Exposure to the elements

The letter had begun: ‘Dear Lee Moore, my grandmother used to sew my clothes into my skin with yellow cotton…’. These words, written in black biro, on narrow, lined paper torn from a notebook, plus the intrusive imagery which accompanied them, prevented me from sleeping. I went downstairs at three in the morning, ate some hot-buttered toast, tried watching TV, then reading, but the imagery and words would not leave me. 

I could not concentrate. Self-medication was not a successful antidote. Abandoning my resolve not to bring work home or into my marriage, I woke my husband and asked him to talk to me. It proved a temporary solution for neutralising what I was shortly to discover was a symptom of secondary traumatic stress (STS). This is a natural stress that can occur in those exposed to traumatic material on a regular basis. STS strikes suddenly and without warning. It is an event, unlike burnout, which is a slow process. 

I had been the first coordinator of the Association of Child Abuse Lawyers (ACAL). In that capacity, I took disclosures of sexual, physical, and emotional abuse from men and woman on a daily basis via phone-calls, emails, and letters. Concurrent to my work with the ACAL, I also accepted instructions to take statements from individuals who had been abused. My specialism was extreme abuse, formerly known as ritual or satanic abuse. I also presented at national and international conferences on issues concerning sexual abuse. 

Forming boundaries

It never occurred to me to put boundaries around my work and exposure to wounded people with traumatic life stories. Ignorance, due to a lack of education regarding the psychological, physical, and professional impact of working with trauma, rendered me vulnerable, as did an unresolved, traumatic history of my own. I did not know I needed, or even think I needed, help or training. 

I was in denial about the adverse impact of my work on my handling of cases, on others, and myself. It was held in place by a work addiction, which I rationalised as enthusiasm and professionalism. A passion to raise awareness about the extent of child sexual abuse in the UK and help insulate and protect people who had experienced sexual trauma from being re-traumatised by our adversarial system, ?motivated me. 

I did not know that other people’s traumas ?could traumatise me until I read the poignant letter about clothes being sown onto a five-year-old child disclosed some 50 years later. It acted as a catalyst for change, for I was also comfort eating. My unconscious solutions for dealing with the impact of cases were becoming problems. I needed to find out how I could continue my work in the field of sexual abuse and violence while maintaining my professionalism, wellbeing, and marriage. 

My Damascene moment came when I read a book by psychologist Charles Figley, entitled Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized. Compassion fatigue is another term for STS, which, if allowed to develop, has the same symptoms as post-traumatic stress disorder. I identified with what was written. I had STS disorder. 

I immediately took a long holiday with my husband. It was important to deal with the symptoms of overworking, overeating, appetite changes, sleep disturbance, catching viruses frequently, headaches, and more. I put together a self-care plan which I follow to this day. I completed my personal healing. My health and wellbeing are now a conscious priority. I meditate daily, which allows me to maintain my equilibrium, whatever the provocation... most of the time. I maintain boundaries about the work that I expose myself too. I eat, drink, exercise, and sleep well. We moved out to the country; I now live in beautiful surroundings. My office has lovely views, a buffer to some work I still do occasionally regarding extreme abuse. I have hobbies, take time out, and I’m no longer a stranger to having fun.

Breaking the isolation?

In 1998, I worked with Sue Richardson, author, psychotherapist, and expert witness. We pioneered, designed, and presented courses on recognising and dealing with STS for lawyers. ?The first course ran beyond the allotted time. People identified and were relieved to have implicit permission to speak about their feelings and be given the opportunity to talk about the impact of their cases on them. Talking broke the isolation most felt. When cases affect you, having feelings is not unprofessional: not talking about them is. Speaking to an enlightened witness is a great de-stressor. I went on to deliver these courses to doctors, paediatricians, and health and social care workers, too. 

There is more to the law than the practice of it; it is learning about how cases and clients can impact you, and taking responsibility for your health and wellbeing, for failure to do so may well mean that the stressed and traumatised are representing the stressed and traumatised, especially in cases concerning sexual abuse and trauma. 

My work now is focused on wellbeing in court ?for all. I present training and talks that support professionals, further protect the vulnerable, and facilitate a trauma-informed approach to justice. 

A former barrister, Lee Moore founded the Association of ?Child Abuse Lawyers, for which she served as president for ten years. Moore is the director of ?Lee Moore & Co leemooreco.com

 

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As Lee’s account shows, all those working with traumatised people should be aware of STS disorder and how trauma can be transmitted to and impact upon advocates and practitioners.

Charles Figley defines STS as ‘the natural consequent behaviours resulting from knowledge about a traumatizing event experienced by a significant other. It is the stress resulting from wanting to help a traumatized or suffering person.’ 

