Funded by the VA HSR&D (Project# SDR 10-012)

Spotlight on Women Cyberseminar Series
From hi hl g y di d stressed to

thriving: A qualitative qualitative analys

analys

relationship behaviors in

Veterans with PTSD

April Gerlock PhD, ARNP & Jackie Grimesey, PhD, HS

Center of Excellence, VA Puget Sound Health Care Sys

Seattle, WA

George Sayre, Psy D. ., L M FT . . . , Seattle Seattle University University, Seattl

Seattl

Cyber‐seminar January 23, 2012

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Background Background on the impact of Vete

Vete

PTSD symptoms on dyadic functio

• Social support, especially that of spouse or int

partner, may counteract or reduce some PTSD

symptoms (King, et al., 1998).

• However, positive effect may be time limited...

impact of living with someone with PTSD start

erode benefits benefits and impact caregiver caregiver and famil

et al., 2006).

• Partner distress may be related to living with s

with PTSD, secondary secondary traumatization traumatization, or prima

prima

trauma secondary to their victimization at the 

of their loved one for whom they are also care

(Manguno Manguno

‐Mire, et al., 2007; Monson, Taft, &

Fredman, 2009).

Cyber‐seminar Jan. 23, 2012 [Gerlock

&

Grimesey]
The Relationships and PTSD St

Detection of Intimate Intimate Partne

Partne

Violence (NRI‐04‐040)

Research Study Team:Principle Investigator: April Gerlock PhD, ARNPProject Director: Jackie Grimesey, PhD; Study Team: George Sayre, PsyD, LMFT; Ofer Harel, PhD; Lynne Berthiaume, MN; Elaine Nevins, BA; Christina Cho, BA; Koriann Brousseau, BA; Alisa Pisciotta, MSW

This material is based upon work supported by the US Department o

Affairs, Office of Research and Development, Nursing Research Iniresearch does not reflect VA policy and opinions expressed do not n

those of the VA those of the VA. 

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Overview of Project

• Part of the larger “PTSD and Relationsh

Relationsh

Study: Detection of Intimate Violence”

– 441 male Veterans randomly selected from 

treatment programs at VA Puget Sound HC

– 441 female wives/partners.

◦ Yes IPV 190 ( ) 44% No IPV 251 ( ) 56%

o Within IPV NO group: 3 women primary aggre

o Within IPV YES group: 2 mutual violence coup

• Veterans’ ages ranged from 22 – 88 yea

• Most ( , 96% 432) had dep y lo ed to a war 

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Research Questions

–“ h W at is the impact of the Vetera

PTSD symptoms on the relations

behaviors of this couple?”

–“How do the couples handle con

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Method ‐ Grounded Theo

• A systematic methodology for the generation of theo

data.

• From the data collected collected, the key points are marked w

series of codes, which are extracted from the text. Th

are grouped into similar concepts in order to make th

workable. From these concepts, categories are formeare the basis for the creation of a theory.

• The emerging theoretical model is continually checke

the data to make sure it is well grounded.

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Procedures

• 23 digitally digitally recorded recorded couple interviews interviews 

purposely selected from the larger stud

sample and transcribed.

• Couples were selected for the qualitativ

analysis analysis based on a representative representative sam

IPV Yes and NO, and who gave rich

descriptions of their relationship relationship issues

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Overall Finding

Care giving, Communication, Community, 

Responsibility are key components to lasting inrel ti hi lationships.

However the presence of intertwined Disa

and Trauma, that is part of PTSD, create uniqucomplex complex and potentially potentially highly problematic problematic dy

dy

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Dyadic Tension Model

• Function/dysfunction of PTSD Veteran Veteran

couples is experienced in a variety of

intertwined tensions: tensions: Disability Disability, care giv

responsibility, trauma, communication 

community.

• These tension reflect three axis of dyad

functioning: functioning: Mutuality Mutuality, locus of contro

contro

approach to weakness.

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Definition of Terms

• Mutuality: “Bi‐directional communication, re

supporting each oth ’ er s d ii ec s ons and lif ’ e s g

enjoying each other.”

• Locus of C tl on ro : A persons t d en ency to perc

their life events as either within (internal locu

beyond their control control (external external locus).

• Weakness: Weakness can be paradoxically p

depending depending on the degree to which weakness weakness 

accepted and integrated or used to exploit or

demean.

