Category Archives: PTSD

Transmitting PTSD From Generation to Generation

ptsd-gen-10Vulnerability to PTSD can be passed biologically from parent to child. Operation Pegasus offers this public health information for the benefit of communities, employers, families, and individuals.

It’s pretty easy to see how an overwhelmingly stressful, life threatening event can impact many biological systems of the body. This type of experience activates the reptilian brain, floods the system with stress hormones and creates changes in functioning – changes that in some develop into Posttraumatic Stress Disorder (PTSD).

But what about a traumatic event that happened to your mother, or to your great grandmother? Could that event from long ago that impacted the biology of your ancestor show up in your body today? And what about a trauma you experienced? Could it show up biologically in your great great grandchildren?

Well, the answer appears to be yes.

Researchers have shown that vulnerability to posttraumatic stress can be passed down biologically from one generation to the next. These findings provide scientific explanations for how PTSD extends beyond the individual, reaching into family lineages, ultimately impacting entire communities and the larger society.

One common finding among all the studies presented here, is that low cortisol levels in the body chemistry make us more vulnerable to developing posttraumatic stress symptoms. Cortisol, which is the hormone linked to management of stress and trauma, can be depleted in the mother due to exposure to traumatic events such as 9/11, the Holocaust, domestic violence or emotional abuse, poverty, housing, financial and food insecurity. The mother, through this exposure to extreme stress, burns through her cortisol reserves and significantly increases her vulnerability to developing PTSD.

This increased vulnerability is biologically transmissible during pregnancy through hormonal (chemical) and genetic means to her child. The child may then grow up to be biologically less able to cope with stress and trauma. Their own biology will be more predisposed to being overwhelmed by feelings of anxiety, fear and stress, and if confronted with a traumatic experience, they will have a significantly higher likelihood of developing PTSD.

The Research…

Groups of research studies were carried out that examined:

  • Children of parents who had experienced the Holocaust
  • Children of mothers who survived the World Trade Center attack
  • Infants whose mothers had a history of early-life sexual and physical abuse
  • Comparing biological impacts from mother versus father... In one study, researchers aimed to find out if the impact of a mother’s traumatic experiences was more significant than that of the father’s.

Being Vulnerable to PTSD is Key to Developing PTSD

One of these studies (focusing on lineages containing holocaust survivors) shows that there are two essential elements that play a role in developing PTSD. The first is a severe traumatic event. The second is personal vulnerability.1

If a person is not vulnerable, even a severe trauma may not result in PTSD. However, a person who is vulnerable will likely develop posttraumatic stress symptoms when exposed to a traumatic event that is not usually severe enough to trigger PTSD.2,3 So, the obvious question is, “What things make us vulnerable to developing PTSD?”

Two Types of Vulnerability to Trauma – Psychological Versus Biological…

Our vulnerability is shaped by two major causative factors. One is psychological vulnerability which refers to personality traits such as strength of ego, beliefs and coping strategies. The other is biological vulnerability which refers to internal biological systems such as the autonomic nervous system, hormonal patterns and neurotransmitter patterns.4 The group of studies referenced here that examine the generational impact of trauma focus on the biological category of factors. 5-7

The Importance of Cortisol – A Biological Marker of Vulnerability to PTSD

One of the core biological features that contributes to the transmission of PTSD vulnerability to offspring is cortisol.8,9

Cortisol is a hormone produced in the adrenal glands. It is often called “the stress hormone” but may be more accurately thought of as the “anti-stress hormone” because cortisol actually helps counteract the biological effects of stress.

Cortisol has many functions. Cortisol reduces the duration of emotional distress. It increases the availability of the body’s fuel supply (carbohydrate, fat and glucose) which is needed to respond to stress. It promotes proper functioning of the immune system and helps create memories of emotional events that should be avoided in the future. Cortisol levels can be affected by many conditions, such as physical or emotional stress, strenuous activity, infection or injury.10-12

If our cortisol reserve is low due to being used up when handling previous stressful events, then subsequent stressful events have a greater biological impact on us. Thus, low cortisol levels make us more vulnerable to developing posttraumatic stress symptoms.13,14

What does this mean in terms of transmitting PTSD from one generation to the next?

