Trauma Therapy - Secondary Trauma: The Trauma No One Talks About

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Secondary Trauma: The Trauma No One Talks About

Trauma doesn’t just stem from immediately threatening experiences; it can also come from indirect exposure to traumatic events. This indirect exposure is known as secondary trauma.

The effects of secondary trauma are not always immediately apparent, but they can significantly impact mental health and coping.

What Is Trauma?

When we think of trauma, what usually comes to mind is an event that is horrific or life-threatening. Part of the DSM-5 criteria for a diagnosis of Post-Traumatic Stress Disorder (PTSD) includes exposure to death, a threat of death, actual or threat of serious injury, or actual or threatened sexual violence¹.

But trauma is more than just the direct experience of a horrific or life-threatening event. The American Psychological Association (APA) defines trauma as “an emotional response to a terrible event like an accident, rape, or natural disaster.”² Trauma is not simply the event, but also the emotional response one has to it.

What might be surprising is that trauma-related stress can also result from witnessing trauma or indirect exposure to traumatic events. For example, trauma-related stress can happen after exposure to mass disasters via the media³, hearing graphic accounts of a person’s traumatic experience, or as part of one’s work⁴ (e.g., first responders, nurses, etc.). For helping occupations, being exposed to someone else’s trauma is often seen as “part of the job,” and being distressed can sometimes carry some guilt or shame.

Because someone doesn’t directly experience an event, this type of trauma can sometimes be inadvertently overlooked or not immediately recognized as problematic. So, it doesn’t always get noticed right away or talked about. This distress has a name.

What Is Secondary Trauma?

Secondary trauma, sometimes referred to as secondary traumatic stress or vicarious trauma, is the emotional distress that can result from learning about the firsthand traumatic experiences of others. It is caused by “repeated or extreme confrontation with details of traumatic situations without any direct sensory impressions and is described as the victims’ symptoms being transferred to another individual.”⁵

What Are the Signs of Secondary Trauma?

The symptoms of secondary trauma can be very similar to PTSD and C-PTSD. These symptoms can manifest in a few ways: cognitively, emotionally, behaviorally, and physically⁸.

Cognitive Signs:

  • Lowered Concentration
  • Apathy
  • Rigid thinking
  • Perfectionism
  • Preoccupation with trauma

Emotional Signs:

  • Guilt
  • Anger
  • Numbness
  • Sadness
  • Helplessness

Behavioral Signs:

  • Withdrawal
  • Sleep disturbance
  • Appetite change
  • Hyper-vigilance
  • Elevated startle response

Physical Signs:

  • Increased heart rate
  • Difficulty breathing
  • Muscle and joint pain
  • Impaired immune system
  • Increased severity of medical concerns

Who Is at Risk for Secondary Trauma?

This type of trauma is often seen in people who work in helping professions where contact with trauma survivors is common, such as first responders, nurses, and even therapists who do trauma work. Secondary trauma is more involved than burnout.

For those in the helping professions, this type of trauma is sometimes referred to as compassion fatigue because it stems from helping others. Even supporting a loved one through a traumatic event they’ve experienced can result in secondary trauma.

Secondary trauma can also result from indirect exposure to traumatic events via the graphic retelling of stories related to disasters or other tragic events. This phenomenon is sometimes seen after prolonged tragic events such as terrorist attacks, natural disasters like hurricanes or wildfires, or war images. Studies have found a relationship between disaster-related news coverage⁶, social media use⁷, and psychological distress, including anxiety, depression, stress, substance abuse, and PTSD.

Even if you don’t experience trauma directly, indirect exposure can place you at risk for impact.

A healthcare worker dressed in full PPE outside.

Assessing Your Risk for Secondary Trauma

Of course, these symptoms can also be related to other issues. For this reason, it’s essential to be aware of indirect exposure to trauma that might be affecting you or someone you love. We don’t always realize that something is creating distress. The impact of indirect exposure to distressing experiences often accumulates over time and goes unnoticed in its early formation.

Suppose you work in an occupation that brings you into frequent contact with traumatic situations or trauma survivors, or you find yourself often overwhelmed with “too much information” about traumatic events or information. In that case, it’s essential to take care of your emotional well-being.

How to Heal Secondary Trauma

While it’s easy to care for others and put their needs ahead of ourselves, it can be more challenging to address the root cause of secondary trauma and get the help you need. If you find yourself dealing with secondary trauma, it is important to address it. Left unattended, it can impact your well-being and how you interact with others.