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Care Giving

Caring/ Self‐protection

Community

Others as:

Self‐care/other care

Caring/Trigger

Necessary/Threat

PTSD: “we”/”me”

Dysfunction

‐Low mutuality

‐Unbalanced Locus of

control

DisabilityPartner/Patient/CPTSD: victim/age

Communication

Secrets= Protection/Control

Safety/Isolation control

‐Intolerance of weakness Sharing= Impotence/Disab

Intimacy/Vulnerability

ResponsibilityKnowledge/responsibilityHelplessnessVeteran Control

Trauma

Traumatized/Traumatizer

Victim/Perpetrator

Fear in others: others: Good/Disturbing Good/Disturbing Veteran Control
Disability

• Both Veterans and their partners described the following PTSD 

and related related issues as having significant significant impact on their relation

relation

avoidance, emotional numbing, depression, a heightened need 

control, hyper‐vigilance, self‐harm & risk taking, aggression and 

medication. Many of the participants specifically identified the

related symptoms.

• They also described a wide variety of physical and cognitive

impairments/limitations that the Veterans suffered in relation 

deployment deployment not directly directly related related to their PTSD symptoms: symptoms: diabe

diabe

hearing loss, medication related erectile dysfunction, loss of m

cognitive problems such as attention and memory impairment

• The majority majority of Veterans Veterans and their partners partners described described the Vete

Vete

history of alcohol and/or substance abuse and use for self med

manner that exacerbated both PTSD and medical issues. The p

these symptoms was woven throughout the couple’s descriptio

conflict conflict, communication communication and over all relationship relationship.

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Tensions around Disability

• PTSD agent/PTSD victim• Partner/Patient/Child• Impotence/Disability

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Examples: Disability

• I don’t even think we’ve had a disagreement because he’s been 

medical state on all, so many dynamic levels of needing to take 

himself himself that I didn t’ want to add to that. (Partner) (Partner)

• I’d wind up crisis firefighting on everything. Bills, house cleaning

One time I came home and there wasps in the entire house bec

had bored through the ceiling. And, he was terrified, and I could

understand that. And, I was compassionate. And, I jumped on i

I’m a task‐oriented and I’m a fixer and, and like to take care of t

then I compartmentalize compartmentalize and I have my reactions reactions later. (Partner

(Partner

• I just go by whatever she feels. I just try to make her life easy, yo

“Do what you need...It’s easier for me, I don’t have to deal with 

do anything, myself. Like, I put myself in a little cage. (Veteran)

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Examples: Disability

• Well, she won’t tell me if, if something’s going on. 

to keep me out of the loop, knowing that I’ll, that I

about it. And that, and that, I think, actually, upset

more. It seems to piss me off more than her spend

money. Or, you know, or hiding the fact that we go

bill, or something, you know. And, that ‐ I hate tha

sh ’ll e , sh ’ll e t ka e, try to t ka e care of it with t ou me k 

about it. And, then, I find out and it just blows up b

I think she is trying to minimize the stress all aroun

it s’ still upsets the hell out of me. (Veteran) (Veteran)

• He felt I was intruding. He felt that I was treating h

child. He f lt e I was asking of him things th t a were

unreasonable. And, really, what I was concerned a

making sure that he was safe and that he was goin

home OK and on time. (Partner) (Partner)

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Care Giving

• A vicious cycle in which caring for the symptoms of PTSD is received/e

as a source of PTSD symptoms.

• In these coup , les caring/care g g, ivin normally a p /p henomena/experien

in concern for the other, has been transformed/is simultaneously a sta

concern.

• Reflecting the combination of a very high felt need to manage the Vet

b i e ng, moti d vate by b h ot empathy (concern for the oth ) er and anxiet

for self), and minimal information regarding PTSD resulting in being m

effective at either supporting the Veteran or managing their aggressio

expressed self‐blame, a sense of help , less incompetence and frustrati

described poor self care, and an overall sense of losing themselves in 

relationship.

• When discussing the volatile and sometimes violent behavior of the V

partners expressed anxiety regarding his emotional state, and a desire 

triggers, but these descriptions were marked by self preservation/pro

defensive language rather than concern.