When mothers who were Holocaust survivors had PTSD and low cortisol levels, the low cortisol levels were significantly associated with lifetime PTSD vulnerability in their biological children (both first and second generations). These children had lower cortisol levels than children with PTSD whose mothers did not have PTSD.15 It was also found that greater severity of PTSD symptoms in parents correlated with greater severity of PTSD symptoms in children.16

Childhood Trauma…

The role of childhood trauma was also examined in this group. The adult children of Holocaust survivors reported high levels of childhood trauma, particularly emotional abuse and neglect.17 Their cortisol levels were lower than in those without a history of emotional abuse.

It was also found that traumatized parents are more likely to express improper (abusive or neglecting) behavior toward their offspring during a critical developmental window, and that such behavior may have long-lived effects on cortisol regulation in the offspring.18

Hence, the experience of childhood trauma could be a key factor in the biological transmission of PTSD vulnerability from parent to child.19

The World Trade Center Attack…

The attack on the World Trade Center in New York City also allowed researchers to study the relationship between PTSD in mothers and PTSD in their infant offspring.

Cortisol levels were measured in infants and their mothers who had been directly exposed to the World Trade Center attack during pregnancy. At nine months old, the levels of cortisol in the infants of women with PTSD were significantly lower than in those infants whose mothers had not developed PTSD.

Interestingly, lower cortisol levels were most apparent in babies born to mothers with PTSD who were exposed to the World Trade Center attack in their third trimesters. The authors also suggested that exposure to traumatic experience during pregnancy is a stronger vulnerability factor than abusive parenting.20

Early-Life Sexual and Physical Abuse (of Mothers)

A similar study was conducted that found that infants whose mothers had a history of early-life sexual and physical abuse showed significantly lower baseline cortisol levels and therefore greater vulnerability to developing PTSD.21

Other similar studies have indicated that PTSD in mothers may be due to their genetics. The mother’s genetics can be altered by early life sexual and physical abuse. Those genetic alterations can account for the low cortisol levels in the mother, which can be transmitted to her offspring.22

Fortunately, other studies show that even if the mother has PTSD, and her offspring has low levels of cortisol, it does not mean that her offspring will certainly develop PTSD.23

The Unique Role of the Mother

Another study was aimed at determining if the biological transmission of vulnerability to PTSD by the mother was more significant than transmission by the father. In this study, 284 communities recruited participants to identify their lifetime traumatic experiences and their psychiatric diagnoses. The analysis demonstrated that offspring who had fathers with PTSD (and mothers who did not have PTSD) were not significantly different from offspring with fathers who did not have PTSD.

The same study also found that offspring who have both parents with PTSD had low cortisol levels similar to offspring with only a mother with PTSD. The authors hypothesize that these findings provide evidence that PTSD in mothers may contribute in a unique (biological) manner to decreased cortisol levels in her offspring.24

How Does it Happen? Chemical Programming of the Fetal Brain and Altered Gene Expression

We have looked at biological evidence that vulnerability to PTSD can be transmitted from one generation to the next. A couple of studies explain how low cortisol levels can be transmitted biologically in a couple of ways:

  1. Exposure of the fetus to the mother’s body chemistry that has been altered by her exposure to traumatic experiences during pregnancy may program the stress response pattern in the fetus’ brain (increasing its vulnerability to PTSD).25 (Note that her altered body chemistry may have been transferred to her from her own mother.)
  2. Vulnerability may occur due to changes to the mother’s and fetus’ gene expression. Gene expression is “the flow of genetic information from gene to protein; the process, or the regulation of the process, by which the effects of a gene are manifested; the manifestation of a heritable trait in an individual carrying the gene or genes that determine it.”26 Severe environmental stressors are associated with gene expression that results in lower cortisol levels and therefore increased vulnerability to developing PTSD.27

As mentioned before, although there is evidence that both parents may contribute to vulnerability to PTSD in their offspring, the mother has a unique role in that contribution. This could be because of how chemical programming and gene expression are passed through the biology of pregnancy.28

More Research Needed

The studies referenced in this article had some limitations. The authors who presented this research noted the limitations of their studies as the following:

  • Limited sample sizes in many of the studies
  • Most samples comprised a specific type of patients with a particular trauma, namely, Jewish victims of the Holocaust.
  • Not every subject exposed to early-life or in utero stressors developed PTSD

The authors also note that these findings should be studied in more detail in other types of trauma with different severities and other populations with a variety of genetic backgrounds. Survivors of the tsunami in Southeast Asia and of the earthquakes of Tabas (Iran), Japan, Pakistan, and Turkey seem to be reasonable cases for further investigation.


