Neha Pathak, MD, FACP, DipABLM: Welcome to the WebMD Health Discovered Podcast. I'm Dr Neha Pathak, WebMD’s Chief Physician Editor for Health and Lifestyle Medicine. Before we begin today's conversation, we want to offer a gentle heads-up to our listeners. This episode includes discussion of trauma, assault, and post-traumatic stress, which may be distressing for some people. Please take care of yourself as you listen, and know that it's okay to pause, step away, or return when you feel ready.

Today, we're talking about how trauma that occurs within relationships can shape how we see ourselves, how we connect with others, and how we move through the world long after the traumatic event itself has passed. We'll explore what PTSD can look like for those existing in the wake of a traumatic event, including hypervigilance, shame, emotional overwhelm, and the many destabilizing ways trauma shows up in intimacy, trust, and communication. We're also going to talk about healing, because that's an important and oftentimes overlooked part of the discussion.

We'll touch on how safe relationships, self-care, community, and even spirituality can become powerful tools for recovery. This is a conversation about naming harm honestly, while also making room for hope, growth, and the possibility of thriving on the other side of trauma.

But first, let me introduce my guest, Dr Thema Bryant. Dr Thema Bryant is a renowned psychologist, author, professor, and minister who weaves psychology, spirituality, and social justice into her work. She's currently a tenured professor at Pepperdine University, where she directs the Culture and Trauma Research Laboratory. Dr Thema is also the host of The Homecoming podcast and author of several books, including Matters of the Heart: Healing Your Relationship with Yourself and Those You Love.

Welcome to the WebMD Health Discovered Podcast.

Oh, thank you so much. I'm glad to be back with you all.

Well, it is wonderful to be with you again, and I'd love to ask, before we jump into our conversation for today, about your own personal health discovery as it relates specifically to our topic today with regard to PTSD and relationships.

Thema Bryant, PhD: Yes, I have discovered, as a result of not only being a trauma psychologist and trauma researcher, but also a trauma survivor myself, the importance of looking at the ways in which we cope and the ways in which we heal. In the aftermath of my sexual assault, which occurred during my college years, when I looked around, I could see a lot of information documenting the pain and destruction and the negative consequences of sexual assault, but I didn't see a lot that gave information about post-traumatic growth—about healing, about possibility on the other side.

And so that has really motivated my lifelong work to not just document the pain, which is important to recognize, but also to document and discover the ways in which people heal and, in some cases, even thrive.

Pathak: Wow. That is really so beautifully said, and I'd love to really, as we kick off our conversation, just delve into that a little bit more. So can you share with us why this topic—why having a conversation with both acknowledging the trauma, but also thinking about the healing—is so important given your clinical expertise? How common is this experience of trauma in relationships for the people you work with?

Bryant: With the clients I work with, and then just the overall research, unfortunately, trauma is quite common. Interpersonal trauma, including child abuse, sexual assault, intimate partner violence. And it's interesting—when the diagnosis post-traumatic stress disorder was first developed, it had a word in the definition which was “rare.” A rare event. And they ended up needing to take that word “rare” out.

Unfortunately, how common it is for people to experience violation at the hands of other people—most often at the hands of people who are known to them, whether family, friends, acquaintances, teachers, coaches, dating partners. And so I see it a lot with the people that I work with, and then also see the benefits of healthy relationships.

So interpersonal trauma and violence between people can have devastating effects, but we also know that healthy relationships are what we would call a protective factor. You can think about when you're going through hard times in your life—grief and loss, a change in where you live, or a change in work. One of the things that really helps us to cope with major transitions and difficulties are healthy connections.

So I know that the ways in which we harm people can have long-term consequences, but also the ways in which we show up for people, the ways in which we love people, the ways in which we support each other can have incredible, life-altering implications as well. And so we think about our relationships as a potential site of harm, but also a beautiful potential site for healing, wholeness, and wellness.

Pathak: Wow. That is really so beautifully said. Can you talk to us a little bit about how one would acknowledge or identify that they're in an unhealthy relationship?

