Bradey, Emily --- "Understanding vicarious trauma and working safely in the law" [2022] PrecedentAULA 62; (2022) 173 Precedent 14

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UNDERSTANDING VICARIOUS TRAUMA AND WORKING SAFELY IN THE LAW

By Robyn Bradey

This article describes vicarious trauma from a brain-based perspective. It discusses the risks for legal practitioners and shares some practical ideas and models for safe practice.

WHAT IS VICARIOUS TRAUMA?

Vicarious trauma (VT) is the trauma you get from other people’s trauma. It is essentially post-traumatic stress disorder (PTSD) but about other people’s stories. It happens because the brain cannot make the distinction between a story, a memory, and a real-time event. It reacts to distressing details as if the distress is happening now and to us. Because we have developed empathy, via our mirror neurons and other mechanisms, other people’s distress, quite rightly, distresses us. It is part of the fright/fight/flight mechanism largely run by the fear centre in the brain, which makes us check if we are in any kind of danger and then act to get to safety if we can. It is important to note that this is an involuntary and unconscious response.

Once the trauma response is triggered, cortisol is released by your brain into your system to make more sugar available for energy, your heart rate goes up, and adrenalin and other hypertensive hormones are released into your body. And you do not stop to think. All of this makes perfect sense if the threat is a snake or a lion and will last generally for a brief period, until you are safe (or not)!

However, modern humans, because of our larger cortex, have developed language, which gives us the ability to ruminate, remember and keep telling the story. We also anticipate future events and so worry about what could happen next. Lawyers are trained to anticipate what could go wrong. Ruminating and anticipating are useful to a point. Humans have the unique capacity to think through what just happened and think of a way to avoid or anticipate it next time. The trouble is we have not yet become very good at turning the ruminating off. According to Robert Sapolsky, a world-leading expert on the physiology of stress, this has turned our useful, short-term response into an unhelpful, long-term state of mind.^[1] In other words, we are the only animal on the planet that can think our way into a fright/flight/fight response and stay there.

Of course, people working in justice settings^[2] are not just hearing one sad story or dealing with one distressed person. You are dealing with one after the other, day in, day out, year in, year out. And here’s the kicker: the more dedicated you are and the more empathy you have, the higher the risk. If you have perfectionist tendencies^[3] as well, this exacerbates the problem, because you keep overthinking things and are fearful of making mistakes. One final (not so) great piece of news: this kind of stress accumulates, so the longer you have been working like this, the greater the risk. And the more isolated or unsupported you are, the worse vicarious trauma gets.

RISKS AND SYMPTOMS

Physical risks

The risk of VT is not just psychological; some physical risks include diabetes (from all that sugar chugging around your system) and problems with the heart and other major organs, like the kidneys, pancreas, and gut. Headaches, teeth grinding, arthritis and other inflammatory conditions are all associated with trauma, as are sleep disorders – which lead to a whole pack of problems on their own.

Psychological symptoms

The psychological symptoms include cynicism and loss of empathy (which undermine professional and personal relationships), anxiety, depression, underreacting to important things and overreacting to trivial things, avoidance, intrusions, nightmares, and anger. Sometimes people reach for drugs, booze, sex, or gambling to deal with these symptoms and that, of course, only compounds the problem. Efficiency and clear decision making are hard to maintain in this state of mind for all the reasons outlined above. So, corners are cut, work is late, conflict arises at work and at home, and you are too tired and defeated to deal with any of it. Sound familiar?

Finally, your world view can change generally, it gets grimmer. Does anyone reading this, like me, play ‘spot the perpetrator’ wherever they go? All of this can lead to the practitioner being alone in their own head, which is full of rubbish and rumination. Mental illness and suicide rates among legal practitioners have been excessively high for many years now,^[4] indicating that the legal workplace is not currently safe.

WHAT CAN WE DO TO RESPOND TO THE RISK?

Psychology professor Charles Figley^[5] the first to study VT in the modern era, makes the following suggestions.

Finding ways to keep practitioners connected to the bigger picture helps. It helps to consciously be proud of what you do and realise it is meaningful work. It helps to connect with people who understand that and can remind you. It is also helpful, when reflecting on the work, to call to mind things done well and take a strengths-based approach. Psychologist Martin Seligman^[6] says that focusing on the skills and the importance of doing a difficult job well can turn post-traumatic stress into post-traumatic growth.