• Caring/trigger Caring/trigger‐ a crucial crucial dynamic dynamic defining defining Veteran Veteran‐PTSD relationships relationships 

tension around care giving being experienced as both support and as 

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Tensions Around Care Giving

• Self‐care/other care• Caring/trigger• Caring/self‐protection

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Examples: Care Giving

• That wasn’t me, but I, I guess I was at that point where I was, li

I need a liberation here.”(Partner)

• Well, I also did them for me but, you know, I was secondary secondary. An

another thing that I would like it known is that the family and t

become secondary to everything. And, you, kind of, get lost in t

Everything is focused on it, everything. And, in some ways, righ

but, also, the ‐ my emotions emotions, my feelings feelings, my medical medical care, my p

p

care, my sexual desires, my life desires, you know, work, everyth

the wayside. And, it all is about them. (Partner)

• So that I could ‐ so that I could know whether I was safe or not.

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Examples: Care Giving

• ...depends on a trigger. If she hits a trigger, like she’s, som

let’s see, when, when I have the feeling that she’s nagging

you get the feeling that she, she’s nagging, and, then, all 

sudden, it’s, like, bam, bam, bam. ...‐ I can’t be speci‐, I ca

specific, but that’s pretty much what happens. (Veteran)

• ...and he doesn’t even recall these things. Not today. So, h

learning and I’m learning how to recognize either environ

at the end, or stresses, or, you know. So, today, it’s hard to 

how it is now is when something gets triggered for either 

through the work we’ve been doing, both here ‐ well, in a 

different ways, but, we’ve learned to recognize the trigge

...(Partner)

• I try and figure out what triggered him to want to argue, 

at it from a different direction. (Partner)

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Responsibility

• Both Veterans and partners tended to imp 

licitl

explicitly speak of the partner as responsible fo

Veterans emotional state. This dynamic was m

clearly clearly expressed expressed around the themes of “trigge

trigge

• Partners Partners tended to be acutely acutely aware of, and fre

fre

more articulate and detailed than the Veteran’themselves. Their descriptions reflected an exp

of attending attending closely closely to the symptoms symptoms, states, a

being of their Veteran partner.

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Tensions Around Responsibili

• Knowledge & naivety• Veteran passii / v ty Veteran control• Helplessness

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Examples: Responsibility

• And, the fact that it f ll e on me all the time to be responsible for 

sure that he got the medical help that he needed. It was a huge

responsibility. And, the majority of which I didn’t know enough 

I’ve worked in and out of medical hospitals and clinics, and I kn

about it to ask the ri hg t questions and get it just b f e ore it gets r

But, if I’m not there, then there’s not anything I can do about it. 

• ...we had a pretty good relationship in the beginning, but I didn

anything and I was pretty bli dn . (L ht ) (Laughter) It was like the bli dn 

blind. And, you know, like, like they say, love is blind, OK? (Partn

• I know that when he has bad nightmares, I smell ‐ I wake up sm

me, he smells like rancid maple syrup... I can get up and say, “O

a bad night.” And, he goes, “Yeah, I did.” ... Sometimes, it’s just, 

didn’t sleep last night.” And, that doesn’t mean anything. (Partn

• So, and then, after awhile, I got to thinking thinking, “Boy, I was really st

know, I felt stupid, and humiliated, ... ashamed... that I didn’t ca

didn’t do something (Partner)

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Examples: Responsibility

• But, yeah, I could definitely have a lot of pent‐up rage that I can

know how to get rid of instantly. And, that’s where there’d be a 

wall from. And, that happened a few times. I don’t know. It, it e

up at si i tuat ons. S i omet mes, I d ’ on t even know where it comes 

honestly. (Veteran)

• ...we check in with ourselves to find out what that trigger is bef

reacting. ... really, for me, anyway, when, when I’m f li ee ng like 

triggered, I want to know how much, how much do I want to in

particular thing? I de‐escalate it, and I just let it go. If it’s a high 

then I ll ’ say something something like, “We need to talk about this when I 

’ 

angry.” (Veteran)

• He did get better over time. But, it still was a struggle to get him 

I would ask him for information information about finances finances, because because we use

decisions together about finances. And, probably the last 10 of 

years after he was injured in 1995, everything pretty much got 

into my lap. In other words, he abdicated abdicated his entire life. (Partne

(Partne

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Trauma

• Entitlement “you owe me” because of what I’ve been through, 

well as impotence justified in this way, weakness & vulnerabilit

back so others have to deal with me.

• “Triggering” (being activated by environment) used as excuse f

• Veterans significant need for control and the level of aggressio

described as inducing neither empathy nor concern, but fear a

• An awareness of the Veteran’s capacity to harm, noted in refer

size, streng , th or past history, military or previous IPV, created 

partner fear and anxiety.

