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Hiding in plain sight

Vicarious trauma is just part of the job for many lawyers. Time to talk—and do—more about it.

By Natalie Netzel

I hid crumpled on the floor sobbing, thinking I was out of view and alone at the courthouse during the lunch break from a termination of parental rights trial. When the bailiff knocked on the interview room door to hand me a roll of toilet paper, I realized I just might not be okay. 

Before the break, there had been a brutal cross-examination by a merciless county attorney. My client was a woman I wholeheartedly believed to be a loving and capable mother, undeserving of her seemingly inevitable fate. Despite making every objection under the sun, I couldn’t protect her. I tried and I failed. We left the courtroom. With perfect composure, I comforted and consoled my distraught client. I attended to the shell-shocked law student and ensured he was okay. I told them I would meet up with them again in just a minute. A full-blown panic attack followed. I questioned whether I deserved to have a law degree at all, let alone to be a law professor or to enjoy the life I had because of it. After a few minutes I dusted myself off, went for lunch with my client and student, and dove back into the afternoon of trial like nothing had happened. Other than that bailiff, no one had a clue.
When we, as lawyers, work with those in crisis, we knowingly put ourselves in the lives of others in moments where they are experiencing tremendous trauma. An utterly foreseeable and completely normal consequence of this is that we experience the negative effects of vicarious trauma. Despite the prevalence of vicarious trauma and its many adverse effects in our profession, lawyers rarely discuss it openly. When we shy away from these conversations, we make things worse for ourselves and each other. 

Trauma defined

In order to have a meaningful discussion of vicarious trauma in the legal profession, we must ground ourselves in a shared understanding of trauma. On its most basic level, trauma occurs when an event happens to an individual, or group, over which they have no control, with little power to change their circumstances, and which overwhelms their ability to cope. When these events happen without the buffer of supportive connections, or the availability of healing practices, brain chemistry changes in fundamental ways. Understood through this lens, trauma is more than just a past event. Instead, trauma is the imprint that such an experience leaves on the mind, brain, and body.1 Trauma can evoke feelings of fear, terror, helplessness, hopelessness, and despair. These intense feelings are often subjectively experienced as a threat to one’s own survival. For many of our clients, their interaction with the legal system represents an event that overwhelms their ability to cope and over which they have little if any control, and that is traumatic in and of itself.
One cannot discuss trauma without acknowledging the research into Adverse Childhood Experiences (ACEs). This groundbreaking research showed a causal connection between experiencing specific adverse events in childhood and resulting adverse health and social outcomes. Our legal system is full of people who have extensive trauma histories. The original ACEs research shows connection between a greater number of ACEs and “high-risk” behaviors (such as substance use and alcoholism) that predispose individuals to have more interaction with legal systems. More recent research also shows a connection between increased ACE scores and criminal behavior.2
ACEs is a useful tool to understand the types of events that can lead to poor outcomes in several areas. At the same time, it focuses primarily on discrete events that happen in the life of an individual. It is helpful to also consider the role of environment and social systems as we think about trauma. Our legal system is certainly a contributor to adverse community experiences. For example, the destruction of families through our criminal justice, child welfare, and immigration systems oppress communities and diminish their strength. Clinicians refer to a phenomenon known as the “Pair of ACEs”—that is, a trauma double-whammy consisting of both adverse childhood experiences and adverse community experiences. The Pair of Aces model acknowledges that trauma, and healing from trauma, are not purely individual experiences.
 As this article explains and explores vicarious trauma, it is helpful to keep in mind that, just as trauma and healing from trauma are not purely individual experiences, neither are vicarious trauma and healing from vicarious trauma. Models of communal or mutual care, rather than self-care, are essential in creating institutions and systems that truly understand and work to address vicarious trauma. The legal profession needs to adopt an approach to healing from vicarious trauma that recognizes the necessity of mutual care.

What is vicarious trauma?

Trauma affects more than just the individual who experiences it. Professionals who work with individuals with trauma histories often encounter traumatic responses as if they themselves were experiencing the trauma. This is known as vicarious trauma, which refers to “harmful changes that occur in professionals’ views of themselves, others, and the world, as a result of exposure to the graphic and/or traumatic material of their clients.”3 
Vicarious trauma is not just something that might happen to lawyers. When lawyers work with people who have experienced or are experiencing trauma, vicarious trauma is entirely normal. It is well-documented that lawyers are at an increased risk of experiencing vicarious trauma, both because of indirect exposure to the trauma of our clients and our direct work within the systems that often yield unjust results for our clients.4 In addition, unlike many other professions in which vicarious trauma is common, the legal profession lacks concrete and curricular professional education about recognizing and responding to vicarious trauma, which in turn leaves lawyers particularly vulnerable to its negative effects.
Higher levels of vicarious trauma among professionals have been associated with work characteristics such as having a heavy caseload of traumatized clients, a lack of support within the work environment, and a lack of formal trauma training.5 In our overburdened systems, many lawyers have staggering caseloads. We are a profession that discourages vulnerability and encourages a veneer of infallibility. To the extent lawyers have had any formal training on trauma, it is most often in the form of a lunchtime CLE—not the extensive substantive training on trauma we need considering the prevalence of trauma in our work. So it should come as no surprise that lawyers are more at risk to suffer negative consequences of vicarious trauma than mental health practitioners.6 

