Willa Gelvick, Santa Clara School of Law ’10

 

For many years, it was known that therapists and other mental health providers who work with victims of human rights abuses are affected in multiple ways by their clients’ stories of torture and persecution. Increasingly, it is becoming clear that all professionals who work with trauma victims—including lawyers, judges, court staff, and interpreters—can suffer from forms of secondary trauma and other psychological conditions that may negatively affect in their relationship to the injured person and their ability to perform the functions associated with their position.^[1]

 

Secondary Trauma & Related Conditions

 

The phenomenon of secondary trauma encapsulates several discrete conditions. Secondary traumatic stress is one form of secondary trauma experienced by professionals working with victims of trauma. Secondary traumatic stress can cause symptoms similar to the symptoms of Post Traumatic Stress Disorder (PTSD), which may include: feelings of fear, hopelessness, horror, anger, and rage; sleep disturbances; changes in memory; difficulty concentrating; and estrangement and detachment from others and from daily life. Thoughts about a client’s experiences may begin to intrude on a professional’s daily life.^[2] Professionals may also have nightmares about their clients’ experiences or avoid things that remind them of those experiences. People who work with victims of trauma may feel alternatively numb or experience hyper-arousal—a feeling of being in danger at any moment.^[3] Another form of secondary trauma is vicarious traumatization. People working with victims of trauma may internalize their client’s trauma, which can change their perception of the world and their ability to trust others.^[4] 

Secondary trauma can interfere with professionals’ relationships with their clients, to the detriment of the client. For example, some attorneys working with victims of trauma respond to their clients’ stories by distancing themselves emotionally from their clients. This can damage the attorney-client relationship and the client’s ability to trust the attorney, who may appear insensitive to the client’s stories of torture or abuse.^[5] Secondary trauma can affect a professional’s ability to make decisions and can lead to inhibited listening.^[6]

 

Secondary trauma can also render it difficult to maintain appropriate boundaries. Attorneys working with victims of trauma often experience difficulty defining their role in relation to their clients. For example, when interviewed for a study on secondary trauma in the legal profession, attorneys working with victims of domestic violence stated that they often became overextended with their clients by helping them with problems other than domestic violence issues.^[7] Attorneys doing asylum work have reported that they have difficulty knowing how to respond to their clients’ stories of torture and persecution. A number of asylum attorneys have stated that they did not know how to strike a balance between being professional and offering basic sympathy.^[8]

 

In addition to secondary trauma, many people working with victims of trauma may begin to feel "burnout." Burnout is often caused by stress and loss of idealism. Professionals experiencing burnout may suffer from headaches, depression, fatigue, and trouble sleeping. They may also have a negative perception of themselves and their work. Burnout may lead to aggression, irritability, substance abuse, and poor job performance.^[9]

 

Secondary Trauma in Lawyers & the Legal System

 

In Vicarious Trauma in Attorneys—the first study conducted on secondary trauma in the legal profession—Andrew P. Levin, MD, and Scott Greisberg, MA, surveyed attorneys working in family law, domestic violence, and legal aid criminal defense as well as mental health providers and social service providers working with the mentally ill. Levin and Greisberg found that attorneys had higher rates of secondary trauma than the other professionals surveyed. Levin and Greisberg attributed this discrepancy partially to the higher case loads taken on by the attorneys and partially to the lack of training given to the attorneys on how to work with traumatized clients.^[10] In Even Heroes Need to Talk: Psycho-Legal Soft Spots in the Field of Asylum Lawyering, Tehila Sagy identified the lack of emotional support given to attorneys working with traumatized clients as a major factor causing secondary trauma and burnout. Many attorneys are trained to separate their emotions from their work. Attorneys often work in environments in which becoming emotional about a case is equated with being unprofessional. This means that many attorneys are left to work through their responses to their client’s experiences without support from their colleagues.

 

In Stress and Coping in Traumatized Interpreters: A Pilot Study of Refugee Interpreters Working for a Humanitarian Organization Helle Holmgren et al. identified secondary trauma in Kosovo-Albanian interpreters working with victims of trauma through the Danish Red Cross. Most of the interpreters had fled Serbian persecution in Kosovo. The secondary trauma experienced by the interpreters was intensified, because their client’s stories often caused them to worry about family members still in Kosovo or reminded them of their own traumatic experiences. This situation was compounded by the fact that the interpreters were given very little recognition and respect for their work at the Danish Red Cross.