Bryant: Yes. So when I am in an unhealthy relationship, there is fear there. There is a sense of not feeling safe—not being safe. It can create a lot of shame that, in this person's presence and after I'm in their presence, instead of feeling better about myself, which a good friend would be affirming and validating and encouraging, I end up feeling worse about myself. I end up feeling unworthy, insecure, not enough.

And so we think about: How does your sense of yourself bloom in their presence, or how is it shattered in their presence? We think about the various forms of abuse as well. So with emotional and verbal and psychological abuse, is this person always putting me down, always criticizing me, always insulting me—whether in private to humiliate me or sometimes around other people?

We can also think about those relationships as having physical violence or sexual violence, where a person does harm to me, where what I say and what I think and what I feel is not honored, that it always has to be their way and what they want. There can also be financial abuse or spiritual abuse. And so the major theme is power and control. Is this someone who is trying to control and minimize me, or is this someone who wants to encourage me to be my best self?

Pathak: That really paints a vivid picture. So then I want to talk a little bit about what that experience of having PTSD or having trauma looks like. How does that show up in your behaviors?

Bryant: So with post-traumatic stress, you can have intrusive thoughts—so you're thinking about it even when you're trying not to think about it. You can develop what we would call hypervigilance, meaning you're always guarded, always bracing yourself for things to go wrong, always preparing yourself for the worst. It can also show up in nightmares, in flashbacks, and it becomes difficult for you to function in other areas of your life as well.

John Breer, who does work in child trauma, talks about when you've experienced complex trauma, which is not just one incident but perhaps ongoing. So that could be a long-term dating relationship or abuse by your parents or caregivers. The three categories he talks about in terms of the trauma effects are a disruption in your identity—so it disturbs your sense of who you are. You might start seeing yourself through the eyes of the abuser.

A second thing that it does is it makes it difficult for you to regulate your emotions. So if you find yourself kind of easily or unexpectedly going from level one to level ten, feeling overwhelmed by your emotions, and it may feel like little incidents can leave you unraveled, and that can be because you're already on edge from everything that you've been carrying.

And then the third category is difficulty maintaining or creating relationships—challenges around trust and connection. So for everyone who is listening who has experienced trauma, you can reflect on that with yourself: How do I see myself? How am I able to express my feelings? Am I quick to shut down or quick to become explosive or overwhelmed? And then what are relationships like for me? Is it possible for me to let people in? Is it possible for me to be authentic in the presence of others? Is it possible for me to maintain connection?

Pathak: You mentioned various types of abuse or trauma that we might suffer in relationships. And you mentioned sexual assault. So are there any differences with regards to how one might experience PTSD if they're the survivor of sexual assault?

Bryant: Yes. So one piece is what we would call embodiment. And I like to use the term homecoming. Am I at home with myself? And when we have experienced sexual violence, then the site, the location of the trauma, is your body. And so then you are with your body all the time. But there can be ways in which, as a result of the sexual trauma, you feel disconnected.

And the way those symptoms can show up can vary. For some people, in order to be sexually intimate, they need to be under the influence because it’s so triggering for them as a result of those experiences of sexual trauma. Some people can adopt a performative approach to sexuality, where it’s hard to be emotionally open and vulnerable. So instead, they may approach sex as an activity to do for other people’s pleasure, an activity where you’re in some ways outside of yourself, but performing. And the focus becomes what other people think and what your romantic partner feels, while you may be disconnected from your own feelings.

You may also, if you experience sexual trauma early on in life, have come to believe that your body or sexuality is the only reason why people would choose you. So you may offer that first, thinking that is the one thing that people have liked about me, and not really have experience with people appreciating the wholeness of you. So challenges around sexuality and around intimacy can come as a result of sexual trauma.

Pathak: I’m really curious about how these types of feelings are communicated. So when I say that, I mean that with regard to internal communication. So how are we talking to ourselves when we’re trauma survivors? What are some of those internal thoughts, fears that we’re telling ourselves?

And then the second part I’d love to talk about is how are we then communicating, or how does this kind of communication challenge manifest to the external world?

Bryant: So in our society—and I should say nationally, but also this is a reality, unfortunately, globally—victims are often blamed. And so the messages survivors have often gotten received, based on their specific circumstance or even as they overhear how other victims are talked about in the media, in their family, and in their community.

