Hidden extras - a first-hand account of secondary traumatic stress
Warning: this blog contains disturbing and graphic content about paedophilia and child abuse.
Lee Moore, a non-practising barrister, pioneered, designed and presented the first UK accredited training for lawyers on Recognising and Dealing with Secondary Traumatic Stress, Burnout and Vicarious Trauma, at Cambridge University in 1999. She founded The Association of Child Abuse Lawyers.
Photographic evidence was always the toughest to study
The photograph, from a paedophile's journal, showed two boys, about eight years old, lying side by side, across a railway track, their arms and legs tied to each rail. They were naked, save for the white underpants pulled down to their knees. I felt shocked.
The image, especially the haunted look on each boy's face, replayed in my mind's eye for weeks, together with intrusive thoughts about what other horrors they may have experienced. I was revolted by the motivations of the person or individuals who had bound and placed them there. I felt nauseous wondering about potential parental involvement and how terrified those boys must have felt, defenceless against evil. The photo sickened me, as did practising family and criminal law without possessing the knowledge enabling me to recognise and deal with the adverse impact of distressing cases upon my health and quality of work. In 1974, secondary trauma was unrecognised. Its many symptoms, such as loss of concentration and errors, were hidden extras that came with the job.
Secondary Traumatic Stress
Minutes of scrutiny resulted in decades of traumatic memories sitting silently in my psyche, and muted by my stiff upper lip which, I believed, affirmed professionalism, waiting for the field of traumatology to evolve.
As expressing emotion was regarded unseemly by peers, I suppressed uncomfortable feelings through self-medication, I went drinking with colleagues. Exposure to upsetting evidence often propelled us to unwittingly seek succour in the nearest hostelry; alcohol, our emotional anaesthetic.
Owing to the absence of risk assessments regarding exposure to traumatic cases and with no self-care protocol to follow, a series of back to back child abuse cases caused me to express a prime symptom of Secondary Traumatic Stress, [STS], that of leaving a field of work prematurely. In 1975 I switched to maritime law.
The Association of Child Abuse Lawyers
In 1996, I returned to the field of child abuse following the abduction and non-return of my child. I founded The Association of Child Abuse Lawyers (ACAL). I hoped to break the denial regarding the prevalence of child sexual abuse in the UK and to support victims. Neither I, nor ACAL members who were practising personal injury lawyers, were prepared for the negative effects cases had upon us. We did not know that:
- being a parent
- experiencing a trauma
- unhealed trauma
- being exposed to children's suffering
rendered us more vulnerable to Secondary Traumatic Stress.
As coordinator, I took disclosures by phone, and read letters and emails detailing acts of neglect, physical, and sexual violence. Prolonged exposure caused my immune system to weaken, viral infections followed. My husband remarked, 'you are either flat out or flat out.' Besides overworking, I began overeating to suppress the discomfort of bearing witness to other people's pain.
In 1998, when feeling depleted, I read a letter describing acts of sexual sadism. The imagery haunted me. Sleep evaded me. Self-medication did not work. I needed help. Fortunately, the field of trauma had evolved.
I read Compassion Fatigue, Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized, Figley, Brunner / Mazel 1995. I was symptomatic of STS. I learned this is the natural stress that occurs when exposed to the suffering of others. Unlike burnout, which is a process, STS is unavoidable and can strike suddenly, without warning; unrecognised it develops into Secondary Traumatic Stress Disorder, the symptoms of which, mirror Post Traumatic Stress Disorder.
On the road to recovery
Following guidance on recovery, I took a holiday. On my return, I developed a self-care plan. It included setting boundaries around my workload, daily meditation, engaging in acts of creative self-expression, taking breaks and enjoying restorative activities such as being in nature.
As research confirmed sharing with colleagues helps mitigates the impact of STS, I introduced regular meetings for ACAL members. We shared about the effects that cases and clients had upon us, plus secretaries, temporary staff and costs clerks who were exposed when typing up statements and reading files. Discussions helped us identify symptoms and offer suggestions on what helped us avoid or process and release them. We supported each other without judgment.
Acting for victims of child sexual abuse: the impact on the practitioner
To fill the vacuum in legal education I worked with Sue Richardson, a psychotherapist and author, to design CPD accredited training for lawyers. We successfully presented, Acting for Victims of Childhood Sexual Abuse: The impact on the practitioner, at University of Cambridge in 1999.
Encouraged by enthusiastic feedback, approaches were made to unresponsive legal education providers and professional bodies to tackle the issue of secondary traumatisation. Students intending to practise family, criminal or personal injury law, plus lawyers and judges already working in those areas, needed vital education, tools and guidance enabling them to prepare for, identify and deal with Secondary Trauma, burnout and more.
In 2013, the Diagnostic and Statistical Manual of Mental Disorders [DSM V] published by The American Psychiatric Association expanded the definition of trauma and diagnostic criteria for Post Traumatic Stress Disorder to include: "Indirect exposure to aversive details of the trauma, usually in the course of professional duties." Despite such corroborative support, the legal establishment remained obdurate. At one meeting in 2015, I was told, "this would open a can of worms," suggesting that some lawyers and judges maybe practising, albeit unintentionally, whilst traumatised.
Wellbeing at work has recently emerged as an issue, with some support and training being offered. However, until education is compulsory, and self-care protocols, guidance and risk assessments are mandatory, many judges, practitioners and staff working on traumatic cases will be exposed to the 'cans of worms' that remain buried in photos, statements and recordings as 'hidden extras' that come with the job and which can and probably are adversely affecting health and professionalism.
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