Ideas From the Front

Ripple Effects

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Margaret drew had just started her family law practice when one of her clients tried to commit suicide.

Drew was so upset by her client’s situation that she started experiencing physical symptoms like heart palpitations and in­somnia. At the time, Drew wasn’t familiar with terms like “secondary trauma” and “vicarious trauma,” but she was certainly feeling the effects.

Today, more than 20 years later, Drew is well-versed on these two types of trauma common among members of helping professions. As director of the Domestic Relations/ Violence Clinic at the University of Cincinnati College of Law, she helps lawyers and law students deal with adverse reactions arising from work with suffering clients.

Those who experience secondary trauma can feel as if they’ve suffered their clients’ traumas themselves, says Dr. An­drew Levin, an assistant clinical professor of psychiatry at Columbia Universi­ty College of Physicians and Surgeons in New York City. Common reactions are depression, irritability and feelings of being burned out.

Jean Koh Peters, who runs two legal clinics at Yale Law School in New Haven, Conn., likens secondary trauma to a boulder falling into raging river: “The raging river is the client’s life,” she says. “The boulder falling is the trauma occurring. The image of secondary trauma is a lawyer standing in the river. They don’t get hit by the boulder, but they feel the ripple effect.”

When an attorney-client relationship is particularly intense or long-term and the lawyer internalizes the client’s suffering, “vicarious trauma” can result. This disrupts one’s central schemas, including assumptions about the world, trust and dependency, Levin says.

Secondary and vicarious traumas are occupational hazards for lawyers who work with trauma victims, Peters says. Lev­in has found that the attorneys he’s worked with in the fam­ily court system are especially prone to the problem. He points out attorneys often see people when they’re at their worst. “Once they’re OK, you don’t see them anymore,” he says.

In a study Levin conducted and then wrote about in Pace Law Review’s fall 2003 issue, he found that lawyers working with domestic violence victims and criminal defendants experienced a higher level of secondary trau­mat­ic stress and burnout than two control groups of mental health pro­viders and social service workers.

Levin noted the lawyers encountered more traumatized clients than the other professionals did, and they often lacked knowledge about trauma and its effects on both cli­­­ents and themselves. Lawyers said that their supervisors weren’t knowledgeable about trauma, and that they had no regular forums to talk about their feelings. These factors con­­trib­uted to secondary trauma.


Lawyers at risk for secondary and vicarious trau­ma can avoid its effects just by educating themselves, Levin says. “I would say 60 or 70 percent of dealing with traumatized people is being aware of what effect working with them might have on you—preparing people for secondary trauma is a big part of the battle.”

Drew says understanding the limitations of her role as a lawyer helps her. “Domestic violence clients have multiple things going on—housing, employment, a whole range of issues,” she says. “We can still help with the other issues, but not by doing the work ourselves. We can make re­ferrals.

“We need to figure out what our skills are and work in that arena. I became more careful to recognize what issues I could deal with in the legal framework.”

Drew now requires her clients to be in some sort of sup­port system, be it a 12-step program or a shelter, so long as it can help them cope with trauma.

Peters emphasizes self-care for her students and herself. She avoids disturbing scenes, whether they’re in news­pa­pers, movies or novels, so she doesn’t hit trauma over­load. Exercise helps, too. “Some­times the best thing students can do for their clients,” she says, “is go for a run.”

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