Secondary Trauma: The Weight of Witnessing Someone Else's Pain

What is secondary trauma and what are its signs? Learn how hearing a loved one's trauma or watching disaster footage leaves a mark, and how to cope.

Can you have nightmares about an event you never lived through yourself? Someone who listens for months to what their brother went through as he was pulled from the rubble, a nurse who witnesses another family's screams on every shift in the emergency department, or a teacher who spends days watching footage from the earthquake zone may, after a while, struggle to recognise themselves. Secondary trauma describes reactions that resemble direct trauma and arise from listening to, seeing or closely caring for someone who has lived through a traumatic event. In this article I will look at how this burden builds up, the signs through which it shows itself, and what you can do to make it bearable.

What Is Secondary Trauma?

A traumatic event does not only affect the person who lives through it directly. When we listen to the fear, helplessness and pain of someone we love, we experience those feelings to some extent in our own bodies too. The capacity we call empathy allows us to enter another person's inner world; but the same door also lets the horror in that world seep into us.

Known in the field by names such as "vicarious traumatisation" or "secondary traumatic stress", this condition was first described among professional groups who work with trauma survivors. Today, however, it is understood as a concept that covers not only professionals but also the spouse, child and parents of someone who has experienced trauma, and even ordinary people who spend hours in front of a screen watching disaster news.

I would like to underline an important distinction here: secondary trauma does not mean that you are "too sensitive" or "not resilient enough". On the contrary, it is very often the people who care the most, listen the most attentively and do not pull away who come up against this burden.

How it differs from burnout and compassion fatigue

These three concepts are often confused. Burnout is a loss of energy and meaning that develops gradually through long-term workload and a lack of resources; its content does not have to be traumatic. Compassion fatigue is the emotional exhaustion that comes from constantly responding to other people's pain. In secondary trauma, however, the defining feature is that the images, sounds and fear of the event you have heard about or watched settle into your own mind. You begin to picture a scene you never lived through as though you were remembering it.

What Are the Signs of Secondary Trauma?

The signs are very similar to the reactions seen in people who experience trauma directly. The difference is that their source is not your own experience but someone else's.

Mental and emotional signs

• Images of the event you have heard about or watched coming involuntarily before your eyes,
• Nightmares about that event, or scenes that appear as you fall asleep,
• New and rigid beliefs that the world is a dangerous place and that no one can be trusted,
• A constant state of alertness that something will happen to your loved ones,
• Numbness and emotional flatness towards things you used to enjoy,
• Guilt: the thought "I am living comfortably here while they went through all that".

Physical and behavioural signs

• Startling excessively at sudden sounds, and particular sensitivity to vibration and shaking,
• Sleep problems, constant tiredness, tension and headaches,
• Avoiding news, people or places that remind you of the subject,
• Or the opposite: being unable to let go of information, endlessly searching for new news and footage,
• Withdrawing from loved ones, impatience, quickly losing your temper.

Let's say your younger brother survived the earthquake and tells you again and again about the hours he spent under the rubble. So as not to leave him alone, you listen every time. A few months later, even if someone runs up the stairs of your apartment building your heart starts racing, and when you get into bed at night you feel the darkness and sounds he described as though you had lived them yourself. This does not mean it was "wrong" to listen to him; but it is a sign that you, too, are carrying a burden.

These signs do not on their own amount to a diagnosis. But if they last for weeks and restrict your life, they deserve to be taken seriously.

Who Is at Greater Risk?

Secondary trauma can happen to anyone; however, certain conditions increase the risk.

• Close relatives of people who have experienced trauma: People whose spouse has been subjected to violence, whose child has had an accident or whose parents survived a disaster are the ones who carry their loved ones' pain most closely.
• Healthcare workers: Those working in emergency departments, intensive care and ambulance teams frequently witness harrowing scenes. I have discussed the workload side of this separately in the article on healthcare worker burnout.
• Search and rescue volunteers and disaster workers: People who work at the rubble, inform families or take part in funeral procedures.
• Lawyers, social workers, teachers and reporters: Professions that read violence case files, follow child abuse cases or report from disaster zones.
• People with trauma in their own past: When the story you are listening to touches an old wound of your own, the burden feels heavier.
• People left without support: Those who cannot share what they hear with anyone and keep everything inside, telling themselves "I have to be strong".

A Shared Witnessing in Turkey: Earthquakes, Screens and Professions

The 6 February 2023 earthquakes were a disaster that many people in this country witnessed at the same time. Millions of people who were not in the earthquake zone watched footage of the rubble for days, heard the voices calling for help and saw families waiting with hope in live broadcasts. Many noticed afterwards that their sleep had been disrupted, that they jumped up at the slightest tremor, and that they had begun to think obsessively about how sturdy their building was.

Social media plays a particular role here. Algorithms push the most striking and painful footage to the front; you move on to the next video before finishing the last. Scrolling that begins with the feeling "I need to know" can quickly turn into a cycle that fills the mind with disaster scenes. I have described this habit in more detail in the article on doomscrolling.

Then there is the secondary burden carried quietly within families. In our culture, a person who goes through something hard usually tells their closest relative; instead of seeking professional support, their sister, mother or spouse becomes their "therapist". This closeness is valuable, but it is often forgotten that the listener also needs somewhere to breathe. A woman who is listening at the same time to her mother-in-law's illness, her husband's accident at work and what her neighbour lost in the earthquake may not understand why she feels so tired.

