Secondary traumatic stress disorder: the emotional duress that results from firsthand exposure to the trauma experiences of another. People with secondary trauma have symptoms that mimic those of posttraumatic stress disorder (PTSD); those symptoms include intrusion, hyperarousal, and avoidance.



Intrusion: the inability to keep memories of the event from returning.


I was in a chilly movie theater when I had my first flashback. I remember rubbing my bare arms to warm them, smoothing down the raised hairs on my forearms, wondering why the air conditioning was so cold.

My friend Kim and I had decided to see the movie The Constant Gardener, a film set in Kenya and Sudan, starring Ralph Fiennes in another tragic white-man-in-exotic-Africa role (reprising his success in The English Patient). We loved doing this sort of thing together—watching movies set in foreign places, eating Indian food, going to cultural events in the city, wearing jangly earrings. It made us feel different, educated, elite, and decidedly unlike our classmates (many who were also white and privileged, also raised in the suburbs) at our evangelical Christian college. Kim had just gotten back to the United States from Honduras; I had spent three months in Kenya. We both studied international relations and fancied ourselves serious students of the world, ones concerned with seeking justice in places ignored by Western media.

But I wasn’t prepared for the scene of men on horseback, Kalashnikovs raised, galloping toward a small village. The sight of people running, kicking up sand and dust. I clutched at my arms, giving myself a desperate hug, my fingernails leaving half-circle indentations on my skin. There was screaming. Straw thatched roofs were on fire, a woman was smacked in the face with the butt of a rifle. Villagers were running away alongside the white doctor and British diplomat on the screen, racing toward a small airplane that was already taxiing down the dirt runway.

The white men climb the stairs and lunge inside the plane. Fiennes’ character wants to bring along a little Sudanese child. He can’t bring her, the pilot says, he has to leave her behind. The plane doors close. The little girl keeps running alongside as the plane gains speed, faster and faster.

“What will happen to her?” asks Fiennes, staring out the window at the girl.

“She might make it to a refugee camp,” the doctor replies, “if she’s lucky.”

My hands felt clammy and I struggled to breathe, my throat tightening like a belt. I closed my eyes and listened to my heart, which was raging in my ears. I kept seeing it over and over again, the plane taking off. The white “helpers” flying away to safety. The abandoned villagers left below. The little girl running, running, running. Slaughter. Screams. Smoke.

Later, after the movie ended, I walked out of the icy theater as if in a fog. Kim and I were in a mall in a wealthy suburb just north of Chicago, the stores upscale, the shoppers carrying Urban Outfitters shopping bags. I looked at the beautiful things in the windows as we walked by, the slippery necklaces and soft scarves for sale. The American Apparel and two-story Borders bookstore.

It all felt false, unreal. Like a glittery facade, a covering over the dirt and despair of so many forgotten people. How can both exist? I wondered. These healthy, wealthy people with their blonde highlights and J. Crew cardigans and the people I interviewed mere weeks ago with their stories of villages destroyed, of family members killed? The dissonance between what I was seeing and feeling and remembering rendered me dazed, sloth-like, slow. Even after we exited the mall into the humid September evening, I kept rubbing my arms. I carried the chill with me.



Hyperarousal: an alert jumpiness that may include insomnia, a tendency to be easily startled, a constant fear that danger is nearby, lack of concentration, extreme irritability, or even violent behavior.


My boss in Kenya is loud, short, and Greek. He is so Greek that his name is Pericles, who is like the George Washington of ancient Greece. My boss talks with his hands, using large swinging gestures. His temper is short. His accent is so thick that I have a hard time understanding him. He says “of course” after most statements, but it sounds like ov curse, and he flips his hand toward me in the universal gesture of comradeship, a scooping motion that envelopes me into assumed agreement. We are in the middle of the United Nations High Commissioner for Refugees (UNHCR) headquarters across the road from a refugee camp that is seven miles long. I am twenty-one years old. I want him to like me.

The first week I follow Pericles everywhere, a nodding, agreeing shadow. I sit quietly on a spare chair in a corner of his office while he rummages through his files and whistles or curses to himself in Greek. I am quiet, but my eyes are everywhere, scanning, watching.

I have come to Kakuma refugee camp to intern with the resettlement unit, which is tasked with finding the most “deserving” refugees for a one-way ticket to Australia, Canada, New Zealand, the United States, or one of a handful of Northern European countries. Resettlement is an option for only a small minority of refugees—one percent globally[1]—but hopes run high in Kakuma, Pericles tells me. Large numbers of the Lost Boys of Sudan had been resettled from Kakuma a few years earlier, and the Somali Bantu program was just wrapping up that summer of 2005.

Pericles is relatively new here, too. He was brought onboard in the wake of a major scandal where some UNHCR staff in Nairobi accepted bribes from refugees who sought resettlement.[2] Pericles is under great pressure to make sure there isn’t a whiff of corruption in the Kakuma suboffice.

