Stress and Its Ugly Cousins
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Contributing Author: Kirsten Pabst, NDAA Well-being Task Force Chair
The Four Usuals
As our understanding of the challenges that face prosecutors and other criminal justice professionals evolves, we have been able to identify four common beasts of burden: secondary trauma, compassion fatigue, moral injury and good old-fashioned burnout. Each make doing our good work more difficult but when they work as their own evil multi-disciplinary team, it can be next to impossible.
The characteristics of all four are unique, though there is often overlap. Their infiltrations into our psyches are not limited to one at a time and their dirty work isn’t mutually exclusive. They often collaborate with each other and with other historical and environmental evil-doers to wreak havoc on an individual’s wellbeing.
Secondary Trauma
Prosecutors, social workers, corrections officers and especially law enforcement are immersed in secondary trauma, also called vicarious trauma. Secondary trauma stress [STS] is the manifestation of long term, indirect and repetitive exposure to work-related human tragedy. STS, just gaining recognition in the legal field, largely impacts professionals on the front lines of the helping fields such as social work, emergency medicine, law enforcement, mental health and litigants. Constant and cumulative exposure to violence and trauma through work has documented negative effects, personally and professionally. Immersion in STS is often the essence of our jobs. It can alter brain function in significant ways. Reactions to its cumulative effects vary and are influenced by internal and external factors. Unmitigated, STS can have profound negative effects and — especially coupled with other challenges justice professionals face — and can lead to physical, psychological and social problems.
Trauma psychologists tell us — and we’ve seen firsthand — that those who work with victims of crime for prolonged periods often experience symptoms similar to those of PTSD, such as difficulty concentrating, headaches, stomachaches, depression, intrusive images, nightmares, strained personal relationships, fatigue, difficulty sleeping and problematic parenting. Cumulative effects at work include decreased productivity, diminished intellectual processing, inability to embrace complexities, reduced ability to empathize, and compromised judgment. Over the long term, STS can contribute to chronic conditions like inflammation, substance abuse disorder, mental health crisis, relationship failures, chronic disease, and suicide.
Andrew Levin, M.D., Assistant Clinical Professor of Psychiatry at Columbia, wrote, “[T]here is a consensus that STS and VT (vicarious traumatization) degrade the professional’s ability to perform his or her task and function in daily life beyond the job.” (Andrew P. Levin, & Scott Greisbert, Introductory Remarks: Vicarious Trauma in Attorneys, 24 PACE L. REV. 245, 250–252 (2003); Ripples Against the Other Shore: The Impact of Trauma Exposure on the Immigration Process through Adjudicators, Kate Aschenbrenner, Michigan Journal of Race and Law, Vol 19 (2013)).
Despite the level of suffering and negative personal and financial effects of secondary trauma on justice professionals — particularly those working in domestic and sexual violence, child abuse and homicide — there remains a notable lack of programming designed to prevent and mitigate the negative effects on those dedicated employees. The good news is that, although work stress and adversity is a reality that isn’t going anywhere, we can teach and learn ways to metabolize STS and use it to our benefit.
As a profession, we’ve been catching up on studying primary trauma as we begin to understand the profound effects of traumatic experiences on the human brain. We are learning that when a person or child suffers ongoing or intense abuse, the experience can change the physiological structure of the brain and ushers in psychological effects that change the person’s view of and response to stress, to others and to the world. Trauma affects the brain’s ability to process information, recall events and communicate to others.
Similarly, indirect exposure to others’ trauma such as listening to details of abuse, preparing cases for court and pouring over photographic evidence can accumulate over time and, unless the person utilizes strategies for preventing and addressing STS, that cumulative exposure can significantly impact the professional’s work life, personal life and every facet of wellbeing.
STS seems to target the most effective prosecutors. Like criminal investigators, prosecutors and staff who work with victims of violent crime are at very high risk to suffer the effects of STS and the best ones often are affected to a greater degree. In fact, according to Laue, “Professionals who are the most successful, because of their ability to openly and effectively engage with victims, suffer the greatest negative consequences of secondary trauma.”