And of course also by the offender and perpetrator, they will often receive messages that you should not have gone there, or it’s because of the way you were dressed, or it was because you had substances, or something about you just must have drawn that to yourself.

And so as a result, survivors often internalize those messages. And so there can be a lot of shame and self-blame. I wish I had fought harder, or I wish I was stronger. I wish I was louder. And survivors can replay the event over and over again in their heads, just trying to figure out what I could have done differently.

And it is so, so important for us to distinguish risk reduction, right? So there are things we could do to reduce the risk, but we also want to be very clear that offenders and perpetrators are responsible for the action they chose to take. So an example of that might be if you connected with someone on a dating app or on social media, and you went out on a date with them, and then you went to their place, or they said they were gonna make you dinner, and they assaulted you, right?

You may say, I wish I hadn’t gone to the home of someone I don’t know. Well, that’s fine to say risk reduction. You know, in the future, if I go on a first date, I wanna try to meet in public. And at the same time, we want to also be clear that those who are perpetrating violence still do not have permission and consent to harm someone because that person is in their home.

And so the shame and self-blame are often in a person’s head. And also then the vigilance. So, you know, the message you can tell yourself is, this isn’t safe. And you know, we even see this in society where there’s so much talk about red flags and not much talk about green flags. So then, you know, when people are meeting someone, they’re scanning for signs of danger, signs of harm, signs that you’re a bad person.

And so that can make it hard to actually build relationship and connection and to know that we are worthy of that.

Pathak: Talk to us a little bit about how this internal self-talk, this dialogue that just makes you fearful and not very trusting, shows up when we’re trying to relate or communicate with others.

Bryant: So in, you know, let’s say in dating relationships, romantic relationships in particular, some people will give their trauma history in the first conversation, which can be very overwhelming for the listener. Some people will call it trauma dumping, or like this accelerated pace of getting to know someone.

And so a part of that can be that I define myself through the trauma. And so then I introduce that to you before you have gotten to know anything else about me. And so then that becomes the centerpiece of my identity, which can be challenging. And it can also lead to a lot of frustration, because then if people don’t follow up or don’t engage, then, you know, people can feel devastated or disappointed, when I really didn’t have a sense of the person to begin with.

On the other hand, we also have those who, instead of giving all the graphic detail in the beginning, never share and are living in shame. Because often when we are silent about our experiences, it’s ’cause we are stuck in embarrassment, stuck in shame, and fearing that if they knew this about me, I would not be acceptable.

And the unfortunate reality is we know that that fear is because some people have experienced that rejection. And so either hiding that part of your journey or sharing it so quickly that there wasn’t like a solid ground or a solid opening to be able to communicate your journey.

Pathak: It’s interesting, this concept of trauma dumping or oversharing before you sort of have that foundation.

Bryant: Right. And I’ll say, in terms of the way we share that, a part of what can be showing up is our level of processing and our level of healing.

Because I’ve heard survivors share their story kind of—I don’t say matter-of-factly in a cold way—but just that it’s one of the various things they’ve experienced in their life, and they can say it and have some perspective on it.

And then there are some people who, when they share it, it may have been 10 years ago, but it sounds like it was last night. So it’s still in a very raw place. It’s in a very overwhelmed place, which is also what people can be responding to—is not only the content, but they may feel overwhelmed by our level of overwhelm.

Pathak: Hmm. I’m also curious about long-term abuse. So if you’ve suffered potentially a very severe traumatic episode once versus someone who suffered long-term abuse, is there a difference in ways that that shows up?

Bryant: Yes. When we think about who we fear or who we’re anxious around with the one-time incident, you know, you may think— not always—but in some of those instances, it’s strangers. And so then people may have more of like the stranger danger, the anxiety about going out in public, the anxiety about meeting new people.

And then if it’s long-term, then usually these are people who had access to you. There was some level of relationship, whether it was a family member, a dating partner, a teacher, a coach, a neighbor. And so then that translates more as it relates to future relationships, right?

Because then it mixes in there: this is someone who was supposed to care about me. This may be someone who said they loved me. Versus a one-time incident, it is not usually in the context of relationship, where even if they weren’t a stranger, you know, maybe I went out with them once, or somehow they had access to me.