Certainly more research is needed, but even based on just what we know now, there are many potential implications. One traumatic event appears to affect not just one person but potentially many generations, which means that one traumatic experience can potentially result in hundreds of years of psychological impairment. Future generations could be directly and personally impacted by current events such as wars, natural and manmade disasters, economic depressions, unemployment, and major dislocations. Other traumatic events are more personal and private for families and individuals. These include various types of rejection such as abuse, abandonment, deceit, disappointment, humiliation, and betrayal of trust. Accidents, assaults, multiple medical procedures, and difficult childbirth experiences are further examples of other types of traumatic events.

People who are born with biological vulnerability to trauma could experience disabling problems in the life cycle such as difficulty with employment, relationships, and feelings of well being. There is also a financial cost to society, as people who suffer from PTSD may have a greater need for government services.

The study of the transmission of PTSD from generation to generation could lead to more personal insight into one’s own individual case, greater understanding from healing professionals, employers, educators, law enforcement, as well as scientific advances, such as the ability to scientifically measure the impact of trauma to individuals (including service-related PTSD disability determination for military service members), families, and society over time.


The study was conducted by two universities; first is the Mazandaran University of Medical Sciences in Sari, Iran. The other is the Medical University of the Americas, Charlestown, Saint Kitts and Nevis (in the Caribbean). The article is titled A review on the evidence of transgenerational transmission of posttraumatic stress disorder vulnerability. The researchers are Seyyed Taha Yahyavi,1 Mehran Zarghami,1 Urvashi Marwah2.

1. Perkonigg A, Kessler RC, Storz S, Wittchen HU. Traumatic events and posttraumatic stress disorder in the community: Prevalence, risk factors, and comorbidity. Acta Psychiatr Scand. 2000;101:46-59.

2. Davidson JR, Stein DJ, Shalev AY, Yehuda R. Post-traumatic stress disorder: acquisition, recognition, course, and treatment. J Neuropsychiatry Clin Neurosci. 2004;16:135-47.

3. McFarlane AC. Posttraumatic stress disorder: a model of the longitudinal course and the role of risk factors. J Clin Psychiatry. 2000;61:15-20.

4. Yehuda R, Bierer LM. Transgenerational transmission of cortisol and PTSD risk. Prog Brain Res. 2008;167:121-35.

5. Yehuda R, Bierer LM. Transgenerational transmission of cortisol and PTSD risk. Prog Brain Res. 2008;167:121-35.

6. Yehuda R, Schmeidler J, Giller EL Jr, Siever LJ, Binder-Brynes K. Relationship between posttraumatic stress disorder characteristics of Holocaust survivors and their adult offspring. Am J Psychiatry, 1998;155:841-3.

7. Yehuda R, Schmeidler J, Wainberg M, Binder-Brynes K, Duvdevani T. Vulnerability to posttraumatic stress disorder in adult offspring of Holocaust survivors. Am J Psychiatry. 1998;155:1163-71.

8. Mason JW, Giller EL, Kosten TR, Ostroff RB, Podd L. Urinary freecortisol levels in posttraumatic stress disorder patients. J Nerv Ment Dis. 1986;174:145-9.

9. Boscarino J A. Posttraumatic stress disorder, exposure to combat, and lower plasma cortisol among Vietnam veterans – findings and clinical implications. J Consult Clin Psychol. 1996;64:191-201.

