Abusive relationships can do a lot of damage to your emotional health and mental well-being.
It can feel painful and deeply distressing — to say the absolute least — when someone you love and trust:
- begins to criticize you or put you down
- tries to control or manipulate you into doing what they want
- becomes physically or sexually abusive
These behaviors don’t just hurt you in the moment. They can destroy your sense of safety, diminish self-confidence and self-worth, and make it difficult to trust anyone else.
Once you end the relationship, loved ones might try to offer encouragement by reminding you that once you heal, you’ll find someone better, someone kind and safe and caring.
Yet despite their reassurances, you might feel unable to escape reminders of the relationship that remain ever-present in your thoughts. There’s a good reason for that: Trauma isn’t something you can easily shake off and walk away from.
Here’s what to know about relationship-based post-traumatic stress, or post-traumatic relationship syndrome.
What does relationship PTSD mean, exactly?
You probably know it’s possible to develop lingering symptoms of fear and distress after a single traumatic event. When flashbacks, avoidance, and other symptoms persist after the trauma has ended, mental health professionals may diagnose PTSD.
An abusive relationship is trauma of a different kind. Leaving the relationship can put a stop to repeated emotional, physical, or sexual abuse, but it may not necessarily free you from their effects.
In an effort to better recognize and address this specific type of trauma, experts have introduced the concept of post-traumatic relationship syndrome (PTRS).
People who experience physical, sexual, or emotional abuse in an intimate relationship may have a very different response to trauma than people who experience other traumatic events.
Instead of blocking out and avoiding your memories of the abuse or numbing yourself to them, you might continue to revisit them, experiencing them again and again.
The pain of this retraumatization can get in the way of healing, moving forward, and eventually building safe, healthy relationships with future partners.
What’s the difference between PTRS and PTSD?
Traumatic stress after an abusive relationship can look a little different from typical PTSD.
A diagnosis of PTSD requires symptoms in four categories:
- arousal and reactivity
- cognition and mood
People living with PTSD often shift between two different states. Flashbacks, memories, and intrusive thoughts bring the trauma into your conscious awareness, returning you to a state of crisis. In response, you begin avoiding everything to do with the traumatic event, generally in order to avoid triggering those memories.
PTRS doesn’t involve the same avoidance that characterizes PTSD.
With PTRS, you may find yourself unable to avoid memories or reminders of the traumatic relationship, and you remain fully aware of what happened. Since you can’t numb yourself to the distress, you might cope by trying to manage your emotional response instead.
Maybe you talk or journal about what happened. Or, you try to replay and reframe the situation, but your efforts leave you doubting yourself. You may even attempt to navigate loneliness (and replace those painful memories) by seeking out a new partner right away.
These emotion-focused coping strategies are great ways to deal with some types of distress, but they don’t always promote healing in the immediate aftermath of abuse.
They might instead keep the trauma overwhelmingly fresh in your thoughts, making it even harder to find relief.
PTRS differs from PTSD in a few other key ways:
- A diagnosis of PTSD involves experiencing or witnessing a threat of physical harm, including injury or death. You can experience PTRS without ever facing physical harm.
- PTSD diagnostic criteria don’t list any specific symptoms for people who experience relationship trauma, while symptoms of PTRS center around relationship trauma and its long-term effects.
- Key symptoms of PTRS include rage, horror, and fear toward the abusive partner. With PTSD, you might experience anger or rage, but this isn’t a key symptom for everyone.
What does PTRS look like?
While many experts consider PTRS a very real response to the trauma of abuse, the condition has yet to be recognized as a formal mental health diagnosis in the new edition of the Diagnostic and Statistical Manual of Mental Disorders.
Researchers haven’t reached a complete consensus on PTRS symptoms and diagnostic criteria, but experts generally agree it includes:
- an initial response of terror, horror, and rage toward the abusive partner
- intrusive, arousal, and relational symptoms that began after the abuse
Anything that leads you to re-experience the trauma can fall into the category of intrusive symptoms.
This might include:
- flashbacks, or feeling as if you’re experiencing the abuse in the present moment
- intrusive thoughts or rumination
- fear and other emotional distress when remembering the abuse
- physical sensations of anxiety, such as a pounding heart, shaking, or sweating palms, when remembering the abuse
You might experience these symptoms when you see or do anything that reminds you of the relationship — going somewhere you often went together, hearing a phrase or nickname they often used for you, or even starting a new relationship.
Reactivity or arousal symptoms stem from your body’s fear response.
With traumatic stress, your body remains in a near constant state of hyperarousal to leave you better prepared to respond to the threat of abuse.
The hormones involved can:
- contribute to insomnia and other sleep problems
- leave you on edge and struggling to concentrate
- lead to restlessness, irritability, and anger
- trigger feelings of panic or anxiety
Remaining vigilant to any possible threat can leave you constantly on edge, unable to relax or feel safe. This can make it difficult to maintain healthy routines, like eating balanced meals or getting enough sleep.
While PTSD symptoms can eventually begin to create stress in your relationships with others, certain symptoms of PTRS directly relate to your interpersonal relationships.
After experiencing relationship trauma or abuse, you might:
- believe you don’t deserve a healthy relationship
- feel unconsciously drawn to unhealthy dynamics and end up in another abusive relationship
- have a hard time trusting loved ones and new romantic partners
- feel anxious and insecure in new relationships
- believe loved ones blame you for what happened
- lack support from loved ones who don’t know or understand what happened
- isolate yourself in response to feelings of shame or self-blame
- lose interest in sex or feel unable to have sex
Are there different types of PTRS?
Research specifically focusing on PTRS remains in the early stages, so experts have yet to outline any distinct types or subtypes.