Experiencing vicarious trauma

Innovative scholarship on “trauma stewardship” identifies 16 warning signs of trauma exposure. Specifically:

• feeling helpless and hopeless; 
• a sense that one can never do enough; 
• hyper-vigilance; 
• diminished creativity; 
• inability to embrace complexity; 
• minimizing; 
• chronic exhaustion or physical ailments; 
• inability to listen or deliberate avoidance; 
• dissociative moments; 
• sense of persecution; 
• guilt; 
• fear; 
• anger and cynicism; 
• inability to empathize/numbness; 
• addictions; and 
• grandiosity (an inflated sense of importance related to one’s work).7

Any and all of these warning signs interfere with an attorney’s ability to do their job well. To be effective as attorneys, we need to address these experiences when they arise in our practice. At the same time, because we want to appear competent, we are under some amount of pressure not to acknowledge the existence of these experiences in our practices. In my own law practice, nonetheless, I have experienced every warning sign on the list—and if I am being honest, there are many I still confront on a weekly basis.

Vicarious trauma can show up in surprising ways, often when you least expect it. After the birth of my daughter, I finally relaxed enough to fall asleep. Despite the warning signs posted in my room, she was in my arms. An hour later, I was awoken by my husband because a social worker was at the door. I panicked and demanded he send her away. He complied, though very confused. Through my sobs, I expressed I didn’t want the social worker to take my baby. I was, irrationally, convinced the social worker was at my door to remove my darling child due to our unsafe sleeping practice. In reality, of course, the social worker was not there to take my baby. She was there for a completely routine post-birth check-in. Even after I calmed down, I worried that the hospital would somehow learn of my intense, irrational emotional response and, in turn, would question my mental health and my parental capacity.

What happened that day? Vicarious trauma. I had been a part of too many child protection cases where social workers removed newborn babies from their mothers’ arms in the hospital. On that day, due to my work, I associated social workers only with the removal of children. This was true even though I had no objective reason to believe my family was at any risk of being separated or that my parental ability would be scrutinized. As a white, upper-middle class, cis-gender woman with her husband present for every moment of labor, delivery, and recovery, I was already cast by social presumption as a “good” mother (a label that others, including the majority of my clients, are unjustly forced to earn). My fears at the hospital that day were grounded not in reality, but in evoking the experiences of my clients in a confusing and surprising way. Our systems discriminate. Vicarious trauma does not.

I know I am not alone in this type of experience. I have heard from a legal aid attorney who panicked when they paid rent a day late, fearing inevitable eviction and homelessness. And a medical malpractice attorney who researches hospitals in advance of vacations because, in the event they would get injured on vacation, they need to make sure there is an acceptable hospital within a few hours’ drive. And a prosecutor who has a hard time letting their children play outside unsupervised because they worry their children could be assaulted or abducted.

These experiences represent more major vicarious trauma responses. Some vicarious trauma responses are more garden-variety. Alongside Miriam Itzkowitz, I have co-led a number of trainings for lawyers on developing resilient practice in the wake of vicarious trauma. We often give lawyers an opportunity to share how vicarious trauma looks for them. Using an online, real-time feedback tool that allows participants to anonymously post answers and see others’ responses on virtual “post-it notes,” we asked groups of attorneys and law students “What does vicarious trauma look like for you?” We also asked participants what gets in the way of their taking care of themselves, and what they need (from themselves or others) when they experience vicarious trauma. 

The responses have been illuminating. Responses range from behavioral concerns (“I wake up in the middle of the night worried about my clients; I don’t return my emails or calls in a timely way; I’m unable to focus; I drink too much; I avoid jail visits.”) to emotional distress (“I have a short fuse with everyone over everything; I feel completely hopeless and like nothing has any meaning; I feel incompetent and inadequate; I feel like I’m going to burst into tears or yell at someone; I cry on my way home from work every day.”). Many respond with rapid-fire one-word responses: fear, anxiety, sadness, hopelessness, avoidance, overeating, exhaustion, headaches, isolation, irritation, rage, dissociating. 
Whenever I speak with lawyers about vicarious trauma, it is abundantly clear that the negative effects are endemic, and we must work together to improve our collective well-being. 

