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PTSD and Intimacy

dr. martinAndrew L. Martin, PsyD

The word intimacy has several meanings. For this article, intimacy means ‘closeness,’ or the act of being close with oneself, or close with others, in meaningful ways. Traumatic events can leave us feeling unable to comfort and soothe ourselves (intimacy related to self), and unable to create and sustain meaningful relationships with others (intimacy related to others).

Some events are so terrible that they overwhelm our usual ability to calm and soothe ourselves. This can lead to an exaggerated belief that we are no longer able to care for emotional needs. People with self-intimacy issues experience inner emptiness/deadness, panic when reminded of a trauma when they are alone, needy and demanding relationships, fear of being alone, and unhealthy use of external substances for support (overeating, substance abuse, self-harm behavior, or risky sexual behavior). They believe if they experience strong emotions, they will lose control, and they cannot handle thinking about their trauma while alone.

Repairing self-intimacy involves learning that while the trauma may have temporarily overwhelmed us, we are still mostly able to soothe and calm ourselves, and that it is normal to need help adjusting to a really terrible event. Therapy helps this process by building new skills for helping us cope with even the most terrible events.

Traumatic abandonment and interpersonal abuse can confuse the brain, making it think that being close to others is what caused the traumatic event. Even though closeness to others is a basic human need, following a traumatic event we may find ourselves unable to make emotional connections with others.

Persons with disrupted intimacy beliefs related to others experience loneliness, emptiness or isolation, and difficulty getting close to others, even those who genuinely love us. They believe that if they get close to someone, they will be hurt, that people only want them for physical intimacy, or that they always be taken advantage of by others.

Repairing intimacy beliefs related to others involves accepting that our trauma was not caused by closeness, but by the person who caused the traumatic event. It means re-learning that most close relationships do not involve betrayal or abuse, even if those are the ones we think about the most. It also means accepting that we may not be able, or may not want to be close with everyone we meet, and that is okay – not every failed relationship is our fault.

Ref: Resick, P. A., Monson, C. M., & Chard, K. M. (2016). Cognitive processing therapy for PTSD: A comprehensive manual. Guilford Publications.


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