Witnessing Violence: Understanding Secondary Trauma & PTSD
Published: 06/29/2026
If you’ve ever been hurt or assaulted, then you’ll know that it’s not just the physical pain that affects you. It’s also how you were impacted emotionally and psychologically, often long after the incident itself. Or, maybe you’ve seen it happen to a relative, a friend, or a colleague.
Even just seeing violence occur, hearing detailed accounts of violent events, or being repeatedly exposed to the suffering of others can all have a noticeable impact.[1]
If you, or someone you care about, has ever witnessed a violent act and has suffered ongoing distress or anxiety afterwards, it may be the result of “secondary trauma.” In some cases, post-traumatic stress disorder (PTSD) can develop if the emotional impact is especially severe.[2]
It’s important to understand how observing traumatic events affects mental health in order to recognize symptoms and get appropriate support. Recovery is possible, and many people experience meaningful improvement with the right care and support.[3] This article will cover:
- What secondary trauma is and how it differs from primary trauma.
- How witnessing violence can lead to PTSD.
- Examples of witnessing violence trauma, and the resulting symptoms.
- Who is most at risk for secondary trauma.
- Trauma counseling, therapy, and other treatment options.
Table of Contents
What Is Secondary Trauma?
Secondary trauma refers to the emotional and psychological effects that can develop after one person is exposed to another’s traumatic experience. Direct trauma, on the other hand, is what may occur after a personal experience with a traumatic event. Secondary trauma can happen after witnessing or even learning about someone else’s experience. Symptoms are generally made worse with repeated exposure.[4]
A person may develop secondary trauma after:[5][6][7][8]
- Witnessing a violent assault.
- Seeing abuse of a loved one, in a domestic setting or otherwise.
- Observing a serious accident, like a car crash.
- Working in a profession that is associated with regular exposure to trauma, such as being a soldier or a first responder.
It’s important to know that secondary trauma isn’t a sign of weakness or oversensitivity. It’s a legitimate stress response, where your brain is processing danger to try to protect you from it in the future. This is what the brain is supposed to do.
Say, for example, you witnessed a car accident. The stress response may create anxiety and fear surrounding car journeys. Your brain has learned that cars are dangerous, and it is trying to keep you safe by making you afraid of them.
The fear element isn’t helpful if you need to drive to work every day. But your brain isn’t thinking about your commute. It’s thinking about survival. Witnessing violence can activate many of the same stress responses that happen during direct trauma.[9] Your body doesn’t always distinguish between “this is happening to me” and “this is happening in front of me.” The threat response can be the same either way.
When discussing these kinds of experiences, mental health professionals also use terms like:[10]
- Secondary traumatic stress.
- Indirect trauma.
- Vicarious trauma.
However, there are subtle differences.
For example, vicarious trauma refers to changes that happen in the long term with regard to someone’s beliefs, worldview, and emotional functioning after witnessing trauma. Vicarious trauma is more common in healthcare professionals and other people who see or hear about trauma on a more regular basis.[11]
Trauma From Witnessing Violence
Studies have consistently shown that being a witness to violence can contribute to PTSD symptoms in some individuals. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) is the diagnostic manual used by healthcare professionals, and it explicitly includes witnessing trauma, not just experiencing it directly, as a pathway to PTSD.[12]
You may have heard the term post-traumatic stress disorder (PTSD) used in the context of military veterans. The nature of their profession means veterans can be repeatedly exposed to trauma while serving. But PTSD can happen to anyone, not just military personnel. Individuals can develop PTSD from growing up around domestic violence, witnessing a violent crime, or seeing violence in their community. Some of those most at risk include:
- First responders such as police and firefighters.
- Mental health professionals, including therapists and psychiatrists.
- Nurses and physicians.
- Social workers.
- Teachers.
- Journalists who report “from the ground” or at the site of traumatic events.
- Family caregivers.
- Children who witness violence.
- Prison employees.
- Social media content moderators.
Picture a therapist who works regularly with survivors of trauma and hears detailed accounts of domestic abuse or violent relationships on a day-to-day basis. This can have a profound effect on someone’s mental health. In some cases, it may cause them to start questioning the good in people and could make them more wary of society as a whole.