In professional groups, meanwhile, a culture of "you'll get used to it" is widespread. Talking after difficult cases can be perceived as weakness. An ambulance worker trying to joke with their children at the breakfast table after a call they returned from in the early hours may notice that they feel nothing inside. A lawyer who cannot tell their family about the details in the files they read may grow quieter and quieter in the evenings. From the outside they look like someone "good at their job, cool-headed"; inside, the accumulated scenes quietly take up space. Yet secondary trauma is a burden that is managed not by getting used to it but through regular unloading and support.

What Can You Do to Protect Yourself From Secondary Trauma?

You may not be able to stop witnessing other people's pain altogether; as a mother, as a nurse or as a sibling, it may be part of your life. But you can have some say over how that witnessing affects you.

Set limits on news and footage

Choose one or two time slots during the day when you will check the news. Preferring written news to video content reduces the number of scenes that settle in the mind. Keeping the hour before sleep free of screens helps lower the risk of nightmares.

Look after yourself while you listen

When listening to a loved one who has been through trauma, asking yourself "How much can I listen to today?" is not selfish. Saying "I want to listen to you, but I'm very tired right now; shall we talk again tomorrow evening?" is a way of protecting the relationship. Also, repeating every detail again and again is not always helpful for your loved one either; with professional support, the account can be moved into a safer framework.

Create transition rituals

After a hard shift or a difficult phone call, give yourself a moment of transition: sitting in the car for a few minutes before going into the house, taking off your work clothes and showering, going for a short walk. These small rituals send the mind the message "that scene is over; now I am home".

Calm your body

Simple techniques such as slowing your breathing, pressing your feet into the floor and counting five objects around you, or washing your face with cold water can soothe a nervous system that is on alert. Regular sleep and eating directly affect your capacity to carry this burden.

Share the load, but don't empty it into the same place

Telling someone what you have heard brings relief; however, take care not to pass detailed and heavy scenes on to someone who cannot bear them, such as your child. Regular sharing meetings with colleagues, supervision, or a limited conversation with an adult you trust are more suitable channels.

See meaning and good things too

A person who witnesses trauma sees human cruelty and the fragility of the world. Seeing solidarity, recovery and the way people look out for one another in the same process can be balancing. Noting a small kindness you saw at the end of the day helps keep the mind from recording only dark scenes.

To be able to carry someone else's pain, you first have to accept that your own shoulders can get tired too.

When Should You Seek Professional Support?

If one or more of the following apply to you, it may be helpful to see a mental health professional:

• If nightmares, intrusive images or excessive startling have not eased for several weeks,
• If you are having marked difficulty doing your job, looking after your children or keeping up your relationships,
• If you have shut yourself down emotionally and can no longer feel anything for anyone or anything,
• If you are trying to suppress the tension you feel with alcohol, sleeping pills or other means,
• If the story you have listened to has revived a trauma from your own past.

These reactions can sometimes come very close to the pictures seen after direct trauma. You can read about what trauma is and how it leaves a mark on the mind in the article what is psychological trauma. If sleep and anxiety symptoms are very intense, whether medication is needed can be determined through an assessment by a psychiatrist.

How Is Secondary Trauma Addressed in Therapy?

The first step in therapy is to name what you are going through. Many people play down their own reactions, saying "But nothing happened to me". Simply seeing that these reactions are understandable brings significant relief.

Within a cognitive behavioural therapy framework, work generally focuses on the following areas:

• Working with images that have settled in the mind: Noticing when and with which triggers intrusive scenes arrive, and developing more regulating responses to them instead of avoidance or suppression.
• Reviewing changed beliefs: Examining thoughts that have hardened after the experience, such as "Nowhere is safe" or "I could lose my loved ones at any moment", with a realistic and balanced perspective.
• A boundaries and self-care plan: Turning your listening capacity, workload and rest times into a concrete plan.
• Addressing the link with your own past: If the story you listened to reopened an old wound, working on this separately and at a safe pace.
• Meaning and values: Remembering again why you do this work or why you stand by this loved one; this is an important resource that makes the burden bearable.

For healthcare and disaster workers, regular supervision and team support are important tools that complement individual work. You can find information about individual work with adults on the individual therapy page.

Frequently Asked Questions

Can just watching the news cause secondary trauma?

Yes, intense and prolonged exposure to footage can lead to trauma-like reactions in some people. Content watched before sleep, or content showing children or rubble, can leave a deeper mark. Limiting viewing time and choosing written rather than visual sources is protective.

Should I stop listening to my loved one who has been through trauma?

No, but you can adjust how you listen and set limits on it. Saying how much you can listen to, taking breaks and directing them towards professional support is healthier both for them and for you. You can keep your closeness without having to be their only source of support.

Do children experience secondary trauma?

Children process what their parents tell them and what they see on screens differently from adults; their fears may show up in their play, their sleep or as physical complaints. It is important not to have detailed and heavy conversations in front of them and to answer their questions calmly and in a way that suits their age. If the signs persist, you can seek the opinion of a child mental health professional.

Does secondary trauma go away on its own?

For many people, reactions ease over time once exposure decreases and support increases. However, if exposure continues, for example if your job means witnessing harrowing scenes every day, the burden can build up without regular self-care and support. If the signs last for weeks, talking with a professional can help you see that it is possible to lighten this load.

• #secondary trauma
• #vicarious trauma
• #mental health after disasters
• #compassion fatigue

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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