In a camp of over eighty-five thousand refugees, only the most vulnerable get resettled, he tells me. It was our job to identify them, to make sure they meet the right criteria. We do this by asking the refugees why they crossed the border into Kenya. We ask them to relive their most traumatic moments. This will be your job, he tells me, to ask questions, to make sure no one is bullshitting us.

“You never can trust what they tell you,” he says before I observe my first interview. “They study for these interviews like you Americans study for college entrance exams. There are tutors in the camp who sell the right stories.”

I watch him interviewing a Somali woman. She tells him a horrific story about being raped. My heart twists as I watch her face, the grief knit between her eyebrows, the sorrow trembling on her lips. A trauma survivor in the flesh—right here in front of me! I think. As I wait for the woman to finish speaking so the interpreter can translate her words, my mind drifts to the Human Rights Watch reports I have read and how all those numbers and statistics are made up of real flesh-and-blood people like this woman. This woman right here, someone’s daughter, someone’s sister. And now she is crying; the interpreter hands her a box of tissues.

But then Pericles is shouting at her: “Stop crying. Stop crying! That’s not going to work here.” He is pounding his fists on the desk.

And I almost leap out of my chair. How could he shout at her? She had just told him—a man!—that she had been raped! But I sit on my hands, my lips squeezed into a thin line. After the interview, my boss pulls me aside and says, “You can’t let them manipulate you. They will try anything to win your emotions.”

I am horrified at how he dismisses this woman’s story and emotions as part of some calculated plan to sway him. But after a month of conducting my own interviews, I find myself thinking similar thoughts: are those tears real, or forced? People compliment me; give me large, exaggerated smiles; bow their heads before me; or kiss my hands, and I feel hatred: at them, at myself, at the UNHCR for assigning a college intern this horrible job of sorting vulnerable people. After the initial handshake, I avoid eye contact, preferring the safety of looking directly at the translator. Still, I can feel their nonverbal pleas pulling on me for a good decision, for a chance to break out of the camp, for a reason they have spent all those years stacked up among other refugees like cans in a storage room. I feel their gaze imploring me to pick them, to give them a ticket to a place where the living walk and breathe.

The first few interviews wrung my emotions out like water from a wet rag; I felt utterly depleted and strangely privileged as I typed these traumatic stories onto my laptop. But then I heard another. And another. And soon the stories of rape and torture and underground cells and burning villages bled into each other, runny at the middle, until they felt normal and I felt numb, blunted, unfeeling. Sometimes I would swing manically—one day, I would treat every detail in every story I heard as Gospel truth, welling with empathy and concern, but the next day, I would be suspicious at the honeyed compliments, at the “oh thank you” and the “you are surely helping us.” The naked appeals for help were embarrassing, horrifying. I felt anger that I was even there, a white girl of twenty-one, making decisions about the lives of brown people who were much older.

At the end of the summer, I had conducted over sixty interviews and decided the fates of one hundred twenty refugees. And when I remembered Pericles’s pounding fists, I no longer felt outrage. I understood it. Some days I wished that I could throw my own anger outward instead of sinking underneath its weight.



Avoidance: an attempt to avoid stimuli and triggers that may bring back traumatic memories.


When I left Kakuma for the last time, I boarded a small airplane not unlike the one in The Constant Gardener. The airplane began its gradual warm-up, the engines humming and revving. I looked out the window: red-brown dirt, chain-link fence, a lone Turkana man herding goats. The plane took off, ascending higher and higher, and as the airplane turned, the aerial views of the camp made me catch my breath. All this time, I hadn’t known the true massiveness of the camp across the road, the sheer sprawl of people, the corrugated tin roofs and the white tops of tents, like the spines of opened books, extending for miles. I was leaving when so many others couldn’t.

I landed at O’Hare International Airport and walked back into my life as a college senior, hauling my suitcase filled with clothes and handcrafted trinkets behind me. I unpacked the swishy skirts and modest blouses, still creased from where they had dried on a clothesline, still smelling of Kakuma’s red dust. I did laundry and felt my tongue go lazy in my mouth when my new roommates asked, “So, how was your summer in Africa?” When they found out that I had spent it in a refugee camp, I got a cheap thrill from the awe and admiration they gave me.

If I had taken the Secondary Trauma Stress Scale questionnaire then, I would have rated how frequently certain statements were true for me in the past seven days, statements like “I felt emotionally numb,” “I had little interest in being around others,” and “I was less active than usual.” If I had filled out the questionnaire used by mental health professionals to assess patients, I might have noticed all of the times I circled “very often” and paused for a moment of self-reflection—why do I take naps every afternoon, sometimes sleeping through class? Why have I gained ten pounds in one month? Why do I want to cry whenever someone in my Christian theology class describes God as good?

