What to Do When Someone With PTSD Pushes You Away

Medical Disclaimer: This article is for informational purposes only and should not replace professional medical advice. If you or someone you know is experiencing a mental health crisis, call 988 for immediate support.

Watching someone you love struggle with post-traumatic stress disorder (PTSD) is profoundly painful. It becomes even more difficult when they push you away, reject your offers of help, or respond with anger when you try to reach out.

If you’re in this position, is there anything you could do to make a difference? The answer is a resounding yes.

Understanding PTSD, learning effective communication strategies, and taking care of your own well-being as a caregiver can help you support trauma survivors while maintaining your close relationships. This guide offers evidence-based strategies to help you navigate this difficult time.

Understanding PTSD: Why Trauma Survivors Push People Away

Before you can effectively support someone with PTSD, it’s essential to understand what’s happening beneath the surface. PTSD is a mental health condition that develops after someone experiences or witnesses a traumatic experience. According to the National Center for PTSD, approximately 6% of the U.S. population will experience PTSD at some point in their lives.

How Traumatic Experiences Affect the Brain and Nervous System

When someone experiences trauma, their nervous system can become dysregulated, remaining in a heightened state of alert long after the danger has passed. This isn’t a choice or a character flaw—it’s a physiological response to overwhelming events.

The traumatic experience fundamentally changes how the brain processes threats and safety. The amygdala, the brain’s fear center, becomes overactive, while the prefrontal cortex, which helps with rational thinking and emotional regulation, may become less effective. This neurological change explains many PTSD symptoms and behaviors that can be confusing to loved ones.

Common PTSD Symptoms That Affect Relationships

Understanding PTSD symptoms can help you recognize what your loved one is experiencing. The symptoms of PTSD fall into four main categories, as defined by the U.S. Department of Veterans Affairs:

Intrusive thoughts: Trauma survivors may experience flashbacks, nightmares, or unwanted memories that feel as real and frightening as the original event. These intrusions can happen suddenly and without warning.

Avoidance: People with PTSD often avoid reminders of their trauma, including conversations about what happened. This avoidance is a coping mechanism, though not always a healthy one. They may avoid places, people, or situations that trigger memories.

Negative thoughts and feelings: PTSD affects how people view themselves, others, and the world. Trauma survivors may struggle with feelings of guilt, shame, or numbness. They might have difficulty experiencing positive emotions or feeling close to others.

Hyperarousal: This includes being easily startled, feeling on edge, having trouble sleeping, experiencing irritability, or engaging in reckless behavior. The nervous system remains in “fight or flight” mode, making relaxation nearly impossible.

Why PTSD Affects Close Relationships

When someone with PTSD pushes you away, it’s rarely about you. Several factors contribute to this behavior:

• Emotional numbing makes it difficult to connect with others, even those they love most
• Shame and guilt about their symptoms or trauma make them want to isolate
• Hypervigilance makes them feel unsafe around others, even in safe spaces
• Fear of burdening others with their pain leads to withdrawal
• Difficulty trusting stemming from the traumatic experience
• Irritability and anger that they can’t always control

Understanding these underlying causes can help you not take their behavior personally while still maintaining appropriate boundaries.

1. Don’t Take It Personally (But Do Set Boundaries)

Obviously, it’s easy to say “don’t take it personally.” But it can be incredibly hard for us to follow this advice, especially when we feel rejected by someone we love.

Even so, it’s important to remind yourself that PTSD symptoms control a person’s feelings and behavior in ways they may not fully understand themselves. Most likely, under different circumstances, this loved one would be happy to accept your help and companionship.

However, this doesn’t mean accepting abusive behavior. If people with PTSD say or do something cruel, hurtful, or inappropriate, you have every right to set boundaries. Be calm yet firm. You might say something like:

“I understand you’re struggling, and I want to support you. But when you speak to me that way, it hurts. I need us to communicate respectfully, even when things are hard.”

Healthy boundaries protect both of you. They preserve your well-being while also helping your loved one understand the impact of their actions. Many trauma survivors actually appreciate clear, consistent boundaries because they provide structure and predictability.

By keeping these perspectives in mind, you’ll maintain a more balanced view of the situation. It becomes easier to stay optimistic, avoid feeling personally rejected, and continue offering support in sustainable ways.

2. Learn About PTSD and Evidence-Based Treatment Options

One of the most valuable things caregivers can do is educate themselves about PTSD and mental health conditions that commonly co-occur with it. Knowledge empowers you to respond effectively, recognize warning signs, and understand what your loved one is experiencing.

