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There is a robust literature documenting an association between post-traumatic stress disorder (PTSD) and poorer spousal relationship outcomes. However, the role of trauma in relationship functioning remains under-explored. Elevated levels of PTSD and trauma-related symptomatology continue to be documented among those who responded to the 9/11/01 World Trade Center (WTC) disaster. The objective of this study was to qualitatively analyze oral histories of WTC responders to understand how the trauma they experienced may have affected relationships with an intimate partner.
Methods
Between 2010-2015, the Stony Brook Word Trade Center Health Program collected 311 oral histories from WTC responders and their families. A semi-structured interview guide was used to allow responders to shape their own narratives. Interviews were videotaped, transcribed, and indexed according to broad topic areas covered in each responder’s narrative.
For this study, a purposive sample of 35 interviews indexed as discussing the “Effect on Family and Relationships” were analyzed. This sample was 74.2% male, with an average age of 50.2 years. Many (42.5%) were police officers; other occupations included social workers, clergy, construction workers, and journalists. Most (74.2%) were married, and the vast majority married their current spouse before 9/11/01. While PTSD was not specifically queried in the interviews, 28.6% of the sample disclosed a current PTSD diagnosis and another 11.4% described, during oral histories, currently experiencing some symptoms consistent with PTSD.
Transcriptions were loaded into Atlas.ti 7.5 and analyzed using principles of grounded theory. Three researchers independently and inductively open-coded and then focus-coded the interviews. Team meetings were held to resolve discrepancies in coding. Themes were developed iteratively, by examining conceptual links among codes and checking links against extant research findings.
Results
Analyses revealed vacillation between trauma and perceived closeness of the intimate relationship. Responders described ‘home’ in positive terms, calling it a place of security and refuge when compared with WTC disaster worksites. However, they also described emotional disconnect with their partners, expressing that partners did not understand the full extent of their experiences. In contrast, they described feeling an unspoken bond with fellow WTC responders. Many responders reported a paradoxically strong pull to return to the WTC disaster worksite, which they felt that partners resented. Responders described this limited communication about the traumatic event with partners as enduring over the years, leading to situations in which they felt only partially understood. Responders who described faring the best in their relationships 9-14 years after 9/11/01 were those who had received treatment for PTSD.
Conclusions and Implications
Many WTC responders currently report experiencing persistent relationship strain after the exposure to the WTC disaster. The findings of this study suggest that they may benefit greatly from treatment to alleviate PTSD symptoms, even now, years later. New methods are needed to de-stigmatize and disseminate mental health treatment protocols for WTC responders. Further investigation is needed on the impact of social support among WTC responders in affecting PTSD symptoms and relationship functioning in order to improve quality of life.