Lawyers feel the stress of dealing with horrific legal cases

Abigail Hansen discusses how to help solicitors who suffer from work-related trauma

'I gave up criminal practice for a number of years because I felt I was losing touch with my self, my family, everything.

Then 12 months ago I joined a defence team for the International Criminal Tribunal for Rwanda.

During our first mission in Rwanda, we were interviewing a genocide survivor, and I suddenly had to leave her hut.

I stood in the corn and cried; I was crying for every miserable thing I'd ever heard, every forensic photo I'd ever seen.' So said Jrme (name changed), a lawyer.

The International Criminal Court is intended to punish crimes that by definition involve horrendous events that often surpass all comprehension.

In the past decade, attention has increasingly turned to identifying the impact of working with those who have been exposed to trauma, whether in a war or not.

It is generally accepted that providing professional assistance to traumatised persons can be dangerous to the listener.

The psychological impact of working with traumatised clients has been called variously co-victimisation, emotional contagion, secondary trauma, compassion fatigue or vicarious trauma.

Of these, vicarious trauma is the most disturbing.

The term was first used in 1990 by Dr Lisa McCann and Dr Laurie Pearlman, who suggested that continued exposure to persons actively experiencing trauma could result in permanent shifts in the professional's personal perception and experience of life.

They said: 'It is the process through which the [professional's] inner experience is negatively transformed through empathic engagement with clients' trauma material combined with a commitment or sense of responsibility to help.'

While vicarious trauma overlaps to some degree with 'burnout', which usually refers to a response to a work situation which is too demanding, stressful, or unrewarding, the effects of vicarious trauma touch the very sense of self.

Dr Pearlman emphasises that a 'spiritual disruption' is the hallmark of the phenomenon, leading to a sense of meaninglessness and cynicism.

These shifts in perception can result in a number of behavioural changes, including tuning out and emotional numbing, becoming judgemental, cynical or angry, losing hope or a sense of meaning, developing rescue fantasies, becoming over-involved, taking on others' problems, developing overly rigid boundaries, feeling heightened protectiveness towards loved ones, or avoiding social and work contact.

The professional may experience distressing emotions, intrusive imagery or recurring memories, sleeping problems, addictive or compulsive behaviours (including alcohol and substance abuse), relationship disturbances, or depression.

The risks may be increased for those who have had prior trauma or are relatively inexperienced, or where they have current life stress factors, an unsupportive work environment, or a high volume of trauma-related work.

Dr Pearlman, who works with the Traumatic Stress Institute in the US, emphasises that lawyers are at risk: 'Lawyers and judges hear terrible stuff and what is harder is that the "contract" between lawyer and client is to shape the information towards a specific non-therapeutic goal.

But where did lawyers learn about how to deal with their own feelings?'

Barry Pritchard, founder of the lawyers' support and advisory service LawCare, says it has dealt with cases that could be categorised as coming within the clinical definition of vicarious trauma.

He considers that 'at risk' areas of law include child protection, family law in general, and criminal prosecution and defence.

'Approximately 70% of our cases are stress-related, and it is worthy of note that two-thirds of these come from those qualified five years or less,' he says.

However, younger lawyers, and women in general, are perhaps more likely to accept that they are experiencing such stress, and seek appropriate assistance.

Vicarious trauma is usually associated with those who work with victims, Dr Pearlman stresses the particular risks for criminal defence lawyers.

'I think perpetrator defence work is probably even harder, since society takes such a dim view of offenders, there is a kind of contagion.

It's a distancing not a supportive response.'

Mr Pritchard has seen much evidence of secondary manifesta-tions of work-related trauma, including depression, alcohol misuse and abuse, difficulties with colleagues and family and significant work/home imbalances, and is concerned by the potential impact on both lawyer and client.

'This can range from time off work, loss of confidence and self respect/worth, or even considering a complete change of career...

inevitably there is an increased risk of negligence or inadequate professional service.'

Dr Pearlman goes further, stating that unaddressed traumatism in a lawyer can lead to a loss of judgement and boundaries, resulting for example in seeking intimacy with the client, or even to a re-traumatism of the client through an avoidance or denial of the client's traumatic experience.

Work-based trauma could also provide the basis of occupational health litigation against employers, which, ironically, could provide the impetus for change.

Dr Pearlman emphasises a holistic approach to prevention and treatment.

'The key words are to be open and aware.

It's an occupational hazard and an inevitable part of the work, but we can protect ourselves better if we stay connected to our feelings and to people who care about us, or if we can balance trauma work with other kinds of work.

It helps to find ways to be creative, to reconnect with beauty and nature and your own body - we can so easily go up into our heads.

Dance, movement, yoga, and for some people spiritual activity, can all help find a balance.'

LINKS: www.lawcare.org.uk

Abigail Hansen is a dual-qualified English and Australian criminal solicitor and a human rights consultant, living in Paris.

She is currently working as a member of a defence team before the International Criminal Tribunal for Rwanda