 

Individuals studying secondary trauma agree that it is important that professionals working with victims of trauma recognize and acknowledge the existence of symptoms associated with secondary trauma. In addition, they should be trained in methods for coping with traumatized clients and their own reactions thereto. For example, Holmgren et al. suggest that interpreters be given supervision by a psychologist experienced in psychotraumatology, so that they can better understand their clients and their own reactions to trauma.^[11] Sagy suggests that training attorneys in how to work with victims of trauma and establishing support systems in which attorneys can talk about their emotions in response to their work would help minimize secondary trauma and burnout.^[12] Sagy writes that organizations working with traumatized clients need to set up institutionalized support systems for their workers to help minimize secondary trauma and burnout. Organizations such as the United Nations, the International Criminal Court, and Human Rights Watch all provide their employees with support groups and self-help manuals to enable them to deal with their responses to their work. Sagy writes that this legitimization of secondary trauma helps ensure that individuals recognize the symptoms of secondary trauma and that they need not deal with their feelings alone.^[13]

 

The Institute for the Study of Psychosocial Trauma (ISPT) provides psychological services to survivors of war, torture, and repression. In addition ISPT provides training on secondary trauma to primary responders, clinicians, and members of the legal profession, including interpreters. In trainings for professionals and students working with victims of trauma, ISPT approaches the use of self care or treatment for secondary trauma as an issue of ethical responsibility.^[14]

 

ISPT’s educational model on secondary trauma is focused on the personal motivations that lead professionals to work with traumatized clients and the connection of those motivations to "purpose, meaning, world view, and the spiritual dimensions of trauma."^[15] ISPT aims to encourage a "mentality of prevention" through lectures, group work, and small "process sessions" on the impact that secondary trauma can have on professionals. They also teach techniques for self care. Because a history of primary trauma can make professionals more vulnerable to secondary trauma, ISPT also provides an opportunity for professionals to discuss their own past traumatic experiences. In A Clinical Perspective: Secondary Trauma in the Legal Professions, an article to be published July/August 2008, ISPT discusses secondary trauma and gives a step-by-step description of the subjects discussed in their trainings.^[16]

 

Secondary Trauma Training at Santa Clara University School of Law

 

ISPT collaborated with Professor Lynnette Parker, a board member of the Institute for Redress and Recovery, to create a training program for law students representing victims of trauma at the Katherine and George Alexander Community Law Center (KGALC) at Santa Clara University. The class on trauma and the law offered by KGALC teaches law students techniques for effectively representing victims of trauma, and also gives law students information about secondary trauma and self care. KGALC teaches seven main skills to enable law students to effectively represent traumatized clients:

 

(1) techniques for interviewing clients and preparing cases with minimal retraumatization of clients,

(2) methods for working with emotional clients,

(3) ways to keep a client focused who is avoiding talking about a traumatic experience,

(4) techniques to help clients remember the details of traumatic events,

(5) strategies for working with clients who miss appointments or show up late,

(6) ways to build trust, and 

(7) methods for defining the role of the legal advocate.

 

These skills help students deal with a number of the problems experienced by lawyers working with traumatized clients, from difficulty interacting with emotional clients, to difficulties defining their role in their client’s lives.^[17]

 

Conclusion

 

Secondary trauma is a problem prevalent among people working with victims of trauma, but it is a problem that receives very little recognition. Training in techniques for working with victims of trauma, coupled with information about secondary trauma and self care, can help professionals avoid and treat secondary trauma and burnout. When professionals receive training and support, they are more equipped to help the victims of trauma with whom they work.

 

 

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^[1] Institute for the Study of Psychosocial Trauma, A Clinical Perspective: Secondary Trauma in the Legal Professions (forthcoming July/August 2008) (hereinafter "ISPT").

^[2] Id.

^[3] Tehila Sagy, Even Heroes Need to Talk: Psycho-Legal Soft Spots in the Field of Asylum Lawyering 21, no. 71 (The Berkeley Electronic Press, Espresso Preparing Series Paper No. 1014, 2006) available at http://law.bepress.com/expresso/eps/1014/.

^[4] Andrew P. Levin & Scott Greisberg, Vicarious Trauma in Attorneys, 24 Pace L. Rev. 245, 246 (2003)

^[5] Sagy, supra, at 49.

^[6] ISPT, supra.

^[7] Levin & Greisberg, supra at 251.

^[8] Sagy, supra, at43. 

^[9] Levin & Greisberg, supra at 250.

^[10] Id. at 251.

^[11] Helle Holmgren et al., Stress and Coping in Traumatized Interpreters: A Pilot Study of Refugee Interpreters Working for a Humanitarian Organization, 1(3) Intervention 22-27 (2003).

^[12] Sagy, supra,at 57-65.

^[13] Id. at 61-65.

^[14] ISPT, supra.

^[15] Id.

^[16] Id.

^[17] Lynette Parker, Increasing Law Student’s Effectiveness When Representing Traumatized Clients: A Case Study of the Katherine and George Alexander Community Law Center, 21 Georgetown Immigration Law Review 163, 182 (2007).