Trauma-informed lawyering

One step that lawyers can take to reduce the negative effects of vicarious trauma is to adopt a trauma-informed approach to their practice. I recommend universal precautions, meaning lawyers should treat every client as if they have a trauma history. While not all clients have experienced trauma, there is little to no harm in treating people well. Most people interact with lawyers because they have an important problem they want solved or they are otherwise voluntarily or involuntarily interacting with the legal system. In most of these experiences, stress runs high, and clients experience heightened emotions. Clients with and without trauma histories will benefit from attorneys who operate with a trauma-informed lens.
While there is no clear definition of “trauma-informed lawyering,” the Substance Abuse and Mental Health Services Administration (SAMHSA) has published more general tenets of trauma-informed care. The six key principles of a trauma-informed approach are: 

• safety; 
• trustworthiness and transparency; 
• peer support; 
• collaboration and mutuality; 
• empowerment; 
• voice and choice; and 
• recognizing cultural, historical, and gender issues.8 

These core principles of trauma-informed care seek to ameliorate the conditions that trauma creates by intentionally ensuring that people have access to the things they didn’t when the trauma occurred. Other disciplines have adopted a trauma-informed approach through the application of these principles, which are also apt for forming a trauma-informed lawyer-client relationship. 

Vicarious resilience

One encouraging concept of trauma research is the idea that the experience of vicarious trauma can also lead to positive outcomes. Vicarious resilience can occur for lawyers when we are able to tap into and connect with the resilience of our clients who demonstrate capacity to overcome adversity. And post-traumatic growth can occur when people experience positive psychological change in the context of, and despite, processing traumatic pain and loss.9 

When we engage in trauma-informed lawyering, it contributes to our client’s capacity to develop resilience. When we work with resilient clients, we are often blessed with the positive effects of vicarious resilience. I have worked with a number of clients who have overcome extreme adversity and found meaning in the face of systems that cause them immense trauma. 

At times when I have felt hopeless and lacked resilience, I have been able to tap into the hope of my clients. A grandmother who did not prevail in a motion for adoptive placement comes to mind. Amid her devastation, her response was “I guess God’s plan for me was to suffer this loss so I can give a voice to the problem so we can change things for other people in my situation.” To date, she has worked as an advocate for families, and graciously encouraged me to share her story to help others. 

I earned her trust because trauma-informed principles were the bedrock of our attorney-client relationship. Her resilience has helped me to move forward, to better serve her, and to better serve others. Vicarious resilience is actually evidence that by being good to others, we can also heal ourselves as individuals and as a legal community.

Trauma and vicarious trauma in legal education

At its core, the legal profession is a helping profession. Many other helping professions take a trauma-informed approach to education, teaching students about trauma and how to minimize the negative effects of vicarious trauma. Historically, legal education has done none of these things. And, while there is an increased awareness about the problems (we have known since the late ‘80s, for example, that law school is associated with a decline in mental health that persists through one’s legal career10), we have only scratched the surface in terms of solutions. From my vantage point as a law professor, I observe how legal education impedes well-being. I believe this is a root cause of our profession’s historical inability to cope with the negative effects of vicarious trauma.

 Historically, legal education has placed little to no emphasis on trauma or vicarious trauma. As a professor of criminal law, every week I assign my students a copious amount of reading that, at its core, is about traumas. Murders, physical and sexual assaults, burglaries—I bombard students and desensitize them. While some students recognize this during the semester, many others, perhaps, read appellate court opinions like just another episode of Law & Order: SVU, detached and removed from the traumatic content. The desensitization sets them up for failure when they begin practicing law and encounter real people experiencing trauma.

While there is movement in the right direction, legal educators do not do a sufficient job integrating trauma stewardship into our curriculum. Conversations around trauma and vicarious trauma need to start in law school, before students are too far down the path of negative consequences. It is my hope that we can normalize the experience of coping with vicarious trauma and minimize some of the shame associated with it. These same conversations are also of the utmost urgency to have with both the bench and the bar. We should not tolerate suffering in shame-induced silence due to a foreseeable hazard of our jobs.