I went to Kakuma with the best of intentions, but when I came home I couldn’t shake the feeling that I had ingested someone else’s story and trauma for my own gain. Working in a refugee camp was a jewel in my undergraduate resume, highlighting my piety and altruism, my commitment to social justice, my status as “one who helps.” But I was only able to go because of my privilege, because my parents were willing to pay thousands of dollars in airline fees so I could spend the summer doing an unpaid internship. It felt like I had purchased my part in the suffering of vulnerable people.

I didn’t know what to do with all of my guilt or where to ask my questions, so I folded inward. I numbed out.



When trauma shatters our world, our meaning, our stories, are disrupted: Indeed, this attack on our assumptions—or our meaning and stories—is part of what causes trauma. Thus, we look for ways to explain what happened, and we tell our stories as a way to recreate our sense of meaning and identity.

—Carolyn Yoder, Little Book of Trauma Healing


Making meaning: a process to attribute purpose or context to a traumatic life event


My last semester of college, I told a few professors about what I had experienced in Kakuma. I came forward with my heavy stories, my guilt, my questions. It was in the midst of these conversations that one professor asked me whether I knew anything about secondary trauma, about how the high levels of exposure that I experienced could lead to the symptoms I was describing: flashbacks, anger, numbness. In normalizing my symptoms, I began to see myself in my story for what I was: a college intern who was woefully unqualified to decide the fates of vulnerable people half a world away. I was young and unprepared. I was around people who were sick with trauma. And I got a little sick, too.

A year later, I was packing my bags again. This time, I was headed for Cairo, Egypt, where I was enrolled in a graduate program in refugee studies. The wounds from Kakuma still felt fresh, but the worst of my secondary traumatic stress symptoms had faded. In my courses, I learned about the global migration crisis, how woefully understaffed UNHCR and other “helper” organizations are in carrying out their mandate to protect refugees. I learned about the stinginess of resettlement countries, who only take a handful of the world’s stateless people every year. And I learned about narrative therapy, which suggests that once trauma survivors can integrate their traumatic events into a greater context or story some healing may be possible. Making meaning, it was called. To hold the pen of your own story, to retell it, to strive for some understanding.

In contrast, an incoherent narrative of trauma is dangerous for the survivor. To hold only fragments of what happened means being lost in a void with no handholds, no lighthouses beaming you forward. The trauma seems random and you don’t know when it may strike again. You only know the pounding heart and racing adrenaline when you hear a backfiring car that you mistake for gunshots. There is no meaning, no reason, no hope. But if you can find a safe environment in which to recast your trauma as part of a greater story, then you may find solace in knowing you are not isolated in your grief. Grief may take on new meaning, but it never entirely leaves you.

Lately, my three-year-old daughter has been saying, “Please read the Jesus book.” She lugs over the Jesus Storybook Bible, the one that depicts Jesus with a mess of noodley hair, a warm grin, and politically correct olive skin. I love the illustrations and easy language of Bible stories I haven’t visited much since my own Sunday school days. We flip through the pages together and she picks a story. She points to the one about Abraham and Isaac, from the book of Genesis, chapter 22.

I start reading, but even as I voice words about Abraham’s obedience to God in offering up his son, I feel uncomfortable. Do I really want my daughter to believe in a God who would ask someone to kill his son, even if that God intervenes before he can plunge the knife in?

The writer of the Jesus Storybook Bible seems to anticipate the dissonance in these Old Testament stories, which are laced with traumas: forced migration, incest, gory battles. Each story is concluded by some reiteration of how God has a great rescue plan for humanity, pointing toward the Messiah to come. I feel suspicious of these disclaimers in the Jesus Storybook version that tidy up the traumatic stories. These stories, like the ones I heard in Kakuma, make me question God’s goodness.

But I am learning to sit with the gritty dissonance. I know I am not isolated in my grief because the Bible tells me so. Biblical characters all suffer from the torn fabric of this fallen world and their stories encompass the human experience. There is no glossing over humanity; people are ragged and wounded and mean. Yet God loves them, uses them, works through them. It’s a narrative in which the symptoms of my brief secondary trauma don’t feel out of place.

The Bible is the untidy story of my people. It beguiles, it discomforts, it disturbs. But it also promises me God’s goodness and faithfulness; it gives me the Sermon on the Mount and the love-breathed words of Jesus. It’s my story—all of it—and, as Saint Peter tells Jesus, “Lord, you have the words of eternal life. To whom else shall I turn?”

So I keep reading the Bible to my daughter, knowing that the trauma-laced stories belong to us. I want her to know them when she comes face-to-face with the evils of this world. I hope she finds, even when grief blinds her, that she is bound up in the greater narrative arc of God’s people, that she is loved by God and belongs to God, that terrible things may happen for no apparent reason, that faith requires only a mustard seed of trust. I hope she never stops looking for meaning. I hope she finds light out there in the fog.


[1] “A New Beginning in a Third Country,” United Nations High Commissioner for Refugees, 2015,

[2] Emma Jane Kirby, “Crime Did Pay in Kenyan UN Office,” BBC News, January 25, 2002,