The Impact of Trauma on Relationships

Written by James A. Bosch MA, LMFT and Cindy Rutter, BSN, AMFT on April 22, 2020

Family + Friends
Personal Growth
Romantic Relationships
Social Interactions
Trauma / PTSD
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View this resource in Spanish here.

Research has shown that burn survivors do better in their recovery when they have a strong support system of family and friends. However, what is often not talked about is how trauma can affect these relationships.

Talking about relationships after a burn injury is to cast a broad net because there are so many different types of relationships, and everyone responds differently to burn trauma. Anecdotally, we see couples and individuals struggle with isolation and become distant from close relationships after a burn injury. Conversely, we sometimes see relationships strengthen and develop in other ways after trauma. This article is a starting point to provide a better understanding of the relationship dynamics that trauma survivors may experience.

Based on our personal experience as burn survivors and as marriage and family therapists, we want to highlight issues that may interfere with healthy relationships and offer tips on how to address them. We recognize that the age you were burned, the circumstances surrounding your injury, and your own personal life experiences will be diverse.

A Shaken Sense of Safety

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), trauma is defined as directly experiencing or witnessing death; threatened death; actual or threatened serious injury; or threatened or actual sexual violence. A burn trauma creates many losses and dramatic life changes that affect interpersonal relationships in deep and lasting ways.

Why is this? Trauma deeply challenges our sense of safety and security in the world. It often prompts us to reflect on the big questions about the meaning of life and creates uncertainty about where we fit into the world and our future. In relationships, a shaken sense of safety can translate to a lack of trust in people. We may think that others don’t understand and can’t relate to our internal experience. This can change our behaviors and communication patterns, from the day-to-day details to the way we do or do not connect with others. And it can lead to a lot of assumptions, hurt feelings, isolation, and fear of reaching out to others. As an example, we may feel that we can’t ask for help or that our feelings can overwhelm others. Building close relationships may be frightening because we don’t want to experience more hurt, or our feelings of anger, depression, and anxiety may be harmful to others.

If our sense of self is shaken and we feel lost or disconnected from ourselves, we can have difficulty connecting with others. Have you felt like you needed a friend’s support but were afraid to reach out? Another potential impact on relationships is when one seeks their missing sense of safety and security to be provided by someone else. However, trauma can also cause this to be a pattern of dependence, or co-dependence.

Having deep, connected relationships is healthy, but for burn survivors, reaching out in a time of need or to ask for help can be particularly difficult. It is crucial to move past these fears of asking for help to return to living a full, balanced and satisfying life with healthy relationships.

Relationship Issues

There are a number of issues that may be keeping you from deepening existing relationships or reaching out for new relationships. The key to this complex topic is the same solution that is needed for general trauma recovery. A sense of trust in the world needs to be rebuilt. This means being able to take risks, being vulnerable with others, and being willing to work through the shame and uncomfortable feelings that come with this. Healthy relationships can be restorative on your journey of healing. After the experience of trauma, self-sufficiency can be difficult, and it is important to remember that it is hard to ask for and accept help.
Trauma survivors often struggle to recognize that others want to provide support, love, and compassion in challenging times. While it is often hard to accept this from those closest to you, it is possible to learn that you deserve understanding relationships as you move through life during good and bad times. Many of us were not taught how to have healthy relationships in our families of origin, so after a trauma, this Is sometimes another skill to learn.

One of the challenges in trauma recovery is the mood changes we can experience as a result of pain, long treatment experiences, and post-traumatic stress symptoms. This can make us cranky, jumpy, short with others, and sometimes irrational. These reactions are not your fault. During the healing process, this might sometimes make us hard to be around or difficult to be around others, but working through these issues and maintaining connection is worth it.
If you are in a relationship at the time of your burn injury, the following are some of the common issues faced by couples:

  • Role Reversal

  • Caregiver Role

  • Sexuality and Intimacy

  • Changes in life activities

  • Financial Impact

  • Grief over change and planned future

Survivors who are burned as children can have difficulties with attachment style, meaning how emotionally warm or close a person likes to be in relation to others. This affects communication, intimacy, and how secure an individual feels being alone versus being in a community. If an early attachment has been altered by the trauma, survivors can often find themselves in unhealthy relationships as adults and it can impact their parenting style.

Rather than being negatively affected by trauma, relationships can be deepened in the process of surviving and healing after life-changing events. Experiencing life-altering events brings the opportunity to heal and look at how we relate to ourselves and others. No matter the situation, there is always an opportunity to re-examine how we choose relationships with people who are authentic, supportive, and share our values. It can give us a new vision of the world.

