General New to the forum and needing advice for my partners anger outbursts.

[Marie251]

Hello. My husband suffers from PTSD, major depression, and anxiety. We’ve been together for 10 years and I’m really struggling on how to continue to navigate our relationship. In the early years, I didn’t know how to handle his random outbursts of anger and we argued a lot. We’ve gotten *slightly* better at handling those moments, but it’s seeming to happen more frequently. He cycles from sadness, to anger, to his normal fun personality. He’s tried medication and therapy, but he’s not able to keep anything up consistently. He’s not able to work so he’s home 24/7. I’m looking for tips to help him manage these ups and downs at home. Any suggestions are welcome. I appreciate it immensely.

 

[somerandomguy]

If he's unable to follow any treatment consistently, don't expect anything to change.

 

[Weemie]

If it were me I would make the stipulation that you are only willing to remain with him if he engages in treatment. He does not need to be "going to therapy" to be treating himself. I have been in and out of therapy (much of it unhelpful) but still regularly, daily, engaging in active management of my symptoms and directive goals for about sixteen years. It sounds like a good first step for him would be to look more closely into anger management. The good anger management that is geared toward grown-ups and doesn't use condescending language that makes us feel stupid or give advice that is not rooted in actual science, is typically based on a 3-axis model: distress tolerance, education and behavioral modification.

Most anger management tools can be quite condescending, I found some good resources from the VA and in particular, AIMS, and the distress tolerance tools of FORNET to be the most effective. In particular "stop" and "distract." For ex I have an app on my phone that says "look at these soothing pictures!" but it's just memes of Draco Malfoy being like "wait til my THERAPIST hears about this" in blingee font. I don't know why but it makes me laugh because I'm dumb. One time the VA app told me I shouldn't bite people. I screenshotted it so now all I see is "DON'T BITE" and it makes me laugh.

Like, stupid shit. Having a plan for when he does lose his temper will be more effective than trying to manage it in the moment. The biggest issue with anger management is that once a person's heartrate and BP go above like 130 (according to Patience Mason, anyway) the ability to engage with your brain's logical and decision-making processes is completely decimated. For me, using the tools from the VA was helpful because when I get angry, my brain has a separate, intentional-conditional pathway to be as aggressive, violent and terrifying as I possibly can -> this is stuff that is also taught to military veterans (via boot camp).

So in many ways, "de-programming" this response can come with a good deal of annihilation anxiety, since "killing rage" is extremely survival-oriented. Having the ability to document the things that make me upset on a day-to-day basis was somewhat helpful, but I found it similar to trying to document my dissociative disorder: basically, I am always in a state of heightened agitation, so anything and everything will set me off and there is no rhyme or reason to it. The problem is neurophysiological, not environmental.

Another tool that has been helpful to me is to attempt to "kickstart" the logical engagement process (usually I need to rely on my phone for this, as I have it written down) where I remind myself that I am in total control of my behavior as an adult and if I lash out violently, I am responsible for that, and I have the choice to act compassionately and reasonably even when I am angry.

Learning about the aggression pathway and the dialectical component of FORNET was very useful to me because I can see in real-time how it impacts my daily living. I get angry, my brain fires a pathway that has been fired millions of times in the past since childhood (what we call appetitive aggression, which is that the more violent you are, the more violent you will be) and because I am so accustomed to that happening I don't question it or stop to engage with it or try to redirect it at all. Especially because a lot of the time, "blowing my top" or losing my temper or engaging in aggression? Is useful!

People are scared of me so they do what I want. I get what I want, I don't have to exert much effort, and I get my needs met. But obviously this is not sustainable in a reciprocal relationship. What good is it if your partner is scared of you all the time? How is that going to promote intimacy and wellbeing in the household? How are you going to raise a child who grows up to be a conscientious citizen when that child is learning the same exact aggression pathways that you have, because you are teaching them the same exact responses? (That very likely began for us, in early childhood.)

Similarly, reducing my exposure to violent content (media, TV, the types of stories I read, in general the content I consume) has helped a great deal by "de-programming" those pathways. Even things like video games, or pornography, or whatever other thing. This is a hugely intentional process that essentially requires totally adjusting how you live your life on a day-to-day basis. It's not easy and it requires the willingness to do it for yourself, because your relationships are suffering. You can't half-ass it, so if he isn't willing, it's not going to work.

Part of my plan involves making sure that those around me understand what they can and cannot do when I get angry. For one thing, they cannot engage with me. They need to leave me alone, and respect my boundaries when I physically remove myself from the situation. If that doesn't happen my capacity to control myself disintegrates and that's when the situation devolves. I cannot manage anyone else other than myself. So someone going "ughhh stop being so mad!" or "idk what to tell you!" or even "omg I'm so sorry" (or, "I understand," or literally anything).

My responses are not rational, but yours are. I'm going to react irrationally and probably yell back something stupid like YOU COULD NEVER UNDERSTAND!!! and throw something at you. This is unfortunately not quite where I should be (I am responsible for my own behavior in all circumstances, or at least I should be) but having my carer understand this has reduced our "conflict zone" by a significant margin. I know when I'm getting frustrated and I will just leave, && she does not follow me. Or I will say "I can't talk right now" and she leaves me alone.