The path forward: Mutual care and vulnerability

We cannot leave the burden of treating vicarious trauma to the individual alone. The legal community is finally having important conversations about self-care. But self-care is not always enough; it is not enough, on its own, to combat the negative effects of vicarious trauma. Merely preaching self-care, in a profession that makes little space for it, makes it a kind of unfunded mandate—one more way lawyers fall short. One more way to fail. We need to move in the direction of “mutual care.” By this I mean that we need to work together to create a profession that allows and respects the time and space needed to take care of oneself. We need to celebrate healthy boundaries and stop the glorification of toughing it out.
 The skills that make us good at being lawyers are, at times, skills that make the rest of our lives hard. Perhaps we want to seem unflappable and impenetrable in the courtroom. Perhaps that serves our clients well. We are excellent issue spotters. We are phenomenal critics. We are taught from day one how to “think like a lawyer.” These incredible skills serve us well. At the same time, to move forward and create a healthier legal community, we must also learn how to “feel like a lawyer.” One primary solution to the issues addressed in this article is among the hardest things for lawyers to do: We need to show vulnerability.
I have been emotionally harmed by the words and actions of judges and other attorneys more than any individual who has caused the harm has realized. I believe the vast majority of the harm was not intended. On my best days, I am able to remind myself that it is not personal. Like me, those judges and attorneys are people working in this legal system with immense amounts of unattended-to vicarious trauma. This framework is helpful in offering grace where my impulse is to give none. It takes a lot of imagination, though, because few people are willing to talk openly about their very real struggles with vicarious trauma. 
And I get it. As I wrote this article, I grappled with the following questions: What am I doing putting this in print? Will I still be taken seriously as a lawyer and law professor if I share my struggles? Are my struggles even real and worth sharing—especially considering that I do not have an extreme trauma history and my vicarious trauma absolutely pales in comparison to the trauma that my clients face?
But ultimately, unexamined vicarious trauma serves no one well—not us and certainly not the people we are hoping to help professionally. When these natural doubts and thoughts pop up for us, we should reframe them by recognizing that attending to vicarious trauma is one kind of professional responsibility. Second, I believe in the power of vulnerability—that insecure feeling we get when we leave our comfort zones and reveal ourselves, which so many of us want from others but have a difficult time giving of ourselves. It is scary to put ourselves out there. It is also necessary to alleviate the shame we feel as lawyers when we experience vicarious trauma.

A hopeful future

The people who have had the greatest impact on me are those who have had the courage to be vulnerable. I’m thinking in particular of attorneys in leadership positions who, instead of making the practice of law look easy, showed me sometimes it is still hard for them. And the colleagues who have the courage to say to me, “this really awful thing happened in court today, and for today I am actually not okay.” My sincere hope is that this article may serve as a catalyst for other attorneys to discuss this normal and foreseeable phenomenon openly. To feel less alone. To not only identify when they need help, but to be brave enough to ask for it.
Once, in a law school classroom, in what I thought would be a brief and simple portion of the seminar, I made reference to the known decline in mental health in law students. I mentioned that law school often demands porous boundaries in terms of one’s time and demands rigid boundaries in terms of portraying perfection and avoiding the appearance of needing help. Sheepishly, one student raised their hand and said, “Thank you for saying that. This is the first time anyone has been transparent with me, and law school is really hard. I have been really struggling.” 

It was as if a floodgate opened. One by one the other students in class chimed in with similar sentiments. Sometimes simply naming an experience can lead to the possibility of change. In that moment I felt hopeful, like I was a part of creating a new kind of lawyer—the kind who can openly admit when they are struggling and gain the benefits of mutual care and support. The kind who is well on their way to being able to cope with the negative effects of vicarious trauma. 

 


NATALIE NETZEL is an assistant professor of law and the co-director of clinics at Mitchell Hamline School of Law, where she is deeply committed to the well-being of her clients, her students, and her colleagues.

Notes

1 Bessel van der Kolk, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma 21 (2014).
2 James A. Reavis, et al., Adverse Childhood Experiences and Adult Criminality: How Long Must We Live Before We Possess Our Own Lives?, 17 Permanente J., Spring 2013, at 44. 
3 Katie Baird & Amanda C. Kracen, Vicarious Traumatization and Secondary Traumatic Stress: A Research Synthesis, 19 Counselling Psych. Q. 181, 181 (2006).
4 Andrew P. Levin & Scott Greisberg, Vicarious Trauma in Attorneys, 24 Pace L. Rev. 245 (2003).
5 Laura J. Schauben & Patricia A. Frazier, Vicarious Trauma: The Effects on Female Counselors of Working with Sexual Violence Survivors, 19 Psych. Women Q. 49 (1995). 
6 Grace Maguire & Mitchell K. Byrne, The Law Is Not as Blind as It Seems: Relative Rates of Vicarious Trauma Among Lawyers and Mental Health Professionals, 24 Psychiatry, Psych., & L. 233, 234–35 (2017).
7 See Laura van Dernoot Lipsky & Connie Burk, Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others 47–113 (Stacy Carlson & Karen Cook eds., 2009).
8 U.S. Dep’t of Health & Hum. Servs. & Substance Abuse & Mental Health Servs. Admin., SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach 9–12 (2014). 
9 I. Rozentsvit, The Post-Traumatic Growth: The Wisdom of the Mind, Its Clinical and Neuropsychoanalytic Vicissitudes, 33 Eur. Psychiatry S568 (2016).
10 G. Andrew H. Benjamin, et al., The Role of Legal Education in Producing Psychological Distress Among Law Students and Lawyers 11 Am. Bar Found. Rsch. J. 225 (1986). 

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