Factors That Increase the Risk of Developing Trauma After Witnessing Violence
Not everyone who sees violence ends up with a PTSD diagnosis. But being exposed to traumatic events, especially repeatedly, can mean that the brain’s normal coping mechanisms are constantly challenged.
After trauma, occasional coping mechanisms can become permanent states. For example, temporary anxiety can become hypervigilance. Occasional avoidance can become isolation. These responses might fade naturally after a few weeks for some people, but for others, they persist for years.[9]
Factors that can increase the likelihood of PTSD include:[12]
- Severity of the event: More graphic, distressing, or consequential experiences increase the risk of PTSD.
- Previous trauma history: If you already have unprocessed trauma, your brain may already be primed for threat.
- Lack of social support: Witnessing something traumatic and then going home alone without anyone to talk to makes processing harder.
- Existing mental health conditions: Anxiety or depression can make you more vulnerable to developing PTSD after witnessing violence.
- Ongoing exposure to violence: Growing up around violence in the community or at home.
The symptoms of secondary trauma are sometimes dismissed because the person wasn’t the direct victim. When assessing and deciding on treatment, it’s important to consider all the above factors, as each individual has a unique background and needs.
Examples of Witnessing Violence Trauma
Being a witness to violence doesn’t always happen in the more obvious scenarios, such as car crashes or fights on the street. Some common examples of violence that can cause trauma, secondary trauma, and PTSD include:
Domestic Violence
People who grow up around domestic violence between family members, or are exposed to it in adulthood, often experience significant emotional distress. Studies confirm that witnessing domestic violence can affect:[5]
- Emotional development.
- Long-term mental health.
- Relationships.
Children who watch one parent hurt the other often carry that experience into adulthood. They may have difficulty trusting partners, or they may unconsciously repeat patterns they witnessed.
Community Violence
Exposure to violence within neighborhoods, schools, or public spaces can contribute to ongoing fear, anxiety, and trauma. Community violence is associated with higher rates of PTSD symptoms, depression, and emotional difficulties.[6]
The environment shapes how safe you feel in the world. A child who grows up hearing gunshots at night learns that their environment is dangerous. A teenager who sees a classmate beaten up at school may start avoiding school entirely.
Workplace Incidents
If you’re an emergency room doctor, a social worker, or a police officer, you’ll likely have some experience with injuries, deaths, or even acts of violence as part of your job. Research confirms that repeated exposure to these events can increase the risk of secondary traumatic stress and burnout.[7] The accumulation is often an important factor. One bad shift is difficult, but years of bad shifts can fundamentally change how you see the world.
Common Trauma Symptoms After Witnessing Violence
Trauma symptoms can vary depending on the individual. Some experience immediate distress, while others don’t notice symptoms emerging until weeks or even months later.
Some common symptoms of trauma that can occur after witnessing violence include:
Intrusive Memories
After seeing something traumatic, it’s not uncommon to keep reliving it in your head. These memories can feel vivid and difficult to control.[12] They intrude, take over, and can put you in a state of constant fear or anxiety.
Nightmares
Disturbed sleep is common after trauma.[13] You may wake up in a cold sweat, panicked after a nightmare that felt real. In some cases, it can be a nightmare replaying something in the past that you had forgotten or had been unconsciously suppressing. Sleep is supposed to be when you recover. When nightmares affect your sleep on a regular basis, exhaustion can make all the other symptoms worse.
Hypervigilance
This is a state of being “on guard”. It’s a coping mechanism the brain puts in place to react quickly in moments of danger. But when it is a persistent state in your day-to-day life, even though there are no immediate threats, you can feel easily startled or unsafe in otherwise normal environments.[14]
Avoidance
Many individuals avoid reminders of the event, including specific places, people, conversations, or activities associated with the trauma.[12] Avoidance provides short-term relief but can shrink your world and significantly affect the quality of your life.
Anxiety and Depression
Trauma can contribute to persistent anxiety, low mood, irritability, feelings of hopelessness, and difficulty concentrating.[15] You might not connect the anxiety or depression to the trauma at first, especially if symptoms didn’t appear immediately, but they are closely linked.