10. Kennedy, Ron. “Cortisol (Hydrocortisone)”. The Doctors’ Medical Library.

11. de Quervain DJ, Roozendaal B, McGaugh JL; Roozendaal; McGaugh (August 1998). “Stress and glucocorticoids impair retrieval of long-term spatial memory”. Nature 394(6695): 787–90. doi:10.1038/29542PMID 9723618.

12. Yehuda R. Current status of cortisol findings in post-traumatic stress disorder. Psychiatr Clin North Am. 2002;25:341-68.

13. Resnick HS, Yehuda R, Pitman RK, Foy DW. Effect of previous trauma on acute plasma cortisol level following rape. Am J Psychiatry. 1995;152:1675-7.

14. Delahanty DL, Raimonde AJ, Spoonster E, Cullado M. Injury severity, prior trauma history, urinary cortisol levels, and acute PTSD in motor vehicle accident victims. J Anxiety Disord. 2003;17:149-64.

15. Yehuda R, Bierer LM, Schmeidler J, Aferiat DH, Breslau I, Dolan S. Low cortisol and risk for PTSD in adult offspring of holocaust survivors. Am J Psychiatry. 2000;157:1252-9.

16. Yehuda R, Halligan SL, Bierer LM. Cortisol levels in adult offspring of Holocaust survivors: relation to PTSD symptom severity in the parent and child. Psychoneuroendocrinology. 2002;27:171-80.

17. Yehuda R, Halligan SL, Grossman R. Childhood trauma and risk for PTSD: relationship to intergenerational effects of trauma, parental PTSD, and cortisol excretion. Dev Psychopathol. 2001;13:733-53.

18. Yehuda R, Bierer LM. The relevance of epigenetics to PTSD: implications for the DSM-V. J Trauma Stress. 2009;22:427-34.

19. Gunnar MR, Vazquez DM. Low cortisol and a flattening of expected daytime rhythm: potential indices of risk in human development. Dev Psychopathol. 2001;13:515-38.

20. Yehuda R, Engel SM, Brand SR, Seckl J, Marcus SM, Berkowitz GS. Transgenerational effects of posttraumatic stress disorder in babies of mothers exposed to the World Trade Center attacks during pregnancy. J Clin Endocrinol Metab. 2005;90:4115-8.

21. Brand SR, Brennan PA, Newport DJ, Smith AK, Weiss T, Stowe ZN. The impact of maternal childhood abuse on maternal and infant HPA axis function in the postpartum period. Psychoneuroendocrinology. 2010;35:686-93.

22. Bartels M, Van den Berg M, Sluyter F, Boomsma DI, de Geus EJ. Heritability of cortisol levels: review and simultaneous analysis of twin studies. Psychoneuroendocrinology. 2003;28:121-37.

23. Yehuda R, Teicher MH, Seckl JR, Grossman RA, Morris A, Bierer LM. Parental posttraumatic stress disorder as a vulnerability factor for low cortisol trait in offspring of holocaust survivors. Arch Gen Psychiatry. 2007;64:1040-8.

24. Yehuda R, Bell A, Bierer LM, Schmeidler J. Maternal, not paternal, PTSD is related to increased risk for PTSD in offspring of Holocaust survivors. J Psychiatr Res. 2008;42:1104-11.

25. Seckl JR. Prenatal glucocorticoids and long-term programming. Eur J Endocrinol. 004;151:U49-62.

26. Gene expression. (n.d.) Mosby’s Medical Dictionary, 8th edition. (2009). Retrieved January 19 2015 from

27. Yehuda R, Bierer LM. The relevance of epigenetics to PTSD: implications for the DSM-V. J Trauma Stress. 2009;22:427-34.

28. Maurel MC, Kanellopoulos-Langevin C. Heredity — Venturing beyond genetics. Biol Reprod. 2008;79:2-8.


Nine Things You Can Do To Improve Your Sleep

The previous post on PTSD and Sleep presented 10 Reasons PTSD May Cause Problems Sleeping. When we lose sleep, the brain keeps an exact accounting of how much sleep is owed in order to get caught up. This is called our sleep debt. The effect of each successive night of partial sleep loss is carried over, and the effect accumulates. The strength of the tendency to fall asleep is progressively greater during each successive day. If we miss three hours one night, we must sleep 11 hours the next night in order to feel alert throughout the day. In fact, we don’t work off a large sleep debt by getting just one good night’s sleep.

