At intake, the couple described a sense of all the air being sucked out of the room. X’s offhanded comment had resulted in an emotionally cold and distant response from Y. Y looked directly at X and, with absolute conviction, stated, “I knew you’d do this. I just didn’t think it’d be so soon.” X was flabbergasted! Clarification was requested, but Y walked out of the house without stating an intended destination or time of return. X, alone in the house, chose to watch some TV, clean a bit, but more than anything, functioned in a fog. It wasn’t until late that evening when Y returned home; still cold and aloof. X gave Y some space, hoping this would offer some appeasement. After a long and silent dinner, as bedtime approached, there seemed to be no relief in the tension. As the couple drifted off into the fitful sleep only emotional exhaustion can foster, Y began to shout and cry while sleeping. Y flailed out with their arms, then drifted back into silent sleep. Naturally, this had upset X, who also slept in small spurts, punctuated by the sounds and movements of Y.
The next morning, though tired, the gravity of the situation had seemed to reduce. Y was in a better mood, had smiled at and even hugged X, and had left for work as normal. X breathed a sigh of relief and returned to a regular routine. Things seemed to be getting better, but over the next few weeks X noticed Y was working longer hours, often not returning home until late at night, well after their usual bedtime. Physical intimacy decreased to zero and, when questioned by X, Y become very hostile and angry. X attempted to clarify the concern regarding their intimacy. Y responded defensively citing exhaustion from an increased work-load, accused X of not appreciating how hard Y was working, and would often disappear for several hours after these discussions.
During the interview, Y regularly looked surprised as X recounted many of their interactions. Y claimed to remember fewer than half of these discussions and sat through the majority of the session avoiding eye contact, with closed body posture, and minimal participation. X was the primary agonist for pursuing therapy and was the most verbal historian at intake.
Now let’s explore how the potential ePTSD reactions could be expressed (1-4) and a few interventions (responses) the existential therapist may use to encourage meaningful healing. Many of these symptoms may overlap at various points. This is common in working with families and individuals dealing with trauma.