After a burn trauma, some relationships return to “normal,” some relationships terminate, and sometimes new powerful relationships emerge. Establishing a sense of safety and security in any relationship following a trauma is imperative to personal growth. You don’t have to heal alone, and through in-person and online burn support groups, there is always someone who will be able to relate to your experience on this journey.

10 Tips For Improving Relationships

We can always learn to improve relationships. The following strategies can be helpful in rebuilding relationships and learning new ways to connect.

  1. Practice vulnerability and speaking shame: In her TEDx talks on vulnerability and shame, Brené Brown suggests that by bravely being authentic and willing to learn life lessons in relationships, you allow people to know your thoughts, feelings, weaknesses, and challenges. This is how we learn to become intimate with others. When we talk to others and are honest about our thoughts, we learn we are not alone, which helps us to not feel isolated.

  2. Avoid trying to fix others: Allow individuals to have their own experiences and practice good listening skills. Help others find their own solutions to their problems by being a good friend that walks alongside rather than carrying them.

  3. Try not to take things personally: Many times, people are responding to things in their own mind and it has nothing to do with you. Learning to challenge misconceptions about a situation can help us stay in relationship rather than harboring resentments toward others. For example: If a friend stops coming around or calling, it may mean his is struggling with his own life, and it does not mean he doesn’t want to have anything to do with you.

  4. Watch out for assumptions: In relationships, we often make assumptions about what the other person is thinking and feeling about us. When we already have a shaky foundation, these assumptions can increase after trauma. In relationships, we can learn to ask the brave questions such as: “I am wondering if you are thinking this….,” “I am wondering if this is true….” Or as Brené Brown says, “The story I am telling myself right now is…..” By practicing being vulnerable and asking these questions, we can clear up assumptions and be closer to each other.

  5. Learn new communication skills: When you don’t communicate what is going on, others may feel confused and left out. It is important is to learn to express what you are feeling and what you need. If you just need to be listened to, then say that. If you need guidance, learn how to ask for input or support. You can take online courses on active listening or nonviolent communication. Phoenix Society’s online courses on communication, as well as their live Education + Support group discussions on these skills, may be especially helpful as you build your tools.

  6. Practice authenticity and transparency: In practicing authenticity, you are honest with yourself. Being authentic is a form of self-love. You can’t love others until you fully love yourself. It is important to be deliberate about your own internal, emotional awareness. To be transparent means that you share information and why you made the decisions that you did. Engage in the difficult conversations and say what it is that you are actually thinking in a tactful way.

  7. Find your passion: As you find your new normal or a new passion, engaging in life-affirming activities that bring you joy will not only help in your recovery, they will attract people to you and take you to places where you can meet like-minded individuals.

  8. Embrace your personal spirituality: Spirituality starts with considering what you believe and feel grounded in. At the end of the day, there may be no one around except your own personal idea of a higher power or spirituality. Nurturing a sense of spirituality also improves your relationship with yourself which will reflect in your relationship with others.

  9. Find your community/peer support: Watching someone find their confidence at an event like the Phoenix World Burn Congress or at a burn support group meeting is transformative. There is nothing like seeing your story in someone else’s experience. It decreases isolation and increases community. Finding your people, whether it is burn related or some other common interest, is the best way to practice being in a relationship and healing.

  10. Get counseling/therapy as in individual or couple: Therapy is a great place to heal and repair relationships with self and others. We can talk about things with a professional that we feel incapable of discussing with our loved one, which can benefit all types of relationships. Therapists or life coaches can be great moderators and teachers for us to how to improve communication and enhance intimacy.

Facebook Live: 10 Tips for Improving Relationships

James Bosch and Cindy Rutter joined us for a live video to expand on their tips from this article. Watch the recording for more information and helpful tips.

Watch Video

James Bosch was burn injured as an infant. He has dedicated much of his professional life to helping other burn survivors and their families heal and find meaning after a burn. Acceptance of new life, new body, and finding new meaning are at the core of his work. He speaks and facilitates at burn support meetings in Canada and the United States. He has a private practice and telemedicine practice in California.

Cindy Rutter has been an advocate for Phoenix Society for Burn Survivors and involved in the burn community for more than 30 years. She recently completed her master’s degree to become a marriage and family therapist. Cindy has been a burn survivor for 61 years and is the former nurse manager of the burn unit in San Diego.

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