People who work with or help traumatised people are indirectly or secondarily at risk of developing the same symptoms as the persons directly affected by the trauma. Clinicians and advocates who listen to their clients describe the trauma are known to be at risk. STS is sometimes confused with burnout. Unlike STS, burnout can be described as emotional exhaustion, depersonalisation, and a reduced feeling of personal accomplishment, which begins gradually and becomes progressively worse. 

STS, conversely, can occur following the exposure to a single traumatic event. Training enables practitioners to understand who is more vulnerable ?to STS and why, perform a self-diagnosis for symptoms, create and maintain a self-care plan, ?and know how to manage the impact of STS. 

This year I chaired the working party on behalf of  The Advocate’s Gateway, which produced a toolkit for advocacy with vulnerable people in civil proceedings in England and Wales. Lee Moore was part of our group. We did not have the resources of the Northern Ireland Law Commission Report which produced a report on vulnerable witnesses in civil proceedings in 2011, but we were assisted by the recent comprehensive Law Society guidance on meeting the needs of vulnerable clients, which is also an openly available resource. 

Bruising experience

Some litigants, particularly in civil compensation claims, have already undergone a bruising experience in the criminal courts. Asylum seekers, vulnerable employees, those who have suffered illness or injury, and many others will come to the civil justice system as damaged individuals with long-standing psychological problems. This is not confined to personal injury law. 

For some, the process itself will trigger vulnerability. In the civil justice system, anecdotal evidence suggests there are clients who have taken a lower offer than advised in order to avoid the trauma of a final hearing. Some suggest findings of incapacity may be being made when all a person really seems to need is assistance to communicate. Whether these views are accurate is not the purpose of this article. What our working party was able to do was to identify where the relevant guidance already sits, and how the civil justice system can be improved for vulnerable people.

On a practical level, the use of intermediaries and of pre-recorded oral evidence, for example, can enable vulnerable witnesses to participate in a hearing in a manner that best meets their needs by ensuring the evidence they give is the best evidence achievable. Inconsistencies can be agreed on paper without the need to cross-examine at all, and advocates need not put an obvious case theory to a vulnerable witness at all. It should already be obvious. 

Training in this area, of judges, advocates, and representatives, is vital. If everyone does their job properly, judges need not intervene at all. Several of us at The Advocate’s Gateway have pioneered the sensitive approach to be taken, particularly in cases involving sexual offending. A well-prepared representative can take a complainant’s account sensitively, and a well-prepared advocate can effectively challenge the evidence of a witness and show it to be wrong without the witness having to be bullied or humiliated by the experience. It can all be done with dignity and respect, whether the witness is the alleged victim or the accused. 

The approach to such cases needs to be balanced and collaborative. It is not a lawyer-bashing exercise. It does not require an intermediary in every case, nor is it an opportunity for judges to become autocratic or enter the arena. It really is time to recognise that people with vulnerabilities and disabilities can be assisted to fully participate in the civil process whether the matter settles or goes to trial. 

Modern approach

The old-fashioned adversarial approach is based ?on historic rules of competence: calling evidence from women and children and other vulnerable witnesses was believed to be inherently dangerous (R v Brasier (1779) 1 Leach 199; 169 ER 202). Corroboration was required and judges routinely warned that such testimony was unreliable. ?The modern approach recognises that, given the right assistance, witnesses can be questioned and cross-questioned without unnecessary trauma in a balanced way that allows for a fair hearing for all concerned. 

This has been recognised and is being applied in criminal and family cases – and the civil courts will have to follow suit. Recognition of vulnerabilities, including by advocates, practitioners, and judiciary, at an early stage is vital to ensure vulnerable witnesses and parties are identified and enabled to effectively participate, largely by facilitating communication. It follows that attention should also be paid to the potential for triggers to vulnerability, for parties, witnesses, and professionals, too, throughout proceedings. As set out above, civil litigation can cover a wide range of civil and commercial disputes, immigration, employment, housing and public law, and so on. The toolkit we produced may also be a useful guide for formal inquiries, such as the forthcoming Goddard inquiry into institutional responses to child sexual abuse. 

Moore and I also assisted in the production of toolkit 18, one which specifically addresses working with traumatised people in justice systems. Trauma can significantly affect a person’s ability to give their best evidence or to follow proceedings. Trauma affects the ability to understand language, to communicate answers, to process and think logically, and to cooperate with court procedures. 

Attention should be paid to the potential for triggers to vulnerability throughout proceedings. The understanding of trauma and the underlying mechanisms is an evolving field, and advances in neuroscience and psychology (including somatic psychology) are being made continuously. ?This toolkit aims to raise awareness and further understanding of trauma and its effect on witnesses and/or defendants. 

However, it can only provide an overview. Everyone involved in communicating with witnesses, defendants, or parties should have a basic understanding of how trauma affects the brain, so that they may facilitate best evidence and avoid the legal process re-traumatising witnesses, defendants, and indeed themselves. SJ

Felicity Gerry QC is a barrister practising from William Forster Chambers, Darwin @felicitygerry www.felicitygerry.com