Sexual Dysfunction and Relationships, Part II

*Disclaimer: This is a really broad topic, and I’m not a sex therapy expert, so I won’t be able to cover everything that’s relevant. Most of my patients are male and heterosexual, so I’m addressing the topic from that perspective. I don’t mean to leave anyone else out, I just try to stick to writing about what I know.

Last post, we discussed how sexual dysfunction can impact how you feel about yourself, and how it might impact your thoughts about getting into a new relationship if you’re single.

If you’re already in a relationship, then that’s a whole different kind of situation: for one thing, you and your significant other probably have some sense of what you can expect of your sex life: how often, where, for how long, and so on.

When your body suddenly decides it’s not going to go along with your established norm, it can be frustrating and confusing to both of you. It’s easy to get sucked into feelings of guilt, shame, embarrassment… And those feelings just make it more likely that you pull away from your partner even more. The more you pull away, the more disconnected from each other you feel, and the more difficult it can be to work on this.

So – it’s important for both of you to realize that it’s not your fault, or your partner’s fault either. It’s just another part of PTSD. You’re a team. You will deal with this as a team.

Ddon’t allow this issue to stop you from showing affection to each other. Take time to hold hands, look each other in the eye, and smile at each other; cuddle, or drive out to a nice peaceful spot and have a lovely, romantic picnic. These are all examples of ways to feel more connected with each other, and that’s likely to help.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

 

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Wojtek Rajski, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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Sexual Dysfunction and Relationships, Part I

*Disclaimer: This is a really broad topic, and I’m not a sex therapy expert, so unfortunately, I won’t be able to cover everything that’s relevant. Most of my patients are male and heterosexual, so I’m addressing the topic from that perspective. I don’t mean to leave anyone else out, I just try to stick to writing about what I know.  

So… Judging by the number of pageviews on the last post, it looks like some of you find it less awkward to discuss sexual dysfunction on the blog than in person.

Good – you need to have access to this information, even if you feel too embarrassed to ask about it face-to-face.

You know, I briefly considered writing the last post about Dave the Zebra. I thought, maybe that would be less awkward for people?

However – Dave the Zebra is actually named after Dave the Dude. I value my friendship with Dave the Dude. Somehow, he didn’t like the idea of putting his name in the same sentence as sexual dysfunction, in a blog read by thousands of people. Go figure, eh?

Well – let’s talk about it. (Dave the Dude, you can relax. I’m keeping you totally out of this…)

In the last post, we talked about how and why PTSD can mess up your sex life.

Today, we’re going to discuss how the mess in your sex life can have a ripple effect on the rest of your life.

Sexual dysfunction messes up your relationships, starting with the relationship that you have with yourself.

(Hey – can we try to focus please? I’m talking about the emotional relationship with yourself – not the five-knuckle-shuffle relationship with yourself! …Not that there’s anything wrong with that…)

Look – who you are in bed is part of your identity. You don’t need to go through life being Mr. Don Juan – even if you’re a relatively vanilla kind of dude, you have a sense of how your plumbing works and what you enjoy doing with it.

When that changes, it can have a big impact on how you feel about yourself. We live in a culture where, as a guy, you’re supposed to be obsessed with sex, or so the media would have you believe. So a lot of guys end up feeling like they’re somehow less of a man when stuff like this happens. You might feel angry and ashamed, and try not to think about it.

If you’re a single dude, this might really have an impact on your confidence about getting into a new relationship. You might question whether a woman would want to be with you, if things don’t quite work the way they used to.

(Answer: yes, the right woman would still want to be with you. The right woman would love you for your sense of humour, your smile, and whatever else it is that makes you awesome in her eyes. And you can sweep her off her feet with flowers and chocolates and kisses and dancing and backrubs and… Well, when it actually comes to sex, most women like all that stuff that most guys rush through to get to the main course. So, serve up a really good appetizer, and she won’t really miss the main course, you catch my drift?)

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

 

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Wojtek Rajski, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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Spouses want to know: PTSD and Sexual Dysfunction

So – guess what we’re talking about today? (Go ahead, check the title again). That’s right.

