Nelson Goff and Smith (2005) in a qualitative study examined how trauma affects couples and introduced The Couple Adaptation to Traumatic Stress (CATS) Model, which emphasized the reciprocal nature of primary and secondary trauma symptoms. The theory of secondary trauma suggests that individuals who are emotionally close with those who survived past trauma develop stress symptoms that mirror the symptoms of the survivor (as cited in Nelson Goff & Smith, 2005).

According to Nelson Goff and Smith, not only can the trauma symptoms in a primary trauma survivor be transmitted to his or her partner, but they can also be exacerbated by the symptoms of a secondary trauma survivor. The authors suggested that therapists be attentive to consider predisposing factors and resources when treating trauma survivors and their spouses (as cited in Nelson Goff and Smith, 2005).

For example, individual characteristics or previous unresolved traumas can affect survivors’ coping skills, thus, making them more vulnerable to other traumatic stresses. The presence or absence of resources, such as social support, health and employment, can have either positive or negative effect on an individual or a couple, dealing with the aftermath of trauma.

According to the CATS Model, predisposing factors, resources, an level of functioning can all affect a couple’s adjustment to a traumatic event. The authors hypothesized that a traumatic event could disrupt a couple’s functioning, leading to relationship dissatisfaction, problems with intimacy and communication.

Nelson Goff and Smith (2005) provided literature review of research studies that demonstrated that both trauma survivors and their partners (secondary trauma survivors), although not directly exposed to trauma, nevertheless experienced lower marital satisfaction, interpersonal difficulties, lack of intimacy and higher individual stress symptoms than couples where neither of the partners had a history of trauma or were diagnosed with post traumatic stress disorder (PTSD).

The authors suggested that partners of trauma survivors become secondary survivors of trauma not through exposure to a traumatic event but through the internalization of the effects of trauma and identification with a survivor (as cited in
Nelson & Wampler, 2000).