• Assaults during sleep added to the knowledge that the Veteran 

killed/could harm actively or p y assively.

• Possession of weapons was common with the Veterans and a r

theme among the more distressed and violent couples, becom

focal point of the Veteran’s cap y acit to harm.

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Tensions Around Trauma

• Experience = traumatized/ traumatized/traumatizer traumatizer• Actions = victim/ perpetrator• Status = powerf l u soldi / er di i i h d minished V

• Time = immersed in immediate/ past/ f

• Aftermath = capacity to ensure safety/

lethality induces fear “to protect and sc

• Secondary PTSD: Veteran as a ‘carrier’ o

trauma

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Examples: Trauma

• “So I was going through this triggering thing. And I got the thing for d

violence anyway. And – you know, the preclusion to it with my dad an

So, everything just hit just right, you know? It was like the perfect stor

domestic domestic violence violence, with the anger, the guilt, and everything everything just meshe

wasn’t a pretty sight.” (Veteran)

• “He says, ‘I killed people in Vietnam’. Now, what does that make you 

you’re yelling at someb do y and they say ‘I kill de b f ’” e ore’.” (P t ) ar ner)

• “I get nervous about it, because I don’t know what he’s going to do. I 

kill.” (Partner)

• “I think she’s scared of me, because of what she knows of my, my milit

(Veteran)

• “Well, I have knives and, well, I had knives and weapons around the h

the day. And I told her if she kept on doing, arguing and saying things 

appreciate or didn’t like, she would come up missing. And, told her I w

weapon and kill h ” er. ( ) Veteran)

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Examples: Trauma

• At its worst, something could be said that was not kind. You kno

whatever reason, it would escalate very quickly. And, it would f

you know, I’ll be frank: It would feel like I, I never knew quite wh

going to go. His temper, he ‐ I always knew if he started laughi

was in trouble. It, the l h aug ing was an indicator for me that he 

taking this seriously, and, that he was, kind of, that laughter, fo

kind of, a, a way of trying to manage his rage. And, it never wo

was never very smart about it, either. Instead Instead of, maybe, just do

said I now do, ...where, you know, I really kind of de‐escalate it? 

not leave it alone. And, if I felt like I’d been disrespected, or offe

some way, then I, I tended to just, like, bite and not let go. And, 

result in a lot of screaming. (Laughs) A lot of screaming and sho

...unkind things. (Partner)

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Communication

• PTSD symptoms (emotional numbing, avoidance, need for control, an

are impediments to communication.

• P t ar ners have to d l eve op h i il ypervigilance in absence of communi ti ca on

his nightmares.” Partners may already “know” the secret, the tension 

disclosure.

• When describing describing their partners partners attempts attempts to communicate communicate or manage 

triggers, Veterans tended to express annoyance or resentment at bein

Many described a diminished sense of self, being treated like a child, p

compliance. In this way, partner’s attempts to manage their Veteran a

th l emse ves experi d ence as “i ” tr ggers”, the partner was percei d ve as re

both the Veteran’s emotional experience and aggression/violence.

• The lack of communication was experienced by partners as resistance 

frustration frustration and anger toward the Veteran Veteran and contributed contributed to the part

part

sometimes adopting power assertion methods/style of relating.

• Both identified partners as highly talkative, expressive, communicatio

and pursuing of connection. This was often framed as either complim

compensatory for, the Veteran’s lack of communication. (Partner forc

way of engaging the world?)

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Tensions Around Communicat

• Secrets = protection/control• Sh i ar ng = i i / l bili intimacy/vulnerability• Silence = safety/isolation• Mutuality = partnership/adversary

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Examples: Communication

• “I mean, he has secrets. He would withhold stuff from me. He 

tell me where he was, what he was feeling, what he needed, wh

wanted. He would not go to the doctor, he wouldn’t schedule

appointments. He would ’ n t write down his meds – he would re

remember what his meds are, even if they’d changed.” (Partne

• “She s’ heard more details details when me and my buddies buddies have been f

f

gums, and she just happened to be overhearing what was going 

(Veteran)

• “I felt very abandoned. (Veteran)

What kind of response would you hope for? (Interviewer)

Understanding. (Veteran)

