Because families are systems of interconnected and interrelated individuals, what happens to one family member impacts others. Thus, traumatic exposure always affects couples and families, irrespective of who was directly exposed. For example, whether the whole family lives in disaster or war zone, or one or some family members were involved in a road accident, all members are affected by association (secondary traumatization). Effects on individual family members who were not directly exposed to the traumatic event but are experiencing it second hand were discussed in Chapter 4 . This chapter focuses on the impact on relational systems, specifically the couple and the family as a whole.