Resources for Understanding PTSD

Start with authoritative sources that provide accurate, research-based information:

• National Center for PTSD (www.ptsd.va.gov): Offers comprehensive information about PTSD symptoms, treatment options, and resources for both trauma survivors and their families
• U.S. Department of Veterans Affairs: Provides extensive research and treatment guidelines
• National Alliance on Mental Illness (NAMI): Offers support groups and educational programs for families
• PTSD Alliance: Connects you with local resources and treatment centers

Evidence-Based Treatment Options

Understanding treatment options helps you have informed conversations when your loved one is ready to seek help. The most effective PTSD treatments include:

Cognitive Behavioral Therapy (CBT): This trauma-informed approach helps people identify and change negative thoughts and beliefs related to their trauma. CBT for PTSD typically involves gradually and safely facing trauma-related memories and situations that have been avoided.

Eye Movement Desensitization and Reprocessing (EMDR): This evidence-based therapy uses bilateral stimulation (often eye movements) to help the brain process traumatic memories differently. Many trauma survivors find EMDR particularly effective for reducing the emotional intensity of flashbacks and intrusive memories.

Prolonged Exposure Therapy: A specific type of CBT where people gradually approach trauma-related memories, feelings, and situations in a safe, controlled environment.

Cognitive Processing Therapy: Focuses on how PTSD affects thoughts and helps people develop more balanced perspectives about their traumatic experience.

Treatment Settings and Support Systems

Treatment can occur in various settings depending on severity:

• Outpatient therapy: Regular sessions with a mental health professional while living at home
• Intensive Outpatient Programs (IOP): More frequent sessions (several times per week) for those needing more support
• Residential treatment centers: 24-hour care in a structured environment for severe cases
• Support groups: Peer support from other trauma survivors
• Family therapy: Addresses how PTSD affects close relationships and helps families develop effective communication

Many people benefit from a combination of these approaches. Treatment centers specializing in trauma often offer integrated programs addressing both PTSD and co-occurring conditions like substance use disorders or depression.

3. Practice Active Listening and Just Be There

You don’t have to be a therapist or have all the answers. Often, the most helpful thing you can do is simply be present and listen.

Create a Safe Space for Communication

A safe space isn’t just physical—it’s emotional. Your loved one needs to know they can share without being judged, fixed, or rushed. Here’s how to create that environment:

Don’t force conversations about the trauma: Wait until they bring it up. Pushing them to talk before they’re ready can increase avoidance and damage trust.

Listen without judgment: When they do share, resist the urge to offer solutions, minimize their pain, or compare their experience to others. Sometimes people just need to be heard.

Validate their feelings: You might say, “That sounds incredibly difficult,” or “It makes sense that you’d feel that way.” Validation doesn’t mean agreeing with everything—it means acknowledging their emotional experience.

Use active listening techniques:

• Make eye contact and give them your full attention
• Put away your phone and eliminate distractions
• Reflect back what you hear: “It sounds like you’re feeling…”
• Ask open-ended questions: “How are you feeling about…?” rather than yes/no questions
• Don’t interrupt or finish their sentences
• Sit with silence when needed—you don’t have to fill every pause

Maintain Consistent Support

Instead of focusing on the trauma, emphasize that you’re there for them, period. You might say:

“I’m here whenever you want to talk—about anything at all. We can talk about the weather, your favorite show, or anything that’s on your mind. No pressure.”

Provide sincere compliments when appropriate. Notice their strengths and efforts: “I really admire how you showed up today, even though I know it was hard.”

Keep saying “I love you” or “I care about you”—sometimes trauma survivors need repeated reminders that they’re valued and loved.

Check In Regularly (But Gently)

Regular check-ins show you care without being intrusive:

• A simple text: “Thinking of you today. No need to respond, just wanted you to know I care.”
• A specific offer: “I’m going to the store later. Can I pick anything up for you?”
• An invitation without pressure: “I’m making dinner on Friday. You’re welcome to join if you feel up to it—no worries if not.”

The key is consistency without expectation. You’re letting them know you’re available without demanding reciprocation during their difficult time.

4. Create Stability and Safe Routines

For someone whose nervous system is in constant fight-or-flight mode, predictability can be incredibly comforting. Do whatever you can to maintain a sense of normalcy.