*Disclaimer: This is a really broad topic, so I won’t be able to cover everything that’s relevant. The question was originally asked by a female spouse of a male veteran. Most of my patients are male and heterosexual, so I’m addressing the topic from that perspective. I don’t mean to leave anyone else out, I just try to stick to writing about what I know.

In person, some of the patients that I work with find this really awkward to discuss.

Well – look on the bright side: this is a blog! You don’t have to ask this stuff in person! All the answers, none of the awkwardness!

The research is pretty clear that there’s a link between PTSD and sexual dysfunction. Most studies show that in veterans with PTSD, about 8 to 9 out of every 10 have some sort of sexual dysfunction. That’s much higher than combat veterans without PTSD, and higher than veterans with other mental health diagnoses. “Sexual dysfunction” can be a whole list of different problems – including having less sexual desire; erectile dysfunction; premature ejaculation, or inability to reach orgasm.

8 to 9 out of every ten. That means that, if you have PTSD and you don’t have some sort of sexual dysfunction – you’re the exception.

If you didn’t know that before, then it’s important that you know this about your body, and what PTSD can do to it. It’s not you, it’s not your fault, it’s not because you’re doing something wrong. It’s not your partner’s fault either. Add it to the long list of things you dislike about PTSD.

But – let’s talk about how and why this happens, and then, most importantly, let’s talk about what to do about it.

First, the “why”: remember that PTSD is survival reflex on overdrive; remember how we talked about reflex making all your big muscle groups tense up? Yeah – apparently, your survival reflex doesn’t consider that part of your body as a big muscle… Go figure.

Basically, reflex thinks that anything that doesn’t help you fight or flee is a waste of energy.

PTSD also makes you feel anxious and hyper-alert pretty much all the time, and that makes it hard to get in the mood and stay in the mood for long enough. Many people who have PTSD also feel disconnected and detached from loved ones, and that can make it hard for both partners to get in the right headspace. Increased anger and irritability can also put a damper on your relationship, and that can make the physical part of your relationship suffer too.

…Sounds pretty bad, huh?

Yeah… I know…

It can get better. Not magically, overnight better, but slowly and with some work – it can get better.

(Yes, pills can help. Talk to your doctor about getting some. But don’t expect pills to be a quick, easy, magic cure-all.)

First – go to therapy, and work on learning to manage your PTSD. When you learn more about how to manage your symptoms, this will make a difference.

Next – consider couples therapy. Especially if you’ve been struggling with this stuff for a long time, chances are there’s a lot of misunderstandings and hurt feelings from both of you that are driving a wedge between you. Couples therapy may help you to reconnect and feel closer, and that might help.

Third – don’t give up. Don’t lose hope. As long as you’re willing to try, things can get better.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

 

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Wojtek Rajski, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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Spouses want to know: “He doesn’t want to talk about his PTSD”

Well, hello again, everyone!

Today’s question is: “He doesn’t want to talk about it [his PTSD], or tell people. But I don’t think he has anything to be ashamed of, and I think it will help people understand why he is acting this way. What should I do?”

First, a disclaimer: I usually try to write in a way that applies as widely as possible. This time, I’m answering a reader’s question, so not everyone might relate. I know that not everyone who has PTSD is male, or married. If you have a different question you’d like me to answer in a post, please let me know.

This reader’s point of view goes sort of like this:

“Honey, you have nothing to be ashamed of; you didn’t choose to get sick, this happened to you. It’s no more shameful than a physical injury. I want to tell people so that when you need your space, they can be more understanding.”

Makes perfect sense, right? So – why is her husband (and maybe yours) so adamant that he doesn’t want anyone to know?

Because being able to talk about it happens at a point in his healing called acceptance, and he’s not there yet.

Because he’s still used to being Superman, and it’s hard to wrap his head around the idea of being this “sick guy” who needs to be fussed over.

Because he’s sick and tired of being sick and tired, and talking about it just reminds him when sometimes, he’d just like to forget.

