my life—even when (you drive me crazy/things don’t work out/we have a fight). I’m sorry I can’t (give you what you need right now/make this right/etc).” If you can do something for/with them, “How about we do X for a while, I think that might cheer both of us up.” If you need to take care of yourself or need to get out the door, “I really need to do this right now, but maybe when I get back we can do X.”

Reassure, offer support, and don’t let their negative thoughts/outbursts/etc keep you from doing what you need to do.

Later, when they are in a better place mentally and you are calm, is the time to bring up. “When you get upset and say things like that, it comes across as a guilt trip/manipulative/emotional abuse. I know you don’t mean to or want to do that. I need you to be aware of the way you say things.”

It will take TIME to make a change. Because they are not fully in control of themselves, because their thoughts and perceptions are distorted, and because they are dealing with psychological arousal, they won’t be able to “stop and think before you speak.” But if they aware of the problem, they will work to be aware of how they communicate and get better. It will probably start with their saying something about it after they calm down, “Hey, I shouldn’t have said that before, I’m sorry.”

I have had PTSD, I have had a long term partner with PTSD, and I have had a metamour with PTSD. Of all the mental illnesses I have dealt with, PTSD is the most difficult in a polyamorous relationship (or, I believe, any relationship). The flashbacks, dreams and memories are horrifying, but at the end of the day they are just a thing. You get through them. The psychological arousal combined with negative thoughts are destructive. Both destructive to the person with the disorder and destructive to the people who care for them.

Mild trauma and stress related disorders aren’t easy to deal with. But most people I have known who are willing and able to do the work involved in polyamory have also been full capable of doing the work involved in maintaining a health relationship while dealing with the disorder. Severe trauma and stress related disorders demand a huge amount of time, energy, and compassion. Polyamory can work with severe trauma and stress related disorders—in fact, a healthy polycule can make the disorder easier for everyone involved and help the person with the disorder heal. But it is definitely not a relationship that is right for everyone.

 

This post is part of the Polyamory and Mental Illness blog series.

This post and others discussing specific mental disorders will reference the Diagnostic and Statistical Manuel of Psychiatry and Psychology, Edition Five (DSM-5). Apologies to my international readers, I’m just not familiar enough with the ICD to use it as a reference.

Trauma and Stress Related Disorders

1. Post Traumatic Stress Disorder (PTSD)
2. Acute Stress disorder
3. Reactive Attachment Disorder
4. Disinhibited Social Engagement Disorder
5. Adjustment Disorder

PTSD is the best known of the trauma and stress related disorders. In the US it is widely associated with military personnel and the psychological damage of military service. However Trauma and Stress Related Disorders, including PTSD, can be caused by any type of trauma. Car accidents, abuse, natural disasters, and high-stress jobs such as working in an ER or fire department are only a few of the possible causes of trauma and stress related disorders.

PTSD and Acute Stress Disorder are can be caused by trauma that has happened in the past or long term ongoing traumas.

Reactive Attachment Disorder and Disinhibited Social Engagement Disorder are childhood disorders. From what I can find they result from trauma related to loss of caregivers or damage to a child’s ability to connect with their caregivers. While these disorders develop in childhood, they don’t magically disappear when people become adults. Residual effects can cause difficulty with social interaction or forming attachments to loved ones.

Adjustment Disorder is a (relative) mild disorder caused by ongoing life stress. These stresses don’t need to reach the level of trauma. Anything from a family illness, to job instability, to loss of a relationship, can cause adjustment disorder. An important facet of adjustment disorder is that it is not an ongoing psychological condition. As soon as the stressor causing adjustment disorder is removed, the disorder will go away on its own.

Symptoms of Trauma and Stress Related Disorders

Symptoms vary a great deal, and everyone’s experience of trauma and stress related disorders will be different. However most symptoms fall into a few general categories:

1. Re-experiencing the event—flashbacks are the best known form of this. Literally reliving the event or events that caused the trauma. However it can also take the form of dreams, obsessive thoughts, or disturbing memories popping up out of no where. One note about flashbacks: most people assume flashbacks are either visual (seeing the event again) or full-sensory (experiencing it with all your senses). However flashbacks can take other forms. A person may suddenly feel their abusers hands on them, reliving the physical feeling of the abuse. Of hear screaming or other sounds associated with the trauma.
2. Heightened arousal—Arousal in the psychological sense is not the sexual arousal we usually associate with the word. In fact, arousal in psychology is a lot closer to what laypeople call the “fight-flight-freeze” response. In a state of arousal, everything is more intense. Arousal can lead to everything from aggressiveness to impulsiveness. It often causes hyper-vigilance and sleep disorders.
3. Avoidance—someone with a trauma or stress related disorder will often go out of their way to avoid anything that reminds them of or is associated with the trauma or stress.
4. Negative thoughts, mood, or feelings—this can take a lot of forms, from negative thoughts about yourself, to negative thoughts about the whole world. At base it is a distorted perception caused by the trauma or stress. Someone with adjustment disorder related to job loss might think that there is no point in trying to find a job. Obviously they just aren’t worth hiring. An abuse survivor will often expert other people to act like their abuser did. Etc. Memory loss from the trauma is also associated with this symptom.