You mean, in terms of listening, listening, and trying to understand? understand? Or, getting getting 

on their own? Or, what, what could have helped, do you think? (Interv

Understanding at a level where the other person would know that I w

vulnerable, because of certain incidents. And, I was having a hard time 

it. I need de th i e r ability to d l ea wi ht me as I coped wi ht those issues. S

ability to relate, but a little lower level.” (Veteran)

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Examples: Communication

• I was not assertive enough, and I think of the things that he did 

... kills me, you know what I mean? Well, yeah, advantaged of, 

ash d ame that I did ’ n t do something sooner. (P ) artner)

• Well, most of the time, she’s controlling, too controlling. I don’

controlled controlled. She s’ a type of person who s’ loud, she s’ inconsiderat

inconsiderat

• We ended up being two strangers in the same house. She didn

that I’d come back a different person and that there were a lot 

that I couldn’t talk to her about, that I can’t talk to her about. S

wasn’t sleeping at night. If a needle fell on the carpet I could he

know? She was very critical of the fact that I just wasn’t the sa

I was d d epressed. (V t ) e eran)

• ...because there’s no room for a relationship when you’re havin

the time. (Partner)

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Community

• This lack of effective inter‐relating was worsened by the Vetera

experience & culture in which secrecy and security is valued an

sometimes necessary, and there is a strong sense of distinction 

soldiers/civilians leading to a sense that partners cannot under

• Service dogs – liked for helping/protecting, partners – resented 

Service dog gets to succeed at what wife is punished for.

• Hypervigilance motivated by caring/love and/or by pathologica

protectiveness.

• Partners spoke of how connections wi ht other Veterans were a

part of not only PTSD awareness, but also vital support system 

Veteran.

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Tensions Around Community

• We/ me, us/ them = understanding needed from partner and o

conflicts with the belief that only Vets can understand the uniq

experiences of military culture & combat.

• Society as threatening/society as benign.

• Love as desired and loss grieved/love avoided as fear of rejecti

further loss.

• H i il ypervigilance moti t d va e by caring & l /b ove y path l i l o ogical fear 

protectiveness.

• Moral dilemma dilemma exists in Veterans Veterans role to protect/ability protect/ability to harm

• “Survival guilt” prevents intimacy or even friendship in many re

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Examples: Community

• A lot of it was job related, because I was working – it was nothi

a 90 hour week, which meant we never saw each other. I was t

her through through school to get her master s master’s degree, degree, but, basically, basically, I w

I didn’t want to have to be out in public. I didn’t want to have t

with people. If you work the night shift, you don’t do those thin

got to the point that there was no room left for anyone or anyt

wasn’t receiving any feelings or information or anything from m

became just intolerable for her. (Veteran)

• “She pretty much told me that if I didn’t get help, she was leavi

...And then we had seen VFW people up at the Safeway, and I g

with that, and the guy started talking to me and I ended up her

awhile, ‘cause I didn’t think I needed to come in here. You know

she told me she was going to leave, then I thought, ‘Shit. OK, ... 

try it out’.” (Veteran)

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Examples: Community

• And, you try to sympathize with him, and you say, you know, “I 

imagine that. I feel so bad for you.” And, then, he gets real defe

“You can’t possibly understand what it was like.” (Partner)

• I couldn’t even go to the grocery store by myself, and, I mean, it 

point where my friends no longer liked him. They despised him 

he did was call. It got to the point to where I stopped stopped going and 

friends. I stopped going out and being social, you know?”(Part

• I remember she got scared and she took the kids in the bathroo

wasn’t really going to do anything, and, next thing I know, I’m s

door.” (Veteran)

• He changed more when he came home from deployment. The 

he’s telling me “If you leave me, or you cheat me, or something

I prefer to kill you and put you in pieces and spread you everyw

said “If you leave me, I’m going to kill somebody.” But he doesn

who h ’ e s going to kill, or if hi lf mse , or myself, or my son ,or ? H

out, so I don’t know what he’s talking about. (Partner)

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
PTSD Treatment & Healing

Wife/Partner

Triangle of Healing

VA Staff Other Vets/Co

Cyber‐seminar Jan. 23, 2012 [Gerlock &

Grimesey]
PTSD Treatment & Healing

• Treatment that effectively addressed PTSD and related sympto

alcohol abuse was identified as helpful in several couples, espe

around overt physical violence (but not in regard to ongoing IPV 

It should be noted that although several participants reported 

some form of anger management, or “DV” treatment, none sp

detail or attributed any specific behavioral change to it.

