Dr Cathy Kezelman, AM, President of the Blue Knot Foundation National Centre of Excellence for Complex Trauma, discusses the importance of having a trauma-informed legal practice in the conclusion to her two-part article series. The combination of stressed legal practitioners and traumatised clients is hazardous: Stress breeds and triggers further stress, she writes. Read Part 1 of the article series here.
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Cathy will present on the topic, Trauma and Vicarious Trauma for Personal Injury Practitioners, at the 12th Annual Personal Injury Conference on 8 March.
Engaging with the law and justice system in any capacity is stressful for many members of the public, regardless of the presence of trauma. When legal practitioners and other personnel are alert to the traumatic stress which underpins shifts in arousal they can better understand these reactions and develop more constructive ways of interacting with a client, witness or offender. This helps to de-escalate stress and reintroduce calm.
It is also important to understand that some people with trauma histories will dissociate at different times. Dissociation is a protective response to threat, in which compartmentalisation of self occurs meaning the person is unable to connect their consciousness with the memory emotions and beliefs. Developing most commonly in childhood it can become a default coping mechanism or be reactivated in situations in later life. People who dissociate appear to ‘space out’ and may seem inattentive. Understanding the situations in which people may dissociate can help those interacting with them to understand their client’s disconnection.
The issue of credibility
Overwhelming stress can impede the imparting of coherent narratives and make the testimony and accounts of traumatised people appear discursive, episodic, unreliable and even mendacious. Apparent `cooperation with authorities’ is less likely to occur in stressful situational contexts.
Trauma-informed principles recognise this, and foster policies and modes of interaction to help the person feel safe, and better able manage their emotions, to reduce additional stress. This minimises the risk of re-traumatisation and fosters potentially more consistent reliable accounts.
Current memory research has major implications for the issue of `credibility’. It’s important to understand that there are two main types of memory – explicit and implicit memory. Explicit memory relates to conscious recall. Implicit memory is elicited by situational cues (e.g. fragrance or sound) and primarily experienced in the body. The person is generally not consciously aware of the prior experience it evokes (Siegel, 2009, Ogden et al., 2006[1]). This means that absence of conscious recall is not itself a sign of untruthfulness but is consistent with how different types of memory operate.
Current neuroscientific findings around the stress response and the nature of memory provide vital information all personnel of legal and judicial systems.
Trauma-informed practice
Trauma-informed practice is a strengths-based approach informed by the sensitivities and vulnerabilities of people with trauma histories. The trauma-informed principles of safety, trustworthiness, choice, collaboration and empowerment need to be embedded in every interaction to foster constructive interactions which assist recovery and well-being. It attunes to the myriad ways in which stress can further traumatise people whose physiology and psychology are disrupted and dysregulated. Its application reduces additional stress for defendants, victims, witnesses and legal personnel alike and helps to defuse and de-escalate arousal.
‘Do no harm’ is an underlying principle. Often people have already experienced harm from prior encounters with the law. Containing and minimising additional harm is respectful and soothing to everyone, enhancing the likelihood of smooth processes and optimal outcomes. Becoming trauma-informed means being attuned to all aspects of a service, how it is delivered and the manner in which clients are engaged (Fallot and Harris, 2009[2]). It applies to all levels of service delivery (Bloom, 2006[3]). Everybody benefits from being trauma- informed – staff as well as clients; people with `normal life stress’ and the chronically traumatised. Its embedding at all levels, throughout all practices, services, and institutions is strongly recommended.
Vicarious trauma
The profession of law is inherently intensely stressful at a systemic and `individual’ level. Many in the profession are regularly exposed to traumatic material. This exposure increases the risk of `vicarious’ trauma (Jenkins and Baird, 2002[4]). Lawyers and diverse legal personnel are at high and largely unrecognised risk of experiencing VT (Murray and Royer, 2008[5]) It is an occupational hazard (Pearlman and Caringi in Courtois and Ford 2005[6]) and not a sign of weakness (Allman, 2015[7]).It cannot be overcome by willpower alone.
