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.
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 Traumatization 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. Secondary Stress in Caregivers of PTSD Victims
Symptoms of Secondary Traumatization
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 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
Sleep and/or appetite disturbances
Difficulties with attention and focus
Please monitor your child, be proactive, and immediately seek medical or mental health support if you suspect your child is struggling.
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 an online community.
This does not always mean a group. It could mean following pages or conversations with like-minded individuals.
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:The National Child Traumatic Stress Network: Secondary Traumatic StressSecondary Stress in Caregivers of PTSD VictimsVicarious TraumaBasics of Compassion Fatigue Workbook (Downloadable PDF)
Secondary Traumatisation and Systemic Traumatic Stress