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Secondary Traumatic Stress

Posted September 6 2018

This blog posting is by Heather Tuba, who specialises in trauma-informed coaching support for partners in the USA, who describs her experience here as a result of her husband suddenly getting visual flashbacks that disturbed him to the point of shut-down.  It is a back-up article written describing some of diagnostic and advice.  Please be aware this is quite a clinical document.

The High Risk of Secondary Traumatic Stress for Families of Adult Survivors

by Heather Tuba

I was at my second appointment with my new therapist. She asked, “Do you think you have secondary trauma?” I paused and answered: “Yes.”

An online search of ‘secondary trauma’ pulls up information for mental health workers, therapists, healthcare workers, first responders, veterans, families of veterans, and families of those with traumatic brain injury. While not an exhaustive search, the closest article I found mentioning secondary stress, trauma survivors, and partners is called Secondary Stress in Caregivers of PTSD Victims.

Despite the omission of families of adult survivors from the list of those impacted by another’s trauma, I know from personal experience, from my support groups, and from the limited available information that families and partners are deeply impacted by an adult survivor’s childhood trauma. I believe many partners and family members, myself included, have symptoms of secondary trauma.

Secondary Trauma

When my therapist asked if I had secondary trauma, she was referring to a broad range of symptoms, not a specific diagnosis. In fact, there is not an official term or diagnosis of ‘secondary trauma,’ but there are a few definitions that can help to clarify what it is. Some of the terms are used interchangeably.

1. Secondary Traumatic Stress refers to the presence of PTSD symptoms caused by at least one indirect exposure to traumatic material. More on symptoms below.

2. Compassion Fatigue is a less-stigmatizing term used for secondary traumatic stress.

3. Vicarious Traumatisation is used to describe the cumulative effect of working with traumatized persons. This term is frequently used in reference to professionals as opposed to caregivers.

4. Burnout is a state of mental and physical exhaustion that can result from ongoing stress. Burnout is not used exclusively in reference to ongoing exposure to trauma.

For partners and families of adult survivors, perhaps this quote best sums it up:

'Secondary stress is the stress caretakers experience from taking care of traumatized victims with PTSD. Secondary stress occurs when the caregivers experience a host of symptoms that arise in the course of, and due to the care of, the trauma victim. Healthcare workers, emergency workers, and wives and husbands of veterans are examples of caregivers who can be affected with secondary stress.'

From Secondary Stress in Caregivers of PTSD Victims.


Symptoms of Secondary Traumatisation

People respond to traumatic stress in individual ways. Factors that may buffer the development of symptoms include access to support systems, one’s personal history, established self-care practices, and resilience or adaptability to circumstances.

Symptoms may include:
1. Physiological:

sleep disturbances, fatigue, headaches, lowered immune system response, changes in appetite.

2. Emotional:

irritability, anger, anxiety, depression, loss of interest in pleasurable activities, feelings of overwhelm and helplessness, apathy.

3. Behavioral:

isolation and withdrawal, lashing out, use of substances to numb, inability to focus, work absenteeism.

4. Cognitive:

difficulties with concentration, focus, and memory, cynicism, indecisiveness, inability to stop thinking about your partner’s problems.

5. Spiritual:

questioning of one’s values and beliefs, diminished feelings of purpose, hopelessness, feelings of disconnection to oneself, others, and a higher power.

Children and Secondary Traumatization

'PTSD sufferers can have significant difficulties in relationships with their children due to their own emotional difficulties and behavioral patterns.'

From Secondary Traumatisation and Systemic Traumatic Stress

Children are deeply affected by the trauma symptoms of a parent. Parents, and in particular, the non-survivor parent, must acknowledge and recognize possible signs of secondary traumatization in your child.

Symptoms may include:

  • Behavioral problems, including risky behaviors during adolescence
  • Depression
  • Anger
  • Withdrawal
  • Sleep and/or appetite disturbances
  • Difficulties with attention and focus
  • Hyperactivity

Please monitor your child, be proactive, and immediately seek medical or mental health support if you suspect your child is struggling.

Finding Help

The topic of secondary trauma in the families of adult survivors is largely unaddressed. And access to skilled trauma clinicians who are willing to look at this issue in the context of survivor-partner-family relationships is challenging.

This needs to change.

Here are a few suggestions to help:

1. Talk about it.

Find a good friend with whom you can express your experiences and express your feelings.

2. Educate yourself.

Education about the impact of your partner’s trauma on your family will equip you to advocate for your needs and those of your children.

3. Join a support group.

Social support is one of the strongest resources for dealing with stress and trauma, and it plays a major role in the healing process. Secondary Traumatisation and Systemic Traumatic Stress

Join one of Heather Tuba's Facebook Support Groups for Partners, Families, and Friends.

4. Start your own online conversation.

If you are a blogger, advocate, writer, speaker, or clinician, please join my voice. Conversation, connection, and collaboration at the grassroots level are needed.

5. Practice self-care.

Take time to work on your own personal growth. Ensure you are taking care of your physical and mental health.

To Learn More:

(Note: if any reader comes across any other resources especially from other countries and cultures, please let Cathy know.)

The National Child Traumatic Stress Network: Secondary Traumatic Stress

Secondary Stress in Caregivers of PTSD Victims

Vicarious Trauma

Basics of Compassion Fatigue Workbook (Downloadable PDF)

Secondary Traumatisation and Systemic Traumatic Stress



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