Lived experiences of compassion, guilt, and forgiveness of a secondary survivor with symptoms of Post Traumatic Stress Disorder (PTSD)

Trauma extends beyond the primary survivor to those closely connected, yet the experiences of secondary survivors remain underexplored. This single case study examined how a secondary survivor with symptoms of posttraumatic stress disorder (PTSD) experiences and interprets compassion, guilt, and forgiveness following indirect exposure to a sibling's sexual abuse. Using a phenomenological single-case design, one participant (male, 23) whose younger sister experienced sexual abuse by their stepbrother was purposively selected after screening positive for moderate-to-severe PTSD symptoms on the Impact of Event Scale—Revised (IES-R mean = 3.14). Data were collected through semi-structured interviews and standardized measures of compassion, guilt, and forgiveness, then analyzed using thematic analysis. Three themes emerged: (1) emotional flexibility in compassion, expressed through seven regulation strategies including emotional expression, seeking support, positive appraisal, and worry; (2) multidimensional manifestation of distress related to guilt, encompassing behavioral withdrawal, cognitive self-blame and rumination, emotional self-resentment, and somatic symptoms; and (3) gradual, non-linear processing of forgiveness across uncovering, decision, work, and deepening phases. Findings suggest that compassion may function as both a resource and a source of strain, guilt remains a persistent and embodied distress, and forgiveness unfolds conditionally and incrementally. This case illuminates the complex emotional landscape of secondary trauma survivorship and underscores the need for trauma-informed interventions that address somatic concerns, support emotional regulation, and respect the gradual nature of forgiveness.