Fortunately, you can do a number of things to improve the quality and amount of sleep that you get. In this companion post you’ll find 9 recommendations from sleep researchers about steps you can take to improve your sleep quality.

Sleep 1B Image

1. Exercise during the day

Do aerobic exercise regularly, but not close to bedtime. This can take various forms such as a routine like walking, jogging, aerobic classes, various workout routines, and vigorous work that raise your heart rate for a half hour or longer. However, try to avoid exercise within four hours of your bedtime. Reading boring material helps with calming down after exercise.

2. Keep to a Regular Sleep Schedule

Try to stick to a regular sleep schedule. Over millions of years our bodies have developed a remarkably precise biological clock that regulates sleeping and waking. The nighttime – daytime cycle is represented in miniature within our cells. It also synchronizes a vast array of biochemical events in our bodies such as chemical, hormonal, and nerve cell activities that promote our daily fluctuation in feelings and actions.

Bright light, like sunlight can reset the night/day (circadian) cycle. Light is the most powerful time cue our bodies have. The use of electric lights in the evening, which we previously thought had no effect, can have a profound effect in lengthening our biological day and shifting our clocks. Even doing email or reading at night has the potential to fool our bodies into delaying our biological onset of sleepiness. Being surrounded by electric lights in the evening pushes our biological clocks around, so that our clocks start lagging about an hour every day.

Also, be aware that your infant’s sleep patterns may reflect your evening activities such as going to a mall in the evenings – exposure to bright lights. For more regular sleep, prefer a more routine and less light-stimulated evening schedule.

3. Avoid Heavy Meals before Bedtime

Avoid eating heavy meals before going to bed; however, make sure that you do not go to bed hungry. To increase your chances of a good night’s sleep, have a milk product or light carbohydrate snack shortly before bedtime. Don’t sweeten your warm milk with artificial sweetener. Food additives in general and artificial sweeteners in particular tend to increase alertness, which interferes with sleep.

Consume carbohydrates and fats as evening snacks if you eat snacks after dinner. Avoid beans and other protein-rich foods, raw onions, cruciferous vegetables (broccoli, cauliflower, cabbage), and spicy foods shortly before bedtime.

4. Limit Alcohol, Caffeine, and Nicotine Consumption

Alcohol consumption reduces the relative amount of time spent in REM sleep; therefore, sleep following alcohol consumption is not as restful as alcohol-free sleep. The more alcohol we consume, the less REM sleep we get and the less rested we are in the morning. It’s best to avoid consuming alcohol within three hours of your bedtime.

Also, reduce the amount of caffeine and nicotine that you consume during the day. Because caffeine and nicotine are stimulants, avoid drinking caffeine after lunch time, and do not smoke just before going to bed.

5. Avoid Naps after 3 PM

The ideal time for a nap, according to sleep researchers, seems to be 12 hours after the midpoint of one’s previous night’s sleep. So if you sleep from 11:00 PM to 6:00 AM, your nap urge should be around 2 PM. The ideal length seems to be 30 minutes. Evening naps appear to interfere with sleep.

The effects of napping are different for the sleep-deprived and the non-deprived. For the sleep-deprived, napping improves performance but not mood. For normal sleepers, napping improves mood but not performance.

6. Change Tactics after 30 Minutes of Trying

Trying to force yourself to fall asleep often fails. If you are having a hard time falling asleep after 20 to 30 minutes, get up out of bed and try to do something relaxing (for example, drinking warm milk or a calming herbal tea, reading a book). If you can’t quiet your thinking, try writing down what’s on your mind. Return to bed when you feel drowsy.

7. Make Your Bedroom Quiet, Dark, and Cool

Try to make your bedroom a relaxing place, and try to limit your activities in the bedroom. For example, do not eat, watch television, check e-mail on your laptop, or talk on the phone in bed. Your bedroom should be associated with sleep. Utilize a white noise machine, ear plugs, or an eye mask to help block out any distracting noises or light. Try to keep your bedroom at a cool and comfortable temperature.