• The Veterans who had more open communication with their pa

PTSD and their emotional state experienced less relational dist

• The partner’s involvement in the Veteran’s treatment as a coup

described as very beneficial.

• Partners in less distressed couples expressed having created bo

and communicated with the Veteran about the effects PTSD wa

them. They more often spoke in terms of “we” when describin

conflict, support, and resolution.

• Partners spoke of how connections with other Veterans were a

part of not only PTSD awareness, but also a vital support system

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Examples: Treatment & Heali

• I think that the healing didn’t really start to take a deeper road 

started coming to the VA and doing the work with other Vetera

was really a huge shift. I can’t emphasize how much that chan

(Partner)

• I did go to some of his sessions as a spouse, I guess that was jus

me weather through and understand the process that my husba

be going through. It’s a joint venture. I cannot totally rely on t

my husband’s problem, but , you know, It helped me to underst

grounded me, ‘cause I never knew what this PTSD was, I always 

was just getting grumpier. But yeah, I would have to say the VA 

me to understand, and helped me to cope. (Partner)

• You need help. But, he was so much in denial, where he doesn’t 

get h l e p. A dn , h ’ e s telling me, ”D ’ on t get me in trouble, ‘cause I

know, “I’m not doing anything,” you know ‐ he felt like he was c

help was trouble for him. (Partner)

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Examples: Treatment & Healing

• “I have ti d r e to t lk a to him ab t ou it, and th t’ a s how I got him to go to ‐ we

the divorce is what got him to go to the Vet center for PTSD. No, I went to 

center and I said, “What in the world?” That was the day I woke up and he 

on me. And, ...He was asleep. I said, “What do I do? I can’t even have a fig

about it, because he doesn’t know he did it.” I said, “What do I do?” So, th

needs to come in here.” And, he wouldn’t go. He wouldn’t go. He wouldn’

it came down with all the eggshells and the yelling and ‐‐ I went and got a

p pa erwork for a divorce. I didn’t get a lawyer, I just got all the p pa erwork out. And, I sat it on the coffee table and I said, “Sign this and get out of th

And, I took the kids and I left home, went to a party. And, I came back and 

and he was watching TV, and I put the kids to bed, and I came in, I said, “Wblazes? blazes?” I used some superlatives. superlatives. I said, “What are you doing in this hous

that paper and get out of this house.” And, he sat there looking at the TV, 

tears coming down his face. “Baby, I’ll do anything you want, but, please, 

me sign that paper. Please, don’t make me sign that paper.” I said ‐ he said

said, “I ll ’ do anything anything you want.” I said, “You ll ’ go to the PTSD, you ll ’ go to 

center and talk to them.” “I’ll do that tomorrow, baby, if they’re not open t

do it day after tomorrow.” He said, “Just don’t make me sign that paper.” 

said, “The paper’s going to stay there. Unless you go to the Vet center, it i

si d gne and you are getting out of this h ” ouse. I said, “We cannot live this w

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
Contact for references references & questi

questi

• A il pr Glk er oc PhD, ARNP:

– gerlockaprila@comcast.net (253‐581‐7378

• Jackie Grimesey, PhD:

– Jackie.Grimesey@va.gov (206‐768‐5357)

• George Say , re Psy.D., L.M.F.T.

– sayreg@seattleu.edu (206‐296‐4614)

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]
References

• King, L.A., King, D.W., Fairbank, J.A., Keane, T.M., & Adams, G.A

Resilience‐recovery factors in posttraumatic stress disorder am

and male veterans: H di ar ness, postwar soci l a support, and add

dd

stressors. J of Personality and Social Psychology. 1998; 74: 420‐

• King, D.W., Taft, C., King, L.A., Hammond, C., & Stone, E.R. Direc

the associ i at on between soci l a support and posttraumatic stre

A longitudinal investigation. J of Applied Social Psychology. 200

2980‐2992.

• Manguno‐Mire, G., S tt au er, F., Lyon, J., Myers, L., Perry, D., She

et al. Psychological distress and burden among female partners 

veterans with PTSD. The Journal of Nervous and Mental Diseas

195 (2): 144‐151.

• Monson, C.M, Taft, C.T., & Fredman, S.J. Military‐related PTSD a

intimate relationships: From description to theory‐driven resea

intervention intervention development development. Clinical Clinical Psychology Psychology Review. 2009; 29

Cyber‐seminar Jan. 23, 2012 [Gerlock & Grimesey]