 

[Sweetpea76]

I’m looking for tips to help him manage these ups and downs at home.

I don’t know much about helping him manage, but I know about managing *myself* in a relationship with my combat vet sufferer. That’s really all you can do, as much as it sucks.

The anger outbursts are the easiest, believe it or not. I do not engage. If he lashes out I remove myself from the situation. I don’t argue back, reason, defend myself… nada. I leave the situation with no discussion. If he wants to speak calmly to me like an adult he can give me a call. He has learned over the years that I do not tolerate that shit at all.

Doing that was the best advice I got when I started here almost 10 years ago.

The depression is the hardest, especially if he has suicidal ideation. That’s hell. I don’t have any advice about managing that, except for not letting him suck you under with him.

 

[Marie251]

If it were me I would make the stipulation that you are only willing to remain with him if he engages in treatment. He does not need to be "going to therapy" to be treating himself. I have been in and out of therapy (much of it unhelpful) but still regularly, daily, engaging in active management of my symptoms and directive goals for about sixteen years. It sounds like a good first step for him would be to look more closely into anger management. The good anger management that is geared toward grown-ups and doesn't use condescending language that makes us feel stupid or give advice that is not rooted in actual science, is typically based on a 3-axis model: distress tolerance, education and behavioral modification.

Most anger management tools can be quite condescending, I found some good resources from the VA and in particular, AIMS, and the distress tolerance tools of FORNET to be the most effective. In particular "stop" and "distract." For ex I have an app on my phone that says "look at these soothing pictures!" but it's just memes of Draco Malfoy being like "wait til my THERAPIST hears about this" in blingee font. I don't know why but it makes me laugh because I'm dumb. One time the VA app told me I shouldn't bite people. I screenshotted it so now all I see is "DON'T BITE" and it makes me laugh.

Like, stupid shit. Having a plan for when he does lose his temper will be more effective than trying to manage it in the moment. The biggest issue with anger management is that once a person's heartrate and BP go above like 130 (according to Patience Mason, anyway) the ability to engage with your brain's logical and decision-making processes is completely decimated. For me, using the tools from the VA was helpful because when I get angry, my brain has a separate, intentional-conditional pathway to be as aggressive, violent and terrifying as I possibly can -> this is stuff that is also taught to military veterans (via boot camp).

So in many ways, "de-programming" this response can come with a good deal of annihilation anxiety, since "killing rage" is extremely survival-oriented. Having the ability to document the things that make me upset on a day-to-day basis was somewhat helpful, but I found it similar to trying to document my dissociative disorder: basically, I am always in a state of heightened agitation, so anything and everything will set me off and there is no rhyme or reason to it. The problem is neurophysiological, not environmental.

Another tool that has been helpful to me is to attempt to "kickstart" the logical engagement process (usually I need to rely on my phone for this, as I have it written down) where I remind myself that I am in total control of my behavior as an adult and if I lash out violently, I am responsible for that, and I have the choice to act compassionately and reasonably even when I am angry.

Learning about the aggression pathway and the dialectical component of FORNET was very useful to me because I can see in real-time how it impacts my daily living. I get angry, my brain fires a pathway that has been fired millions of times in the past since childhood (what we call appetitive aggression, which is that the more violent you are, the more violent you will be) and because I am so accustomed to that happening I don't question it or stop to engage with it or try to redirect it at all. Especially because a lot of the time, "blowing my top" or losing my temper or engaging in aggression? Is useful!

People are scared of me so they do what I want. I get what I want, I don't have to exert much effort, and I get my needs met. But obviously this is not sustainable in a reciprocal relationship. What good is it if your partner is scared of you all the time? How is that going to promote intimacy and wellbeing in the household? How are you going to raise a child who grows up to be a conscientious citizen when that child is learning the same exact aggression pathways that you have, because you are teaching them the same exact responses? (That very likely began for us, in early childhood.)

Similarly, reducing my exposure to violent content (media, TV, the types of stories I read, in general the content I consume) has helped a great deal by "de-programming" those pathways. Even things like video games, or pornography, or whatever other thing. This is a hugely intentional process that essentially requires totally adjusting how you live your life on a day-to-day basis. It's not easy and it requires the willingness to do it for yourself, because your relationships are suffering. You can't half-ass it, so if he isn't willing, it's not going to work.

Part of my plan involves making sure that those around me understand what they can and cannot do when I get angry. For one thing, they cannot engage with me. They need to leave me alone, and respect my boundaries when I physically remove myself from the situation. If that doesn't happen my capacity to control myself disintegrates and that's when the situation devolves. I cannot manage anyone else other than myself. So someone going "ughhh stop being so mad!" or "idk what to tell you!" or even "omg I'm so sorry" (or, "I understand," or literally anything).