So our ideas about love, our ideas about relationship, our ideas about trust—they can be affected as a result of that, the dynamic or the context in which the assault took place, or multiple assaults.

Pathak: So let’s pick up the thread that you started our conversation with, which is really thinking about moving toward a healing journey. So can you help us dig into that piece? And how do we, if we’re coming from a place of trauma, coming from a place of fear and sort of have these red flags around building new relationships, how do we get to a space of a healing relationship?

Bryant: Yes. So a part of it is self-care and community care. So nourishing myself emotionally, spiritually, physically, socially, because I’m resetting my nervous system, right? So that I’m not perpetually in that vigilant state. So then what I do to calm myself, to soothe myself—for some people that might be journaling. It might be my creative art expression. It may be talking with a therapist. It may be taking a bubble bath, drinking tea, meditation, prayer.

So what are ways that I can give myself a sense of calm and a sense of peace and a sense of safety? So we can do that intentionally for ourselves. And that’s an important piece too, as it relates to relationships—is I’m not just waiting for someone else to give it to me, right? There’s a way in which we can be guarded and waiting to be rescued. Versus, so it’s like, well, once someone loves me, then I could exhale. So I wanna learn how to exhale.

Because being in a more relaxed state will change my selection process when I’m dating, right? If I am super guarded, then the kind of people who approach me or the people I feel drawn to—it can be, I would like to say, you know, sometimes we are letting our wounds choose for us instead of our healed self choosing for us.

So yeah, doing your self-care is important. But then also community care and social support. So I like to say, you know, check your circle. Who are the people I’m around? Because sometimes we get stuck in not healing because we are surrounded by people who are not caring.

So I stay in friendships too long where it’s clear the person really is not my friend. I stay in access with family members who are harmful. I stay in dating relationships where there are no boundaries and they don’t honor or respect me. And so staying in unhealthy environments prolongs or intensifies our trauma symptoms and our distress.

So a part of my healing is choosing healing friends, right? So who are the people who I feel good about myself in their presence, that they are safe, that they honor it when I speak up and share what I think, what I need, what I feel. So then I get to—and my nervous system gets to—have a new experience, a refreshing experience where I can have ease in the presence of other people.

Pathak: I love what you're saying. And I am kind of resonating with this idea of refreshing. Or maybe even doing an internal inventory, where you're sort of really thinking about your environment in the ways that you've talked about—creating time for rituals, but also what does it mean to have a relationship with maybe something higher? Does that help in these situations?

Bryant: Great question. So, you know, one, we can say foundationally the idea that I'm sacred, because I haven't always been treated sacredly. Like, can I believe that I'm sacred and treat myself sacredly, and I honor myself in that way instead of just through the lens of shame or brokenness or unworthiness.

So our sense of spirituality can shift our view of ourselves. And then as it relates to a higher power, there's interesting research about positive religious coping or negative religious coping. So with positive religious coping, I believe there is a source, a higher power—God—who loves me, who cares about me, who is working with me for things to turn out good for me. And of course, if you have that kind of positive religious coping, that's associated with more emotional wellness, wholeness, optimism, all the things.

Versus some of us have negative religious coping, which is the idea that this higher power or source or God is angry at me, hates me, is out to catch me messing up so they can punish me, doesn't believe in me. And of course, then that gets associated with all kinds of shame and insecurity and fear and guilt and unworthiness.

And so, you know, the question then becomes for your wellness and cleansing, not just do you have faith, but what is the nature of what you believe in? And is the nature of what you believe in loving toward you, right? Or does that source despise you? That is just such an interesting point.

I think so, so key, and I think we do, in the health professional world or when you are seeking help in a health professional setting, I think it's something that we need to also be thinking about when we are helping someone process or manage trauma. So how do you do that with your patients?

So, working with survivors, there are a couple of themes that we look at, and these themes were developed by Judith Herman. So one is this notion of safety and helping people to recognize safety, not just danger, right, but getting a sense of recalling times in your life when you felt safe, however rare or short-lived they were, to get a sense of what that was, what that felt like, and not only safe as it relates to others, in terms of how I treat myself.

