KILEY TILBY AND JAMES HOLBROOK
This article discusses secondary traumatic stress (STS) among lawyers and judges, describing what it is, risk factors, coping measures, and what steps legal and professional education should take to both mitigate the symptoms of STS and increase our resilience in dealing with it.
Many people have experienced trauma or know family members or friends who have suffered from a single traumatic event such as a natural disaster, the sudden death of a loved one, or violent crimes such as rape or murder. Trauma also includes responses to chronic or repetitive experiences such as child and vulnerable-adult abuse and neglect and domestic violence. Lawyers' clients in many other kinds of disputes, as well as parties in court, also are often traumatized by conflict, expense, uncertainty, and lack of control of both the legal process and the ultimate outcome of a dispute or case.
To understand secondary trauma stress, we need to understand trauma. In 1980, the 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, included fear-based Post Traumatic Stress Disorder (PTSD) as a recognized condition for the first time, the DSM-III states that PTSD occurs when "a person experienced, witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of others; and the person's response involved intense fear, helplessness or horror."
Guilt-based PTSD occurs when a person feels extreme guilt for surviving when others did not, or feels like he or she should have done more to prevent an adverse incident from occurring to another, or feels he or she violated his or her own moral code in doing or gaffing to do something, or feels betrayed by a person or institution he implicitly trusted. Brett T. Litz et. al., Moral Injury and Moral Repair in War Veterans: A Preliminary Model and Intervention Strategy, 29 Clinical Psychology Review 695, 695-706 (2009). See also Tony Dokoupil, A New Theory of PTSD and Veterans: Moral Injury, Newsweek (Dec. 3, 2012), http://www.newsweek.com/new-theory-ptsd-and-veterans-moral-injury-63539.
The DSM-III identifies symptoms of PTSD as: fear, helplessness, horror, anger, rage, sleep disturbance, alterations in memory, irritability, difficulty concentrating, re-experiencing traumatic events, avoidance or numbing to avoid thoughts and feelings connected with the traumatic events, detachment, and estrangement from others. The latest edition of the DSM has added...