As a survivor of interpersonal trauma, commitment and intimacy have never been easy, which is why I never did remarry after my first marriage fell apart. That is until last October, when my boyfriend who had been living at a comfortable distance (measured in thousands of miles) suggested I pack up my apartment and ride out the pandemic with him in Hawaii. Thus began an adventure that had me breathing into paper bags and him warranting a nomination for the Nobel Peace Prize.

I get bent out of shape easily. On days when I haven’t had enough sleep, I’m particularly vulnerable to being disgruntled and snappy, finding everything about my partner annoying, right down to his very existence. I usually seek refuge in elaborate plans of escape. (No doubt on those days my husband is similarly engaged.) I dream of a light-bathed studio giving onto a beach or a small cabin perched by a lake and surrounded by pines. The scene changes, the head count doesn’t. I am on my own.

For many trauma survivors, “avoidance”—a symptom of post-traumatic stress and driver of my escape fantasies—is the only way to make our lives feel manageable.

The latest edition of the Diagnostic and Statistical Manual of Mental Disorders describes avoidance as “efforts to avoid distressing memories, thoughts, or feelings” and “external reminders (people, places, conversations, activities, objects, situations)” associated with traumatic events. But what if the source and reminder of the trauma is other people? And what does that mean for our relationships?

The essential dilemma for survivors of interpersonal trauma is that, as Judith Herman has written, “recovery can take place only within the context of relationships; it cannot occur in isolation.” It makes sense that for those of us who have suffered abusive relationships, safe, stable relationships would be the cure, in the same way someone who has been poisoned might flush out toxins with pure water. However, as survivors of interpersonal trauma, getting close to people also feels inherently unsafe. In many cases, our trauma stems from the fact that the people who were supposed to love and protect us instead hurt us. We learned—sometimes at a young age—to distrust and fear the very thing we need as humans to survive. In The Boy Who Was Raised as a Dog, Bruce Perry writes:

“Being harmed by the people who are supposed to love you, being abandoned by them, being robbed of the one-on-one relationships that allow you to feel safe and valued and to become humane—these are profoundly destructive experiences. Because humans are inescapably social beings, the worst catastrophes that can befall us inevitably involve relational loss.”

Even more worrying, the inability to tolerate close relationships not only impedes trauma recovery but may even shorten our lifespan. A 2015 Brigham Young study reported that isolation is as bad as smoking 15 cigarettes a day in terms of the impact on our mental and physical health—and ultimately our longevity. The daily pain of social isolation is very real; it actually registers in the same region of the brain as physical pain. For some trauma survivors, isolation can be “iatrogenic”—meaning, the remedy is worse than the disease.

Some people get around the need for emotional connection with other humans by befriending other large mammals: dogs or horses are regularly used in trauma therapy. For those of us who dare to dip a toe into the potentially tumultuous waters of relationships with other humans, the experience is probably best approached as a kind of exposure therapy, where you face the thing you most dread in small increments until your brain is rewired and you no longer sense a threat. The problem is that marriage—to go back to my own situation—does not work like that. You can’t be married for say, one day a week, until you build up a tolerance. And, quite apart from your own ability to tolerate this unaccustomed state of being close to another person, unless your partner understands trauma well—and, like my husband (thus far), has enduring patience—there is a serious risk that the relationship will end up imploding.