Establish Consistent Routines

If you live with someone who has PTSD, try to maintain regular patterns:

• Consistent mealtimes and bedtimes: Routine helps regulate the nervous system
• Regular schedule for chores and errands: Predictability reduces anxiety
• Designated quiet times: People with PTSD often need periods of low stimulation
• Familiar rituals: Morning coffee together, weekly movie nights, or other comforting traditions

Incorporate Calming Activities

Engage in low-stress activities that don’t require heavy conversation or emotional processing:

• Nature walks or time outdoors
• Board games or puzzles
• Cooking together
• Gentle exercise like yoga or swimming
• Creative activities like art or music
• Watching familiar, comforting shows or movies

These activities provide connection without pressure. They remind your loved one that life can still include moments of peace and normalcy.

Be Mindful of Triggers

As you learn more about your loved one’s specific triggers, you can help create an environment that feels safer:

• Avoid sudden loud noises when possible
• Be aware of sensory triggers (certain smells, sounds, textures)
• Give advance notice about plans or changes when feasible
• Respect their need to leave situations that feel overwhelming

5. Prioritize Self-Care for Caregivers

Supporting trauma survivors is emotionally and physically demanding. Caregiver burnout is real, and it benefits no one if you become depleted.

Recognize the Impact on Your Own Well-Being

Caregivers of people with PTSD often experience:

• Emotional exhaustion and compassion fatigue
• Anxiety or depression
• Trouble sleeping due to worry
• Neglect of their own needs and relationships
• Secondary traumatic stress (experiencing trauma symptoms themselves)
• Feelings of helplessness or frustration

Acknowledging these challenges isn’t selfish—it’s necessary. You cannot pour from an empty cup.

Essential Self-Care Strategies

Build your own support system: Connect with other caregivers who understand what you’re going through. Support groups for families of people with PTSD can be invaluable.

Maintain your own therapy: Seeing a mental health professional provides a confidential space to process your own feelings, develop coping mechanisms, and prevent burnout.

Protect your physical health:

• Prioritize sleep, even when you’re worried
• Maintain nutritious eating habits
• Exercise regularly to manage stress
• Attend your own medical appointments
• Limit alcohol or substance use as a coping mechanism

Set aside time for yourself: Schedule regular activities you enjoy, separate from caregiving. This might be hobbies, time with other friends, or simply quiet time alone.

Practice saying no: You can love someone deeply and still decline to do everything they ask or want. Boundaries protect relationships over the long term.

Consider family therapy: Many treatment centers offer programs that include family members. This provides education, support, and strategies for effective communication while addressing how PTSD affects the entire family system.

Accept What You Cannot Control

One of the hardest lessons for caregivers is accepting that you cannot fix someone else’s PTSD. You can offer support, encouragement, and resources, but ultimately, healing is their journey. Your role is to be a steady, supportive presence—not to cure them.

6. Encourage Professional Help and Treatment

While your support is valuable, professional treatment is essential for recovery from PTSD. A mental health professional has specialized training in trauma-informed care and evidence-based therapies.

When and How to Suggest Treatment

If your loved one isn’t already getting help, approach the topic with sensitivity:

Choose the right moment: Don’t bring it up during a crisis or argument. Find a calm time when you’re both relatively relaxed.

Focus on specific concerns: Instead of general statements like “You need therapy,” try specific observations: “I’ve noticed you’re having trouble sleeping and seem really on edge. I’m worried about you. Would you consider talking to someone who specializes in trauma?”

Emphasize that seeking help is strength: Many people resist treatment due to stigma. Remind them that getting professional support is courageous, not weak.

Offer practical support:

• Help research therapists who specialize in PTSD treatment
• Offer to help with insurance questions or finding affordable options
• Volunteer to drive them to appointments if needed
• Suggest attending the first session together if they’re nervous

Share information about treatment options: Sometimes people resist because they don’t know what to expect. Explain that modern PTSD treatment has high success rates and that therapists use proven approaches like CBT and EMDR.

What to Expect From PTSD Treatment

Understanding the treatment process can help you support your loved one through it:

• It takes time: PTSD treatment isn’t quick, but it is effective. Symptoms typically improve gradually over weeks and months.
• It may get harder before it gets better: Processing trauma can be emotionally difficult. Your support during this phase is crucial.
• Different approaches work for different people: If one treatment option or therapist doesn’t feel right, encourage them to try others.
• Medication may be part of treatment: Some people benefit from medication alongside therapy, particularly for managing symptoms like trouble sleeping, anxiety, or depression.