Keep in mind, though, that people experience and respond to trauma in different ways. Two people with PTRS may not necessarily have the exact same symptoms, and some people might face more severe symptoms than others.
It’s also important to recognize that PTRS only describes one specific type of relationship trauma.
Survivors of abusive relationships can still experience PTSD or complex PTSD (CPTSD). The symptoms involved will just be slightly different.
If you attempt to avoid or block out memories of the abusive relationship, struggle to remember details, or feel detached, you could have PTSD.
CPTSD, a response to ongoing trauma, involves symptoms of PTSD along with other experiences, including:
- extreme negative feelings toward yourself, such as shame, guilt, or self-blame
- changes in self-identity
- trouble regulating your emotions
- feelings of hopelessness, despair, sadness, or thoughts of suicide
An unhealthy or toxic relationship could contribute to any of these three conditions.
Working with a mental health professional can help you get more insight on key signs of trauma and begin addressing the effects of abuse in a safe environment.
What causes PTRS?
The direct cause of post-traumatic relationship stress is relationship abuse, or experiencing one or more of the following in an intimate relationship:
- physical abuse, including direct physical harm or threats of physical harm
- sexual abuse, including rape, other sexual assault, or sexual coercion
- emotional abuse, including gaslighting, manipulation, or control
More specifically, you can consider PTRS a response to the lingering fear of abuse and the potential for future abuse.
It’s absolutely possible to experience emotional distress when a partner pulls you into repeated conflict, gives you the silent treatment, or ignores you after a bad day. These behaviors can suggest a toxic dynamic, especially when they happen frequently.
Yet toxic behaviors don’t always translate to abuse, since abuse is typically about control, and they won’t necessarily lead to traumatization.
Infidelity can also lead to betrayal trauma, a recognized type of relationship distress with symptoms that can resemble post-traumatic stress. But again, though infidelity can cause lasting pain, cheating alone doesn’t constitute abuse.
What should you do if you recognize this in yourself?
Healing and recovering from trauma on your own can be a pretty challenging task.
It can feel frightening to consider opening up to someone else about experiencing abuse, but a compassionate therapist can offer guidance and support as you work to heal.
Therapy can help you:
- overcome feelings of self-blame and guilt
- understand the abuse wasn’t your fault
- process feelings of anger and fear
- address related mental health symptoms, including anxiety or depression
- work through lingering insecurity and trust issues
- work to develop a healthy support system
When trauma feels so overwhelming that you can’t escape, as is often the case with PTRS, you might struggle to break down what happened into manageable parts you can actually process.
In therapy, however, you can learn important desensitization techniques that make it easier to navigate the trauma while remaining in control. Desensitization doesn’t make your feelings go away, but it can help you learn to manage them in safe and productive ways.
A strong support network can also go a long way toward helping you recover from the effects of abuse, so connecting with trusted loved ones can make a big difference.
Friends and family can offer a sense of safety and help reinforce your sense of self.
When fear and distrust make it difficult to trust others, it becomes even more important to reach out to a therapist for support. Some people also find it helpful to join a support group and connect with other survivors of relationship abuse.
Emotion-focused coping techniques like meditation, journaling, and art can help you manage your emotional response to situations you can’t control. These techniques can still have benefit for managing PTRS symptoms, but experts consider desensitization a key component of recovery.
What if you recognize this in a partner?
If you notice signs of PTRS, or any other traumatic stress, in your romantic partner, it’s generally best to encourage them to reach out for professional support.
No matter how kind, compassionate, and loving you are, a healthy relationship alone generally can’t heal the lingering effects of abuse. You can’t save your partner from what they experienced or take their pain away.
That said, your patience and understanding can have a positive impact on both their recovery and the outcome of your relationship.
Tips to keep in mind
- Give them space. They may have widely varying needs as they work toward healing. On some days they don’t want to leave your side, while on others you feel as if they’re pushing you away.
- Talk about it. Good communication can always strengthen a relationship. Just know they may not always be able to clearly explain what they’re feeling.
- Respect their boundaries. This involves learning about potential triggers and avoiding those behaviors. If hugging them when you wake up in the middle of the night reminds them of their ex, for example, you’ll want to avoid doing that.
- Offer validation. If they put themselves down or take on the blame for the abuse, you can offer support through gentle reminders that they weren’t at fault.
- Consider working with a relationship counselor. While individual therapy can help your partner, a couples therapist trained to help couples navigate relationship trauma can offer more specialized support.
Note: When talking about what happened seems to worsen your partner’s distress instead of helping them process, it may help to encourage a distraction without dismissing them.
For example, you might say:
“I’m always here to listen, but I’m worried talking about this right now is making you feel worse. Would it help to take a short break and go for a walk?”
How can this affect you long-term?
Without support, PTRS can get worse.
Feeling unable to share what happened with others can leave you isolated and alone.
The persistent fear that comes with ongoing retraumatization can make relaxation and self-care difficult, leaving you vulnerable and stressed to the point of burnout.
You might struggle to feel safe with anyone and begin to fear the world as a whole. If you blame yourself for the abuse, you might feel unable to shake feelings of guilt, helplessness, or unworthiness.
If you can’t avoid reminders and memories of the abuse, you might respond by turning away from healthy, nurturing relationships with family, friends, and potential romantic partners.
When you find yourself struggling to cope alone, support from the right therapist can make a big difference.
What’s the bottom line?
Relationship abuse can cause lingering trauma, but you don’t have to live with these effects forever. With time and support, you can heal and recover.
Connecting with a trained therapist can help you process the abuse, recreate a sense of safety, and begin to thrive, instead of just survive.
Explore resources for abuse support and recovery:
- National Domestic Violence Hotline
- Rape, Abuse, & Incest National Network (RAINN)
Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, she’s committed to helping decrease stigma around mental health issues.