8. Use a Relaxation Routine

Practice relaxation before or after going to bed. Relaxation routines are designed to release muscle tension, stop thinking about activities, and slow down your breathing. A technique called progressive relaxation is very effective. Start by focusing your attention on your feet and ankles and release all the tension in them. Then, focus your attention on the muscles from your ankles to your knees and release all the tension in those tissues. Keep working your way up your body this way. The next segment is from your knees to your hips. Then from your hips to your waist. Next, from your waist to your shoulders. Then your arms, hands, and fingers. Then your neck, jaw, and face. Notice that the tissues in each segment are completely relaxed and at ease before going to the next segment. This is also good for getting back to sleep when you wake at night.

9. Use Medications for Sleep Cautiously and Only Under a Physician’s Supervision

In his book titled The Owner’s Manual for the Brain, Pierce J. Howard, Ph.D. provides some guidelines for using the over-the-counter medication called melatonin. He recommends taking melatonin only in the evenings, unless you are taking it for help with sleep problems associated with changing work shifts. In that case, take your dosage two hours before desired sleep onset, regardless of the time of day.

He notes that people in their 20’s should take melatonin infrequently and only for insomnia. Those in their 30’s to 50’s may take it more frequently for insomnia; those over 60, daily. Begin with 0.5 mg of melatonin two hours before desired sleep onset, and increase by 0.5 mg until desired sleep quality is attainted.

For jet lag associated with travel involving time-zone changes, try 1 mg of melatonin for each time zone crossed. Take your dosage a few hours before bedtime at your destination. Do the same again when you return.

He emphasizes consulting your physician if you are taking other medications, or if your dosage of melatonin exceeds 10 mg.


 Those of us with Operation Pegasus help people understand posttraumatic stress and how to self-administer the symptom management skills of the Trauma Resiliency Model (TRM). Family members are invited to participate. Get control and get relief. Call or email us today. We’ll get started right away.


Types of Abuse

Types of Abuse – Physical, Sexual, Emotional, and Economic Coercion

One of the major conditions for causing trauma in an individual is feeling helpless to protect yourself or escape from a situation that is threatening to you. When someone intends to do you harm, the traumatic effect is greater than events such as accidents or natural disasters. When the abuse comes from within the family, the traumatic effect is most often more painful and damaging than abuse from outside the family. About half of all marriages involve some type of abuse. Quite often, the abusive partner has suffered trauma in the past.

Abuse is behavior that includes violence and intimidation or the threat of violence and intimidation in order to gain power and control over another individual. In order to gain power and control, the abuse is repetitive and gets more severe (and more frequent) over time.

Physical abuse, sexual abuse, economic coercion, and emotional/psychological abuse cause great emotional distress. Here are the definitions of these types of abuse.

  • Physical Abuse—Any act of violence that is designed to control, hurt, harm or physically assault a partner. This includes pushing, punching, kicking, grabbing, pulling hair, choking, slapping, damaging property or valued items, the use of weapons and refusing to help a sick partner.
  • Sexual Abuse—Any action forcing the partner to perform sexual acts against her or his will. This includes pursuing sexual activity with a partner that is not fully conscious, uninvited touching, unwanted sexual intercourse and coercing a partner to have sex without protection against pregnancy or sexually transmitted diseases.
  • Economic Coercion—Any action forcing the partner to become dependent on the abuser for money and survival. This includes withholding money, a car or other resources; sabotaging attempts to make money independently; or controlling all family finances.
  • Psychological or Emotional Abuse—Any action intended to degrade, humiliate or demean, both in public or private. This includes verbal threats, yelling, intimidation, harassment, criticism, untrue accusations, withholding information and isolation from family or friends. Psychological abuse may precede or accompany physical violence as a means of control.

Women are the biggest group of victims who suffer abuse. Abuse crosses all ethnic, racial, religious, sexual orientation, and socioeconomic lines in America. Over 3 million women are abused by their husbands or partners each year. In fact, battering is the number one cause of injuries to women – more than rapes, muggings, and car crashes combined.

