Walking on Eggshells: The Lived Experience of Partners of Veterans with PTSD

The impact of posttraumatic stress disorder (PTSD) on military veterans has long been the focus of empirical research (Rose, Aiken, & McColl, 2014). Only in the past 25 years has attention shifted to the cohabiting partners of PTSD veterans (PoPVs) and the distinct ways in which trauma impacts the family system (Beckham, Lytle, & Feldman, 1996; Calhoun, Beckham, & Bosworth, 2002; Jordan et al., 1992; Mansfield, Schaper, Yanagida, & Rosen, 2014; Verbosky & Ryan, 1988). Most of the extant research on PoPVs has focused on isolated symptoms of distress and the prevalence of mental health conditions among this population (Calhoun et al., 2002; Manguino-Mire et al., 2007), yet few studies have examined the experiences of PoPVs, the meaning they ascribe to their lives, and the strengths and strategies they used to manage the after-effects of combat. Furthermore, no studies to date have explored the sharing of PoPVs' personal experiences via online communities, which represents a source of untapped experience and discrete knowledge that has the potential to inform those who work with military families. Therefore, the purpose of this phenomenological study was to examine descriptions of lived experience among PoPVs via internet discussion forums.Approximately 11% to 20% of veterans experience PTSD because of their military service in Iraq and Afghanistan (U.S. Department of Veterans Affairs, 2011). Although there is considerable variation in prevalence rates of combat PTSD among military populations globally (Castro, 2014; Thompson et al., 2011; Zamorski & Boulos, 2014), it is clear from this body of literature that the after-effects of combat exposure has significant implications for military service personnel and their family members (Dekel & Monson, 2010). Research has confirmed that cohabiting partners and spouses play a central role in the veterans' mental health and rehabilitation (Meis, Barry, Kehle, Erbes, & Polusny, 2010), yet they experience their own unique stressors and hardships (Gorman, Blow, Ames, & Reed, 2011; Mansfield et al., 2014). With the increasing number of PTSD cases among military personnel returning from deployments, and the significant impact of the illness on partners and spouses, it is necessary that healthcare systems be equipped to address the needs of military families affected by combat exposure. Yet, in order to develop tailored supports and services for military families, and, more specifically, partners of veterans affected by combat exposure, it is necessary to obtain a rich account of their experiences of living with a veteran who struggles with PTSD. Without an in-depth understanding of the experiences of PoPVs, the responsiveness of psychosocial support and services are compromised, and the needs of PoPVs in this situation are likely to persist. In order to establish a contextual understanding of PoPVs' experiences, a review of the existing research on the systemic impact of PTSD on families and intimate partners are warranted.Literature ReviewImpact of PTSD on Military FamiliesResearch has confirmed that symptoms of combat-related PTSD influence family functioning and cohesion in distinct ways (Tunac de Pedro et al., 2011). Specifically, family members' long-term exposure to re-experiencing and hyper-arousal symptoms associated with PTSD has the potential to result in the intergenerational transmission of trauma (Tunac de Pedro et al., 2011). Furthermore, the restricted emotional expression associated with combatrelated PTSD in veterans may lead to difficulties in maintaining intimate relationships with partners and children (Meis et al., 2010). Families of PTSD veterans also report the persistent need to adjust their behaviours in order to avoid triggering veterans' PTSD symptoms (Mansfield, Schaper, Yanagida, & Rosen, 2014). Although it is evident that PTSD affects the entire family system, PTSD-related mental health services are primarily targeted toward veterans (Wadsworth et al. …