The Contribution of Empathy and Attachment to Adaptation of Partners of PTSD Veterans

The 2006 Israel-Lebanon War, as part of a long-lasting conflict reality in Israel, had exacted a heavy toll in fatalities and mental health casualties. Many combat soldiers have returned from combat zones with mental distress which has become manifested in various realms of their lives. This fact corresponds to research findings which predict a development of Post-Traumatic Stress Disorder (PTSD) in some returning combatants. The disorder and its aftermaths can both result in a higher risk for developing a mental health distress in people who maintain a close relationship with the war veteran, and especially in their partners. Already variably accorded for, in the literature this distress is known as Secondary Traumatic Stress – STS (Figley, 1988).

The current research offers a wider perspective of the partners’ mental health by choosing three aspects of adjustment in PTSD veterans’ partners: their levels of STS, mental wellbeing, and functioning. In order to explain the variance in the adjustment the role of female’s empathy and attachment were examined. According to Figley’s model of transmission of PTSD, empathy plays a central role in the mechanism of PTSD transmission. Attachment is crucially important as well, as a mental resource for catering for the relationship. Finally, attachment theory's scholars have already pointed out the link between an aspect of attachment and empathy.

The current work is part of a wider-scope research that was conducted between the years 2011-2013 among 300 veteran soldiers of the 2006-Israel-Lebanon War (hereinafter, the 2006 Lebanon War) and their partners who have lived with them at least for one year as partners. Of this sample the research group consists of 150 couples (N=150) in which the male has applied to the IDF’s Combat Response Unit in the  Mental Health Division or to the Ministry of Defense, due to experiencing a distress developed as a result of his participation in the 2006 Lebanon War; the other 150 couples comprise the comparison group. The current research focuses only on the research group females and their male partners.

Research data were collected by conducting structured questioners with proven psychometric features that examined the following traits: (1) social-demographic characteristics; (2) post-traumatic symptoms (Solomon, Benbenishty, Neria, Abramowitz, Ginzburg, & Ohry, 1993); (3) functioning (Green, Lowry & Kopta, 2003); (4) mental health (Veit & Ware, 1983); (5) empathy (Interpersonal Reactivity Index – IRI, Davis, 1980); and (6) attachment – by employing Brennan’s Questionnaire of Experiences in Close Relationships (Brennan, et al., 1998).

First, the research examined the association between the severity of PTSD symptoms in 2006 Lebanon War veterans and the level of their partner’s adjustment, and as expected, a negative association was found. Next,  a positive association was found between the level of in the female's insecure  attachment and her adjustment. Furthermore, a partly negative relationship was found in the female empathy and her adjustment. Third, in the realm of affective empathy it was found that the higher the degree of affective empathy aspect of personal distress was, the lower the degrees of the entire adjustment measures were. In the realm of cognitive empathy it was found that the higher the degree of cognitive empathy aspect of perspective-taking was, the higher the levelsof mental wellbeing and functioning measures were. This finding stands in opposition to one of the research hypotheses. In addition, the hypothesis of the moderating effect that the attachment variable plays on the mental health and functioning indices was supported.

The main object of this research was partly achieved: it was found that the empathy variable contributes to female adjustment; however it was not equilaterally found and proven as a contributing variable for the mechanism of traumatic transmission; furthermore, the attachment variable was found as having a moderating effect on some of the female adjustment indices, e.g. on her mental wellbeing and functioning.

This research has several clinical implications: first, the need to properly treat the of PTSD veterans’ partners since their situation is directly connected to the PTSD veterans’ distress. Second, the need to expand interventions with PTSD veterans into wider spheres of clients stems from the recognition that the post-traumatic stress disorder has interpersonal aftermaths in addition to intra-psychic conflicts. The fact that the distress of a PTSD veteran’s partner could be due to previous traumatic life events and/or due to her own personal mental health situation in particular, should be taken into consideration. 

The findings of this current research strengthen what we know about the significant contribution of personal factors in predicting the levels of adjustment in partners of PTSD veterans. A secure attachment can become an appropriate coping strategy for decreasing the levels of stress and distress and for enhancing the levels of mental wellbeing and functioning. In regard to   empathy newer updated tools are needed in order to reexamine this concept.