So, things like pro-bono work, engaging in law reform, and meeting with others and hearing what they are doing both personally and professionally, are all good antidotes. Training, learning, and teaching are too. Writing about the work and writing policy also help. You will notice that these are all left-brain activities. The work of Iain McGilchrist suggests that taking right-brain distress and putting it through a left-brain filter of words calms the right brain down and takes the distress out of the story.^[7] A lot of therapy for PTSD works the same way. Psychiatry professor Daniel Siegel, who has done more than most to bring the knowledge of neuroscience to the treatment of trauma, says ‘if you name it, you can tame it’.^[8]

Next, supportive relationships are crucial. Keep the workplace safe – bullying is not to be tolerated. VT can turn a practitioner into an unintentional bully and make them vulnerable to an intentional one. If you work alone, find some peers you can meet with regularly. A mentor or coach is also helpful. Mentoring programs in firms, government departments and in-house should be put in place. Proactive wellbeing sessions modelled on the clinical supervision used to support social workers and psychologists are now being offered in many legal workplaces and courts. These involve practitioners meeting regularly, either in a group or individually, with a clinician to reflect on how they are coping with the work and develop proactive strategies for working safely. Employee assistance programs and counselling services for lawyers and those who work with them also have a role to play here. Make sure these sessions always end with strategies and action plans. Venting in and of itself is not helpful!

The risk of VT goes up when workload increases. Hours need to be watched so that you are not working dreadfully long days. Billable hours need to be questioned and, in my view, ditched.^[9] Job descriptions need to accurately reflect the work and responsibilities. Performance review needs to be supportive. Training needs to be regular and relevant.

Finally, a break from certain kinds of matters can help people to recharge and come back fresh. Holidays and leave need to be flexible and judiciously used.

Personal wellbeing strategies

First, consciously approach the work and only deal with distressing content and distressed people when in role and on task, using your technical skills. Accidental exposure to the material is the greatest risk. Accidental exposure can happen at work by listening to someone else talk about a case you are not working on. It can happen flipping through a file with or without a stated aim as to what you want to extract from it. It can also happen by watching movies or TV on traumatic subjects. Learning mindfulness techniques to notice what you are focusing on and using those techniques to redirect your mind from triggers and ruminations is incredibly useful. Body posture should be upright, with a straight back; standing desks are a great idea.

This next list of factors that are important for personal wellbeing is suggested by Candace Pert,^[10] who was a leading neuroscientist and pharmacologist:

• sleep (eight hours a night).

• healthy diet.

• exercise.

• sweating.

• stretching.

• mindfulness techniques; and

• having fun and socialising with nice, safe people.

Seligman would add gratitude practices and Figley would add holidays every year: four weeks minimum.

FINALLY

The work you do is incredibly important. Thank you for undertaking it but now make sure that working safely becomes a part of how you work, not an additional element. Go forth, support each other, take care of yourself and flourish.

RECOMMENDED RESOURCES

Wellbeing at the Bar, Vicarious trauma <https://www.wellbeingatthebar.org.uk/problems/vicarious-trauma/>.

R Bradey, The Resilient Lawyer: A Manual for Staying Well @ Work, 2nd ed, Lawcover, 2020 <http://www.lawcover.com.au/personal-wellbeing/> .

R Wax, A Mindfulness Guide for the Frazzled, Penguin Books Limited, 2016 <www.rubywax.net/books>.

Robyn Bradey is a Mental Health Accredited Social Worker with 43 years’ experience, 32 of those in private practice. She offers professional supervision to a wide range of health, welfare, and legal workers. She has been a counsellor, specialising in loss, grief, trauma, work-related stress and injury. Since 2008, she has specialised in training, consulting and supporting members of the legal profession in Australia, New Zealand, the Pan Pacific, and the UK.

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^[1] R Sapolsky, Why Zebras Don’t Get Ulcers, 2nd ed, WH Freeman, 1998.

^[2] For a comprehensive study on stress in the legal profession see the Bar Council UK/Positive, Wellbeing at the Bar: A Resilience Framework Assessment (RFA) (Report, April 2015) <barcouncil.org.uk>.

^[3] T Ben-Shahar, The Pursuit of Perfect: Stop Chasing Perfection and Discover the True Path to Lasting Happiness, McGraw-Hill, 2009, is a great resource to help transform you into a ‘functional perfectionist’ or an ‘optimilast’ as he calls it.

^[4] See Minds Count Foundation, Research: Australian Research, Reports, Studies <https://mindscount.org/research/#>.

^[5] CR Figley (ed), Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized, Brunner/Mazel, 1995.

^[6] MEP Seligman, Flourish: A New Understanding of Happiness and Well-being – and how to Achieve Them, 1st ed, Nicholas Brealey Publishing, 2011.

^[7] I McGilchrist, The Master and His Emissary: The Divided Brain and the Making of the Western World, Yale University Press, 2009.

^[8] Dan Siegel: Name it to Tame it, YouTube (2014) <https://www.youtube.com/watch?v=ZcDLzppD4Jc>; also see D Siegel, Mindsight: Change Your Brain and Your Life, Scribe Publications, 2009.

^[9] Beaumont and Beaumont, How Billable Hours Are Affecting Firms and Lawyers (2016) <https://www.beaumontandbeaumont.com.au/news-and-events/news/article/?id=how-billable-hours-are-affecting-firms-and-lawyers>.

^[10] CB Pert and N Marriott, Everything You Need to Know to Feel Good, Hay House, 2006.