  • Women are more likely to be assaulted, injured, raped, or killed by their male partner than by any other type of assailant. Women with an excessively jealous or possessive partner are at a greater risk.
  • Male children who witness abuse to their mother are 3 times more likely to abuse their own wives than children of nonviolent parents.
  • About half of male assailants repeat the abuse over three times a year.
  • Over half of female homicides are committed by male partners.
  • 58,000 US military service members died during the Vietnam War. During that same period, 51,000 women were murdered by their partners in the United States.
  • Women between the ages of 19 and 29 report more violence by intimate partners than any other age group.
  • Separated or divorced women are 14 times more likely than married women to report having been abused.
  • Medical sources suggest that about 37% of pregnant women are abused during pregnancy. Women abused before becoming pregnant face the risk of more severe violence.

Those of us at Operation Pegasus help you understand the different ways that traumatic experiences affect you, your family, and others around you. You also learn how to stop the harsh internal sensations such as panic, rage, and guilt that are triggered by certain places, people, situations, and events. Contact us to learn how to get relief and freedom from trauma symptoms and feel like yourself again.

How PTSD Affects My Family

Posttraumatic stress affects relationships as well as the individual. We invite you to follow the research discoveries presented in the next two blog posts that covers the impact that posttraumatic stress has on relationship intimacy. Today’s post discusses Five Fears that Interfere with Intimacy. The next post will cover The Things To Do To Help Intimacy Flourish.


With PTSD, we seem to have more relationship difficulties such as divorce and avoidance of intimacy. Some appear to marry in hopes of recreating a pre-trauma life or escaping difficult circumstances before sufficient healing has taken place. For some, fear of intimacy interferes with connectedness. One research participant said, “I heard that love casts out fear, but in my case fear casts out love.” Schiraldi has identified five fears that interfere with intimacy and which must be neutralized in order for intimacy to grow. Otherwise, sufferers can sabotage intimacy in ways that include workaholism, picking fights, abandoning their partner, or drinking excessively. As you will see, these fears make perfect sense for anyone who has suffered trauma. The fears are:


Loss of control. In intimacy, we open ourselves up emotionally. This means that we are vulnerable to the emotions that accompany the intrusions of traumatic memories. This can lead to avoidance or anger to prevent loss of control over the memories. It is logical, then, to sufficiently heal so that intimacy might progress. In some cases, sufferers fear being controlled by their partner. This often happens after a traumatic experience/s where choice and control were taken away, especially when it was another human taking control from the victim. The antidote is to find a trustworthy person/s who can be viewed as an ally and teammate. In such a relationship, we gradually learn to relinquish or share some control.


Abandonment. When we have experienced abandonment by significant people in our life (or abandonment by their failure to protect us), we want to avoid experiencing this again. Feeling vulnerable to abandonment can cause us to

  • Never love again
  • Engage in casual sex without emotional involvement
  • Be distant or revengeful in relationships
  • Be clinging or have jealous insecurity

Rejection. To protect against experiencing further rejection, we might not let ourselves be fully known, or will reject the other person first. This fear arises from the feeling of being damaged and unlovable, and by the perception that people will reject us if they know our secret about the traumatic event/s to which we have been exposed.


Attack. In close relationships (including family relationships), we are more vulnerable to being hurt and/or angered by put-downs, teasing, or other abusive acts. Such behaviors are experienced as a betrayal of the unspoken pledge to support and protect one’s loved one. When we have become sensitized to danger, we have an even greater need for safety. Because of this vulnerability, we are likely to feel threatened by even small disagreements. A mindset of “You are either with me, or against me,” can develop, which makes communication difficult.



Our own tendency to hurt others. We may not see our anger, disappointment, or hurt as normal feelings after trauma. Also, we have difficulty understanding that our trauma-related behaviors hurt those around us. Trauma-related behaviors can cause our significant others to experience rejection, abuse, abandonment, disappointment, deceit, humiliation, and betrayal. Those experiences often undermine trust from those around us and can cause them to feel increased fear, sadness, remorse, contempt, disgust, and anger toward you.


