Recognizing Secondary Trauma in Caregivers
Caring for those who have experienced trauma is both a privilege and a heavy
responsibility. Whether it is a counselor supporting clients, a nurse on the frontlines of
medical crises, or a family member helping a loved one heal, caregivers often pour
themselves into the work of holding another’s pain. Yet in the process, many neglect
their own emotional well-being. One risk in this role is developing secondary
trauma—the emotional distress that comes from being indirectly exposed to another
person’s suffering. Recognizing the signs early is critical, both for the caregiver’s own
health and for their ability to continue offering compassionate care.
What Is Secondary Trauma?
Secondary trauma, also known as vicarious trauma or compassion fatigue, occurs when
caregivers internalize the trauma narratives of those they support. Unlike burnout, which
develops gradually due to chronic stress or workload, secondary trauma can emerge
suddenly after hearing a particularly distressing story or witnessing repeated suffering
(Hensel et al., 2015).
Research highlights the prevalence of this issue. The National Child Traumatic Stress
Network found that up to 26% of therapists and nearly 50% of child welfare workers
reported significant symptoms of secondary traumatic stress at some point in their
careers. This shows that the risk is not rare, but rather a common reality across helping
professions.
Common Signs and Symptoms
Secondary trauma shows up differently for everyone, but some of the most common
signs include:
Nightmares, intrusive thoughts or images related to the trauma stories heard
from others.
Emotional numbing or feeling detached from clients, patients, or even loved
ones.
Increased substance use.
Hypervigilance and anxiety, including difficulty relaxing or sleeping.
Irritability, sadness, or hopelessness that lingers beyond work hours.
Physical symptoms such as headaches, fatigue, or gastrointestinal distress.
Reduced empathy or compassion, sometimes referred to as “compassion
fatigue.”
These reactions mirror post-traumatic stress disorder (PTSD) symptoms. Secondary
trauma can lead to PTSD-like experiences even in individuals not directly exposed to
the original trauma.
Why Caregivers Are at Risk
Caregivers often enter their roles with deep empathy and a strong desire to help. This
very quality, while essential for building trust and rapport, also increases vulnerability to
secondary trauma. Professions such as social work, counseling, nursing, first response,
and child welfare carry especially high risks, as do informal caregivers supporting family
members with chronic illness or trauma histories.
According to a 2015 meta-analysis in the Journal of Traumatic Stress, there are several
factors can heighten the likelihood of secondary trauma:
High caseloads or long hours with little recovery time.
Personal trauma history that resonates with clients’ experiences.
Lack of supervision or peer support, leading to emotional isolation.
Workplace cultures that discourage vulnerability or self-care.
The Importance of Early Recognition
Recognizing secondary trauma is the first step toward addressing it. Unfortunately,
many caregivers dismiss their symptoms as “just stress” or believe they must push
through for the sake of those they serve. Over time, this avoidance can lead to burnout,
mental health struggles, and reduced quality of care.
By identifying early warning signs, such as emotional exhaustion, changes in worldview,
or intrusive thoughts, caregivers can take proactive steps before symptoms worsen.
Just as airlines remind passengers to secure their own oxygen mask first, caregivers
must prioritize their well-being to effectively support others.
Strategies for Coping and Prevention
While secondary trauma is an occupational hazard, there are concrete strategies that
can protect caregivers’ resilience:
1. Self-awareness and reflection
Regularly check in with yourself: How am I feeling emotionally, physically, and
mentally after my caregiving responsibilities? Journaling or mindfulness practices
can help track patterns and recognize when symptoms arise. Research on
mindfulness-based stress reduction shows it can lower stress and improve
resilience in healthcare workers (Shapiro et al., 2005).
2. Professional support
Supervision, peer consultation, or therapy provides a safe space to process the
emotional impact of caregiving. Studies show that organizations offering
structured peer support see lower turnover and greater caregiver well-being.
3. Healthy boundaries
It’s important to separate your professional or caregiving role from your personal
identity. Boundaries help create space for recovery and prevent emotional
spillover.
4. Self-care routines
Exercise, rest, creative outlets, and time in nature are not luxuries, they are
essential tools for maintaining balance. Regular physical activity has been shown
to reduce symptoms of stress and anxiety (Harvard Health, 2020).
5. Workplace culture shifts
Organizations can support staff by offering trauma-informed training, encouraging
open dialogue about stress, and fostering team cohesion. A supportive
environment significantly reduces secondary trauma symptoms.
Caregivers play a vital role in helping others rebuild after trauma, but they are not
immune to the emotional toll. Recognizing and addressing secondary trauma is not a
sign of weakness, but rather it is an act of strength and responsibility. By staying
attuned to their own needs, seeking support, and practicing healthy boundaries,
caregivers can sustain both their compassion and their well-being.
Sources
Harvard Health Publishing. (2020). Exercising to relax. Retrieved from
https://www.health.harvard.edu/staying-healthy/exercising-to-relax
Hensel, J. M., Ruiz, C., Finney, C., & Dewa, C. S. (2015). Meta-analysis of risk factors
for secondary traumatic stress in therapeutic work with trauma victims. Journal of
traumatic stress, 28(2), 83–91.
Shapiro, S. L., Astin, J. A., Bishop, S. R., & Cordova, M. (2005). Mindfulness-Based
Stress Reduction for Health Care Professionals: Results From a Randomized
Trial. International Journal of Stress Management, 12(2), 164–176.