As well as emotional distress, secondary trauma can also lead to:[10][16]
- Declining work performance.
- Little engagement or enjoyment in activities or hobbies.
- Social withdrawal.
- Physical exhaustion.
- Increased conflict with loved ones.
Mission Connection is here to help you or your loved one take the next steps towards an improved mental well-being.
Treatment Options for Secondary Trauma and PTSD
There are various forms of treatment available for secondary trauma and PTSD. These include:
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
Cognitive behavioral therapy (CBT) is consistently supported by research as an effective way to treat trauma-related conditions. It’s a talk therapy that focuses on unhelpful or overly negative thinking patterns that aren’t serving you well. A therapist can help you reframe your thinking to be more balanced and realistic.[17]
TF-CBT specifically adapts CBT techniques for trauma, helping you process the traumatic experience and develop coping strategies.
Eye Movement Desensitization and Reprocessing (EMDR)
In Eye Movement Desensitization and Reprocessing (EMDR), the therapist asks you to recall traumatic experiences while following prompts relating to eye movement. Studies have found this to be effective in the treatment of PTSD.[18] The mechanism isn’t fully understood, but the theory is that the eye movements help the brain reprocess traumatic memories so they become less distressing.
Trauma Counseling
Trauma counseling provides a safe space to:[3]
- Explore emotional reactions.
- Develop coping strategies.
- Process difficult experiences.
Not all therapy needs to follow a specific protocol. Sometimes what helps most is having a trained professional who understands trauma and can help you work through it at your own pace.
Medication
In some situations, medications may help reduce symptoms of:
- Anxiety.
- Depression.
- Sleep disturbances.
- PTSD.
Treatment decisions should always be made in consultation with qualified healthcare professionals.[12] Medication isn’t a standalone treatment for trauma, but it can help manage symptoms enough that therapy becomes possible or that daily functioning improves.
Ways of Supporting Your Own Trauma Recovery
Processing trauma from witnessing violence is rarely a straight line, with good days and bad days. Many who have ongoing symptoms of trauma find it helpful to focus on:[19][20][21]
- Developing healthy routines. Getting up at a set time each day, allocating time for moderate exercise, eating right, getting enough quality sleep, and participating in hobbies and social activities can all provide structure when everything else feels chaotic. It doesn’t fix the trauma, but it gives you something stable to hold onto.
- Exploring personal interests and hobbies as a means of keeping thoughts relating to trauma at a distance.
- Building supportive relationships and connecting to people you trust. Support networks, and even just having a few friends to talk to, can help you process distressing thoughts.
- Celebrating small signs of progress. Even little wins add up. It’s important to acknowledge when things go well to promote balanced thinking and prevent being overly self-critical.
These strategies support recovery, but they’re not a substitute for professional treatment if symptoms are severe or persistent. If you’re struggling to function, or if symptoms aren’t improving, it’s time to seek help.
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Get Treatment for Secondary Trauma With Mission Connection
Whether you have suffered violence or witnessed it, it’s important to reach a place of safety and healing. The experienced team at Mission Connection knows that recovery from witnessing trauma doesn’t just happen overnight. It often requires compassionate, long-term mental health support.
We go beyond traditional treatment and provide life-changing care that includes a variety of evidence-based therapy options, holistic approaches, and lifestyle changes that can be tailored to your circumstances and needs. Our team also offers comprehensive medication monitoring alongside these various treatments and therapies to help you make a successful and sustained recovery.
We offer several options for effective outpatient treatment, including in-person programs at our locations in California, Virginia, and Washington, virtual telehealth, and a hybrid program that combines in-person and virtual care.
Our online telehealth services mean you can access care from wherever you feel safest, without needing to leave home to get help. For many trauma survivors, the idea of going to a new place and meeting new people is itself anxiety-provoking. Telehealth removes that barrier.
Mission Connection accepts most major insurance providers, so that your recovery is not hindered due to financial issues. If you’re ready to explore our treatment options or have questions about what we offer, call us at 866-833-1822 or complete our confidential contact form for more information.
