Many lawyers are in denial about the toll traumatic cases can take on them and their work. Time to drop the stiff upper lip, says Lee Moore
It was four decades ago, at Reading Crown Court, when the unavoidable impact of secondary traumatic stress (STS) – a condition that is little acknowledged within the legal profession – first struck me. Sitting and listening to evidence of severe vaginal injuries and the mutilation and murder of a baby by one of her parents was harrowing. Fleeing the court in distress would not have assisted my advancement from pupil to tenant at the criminal and family law chambers where I worked, so I demonstrated ‘professionalism’, instead. I kept a stiff upper lip and remained silent about how I felt. As a result, I went on to develop secondary traumatic stress disorder (STSD)-, a condition with the same symptoms as post-traumatic stress disorder. (PTSD)
As traumatic stress only became the subject of study in the 1980s, I was unaware that I was being traumatised by the nature of the cases I was exposed to. I dealt with the impact of repeatedly acting in sexual abuse cases by comforting myself with carbohydrates, overworking, plus some stiff drinks after leaving chambers at night. Despite being an ineffective remedy to ward off the repetitive thoughts and intrusive imagery I was experiencing, I continued self-medicating in this way until a surfeit of back-to-back child abuse cases, activated another symptom of STS, that of leaving the profession prematurely. I fled to the emotional desert of maritime law.
I remained there for 24 years until a constellation of circumstances compelled me to establish the Association of Child Abuse Lawyers. (ACAL). As first coordinator and president for 10 years, I received many disclosures by letter, phone and email from people alleging sexual violence and abuse in childhood. STS bit again. Unable to sleep properly, suffering frequent virus infections from a reduced immune system, appetite disorders and more, I sensed that work was badly affecting my health and began research.
I discovered Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized, edited by Charles R Figley, PhD (Brunner/Mazel 1995). This book enabled me to understand for the first time that I was being traumatised by my work. Unwittingly, I had allowed Secondary Traumatic Stress to develop into Secondary Traumatic Stress Disorder.
I learned that STS is the unavoidable, natural stress that occurs when working on traumatic cases or with troubled clients. Previously, the focus had been on individuals who had directly experienced a traumatic event, not on the people who worked with it indirectly. I realised there was nothing to feel ashamed about. What I was suffering was a harmful and disruptive by-product of my work.
I took immediate steps to recover. I also created a self-care plan, which I continue to follow. This enables me to identify, manage and release the symptoms of STS when they arise and prevent them from becoming the disorder. It is essential I do so, for STS impairs work performance, too. Symptoms include: loss of concentration, mistakes, lack of judgment, irritability, staff conflicts, being late for appointments, a reduction in the quality of work, cynicism, numbness of feeling and more, with potential harm and disrespect to clients, such as pathologising them or labelling them negatively. One solicitor telephoned me and began our discussion with the words: ‘I’ve got this alcoholic sitting here in front of me.’
Judges and lawyers working in family, criminal, personal injury and immigration law or working on inquests are particularly vulnerable to secondary traumatisation.
There are many reasons why secondary trauma is an under-recognised issue within the legal profession. The first is shame, with its toxic twin, fear. Individuals are reluctant to admit that their work is affecting them for fear of being deemed unprofessional. One professional who ‘confessed’ to feeling emotionally stressed by her work, was told by a colleague ‘if you can’t stand the heat, you had better get out of the kitchen!’
Furthermore, admissions of feeling traumatised could lead to a loss of instructions and, in consequence, income. Some lawyers, in acknowledging they have a problem, may discover they are in breach of their professional conduct rules by accepting cases when unfit to do so.
Breaking through the denial that exists around secondary trauma would be, as I have been told, ‘opening a can of worms’. How fit are some lawyers and judges to take and sit on cases? Are there cases where vulnerable, stressed and traumatised lawyers and judges may have been, or are still are, acting for or presiding over vulnerable, stressed and traumatised clients with negative consequences?
Shattering the silence would also prove expensive to professional bodies and employers, in a time of financial constraint. There would be extra costs for training, the need to perform risk assessments; putting support structures and new resources in place.
The terminology is also unhelpful. Secondary traumatic stress and secondary traumatic stress disorder are not easy words to identify with and own, if one is a lawyer. The reality is daunting: to admit experiencing the same symptoms as some clients. Alternative terms for both conditions are respectively, compassion stress and compassion fatigue. They sound and feel more professionally acceptable. A change of usage may encourage people to speak out.
Silence may also be due to some lawyers not realising the impact of cases on them. There is a vacuum in legal education regarding trauma transmission.
People need training so they can: recognise who is more vulnerable and why; perform a self-diagnosis for symptoms; and be given tools to process them, so they are no longer disruptive to work performance or impair health.
The appears to be little leadership from the Law Society, Bar Council and the Judicial College regarding making new policy which tackles secondary traumatisation head on. Guidance is needed regarding setting boundaries around the nature of cases individuals are exposed to and the time spent in dealing with them. Codes of practice need to include compliance with a self-care plan. Peer group support needs to be established. It worked well at ACAL. Above all, we need to change perceptions around secondary traumatisation and give people permission to speak about the impact of distressing cases on them. It is unprofessional not to do so. It is time to evolve professionalism.
The task of a lawyer is a commitment to truth. On the issue of secondary trauma, we are currently burying it.
This week is Mental Health Awareness Week – more here. Lee Moore provides training which deals with STS and STSD. (www.leemooreco.com/professional-resilience-and-well-being)