In couples dealing with trauma this is particularly problematic. For example, research suggests that combat veterans wives find their partner's withdrawal extremely aversive and these partners become profoundly lonely and vulnerable to a variety of somatic complaints. Numbing and avoidance also makes new experiences, that might provide new information to the trauma victim, or a new experience of connection, hard to come by. There is little opportunity then to potentially balance or correct the negative lessons learned in the trauma experience about what it is to be vulnerable to or dependent on others. More globally, the loss of ability to regulate affective states is generally accepted as a, if not the, primary effect of trauma.
Survivors describe themselves as being in a perpetual state of alarm or numb.
Neither of these states make for open flexible communication or interactions with others. The third aftereffect noted in the DSM IV is increased arousal, hypervigilance and irritability. This often shows up as outbursts of anger, hostility and an extreme intolerance to any difficulty or threat. It is important for the couples therapist to ask specifically about violence and abuse and if necessary, to refer violent partners for help with this issue, preferably before beginning couples therapy. The victim's partner often comes to be defined as the enemy, as yet another betrayer, particularly since survivors have such compelling reasons not to trust and to be vigilant for slights or signs of threat.