Support Groups and Peer Connections

In addition to individual therapy, suggest support groups where trauma survivors can connect with others who understand their experience. The shared understanding in these groups can be powerful. Your loved one no longer has to feel alone or misunderstood.

For family members and caregivers, there are also support groups specifically for you. Organizations like NAMI offer family-to-family programs that provide education and connection with other caregivers.

7. Recognize When Immediate Help Is Needed

Sometimes situations escalate beyond what you can handle alone. Knowing when and how to get emergency help can be lifesaving.

Warning Signs of Crisis

Be alert to signs that your loved one may be in immediate danger:

• Talking about suicide or death
• Giving away possessions
• Saying goodbye as if it’s the last time
• Sudden calmness after a period of severe depression (sometimes indicates a decision to act on suicidal thoughts)
• Extreme, uncharacteristic recklessness
• Escalating substance use
• Complete inability to function or care for themselves
• Threats of violence toward others

Getting Emergency Help

For immediate crisis support:

• Call 988: This connects you to the Suicide and Crisis Lifeline, staffed 24/7 by trained counselors
• Text “HELLO” to 741741: Connects to the Crisis Text Line
• Call 911: If there’s immediate danger to your loved one or others

For veterans:

• Veterans Crisis Line: 988, then press 1
• Text to 838255
• Confidential chat at VeteransCrisisLine.net

When calling for help, clearly describe the situation, mention that the person has PTSD, and specify any immediate risks. If possible, have information ready about any medications they’re taking or other mental health conditions.

After a Crisis

If your loved one has experienced a mental health crisis, the period afterward requires extra attention and care. This may involve:

• Increased professional support and monitoring
• Possible changes to treatment plans
• More frequent check-ins
• Addressing any underlying issues that contributed (like substance use or medication changes)
• Additional support for family members who may be shaken by the crisis

Living With PTSD: A Journey, Not a Destination

Recovery from PTSD isn’t always linear. There will be good days and difficult days. Progress might include:

• Fewer and less intense flashbacks
• Better sleep and fewer nightmares
• Improved ability to be present in the moment
• More willingness to engage in previously avoided activities
• Developing healthy coping mechanisms
• Reconnecting with interests and relationships
• Reduced negative thoughts and increased self-compassion

Celebrate small victories along the way. The fact that your loved one got out of bed, attended a therapy session, or had a moment of genuine laughter—these all matter.

Understanding the Connection Between PTSD and Substance Use

It’s important to note that trauma survivors have higher rates of co-occurring disorders. Substance use, in particular, is common among people with PTSD. Approximately 40-60% of individuals with PTSD also struggle with substance use disorders.

People may use alcohol or drugs to:

• Numb emotional pain
• Reduce hyperarousal and help with sleep
• Avoid memories and feelings related to trauma
• Self-medicate PTSD symptoms

If you notice signs of substance use, this doesn’t mean failure—it means your loved one needs integrated treatment that addresses both conditions simultaneously. Effective treatment options exist for co-occurring PTSD and substance use disorders.

Conclusion

Supporting someone with PTSD while they push you away is one of the most challenging experiences you’ll face. But your presence, patience, and willingness to learn can make a profound difference.

Remember these key principles:

• Educate yourself about PTSD symptoms and treatment options
• Practice effective communication and active listening
• Create stability and safe spaces in their environment
• Prioritize your own well-being as a caregiver
• Encourage professional treatment while being patient with their timeline
• Know when to seek emergency help
• Accept that recovery is a journey with ups and downs

Your loved one’s healing journey is ultimately their own, but having someone who consistently shows up, maintains boundaries, and offers unconditional support can be transformative.

At Recreate Life Counseling in Boynton Beach, Florida, we offer evidence-based, trauma-informed treatment for both PTSD and co-occurring conditions including substance use disorders. Our experienced team uses proven therapies like CBT and EMDR to help trauma survivors reclaim their lives.

If you or someone you love is struggling with PTSD, you don’t have to navigate this alone. Please contact us to learn more about our comprehensive treatment programs.

Remember: Healing is possible. Treatment works. And your support matters more than you may realize.

If you or someone you know is in crisis, call 988 for 24/7 support from the Suicide and Crisis Lifeline.

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Written by: The Recreate Life Counseling Editorial Team
Editor: Isaac Adams-Hands
Medically Reviewed by: MedicallyReviewed.com

Published on: December 30, 2022
Updated on: March 1, 2026