So we do safety. We deal with self-care and shattering shame. A part of shattering shame is addressing what we would call those cognitive distortions, which are just the lies that we tell ourselves and the lies other people have told us that made us feel as if we were discardable or unworthy or insignificant or undeserving.

We also have to have a space where we can grieve the losses. What did the violation take from you? It may have taken your time, your innocence, your trust, your connection to your body, your ideas about sexuality, and, you know, lost time—the time that people spend just trying to function in ways that can be all-consuming and are things that other people don't have to fight through in the same way.

So to be able to grieve the losses and also to be able to get in touch with our anger about it. I like to say it's healthy to be outraged about outrageous things, and violation is an outrageous thing. So then we just talk about what to do with the anger—have constructive anger versus destructive anger.

So constructive anger, then I can become a change agent, right? Meaning some people, like myself, became rape crisis counselors or I wanted to work in schools talking about good touch and bad touch or talk to children and their family about healthy relationships. And so sometimes our anger can be a motivator to help us to work for change or to try to work to prevent this from happening to other people.

Versus a destructive anger where our focus is on destroying other people or destroying ourselves. And then we want to look at healthy coping strategies instead of unhealthy coping strategies. We can look at healing our sexuality, where I'm not just tolerating it, but can there be joy and pleasure and freedom in that for me—for it to be liberating.

And then overall, our sense of thriving. Eve Ensler says, you know, we spend so much time healing from what other people have done to us. What if we could use that time creating, building, writing, producing? And so I like to talk with clients about that—not only the healing, but then getting in touch with your own sense of purpose and identity that is not centered around the harm, but more clarity about your own sense of self.

Pathak: Wow. This is why it's just so important to have these conversations with you. You have just really laid everything out so beautifully and really helped us understand what a healing journey can look like in the face of trauma. So thank you for all of your time, and I'd love to end the episode by just giving you the floor.

For anyone who's listening and our conversation is really resonating with them, what's that next step that they can take now that they've identified this as potentially something that they are processing or still in the process of processing? What's their best next step to take?

Bryant: Well, I want to appreciate you for listening. I want to invite us to be patient and compassionate with ourselves. Sometimes we judge ourselves so harshly by saying, “I should be over it by now.” But it is a lifelong journey of healing, of growth, and of recovery, and you don't have to carry it alone.

So I would encourage you, if you have not said it out loud, if there is someone who is trustworthy—a friend or a family member—who has indicated to you perhaps on other topics that they are supportive of survivors, if you can share with them that you are a survivor, shattering that silence and that secrecy can be liberating.

I would also encourage you to seek out therapy, to not try to carry it alone, but it is healing to be able to be in the presence of people who can hold space with you and for you and guide and facilitate you on your healing journey.

Pathak: Thank you again, Dr Tema. Just appreciate your time, as always.

Bryant: Thank you so much.

Pathak: As we close today's episode, we want to leave you with a few key takeaways to carry with you. First, trauma can shape how we see ourselves, regulate our emotions, and connect with others, often in ways that aren't immediately obvious. If you recognize patterns like hypervigilance, shame, difficulty trusting, or feeling disconnected from your body or your emotions, those are not personal failures. They're common, understandable responses to trauma.

Second, healing doesn't happen in isolation. Safe, affirming relationships can be a powerful antidote to trauma, helping reset the nervous system and rebuild trust over time. This includes caring relationships with others as well as the relationship we have with ourselves. Self-care, boundary setting, and challenging internalized blame can help shift you into compassion rather than shame.

Finally, healing is not about getting over it on a timeline. Healing is a process that includes grief, anger, meaning-making, and growth, and it looks different for everyone. If this conversation resonated with you, reaching out to a trusted person, a therapist, or a support community can be a powerful next step. You're not alone, and you don't have to rush your healing process.

There is space for both acknowledging what happened and imagining a future grounded in safety, connection, and wholeness. To find out more information about Dr Thema Bryant and her book Matters of the Heart: Healing Your Relationship with Yourself and Those You Love, make sure to check out our show notes.

Thank you so much for listening. Please take a moment to follow, rate, and review this podcast on your favorite listening platform. If you'd like to send me an email about topics you are interested in or questions for future guests, please send me a note at [email protected]. This is Dr Neha Pathak for the WebMD Health Discovered Podcast.