It's good to see this thread out there. I am joining after my wife's most recent episode with self harm (drinking, head hitting, self bruising). She will take the self-harm as far as necessary to prevent me from expressing my own distress and spousal emotional needs, especially when it's really bad for me, so it is a manipulative environment. I blame PTSD not her true self. I have my own anxiety and minor depression as well. If I ever had a nervous breakdown and required hospitalization, I believe her own self-harm could go to an extreme. She needs to be able to express her thoughts and threats of separation and divorce constantly but I cannot, lest the violence ensue. It is a numbing and heavy way to live.
I have moderate to severe ADHD. I am now self-diagnosing with vicarious trauma on top of my own issues. The boundaries she needs I cannot enforce consistently, and the cues I need she resents. We are just lovely and charm the world with our 4-year old when things are well, and when things are not it's a mini pit of hell. We are both highly educated and use clinical language both as coping and as cover-up. There are so many layers it will never untangle and I'm trying to accept this now. Disorganized finances, scattered social life, and no room for my own feelings. There is mental illness at various degrees in both our families. My wife is constantly comparing me to her ex as well, especially as I unwittingly adopt the same coping mechanisms, especially the unhealthy ones.
Right now I am focusing on providing a safe environment, where I don't mention my stress (especially caused by her behavior), where her normal brain can take control. When there is no stress, she is the woman I fell in love with. As soon as possible, more openly I plan to work on the tremendous role PTSD plays in our life together without blaming the person. I'm working on shedding the bitterness of being left with my own emotions for long periods.
She refuses therapy for it but we are in couple's therapy. There is a fair amount of denial. She manages to keep the focus away from PTSD so my current strategy is to bring it back front-and-center and let the chips fall. Again, with love and compassion, not blame.
At least, we both (all 3 of us) cry easily, so that can bring temporary relief.