As a normal reaction to the stressful experience of multiple exposure to traumatic material (McCann & Pearlman, 1990) vicarious trauma needs to be differentiated from burnout, which reflects general stressors in the workplace and is not generally trauma-related (Brown, 2009:[8]).
Vicarious trauma can be challenging to recognise, at least initially, as it is insidious in onset. The subtle signs of reduced well-being can be easily missed, especially by goal-oriented people who work long hours in an often competitive culture.
Conscious awareness of the risks of VT is insufficient to mitigate the risk of its occurrence. Its risks need to be understood, early signs recognised and mitigation strategies on individual, team, organisational and systems levels introduced.
The combination of stressed legal practitioners and traumatised clients is hazardous. Stress breeds and triggers further stress. Safety as the fundamental core principle to support change to individual practice and systems to enhance wellbeing for all.
Dr Cathy Kezelman. AM. is a medical practitioner, President of the Blue Knot Foundation – National Centre of Excellence for Complex Trauma; prior member of Independent Advisory Council on Redress; member of the Mental Health Community Advisory Council (NSW), member of NSW Standing Committee of Child Safety. Cathy worked in medical practice for 20 years, mostly as a GP. Under her stewardship over 15 years, Blue Knot Foundation has grown from a peer support organisation to a leading national organisation combining a prominent consumer voice with that of researchers, academics and clinicians advocating for socio-political change and informed responsiveness to complex trauma. She is a prominent voice in the media and at conferences, as well as author of a memoir chronicling her journey of recovery from child sexual abuse: Innocence Revisited- a tale in parts. She is co-author of multiple publications including the seminal Blue Knot Foundation document – Practice Guidelines for Treatment of Complex trauma and Trauma Informed Care and Service Delivery and Trauma and the Law – Applying Trauma-informed Practice to Legal and Judicial Contexts. On Australia Day 2015 Cathy was awarded an AM “for significant service to community health as a supporter and advocate for survivors of child abuse”. Contact Cathy at ckezelman@blueknot.org.au or connect via LinkedIn .
You can also connect with the Blue Knot Foundation via Facebook, Twitter and LinkedIn. Visit the Blue Knot Foundation for more information on Managing Vicarious Trauma training for the Legal and Justice Sector, and Trauma-Informed Care and Practice Training for the Legal and Justice Sector.
[1] Siegel, D. J. (2009) Mindsight New York: Random House, 2009.
Ogden, P., Minton, K. & Pain. C. (2006) Trauma and the Body. New York: Norton.
[2] Fallot RD, Harris M. Creating cultures of trauma-informed care (CCTIC): A self-assessment and planning protocol. Washington, DC: Community Connections; 2009
[3] Bloom, S. L. (2006). Organizational Stress as a Barrier to Trauma‐Sensitive Change and System Transformation, White Paper for the National Technical Assistance Center for State Mental Health Planning (NTAC), National Association of State Mental Health Program Directors. http://www.nasmhpd.org/publications.cfm.
[4] Jenkins, S. R., & Baird, S. (2002). Secondary traumatic stress and vicarious trauma: a validational study. Journal of Traumatic Stress, 15, 423 – 432.
[5] Murray, D. C., QC & Royer, J.M. (2008) `Vicarious Traumatization: The Corrosive Consequences of Law Practice for Criminal Justice and Family Law Practitioners’ Presentation to the CBA- Nunavut Branch, pp.1-89 http://nunavut-cba.org/main/pdf/lap_vicarious_paper.pdf
[6] Pearlman, L. A., & Caringi, J. (2009). Living and working self-reflectively to address vicarious trauma. In C. A. Courtois & J. D. Ford (Eds.), Treating complex traumatic stress disorders: An evidence-based guide (pp. 202-224). New York, NY, US: Guilford Press.
[7] Allman, K. (2015) `The High Cost of Caring’, Law Society of NSW Journal (August) pp.38-43.
[8] Brown, Laura S. (2009) Cultural Competence in Trauma Therapy (Washington, DC: American Psychological Association).