Compassion Fatigue
Compassion Fatigue [CF], STS’s cousin, refers to the spiritual deficit that results from the unrestrained giving too much of ourselves to those in need. William Steele, in his book Reducing Compassion Fatigue, Secondary Traumatic Stress and Burnout, tells us that the term was first used in a study of nurses who experienced burnout and was described as “the loss of the ability to nurture.” Steele warns that “too much empathy leaves us drained, overwhelmed and unable to help. CF is the decreasing ability to help due to being unable to distance ourselves from the emotions, the pain of others.”
CF has a voracious appetite and, in the absence of established boundaries protecting our internal resources, it will take everything. If we each start with a tank full of empathy for the people in our care, and a reserve tank of empathy for our co-workers, CF will eat that all up, belch, and rustle around for more. When will give our attention and our gifts away, unbounded and unrestrained, we end up with a deficit so deep that it can be difficult to replenish.
Moral Injury
Unlike CF’s and, as we’ll see in a minute, Burnout’s depletion tactics, their cousin Moral Injury proactively targets our value base — the stuff that brought us to the job in the first place; those values that house our purpose. Moral injury refers to the internal incoherence created when people have to do things for work that are repugnant to their own value system. Examples of moral injury include a prosecutor litigating a capital case while opposing the death penalty; or a police officer who is supposed to deconstruct a homeless encampment knowing that the people living there will not likely be able to replace those possessions or soon find a warm place to sleep; or a defense attorney who has to cross examine a victim, knowing her client committed an assault; or a child abuse social worker who must place a child back into the home, knowing that the decision will likely put the little right back into harm’s way. It is important for employees and leaders to recognize the face of moral injury and, when she’s in the room, take appropriate steps to neutralize her poison, by closely examining the source of the conflict to alleviate the dissonance.
Burnout
Burnout [BO] can happen in any job and is not unique to lawyers, prosecutors or justice professionals. According to Steele, burnout consists of 1) emotional exhaustion, 2) depersonalization, or cynicism, and 3) feelings of ineffectiveness, and can make workers more prone to the negative effects of STS and CF.
BO in our business is associated with runaway caseloads. The growth in crime has outpaced growth in workers. In addition to more cases, each case now takes more time and attention, as the volume of discovery increases and quality of investigations continually improves. Add in the pressures of raising families, caring for aging parents, and everything else. BO happens when we’re spread too thin and unable to do a good job on any one thing because of the thousands of tasks competing for our limited bandwidth.
From the outside looking in, BO looks like lack of engagement, like the person no longer cares about the job. Burnout sounds like sarcasm. Burnout feels like deep-down-to-the-marrow exhaustion. Burnout is the reason that the once exuberant I-don’t-do-this-for-the-money worker now says, “You can’t pay me enough to keep doing this job.”
From the outside looking in, BO looks like lack of engagement, like the person no longer cares about the job. Burnout sounds like sarcasm. Burnout feels like deep-down-to-the-marrow exhaustion. Burnout is the reason that the once exuberant I-don’t-do-this-for-the-money worker now says, “You can’t pay me enough to keep doing this job.”
From an employer’s perspective, BO is toxic, contagious, and very expensive. In Spotting Employee Burnout Before it Becomes Obvious, Dave Kerpen points out signs to BOLO include anxious behavior, erosion of boundaries, decline in health and/or increase in use of sick days. (). By the time these four big stressors — individually or as a team — have grown to the point they are causing behavior changes in an employee, damage has already been done.
New Arrivals
The four ugly cousins — secondary trauma, compassion fatigue, moral injury and burnout — love to collaborate with their second-cousins-of-doom, like pandemics, medical emergencies and financial pressures. Add on other newish challenges like generational value mis-alignment, racial reckoning, exploding caseloads, individual unresolved personal issues and now, the Great Resignation. None of these was caused by us and most are out of our control, but when they show up in our work space, they can quickly become our problems. We didn’t invite these ne’er-do-wells in, but we can control, in every single instance our responses to them.