My responses are not rational, but yours are. I'm going to react irrationally and probably yell back something stupid like YOU COULD NEVER UNDERSTAND!!! and throw something at you. This is unfortunately not quite where I should be (I am responsible for my own behavior in all circumstances, or at least I should be) but having my carer understand this has reduced our "conflict zone" by a significant margin. I know when I'm getting frustrated and I will just leave, && she does not follow me. Or I will say "I can't talk right now" and she leaves me alone.

I deeply appreciate your response and the details you’ve shared. You just hit the nail on the head for so many aspects that I’m dealing with in my marriage. It’s comforting to hear similar situations to ours and I will definitely explore the methods you’ve mentioned further.

I don’t know much about helping him manage, but I know about managing *myself* in a relationship with my combat vet sufferer. That’s really all you can do, as much as it sucks.

The anger outbursts are the easiest, believe it or not. I do not engage. If he lashes out I remove myself from the situation. I don’t argue back, reason, defend myself… nada. I leave the situation with no discussion. If he wants to speak calmly to me like an adult he can give me a call. He has learned over the years that I do not tolerate that shit at all.

Doing that was the best advice I got when I started here almost 10 years ago.

The depression is the hardest, especially if he has suicidal ideation. That’s hell. I don’t have any advice about managing that, except for not letting him suck you under with him.

I appreciate you sharing your experience. I’ve tried the walking away technique more recently and it does seem to cut down on the length of the outbursts. However, when he is in the depressive/suicidal ideation stage, he tends to mention how I abandon him or leave him to deal with this alone.. I’m having a hard time trying to find a balance between the two

 

[Sweetpea76]

My sufferer and I had to have a talk when he was in a better place. He knows I love him, and that me walking away from his anger outbursts is the healthiest reaction for the both of us. A). It de-escalates the situation. He’s a literal foot taller than me, and although he has never touched so much as a hair of my head in anger there are times when he scares me. Leaving is safe. B). My feelings don’t get hurt if I leave. C). He don’t have to feel guilty about saying mean shit after he comes down. D). He doesn’t lash out nearly as much as he used to… at least directed at me. He knows I’ll walk out.

The depression is harder. You can’t do the same thing, and you sure can’t comfort them. The only hard boundary I have for depression is that I will not play the “I’m gonna kill myself” game. I can’t be on suicide watch while he’s deep in ideation. If he says he’s suicidal I will call for help. Other than that, I have to take breaks every so often, even if it’s just dinner with the girls.

 

[anthony]

However, when he is in the depressive/suicidal ideation stage, he tends to mention how I abandon him or leave him to deal with this alone.

Be very careful with that. He is guilting you into staying around to be abused. Like @Sweetpea76 mentioned, talk with him when he is in an OK mood. Stick a note on the fridge or such about rules you agree upon, then stick to those rules.

If he loses his shit at you, walk away. You first. He will do it less IF he wants you around, without the need to guilt you into being around, which is abusive in itself, and he will just unleash on you because you're around due to guilt.

You first.

 

[Sweetpea76]

You first.

Exactly. Being a martyr isn’t romantic, even if the “he’s sick” guilt is real. Both of you going down isn’t doing either of you a favor.

If it still feels selfish, think of it this way…Somebody has to keep it together for the sake of both of you.

 

[Hopefulspouse]

oh man, the depression and suicide ideation is the toughest. I would love help with that more than anything.

I have no idea after so many years of how to help. I guess that’s why I’m here to see if anybody has any answers in that regard.

 

[Sweetpea76]

We can’t help. That’s the hard part.

It’s a mental health issue. It’s just like any other health issue. We couldn’t help with somebody’s diabetes. We could not keep sweets in the house, but we can’t make the diabetes go away.

We can be supportive and patient, but we can’t help or fix. They have to work through that stuff on their own. We’re just along for the ride, and the ride sucks ass sometimes.

 

[Hopefulspouse]

I’ve never heard it put that way. You’re absolutely right. I know that I can’t fix his mental health. Well cognitively I know that. Emotionally sometimes it’s really hard to remember.
I am blamed so much for so many things. But the thing that hurts the most is that I’m always told that I’m not trustworthy or supportive. He insists that he cannot get better because he doesn’t have a support system.
I can sit here and explain all of the ways that I think that I’ve been supportive but at the end of the day, it doesn’t matter, if that is how he feels.

 

[Sweetpea76]

You could be the most supportive, patient, understanding woman in the world, who looks like Bella Hadid, cooks like Gordon Ramsey, and has a PhD in psychology… you’re still not going to be “good enough.”

It’s because it’s a him problem, not a you problem. That’s lashing out and projection. Didn’t you know? It’s not that he cannot manage his mental health… oh no. It’s because you didn’t have the laundry done. That’s why he can’t get better. That’s PTSD.

He can’t trust anybody because he, himself, has trust issues. It’s not that you’re untrustworthy. That’s PTSD.

PTSD is a selfish as hell disorder. They’re in survival mode, so it’s all about #1 when they get like this. Don’t let him talk you into thinking any of this is your doing.