On the last track, we discussed Shattering Assumptions. As
you may know, grieving clients may be forced to reconsider three assumptions
about themselves. They are the loss of invulnerability, the loss
of an orderly world, and the loss of a positive self-image.
On this track, we will discuss Secondary Wounding. As
you may already know, secondary wounding occurs when the people
the client turns to for support respond in a way that further injures the client. In
my practice, I have found five basic types of secondary wounding experiences.
They are disbelief, discounting, ignorance, labeling, and cruelty. As
I describe the five types of secondary wounding, you
may want to use this as a checklist to evaluate a client you
may be treating.
Five Basic Types of Secondary Wounding
Sarah, age 23, was sexually assaulted by a stranger. Sarah stated tearfully, "After
I was attacked, I felt really alone. My boyfriend dumped me because he
thought I was making up stories to get attention. He actually called
me a liar." Clearly, Sarah was experiencing secondary wounding
through disbelief. Her boyfriend’s disbelief led
to Sarah feeling as though she could not relate to anyone regarding her trauma. I
stated to Sarah, "Disbelief is a form of denial. Do
you think he disbelieved you because he was afraid to face
the reality of the attack?"
Sarah stated, "Yeah, but
so what? Maybe it would be easier to pretend it never happened." As
you can see, Sarah’s secondary wounding experience was in danger of preventing
her from continuing the healing process.
Sarah also suffered from the secondary wound of discounting. Sarah’s
sister made statements minimizing the effect of the trauma and the magnitude
of the event. Sarah explained her sister’s discounting when
she stated, "It seems like no one cares that I was attacked. After
my boyfriend called me a liar, my sister told me I was overreacting. I
feel like shit about myself!! Maybe I deserved what I got!" As
a client experiences discounting of the trauma, he or she
may begin to feel that it is their fault that the event had
such a profound impact. Would you agree that this type of secondary wounding
can result in low self-esteem?
In addition to disbelief and discounting, the third type
of secondary wounding is ignorance. As
you know, ignorance plays a major role in secondary wounding experiences. Would
you agree that people who have no experience with trauma often do not know
what to say or how to respond to a client? As with disbelief, secondary
wounds caused by ignorance can result
in clients feeling unable to relate to anyone regarding their trauma.
As you may be aware, one of the social consequences for clients who are traumatically
victimized is being labeled a victim. You are well
aware that once clients become so labeled, others have a
tendency to interpret most, if not all, of the client’s actions in
terms of that label. Furthermore, once labeled,
it may be difficult to escape from that label. It
may also be assumed that because clients suffer ill effects from trauma that
those effects are irreversible.
For example, prior to the sexual assault,
Sarah worked as a department manager. Her supervisor assumed that
because Sarah had taken a few days off work and attended a rape crisis group,
she would be unable to function as a department manager. Sarah stated, "When
I went back to work, my boss asked me to serve as a receptionist instead
of department manager. When I asked why I was being demoted, my boss
said it was because she didn’t know if I could emotionally handle
a management position." Would you agree that Sarah’s boss
had labeled her a victim? Do you have a client you are currently treating
that is being labeled as a victim.
In addition to disbelief, discounting, ignorance and labeling, cruelty is
the fifth type of secondary wounding. As
you probably know, almost all secondary wounding experiences
are cruel. Therefore, it may be difficult to determine
whether the person involved is trying to cause pain or whether the pain is
the result of disbelief, discounting, ignorance or labeling. Would
you agree that sometimes cruelty is combined with the other types of secondary
3-Step "Dealing with Secondary Wounding Experiences" Technique
To help Sarah, who suffered from a sexual attack, identify and heal her secondary
wounds, I decided to try the "Dealing with Secondary
Wounding Experiences" technique.
--The first step is to identify specific secondary wounding experiences. Sarah
identified three distinct secondary wounding experiences. The three Sarah
identified were disbelief from her boyfriend, discounting from
her sister, and labeling from her boss.
--The second step in the "Dealing with Secondary Wounding Experiences" technique
is to identify specific emotional responses. I asked
Sarah what feelings she experienced from each of her secondary wounds. Sarah
stated, "I feel anger, pain, disgust, and sorrow. I also want to
get back at all of them for hurting me even more."
-- In addition
to identifying specific secondary wounding experiences and identifying
specific emotional responses, the third step is to consider
the effects of the secondary wounding. I asked Sarah if her
secondary wounds altered her self-image, relationships, or ability to participate
Sarah stated, "I always thought I was a good person. So
why would everyone close to me try to hurt me more? I thought friends
and family were supposed to support each other." I stated to Sarah, "They
are, but your friends and family are just as hurt as you by the attack. They
are afraid to acknowledge that you were hurt. If you can forgive them
for not knowing how to react to you, you can take away the power of these secondary
Would you agree that Sarah’s ability to forgive
others while experiencing her own pain and grief may help her through the healing
process? In a later session, Sarah stated, "I don’t feel
so bad now. I know why my friends and family said the mean things they
said. I forgave them and they apologized. Now we can actually talk
about what happened and I don’t feel like such an outsider."
On this track, we discussed five basic types of secondary
wounding experiences. They are disbelief, discounting, ignorance, labeling,
On the next track, we will discuss Healing Self-Statements. In the version
I use, there are three steps in helping clients to create healing self-statements. They
are considering grief neutrally, identifying needs, and identifying strengths.
Peer-Reviewed Journal Article References:
Bonanno, G. A., & Lilienfeld, S. O. (2008). Let's be realistic: When grief counseling is effective and when it's not. Professional Psychology: Research and Practice, 39(3), 377–378.
Diminich, E. D., & Bonanno, G. A. (2014). Faces, feelings, words: Divergence across channels of emotional responding in complicated grief. Journal of Abnormal Psychology, 123(2), 350–361.
Jordan, A. H., & Litz, B. T. (2014). Prolonged grief disorder: Diagnostic, assessment, and treatment considerations. Professional Psychology: Research and Practice, 45(3), 180–187.
Online Continuing Education QUESTION
What are the five basic types of secondary wounding experiences?
To select and enter your answer go to .