Generational Value Misalignment
This topic is large and complex and gets blamed for a lot of wellbeing crisis at work. Old-timers complain about Millennials the same way that the Silent Generation complained about the Boomers. Each new generation has a value structure born of contemporary and rapidly changing social phenomena and those values seem to be misunderstood and ridiculed by each current round of elders.
Old Guard criminal justice professionals express their frustrations with newer hires. Why don’t they want to work? Why are they so spoiled? Why are they recalcitrant to jump into a trial? What is Venmo?
Some older generation lawyers fail to recognize that nostalgia can be a tricky and alluring emotion — an alchemist that can alter a memory to the good, which sounds good, but isn’t always. I was at a meeting recently when one salty old-timer referred to new lawyers in his office as snowflakes and then boisterously recited how things use to be, with a heavily-filtered romantic spin on chaos. It went something like this:
“When I was a new prosecutor, I handled hundreds of felony cases, with little mentoring, no support, and went to trial with files I’d never laid eyes on. We didn’t get to wait until we were ready, we jumped in. We got up early, stayed late and worked on weekends. We didn’t complain like these kids do now. We just did what the job required and we felt lucky to have a good job. I won almost all of my cases and it was hard, but very rewarding.”
In her new book, Atlas of the Heart: Mapping Meaningful Connection and the Language of Human Experience, Random House (2021), Brene Brown brilliantly describes and defines hundreds of human emotions to provide a common language for us to better engage in difficult but important discussions. She nails nostalgia, pointing out the positive aspects of remembering the olden days, as well as the complicated context in which these memories often emerge.
“Nostalgia is also a dangerous form of comparison. Think about how often we compare our lives to a memory that nostalgia has so completely edited that it never really existed.”
This generational rift, unless deconstructed and addressed, results in many unhappy people at all levels of an organization. It is a large part of high turnover rates and challenges filling openings in DAs’ and Public Defenders’ offices. The solution, which we’ll explore in more depth, lies in focusing on our inter-generational commonalities, highlighting the unique strengths that the new generation brings to the work, reframing what we perceive as weaknesses and making reasonable concessions. In short, do what we do best: negotiate.
Other Current Challenges
The spectrum of stress looks different for everyone, with infinite combinations of frequency, intensity and duration. In addition to the biggies we’ve discussed, other current external stressors include the Russian invasion of Ukraine, the increase in mass shootings in schools and workplaces, and the deteriorating trust between citizens and our law enforcement community, highlighted after the murder of George Floyd. Most people want to do the right things, but few will agree on what the right things entail. The narrative is uncomfortable and a lot of blame is projected. Criminal justice is the place where these tensions are undeniably visible and often the bloody arena where the battles are fought and then posted in real time.
The pandemic forced huge changes upon all of us. Work-flow was disrupted and quickly re-written, leaving gaps. We were cut off from our families, peers, co-workers, and other support people. The ubiquitous threat of illness and corresponding grief for those lost compounded the situation.
Cost of living increases which are out-pacing wage increases, inaccessibility of housing, student loans and other financial pressures mount as well. Nobody signed up to get rich, but the standard of living continues to decrease for public servants, most dramatically affecting those who have recently graduated. Many are also juggling family obligations, caring for aging parents and their own health crisis, in addition to maneuvering within these societal shifts.
Couple the external pressures with other aggravating factors like unresolved childhood trauma, grief, addiction and, sometimes, personalities less conducive to constructive stress processing, and the potential for collapse is very real.
In the next several months we’ll look at ways to build resilience to all of the special kinds of stress that we prosecutors experience, as well as tools to address the big, unexpected stressors when they show up at your door.
Stress and Its Ugly Cousins is an excerpt from Kirsten Pabst’s book, Thriving Through Chaos — Survival Gear for Criminal Justice Professionals, and is re-posted here with the author’s permission.
Kirsten Pabst chairs NDAA’s Well-being Task Force and serves as the County Attorney for Missoula County, Montana.