It can be challenging to prioritize caring for yourself. Luckily, there are things you can do to help mitigate the effects of secondary trauma.

Practice Good Self-care

Trauma takes a tremendous toll on a person physically and emotionally. Make sure that you are nurturing yourself in healthy ways:

  • Eat nutritious meals
  • Get enough rest
  • Get fresh air
  • Move daily — even gentle stretching or walking is helpful
  • Do things that you enjoy with supportive loved ones
  • Journal

Connect with Others

While it can be helpful to talk with a trusted friend or colleague, a therapist is best equipped to help you navigate recovery from secondary trauma. Connecting with others gives you a place to talk about your feelings and receive support.

Learn to Say No

It can be very tempting to want to do more and more for others, and sometimes, it can feel like it’s never enough. Saying no sounds selfish, but it’s not – you can’t help others when you’re struggling too.

It is essential to evaluate your relationships and identify where you continue to give, even at your own expense. Perhaps there are some codependent tendencies that need work and boundaries.

Setting healthy boundaries allows you to separate from the source of distress and prioritize your needs and well-being. It’s like giving yourself permission to take care of yourself.

Practice Mindfulness

In simple terms, mindfulness is simply being fully aware of and attentive to what is happening in the moment. It is a non-judgmental way of attending to thoughts and feelings and has been shown to reduce stress and anxiety.

Studies have found that practicing mindfulness can help mitigate the effects of secondary trauma. Some examples of mindfulness-based interventions include:

Over time, you can build resiliency and find the coping skills that work best for you. You give so much to others – make sure that you are on that giving list too.

Finding Support for Secondary Trauma

Sometimes, it’s hard to know where to start or whether what you’re experiencing stems from trauma, burnout, or something else. That’s when a therapist can make a difference. A therapist specially trained in trauma-informed care can help you to sort through what you’re feeling, identify your needs, and help you find healthy ways to cope and heal.

At All Points North, we understand trauma. Our team of expert trauma-informed clinicians is ready with the skills and programs to help you take the next step towards healing and recovery.

Nestled in the beautiful Rocky Mountains, All Points North Lodge offers a luxury rehab experience with the perfect environment for healing, personal growth, and recovery. We use a combination of evidence-based healing modalities in conjunction with holistic and alternative therapies like yoga, mindfulness, meditation, nutrition, and massage therapy. We pair these therapies with cutting-edge technologies like Hyperbaric Oxygen Therapy (HBOT) and Deep Transcranial Magnetic Stimulation (Deep TMS).

To learn more about treatment at APN Lodge, reach out to one of our Contact Center team members at  855-510-4585 or via . Let us help you reclaim your well-being and find your way forward.



  1. Diagnostic and Statistical Manual of Mental Disorders, 5th, ed. American Psychiatric Publishing, 2013. DSM-V, appi
  2. “Trauma and Shock.” American Psychological Association,
  3. Abdalla, Salma M et al. “Media Exposure and the Risk of Post-Traumatic Stress Disorder Following a Mass traumatic Event: An In-silico Experiment.” Frontiers in psychiatry vol. 12 674263. 25 Nov. 2021, doi:10.3389/fpsyt.2021.674263
  4. Ogińska-Bulik, Nina et al. “Prevalence and predictors of secondary traumatic stress symptoms in health care professionals working with trauma victims: A cross-sectional study.” PloS one vol. 16,2 e0247596. 23 Feb. 2021, doi:10.1371/journal.pone.0247596
  5. Greinacher, Anja et al. “Secondary Traumatization, Psychological Stress, and Resilience in Psychosocial Emergency Care Personnel.” International journal of environmental research and public health vol. 16,17 3213. 3 Sep. 2019, doi:10.3390/ijerph16173213
  6. Pfefferbaum, Betty et al. “Disaster media coverage and psychological outcomes: descriptive findings in the extant research.” Current psychiatry reports vol. 16,9 (2014): 464. doi:10.1007/s11920-014-0464-x
  7. Goodwin, Robin, et al. “In the Eye of the Storm or the Bullseye of the Media: Social Media Use during Hurricane Sandy as a Predictor of Post-Traumatic Stress.” Journal of Psychiatric Research, Pergamon, 11 May 2013,
  8. “Secondary Traumatic Stress.” Administration for Children & Families, U.S. Department of Health & Human Services,

Reviewed by Emmeline Massey MSW, LSW

Jess Johnson

Content Marketing Manager

As a fierce proponent of mental health services, Jess believes in the compassionate care and person-centered approach at All Points North. She works to create content that inspires clients and families to advocate for the support they deserve.