Treatments for Trauma and Stress Related Disorders

Medication

There are no medications specifically for trauma and stress related disorders. Unlike many mental illnesses, with these disorders there is a very clear, non-biological cause. Effective treatment needs to address the experience and associated feelings.

That said, medication is sometimes used in association with other treatment. Anti-depressants, anti-anxiety meds, and sleeping medications are sometimes used to treat the symptoms, especially with PTSD. These medications can help a person with a trauma or stress related disorder to continue with as close to normal life as possible while they heal.

Therapy

Cognitive behavioral therapy (CBT) is often cited as the most effective treatment for trauma and stress related disorders. Exposure therapy—gradually exposing yourself to the trauma and things that remind you of the trauma in a safe place—is often used and can be very effective. Even more than other forms of therapy, exposure therapy requires the right therapist. You NEED to feel safe and secure in order for exposure therapy to work. Support groups for survivors of various traumas often include unofficial exposure therapy, as people discuss their own experiences with others who they know will understand.

Eye movement desensitization and reprocessing (EMDR) is a relatively new approach to trauma therapy. Ever notice it’s easier to talk about hard stuff if you have something to distract you? A lot of people like to have “something in their hands” when discussing emotionally difficult topics. This is because having something benign to focus on helps distance our emotional reaction. EMDR uses this tendency to help trauma survivors face and deal with their trauma without the extremes of emotional reaction. There is still a lot of speculation about how and why it works. It does seem to allow trauma survivors to better cope with their trauma, reducing symptoms and speeding healing.

Alternative Treatments

I don’t know of any alternative treatments that I would trust which are specifically for trauma and stress related disorders. That said, herbal calmatives may help reduce arousal symptoms, meditation can also be helpful in dealing with negative thoughts and gaining space from strong emotions, and I personally have found that Massage Therapy can be a huge help in healing from trauma associated with sexual abuse.

When Trauma and Stress Related Disorders and Polyamory Collide

Some problems that come with trauma and stress related disorders are obvious. I’ve had flashbacks, and I’ve held loved ones while they relived the worst experiences of their life. I honestly can’t tell you which is worse.

Other problems are both more subtle, and more frustrating.

Someone whose trauma or stress was related to betrayal, abuse within a relationship, abandonment, and similar issues will find themselves triggered by many things that are a normal part of polyamorous relationships. And constantly waiting for your current partners to abuse you/betray you/abandon you like the people who caused your trauma never does good things for a relationship. In a poly relationship, your poly partners spending time with someone else—or even just the expectation of them spending time with someone else—can definitely be triggers.

Worse, the combination of psychological arousal and negative thoughts can come across as anything from a jealous rage to a guilt trip to gaslighting. (Remember—distorted perspective. Someone with a trauma or stress related disorder literally doesn’t see the world the way it really is.) And while the person lost in their trauma doesn’t intend or even realize that this is how they are acting, the people around them can still be hurt by it.

Let me note that this level of problem is not universal with trauma and stress related disorders. Please do not assume everyone with a trauma or stress related disorder will be affected this way. This is the most damaging effect trauma and stress related disorders can have on relationships—that does NOT make it the most common.

Other types of trauma can cause other types of problems. Trauma from a car accident may make riding in a car difficult to impossible—which interferes with going on dates, poly meet ups, or just picking a visiting partner up from the hospital.

For partners who don’t understand the impact trauma and stress related disorders can cause, refusing to do something that seems simple to them can cause other problems. “Why do I always need to come visit you. It’s just a short drive!”

Because of my specific trauma, I used to get flashbacks eating certain foods. The consistency and texture of food is a big meal to me, which many people have never understood or accepted. Being invited over to dinner was a mine field. I would struggle to navigate trying to be polite, trying to avoid conversation ending-explanations, and trying not to trigger myself. So as awesome as it might sound for a poly partner to offer to put together a picnic for us…

And of course, having a panic attack, flash back, or other trauma related freak-out as your partner is walking out the door to go on a date—no matter what the trigger or cause—is not only disruptive to your own relationship, but to your partner’s relationships as well.

Part II on ways to manage PTSD and other Trauma and Stress Related disorders.

This post is part of the Polyamory and Mental Illness blog series.