Because talking about a problem is the way we women naturally tend to cope. Guys like to fix things, and if they can’t fix it, they don’t want to talk about it.

Because facts and feelings are two different things – so his head may understand that this illness is not his fault, but he may still feel shame, guilt, and anger at himself for “allowing” this to happen to him.  He may feel broken or weak, and helpless that he can’t just “buck up” and shake this thing off.

If he’s sick enough that he can’t work right now, he may be struggling with the fact that he can’t work to provide for his family.

If his illness has led to out-of-character temper outbursts that have frightened you and the kids, he may have feelings of shame and guilt about that, too.

And thinking about it all is just so painful and overwhelming, that he just can’t. Not because he’s being to be stubborn, but because it’s all just too much.

So… That leaves you, the spouse, in a bit of a conundrum: his behaviour is different, and maybe he can’t attend family functions, so friends and family are asking what’s wrong. Yes, it would be a lot easier if he was ready to talk about it – but he’s not there yet, and pressuring him won’t speed his healing process.

So – what do you do?

You take care of you. This is tough on you – so get support from other spouses who can relate, and consider getting some counselling yourself, to help you cope.

You can be helpful by doing other things, like offering a smile or a hug. If he’s okay with it, maybe the two of you can talk with his therapist about what might be fun, trigger-free things for the two of you to do as a couple, or things to do as a family – because making life seem a little more “normal” might be just the ray of hope that both of you need to see that life can go on.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

 

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Wojtek Rajski, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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Spouses want to know: PTSD, Withdrawing, and How to Respond

Today’s question is: “What’s the best way to deal with withdrawal by a spouse with PTSD – call them on it, or what????”

As luck would have it, just as I was sitting down to write this post, I also received the flipside of the question:

“My wife more or less just gets mad at me when I leave the room to cool down; she says I’m running away to hide… How can I help her understand?”

If you’re the spouse of someone who has PTSD, it can be lonely and frustrating to be married to someone who keeps pulling a disappearing act. Even at the best of times, you might feel rejected and pushed away. At the worst of times, when your partner takes off while the kids are screaming and dinner’s burning, you might feel downright abandoned that your partner isn’t pulling their weight.

An important part of how you cope is to get some support for YOU – whether that means therapy, peer support, family or a babysitter to help if you have young kids, whatever you might need. You’ve got a lot on your plate, and you need to be able to vent to someone who won’t judge you or your partner.

As a spouse, you have every right to feel angry and frustrated – BUT, remind yourself that you’re angry and frustrated with your partner’s illness, not with your partner. If your partner is withdrawing because they are overwhelmed or triggered, this is very different from running away because they’re a lazy, selfish jerk who won’t lift a finger to help out, or because they don’t care about your feelings. Don’t confuse illness with selfishness; don’t treat one as if it was the other.

On the other hand, the stuff that’s going on inside the head of a person with PTSD is more than most of us can imagine. If it sometimes seems like your spouse with PTSD is only going through the motions of day-to-day life, it’s because at that moment, that might be the best they can do. Chances are, they realize that they aren’t there enough for you, and they carry a lot of guilt and shame about not being able to do more. They may be feeling helpless, worthless, and angry that they can’t do more to beat this thing. Feeling this way doesn’t help them get a leg up on coping – it just pushes them down more.

The best way to try to cope is together, as a team. Realize that you’re not angry at each other – you’re both angry at the PTSD, and at what it’s doing to your family. Thinking this way puts you on the same side, and that makes it easier to support each other.

Here’s some statements to try out:

Spouse of person with PTSD: “I know you’re doing your best; I’m not blaming you. I just hate that this happened to you. I hate that it gets in the way of things you would like to do.”

Person with PTSD: “I hate that it gets so bad that sometimes crawling into my shell is all I can do. I wish I could just shake this thing off. I know it’s not fair to you.”

Hug each other. Support each other. It won’t magically fix things, but it will get easier if you and your spouse feel like you’re on the same team, and you have each other’s back.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

 

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Wojtek Rajski, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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