Those of us with Operation Pegasus want to help people understand posttraumatic stress and how to self-administer the symptom management skills of the Trauma Resiliency Model (TRM). Contact us for more information about this life-changing treatment option.


The information about the Five Fears that Interfere with Intimacy is from Glenn R. Schiraldi; The Post-Traumatic Stress Disorder Sourcebook; Lowell House: California; 2000. Our next post, from the same source, will cover the things to do to help intimacy flourish.

What causes PTSD?

What causes PTSD?

Actually, this question has two answers. The first answer is that PTSD is caused by our own stress hormones. Stress hormones are toxic to nerve cells (neurons). When the level of stress hormones released into our body chemistry reaches a certain threshold, nerve cells are damaged. The result is that our nervous system becomes highly sensitive or numbed-out. So, PTSD is like an internal chemical burn to our nervous system.


The second answer is that any event causing the release of enough stress hormones to chemically burn our nerve cells will cause PTSD. These events include the threat to life and the integrity of our body such as combat, assault, and accidents. The damage is usually worse when there is intent by someone (or others) that intends to hurt us. This can include humiliation, rejection, abuse, abandonment, deceit, and betrayal. Other events may not be life threatening, but are still traumatic because they usually happen repeatedly, which makes it more difficult to recover. This can include repeated medical procedures (especially for children), difficult childbirth, and living with a debilitating or terminal medical condition.




Military service personnel may have had multiple exposures and long durations of exposure due to frequent patrols and multiple deployments. They, like emergency service personnel, such as firefighters, law enforcement, and EMT workers, are vulnerable to trauma from:

  • Occupational exposure to violence
  • Exposure to noxious agents
  • Physical harm or injury
  • Witnessing death and grotesque injuries
  • Witnessing harm to another
  • Witnessing or learning about violence to loved ones or those in one’s unit
  • The perception of surviving an experience by chance when others lost their life or were severely injured


Individuals with a history of child abuse who experience a trauma as an adult are likely to experience worse symptoms. That’s because childhood trauma (especially abuse) typically has a profound impact on the child’s developing nervous system. As adults, they are more vulnerable to developing PTSD – even decades later. Like an injured knee joint, an injured nervous system is more vulnerable to re-injury. This is one reason why two people can experience the same threatening event (say a minor car accident), and one person has little or no harsh internal trauma sensations afterward while the other one has great difficulty with them.



What is PTSD?

Posttraumatic stress disorder (PTSD) is a condition of the nervous system. This condition has to do with the sensitivity of the nervous system. Its sensitivity is either heightened or numbed-out. When sensitivity is heightened we are easily startled, quick to panic, quick to rage, and irritable. When sensitivity is numbed-out, we seldom experience panic or rage. Also, we seldom experience joy from the activities that used to bring us enjoyment. In both cases, a major loss is the ability to trust people, events, and situations. Also in both cases, we have a strong urge to withdraw from social and leisure activities.

Once something has triggered the nervous system of someone with heightened sensitivity, it takes a long time to calm down…hours, days, or even weeks and months. It depends on the severity of the condition. The heightened sensitivity of the nervous system causes harsh internal sensations in our organs and muscles. These are the sensations of panic and rage – pounding heart, fast breathing, intense gut sensations like stage fright or butterflies, tense muscles, and trembling. Together, these sensations create an overwhelming urge to fight or an overwhelming sense of vulnerability, which creates the urge to withdraw and avoid situations that trigger these sensations. Some of the many triggers of PTSD sensations can include certain situations, events, places, smells, people, objects, and sounds.

In addition to the harsh internal sensations (overwhelming emotion), is the automatic replaying memory of the traumatic event/s that we experienced. As the memory is replayed, the overwhelming internal sensations are triggered. Our attention is locked on the replaying. We cannot function normally in social, work, and family situations because our memory is highly impaired, so is our ability to plan, or be fully aware of activities going on around us. Our attention is horribly distracted, and we easily lose track of time. These are the hallmark symptoms of PTSD – (1) intrusive memories/thoughts, (2) overwhelming internal sensations accompanying the intrusive memories, and (3) avoidance – the intense urge to avoid situations that will trigger the first two symptoms.